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Invasive Methicillin Resistant Staphylococcus aureus (MRSA) Surveillance


To perform active population-based surveillance for invasive MRSA infections in Monroe County, New York.

Goals and Objectives

  • MRSADocument the incidence and epidemiologic characteristics of invasive MRSA infections in diverse geographic areas in the United States and determine if the infection is Health Care-Associated (HA-MRSA) or Community-Associated (CA-MRSA). HA-MRSA cases are further characterized as Hospital-Onset (HO-MRSA) or Community-Onset (HACO-MRSA).
  • Determine the molecular epidemiologic patterns and microbiologic characteristics of invasive MRSA isolates.


Potential cases of invasive MRSA infections are identified by obtaining a weekly listing from microbiology laboratories serving Monroe County hospitals. For confirmed cases, a standard case report form is completed. The case report data is entered into a database and de-identified data is sent monthly to the CDC. Data on demographics, patient outcomes, types of infections and co-morbidities is extracted from chart reviews. Classification of cases as CA-MRSA and HA-MRSA is based on current criteria related to health care risk factors.

Select isolates are sent to Wadsworth Center Bacteriology Laboratory (WCBL) from two microbiology laboratories. All isolates from CA-MRSA are sent, followed by isolates from non-blood sterile sites, followed by a random sample of isolates from blood cultures. WCBL then forwards the isolates to the CDC for further characterization.


  • Epstein L, Mu Y, Belflower R, Scott J, Ray S, Dumyati G, Felsen C, Petit S, Yousey-Hindes K, Nadle J, Pasutti L, Lynfield R, Warnke L, Schaffner W, Leib K, Kallen AJ, Fridkin SK, Lessa FC. Risk Factors for Invasive Methicillin-Resistant Staphylococcus aureus Infection After Recent Discharge From an Acute-Care Hospitalization, 2011-2013. 2015 Sep 3; Epub 2015 Sep 03. Article Link
  • Klevens RM, Morrison M, Fridkin S, Reingold A, Petit S, Gershman K, Ray S, Harrison L, Lynfield R, Dumyati G, Townes J, Craig A, Tenover F.  Community-associated Methicillin-resistant Staphylococcus aureus and Healthcare Risk Factors. Emerg Infect Dis. 2006 Dec;12(12):1991-3. Article Link
  • Klevens RM, Morrison M, Nadel J, Petit S, Gershman K, Ray S, Harrison L, Lynfield R, Dumyati G, Townes J, Craig A, Zell E, Fosheim G, Carey RB, Fridkin S. Invasive Mecithillin-Resistant. Staphylococcus aureus in the United States. JAMA. 2007 Oct 17;298(15):1763-71.
    Article Link
  • Limbago L, Fosheim GE, Schoonover V, Crane CE , Nadle J, Petit S, Heltzel D, Ray SM, Harrison H, Lynfield R, Dumyati G, Townes JM, Schaffner W, Mu Y, Fridkin SK, for the Active Bacterial Core surveillance (ABCs) MRSA Investigators. Characterization of Methicillin Resistant Staphylococcus aureus Isolates Causing Invasive Disease: A Population-Based Analysis, 2005–2006. J. Clin. Microbiol, 2009 May;47(5):1344-51. Article Link
  • Kallen AJ, Mu Y, Bulens S, Reingold A, Petit S, Gershman K, Harrison LH, Lynfield R, Dumyati G, Townes JM, Schaffner W, Patel PR, Fridkin SK and the Active Bacterial Core Surveillance (ABCs) MRSA Investigators of the Emerging Infections Program. Healthcare-Associated invasive MRSA infections, 2005-2009. JAMA, 2010, 304, 6, 641-648. Article Link
  • Duffy J, Dumyati G, Bulens S, Namburi S, Gellert A, Fridkin SK, Lessa FC. Community-Onset Invasive Methicillin-resistant Staphylococcus aureus Infections Following Hospital Discharge. American Journal of Infection Control. 2013 Feb 5. Article Link