GP role in tackling MRSA 'inevitable'

Exclusive - Survey finds GPs only receive information on MRSA after asking for it.

A future role for GPs in tackling MRSA looks inevitable as the Health Protection Agency (HPA) strengthens its guidance for practices.

The HPA plans to publish GP-specific guidance at the end of April. Its draft guideline on community-acquired MRSA, published in November, will include advice for GPs following feedback from the RCGP.

The HPA has already called for GPs to be involved in screening patients with recurrent abscesses or necrosis for community-acquired MRSA.

Community-acquired MRSA is feared to be a growing problem in the UK, especially as 2 per cent of cases carry the tissue necrotising toxin Panton-Valentine leukocidin.

In a GP survey of 169 GPs, 62.1 per cent of respondents had not received any information on what to do with a suspected case of MRSA.

Those who had received information had done so from a range of sources, such as local microbiologists, and often only after they requested it. When asked to rate their knowledge of MRSA, just 21.3 per cent of GPs said 'good'. A further 2.4 per cent rated their knowledge 'excellent', 59.2 per cent 'fair' and 17.2 per cent 'poor'.

The survey also showed that 52 per cent of respondents backed GPs testing patients for community-acquired MRSA and 85.2 per cent believed controlling antibiotic prescribing would help tackle the problem.

Dr Maureen Baker, honorary secretary of the RCGP, said: 'Obviously, if patients are symptomatic and they need treatment then, yes, there's a need to know.

'There's also the need to know if there's anything to do with asymptomatic MRSA in the community.'

Details about how to handle patients discharged from hospital with MRSA is also needed, she said. But Dr Baker was uncertain if guidance on MRSA alone is the best strategy.

'It's one particular pathogen and antibiotic-resistant pathogen and it makes more sense to have a knowledge of the area as a whole, rather than one bug.'

Professor Mark Enright, an expert in infectious disease epidemiology at Imperial College, London, said: 'Community-acquired MRSA tends to present to GPs with skin and soft tissue infections. If they need drainage it's quite easy to send samples for testing.

'In community-acquired MRSA (GPs will) be the front line,' he added.

'I think it might be a matter of time before community-acquired MRSA becomes as big a problem as hospital MRSA.'

Knowledge gap

62% of GPs had no information about what to do if faced with MRSA

Source: GP survey.

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