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  • Title: Value of performing active surveillance cultures on intensive care unit discharge for detection of methicillin-resistant Staphylococcus aureus.
    Author: Furuno JP, Harris AD, Wright MO, Hartley DM, McGregor JC, Gaff HD, Hebden JN, Standiford HC, Perencevich EN.
    Journal: Infect Control Hosp Epidemiol; 2007 Jun; 28(6):666-70. PubMed ID: 17520538.
    Abstract:
    OBJECTIVE: To quantify the value of performing active surveillance cultures for detection of methicillin-resistant Staphylococcus aureus (MRSA) on intensive care unit (ICU) discharge. DESIGN: Prospective cohort study. SETTING: Medical ICU (MICU) and surgical ICU (SICU) of a tertiary care hospital. PARTICIPANTS: We analyzed data on adult patients who were admitted to the MICU or SICU between January 17, 2001, and December 31, 2004. All participants had a length of ICU stay of at least 48 hours and had surveillance cultures of anterior nares specimens performed on ICU admission and discharge. Patients who had MRSA-positive clinical cultures in the ICU were excluded. RESULTS: Of 2,918 eligible patients, 178 (6%) were colonized with MRSA on ICU admission, and 65 (2%) acquired MRSA in the ICU and were identified by results of discharge surveillance cultures. Patients with MRSA colonization confirmed by results of discharge cultures spent 853 days in non-ICU wards after ICU discharge, which represented 27% of the total number of MRSA colonization-days during hospitalization in non-ICU wards for patients discharged from the ICU. CONCLUSIONS: Surveillance cultures of nares specimens collected at ICU discharge identified a large percentage of MRSA-colonized patients who would not have been identified on the basis of results of clinical cultures or admission surveillance cultures alone. Furthermore, these patients were responsible for a large percentage of the total number of MRSA colonization-days during hospitalization in non-ICU wards for patients discharged from the ICU.
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