PATIENTS carrying MRSA are taking the superbug out of hospital and spreading it in the community, a study has revealed. Researchers now believe patients should be tested for MRSA when they leave hospital to halt infection levels.
A study at Aberdeen Royal Infirmary found that incidents of MRSA diagnosed in the local community increased with a rise in cases at the hospital. The research, published in the Journal of Hospital Infection, estimated that for every ten cases of MRSA
occurring in hospital, there would be one extra case in the community a month later.
Dr Ian Gould and his colleagues suggested that patients could be tested for MRSA when they left hospital to stop it spreading in the community.
The research gives extra ammunition to campaigners angered by claims that rising MRSA in hospitals is caused by patients bringing it in. Gould says they estimated that between 5 per cent and 10 per cent of patients discharged from hospital could be carrying the MRSA bug without showing any symptoms.
Their study found peaks and troughs in MRSA found in the community linked to the number of cases in hospital.
Scotland is set to start screening patients for MRSA when entering hospital. But the Aberdeen study suggests this could be taken a step further.
"Screening at patient discharge should be tested as a new measure to help control spread of MRSA in the community," the researchers say.
Gould adds: "The vast majority of MRSA in the UK is almost certainly acquired in hospital or nursing homes, but as nobody has ever published data from discharge screens we don't know figures.
"I have estimated that between 5 and 10 per cent of discharges could be MRSA- positive in hospitals with major MRSA problems."
Gould says that hospitals were probably reluctant to screen for MRSA on admission and discharge because it may provide "ammunition for litigation" among patients who are found negative on admission but positive when leaving hospital. "But it would certainly give us a good idea of the real size of the crossinfection problem," he says.
Gould adds that if a patient was found to be carrying MRSA when being discharged, they would not have to stay in hospital. Instead, they could be cleared of the bug using treatments at home.
Gould says that the United States already had a major problem with communityacquired MRSA. "The fear is that this will happen in UK some time soon," he adds.
Hospital acquired infections (HAIs) such as MRSA and the even more deadly Clostridium difficile have certainly become a major focus in Scotland and the UK as a whole.
Figures suggest that such infections cost the NHS at least £183 million a year, with patients needing extra treatment and longer stays in hospital. But coming up with new ways of tackling infections in an effective way has not proved simple.
Dr Alistair Leanord, the director of the Scottish Infection Research Network, which aims to improve research into healthcare-related infections, says screening patients on discharge would need to be closely examined.
"This is something we would have to consider very carefully before introducing it. We have to look for what is going to give us the biggest bang for our buck. With scarce resources it is something we would have to examine closely," he says.
Leanord says there was a concern about growing cases of MRSA in the community - both those linked to hospitals and a different strain of the virus, known as communityacquired MRSA.
"As well as cases of hospital associated MRSA going out in the community, we are also seeing more cases of a different strain of community-associated MRSA," Leonard says.
"This is in people who have no reason to be carrying MRSA because they have not got links to hospital or healthcare settings. These are two very distinct problems but both need to be examined."
Linda McCafferty, a Scottish representative of MRSA Action UK, says the charity would welcome any measure to cut the suffering caused by MRSA.
"People will be screened when they go into hospital and they are found negative," she says. "But when they get screened later on they are positive for MRSA but the hospitals won't admit where they got it from. They often say it is the patients bringing it in, but they are also taking it out."
Dr Jean Turner, of the Scottish Patients Association, says messages on good hygiene in hospitals needed to be "ingrained" in staff.
"The feedback I have had from patients is that all the good practices have been lost by the wayside either because of not enough nursing staff or people not dedicated to the area of cleanliness," she says.
"It seems these practices have not been ingrained in them."
The research undertaken at Aberdeen Royal Infirmary came after Pulse magazine reported that the Department of Health in London is to set up a "robust and comprehensive" MRSA surveillance system at GP surgeries after researchers found a "very large" increase in hospitalisations related to the bacteria.
The full article contains 844 words and appears in The Scotsman newspaper.
