Clarity is needed on which sites to screen

doi:10.1136/bmj.b1308

Published 31 March 2009, doi:10.1136/bmj.b1308
Cite this as: BMJ 2009;338:b1308

Letters

MRSA screening

Clarity is needed on which sites to screen

The first 150 words of the full text of this article appear below.

Kluytmans and Struelens, in their clinical review on meticillinresistant Staphylococcus aureus (MRSA) in hospital, concludedthat the most important site to screen for MRSA carriage wasthe nose and that screening other non-clinical sites (perineum,groin, or axilla) was not useful.¹

This is contrary to the practice in most UK hospitals, wherethe perineum and groin are also screened on the basis of thenational guidelines published in 2006.² Screening the nose alonewill detect around 80% of carriers; including the perineum increasesthis to 93%.³ Not only is the overall detection rate increased,but detection of perineal carriers is important because thisis correlated with more heavy dispersal of MRSA into the environment.⁴⁵

This is an important issue for trusts having to implement theDepartment of Health’s requirement to screen all electiveadmissions by 1 April 2009.The two sets of operational guidancedo not specify which sites should . . . [Full text of this article]

Simon F Hill, consultant microbiologist

¹ Poole Hospital NHS Foundation Trust, Poole, Dorset BH21 3XA

simon.hill@poole.nhs.uk