Demographic screening for MRSA may compromise the effectiveness of ring fencing on a joint replacement unit

• Published in: The Journal of hospital infection Vol. 82; no. 3; pp. 207 - 209
• Main Authors: Schmidt, H.-M.A, Izon, C, Maley, M.W
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-11-2012; Elsevier
• Subjects: Adult; Aged; Australia - epidemiology; Biological and medical sciences; Carrier State - epidemiology; Carrier State - microbiology; Colonization; Demography; Female; General aspects; Hospitals; Human infectious diseases. Experimental studies and models; Humans; Infection; Infectious Disease; Infectious diseases; Joint replacement; Male; Mass Screening - methods; Medical sciences; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Middle Aged; MRSA; Orthopaedic surgery; Orthopedic surgery; Ring fencing; Risk assessment; Risk Assessment - methods; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcus aureus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical site infection; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Young Adult; Australia; British Isles; Australia, New South Wales, Sydney; Surgical site infection; Joint replacement; Ring fencing; MRSA; Orthopaedic surgery; Surgical wound; Nosocomial infection; Prosthesis; Medical screening; Orthopedic surgery; Treatment; Bacteria; Micrococcales; Micrococcaceae; Public health; Staphylococcus aureus
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2012.07.020

Summary Ring fencing of joint replacement (JR) units has been reported to reduce infections and is recommended by health authorities in Australia and the UK. It has not been determined whether a demographic risk assessment is adequate to prevent the admission of patients colonized with meticillin-resistant Staphylococcus aureus (MRSA) to ring-fenced units. As such, 250 admissions to the JR unit of a suburban Sydney hospital were screened, and MRSA colonization was identified in 2.8% of patients complying with the demographic risk assessment. Demographic risk assessment is not an adequate substitute for physical MRSA screening, and undermines the effectiveness of ring-fencing procedures.