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In most UK hospitals there are small numbers of single rooms available for patient isolation. This explains the very low compliance with isolation in both arms of the study (approximately 17%) meaning that the dominant intervention was early patient identification; resulting in the implementation of infection control precautions and decolonization treatment. Early notification of MRSA in the rapid arm resulted in a greater percentage of patients receiving decolonization treatment, with a higher percentage of the culture arm being discharged before the result was available and therefore receiving no decolonization treatment. Since the introduction of rapid molecular tests, other studies have been published investigating the impact of these tests on MRSA transmission and infection rates [15�C22]. The majority of these have a retrospective, time intervention study design which does not control for confounding variables. Our [http://www.selleckchem.com/products/MK-2206.html this website] study adopted a prospective cross-over design, enabling the elimination of sampling biases and ensuring, as far as possible, that there were no changes to the ward environment or practices during the study. Although the wards were not [http://www.selleckchem.com/products/pci-32765.html Ibrutinib solubility dmso] randomized, they were matched as far as possible to ensure that seasonal bias was not introduced. No wash out period was used as no operational changes were required, but this did result in a nominal delay ([http://en.wikipedia.org/wiki/TRIB1 TRIB1] these two factors resulted in a much lower detected transmission rate, 0.36 as opposed to 0.84 in our study. Elucidation of the impact of rapid screening in previous studies has been hampered by the introduction of multiple interventions, for example the introduction of rapid screening and pre-emptive isolation [19]. Re-screening patients every 4?days may well have contributed to the effectiveness of rapid testing, with new acquisitions being identified more promptly. All of the other published studies reporting the effects of rapid testing have focused on admission screening and used the availability of clinical or discharge samples as evidence of transmission. There is evidence that using either clinical samples or discharge screening to determine transmission events will result in an under reporting [23�C25].