Opinion Former Article

Change in universal screening policy for MRSA coincides with a rise in infections in hospitals in England

Although progress has been made since mandatory reporting of MRSA has been introduced, MRSA shows resilience and despite best efforts trends for the last 5 years are now beginning to show an increase.

Latest figures show that 65% of MRSA bloodstream infections were attributable to causes outside of the hospital setting. Causes of these infections were identified during the post-infection review process, a valuable tool for learning and providing evidence to suggest that screening plays an important role in reducing risks for patients needing surgery. Figures show an increase in the numbers of bloodstream infections caused by Staphylococcus aureus, including the strain of bacteria susceptible to Meticillin related antibiotics (MSSA). The increase coincides with the decision to move away from universal screening.

The change in policy was published in August 2014. Increases in the numbers of infections recorded in NHS hospitals in England were seen from December 2014.

MRSA Action UK were never invited to participate in the consultation evaluating universal screening for MRSA and when we offered our views these were dismissed.

We campaigned very strongly for the introduction of publicising data on infections and universal screening because of personal experiences of acquiring infections during hospital care. Many of us had no information of infection rates in our hospitals or choice of where to be treated.

When the publicised data was introduced we emphasised that it should be kept simple so that the public could see infection rates for their local hospitals, however it would seem that the Government wish the public to think infection rates are lower in our hospitals than they actually are. Although 65% of MRSA bloodstream infections are attributed as being caused by treatment in primary care or for some other reason, the 884 recorded between May 2015 and May 2016 bloodstream infections were recorded in hospital, re-emphasising the need for screening.

We applaud Trusts that screen their patients before admission, as the policy of not screening surely goes against the Government’s ambition to reduce antimicrobial resistance, if we can prevent an infection by taking additional precautions where a positive screen is obtained then surely this reduces the need for antibiotics and makes a better outcome for the patient and save lives.

Staphylococcus aureus is a pathogen that we live with every day and is proving to be a significant challenge in and outside of hospital. There were 8,767 cases of MSSA reported in the primary care setting 5 years ago, rising by 18% to 10,584 in 2016. It is unclear from the surveillance what proportion were attributed to lapses in care or unrelated to healthcare, but in terms of tackling antibiotic resistance, a worrying trend if more antibiotics are needed to tackle the infections. Screening for this pathogen can make a significant difference to outcomes for patients undergoing surgery, and we believe universal screening should be re-introduced as standard practice to save lives.

Derek Butler
MRSA Action UK
Email: derek.j.butler@mrsaactionuk.net
Telephone: 07762 741114

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