MRSA screening of 'no real value'

SCREENING FOR MRSA infection outside the acute hospital setting serves no real value and can in fact create unnecessary anxiety, a conference in Galway has heard.

Prof Martin Cormican, Professor of Bacteriology at NUI Galway, highlighted the need for what he said were very different approaches in managing MRSA (Methicillin-resistant Staphylococcus aureus) inside and outside the hospital setting.

"The key message I am trying to get across is that we need a balanced approach to this. MRSA is a very real problem and needs to be addressed, but sometimes it seems to cause a great deal of anxiety in settings where there is no need for it in particular," he said.

Prof Cormican was addressing the 23rd annual rural doctors conference on the topic of Managing MRSA: Between Hype and Indifference in Galway at the weekend.

Although MRSA can cause serious problems for vulnerable patients on antibiotics in the hospital setting, Prof Cormican said the bacterium was everywhere in the community but it was relatively uncommon for it to be associated with serious infection. "If a patient goes home from hospital well and with MRSA, there is no need for further tests or screening in the community, for example, in residential care settings. If you screen in those settings and find MRSA, it causes a great deal of unnecessary anxiety and stress and there is a stigma attached to the patient."

Prof Cormican said it was his practice to refuse to accept swabs for MRSA from most situations in the community, except for special reasons, ie if the patient is going for major surgery. He explained that, in general, such requests from outside the hospital served no value and just created anxiety where there was no need.

He said most mild to moderate MRSA infections could be treated very simply with the older antibiotics that have been around for 30 or 40 years. Very vulnerable patients who were infected with the bacterium would require more intensive treatment, he said.

"MRSA is a very important issue, but sometimes it's surrounded by so much fear and misinformation that it becomes even more scary for people than it needs to be and engenders a lot of unnecessary anxiety," he said.

Prof Cormican said that contrary to popular perception, MRSA was not a disease and was never the cause of death. People die of diseases such as pneumonia, bloodstream infection or meningitis that may or may not be associated with MRSA or another organism. He said the majority of people who picked up the MRSA bacterium were never bothered by it.

"My advice to GPs is that the general care of people is important, limited use of antibiotics is important but screening for MRSA outside the acute hospital setting has no value," he said.