MRSA screening for older patients at hospital admission recommended
Routine screening for methicillin-resistant Staphylococcus aureus of nursing home patients at hospital admission may help identify colonized patients, according to recent study findings published in the American Journal of Infection Control.
“Because risk factors and prevalence rates vary among different hospitals and perhaps also in the same hospital over time, active surveillance screening practices and risk factors for colonization with MRSA should be evaluated periodically to ensure their continued validity,” researchers wrote. “Ideally, hospitals should monitor their individual rates and risk factors for MRSA colonization and infection to determine their own best screening strategy. A larger proportion of patients may need to be screened in settings with high prevalence or increasing infection rates.”
Nine variables reported at risk factors for MRSA colonization were analyzed. Both the retrospective derivation and prospective validation studies were conducted at St. Mary’s Hospital in Rochester, Minn.
Researchers found four risk factors in particular were significantly associated with MRSA, including: nursing home residence, diabetes, hospitalization in the past year, and chronic skin condition/infection. Using a cut-off score of 8 or more would result in screening 20% of admission and detect 71% of MRSA colonized patients.
Results from the prospective validation study found that a cut-off score of 8 or more required screening 21% of admissions and detected 54% of MRSA. Residence in a nursing home was the greatest predictor of MRSA.
“Further studies need to be done to validate the currently accepted risk factors for MRSA and the utility and cost-effectiveness of our screening practices,” researchers wrote. “Although our study identified four risk factors for MRSA colonization, it also underscores the variability in risk factors for colonization with MRSA between patient populations and the importance of validating the potential risk factor scoring systems and screening practices prior to implementation in clinical practice.”
Disclosure: The study was funded in part by NIH. The researchers report no relevant financial disclosures.