More than 7% of admissions tested positive for MRSA

MORE THAN 7 per cent of patients coming into a major Dublin hospital already had MRSA on their skin when they were admitted, …

MORE THAN 7 per cent of patients coming into a major Dublin hospital already had MRSA on their skin when they were admitted, research has found.

The study, conducted over the past year in an attempt to help trace the sources of MRSA in patients, looked at nearly 1,000 patients admitted to Beaumont Hospital.

Some 635 patients were screened immediately on admission and 47 of these or 7.4 per cent of the patients were already carrying MRSA.

The 588 of these 636 patients who were not carriers of MRSA on admission were followed up a week later to see if they picked up the superbug while in the hospital. After one week, four of these patients (0.7 per cent of the group) tested MRSA positive, indicating they acquired MRSA while in the hospital.

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A second cohort of 303 patients, who were already in the hospital and not screened for MRSA on admission, were also examined. Some 13.5 per cent of these patients - all of whom were in hospital for more than three days but in some cases were in hospital for weeks - tested MRSA positive.

This is an indication of "reservoir" or background levels of MRSA in patients in the hospital. Some of this group included elderly patients with complications as well as others awaiting accommodation in nursing homes.

The overall results of the study, which is part of a major research project being done jointly by Beaumont, the Royal College of Surgeons in Ireland (RCSI), Trinity College Dublin's Dublin Dental School and Hospital and the Health Protections Surveillance Centre, in partnership with the national MRSA reference laboratory at St James's Hospital, will spark debate on whether all patients should be screened for MRSA when going into hospital.

The UK is now looking closely at universal screening.

Prof Hilary Humphreys, who works at Beaumont and the RCSI, said while 7.4 per cent of patients were carriers of MRSA on admission it was difficult to comment on the figure in terms of whether it was high or low because there was an absence of similar studies from other hospitals with which to compare it.

Asked if the 47 patients who were positive for MRSA on admission would have community-acquired MRSA, he said there was very little "true community-acquired MRSA" in this country. Most of it would be hospital or healthcare related and he believes most of the 47 patients who were MRSA positive coming into hospital would have acquired it while in hospital before or in some other healthcare facility such as a nursing home.

He said the issue now was whether a rate of 7.4 per cent of patients with MRSA on their skin on admission to hospital warranted universal screening of all patients going into hospital or if it just warranted expanding the categories of at-risk patients who are currently screened.

"You have to balance the yield from that against resources," he said, adding that it was an issue now for debate. "I've an open mind on it," he said.

Patients in the study were carriers of MRSA but did not have it in their bloodstream, which can prove fatal.

At present, certain at-risk groups of patients are screened for MRSA on admission to Beaumont. These include people who were previously MRSA positive and those coming from abroad.