Invasive Staphylococcus aureus Active Bacterial Core Surveillance (ABCs) Case Report Form

This form is used for sentinel surveillance reporting of Invasive Methicillin-resistant Staphylococcus aureus in Hennepin and Ramsey Counties from selected sites to the Minnesota Department of Health.

On this page:
IMRSA form & instructions
Frequently asked questions
Returning the completed form
Diseases to report on this form

IMRSA form & instructions

• Invasive Methicillin-Resistance Staphylococcus aureus Active Bacterial Core Surveillance Case Report Form (PDF)
  Updated 5/2018.
  • Invasive MRSA Case Report Form Instructions (PDF)
    Step-by-step instructions for filling out the Invasive MRSA Case Report Form.

Frequently asked questions

• More about sentinel surveillance reporting of Invasive Methicillin-resistant Staphylococcus aureus in Hennepin and Ramsey Counties from selected sites: Invasive Staphylococcus aureus Reporting (including MRSA and MSSA).
  
  
• If you have additional questions regarding this form, please call 651-201-5414.
  
  
• When reporting on this form, a Yellow Card is not necessary.
  

Returning the forms

• By mail (please mark the envelope "confidential") to:
  Infectious Disease Epidemiology, Prevention and Control
  625 North Robert Street
  Post Office Box 64975
  St. Paul, MN 55164-0975
• By fax to:
  1-800-233-1817

Diseases to report with this form

• Invasive Staphylococcus aureus Reporting (including MRSA and MSSA)

More about these diseases

• Methicillin-resistant Staphylococcus aureus (MRSA)