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MRSA superbug control measures 'lack evidence'

21 August 2014

The jury is still out on the effectiveness of meticillin-resistant Staphylococcus aureus (MRSA) superbug control policies in hospitals, according to an international report in the Lancet.

The authors suggest there is poor evidence to support screening and isolating infected patients —even though these methods have long been regarded as the gold standard MRSA prevention strategy and are required by law in some countries.

But good hand hygiene and bathing with antibacterial solutions are key to reducing infections, they say.

After reviewing studies on preventing the spread of MRSA in hospitals over the past decade, the authors argue that more studies are needed before any change in protocols. 

Measures taken by hospitals to tackle MRSA include: careful hand washing; masks, gloves and gowns for healthcare workers and visitors; screening people for signs of infection before admission; and isolating infected individuals in private rooms.

Most scientists investigated several infection control measures in combination, making it difficult to tease out which ones worked best. However, researchers say the limited evidence focusing solely on isolation or screening suggest they may not reduce spread of the disease and could do more harm than good.

Prof Gerd Fatkenheuer, from the University Hospital Cologne, Germany, who was part of the research team, said: "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."

The scientists emphasised that evidence backs good hand-washing and suggests people with the bug should bathe daily using antibacterial solutions.

The report authors say as MRSA levels continue to drop this provides a good opportunity to reassess how best to tackle the problem. They also recommend that scarce resources could be redeployed to combat other infections – rather than singling out 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 control measures for MRSA should be abandoned."