SHOULD WE VIGOROUSLY TRY TO CONTAIN AND CONTROL METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS

OBJECTIVE: To review practices currently used to control transmission of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals, determine the frequency of their use, and discuss the indications for implementing such measures. DESIGN: A questionnaire survey to determine how commonly selected control practices are used, and a literature review of the efficacy of control practices. PARTICIPANTS: Two hundred fifty-six of 360 hospital-based members of the Society for Hospital Epidemiology of America, Inc. (SHEA) completed the survey questionnaire. RESULTS: Many different combinations of surveillance and control measures are used by hospitals with MRSA. Nine percent of hospitals stated that no special measures were used to control MRSA. The efficacy of commonly used control measures has not been established by controlled trials. CONCLUSIONS: Implementing control measures is warranted when MRSA causes a high incidence of serious nosocomial infections, and is desirable when MRSA has been newly introduced into a hospital or into an intensive care unit, or when MRSA accounts for more than 10% of nosocomial staphylococcal isolates. While the value of some practices is well established, measures such as routinely attempting to eradicate carriage of MRSA by colonized patient and personnel require further evaluation.