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To the Editor: The study by Dr Harbarth and colleagues¹ and the accompanying editorial by Drs Diekema and Climo² conclude that selective and incomplete expansion of MRSA screening may not prevent MRSA hospital-acquired infections. There are several issues that we believe require clarification.

First, the term "universal screening" for MRSA is misused and misleading. In this quasi-experimental study, 2 surgical subspecialty patient groups were screened for MRSA sequentially, not simultaneously. This is not universal screening of all hospital patients or even all surgical patients. A recent observational study using true universal MRSA screening (all patients on admission) found significantly reduced rates of MRSA hospital-acquired infections.³

Second, it is not clear whether the surgical patients screened were in wards or units that were separate from those not screened or if health care workers (particularly surgeons) moved between screened/isolated and nonscreened/nonisolated populations. Third, the current study by Harbarth et al did not . . . [Full Text of this Article]

William R. Jarvis, MD
wrjmj@aol.com
Department of Pediatric Infectious Diseases
Emory University School of Medicine
Atlanta, Georgia

Carlene Muto, MD, MS
University of Pittsburgh
Pittsburgh, Pennsylvania

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RELATED ARTICLE

Universal Screening for Methicillin-Resistant Staphylococcus aureus at Hospital Admission and Nosocomial Infection in Surgical Patients
Stephan Harbarth, Carolina Fankhauser, Jacques Schrenzel, Jan Christenson, Pascal Gervaz, Catherine Bandiera-Clerc, Gesuele Renzi, Nathalie Vernaz, Hugo Sax, and Didier Pittet
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Universal Screening for Methicillin-Resistant Staphylococcus aureus by Hospitals
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Universal Screening for Methicillin-Resistant Staphylococcus aureus by Hospitals
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Universal Screening for Methicillin-Resistant Staphylococcus aureus by Hospitals—Reply
Stephan Harbarth and Didier Pittet
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Universal Screening for Methicillin-Resistant Staphylococcus aureus by Hospitals—Reply
Daniel J. Diekema and Michael Climo
JAMA. 2008;300(5):505-506.
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