The attitude towards MRSA in the United Kingdom is a case of shutting the gate after the horse has bolted

The attitude towards MRSA in the United Kingdom is a case of shutting the gate after the horse has bolted, argues a doctor in a letter to this week's BMJ.

Nicholas Akerman's experience of working in Australia was that people are unable to work with patients without being screened and cleared. Yet, having worked in England in medicine for over 12 years, he has never once been screened. "Surely we should at least be adopting this policy to help combat the problem?" he asks.

He also believes that patients themselves must shoulder some of the blame in bringing MRSA into hospitals. "It would be a mammoth task to screen the entire hospital population, but a staggered approach would be a start," he writes.

In the long term, stopping MRSA being brought in at the front door, so reducing lengthy hospital stays, expensive drug treatment, and potential litigation, will be more cost effective, he concludes.

The spread of MRSA has been wholly apportioned to poor handwashing techniques by doctors and nurses. Although handwashing must be improved, other quite blatant modes of transmission are swept aside, adds Frank Conroy in another letter.

For instance, practices such as taking blood (phlebotomy) may well be giving MRSA the helping hand it needs.

Phlebotomists currently use the same tourniquet to take blood from patients on all the wards throughout the hospital, no doubt ensuring a spread of MRSA. To overcome this risk of transmission, the tourniquet must be disposed of after each use, he writes.