The use of active surveillance cultures in adult intensive care units to reduce methicillin-resistant Staphylococcus aureus-related morbidity, mortality, and costs: a systematic review.
Active surveillance cultures (ASCs) are universal or targeted microbiological screening cultures for patients admitted to a hospital. ASCs have been proposed to control the increasing numbers of infections due to multidrug-resistant organisms, but their efficacy and cost-effectiveness are unproven. We conducted a systematic review of the literature pertaining to the use of ASCs and control of methicillin-resistant Staphylococcus aureus (MRSA). We searched relevant journals and the PubMed Medline, Web of Science, CINAHL, and Cochrane Library databases. No randomized, controlled trials were identified. Sixteen observational studies and 4 economic analyses were reviewed. Only 2 of the observational studies had a control group. None of the studies were of good quality. Thus, we identified important gaps in the literature, including a need for a clear definition of ASCs, a clear implementation protocol, and rigorous economic evaluations. Existing evidence may favor the use of ASCs, but the evidence is of poor quality, and definitive recommendations cannot be made.
McGinigle
Katharine L
KL
School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA. kmcginig@unch.unc.edu
Gourlay
Margaret L
ML
Buchanan
Ian B
IB
D000328:Adult; D006801:Humans; D007362:Intensive Care Units; D016106:Methicillin Resistance; D009017:Morbidity; D013203:Staphylococcal Infections / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects*