Case studies: Rigorous testing slows MRSA germ in VA hospitals, Tacoma General

The nation's most aggressive MRSA screening program is run by the U.S. Department of Veterans Affairs (VA). All patients are tested at 155 VA medical centers, including five in this state.

Patients are screened on arrival, once a week during their stay, and whenever transferred within the hospital, said Marcus Grandjean, a MRSA project coordinator for the VA Puget Sound Health Care System.

VA officials ordered screening in May 2007, after pilot projects yielded dramatic reductions in infection rates. MRSA infections have been reduced to nearly zero inside the hospitals, VA officials report.

Their success underscores how widespread screening halts the spread of MRSA infections, reduces treatment costs and enhances basic infection-control measures such as washing hands, Grandjean said.

Outside the VA system, several Washington hospitals have adopted aggressive MRSA screening and isolation policies — for example, Seattle Children's hospital.

Tacoma General Hospital has held down MRSA infections with widespread screening that began in 1999 — one of Washington's first hospitals to hunt down the germ.

Tacoma General tests all high-risk patients, such as those in the intensive-care unit, said Marcia Patrick, who directs infection control at MultiCare Health System, which oversees four hospitals and dozens of clinics in Pierce County.

Now, fewer than 1 percent of Tacoma General's patients get MRSA, she said.

Most hospitals use a standard culture test to detect germs: They collect bodily fluids with a nasal swab, incubate the fluids, then examine them under microscopes. Getting a result typically takes two days and costs about $20.

Tacoma General uses a more expensive procedure, called PCR testing, that produces results in two hours. Patients can be quickly isolated and treated, inhibiting the germ's spread.

A PCR test, which averages about $40, can save tens of thousands of dollars in medical expenses for just one patient, Patrick said.

"The program pays for itself," she said.

— Michael J. Berens and Ken Armstrong