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August 6, 2008

Universal Screening for Methicillin-Resistant Staphylococcus aureus by Hospitals—Reply

JAMA. 2008;300(5):503-506. doi:10.1001/jama.300.5.505

In Reply: While Drs Jarvis and Muto describe the MRSA screening intervention as “selective and incomplete,” the study by Harbarth et al1 was in fact a crossover design in which screening on the intervention wards was as close to universal as can be reasonably achieved (94% of all admissions screened). The presence of geographically distinct wards that were used as contemporaneous controls strengthens rather than weakens the study. By contrast, the study by Robicsek et al2 to which Jarvis and Muto refer lacked a control group and used multiple simultaneous interventions, flaws that are common to other studies that are cited in support of active surveillance and contact isolation.3,4