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To the Editor: In their cohort study, Dr Harbarth and colleagues¹ concluded that "a universal, rapid MRSA admission screening strategy did not reduce nosocomial MRSA infection in a surgical department with endemic MRSA." Although they cited 2 studies reporting failed control in surgical patients, they did not consider the many epidemiologic studies that have reported success with active detection and isolation, including in surgical patients.^2-4

We believe there are problems with the design of the study by Harbarth et al. The definition of low adherence to contact precautions (absence of isolation sign, no gowns or gloves at room entry) was inadequate in that noncompliance in wearing or removing barriers could explain their negative results. The admission screening was not actually universal because it did not include patients admitted for less than 24 hours even if they were high risk for MRSA colonization; MRSA-colonized patients among this excluded group could have . . . [Full Text of this Article]

Cassandra D. Salgado, MD, MS
salgado@musc.edu
Medical University of South Carolina
Charleston

Margreet C. Vos, MD, PhD
Erasmus University Medical Center
Rotterdam, the Netherlands

Barry M. Farr, MD, MSc
University of Virginia Health System
Charlottesville

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