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Updated: Apr 16, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Active Surveillance and Decolonization Without Isolation Is Effective in Preventing Methicillin-Resistant
Sanchita Das1, Maureen Harazin2, Marc Oliver Wright1
1Department of Infection Control.
Background:
Control of methicillin-resistant Staphylococcus aureus (MRSA) is difficult in select populations. We used molecular typing to study the effect of universal surveillance and decolonization of carriers, without isolation, on MRSA transmission in a specialized unit.
Methods:
Patients admitted to the unit were screened for nasal MRSA at admission and discharge. Those who acquired MRSA during their stay were identified and linked to carriers with shared time in unit. Molecular typing of isolates was performed to identify transmission.
Results:
Of 3285 admissions, 82% were tested for MRSA nasal carriage; the discharge screening compliance was 64.7%. Admission prevalence was 2.3% among patients screened, and 7 (0.42%) acquired nasal MRSA during their stay. All patients who acquired MRSA shared time in the unit with a colonized patient. There were 3.9 MRSA acquisitions per 1000 at-risk days. Isolates from 5 patients that acquired MRSA during their stay as well as their potential donors (11 donor: recipient patient pairs) were available for typing. Pulsed-field gel electrophoresis matched 1 acquisition isolate to a colonized patient isolate. There were no MRSA infections during the study period.
Conclusions:
Despite less than perfect nasal screening compliance and exemption from traditional isolation precautions, acquisition of MRSA was 0.42% in this patient population over a course of 4.75 years, including a single case of acquisition, genetically similar to a known potential donor source. Screening for MRSA colonization and decolonizing of carriers was sufficient in reducing transmission in this vulnerable population.
Insights
Universal surveillance and decolonization effectively reduced methicillin-resistant Staphylococcus aureus (MRSA) transmission in a specialized unit. Screening carriers, without isolation, proved sufficient in controlling MRSA spread in this vulnerable patient group.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses significant control challenges in specific patient populations.
- Traditional isolation precautions may not always be feasible or necessary for MRSA control.
Purpose of the Study:
- To evaluate the impact of universal surveillance and decolonization on MRSA transmission.
- To assess the efficacy of a strategy without isolation in a specialized unit.
Main Methods:
- Nasal MRSA screening at admission and discharge for all unit patients.
- Molecular typing (pulsed-field gel electrophoresis) to identify transmission links.
- Tracking MRSA acquisition and linking to colonized carriers within the unit.
Main Results:
- MRSA acquisition rate was 0.42% (7 cases) among 3285 admissions over 4.75 years.
- All MRSA acquisitions were linked to patients sharing time in the unit with colonized individuals.
- Molecular typing confirmed one transmission event from a colonized patient to an acquired case.
Conclusions:
- Universal MRSA screening and decolonization of carriers significantly reduced transmission.
- This strategy, even without isolation, was effective in a vulnerable patient population.
- Low MRSA acquisition rates were achieved despite imperfect screening compliance.
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