Introduction In the maternity population the benefits of MRSA (Methicillin-resistant Staphylococcus aureus) screening remain unproven. The authors report results of recently introduced screening in Southampton.
Methods Women were screened if booked for elective Caesarean or had other potential risks for MRSA carriage including previous MRSA, recent hospital admission, healthcare workers or being at higher risk of admission to maternal or neonatal high care. Swabs were taken from the nose, groin and any skin lesions including device insertion sites. All women screened were recommended topical decolonisation with chlorhexidine 4% until culture negative; women testing positive were recommended full decolonisation.
Results Between 23 March 2009 and 31 December 2009, 4411 women gave birth, 647 (14.7%) women were screened, the majority prior to elective Caesarean and 7 (1.1%) were MRSA positive (nasal positive, groin negative in all). Of these, one was previously MRSA colonised, one was a healthcare worker, one screened negative 3 weeks previously and three were of Asian ethnicity. The laboratory cost of this screening was £5176. Over a similar period for the Trust as a whole, 0.66% of elective admissions and 1.60% of emergency admissions screened MRSA positive.
The authors identified three Caesarean, and one perineal postnatal MRSA wound infections. Of these three were unscreened women and one (antenatal screen negative) had MRSA detected in the wound 21 days after Caesarean.
Conclusion These results question current MRSA screening criteria in the Southampton maternity population and nationally. The authors recommend further local studies to inform improved targeted screening.
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