Three medical school faculty are downplaying the value of mandatory universal nasal screening of patients for MRSA that have been mandated by some states, including Pennsylvania, Illinois, California and New Jersey. Writing in the November issue of Infection Control and Hospital Epidemiology, the team argues that “hospitals get more bang for their buck with evidence-based infection control prevention.”
MRSA infections cause only 14 percent of hospital infections and investing huge resources into their control is less effective than implementing programs that would reduce the burden of all infections by 50 percent. Further, the cost of nasal swabbing tests for all patients in a screening program was estimated to be two to three times that of adding additional infection control nurses for a broad infection control program.
The team suggests that a focused screening program would have made more sense in the late 1980s and early 1990s since MRSA was the key in antibiotic-resistant pathogens. However, in the last 15 years hospitals are facing multiple bacteria with broad resistance and efforts need to be broad based with a goal of reducing the overall burden of infections.
“The key safety question today, since it is possible to reduce the total risk of hospital infections by half with a broad-based infection control program, is what is the incremental benefit of a component focusing on a single antibiotic-resistant pathogen?” said Richard P. Wenzel, M.D., chair of internal medicine.