The rationale for SA and MRSA surveillance


In the US alone, SA and MRSA infections burden the healthcare system with approximately $9.5 billion and $20 billion in annual care costs, respectively. 1,2

Moreover, these staggering financial figures only capture a fraction of the burden attributed to MRSA and SA infections. Hospitalized patients endure prolonged stays and suffering, resulting in tangible and intangible costs that add to the considerable price tags associated with the increased morbidity and mortality rates due to MRSA/SA infections.

It’s well established that SA is commonly found as part of the normal flora on the skin and in the respiratory tract of 30% of the population without negative effects on the carrier.3 However, up to 93% of hospital-acquired SA infections are caused by a patient’s own colonized flora. 

Colonized patients, specifically, are at increased risk of developing surgical site infections, which lead to prolonged hospital stays, higher costs, and significantly increased risk of death. In fact, SA nasal carriers are 9 times more likely to develop a surgical site infection compared to non-carriers.4 Nasal carriage of SA is also a major risk factor for self-infection in dialysis, ICU, and burn patients.5

A surgical site infection related to undetected SA increases:6,7

  • Risk of death by 2.6 times
  • A hospital stay by 12 days
  • Care costs up to $24,890

A study published in the New England Journal of Medicine demonstrated that programs employing rapid molecular detection of SA colonization followed by targeted decolonization resulted in a 60% reduction in surgical site infections.8

To address the evolving problem of MRSA/SA, growing numbers of hospitals are partnering with microbiology labs to incorporate MRSA/SA screening and surveillance to identify and control these infections.



  1. Noskin GA, Rubin RJ, Schentag JJ, et al. Budget impact analysis of rapid screening for Staphylococcus aureus colonization among patients undergoing elective surgery in US hospitals. Infect Control Hosp Epidemiol. 2008;29(1):16-24. doi:10.1086/524327.
  2. Saadatian-Elahi M, Teyssou R, Vanhems P. Staphylococcus aureus, the major pathogen in orthopaedic and cardiac surgical site infection: a literature review. Int J Surg. 2008;6(3):238-245. doi:10.1016/j.ijsu.2007.05.001.
  3. Centers for Disease Control and Prevention. General information about MRSA in healthcare settings. http://www.cdc.gov/mrsa/healthcare/index.html. Published September 2013. Updated April 2014. Accessed April 15, 2014.
  4. Critchley, IA. Eradication of MRSA nasal colonization as a strategy for infection prevention. Drug Discov Today Ther Strateg. 2006;3(2):189-195. doi:10.1016/j.ddstr.2006.05.003.
  5. Yu VL, Goetz A, Wagener M, et al. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. N Engl J Med. 1986;315(2):91-96. doi:10.1056/NEJM198607103150204.
  6. Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36(5):592-598. doi:10.1086/367653.
  7. Anderson DJ, Kaye KS, Chen LF, et al. Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcomes study. PLoS ONE. 2009;4(12):e8305. doi:10.1371/journal.pone.0008305.
  8. Bode LGM, Kluytmans JA, Wertheim HF, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010;362(1):9-17. doi:10.1056/NEJMoa0808939.