Our hospital has been performing active surveillance cultures
weekly to screen for MRSA among our hospitalized patients for many years; however from 2010 to 2014, we began screening patients who were previously known to be positive for MRSA colonization or infection for at least 1 year.
A case was defined as NDM-producing CRE isolated from clinical or active surveillance cultures
collected from a patient while hospitalized during January 1-October 30, 2012.
This is a comprehensive guide that includes: risk assessment, a surveillance program, hand hygiene guidelines, contact precautions, environmental and equipment cleaning and decontamination, and targeted active surveillance cultures
. These surveillance guidelines, along with a report from the Society for Healthcare Epidemiology of America (SHEA) which recommends testing of high-risk groups, have led to some states implementing mandatory screening of these patients at admission to the hospital (23, 24); to some hospitals wanting to test all patients before admission; and to some wanting to also test all of their workers.
For example, during an outbreak of 39 cases of CRKP infection in a hospital in Puerto Rico in 2008, in addition to a review of infection control practices, active surveillance cultures
were performed on patients in the same units as persons with confirmed CRKP infection.
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 API C Task Force.