This figure is a pictorial description of the key components of laboratory identification of MRSA. This algorithm guides Infection Control Professionals in determining when the National Microbiology Laboratory should be notified and sent clinical isolates for laboratory testing.
Surveillance for MRSA is laboratory-based. Upon laboratory identification of MRSA from an in-patient for the first time, the ICP is to be notified. There are three levels of surveillance that will be conducted, requiring different levels of data gathering.
In order to accomplish the objectives, without placing increased demands on hospital ICPs and hospital laboratories, the 3 levels of surveillance will require different levels of data gathering:
NOTE: A patient can only be counted once, and when possible, should default to the highest level (i.e. in descending order: blood culture isolate; clinical isolate; screening isolate). Therefore, data submitted to CNISP should be updated, when possible, if an initially colonized patient subsequently develops an MRSA bacteremia, or another site of MRSA infection (noting that for calculating rates, the patient is counted only once). Although there is NO timeframe for following MRSA colonized patients to determine if they subsequently develop an infection, should the ICP become aware that an infection has occurred in a previously colonized patient, the database should be updated.