Abstract
SIR—Nijssen et al. [1] screened patients admitted to their medical intensive care unit (ICU) for Staphylococcus aureus carriage over a period of 10 weeks. This ICU has endemic levels of methicillin-resistant S. aureus (MRSA) (5 [36%] of 14 clinical isolates of S. aureus were MRSA). The authors claim that there was not a single episode of transmission of S. aureus, including MRSA and methicillin-susceptible S. aureus (MSSA), between their patients in this period. They conclude that active surveillance and isolation of patients with MRSA may not be warranted, and they caution against the introduction of such measures in guidelines. Although we appreciate the systematic daily sampling of their ICU patients, we question the validity and interpretation of their data.