Experts question value of common superbug control practices

A colorized scanning electron micrograph of a white blood cell eating an antibiotic resistant strain of Staphylococcus aureus bacteria, commonly known as MRSA. Credit: National Institute of Allergy and Infectious Diseases (NIAID)

The jury is still out on the effectiveness of meticillin-resistant Staphylococcus aureus (MRSA) superbug control policies in hospitals, according to leading infectious disease experts in a Viewpoint published in The Lancet. In particular, screening and isolating infected patients—which have long been regarded as the gold standard MRSA prevention strategy and are required by law in some countries—have poor evidence for their effectiveness, say the authors.

After reviewing studies on preventing the spread of MRSA in hospitals over the past decade, the authors argue that although various approaches to tackle MRSA have been examined, most of the research has looked at bundles of control measures, and we don't yet know which individual components work best, or whether some of them could be omitted without increasing transmission.

Gerd Fätkenheuer, study co-author and Professor of Infectious Diseases at the University Hospital Cologne in Germany and President of the German Society of Infectious Diseases explains, "In the haste to do something against the rising tide of MRSA infection, measures were adopted that seemed plausible but were not properly assessed, bundling the effective and harmless with the ineffective and harmful. We know, for example, that isolating patients can result in anxiety and depression and fewer visits by doctors and nurses."

"We need better studies", says co-author Professor Bernard Hirschel, former Chief of the HIV unit at the Geneva University Hospitals in Switzerland and current President of the Swiss Society of Infectious Diseases. "With the tide of MRSA receding and improved treatment options for the infection, a window of opportunity now exists to reassess whether masks, gowns, gloves, and single rooms add anything to the traditional infection control measures of hand hygiene and universal decolonisation (eg, a daily bath with an antibacterial agent) which have proved much more successful in reducing rates of MRSA."

In recent years, MRSA rates have declined and hospitals are facing multiple multidrug resistant pathogens. The key question now, say the authors, is whether scarce resources should focus on screening for one particular pathogen, or assume a broader approach focusing on reducing all -acquired infections, not just MRSA.

According to co-author Professor Stephan Harbarth from Geneva University Hospitals in Switzerland, "The lack of effectiveness of active detection and isolation should prompt hospitals to discontinue the practice for controlling the spread of MRSA in favour of evidence-based measures adapted to local conditions and settings, which weigh up effectiveness, costs, and adverse events. What is more, recommendations and guidelines should clearly state the uncertainties in this field, and legal mandates that dictate the use of specific for MRSA should be abandoned."

More information: The Lancet, www.thelancet.com/journals/lan… (14)60660-7/abstract

add to favorites email to friend print save as pdf

Related Stories

MRSA colonization common in groin and rectal areas

Aug 13, 2014

Colonization of methicillin-resistant Staphylococcus aureus (MRSA) allows people in the community to unknowingly harbor and spread this life-threatening bacteria. The inside of the front of the nose is where this bacteria is mos ...

New methods to identify MRSA in pigs

Aug 05, 2014

Traditionally, MRSA has been associated with severe infections which occur in hospitals and result in prolonged diseases and increased mortality. However, in recent years, MRSA has spread to the rest of the ...

New strategies to combat MRSA in hospitals

Jun 11, 2014

New guidelines aim to reduce the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), improve patient safety and prioritize current prevention efforts underway in hospitals. This drug resistant bacterium is a c ...

Recommended for you

Recorded Ebola deaths top 7,000

7 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

11 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.