Screening for meticillin resistant Staphylococcus aureus (MRSA): who, when, and how?

Meticillin resistant Staphylococcus aureus (MRSA) remains one of the foremost nosocomial pathogens. The changing epidemiology and microbiology of MRSA worldwide provides an important context for decision making with regard to infection prevention and control. MRSA can be categorised as hospital associated, community onset, community associated, or livestock associated. This article concentrates on hospital associated MRSA, although both community associated and livestock associated MRSA are important emergent threats.

Patients colonised or infected with MRSA provide a reservoir within hospitals. Transmission occurs directly from patient to patient, indirectly via the hands of hospital staff after contact with a patient who is colonised or infected, or after handling contaminated materials,1 or by direct patient contact with the contaminated environment.

Infection prevention and control measures minimise risk of transmission to prevent healthcare associated infection. Although there is broad agreement on the control measures required for patients colonised or infected with MRSA, there is considerable controversy over the optimal strategy and extent of screening that should be undertaken.