Aims: Active screening for methicillin resistant Staphylococcus aureus (MRSA) carriers remains a vital component of infection control policy in any health-care setting. The relative advantage of multiple anatomical site screening for detecting MRSA carriers is well recognized. However, this leads to increase in financial and logistical load in a developing world scenario. The objective of our study was to determine the sensitivity of MRSA screening of nose, throat, axilla, groin, perineum and the site of catheterization (central line catheter) individually among intensive care unit patients and to compare it with the sensitivity of multiple site screening. Materials and Methods: Active surveillance of 400 patients was done to detect MRSA colonization; 6 sites-nose, throat, axilla, perineum, groin and site of catheter were swabbed. Result and Discussion: The throat swab alone was able to detect maximum number of MRSA (76/90) carriers, with sensitivity of 84.4%. Next in order of sensitivity was nasal swab, which tested 77.7% of MRSA colonized patients. When multiple sites are screened, the sensitivity for MRSA detection increased to 95%. Conclusions: We found that though throat represent the most common site of MRSA colonization, nose or groin must also be sampled simultaneously to attain a higher sensitivity.
Girou E, Pujade G, Legrand P, Cizeau F, Brun-Buisson C. Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with a high level of endemic MRSA. Clin Infect Dis 1998;27:543-50.
Girou E, Azar J, Wolkenstein P, Cizeau F, Brun-Buisson C, Roujeau JC. Comparison of systematic versus selective screening for methicillin-resistant Staphylococcus aureus carriage in a high-risk dermatology ward. Infect Control Hosp Epidemiol 2000;21:583-7.
Lucet JC, Chevret S, Durand-Zaleski I, Chastang C, Régnier B, Multicenter Study Group. Prevalence and risk factors for carriage of methicillin-resistant Staphylococcus aureus at admission to the intensive care unit: Results of a multicenter study. Arch Intern Med 2003;163:181-8.
Manian FA, Senkel D, Zack J, Meyer L. Routine screening for methicillin-resistant Staphylococcus aureus among patients newly admitted to an acute rehabilitation unit. Infect Control Hosp Epidemiol 2002;23:516-9.
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty First Informational Supplement M100-S21. CLSI, Wayne, PA, USA, 2011.
Datta P, Gulati N, Singla N, Rani Vasdeva H, Bala K, Chander J, et al. Evaluation of various methods for the detection of meticillin-resistant Staphylococcus aureus strains and susceptibility patterns. J Med Microbiol 2011;60:1613-6.
Marshall C, Spelman D. Re: Is throat screening necessary to detect methicillin-resistant Staphylococcus aureus colonization in patients upon admission to an intensive care unit? J Clin Microbiol 2007;45:3855.
Nilsson P, Ripa T. Staphylococcus aureus throat colonization is more frequent than colonization in the anterior nares. J Clin Microbiol 2006;44:3334-9.
Sanford MD, Widmer AF, Bale MJ, Jones RN, Wenzel RP. Efficient detection and long-term persistence of the carriage of methicillin-resistant staphylococcus aureus. Clin Infect Dis 1994;19:1123-8.
Lautenbach E, Nachamkin I, Hu B, Fishman NO, Tolomeo P, Prasad P, et al. Surveillance cultures for detection of methicillin-resistant Staphylococcus aureus: Diagnostic yield of anatomic sites and comparison of provider- and patient-collected samples. Infect Control Hosp Epidemiol 2009;30:380-2.
Meurman O, Routamaa M, Peltonen R. Screening for methicillin-resistant Staphylococcus aureus: Which anatomical sites to culture? J Hosp Infect 2005;61:351-3.
Eveillard M, de Lassence A, Lancien E, Barnaud G, Ricard JD, Joly-Guillou ML. Evaluation of a strategy of screening multiple anatomical sites for methicillin-resistant Staphylococcus aureus at admission to a teaching hospital. Infect Control Hosp Epidemiol 2006;27:181-4.