Rapid MRSA Identification

Ireland is one of only three countries in Europe where antibiotic prescribing outside of hospitals, is on the rise. Antibiotics are frequently taken for viral colds and flu, when in fact they are only effective against bacterial infections. The more frequently antibiotics are used, the more resistant forms of bacteria become to them. The HSE recently launched a national education programme to change prescribing patterns in a bid to curb the use of antibiotics. The level of superbugs like MRSA and C. difficile in our hospitals would fall if antibiotic use was reduced. However, there’s another side to the superbug problem in our hospitals which I believe, has been overlooked.

When I developed serious symptoms of infection some years ago, it took three days for a nasal swab report to come through from the laboratory. In the meantime, I was treated in a ward shared with four other patients, two of whom were recovering from surgery. When my positive MRSA status emerged, I was quickly moved out of the ward and into isolation. You have to wonder at how many patients were cross-infected as a result of this delay in diagnosis. Multiply this by the huge number of MRSA cases passing through our hospitals each year and you get some idea of the scale of cross-infection.

The sad fact is that there is a Rapid MRSA test available which gives same-day results but it appears that the HSE restriction on budgets has ruled out it’s use in Irish hospitals. This decision is short-sighted as rapid MRSA identification can help hospitals make cost savings.

mrsa2“The 3M BacLite Rapid MRSA test allows fast, affordable screening of patients for MRSA. It also has the potential to improve patient outcomes and decrease treatment costs. Rapidly identifying MRSA colonised patients provides hospitals with another tool to assist in pro-actively managing health care associated infections (HCAI).”

If I’d been rapidly screened, the result would have been available in hours, not days thereby enabling infection control teams to act quickly. My MRSA infection was hospital acquired (HCAI) following surgery and resulted in six weeks of expensive in-patient treatment. The infection recurred a year later and since then I have frequently been screened for MRSA as an out-patient. I always have to wait 2-3 days for a result and as far as I know, a similar delay still applies for in-patient screening.  I’d be very interested to hear if anyone knows different?

Everyone has a role to play in stopping hospital infection, patients and their families included.  However, if the HSE seriously wants to reduce MRSA figures and make reductions in their budgets, then it should address the problem of delayed identification. The rapid MRSA test would ultimately lead to huge cost savings for hospitals and more importantly, save lives.

4 Responses to Rapid MRSA Identification

  1. Annb says:

    Again Steph, you have done yet another amazing service to health care in Ireland. Where do you get the energy? As an MRSA, been there, done that, bought the overpriced hand wash, fellow graduate, I can totally concur with your view on the testing procedure. Our boy wonder’s been ‘colonized’ with the bug for nearly 2 years now. It has obviously been well managed since he went through transplant surgery without infection. But the news was a blow initially, to the extent that a family member urged me not tell anyone, as she felt we would be treated like families with TB in the 1950’s! The facts are simple, and easily accessible, MRSA is in the community, we are all at risk so why can’t we even out the score by taking very simple precautions, like avoiding unnecessary antibiotics and washing our hands?
    The HSE could meet us half way by, for just once, showing leadership and foresight. Speed up the testing process, the cost benefit analysis is not rocket science!
    Cheers,
    Annb

  2. Steph says:

    Annb – Thank you for the lovely compliment and for your excellent addition to this post. It’s always particularly good to hear from fellow graduates 😀

    It’s very interesting to hear that Rory’s surgery went ahead when it was known that he was colonised. I suppose this didn’t really feature when you consider the bigger picture of Rory’s situation. I’m just glad that they managed to keep him free of MRSA infection and the complications that go with it.

    When I was due to have my surgery in Nottingham, the NHS wouldn’t accept me for surgery until I’d been through a 3-week screening process to prove I was clear of MRSA colonisation. It wasn’t MY well-being they were concerned about – they didn’t want me contaminating their pristine specialised unit! In Ireland, they screen you before you come OUT of hospital to protect the community 😆

    I’ve written lots of posts about MRSA since I first started blogging, some personal and some ranting about the state of the Irish health service.

    If you’re interested, click on ‘MRSA’ in my tag cloud (this blog is about) and you’ll find your fill!

    Great to see you back and in fighting form!
    Take care, Steph

  3. That budget restriction is just totally shortsighted – it will only cost more in the long run when there are more patients to test!

    There’s a little something for you over at my place!

  4. Steph says:

    AV – Thanks for that! I’m chuffed 😀

    I was hoping that someone in infection control might see this and tell me that same-day results for MRSA testing are available in Irish hospitals but alas, silence so far. I’d love to be proved wrong!

    I found an interesting medical paper on the evaluation of the BacLite Rapid MRSA Test which concluded…

    “The Baclite MRSA test is easy to use and provides a similar level of sensitivity to conventional culture for the detection of nasal carriage of MRSA with the advantage that the results are obtained much more rapidly.”

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1592303

    I’ve concluded that the HSE has ruled this test out as they don’t have enough isolation facilities to house the many patients who would be diagnosed while still in A&E. A positive result would prevent them from admitting MRSA patients to an ordinary ward. This would very quickly show-up the cracks in our health service so the HSE chooses to play Russian roulette with people’s lives instead.

    By contrast, if they continue to admit patients first and then a positive result emerges two days later, they can quietly continue to nurse the patient in a general ward by not informing the patient/relatives of the new infectious status.

    It’s enough to make you weep!

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