Download M55-R: Surveillance for Methicillin-Resistant Staphylococcus aureus

February 2010
M55-R
SA
M
PL
E
Surveillance for Methicillin-Resistant
Staphylococcus aureus: Principles, Practices,
and Challenges; A Report
This document was developed to provide infection preventionists
(infection control practitioners), infectious disease specialists, and
microbiologists with the latest information regarding the development
and implementation of a successful MRSA surveillance program.
A CLSI report for global application.
Clinical and Laboratory Standards Institute
Setting the standard for quality in clinical laboratory testing around the world.
The Clinical and Laboratory Standards Institute (CLSI) is a not-for-profit membership organization that brings
together the varied perspectives and expertise of the worldwide laboratory community for the advancement of
a common cause: to foster excellence in laboratory medicine by developing and implementing clinical laboratory
standards and guidelines that help laboratories fulfill their responsibilities with efficiency, effectiveness, and
global applicability.
Consensus Process
E
Consensus—the substantial agreement by materially affected, competent, and interested parties—is core to the
development of all CLSI documents. It does not always connote unanimous agreement, but does mean that the
participants in the development of a consensus document have considered and resolved all relevant objections
and accept the resulting agreement.
Commenting on Documents
PL
CLSI documents undergo periodic evaluation and modification to keep pace with advancements in technologies,
procedures, methods, and protocols affecting the laboratory or health care.
CLSI’s consensus process depends on experts who volunteer to serve as contributing authors and/or as
participants in the reviewing and commenting process. At the end of each comment period, the committee that
developed the document is obligated to review all comments, respond in writing to all substantive comments,
and revise the draft document as appropriate.
Appeals Process
M
Comments on published CLSI documents are equally essential, and may be submitted by anyone, at any time, on
any document. All comments are addressed according to the consensus process by a committee of experts.
SA
If it is believed that an objection has not been adequately addressed, the process for appeals is documented in
the CLSI Standards Development Policies and Process document.
All comments and responses submitted on draft and published documents are retained on file at CLSI and are
available upon request.
Get Involved—Volunteer!
Do you use CLSI documents in your workplace? Do you see room for improvement? Would you like to get
involved in the revision process? Or maybe you see a need to develop a new document for an emerging
technology? CLSI wants to hear from you. We are always looking for volunteers. By donating your time and
talents to improve the standards that affect your own work, you will play an active role in improving public
health across the globe.
For further information on committee participation or to submit comments, contact CLSI.
Clinical and Laboratory Standards Institute
950 West Valley Road, Suite 2500
Wayne, PA 19087 USA
P: 610.688.0100
F: 610.688.0700
www.clsi.org
[email protected]
M55-R
Vol. 30 No. 5
Formerly X07-R
Vol. 30 No. 5
ISBN 1-56238-719-7
ISSN 0273-3099
Surveillance for Methicillin-Resistant Staphylococcus aureus:
Principles, Practices, and Challenges; A Report
Volume 30 Number 5
Abstract
E
Michele M. Schoonmaker, PhD
Jacques Schrenzel, MD
Douglas J. Shedden
Patricia A. Somsel, DrPH
David L. Tison, PhD, D(ABMM)
Karine Truchon, MSc
Henri Verbrugh, MD, PhD
Stephen G. Weber, MD, MS
J. Scott Weese, DVM, DVSc
Donna Wolk, PhD, D(ABMM)
PL
Cassandra Salgado, MD, MS
Fred C. Tenover, PhD, D(ABMM)
Robert D. Arbeit, MD
Karen Carroll, MD
Phyllis Della Latta, PhD, MSc, D(ABMM)
Patrice Francois, PhD
Tobi B. Karchmer, MD, MS
Lisa Louie, MLT, ART
Frederick S. Nolte, PhD
Lance R. Peterson, MD
SA
M
Methicillin-resistant Staphylococcus aureus (MRSA) infections continue to be significant causes of morbidity and mortality
worldwide in both health care and community settings. One strategy to reduce the transmission, particularly of MRSA, in health
care settings is to conduct active surveillance of patients admitted to hospitals or other health care facilities for colonization using
culture- or molecule-based identification methods. Because colonized patients serve as a reservoir of infection both for
themselves and other patients, placing colonized patients in contact isolation with barrier precautions can reduce the spread of
MRSA. Additional steps to decolonize the patient using mupirocin and chlorhexidine baths can further reduce transmission. CLSI
document M55-R—Surveillance for Methicillin-Resistant Staphylococcus aureus: Principles, Practices, and Challenges; A
Report was developed to provide microbiologists, infection preventionists (infection control practitioners), and infectious disease
specialists with both laboratory and infection control information regarding the development and implementation of a successful
MRSA surveillance program. Information on surveillance of health care workers and animals for MRSA is also provided.
Clinical and Laboratory Standards Institute (CLSI). Surveillance for Methicillin-Resistant Staphylococcus aureus: Principles,
Practices, and Challenges; A Report. CLSI document M55-R (ISBN 1-56238-719-7). Clinical and Laboratory Standards
Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2010.
The Clinical and Laboratory Standards Institute consensus process, which is the mechanism for moving a document through
two or more levels of review by the health care community, is an ongoing process. Users should expect revised editions of any
given document. Because rapid changes in technology may affect the procedures, methods, and protocols in a standard or
guideline, users should replace outdated editions with the current editions of CLSI documents. Current editions are listed in
the CLSI catalog and posted on our website at www.clsi.org. If your organization is not a member and would like to become
one, and to request a copy of the catalog, contact us at: Telephone: 610.688.0100; Fax: 610.688.0700; E-Mail:
[email protected]; Website: www.clsi.org.
Number 5
M55-R
Copyright ©2010 Clinical and Laboratory Standards Institute. Except as stated below, any reproduction of
content from a CLSI copyrighted standard, guideline, companion product, or other material requires
express written consent from CLSI. All rights reserved. Interested parties may send permission requests to
[email protected].
E
CLSI hereby grants permission to each individual member or purchaser to make a single reproduction of
this publication for use in its laboratory procedure manual at a single site. To request permission to use
this publication in any other manner, e-mail [email protected].
Suggested Citation
PL
CLSI. Surveillance for Methicillin-Resistant Staphylococcus aureus: Principles, Practices, and
Challenges; A Report. CLSI document M55-R. Wayne, PA: Clinical and Laboratory Standards Institute;
2010.
Report
SA
Published
February 2010
M
Approved by Board of Directors
February 2010
ISBN 1-56238-719-7
ISSN 0273-3099
ii
Volume 30
M55-R
Contents
Abstract ....................................................................................................................................................i
Committee Membership........................................................................................................................ iii
Foreword ................................................................................................................................................ix
1
Scope.......................................................................................................................................... 1
2
Introduction ................................................................................................................................ 1
2.1
Rationale ....................................................................................................................... 1
Standard Precautions .................................................................................................................. 2
4
Terminology............................................................................................................................... 2
Characteristics of Methicillin-Resistant Staphylococcus aureus ............................................... 6
5.1
6
Laboratory Methods for Detecting Methicillin-Resistant Staphylococcus aureus in
Samples ...................................................................................................................................... 8
6.1
6.2
6.3
7
General Characteristics ................................................................................................. 6
Specimen Collection ..................................................................................................... 8
Anatomical Sites to Sample .......................................................................................... 9
Culture Methods for Methicillin-Resistant Staphylococcus aureus............................ 11
M
5
A Note on Terminology ................................................................................................ 2
Definitions .................................................................................................................... 3
Abbreviations and Acronyms ....................................................................................... 6
PL
4.1
4.2
4.3
E
3
Molecular Detection Methods.................................................................................................. 14
Assay Selection Criteria.............................................................................................. 14
Molecular Aspects of Methicillin Resistance ............................................................. 14
Target Genes and Strategies Allowing for Identification of Methicillin-Resistant
Staphylococcus aureus ................................................................................................ 16
Assays Relying on the orfX-SCCmec Junction ........................................................... 17
Limitations of Current Molecular Assays ................................................................... 19
Role of Culture for Additional Testing ....................................................................... 19
Strain Typing of Methicillin-Resistant Staphylococcus aureus Isolates..................... 20
SA
7.1
7.2
7.3
7.4
7.5
7.6
7.7
8
Factors to Consider Before Implementation of a Methicillin-Resistant Staphylococcus
aureus Surveillance Program in a Facility ............................................................................... 24
8.1
8.2
8.3
8.4
8.5
9
Methicillin-Resistant Staphylococcus aureus Prevalence........................................... 24
Screening of Patients .................................................................................................. 26
Screening Health Care Workers.................................................................................. 33
Screening in Other Settings ........................................................................................ 34
When to Consider Sampling ....................................................................................... 36
Screening Companion Animals for Methicillin-Resistant Staphylococcus aureus ................. 37
9.1
9.2
9.3
9.4
9.5
Screening Pets ............................................................................................................. 37
Screening Horses ........................................................................................................ 38
Screening Methodology: Sampling Sites .................................................................... 39
Screening Methodology: Laboratory Testing ............................................................. 39
Management of Colonized Animals ........................................................................... 39
vii
Number 5
M55-R
Contents (Continued)
References ............................................................................................................................................. 40
Appendix. Methods ............................................................................................................................... 50
The Quality Management System Approach ........................................................................................ 52
SA
M
PL
E
Related CLSI Reference Materials ....................................................................................................... 54
viii
Volume 30
M55-R
Foreword
M
Key Words
PL
E
Considerable attention has been given to the subject of methicillin-resistant Staphylococcus aureus
(MRSA) colonization and infection in the press, particularly since the emergence of communityassociated MRSA infections. The deaths of otherwise healthy college athletes resulting from MRSA
septicemia, the deaths of school-aged children following MRSA wound infections, and the morbidity
caused by outbreaks of MRSA infection among professional sports teams are certainly newsworthy. Yet,
underlying these news events of community disease is the more troubling reality of the transmission of
MRSA and the ensuing morbidity and mortality among hospitalized patients around the world. To be
sure, MRSA is only one of several health care–associated pathogens that deserve attention. Yet, that fact
does not diminish the impact that this organism is having on health care around the world. The cost of
health care–associated MRSA infections in the United States alone is astronomical. Thus, infection
preventionists (formerly called infection control practitioners), infectious disease specialists, and clinical
microbiologists are pursuing a variety of strategies aimed at reducing health care–associated MRSA (and
methicillin-susceptible Staphylococcus aureus [MSSA]) infections. One strategy that is being
implemented in multiple centers is active surveillance of patients admitted to hospitals or other health
care facilities for MRSA colonization in an effort to identify patients who may serve as a reservoir of
infection for other patients. In some cases in the United States, state legislative authorities have mandated
such surveillance efforts, whereas other health care systems have initiated such studies prospectively. It
has become increasingly clear that there is a dearth of information regarding the “how” of conducting
active surveillance (ie, which patient populations to screen, optimal laboratory methods to use, and
metrics to assess the effectiveness of the program), more than the “why” of such efforts (ie, reducing
infection rates and cross-transmission of MRSA among patients). Therefore, this CLSI document was
developed to provide information to those institutions that, for whatever reason, have decided to initiate
an MRSA surveillance program.
SA
Colonization, cross-transmission, epidemiology, infection control, infection prevention, isolation
precautions, methicillin resistance, mupirocin, nucleic acid amplification testing, rapid testing,
staphylococci, surveillance
ix
Volume 30
M55-R
Surveillance for Methicillin-Resistant Staphylococcus aureus: Principles,
Practices, and Challenges; A Report
1
Scope
2.1
Introduction
Rationale
PL
2
E
This report describes a framework for establishing a surveillance program to detect methicillin-resistant
Staphylococcus aureus (MRSA) colonization and infection in patients, health care workers (HCWs), and
animals. It reviews the characteristics of MRSA isolates; both culture-based and molecular methods for
detecting MRSA isolates in clinical samples, surveillance cultures, and environmental reservoirs; strain
typing methods; epidemiological issues surrounding the spread of MRSA isolates in health care and other
settings; interventions to halt transmission of MRSA; MRSA issues associated with animals; and public
health aspects of MRSA transmission. Evidence-based information is presented to assist laboratories that
are charged with the task of setting up MRSA surveillance programs for their institution or community.
Additional information targeted to infection preventionists (infection control practitioners), clinicians, and
public health officials to aid them in implementing a surveillance program for MRSA is also provided.
M
According to reports from the US Centers for Disease Control and Prevention (CDC) and others, the
incidence of infections caused by MRSA has increased dramatically over the last decade, despite
widespread measures aimed at preventing spread.1-5 To further complicate matters, the epidemiology of
this potentially lethal pathogen has also evolved, with an ever-increasing number of MRSA cases arising
among individuals in community settings without prior contact with the health care system.6 These
community-associated MRSA strains (CA-MRSA), and the more familiar health care–associated MRSA
strains (HA-MRSA), have, in some cases, been associated with more severe clinical outcomes and a
substantially increased cost of care for affected patients.7
SA
In response to these changes, many clinicians, health care administrators, and those working in infection
control and prevention are taking a more aggressive approach toward preventing the spread of MRSA in
their health care centers. Yet, a number of patient advocacy groups and public figures have been critical
of what they perceive as too little effort to reduce the spread of MRSA. This has led to a series of
unfavorable editorial commentaries in the popular press and the enactment of legislative initiatives aimed
at promoting additional awareness and control of MRSA.8 Increasingly, a move toward “zero tolerance”
of MRSA has been promoted in some regions in which the goal of prevention efforts is not simply to
reduce the overall burden of infections caused by MRSA but actually to completely eliminate MRSA
from individual units, patient care areas, hospitals, regions, and even entire countries.
For the most part, the tools historically available to prevent the dissemination of MRSA and other
multidrug-resistant organisms (MDROs) have emphasized the management of patients identified as
colonized or infected with these organisms in the course of routine clinical care. In this approach,
standard infection control and prevention methods, including hand hygiene and environmental cleaning,
are applied uniformly for all patients. In addition, more intensive measures, such as the implementation of
isolation precautions (the use of gowns and gloves when in contact with the patient or surrounding
environment), are put in place once a patient is identified as colonized or infected with MRSA.9
Because of the renewed focus on MRSA control, even more aggressive measures have been proposed.
Specifically, patients in many centers are being screened through culture and more rapid molecular
diagnostic methods to identify those who are colonized with MRSA even in the absence of signs or
©
Clinical and Laboratory Standards Institute. All rights reserved.
1
Number 5
M55-R
symptoms of infection. Such active surveillance strategies have been advocated as a key component of
MRSA control by the Institute for Healthcare Improvement and the Society for Healthcare Epidemiology
of America (SHEA).10 Such guidance has been influential: the US Veterans Administration has
implemented a systemwide program in which patients are screened for MRSA colonization at all acute
care facilities and laws mandating surveillance have been enacted in multiple US jurisdictions. More
intensive surveillance to detect MRSA has not been limited to hospital inpatients. HCWs have been
targeted for surveillance in some centers, and environmental sampling has become an increasingly
common practice in health care facilities, particularly in those outside the United States. Moving out of
the health care setting, there has been increasing appreciation of the potential for MRSA transmission in
nonclinical settings, such as long-term acute care hospitals, nursing homes, and other long-term care
facilities. Some advocacy groups have called for surveillance of the home environment, household
contacts, and even companion and farm animals for evidence of MRSA contamination, colonization, or
infection, respectively.
Standard Precautions
M
3
PL
E
MRSA infections add considerably to both the morbidity and mortality rates observed in a variety of
patient populations and to the cost of health care in many countries.11-14 The spread of MRSA in
community settings has complicated the problem of control.15 Efforts to interrupt transmission of MRSA
strains, particularly in health care settings, require the identification of patients who are either infected or
colonized with MRSA.16,17 Several laboratory methods, including traditional culture methods and nucleic
acid amplification methods, are available to identify MRSA carriers. Once carriers are identified, several
different infection control strategies may be used to interrupt the transmission of MRSA from patient to
patient, from patient to HCW, and from HCW to patient. Preventing the spread of MRSA among patients
and HCWs, or in community settings, to family members and other contacts, such as sports participants,
is critical to the overall control of MRSA infections worldwide. This document reviews the laboratory and
infection control issues surrounding the surveillance for MRSA.
SA
Because it is often impossible to know what isolates or specimens might be infectious, all patient and
laboratory specimens are treated as infectious and handled according to “standard precautions.” Standard
precautions are guidelines that combine the major features of “universal precautions and body substance
isolation” practices. Standard precautions cover the transmission of all known infectious agents and thus
are more comprehensive than universal precautions, which are intended to apply only to transmission of
blood-borne pathogens. Standard and universal precaution guidelines are available from the CDC.18 For
specific precautions for preventing the laboratory transmission of all known infectious agents from
laboratory instruments and materials and for recommendations for the management of exposure to all
known infectious disease, refer to CLSI document M29.19
4
4.1
Terminology
A Note on Terminology
CLSI, as a global leader in standardization, is firmly committed to achieving global harmonization
wherever possible. Harmonization is a process of recognizing, understanding, and explaining differences
while taking steps to achieve worldwide uniformity. CLSI recognizes that medical conventions in the
global metrological community have evolved differently in the United States, Europe, and elsewhere; that
these differences are reflected in CLSI, International Organization for Standardization (ISO), and
European Committee for Standardization (CEN) documents; and that legally required use of terms,
regional usage, and different consensus timelines are all important considerations in the harmonization
process. In light of this, CLSI’s consensus process for development and revision of standards and
guidelines focuses on harmonization of terms to facilitate the global application of standards and
guidelines.
2
©
Clinical and Laboratory Standards Institute. All rights reserved.
Number 5
M55-R
The Quality Management System Approach
Clinical and Laboratory Standards Institute (CLSI) subscribes to a quality management system approach in the
development of standards and guidelines, which facilitates project management; defines a document structure via a
template; and provides a process to identify needed documents. The approach is based on the model presented in
CLSI document HS01—A Quality Management System Model for Health Care. The quality management system
approach applies a core set of “quality system essentials” (QSEs), basic to any organization, to all operations in any
health care service’s path of workflow (ie, operational aspects that define how a particular product or service is
provided). The QSEs provide the framework for delivery of any type of product or service, serving as a manager’s
guide. The QSEs are as follows:
Equipment
Purchasing and Inventory
Process Control
Information Management
Occurrence Management
Assessments—External
and Internal
Process Improvement
Customer Service
Facilities and Safety
E
Documents and Records
Organization
Personnel
Facilities and
Safety
Process
Control
Customer
Service
Process
Improvement
Assessments–
External and
Internal
Occurrence
Management
Information
Management
Purchasing
and Inventory
Equipment
Personnel
PL
M07
Organization
Documents
and Records
M55-R addresses the QSEs indicated by an “X.” For a description of the other documents listed in the grid, please
refer to the Related CLSI Reference Materials section on the following page.
X
M02
M07
M22
M
M31
M40
MM01
MM03
MM10
MM11
MM13
MM17
M29
MM03
SA
Adapted from CLSI document HS01—A Quality Management System Model for Health Care.
52
©
Clinical and Laboratory Standards Institute. All rights reserved.
Volume 30
M55-R
Path of Workflow
A path of workflow is the description of the necessary steps to deliver the particular product or service that the
organization or entity provides. For example, CLSI document GP26Application of a Quality Management System
Model for Laboratory Services defines a clinical laboratory path of workflow, which consists of three sequential
processes: preexamination, examination, and postexamination. All clinical laboratories follow these processes to
deliver the laboratory’s services, namely quality laboratory information.
M55-R addresses the clinical laboratory path of workflow steps indicated by an “X.” For a description of the other
documents listed in the grid, please refer to the Related CLSI Reference Materials section on the following page.
MM01
MM01
MM03
M40
MM01
MM03
MM01
MM03
MM13
MM13
MM13
MM01
MM03
MM10
Sample
management
E
Results reporting
and archiving
Interpretation
Postexamination
M02
M07
M31
M02
M07
M31
M02
M07
M31
PL
M02
M07
M31
Results review
and follow-up
Examination
Examination
Sample
receipt/processing
Sample transport
Sample collection
Examination
ordering
Preexamination
MM01
MM03
MM10
MM01
MM10
MM01
MM03
MM10
MM01
SA
M
Adapted from CLSI document HS01—A Quality Management System Model for Health Care.
©
Clinical and Laboratory Standards Institute. All rights reserved.
53
Number 5
M55-R
Related CLSI Reference Materials
Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard—Tenth
Edition (2009). This document contains the current Clinical and Laboratory Standards Instituterecommended methods for disk susceptibility testing, criteria for quality control testing, and updated
tables for interpretive zone diameters.
M07-A8
Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically;
Approved Standard—Eighth Edition (2009). This document addresses reference methods for the
determination of minimal inhibitory concentrations (MICs) of aerobic bacteria by broth macrodilution,
broth microdilution, and agar dilution.
M22-A3
Quality Control for Commercially Prepared Microbiological Culture Media; Approved
Standard—Third Edition (2004). This document contains quality assurance procedures for
manufacturers and users of prepared, ready-to-use microbiological culture media.
M29-A3
Protection of Laboratory Workers From Occupationally Acquired Infections; Approved
Guideline—Third Edition (2005). Based on US regulations, this document provides guidance on the
risk of transmission of infectious agents by aerosols, droplets, blood, and body substances in a laboratory
setting; specific precautions for preventing the laboratory transmission of microbial infection from
laboratory instruments and materials; and recommendations for the management of exposure to
infectious agents.
M31-A3
Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria
Isolated From Animals; Approved Standard—Third Edition (2008). This document provides the
currently recommended techniques for antimicrobial agent disk and dilution susceptibility testing,
criteria for quality control testing, and interpretive criteria for veterinary use.
M40-A
Quality Control of Microbiological Transport Systems; Approved Standard (2003). This document
provides criteria to assist manufacturers and end users of transport devices in providing and selecting
dependable products for the transport of microbiological clinical specimens.
MM01-A2
Molecular Diagnostic Methods for Genetic Diseases; Approved Guideline—Second Edition (2006).
This document provides guidance for the use of molecular biological techniques for clinical detection of
heritable mutations associated with genetic disease.
MM03-A2
Molecular Diagnostic Methods for Infectious Diseases; Approved Guideline—Second Edition
(2006). This guideline addresses topics relating to clinical applications, amplified and nonamplified
nucleic acid methods, selection and qualification of nucleic acid sequences, establishment and evaluation
of test performance characteristics, inhibitors, and interfering substances, controlling false-positive
reactions, reporting and interpretation of results, quality assurance, regulatory issues, and
recommendations for manufacturers and clinical laboratories.
SA
M
PL
E
M02-A10
MM10-A
Genotyping for Infectious Diseases: Identification and Characterization; Approved Guideline
(2006). This guideline describes currently used analytical approaches and methodologies applied to
identify the clinically important genetic characteristics responsible for disease manifestation, outcome,
and response to therapy in the infectious disease setting. It also provides guidance on the criteria to be
considered for design, validation, and determination of clinical utility of such testing.
MM11-A
Molecular Methods for Bacterial Strain Typing; Approved Guideline (2007). This guideline
examines the biology behind molecular strain typing and the process of characterizing and validating
typing systems. The prevalent methods are described with particular attention to pulsed-field gel
electrophoresis (PFGE) and multilocus sequence typing (MLST).

CLSI documents are continually reviewed and revised through the CLSI consensus process; therefore, readers should refer to
the most current editions.
54
©
Clinical and Laboratory Standards Institute. All rights reserved.
Volume 30
M55-R
Related CLSI Reference Materials (Continued)
Collection, Transport, Preparation, and Storage of Specimens for Molecular Methods; Approved
Guideline (2005). This document provides guidance related to proper and safe biological specimen
collection and nucleic acid isolation and purification. These topics include methods of collection,
recommended storage and transport conditions, and available nucleic acid purification technologies for
each specimen/nucleic acid type.
MM17-A
Verification and Validation of Multiplex Nucleic Acid Assays; Approved Guideline (2008). This
guideline provides recommendations for analytic verification and validation of multiplex assays, as well
as a review of different types of biologic and synthetic reference materials.
SA
M
PL
E
MM13-A
©
Clinical and Laboratory Standards Institute. All rights reserved.
55
PL
As we continue to set the global standard
for quality in laboratory testing, we’re
adding initiatives to bring even more
value to our members and customers.
E
Explore the Latest
Offerings from CLSI!
Shop Our Online
Products
Including eM100, the interactive
searchable database for drug
selection, interpretation, and
quality control procedures within
M100-S23.
The value of a CLSI membership begins with significant discounts—
up to 70% off—on our trusted clinical laboratory standards and
guidelines, but the benefits extend far beyond cost savings:
Benefits to Industry
Contribute to Standards that Streamline Product Review Processes
Access a Deep Network of Customers, Peers, Regulators, and Industry Leaders
Raise Your Organization’s Profile in the Clinical Laboratory Community
Benefits to Laboratories
Directly Influence CLSI Standards to Ensure they are Practical and Achievable
Access Globally Recognized Standards for Accreditation Preparedness
Help Drive Higher Levels of Patient Care Quality All Over the World
Benefits to Government
Aid in the Development of Consensus Standards that can Impact Legislation
Connect with Over 2,000 Influential Organizations Across the Global Laboratory Community
Help Laboratories Provide Safe and Effective Care of the Highest Quality and Value
www.clsi.org/membership
About CLSI
M
The Clinical and Laboratory Standards Institute
Visit the CLSI U
Education Center
SA
Where we provide the convenient
and cost-effective education
resources that laboratories
need to put CLSI standards into
practice, including webinars,
workshops, and more.
Shop Our Online
Products
e CLIPSE
TM
Ultimate Access
Including eCLIPSE Ultimate
Access™, CLSI’s cloud-based,
online portal that makes it easy
to access our standards and
guidelines—anytime, anywhere.
Introducing CLSI’s
New Membership
Opportunities
(CLSI) is a not-for-profit membership organization
that brings together the varied perspectives and
expertise of the worldwide laboratory community
for the advancement of a common cause: to foster
excellence in laboratory medicine by developing
and implementing clinical standards and guidelines
950 West Valley Road, Suite 2500, Wayne, PA 19087
P: 610.688.0100 Toll Free (US): 877.447.1888
F: 610.688.0700 E: [email protected]
that help laboratories fulfill their responsibilities
with efficiency, effectiveness, and global applicability.
More Options. More Benefits. More Value.
Join in Our Mission to Improve
Health Care Outcomes
We’ve made it even easier for your organization to take
full advantage of the standards resources and networking
opportunities available through membership with CLSI.
Find Membership
Opportunities
See the options that make it even
easier for your organization to take
full advantage of CLSI benefits and
our unique membership value.
For more information, visit
www.clsi.org today.
E
PL
M
SA
950 West Valley Road, Suite 2500, Wayne, PA 19087 USA
P: 610.688.0100 Toll Free (US): 877.447.1888 F: 610.688.0700
E: [email protected] www.clsi.org
ISBN 1-56238-719-7