title: Screening for methicillin-resistant Staphylococcus aureus … all doors closed?
abstract: OBJECTIVE
  To describe the latest evidence for methicillin-resistant Staphylococcus aureus (MRSA) infection control strategies, with particular emphasis on active surveillance cultures with contact precautions and targeted decolonization, and their impact.
  
  
  RESULTS
  Several major trials published last year questioned the effectiveness of universal screening and contact precautions in controlling MRSA. These trials generally recommend universal decolonization as part of bundles to control MRSA, especially in ICUs, with some even concluding that universal decolonization should replace active screening and contact precautions. However, emerging resistance to agents used for decolonization, such as mupirocin and chlorhexidine, is a major concern. Several other studies confirmed a combination of hand hygiene enhancement, screening, contact precaution and targeted decolonization as a more viable MRSA infection control strategy for specific population groups.
  
  
  CONCLUSIONS
  Universal decolonization is an acceptable MRSA control strategy for intensive care units; however, close monitoring of chlorhexidine and mupirocin resistance is warranted. As a strategy, screening and contact precautions are suitable for hospital-wide MRSA control. Targeted decolonization is a proven measure for patients undergoing clean surgery. Enhancement of hand hygiene is a core measure regardless of the strategy.
authors.affiliation: aDepartment of Infectious Disease, Tan Tock Seng Hospital, Singapore bInfection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Kalisvar
authors.initials: K
authors.lastname: Marimuthu
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
mesh_terms: D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D062486:Public Health Surveillance; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000517:prevention & control