Isolation for MRSA Isn't the Answer

To prevent nosocomial infections, most hospitals routinely screen intensive care unit (ICU) patients for methicillin-resistant Staphylococcus aureus (MRSA) and place carriers in contact precautions. This process is costly for hospitals and isolating for patients. An alternative approach is skin and nares decontamination through chlorhexidine bathing, and intranasal mupirocin. To determine the relative effectiveness of these strategies, investigators conducted an 18-month trial in which 43 hospitals (74,000 patients) were randomized to either MRSA screening with isolation, targeted decontamination (only patients with positive MRSA screens), or universal decontamination (all ICU patients).

Compared with baseline risk, risk during universal dec…