Should healthcare workers (HCWs) be routinely screened for MRSA carriage?
This remains an unresolved and contentious issue. Although reports exists about HCWs have been implicated in MRSA outbreaks, most MRSA hospital acquired outbreaks do not involve a HCW as the point source. The endemic rate of MRSA carriage by HCWs is estimated at 0-15%.
There is a recent review of the literature on routine MRSA screening of HCWs in the Journal of Hospital Infection.
It seems like many answers remain to questions such as:
1. What is the best measure of endemic MRSA carriage by HCWs? Is this estimate valid in acute care settings, ambulatory settings and in long term care facilities?
2. What evidence based protocols exist for HCW MRSA decolonization?
3. How long will decolonization be effective?
4. How should HCWs be decolonized in the event of recolonization?
5. Should a colonized HCW be removed from clinical responsibilities while undergoing decolonization?
6. Should this leave be with or without pay?
Clearly, further research is needed before routinely seeking out MRSA colonized HCWs.
Perhaps it is best not to know?
This remains an unresolved and contentious issue. Although reports exists about HCWs have been implicated in MRSA outbreaks, most MRSA hospital acquired outbreaks do not involve a HCW as the point source. The endemic rate of MRSA carriage by HCWs is estimated at 0-15%.
There is a recent review of the literature on routine MRSA screening of HCWs in the Journal of Hospital Infection.
It seems like many answers remain to questions such as:
1. What is the best measure of endemic MRSA carriage by HCWs? Is this estimate valid in acute care settings, ambulatory settings and in long term care facilities?
2. What evidence based protocols exist for HCW MRSA decolonization?
3. How long will decolonization be effective?
4. How should HCWs be decolonized in the event of recolonization?
5. Should a colonized HCW be removed from clinical responsibilities while undergoing decolonization?
6. Should this leave be with or without pay?
Clearly, further research is needed before routinely seeking out MRSA colonized HCWs.
Perhaps it is best not to know?
