Considering the introduction of universal MRSA screening.

More and more hospitals are introducing universal screening for meticillin-resistant Staphylococcus aureus (MRSA). As with many other interventions imposed in the name of infection control, the evidence for benefit remains controversial. Despite this, screening has aroused political interest and has now become mandatory in some countries. This Leader examines the implications of introducing universal screening for MRSA. In addition to resource requirements, there are practical difficulties and consequences that may not have been fully considered. These include: staff recruitment and working time arrangements in the laboratory; specificity and sensitivity of selected screening sites and laboratory methods; lack of isolation facilities on the wards; timely and continuing management of MRSA-infected and/or -colonised patients; and ethical issues raised by screening patients without considering the role of colonised staff. Furthermore, the focus on MRSA promotes undue emphasis of its importance, which could facilitate legal interest. We should remember that it is the precipitant actions from finding a new MRSA patient that aids control, not the simple act of screening by itself. There is no doubt that universal screening should be explored as a mechanism for controlling MRSA, but more evidence is required before it becomes routine.