MRSA swab validity

Hello all,

Hope you can help.

Currently the trust practices a 4 week validity for MRSA results, which means we can not do our pre assessment earlier than that, which puts a huge pressure to fill the theatre lists in time.

Can not find any literature evidence to support this. Hence, the question is- what is your current practice for MRSA swab validity for elective cases.

Siten Roy

Orthopaedic Consultant & Clinical Director Theatres

Sandwell & City Hospitals

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Very interesting indeed.

In Gloucester/Cheltenham our policy seems quite generous (and practically very useful),

It’s 18 weeks – I have double checked with Pre Assessment and infection control.

Daniel

Gloucestershire Hospitals NHS Foundation Trust

Our current practice is 6 weeks but many of us think this is too short.

The BOA blue book on THA does actually state preop should be done within 6 weeks of surgery and that MRSA is part of preop.

It would be good to have some more up to date guidance from the BOA on this as when I asked our microbiologist he referred me to the BOA guidelines (which were used to write our own local ones).

In the absence of evidence based medicine we can still seemingly rely on eminence based medicine.

Tim Board

Lower Limb CD, Wrightington.

Sudhi, I am as surprised and fascinated as anybody else. I am struggling to convince my Micro colleagues to extend the present 4 week period, but in vain. The evidence now is so variable that it is worth exploring further through BOA route.

Thanks everybody, but keep replying as & when possible.

Regards

Siten Roy

This discussion has been really fascinating. Amazed to know that there is no consensus or guidelines nationally. I have pasted below the response to my question from our consultant microbiologist and infection control lead.

Sudhi

Huddersfield Royal Infirmary

Hi Sudhi

For practical purposes we decided that we would accept a pre-assessment result taken within an 18 week window (thinking along the lines of 18 week referral to treatment target). This would only be valid if the patient had had no in-patient healthcare contact in that period, at which point we would prefer a re-screen.

This is clearly quite a bit longer than other trusts below: what we are seeing locally is that by and large that vast majority of MRSA positive screens are coming from patients who are already known positives for MRSA. It can be a transient coloniser so we will inevitably miss some, hence why we tried to be pragmatic as opposed to imposing rigid, difficult to achieve deadlines with no evidence of harm.

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Swindon: 8 weeks

All patients are re-swabbed on discharge too

Thanks

We have a 12 week limit on Pre-op tests across the board but our patients also do a repeat MRSA swab two week before admission once date confirmed.

Simon Buckley

Clinical Director

We have no time limit in Musgrave Park Hospital.

Gavan

Mr M. Gavan McAlinden BSc MPhil FRCS (Tr & Orth)

Consultant in Trauma and Orthopaedic Surgery

8 weeks currently; will be going up to 12 soon

Ian C

Ian Carmichael

Director for Surgery

and Consultant Orthopaedic Surgeon

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Was not aware of time frame for MRSA results but on enquiry was informed that it is 6 months !

Appears to be too long probably needs changing.

Regards

Ajit Shetty

6 weeks in county durham

Regards

Steve scott

We are at 12 weeks in Crewe

Mr Cefin Barton MB BCh, MRCS, FRCS(Tr&Orth)

Dear Siten

8 weeks at Maidstone and Tunbridge Wells.

Kind regards,

Guy Slater