Control of MRSA in intensive care units

The question of whether to screen patients for possible carriage of meticillin resistant Staphylococcus aureus (MRSA) when they are admitted to hospital has been one of the most controversial areas in infection control during the past decade. The conflicting evidence has led to diverse national policies and local strategies to identify those who should be screened (and possibly undergo MRSA decolonisation treatment).1 Despite this, the prevalence of MRSA has now been reduced, even in high income countries that have not implemented universal MRSA screening and decolonisation policies.

The linked study by Robotham and colleagues (doi:10.1136/bmj.d5694) provides new insights on the subject.2 Using a hypothetical modelling design, the authors tried to determine the most cost effective MRSA control strategy in intensive care units. Screening, isolation, and decolonisation were all effective MRSA control tools but had varying degrees of efficacy. However, universal MRSA screening with isolation alone was not cost effective in most scenarios. Screening added value by limiting the number of unnecessary treatment courses and isolation days, …