MRSA screening of staff....

[sauconyrunner]

• I did a search and I found some threads but none that I found were recent, so I thought I would pose the question here.
  

One surgeon at our facility wants to have all the Operating Theatre staff swabbed for MRSA screening.

I am not against this or actually for it. Some of our patients do come back with Post op MRSA infection. It is not, however, the predominant micro-organism that is infecting our patients. (Since most patients go home after many big procedures it's hard to know exactly where they got the infection when it is a superficial infection, not a deep or organ space infection.) While we do not screen our patients (unless the MD wants to) all our Pt's are decolonized the day of surgery regardless of screen or no screen.

I was asked to investigate the legal side of this, as well as the practical side. So far all articles I have looked at seem to support the screening and treatment of staff. Sadly most indicate that staff usually become re-colonized and their MRSA becomes more resistant to the treatments. So, it seems like it is not worth the expense.

Anyone have any information they can point me to? Especially about the re-colonization. Its tough as most articles only followed the people de-colonized for 3-6 weeks... THanks all. This is an infection control topic really, but I think more eyes will see it in general nursing!

[sauconyrunner]

loriangel14, you can be decolonized and recolonized. People do not stay colonized forever.

[sauconyrunner]

You can actually decolonize a patient using certain products, right before surgery. They stay without MRSA for 12-24 hours. they can be retreated every 12-24 hours if they need to or are high risk.

Sun0408- we don't know. which is why we decolonize EVERYONE regardless.

The surgeon requesting it has already been tested, and he has had only one post op infection in about 3 years. He's great.

And yes the hospital has to pay the sick leave. It's a very sticky situation.

I should add that treatment for MRSA colonization is a topical antibiotic. it is very unlikely to cause anyone to develop C-diff.

[NicuGal, MSN, RN]

Years ago we had a massive MRSA breakout in the unit I work in...they swabbed all of us and the ones that were positive were banished to the MRSA part of the unit and had to be treated with bactroban up our noses. They have never swabbed us again since they have since then figured out that most of us are colonized anyways. We swab all our admissions.

[martymoose, BSN, RN]

Ive worked the reg floors for 8 years, and had 3 surgeries in the last 3 years. I have swabbed negative every single time. thought for sure i would be pos, but apparently not

[sauconyrunner]

Ive worked the reg floors for 8 years, and had 3 surgeries in the last 3 years. I have swabbed negative every single time. thought for sure i would be pos, but apparently not

jrwest, sometimes I think its good luck, but often I think it is that people, like you, are following really good handwashing and stuff...

[wooh, BSN, RN]

There's a reason we use standard precautions.

So you're not sneezing into surgical incisions? I thought that was a standard part of OR procedure.

I should add that treatment for MRSA colonization is a topical antibiotic. it is very unlikely to cause anyone to develop C-diff.

Maybe not c. diff, but topical antibiotics create resistance just like oral and IV antibiotics.

We want to cut down on MRSA, then we need to go treat the colonized staff at WalMart before we start hitting up OR staff.

[KelRN215, BSN, RN]

I had a patient who was an anesthesiologist with systemic MRSA in CSF and the Infectious Disease team had no problem with her continuing to be in the operating room. If the ID team doesn't care about that, I have a hard time thinking that people who are simply colonized with it and are scrubbed need to be swabbed and put out of work.

[sauconyrunner]

Hallelujah! Spoke with Admin, and all have agreed (except Surgeon), that we do not need screening of anyone except patients. Yaaaaay, one less problem.