Clinical use
Screening test for Methicillin resistant Staphylococcus aureus
Background
Methicillin-Resistant Staphylococcus aureus (MRSA) strains are an ongoing concern in healthcare settings, with outbreaks occurring in hospitals and the community. MRSA is associated with high morbidity, mortality and high costs. Screening provides the ability to identify patients who may be at risk of infection and/or involved in the transmission of the organism. Many people are only colonised but act as reservoirs of the organism. Screening of elective hospital admissions and screening of non-elective admissions is now mandatory, guidance on MRSA screening can be found in the HIC12 – Hospital Infection Control Policy for MRSA. This also gives details of the screening and control measures for MRSA and the types of swabs to be sent in the given circumstances. A screen comprises of swabs from, nose/groin, any wounds/IV sites, any skin lesions/eczema etc. or catheter urine if appropriate.
Locally within the lab at James Cook, specialist commercially provided media, this can give a preliminary result after overnight incubation. For those requiring urgent surgery, admission to critical care departments, or were guided by Infection Prevention and Control (IPC), a rapid MRSA Polymerase Chain Reaction (PCR) test can be utilised to rapidly identify (<4 hours) MRSA. Following either culture or PCR, antimicrobial susceptibility testing will be performed, taking a further 16-18 hours. This will provide more specific detail on the resistance associated with the isolate.
Patient preparation
Please see the MRSA Screening swabs user guide
Specimen requirements
Pink topped Copan e-Swab.
Sample types that are acceptable:
- Nasal swabs
- Groin swabs
- Umbilical swabs (infants)
- Sputum (if expectorating or intubated)
- Urines (from catheterised patients)
- Entry sites of catheters/invasive devices (intravascular lines/tracheostomies)
- Stoma sites
- Swabs of lesions/sites of abnormal skin
- Pressure sores/wounds
Limitations and restrictions
Only one swab must be present in the e-Swab container. Please see the MRSA Screening guide for details on how to collect the sample.
The following sample sites will not be processed for MRSA screen:
- Hairline
- Axilla
- Rectal
- Perineum
- Throat swabs
N.B. The lab will process axilla samples from requests originating from Nuffield and patients awaiting transfer to Newcastle hospitals.
Turnaround time
48 hours
Analysing laboratory
Microbiology Lab, James Cook University Hospital, Marton Road, TS4 3BW