Stopping MRSA at the front door

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By Nick Triggle Health reporter, BBC News Ministers have told hospitals to start rolling out MRSA screening over the coming years.

They want to see all patients tested for the superbug to try to curb its spread. But some hospitals are already doing this - with impressive results.

Over 25,000 samples are tested each year

Each day hundreds of pods containing nose swabs from patients at London's University College Hospital are placed in a special air-powered tube.

The samples are whizzed under the busy Tottenham Court Road to the hospital's biochemistry labs 800 yards away.

Once there, they are tested for MRSA in what is fast becoming the front-line battleground in the fight against the superbug.

For all the extra funding for cleaning, infection control nurses and hand gels, the best defence against MRSA is to prevent it entering the hospital in the first place.

And that, more or less, is what the hospital is trying to achieve.

Always a chance

Microbiologist Peter Wilson says: "If we can make sure patients do not have the infection on their skin when they come in for treatment, the risk of them getting an MRSA blood infection reduces from 40% to about one in 30.

"There is always the chance that they could get it from the hospital environment or from visitors, but by ensuring they don't have it on them you are giving them every chance."

The hospital, along with the other units in the trust, which includes a specialist heart centre, was one of the first to introduce mass MRSA screening in 2006.

The risk of them getting an MRSA blood infection reduces from 40% to about one in 30 Peter Wilson, microbiologist

Currently, all elective and emergency surgery patients are tested.

And from later this year that will be extended to all in-patients - three years ahead of the government's deadline for the NHS.

The hospital uses a two-hour test, the fastest on the market, developed by Beckton Dickinson.

Elective patients, who include those undergoing operations such as knee and hip replacements, are tested in their pre-op assessments so doctors know the results before they go under the knife.

If the swabs are MRSA positive, the patients are given nose cream and a special wash to eradicate the contamination.

Obviously for emergency patients it is not possible to decontaminate them before they enter the hospital.

But if the results do show they are contaminated with MRSA, doctors then isolate them and give them the special wash and nose cream.

Expense

Of course, the test is not cheap - £17 per test compared to £6 for the old three-day testing system, which was only used sparingly.

But the benefits for patients and the cost of treating them means the screening more than pays for itself.

In 2006, the rate of MRSA infections fell by 39%.

Financially - based on the extra time patients spend in hospital once they have MRSA - this means a saving is in excess of the £400,000 the new testing is costing.

Mr Wilson says: "We don't know if this is all down to the testing as other measures such as cleaning and isolation technique have been introduced. But I would certainly say it is a major factor."