Active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) decreases the incidence of MRSA bacteremia.
OBJECTIVE
To evaluate the influence of performance of active surveillance cultures for methicillin-resistant Staphylococcus aureus (MRSA) on the incidence of nosocomial MRSA bacteremia in an endemic hospital.


METHODS
Before-after trial.


METHODS
A 700-bed hospital.


METHODS
All patients admitted to the hospital who were at high risk for MRSA bacteremia.


METHODS
Performance of surveillance cultures for detection of MRSA were recommended for all patients at high risk, and contact isolation was implemented for patients with positive results of culture. Each MRSA-positive patient received one course of eradication treatment. We compared the total number of surveillance cultures, the percentage of surveillance cultures with positive results, and the number of MRSA bacteremia cases before the intervention (from January 2002 through February 2003) after the start of the intervention (from July 2003 through October 2004).


RESULTS
The number of surveillance cultures performed increased from a mean of 272.57 cultures/month before the intervention to 865.83 cultures/month after the intervention. The percentage of surveillance cultures with positive results increased from 3.13% before to 5.22% after the intervention (P < .001). The mean number of MRSA bacteremia cases per month decreased from 3.6 cases before the intervention to 1.8 cases after the intervention (P < 0.001).


CONCLUSIONS
Active surveillance culture is important for identifying hidden reservoirs of MRSA. Contact isolation can prevent new colonization and infection and lead to a significant reduction of morbidity and healthcare costs.
Shitrit
Pnina
P
Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel.
Gottesman
Bat-Sheva
BS
Katzir
Michal
M
Kilman
Avi
A
Ben-Nissan
Yona
Y
Chowers
Michal
M
D016470:Bacteremia / Q000453:epidemiology*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000302:isolation & purification*