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Limit patient screening for infection, study says

Screening all incoming hospital patients for a dangerous drug-resistant staph infection and isolating those infected did not curtail its spread, and proved costly, Swiss researchers said on Tuesday.

Some hospitals and a few U.S. states have called for the controversial approach of testing every incoming patient for methicillin-resistant Staphylococcus aureus, known as MRSA, which was blamed for an estimated 19,000 U.S. deaths in 2005.

But a 1-1/2-year study at the University of Geneva Hospitals and Medical School, where MRSA has occasionally been a problem, found screening did not reduce the number of patients who caught the infection during their hospital stays.

Roughly 85 percent of MRSA cases, which is treatable only with a few antibiotics, occur in hospitals, where infection can kill weakened patients.

Hospitals undertake several approaches to combat outbreaks such as strict hand-washing by staff, frequent equipment changes, and extensive cleaning of operating rooms. MRSA outbreaks struck roughly one-quarter of U.S. hospitals in 2003.

As many as 1.5 percent of Americans carry the highly contagious infection and may spread it to others without developing a serious infection themselves.

In the study published in the Journal of the American Medical Association, 515 of the 21,754 surgical patients tested positive for MRSA. Of those, 337 might not have been caught because they had not been previously identified as MRSA carriers.

Infected patients received five days of treatment and special precautions such as isolated hospital rooms that strained hospital resources and raised costs considerably.

During the initial nine-month period when the screening was done in selected hospital wards, 93 patients contracted MRSA infections while in the hospital. That compared to 76 infected in the wards where standard prevention efforts were in place.

"Overall, our real-life trial did not show an added benefit for widespread rapid screening on admission compared with standard MRSA control alone in preventing (hospital) MRSA infections in a large surgical department," study leader Dr. Stephan Harbarth wrote.

The report recommended targeting the screening to patients undergoing elective surgery with a high risk of MRSA infection.

Two U.S. researchers agreed in an accompanying commentary that a multifaceted approach, and not universal patient screening, was likely to be more effective in combating MRSA and other types of hospital germs that infect a total of 1.7 million Americans and kill 100,000 each year.

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