Table 1. Recommendations to Prevent MRSA (cont'd)
Additional Approaches: can be considered for use in locations and/
or hospital patient populations when MRSA is not controlled after
implementation of essential practices
Active Surveillance Testing (AST)
1. Implement a MRSA AST program for select patient populations as part of a
multifaceted strategy to control and prevent MRSA. (M)
Note: Specific populations may have different evidence ratings.
2. Active surveillance for MRSA in conjunction with decolonization can be
performed in targeted populations prior to surgery to prevent post-surgical
MRSA infection. (M)
3. Active surveillance with contact precautions is inferior to universal
decolonization for reduction of MRSA clinical isolates in adult intensive
care units (ICUs). (H)
4. Hospital-wide active surveillance for MRSA can be used in conjunction
with contact precautions to reduce the incidence of MRSA infection. (M)
5. Active surveillance can be performed in the setting of a MRSA outbreak
or evidence of ongoing transmission of MRSA within a unit as part of a
multifaceted strateg y to halt transmission. (M)
Screen HCP for MRSA infection or colonization
1. Screen HCP for MRSA infection or colonization if they are
epidemiologically linked to a cluster of MRSA infections. (L)
MRSA decolonization therapy
1. Use universal decolonization (daily chlorhexidine [CHG] bathing plus
5 days of nasal decolonization) for all patients in adult ICUs to reduce
endemic MRSA clinical cultures. (H)
2. Perform preoperative nares screening with targeted use of CHG and nasal
decolonization in MRSA carriers to reduce MRSA surgical site infection
(SSI), in surgical procedures involving implantation of hardware. (M)
3. Screen for MRSA and provide targeted decolonization with CHG bathing
and nasal decolonization to MRSA carriers in surgical units to reduce
postoperative MRSA inpatient infections. (M)
4. Provide CHG bathing plus nasal decolonization to known MRSA carriers
outside the ICU with medical devices, specifically central lines, midline
catheters, and lumbar drains, to reduce MRSA clinical cultures. (M)
