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Anacin molecular weight Our 8 cases represent an emerging and challenging health care concern that merits investigation. First, with regard to possible prevention, options include screening health care workers as potential carriers, as well as the routine implementation of proper aseptic techniques. Suh et al6 used ribotyping to study the infection rates and route of infection in patients with MRSA who had undergone middle ear surgery. They found that there were identifiable health care workers who were carriers of MRSA. Once carriers were treated and widespread information regarding MRSA infection had been disseminated, with routine precautions implemented, the MRSA infection rate decreased from 11.9% to 7.7%. 6 Given the extremely low incidence of MRSA otorrhea after tympanostomy tube placement seen at CHMCC, screening for carriers and subsequent treatment would appear unwarranted. Routine hand washing and the use of gloves, however, are time-honored and sensible practices. With regard to isolation precautions, at CHMCC both the Department of Infectious Diseases and the responsible physician are notified of a positive MRSA culture result. There is a standard protocol at CHMCC for children with positive MRSA cultures as was followed and described earlier ; . Surveillance cultures are obtained from the anterior nares, axilla, and perirectal area for documentation of carrier status. Children who are inpatients are placed in isolation units, where gowns, gloves, and masks are worn by health care workers. Noncritical medical equipment, such as stethoscopes, blood pressure cuffs, and thermometers, is left in the room. The children themselves are asked not to leave the isolation unit. Family and friends enter and leave as they need to; they are instructed about strict hand washing, and gowns, gloves, and masks are made available, although they are not required. Once a child leaves the hospital, environmental services sanitizes the room thoroughly. The issue arises as to what happens to these children when they leave the hospital. As far as infectious diseases protocol at CHMCC is concerned, the patients are considered MRSA positive until 3 sets of either surveillance cultures obtained from the nares, axilla, and perirectal area ; or cultures from the original site of infection eg, blood or cerebrospinal fluid ; are reported as negative for MRSA. Cultures are obtained a minimum of 7 days apart. Until that point, the patients who are MRSA positive are placed back in isolation if they return as inpatients. However, when they leave the hospital, they go back to school or day care and resume their normal activities. The rationale for this rests in the theory that an otherwise healthy child who is exposed to MRSA will shed the organisms quickly, whereas a sick child in a hospital who is continually exposed to nosocomial MRSA will not shed the organisms and is more likely to become infected. 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