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Legislative Mandates for Use of Active Surveillance Cultures to Screen for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci: Position Statement From the Joint SHEA and APIC Task Force

Published online by Cambridge University Press:  02 January 2015

Stephen G. Weber ,
Susan S. Huang ,
Shannon Oriola ,
W. Charles Huskins ,
Gary A. Noskin ,
Kathleen Harriman ,
Russell N. Olmsted ,
Marc Bonten ,
Tammy Lundstrom  and
Michael W. Climo
...Show all authors
Stephen G. Weber*
Affiliation:
Section of Infectious Diseases, University of Chicago, Chicago, Illinois
Susan S. Huang
Affiliation:
Division of Infectious Diseases and Channing Laboratory, Brigham and Women's Hospital, Boston, Massachussetts
Shannon Oriola
Affiliation:
Sharp Metropolitan Medical Campus, San Diego, California
W. Charles Huskins
Affiliation:
Mayo Clinic, Rochester, Minnesota
Gary A. Noskin
Affiliation:
Northwestern University Medical School, Chicago, Illinois
Kathleen Harriman
Affiliation:
Minnesota Department of Public Health, St. Paul, Minnesota
Russell N. Olmsted
Affiliation:
Infection Control Services, St. Joseph Mercy Health System, Ann Arbor, Michigan
Marc Bonten
Affiliation:
Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
Tammy Lundstrom
Affiliation:
Wayne State University-Detroit Medical Center, Detroit, Michigan
Michael W. Climo
Affiliation:
Virginia Commonwealth University, Richmond, Virginia
Mary-Claire Roghmann
Affiliation:
University of Maryland School of Medicine, Baltimore, MD
Cathryn L. Murphy
Affiliation:
Infection Control Plus, West Burleigh, Queensland, Australia
Tobi B. Karchmer
Affiliation:
Section of Infectious Diseases, Wake Forest University, Winston-Salem, North Carolina
*
University of Chicago Hospitals, 5841 South Maryland Avenue, MC 5065, Chicago, IL 60637 (sgweber@medicine.bsd.uchicago.edu)
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Abstract

Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association of Professionals in Infection Control and Epidemiology (APIC) have developed this joint position statement. Both organizations are dedicated to combating healthcare-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, APIC and SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) SHEA and APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) APIC and SHEA welcome efforts by healthcare consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and healthcare-associated infections. (4) SHEA and APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) APIC and SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.

Type
SHEA/APIC Position Statement
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 3 , March 2007 , pp. 249 - 260
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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References

1.National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;32:470–485.CrossRefGoogle Scholar
2.Obritsch, MD, Fish, DN, MacLaren, R, Jung, R. National surveillance of antimicrobial resistance in Pseudomonas aeruginosa isolates obtained from intensive care unit patients from 1993 to 2002. Antimicrob Agents Chemother 2004;48:4606–4610.CrossRefGoogle ScholarPubMed
3.Muto, CA, Jernigan, JA, Ostrowsky, BE, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol 2003;24:362–386.CrossRefGoogle ScholarPubMed
4.Siegel, JD, Rhinehart, E, lackson, M, Chiarello, L, the Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in healthcare settings, 2006. Available at: http://www.cdc.gov/ncidod/dhqp/. Accessed November 13, 2006.CrossRefGoogle Scholar
5.Illinois General Assembly. Bill Status of SB2771, 94th General Assembly. Available at: http://www.ilga.gov/legislation/BillStatus.aspfGA = 94& DocTypelD = SB&DocNum = 2771 &GAID = 88cSessionID = 508cLegID = 23855. Accessed January 10, 2007.Google Scholar
6.Illinois General Assembly. Bill Status of SB3087, 94th General Assembly. Available at: http://www.ilga.gov/legislation/billstatus.asp?DocNum = 3087&GAID = 8&GA = 94&DocTypeID = SB&LegID = 24218&SessionID = 50. Accessed lanuary 10, 2007.Google Scholar
7.Maryland General Assembly. Hospitals and nursing facilities—health care—associated infections prevention and control program. Available at: http://mlis.state.md.us/2006rs/billfile/hb0966.htm. Accessed January 10, 2007.Google Scholar
8.Navon-Venezia, S, Ben-Ami, R, Carmeli, Y. Update on Pseudomonas aeruginosa and Acinetobacter baumannii infections in the healthcare setting. Curr Opin Infect Dis 2005;18:306–313.CrossRefGoogle ScholarPubMed
9.Blot, SI, Depuydt, P, Annemans, L, et al. Clinical and economic outcomes in critically ill patients with nosocomial catheter-related bloodstream infections. Clin Infect Dis 2005;41:1591–1598.CrossRefGoogle ScholarPubMed
10.Zahar, JR, Clec'h, C, Tafflet, M, et al. Is methicillin resistance associated with a worse prognosis in Staphylococcus aureus ventilator-associated pneumonia? Clin Infect Dis 2005;41:1224–1231.CrossRefGoogle ScholarPubMed
11.Cosgrove, SE, Sakoulas, G, Perencevich, EN, Schwaber, MI, Karchmer, AW, Carmeli, Y. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 2003;36:53–59.CrossRefGoogle ScholarPubMed
12.DiazGranados, CA, Zimmer, SM, Klein, M, lernigan, JA. Comparison of mortality associated with vancomycin-resistant and vancomycin-sus-ceptible enterococcal bloodstream infections: a meta-analysis. Clin Infect Dis 2005;41:327–333.CrossRefGoogle ScholarPubMed
13.Carmeli, Y, Eliopoulos, G, Mozaffari, E, Samore, M. Health and economic outcomes of vancomycin-resistant enterococci. Arch Intern Med 2002;162:2223–2228.CrossRefGoogle ScholarPubMed
14.Engemann, JJ, Carmeli, Y, Cosgrove, SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis 2003;36:592–598.CrossRefGoogle ScholarPubMed
15.Kenner, J, O'Connor, T, Piantanida, N, et al. Rates of carriage of meth-icillin-resistant and methicillin-susceptible Staphylococcus aureus in an outpatient population. Infect Control Hosp Epidemiol 2003;24:439–444.CrossRefGoogle Scholar
16.Wendt, C, Krause, C, Xander, LU, Loffler, D, Floss, H. Prevalence of colonization with vancomycin-resistant enterococci in various population groups in Berlin, Germany. J Hosp Infect 1999;42:193–200.CrossRefGoogle ScholarPubMed
17.van den Braak, N, Ott, A, van Belkum, A, et al. Prevalence and determinants of fecal colonization with vancomycin-resistant Enterococcus in hospitalized patients in The Netherlands. Infect Control Hosp Epidemiol 2000;21:520–524.CrossRefGoogle ScholarPubMed
18.Coello, R, Glynn, JR, Gaspar, C, Picazo, JJ, Fereres, J. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect 1997;37:39–46.CrossRefGoogle ScholarPubMed
19.Pujol, M, Pena, C, Pallares, R, Ayats, J, Ariza, J, Gudiol, F. Risk factors for nosocomial bacteremia due to methicillin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis 1994;13:96–102.CrossRefGoogle ScholarPubMed
20.Huang, SS, Platt, R. Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis 2003;36:281–285.CrossRefGoogle ScholarPubMed
21.Henning, KJ, Delencastre, H, Eagan, J, et al. Vancomycin-resistant Enterococcus faecium on a pediatric oncology ward: duration of stool shedding and incidence of clinical infection. Pediatr Infect Dis J 1996;15:848–854.CrossRefGoogle ScholarPubMed
22.Zirakzadeh, A, Patel, R. Vancomycin-resistant enterococci: colonization, infection, detection, and treatment. Mayo Clin Proc 2006;81:529–536.CrossRefGoogle ScholarPubMed
23.Yeh, KM, Siu, LK, Chang, JC, Chang, FY. Vancomycin-resistant Enterococcus (VRE) carriage and infection in intensive care units. Microb Drug Resist 2004;10:177–183.CrossRefGoogle ScholarPubMed
24.Bradley, SF, Terpenning, MS, Ramsey, MA, et al. Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med 1991;115:417–422.CrossRefGoogle ScholarPubMed
25.Mest, DR, Wong, DH, Shimoda, KJ, Mulligan, ME, Wilson, SE. Nasal colonization with methicillin-resistant Staphylococcus aureus on admission to the surgical intensive care unit increases the risk of infection. Anesth Analg 1994;78:644–650.CrossRefGoogle Scholar
26.Gordin, FM, Schultz, ME, Huber, RA, Gill, JA. Reduction in nosocomial transmission of drug-resistant bacteria after introduction of an alcohol-based handrub. Infect Control Hosp Epidemiol 2005;26:650–653.CrossRefGoogle ScholarPubMed
27.Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000;356:1307–1312.CrossRefGoogle ScholarPubMed
28.Johnson, PD, Martin, R, Burreil, LJ, et al. Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Med J Aust 2005;183:509–514.CrossRefGoogle Scholar
29.Rosenthal, VD, Guzman, S, Safdar, N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. Am J Infect Control 2005;33:392–397.CrossRefGoogle ScholarPubMed
30.Ng, PC, Wong, HL, Lyon, DJ, et al. Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birth-weight infants. Arch Dis Child Fetal Neonatal Ed 2004;89:F336–340.CrossRefGoogle Scholar
31.Dancer, SJ, Coyne, M, Speekenbrink, A, Samavedam, S, Kennedy, J, Wallace, PG. MRSA acquisition in an intensive care unit. Am J Infect Control 2006;34:10–17.CrossRefGoogle Scholar
32.Tenorio, AR, Badri, SM, Sahgal, NB, et al. Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant Enterococcus species by health care workers after patient care. Clin Infect Dis 2001;32:826–829.CrossRefGoogle ScholarPubMed
33.Moran, GJ, Krishnadasan, A, Gorwitz, RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 2006;355:666–674.CrossRefGoogle ScholarPubMed
34.Lucet, JC, Chevret, S, Durand-Zaleski, I, Chastang, C, Regnier, B. Prevalence and risk factors for carriage of methicillin-resistant Staphylococcus aureus at admission to the intensive care unit: results of a multicenter study. Arch Intern Med 2003;163:181–188.CrossRefGoogle Scholar
35.Saigado, CD, Farr, BM. What proportion of hospital patients colonized with methicillin-resistant Staphylococcus aureus are identified by clinical microbiological cultures? Infect Control Hosp Epidemiol 2006;27:116–121.CrossRefGoogle Scholar
36.Calfee, DP, Giannetta, ET, Durbin, LJ, Germanson, TP, Farr, BM. Control of endemic vancomycin-resistant Enterococcus among inpatients at a university hospital. Clin Infect Dis 2003;37:326–332.CrossRefGoogle ScholarPubMed
37.Mascini, EM, Troelstra, A, Beitsma, M, et al. Genotyping and preemptive isolation to control an outbreak of vancomycin-resistant Enterococcus faecium. Clin Infect Dis 2006;42:739–746.CrossRefGoogle ScholarPubMed
38.Puzniak, LA, Leet, T, Mayfield, J, Kollef, M, Mundy, LM. To gown or not to gown: the effect on acquisition of vancomycin-resistant enterococci. Clin Infect Dis 2002;35:18–25.CrossRefGoogle ScholarPubMed
39.Jernigan, JA, Titus, MG, Groschel, DH, Getchell-White, S, Farr, BM. Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol 1996;143:496–504.CrossRefGoogle ScholarPubMed
40.Farr, BM. Prevention and control of methicillin-resistant Staphylococcus aureus infections. Curr Opin Infect Dis 2004;17:317–322.CrossRefGoogle ScholarPubMed
41.Montecalvo, MA, Horowitz, H, Gedris, C, et al. Outbreak of vancomycin-, ampicillin-, and aminoglycoside-resistant Enterococcus faecium bacteremia in an adult oncology unit. Antimicrob Agents Chemother 1994;38:1363–1367.CrossRefGoogle Scholar
42.Livornese, LL Jr, Dias, S, Samel, C, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112–116.CrossRefGoogle ScholarPubMed
43.Karanfil, LV, Murphy, M, Josephson, A, et al. A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol 1992;13:195–200.CrossRefGoogle Scholar
44.Boyce, JM, Mermel, LA, Zervos, MJ, et al. Controlling vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1995;16:634–637.CrossRefGoogle ScholarPubMed
45.Armstrong-Evans, M, Litt, M, McArthur, MA, et al. Control of transmission of vancomycin-resistant Enterococcus faecium in a long-term-care facility. Infect Control Hosp Epidemiol 1999;20:312–317.CrossRefGoogle ScholarPubMed
46.Malik, RK, Montecalvo, MA, Reale, MR, et al. Epidemiology and control of vancomycin-resistant enterococci in a regional neonatal intensive care unit. Pediatr Infect Dis J 1999;18:352–356.CrossRefGoogle Scholar
47.Byers, KE, Anglim, AM, Anneski, CJ, et al. A hospital epidemic of vancomycin-resistant Enterococcus: risk factors and control. Infect Control Hosp Epidemiol 2001;22:140–147.CrossRefGoogle ScholarPubMed
48.Boyce, JM, Opal, SM, Chow, JW, et al. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148–1153.CrossRefGoogle ScholarPubMed
49.Singh, N, Leger, MM, Campbell, J, Short, B, Campos, JM. Control of vancomycin-resistant enterococci in the neonatal intensive care unit. Infect Control Hosp Epidemiol 2005;26:646–649.CrossRefGoogle ScholarPubMed
50.Saiman, L, Cronquist, A, Wu, F, et al. An outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2003;24:317–321.CrossRefGoogle Scholar
51.Nicolle, LE, Dyck, B, Thompson, G, et al. Regional dissemination and control of epidemic methicillin-resistant Staphylococcus aureus. Manitoba Chapter of CHICA-Canada. Infect Control Hosp Epidemiol 1999;20:202–205.CrossRefGoogle ScholarPubMed
52.Murray-Leisure, KA, Geib, S, Graceley, D, et al. Control of epidemic methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol 1990;11:343–350.CrossRefGoogle ScholarPubMed
53.Khoury, J, Jones, M, Grim, A, Dunne, WM Jr, Fraser, V. Eradication of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit by active surveillance and aggressive infection control measures. Infect Control Hosp Epidemiol 2005;26:616–621.CrossRefGoogle ScholarPubMed
54.Back, NA, Linnemann, CC Jr, Staneck, JL, Kotagal, UR. Control of methicillin-resistant Staphylococcus aureus in a neonatal intensive-care unit: use of intensive microbiologic surveillance and mupirocin. Infect Control Hosp Epidemiol 1996;17:227–231.Google Scholar
55.Pearman, JW, Christiansen, KJ, Annear, DI, et al. Control of methicillin-resistant Staphylococcus aureus (MRSA) in an Australian metropolitan teaching hospital complex. Med J Aust 1985;142:103–108.CrossRefGoogle Scholar
56.Jochimsen, EM, Fish, L, Manning, K, et al. Control of vancomycin-resistant enterococci at a community hospital: efficacy of patient and staff cohorting. Infect Control Hosp Epidemiol 1999;20:106–109.CrossRefGoogle Scholar
57.Dembry, LM, Uzokwe, K, Zervos, MJ. Control of endemic glycopeptide-resistant enterococci. Infect Control Hosp Epidemiol 1996;17:286–292.CrossRefGoogle ScholarPubMed
58.Hachem, R, Graviss, L, Hanna, H, et al. Impact of surveillance for vancomycin-resistant enterococci on controlling a bloodstream outbreak among patients with hematologic malignancy. Infect Control Hosp Epidemiol 2004;25:391–394.CrossRefGoogle ScholarPubMed
59.Ridenour, GA, Wong, ES, Call, MA, Climo, MW. Duration of colonization with methicillin-resistant Staphylococcus aureus among patients in the intensive care unit: implications for intervention. Infect Control Hosp Epidemiol 2006;27:271–278.CrossRefGoogle ScholarPubMed
60.Jernigan, JA, Clemence, MA, Stott, GA, et al. Control of methicillin-resistant Staphylococcus aureus at a university hospital: one decade later. Infect Control Hosp Epidemiol 1995;16:686–696.CrossRefGoogle Scholar
61.Sandri, AM, Dalarosa, MG, Ruschel de Alcantara, L, da Silva Elias, L, Zavascki, AP. Reduction in incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection in an intensive care unit: role of treatment with mupirocin ointment and Chlorhexidine baths for nasal carriers of MRSA. Infect Control Hosp Epidemiol 2006;27:185–187.CrossRefGoogle Scholar
62.Thompson, RL, Cabezudo, I, Wenzel, RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97:309–317.CrossRefGoogle ScholarPubMed
63.Farrington, M, Redpath, C, Trundle, C, Coomber, S, Brown, NM. Winning the battle but losing the war: methicillin-resistant Staphylococcus aureus (MRSA) infection at a teaching hospital. QJM 1998;91:539–548.CrossRefGoogle ScholarPubMed
64.Haley, RW, Cushion, NB, Tenover, FC, et al. Eradication of endemic methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis 1995;171:614–624.CrossRefGoogle ScholarPubMed
65.Harbarth, S, Martin, Y, Rohner, P, Henry, N, Auckenthaler, R, Pittet, D. Effect of delayed infection control measures on a hospital outbreak of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2000;46:43–49.CrossRefGoogle ScholarPubMed
66.Siddiqui, AH, Harris, AD, Hebden, J, Wilson, PD, Morris, JG Jr, Roghmann, MC. The effect of active surveillance for vancomycin-resistant enterococci in high-risk units on vancomycin-resistant enterococci incidence hospital-wide. Am J Infect Control 2002;30:40–43.CrossRefGoogle ScholarPubMed
67.Huang, SS, Yokoe, DS, Hinrichsen, VL, et al. Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 2006;43:971–978.CrossRefGoogle ScholarPubMed
68.Hidron, AI, Kourbatova, EV, Halvosa, IS, et al. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage. Clin Infect Dis 2005;41:159–166.CrossRefGoogle Scholar
69.Jernigan, JA, Pullen, AL, Flowers, L, Bell, M, Jarvis, WR. Prevalence of and risk factors for colonization with methicillin-resistant Staphylococcus aureus at the time of hospital admission. Infect Control Hosp Epidemiol 2003;24:409–414.CrossRefGoogle ScholarPubMed
70.Harbarth, S, Sax, H, Fankhauser-Rodriguez, C, Schrenzel, J, Agostinho, A, Pittet, D. Evaluating the probability of previously unknown carriage of MRSA at hospital admission. Am J Med 2006;119:275 e15-23.CrossRefGoogle ScholarPubMed
71.Ostrowsky, BE, Trick, WE, Sohn, AH, et al. Control of vancomycin-resistant Enterococcus in health care facilities in a region. N Engl J Med 2001;344:1427–1433.CrossRefGoogle ScholarPubMed
72.Price, CS, Paule, S, Noskin, GA, Peterson, LR. Active surveillance reduces the incidence of vancomycin-resistant enterococcal bacteremia. Clin Infect Dis 2003;37:921–928.CrossRefGoogle ScholarPubMed
73. Hand hygiene to reduce resistant bacteria in ICUs. ClinicalTrials.gov identifier: NCT00100386. Available at: http://www.clinicaltrials.gov. Accessed May 9, 2006.Google Scholar
74.Cooper, BS, Medley, GF, Stone, SP, et al. Methicillin-resistant Staphylococcus aureus in hospitals and the community: stealth dynamics and control catastrophes. Proc Natl Acad Sci U S A 2004;101:10223–10228.CrossRefGoogle ScholarPubMed
75.Bootsma, MC, Diekmann, O, Bonten, MJ. Controlling methicillin-resistant Staphylococcus aureus: quantifying the effects of interventions and rapid diagnostic testing. Proc Natl Acad Sci USA 2006;103:5620–5625.CrossRefGoogle ScholarPubMed
76.Perencevich, EN, Fisman, DN, Lipsitch, M, Harris, AD, Morris, JG Jr, Smith, DL. Projected benefits of active surveillance for vancomycin-resistant enterococci in intensive care units. Clin Infect Dis 2004;38:1108–1115.CrossRefGoogle ScholarPubMed
77.Pan, A, Carnevale, G, Catenazzi, P, et al. Trends in methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections: effect of the MRSA “search and isolate” strategy in a hospital in Italy with hyper-endemic MRSA. Infect Control Hosp Epidemiol 2005;26:127–133.CrossRefGoogle Scholar
78.Verhoef, J, Beaujean, D, Blok, H, et al. A Dutch approach to methicillin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis 1999;18:461–466.CrossRefGoogle ScholarPubMed
79.Vandenbroucke-Grauls, CM. Methicillin-resistant Staphylococcus aureus control in hospitals: the Dutch experience. Infect Control Hosp Epidemiol 1996;17:512–513.CrossRefGoogle ScholarPubMed
80.Kluytmans-Vandenbergh, MF, Kluytmans, JA, Voss, A. Dutch guideline for preventing nosocomial transmission of highly resistant microorganisms (HRMO). Infection 2005;33:309–313.CrossRefGoogle ScholarPubMed
81.King, MD, Humphrey, BJ, Wang, YF, Kourbatova, EV, Ray, SM, Blumberg, HM. Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA 300 clone as the predominant cause of skin and soft-tissue infections. Ann Intern Med 2006;144:309–317.CrossRefGoogle ScholarPubMed
82.Seybold, U, Kourbatova, EV, Johnson, JG, et al. Emergence of community-associated methicillin-resistant Staphylococcus aureus USA300 genotype as a major cause of health care-associated blood stream infections. Clin Infect Dis 2006;42:647–656.CrossRefGoogle Scholar
83.Karchmer, TB, Durbin, LJ, Simonton, BM, Farr, BM. Cost-effectiveness of active surveillance cultures and contact/droplet precautions for control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2002;51:126–132.CrossRefGoogle ScholarPubMed
84.Muto, CA, Giannetta, ET, Durbin, LJ, Simonton, BM, Farr, BM. Cost-effectiveness of perirectal surveillance cultures for controlling vancomycin-resistant Enterococcus. Infect Control Hosp Epidemiol 2002;23:429–435.CrossRefGoogle ScholarPubMed
85.Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 1999;282:1745–1751.CrossRefGoogle Scholar
86.Montecalvo, MA, Jarvis, WR, Uman, J, et al. Costs and savings associated with infection control measures that reduced transmission of vancomycin-resistant enterococci in an endemic setting. Infect Control Hosp Epidemiol 2001;22:437–442.CrossRefGoogle Scholar
87.Sanford, MD, Widmer, AF, Bale, MJ, Jones, RN, Wenzel, RP. Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1994;19:1123–1128.CrossRefGoogle ScholarPubMed
88.Lai, KK, Fontecchio, SA, Kelley, AL, Melvin, ZS, Baker, S. The epidemiology of fecal carriage of vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1997;18:762–765.Google ScholarPubMed
89.Tacconelli, E, Carmeli, Y, Aizer, A, Ferreira, G, Foreman, MG, D'Agata, EM. Mupirocin prophylaxis to prevent Staphylococcus aureus infection in patients undergoing dialysis: a meta-analysis. Clin Infect Dis 2003;37:1629–1638.CrossRefGoogle ScholarPubMed
90.Laupland, KB, Conly, JM. Treatment of Staphylococcus aureus colonization and prophylaxis for infection with topical intranasal mupirocin: an evidence-based review. Clin Infect Dis 2003;37:933–938.CrossRefGoogle ScholarPubMed
91.Kauffman, CA, Terpenning, MS, He, X, et al. Attempts to eradicate methicillin-resistant Staphylococcus aureus from a long-term-care facility with the use of mupirocin ointment. Am J Med 1993;94:371–378.CrossRefGoogle ScholarPubMed
92.Wong, MT, Kauffman, CA, Standiford, HC, et al. Effective suppression of vancomycin-resistant Enterococcus species in asymptomatic gastrointestinal carriers by a novel glycolipodepsipeptide, ramoplanin. Clin Infect Dis 2001;33:1476–1482.CrossRefGoogle ScholarPubMed
93.Perl, TM, Cullen, JJ, Wenzel, RP, et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med 2002;346:1871–1877.CrossRefGoogle ScholarPubMed
94.Walsh, TJ, Standiford, HC, Reboli, AC, et al. Randomized double-blinded trial of rifampin with either novobiocin or trimethoprim-sulfamethoxazole against methicillin-resistant Staphylococcus aureus colonization: prevention of antimicrobial resistance and effect of host factors on outcome. Antimicrob Agents Chemother 1993;37:1334–1342.CrossRefGoogle ScholarPubMed
95.Roccaforte, IS, Bittner, MI, Stumpf, CA, Preheim, LC. Attempts to eradicate methicillin-resistant Staphylococcus aureus colonization with the use of trimethoprim-sulfamethoxazole, rifampin, and bacitracin. Am J Infect Control 1988;16:141–146.CrossRefGoogle ScholarPubMed
96.Loeb, M, Main, C, Walker-Dilks, C, Eady, A. Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. Cochrane Database Syst Rev 2003:CD003340.Google Scholar
97.Miller, MA, Dascal, A, Portnoy, J, Mendelson, J. Development of mupirocin resistance among methicillin-resistant Staphylococcus aureus after widespread use of nasal mupirocin ointment. Infect Control Hosp Epidemiol 1996;17:811–813.CrossRefGoogle ScholarPubMed
98.Vasquez, IE, Walker, ES, Franzus, BW, Overbay, BK, Reagan, DR, Sarubbi, FA. The epidemiology of mupirocin resistance among methicillin-resistant Staphylococcus aureus at a Veterans' Affairs hospital. Infect Control Hosp Epidemiol 2000;21:459–464.CrossRefGoogle Scholar
99.Mondy, KE, Shannon, W, Mundy, LM. Evaluation of zinc bacitracin capsules versus placebo for enteric eradication of vancomycin-resistant Enterococcus faecium. Clin Infect Dis 2001;33:473–6.CrossRefGoogle ScholarPubMed
100.Hachem, R, Raad, I. Failure of oral antimicrobial agents in eradicating gastrointestinal colonization with vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 2002;23:43–44.CrossRefGoogle ScholarPubMed
101.Vernon, MO, Hayden, MK, Trick, WE, Hayes, RA, Blom, DW, Weinstein, RA. Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Arch Intern Med 2006;166:306–312.CrossRefGoogle Scholar
102.Gerber, SI, Jones, RC, Scott, MV, et al. Management of outbreaks of methicillin-resistant Staphylococcus aureus infection in the neonatal intensive care unit: a consensus statement. Infect Control Hosp Epidemiol 2006;27:139–145.CrossRefGoogle ScholarPubMed
103.Muto, CA, Pokrywka, M, Shutt, K, et al. A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005;26:273–280.CrossRefGoogle Scholar
104.Stelfox, HT, Bates, DW, Redelmeier, DA. Safety of patients isolated for infection control. JAMA 2003;290:1899–1905.CrossRefGoogle ScholarPubMed
105.Evans, HL, Shaffer, MM, Hughes, MG, et al. Contact isolation in surgical patients: a barrier to care? Surgery 2003;134:180–188.CrossRefGoogle ScholarPubMed
106.Kirkland, KB, Weinstein, JM. Adverse effects of contact isolation. Lancet 1999;354:1177–1178.CrossRefGoogle ScholarPubMed
107.Saint, S, Higgins, LA, Nallamothu, BK, Chenoweth, C. Do physicians examine patients in contact isolation less frequently? A brief report. Am J Infect Control 2003;31:354–356.CrossRefGoogle ScholarPubMed
108.Davis, KA, Stewart, JJ, Crouch, HK, Florez, CE, Hospenthal, DR. Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis 2004;39:776–782.CrossRefGoogle ScholarPubMed
109.Lucet, JC, Grenet, K, Armand-Lefevre, L, et al. High prevalence of carriage of methicillin-resistant Staphylococcus aureus at hospital admission in elderly patients: implications for infection control strategies. Infect Control Hosp Epidemiol 2005;26:121–126.CrossRefGoogle ScholarPubMed
110.Kotilainen, P, Routamaa, M, Peltonen, R, et al. Eradication of methicillin-resistant Staphylococcus aureus from a health center ward and associated nursing home. Arch Intern Med 2001;161:859–863.CrossRefGoogle Scholar