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The aim of the study was to compare the epidemiology of MRSA infection in patients who underwent colorectal surgery in two tertiary care centers in Switzerland and in the USA.MRSA infections wereprospectively studied in two hospitals, one in Switzerland and one in Chicago (CHI). Patients were screened for MRSA colonization, and standard infection control measures were implemented for MRSA carriers.Overall, 1373 patients (CHI = 831, SWI = 542) were screened. Eighty-one patients (5.89%) werepreoperatively known MRSA carriers. Swiss patients (N = 13) were more likely than US patients (N = 4) to develop MRSA SSIs (2.39% vs 0.48%, P = 0.002). However, in the Swiss hospital, there were more emergencyprocedures (42% vs 20%); the class of contamination was higher (3.1 vs 22); cancer was moreprevalent (60% vs 34%); and the postoperative hospital stay was longer (15.9 ± 16.3 vs 8.3 ± 7.1, P < 0.001).The overall incidence of MRSA infection after colorectal surgery is low (1.2%). Most (69%) of infected patients were MRSA-free on admission and became colonized during hospitalization. Prevention of MRSA infection after colorectal surgery should rely more on the application of basic surgical basicprinciples, than on vancomycin use for perioperativeprophylaxis.