Authors' recommendations: MRSA screening resulted in lower MRSA colonization, infection, and transmission rates using PCR compared with chromogenic agar, but the results were imprecise in some instances due tothe wide 95% confidence intervals. The turnaround time and number of isolation days were lower for PCR. BD GeneOhm MRSA and Xpert MRSA tests showed high accuracy rates compared with chromogenic agar. The false-positive rates with PCR may lead to unnecessary isolation for patients. The results in the clinical review are to be interpreted with caution according to the limitations of study validity. Furthermore, given the number of studies (15), gaps remain in the published literature, and evidence remains inconclusive. Canadian and international guidelines recommend using MRSA screening in hospitals that targets high-risk patient populations.The results of our primary economic analysis suggest that screening for MRSA at hospital admission, using chromogenic agar or PCR, and isolating MRSA-positive patients reduces theannual MRSA colonization cases by 25%. Factors, such as the number of contacts between a patient and a health care worker, risk level of contacts, effectiveness of isolation and precautionary measures, and MRSA status of hospital-shared equipment and hospital environment, also impact the annual incidence of MRSA colonization. Without the pre-emptive isolation assumption, the results suggest that chromogenic agar produces the lowest ICER; whereas, BD GeneOhm MRSA with a multi-site specimen is the least costly and most effective screening method under the pre-emptive isolation assumption. Several individual and societal ethical issues require consideration by health care institutions that conduct MRSA screening.

Project Status: Completed

URL for project: http://www.cadth.ca/media/pdf/H0484_MRSA_tr_e.pdf

Year Published: 2010

URL for published report: http://www.cadth.ca/index.php/en/hta/reports-publications/search/publication/952

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)