Impact of universal surveillance for methicillin-resistant Staphylococcus aureus (MRSA) at a large United States healthcare organization

Background: The effect of large-scale expanded surveillance for methicillin-resistant Staphylococcus aureus (MRSA) on health care– associated MRSA disease is not known. Objective: To examine the effect of 2 expanded surveillance inter-ventions on MRSA disease. Design: Observational study comparing rates of MRSA clinical dis-ease during and after hospital admission in 3 consecutive periods: baseline (12 months), MRSA surveillance for all admissions to the intensive care unit (ICU) (12 months), and universal MRSA surveil-lance for all hospital admissions (21 months). Setting: A 3-hospital, 850-bed organization with approximately 40 000 annual admissions. Intervention: Polymerase chain reaction–based nasal surveillance for MRSA followed by topical decolonization therapy and contact isolation of patients who tested positive for MRSA