News | March 11, 2008

Critics Say JAMA Article Provides False Findings on MRSA Prescreening

March 12, 2008 – The Committee to Reduce Infection Deaths says a new study in the Journal of the American Medical Association (JAMA) is flawed in evidence in showing screening for MRSA (Methicillin-resistant Staphylococus aureus) using a simple nasal swab is not effective in reducing MRSA hospital infections (“Universal Screening for Methicillin-Resistant Staphylococcus aureus at Hospital Admission and Nosocomial Infection in Surgical Patients,” JAMA Vol. 299, No. 10, March 12, 2008).

The committee said the findings of the authors will be seized upon by the Centers for Disease Control and Prevention (CDC) and advocates of what it describes as “the do-nothing status quo.” The committee says the study is seriously flawed, rendering its findings meaningless.

Researchers used a rapid test, but many patients in the study were not tested until they had already been in the hospital for 12 hours. The results of the MRSA tests in the study also were not acted upon for another 22.5 hours on average. Most patients had completed more than half of their hospital stay before their results were known. The committee said the precautions the hospital should have taken were - isolation, proper antibiotics, chlorhexidine baths -were done late or not at all.

Almost a third of surgical patients (31 percent) who tested positive for MRSA did not get their test results until after their surgery. The committee says this means these patients did not receive any of the precautions they needed. Some people carry MRSA germs in their noses or on their skin without realizing it. The bacteria does not cause infections unless it gets inside the body, usually via a catheter, a ventilator, or an incision or other open wound.

A previous study by the same lead author at the same location, The University of Geneva Hospital, found universal screening on admission with pre-emptive contact precautions decreased MRSA infections in the medical intensive care unit.

The study released today, says Betsy McCaughey, chairman of the Committee to Reduce Infection Deaths, “doesn’t prove that MRSA screening is ineffective. The study omits the precautions that are supposed to follow a MRSA positive test result. It’s like testing a recipe, but omitting half the ingredients or test-driving a car without the tires.”

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