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April 23, 2005

PA Hospitals Using Nose Swabs to Identify & Target MRSA

the Pittsburgh, PA Post-Gazette reports that eight area hospitals, including the Veterans Administration (VA) Medical Center in Oakland, PA, are testing patients for MRSA through nose swabs -- an encouraging development.

Here are some key parts of the article, which I recommend reading in its entirety:
The swab test was part of the standard precautions the VA has used to identify patients who are carriers of methicillin-resistant Staphylococcus aureus, or MRSA, in a surgical ward and an intensive care unit.

Other hospitals in the region are adopting similar procedures in hopes of controlling the spread of the nasty bug, which can cause stubborn infections and, in some cases, be fatal.

The collaborative effort is unusual, said Dr. John Jernigan, a medical epidemiologist at the Centers for Disease Control and Prevention who has been involved in the initiative.

If the participating hospitals can reduce the incidence of MRSA in Western Pennsylvania, "We could potentially see it as a model for other regions of the country," he said. "Perhaps, over time, we can have a national impact on this problem."

Eight local hospitals are performing the nasal swabs and using other infection control measures in intensive care units or other units where patients are at high risk for MRSA infection, said Dr. Jon Lloyd, a retired surgeon who is coordinating the effort locally for the CDC. Other hospitals now using the procedure in some units include Allegheny General Hospital, Mercy Hospital, LifeCare Hospital, Sewickley Valley Hospital and three UPMC facilities: Montefiore, Presbyterian and Shadyside.

At the VA hospital in Oakland, patients who have MRSA are isolated to prevent the spread of the pathogen. Even if nose swab tests are negative, patients are swabbed again when they are released from the targeted units to determine if they acquired MRSA during their stay.

Several local hospitals using the swab tests began doing so in recent months. At UPMC Montefiore and the VA, where some units have employed them for several years, MRSA infections have dropped by 85 to 90 percent [Zap*Germs emphasis].

The surgical unit at the VA hospital, which once had about a dozen MRSA infections a year, now has two or three, said Dr. Robert Muder, hospital epidemiologist for the Pittsburgh VA system.

Within a few weeks, the VA hospital plans to phase in nasal swab testing of all patients admitted and discharged, he said.

While the infection control measures are easily understood, health care officials said they could be difficult to put into practice. A range of hospital personnel has to support and implement the procedures.

Dr. Rick Shannon, chairman of medicine at Allegheny General, said a drawing of a nose with the inscription, "Did you remember to swab?" was posted in one unit to remind staffers to perform the test.


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