UK: MRSA screening branded 'unethical'

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Source: http://www.nursingtimes.net/whats-n...a-screening-branded-unethical/5007180.article

MRSA screening branded 'unethical'

9 October, 2009 | By Steve Ford

Mandatory MRSA screening for elective patients in England is unethical, according to a leading microbiologist. .

MRSA screening was introduced for electives in April and will be extended to include all emergency admissions from the same time next year.

But Dr Michael Millar, consultant microbiologist at the Barts and The London NHS Trust, said: ?Although the policy is presented as a population screening programme, most people who are screened will gain little benefit and may be harmed.?

He questioned the validity of consent for screening because patients are not told it results in high numbers of false positives, patients being placed in isolation and delays in treatment.

?Patients placed in isolation can suffer psychological and physical harms, partly as a result of the reduced contact with healthcare workers and others,? he saidwriting in the online version of the BMJ.

Dr Millar added: ?As currently formulated, the Department of Health?s mandatory MRSA screening policy breaches ethical guidelines and should be reconsidered.?

 

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Re: UK: MRSA screening branded 'unethical'

Source: http://www.telegraph.co.uk/health/healthnews/6272281/Testing-all-patients-for-MRSA-is-unethical.html


Testing all patients for MRSA is 'unethical'
Screening all hospital patients for superbug MRSA is unethical and may do more harm than good, a leading microbiologist has warned.


By Rebecca Smith, Medical Editor
Published: 7:30AM BST 09 Oct 2009

Mandatory screening of all patients going into hospital for routine operations was introduced in England in April this year in order to bring rates of the superbug down.

However, the tests can be unreliable meaning some patients will wrongly test positive for the bug when they do not have it and will be given unnecessary treatment to clear it, causing delays to their surgery, Michael Millar, consultant microbiologist at Barts and the London NHS Trust has said.

The policy will be extended to all emergency patients from next year.

In an editorial published online by the British Medical Journal he said: "Although the policy is presented as a population screening programme, most people who are screened will gain little benefit and may be harmed. The justification for universal screening is therefore unclear."

The latest figures from the Health Protection Agency (HPA) showed a drop in the number of infections from April to June 2009.

There were 509 cases of MRSA in England, a 40 per cent drop on the same quarter last year and a 27 per cent drop on the previous quarter this year.

MRSA, or methicillin resistant Staphylococcus aureus, can be carried harmlessly on the skin or be found in wounds and most seriously in the bloodstream, which indicates infection.

Patients are tested to find out if they are carrying the bug in their nose or on their skin, which can increase the riskm of it getting into the wound during or after surgery. Those found to be carrying it are then given treatment to clear it before they are admitted for surgery.

Dr Millar said the benefits of reducing the risk of infection in people carrying the bug but be balanced against the potential adverse consequences which include being isolated from others in hospital and delays in treatment.

He wrote: "It has been estimated that universal MRSA screening could increase fourfold the numbers of patients placed in isolation. Patients placed in isolation can suffer psychological and physical harms, partly as a result of the reduced contact with healthcare workers and others.

"As well as adversely affecting the patient, isolation may affect control of other infections because it reduces the availability of isolation rooms. Thus MRSA screening of low risk patients is of uncertain benefit and may do harm."

He points out that patients with active MRSA infection pose the biggest risk to other patients and 'it is generally agreed' that the bug is spread around hospitals on the hands of healthcare workers, but they remain unscreened, he said.

He concluded: "As currently formulated, the Department of Health?s mandatory MRSA screening policy breaches ethical guidelines and should be reconsidered."

A spokesman for the Department of Health said: "Although the chance of acquiring MRSA is relatively low, when a patient does it is extremely distressing for them, their family and the NHS staff treating them.

"By screening patients for MRSA, the NHS is reducing a patient?s risk of developing an MRSA infection themselves or passing it on to others within the hospital that may be more vulnerable."