Rapid MRSA Diagnosis needs Rapid MRSA Decolonization Therapeutics

There are several companies which offer rapid diagnostic tests for a drug-resistant staph infection known as MRSA (Methicillin-resistant Staphylococcus aureus), one of the most common superbugs found in hospitals. The Centers for Disease Control and Prevention (CDC) states that MRSA affects 90,000 Americans each year, killing about 18,000.

Rapid diagnosis of MRSA enables a healthcare facility to quickly determine if a new patient is colonized with MRSA and would enable intervention measures to be deployed more quickly. Rapid diagnosis is expected to therefore reduce  the spread of MRSA to other patients via healthcare workers who are seen to be the usual vector of transmission across the healthcare facilities. Deployment measures would include isolation chambers, full gown & glove protocols, hand washing before and after patient visits etc.  An additional use of MRSA diagnostics is the opportunity to apply intervention measures to  prevent surgical site infections since MRSA carriers run the risk of self-infection once their bodies are immuno-compromised after a surgery.

Rapid diagnostics, which require  a few  hours for MRSA identification results instead of days, are therefore less ideal for an imminent surgery patient hoping to avoid self -infection. Diagnosis  immediately prior to major surgery is less effective in the prevention of SSIs (surgical site infections) without a rapid decolonization therapeutic. The current decolonization protocol calls for the application of the antibiotic mupirocin/Bactroban several times per day administered 5 days prior to a surgery.

Rapid diagnosis has therefore not been as successful as it should be.  Many healthcare facilities have refused to adopt the rapid diagnostics as they claim there is no point of a rapid diagnosis of MRSA when the current MRSA decolonization protocols require 4-5 days to achieve decolonization. The nose is “ground zero” for MRSA colonization and is the main source of self-infection. Rapid decolonization replaces lab cultured plate diagnosis which typically requires 2-3 days for confirmation of MRSA culture. Nasal decolonization has been demonstrated to have  had a 40-60% reduction on surgical site infections, which is a significant impact on HAIs. If the traditional nasal decolonization requires 3-5 days to take effect and decolonize the nares of MRSA,  there is no point for a patient in a scheduled or elective surgery  to have a rapid diagnostic moments prior to surgery if there is no instant decolonization treatment.  Instead, it makes more sense to bring in a patient 7 days prior to surgery to test for MRSA as it will take 2 -3 days to grow and confirm MRSA and it will take another 3-5 days to  decolonize using traditional methods.

To gain value out of rapid diagnosis, it is imperative to match it up with a rapid therapeutic such as MRSAid™ Nasal Decolonization System that requires less than 10 minutes to achieve decolonization. Together the combination of rapid diagnostic followed by a rapid therapeutic will have a greater level of impact on surgical site infections as it is impossible to rely on patient compliance at the best of times.

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