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To the Editor: Dr Stelfox and colleagues¹ found that patients with methicillin-resistant Staphylococcus aureus (MRSA) who were isolated for infection control experienced more preventable adverse events, expressed greater dissatisfaction with their treatment, and had less documented care. I have several concerns about the validity of this retrospective case-control study.

First, MRSA colonization or infection had been diagnosed among the isolated cases but not in the control group. Receiving this diagnosis during the hospital stay could also have negatively affected patients' or families' satisfaction independently of the isolation procedure.

Second, examination of baseline characteristics revealed that cases and controls were not "remarkably similar," as the authors stated. For example, more hospitalized patients were found among the cases, as compared with the controls. By increasing the need for assistance, this baseline difference may increase the risk of fall,² independently of the isolation procedure. The same could be said with diabetes (more prevalent . . . [Full Text of this Article]

Jean-Jacques Parienti, MD, DTM&H

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