Barry Farr and Bill Jarvis don't agree. They say that, and more, in a lively letter to ICHE published in the May issue. The letter, and the response by Wenzel, et al., are good reading, so take a look. I recently published my views on this issue in a JAMA editorial, so I won't rehash them here.
We can establish a few facts, though: (1) MRSA accounts for fewer than 1 in 10 hospital acquired bacterial infections, (2) MRSA bloodstream infection rates in US ICUs are declining significantly, without any widespread MRSA screening, (3) MRSA screening programs are resource intensive and pose risks to patients, and (4) resource limitations are becoming increasingly urgent in our cash-strapped hospitals. So knowing all of this, is it wise to demand that all hospitals begin MRSA screening programs? (I report, you decide)
I also note that Farr and Jarvis now routinely denigrate calls for well-designed, controlled trials to address the impact of MRSA screening, arguing instead that "over 100" observational, quasi-experimental, multiple intervention, or otherwise flawed studies should be dispositive.
In that spirit, let me propose just such an observational study. Let's choose as our "intervention" hospital (Hospital A) a large tertiary care center where MRSA screening has been performed for almost 3 decades (Dr. Farr's hospital). The control hospital shall be a similarly large, tertiary-care hospital where no MRSA screening is performed among adult inpatients, and in which a broad-based, "horizontal" approach to infection prevention is preferred (Dr. Wenzel's hospital, "Hospital B"). Hospital B has already reported their ICU MRSA infection rates for the past several years (decreasing significantly). We now only need Hospital A to provide their data, in order to make the comparison. The publicly available data we do have finds Hospital A to have an overall ICU bloodstream infection rate that is more than double that of Hospital B. Food for thought....