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Value of Performing Active Surveillance Cultures on Intensive Care Unit Discharge for Detection of Methicillin-Resistant Staphylococcus aureus

Published online by Cambridge University Press:  02 January 2015

Jon P. Furuno ,
Anthony D. Harris ,
Marc-Oliver Wright ,
David M. Hartley ,
Jessina C. McGregor ,
Holly D. Gaff ,
Joan N. Hebden ,
Harold C. Standiford  and
Eli N. Perencevich
Jon P. Furuno*
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Anthony D. Harris
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland Infection Control and Hospital Epidemiology, University of Maryland Medical Center, Baltimore, Maryland
Marc-Oliver Wright
Affiliation:
Marshfleld Clinic Research Foundation, Marshfield Epidemiology Research Center, Marshfield, Wisconsin
David M. Hartley
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Jessina C. McGregor
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland Department of Pharmacy Practice, College of Pharmacy, Oregon State University, Portland
Holly D. Gaff
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Joan N. Hebden
Affiliation:
Infection Control and Hospital Epidemiology, University of Maryland Medical Center, Baltimore, Maryland
Harold C. Standiford
Affiliation:
Infection Control and Hospital Epidemiology, University of Maryland Medical Center, Baltimore, Maryland
Eli N. Perencevich
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland Veterans Affairs Maryland Health Care System, Baltimore, Maryland
*
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 100 North Greene Street, Lower Level, Baltimore, MD 21201 (jfuruno@epi.umaryland.edu)
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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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 6 , June 2007 , pp. 666 - 670
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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