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Look before you leap: active surveillance for multidrug-resistant organisms
Journal article   Open access   Peer reviewed

Look before you leap: active surveillance for multidrug-resistant organisms

Daniel J Diekema and Michael B Edmond
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.44(8), pp.1101-1107
04/15/2007
DOI: 10.1086/512820
PMID: 17366459
url
https://doi.org/10.1086/512820View
Published (Version of record) Open Access

Abstract

Hospitals in the United States are under increasing pressure to perform active surveillance cultures for detection of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) among newly admitted patients. Results of such cultures can then be used to direct contact precautions to prevent transmission of MRSA and VRE in the health care setting. However, using active surveillance cultures to expand contact precautions is a complicated and resource-intensive intervention that has the potential for several unintended adverse consequences. Therefore, careful forethought and preparation should precede the institution of any active surveillance culture program. We review the following important steps that should be performed when planning any such intervention: preparing the laboratory and reducing the turnaround time for screening tests, monitoring and optimizing the intervention of instituting contact precautions, monitoring and ameliorating the known adverse effects of contact precautions, and measuring important outcomes to evaluate the effectiveness of a program of active surveillance cultures and contact precautions.
 Methicillin Resistance - physiology Vancomycin Resistance - physiology Humans Anti-Bacterial Agents - pharmacology Enterococcus - drug effects Staphylococcus aureus - drug effects Drug Resistance, Multiple - physiology

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