Review of a three-year meticillin-resistant Staphylococcus aureus screening programme.

Area of Science:

• Healthcare Management
• Infectious Disease Control
• Clinical Microbiology

Background:

• Meticillin-resistant Staphylococcus aureus (MRSA) poses a significant healthcare challenge.
• The Department of Health, England mandated universal MRSA screening for all patients.
• Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH) initiated a seek and destroy (S&D) program in 2006.

Purpose of the Study:

• To evaluate the effectiveness and cost-efficiency of NuTH's MRSA S&D program.
• To compare a targeted S&D approach with universal MRSA screening.
• To determine optimal screening strategies for MRSA reduction.

Main Methods:

• Analysis of 168,073 patient screening results from NuTH's S&D program.
• Utilized chromogenic culture method for MRSA detection in nose, throat, and perineum samples.
• Compared MRSA detection rates and laboratory costs between targeted and universal screening.

Main Results:

• Screening all three sites (nose, throat, perineum) is necessary for maximal MRSA recovery.
• MRSA detection rates did not increase despite increased workload from universal screening inclusion.
• A targeted S&D approach identified only seven fewer day-case MRSA carriers per month compared to universal screening, at a lower cost.

Conclusions:

• A clinical risk-based screening strategy is more pragmatic and cost-effective than universal MRSA screening.
• Universal screening may lead to unnecessary costs and increased laboratory workload without significant gains in MRSA detection.
• NuTH's S&D program demonstrates the value of targeted screening in managing MRSA.