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Nurse MRSA checks ‘unrealistic’

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Calls for healthcare workers to be routinely screened for MRSA are unrealistic, infection control nurses have warned.

International researchers – who reviewed 169 studies to assess the role of healthcare staff in the spread of MRSA – found that among 33,818 screened 4.6% carried the bacteria and 5.1% of these had clinical MRSA infection.

They recommended that all healthcare staff should undergo MRSA screening as part of their pre-employment examination or randomly prior to starting shifts, especially during outbreaks – irrespective of whether risk factors or purulent infections are present.

In areas of low MRSA prevalence – such as Scandinavia, the Netherlands and Western Australia – close healthcare worker screening was already practised
routinely, the researchers said in the journal The Lancet Infectious Diseases.

But Judy Potter, president of the Infection Prevention Society, said a ‘one rule fits all’ policy would not work.

‘Screening should be left up to individual organisations because it depends on local experience, the type of organisation and the prevalence of MRSA,’ she said.

‘It is logical to screen staff in places where MRSA is unusual, such as neonatal units but I can’t see the logic in doing it in places where patients are likely to carry MRSA anyway,’ she added.

‘We could end up decolonising staff so often that they end up becoming resistant to the decolonisation products,’ she warned.

Rose Gallagher, RCN adviser for infection control, said: ‘Staff are already screened routinely during an outbreak and periodic screening is sensible in high-risk areas. But screening is not a silver bullet in terms of reducing MRSA in hospitals and has to be targeted alongside pre-existing interventions.

‘The decision to screen staff for MRSA pre-employment needs to be taken at a national level and the RCN would want to see nurse representation to discuss the implications,’ she added.

A spokesperson for the Department of Health said it currently had no plans to introduce routine MRSA screening for nurses and other healthcare staff.

‘The infection control team may advise screening when there are particular epidemiological features to indicate that a staff member or members may be the source of linked cases of MRSA infection,’ she said.

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