The prevalence of drug resistant bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) continues to increase nationwide. Infection control is a regional problem, particularly in urban settings, requiring a coordinated effort. To enable coordinated infection control efforts, we created a citywide electronic notification system to prospectively track and share information regarding all known patients with MRSA. We currently track almost 17,000 patients with a history of MRSA infection or colonization across the Indianapolis region. Since May 2007, we have delivered 2698 admission alerts on patients with a history of MRSA, one-fifth of which (19%) were based on data from another institution. Our system delivers alerts to 20 infection control providers (ICPs) spanning 16 hospital in five different systems across Indianapolis. Electronic coordination of regional infection control information appears to be a critical step to reduce infection rates across an urban population.