Survey of meticillin-resistant Staphylococcus aureus policies in UK eye departments

• Published in: The Journal of hospital infection 2009-08, Vol.72 (4), p.314-318
• Main Authors: Rathod, D, Luqmani, N, Webber, S.K, Hosein, I.K
• Format: Article
• Language: English
• Subjects: Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Biological and medical sciences; Cross Infection - microbiology; Cross Infection - prevention & control; Guideline Adherence - statistics & numerical data; Health Services Research; Healthcare surveys; Human bacterial diseases; Humans; Infection Control - statistics & numerical data; Infectious Disease; Infectious diseases; Mass Screening - methods; Medical sciences; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Meticillin-resistant Staphylococcus aureus; Organizational Policy; Phacoemulsification; Pharmacology. Drug treatments; Practice Guidelines as Topic; Screening; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; Surgical Wound Infection - microbiology; Surgical Wound Infection - prevention & control; Surveys and Questionnaires; United Kingdom - epidemiology
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2009.04.015

Summary The purpose of this study was to investigate meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonisation practices for patients undergoing routine cataract surgery in ophthalmology departments across the UK. A postal questionnaire survey of all ophthalmology departments in the UK was carried out, with 75 of 152 (49.3%) questionnaires returned. Sixty-three percent of units had a departmental MRSA policy. Preoperative MRSA screening was performed in 50 (66.7%) units, three of which screened all preoperative patients and the remainder performed selective screening. The proportion of patients screened for MRSA ranged from 0 to 100%, with a median of 2% and a mean of 9.9% (95% confidence interval: 3.5–16.2%). Overall, 65.3% of respondents felt that their departmental policy was reasonable, although there was considerable dissatisfaction and confusion, with comments identifying lack of evidence and the need for guidelines applicable to day-case cataract surgery. The survey demonstrates significant inconsistencies in preoperative MRSA screening practice in ophthalmology departments throughout the UK. Current recommendations from the Department of Health suggest that day-case ophthalmology patients do not require routine screening, although the implication appears that high risk patients continue to do so. Further investigation is required to ascertain the scientific validity of these recommendations.