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Controversy persists about the best interventions to reduce hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections. In a previous quasi-experimental study conducted at Department of Veterans Affairs (VA) medical centers, a bundle involving active surveillance, contact precautions, hand hygiene, and institutional culture change was associated with a decrease in healthcare-associated MRSA infections. On the other hand, a cluster-randomized study involving adult intensive care units in Hospital Corporation of America facilities found that universal decolonization was more effective than either targeted decolonization or screening and isolation.
Now, VA investigators have hypothesized that these discrepant results could …