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. Author manuscript; available in PMC: 2020 Apr 1.
Published in final edited form as: Nat Rev Microbiol. 2019 Apr;17(4):203–218. doi: 10.1038/s41579-018-0147-4

Table 3 |.

impact of screening and decolonization on the development of methicillin-resistant Staphylococcus aureus infections

Study design Study setting Screening intervention Decolonization Study outcomes impact on study outcomes Refs
Retrospective cohort single centre, n = 6,864 Cardiac surgery ICU (United States)

  • Sites: nares

  • Timing: pre-admission

  • Test: PCR

 USC, TD MU, CH, OTa MRSA SSI Reduced colonization 109
Cluster-randomized trial multicentre, n = 74,256b ICU (United States)

  • Site: nares

  • Timing: variablec

  • Test: culture

 USC, TI, UD, TD MU, CH ICU-attributable MRSA BSI No effect 111
Cluster-randomized crossover trial multicentre, n = 7,735 ICU and bone marrow transplant unit (United States) – UD CH Hospital-acquired MRSA BSI No effect 112
Quasi-experimental pre and post multicentre, n = not available Veteran Affairs
acute healthcare facilities (United States)

  • Site: nares

  • Timing: at admission

  • Test: culture or PCR

 USC, TI OTd Health-care-associated MRSA infections Reduced colonization 106
Quasi-experimental pre and post multicentre, n = 5,043 ICU (United
States)		 – UD CH MRSA BSI No effect 190
Retrospective cohort multicentre, n = 933 Hospital (United
States)

  • Site: nares

  • Timing: at admission

  • Test: culture and PCR

 USC, TD MU, CH MRSA infection No effect 107
Prospective interventional cohort single centre, n = 21,754 Surgery (United States)

  • Sites: nares, perineum

  • Timing: pre-admission or at admission

  • Test: PCR

 USC, TI, TD MU, CH, OTa,e Health-care-associated MRSA infection and MRSA SSI No effect 108
Observational cohort study multicentre, n = 153,340 Hospital (United States)

  • Site: nares

  • Timing: at admission

  • Test: PCR

 USC, TI, TD MU, CH Health-care-associated MRSA infection and MRSA BSI Reduced colonization 191
Observational cohort study single centre, n = 1,462 Cardiac surgery (United Kingdom)

  • Site: nares

  • Timing: at admission

  • Test: PCR

 USC, TD MU, OTa,f MRSA SSI Reduced colonization 110

–, not tested or studied; BSI, bloodstream infection; CH, chlorhexidine; ICU, intensive care unit; MRSA, methicillin-resistant Staphylococcus aureus; MU, mupirocin; OT, other; SSI, surgical-site infection; TD, targeted decolonization; TI, targeted isolation; UD, universal decolonization; USC, universal screening.

a

Adjustment in perioperative antibiotic prophylaxis.

b

Three-group study: group 1 (USC and TI); group 2 (USC, TI and TD); group 3 (UD).

c

Bilateral nares screening on admission for groups 1 and 2 only.

d

Hand hygiene and change in institutional culture.

e

Computerized MRSA alert system.

f

Topical triclosan for 5 days.