Superbug fears raised over gap between testing and hospital admission

PATIENTS due to have surgery in Scotland are being screened for the deadly superbug MRSA up to three months before admission.

Documents released under Freedom of Information reveal wide variations between screening and admission to hospital, even though a lengthy gap increases the risk that a previously-uninfected patient could pick up the bug between testing and going in for treatment.

Experts said that while the risk was small, testing should take place as near to admission as possible - about a maximum of a month beforehand - to allow for anyone carrying the bacterium to be treated.

There were more than 100 cases of MRSA infection in Scottish hospitals in the first three months of this year.

Pre-admission screening was introduced by the Scottish Government to reduce the MRSA infection being carried into hospitals. The procedure involves taking a swab from inside a patient's nose to see if they are "colonised" with MRSA, meaning they carry it without actually being ill.

About 7 per cent of patients admitted to hospital are estimated to be carriers.

The antibiotic-resistant bug is most serious when it enters the bloodstream, which is a greater risk for people who are ill or having surgery.

Some NHS boards, including Ayrshire and Arran, said screening took place up to a month before admission, while NHS Grampian said most patients were screened when they arrived on wards. But NHS Lanarkshire said the longest gap was 12 weeks. NHS Highland and Dumfries and Galloway said the maximum time was nine weeks, while NHS Greater Glasgow and Clyde said screening generally took place no more than eight weeks before admission.

Aberdeen-based microbiologist Professor Hugh Pennington said: "The longer the interval between screening and admission to hospital, the greater the possibility that someone might pick the organism up. Although it's quite a low possibility, it's still there and the longer you leave it, the greater the chance.

Margaret Watt, chair of the Scotland Patients Association, became concerned after a relative was screened seven weeks before their procedure. "They (hospital officials] were quite complacent and said there's no chance of her getting it before she goes in," she said. "But how do they know?"

Derek Butler, chairman of charity MRSA Action UK, said: "We would argue that it should be done when you go in for your operation because you can get a result within hours."

Butler said there needed to be a uniform policy on screening. "We believe two weeks is the maximum it should be done," he said.

Health secretary Nicola Sturgeon said pre-admission screening for MRSA was one of a range of initiatives helping to reduce infection rates in hospitals.

Last week, it emerged that a new superbug, resistant to almost all antibiotics, had been discovered in 37 patients in the UK, including one case in Scotland.Scientists writing in the Lancet warned of the emergence of a new gene, NDM-1 (New Delhi metallo--lactamase), which had allowed bacteria to become highly resistant to treatment.

NDM-1 spread in India, Pakistan and Bangladesh, but it was also found in patients from the UK, who travelled to India or Pakistan for medical procedures, including cosmetic surgery.