A Randomised Crossover Trial of a New, Rapid Method of MRSA
Detection Compared with Conventional Screening: Efficacy and the
Effect upon Hospital MRSA Infection Rates, Transmission Rates and
the Use of Hospital Resources.
This project is headed by Professor GL French, Professor of
Microbiology and Infection Control Doctor, Department of Infectious
Diseases, Division of Immunology, Infection and Inflammatory
Diseases, Guy's, Kings' and St Thomas' School of Medicine and Dr Dakshika Jeyaratnam, Specialist Registrar, Clinical Microbiology and
Virology. Clinical Fellow in Hospital Infection, Prevention and
Control (Guy's and St.Thomas' NHS Foundation Trust).
The aim of the study is to investigate whether significantly faster
detection of MRSA cases does lead to reduction in transmission and
other adverse outcomes by means of a randomised, crossover trial on
both medical and surgical wards. Rapid screening by IDI will be
compared with the current method of MRSA screening, with the aim of
assessing the impact of shortening time to MRSA result. The primary
outcome will be reduction in transmission of MRSA. Secondary
outcomes include incidence of MRSA bacteraemia, length of hospital
stay, use of isolation facilities, bed utilisation and nursing
workload. Test-specific outcomes will be sensitivity, specificity
comparative cost and ease of use of the test using pooled screens
under routine conditions of swab taking. Pooled screens for both IDI
and the conventional methods will be used, and this will allow
validation of the use of IDI for such pooled screens. An economic
evaluation of shortening the time to detection of MRSA will be
undertaken, looking at the cost-effectiveness of IDI and the
threshold cost at which rapid tests become cost-effective.
Setting: Guy's and St Thomas' Hospital Trust (GSTT) is a 1200 bedded
teaching and tertiary referral acute Hospital Trust in central
London, located on two sites about two miles apart. The hospital has
a wide range of referral specialities at particular risk of MRSA
infection and bacteraemia, including a 30 bed ITU, medical and
surgical HDUs and large renal, haematology and oncology, cardiac,
vascular, orthopaedic and dermatology units. The Trust admits many
patients at risk of MRSA carriage, including re-admissions and those
from other hospitals, elderly care homes and from abroad.
Contact details:
Dakshika.Jeyaratnam@gstt.nhs.uk
Department of Infection, Guy's and St.Thomas' NHS Foundation Trust,
St.Thomas' Hospital, Lambeth Palace road, London SE1 7EH.
