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Updated: Jul 17, 2026
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Impact of a methicillin-resistant Staphylococcus aureus active surveillance program on contact precaution utilization
David K Warren1, Rebecca M Guth, Craig M Coopersmith
1Division of Infectious Diseases, Department of Surgery, Washington University School of Medicine, St. Louis, and Barnes Jewish Hospital, St. Louis, MO 63110, USA. dwarren@im.wustl.edu
Objective:
To determine the impact of an active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) on contact precaution utilization, as measured by additional number of contact precaution days attributable to the active surveillance program.
Design:
Prospective cohort study.
Setting:
Twenty-four-bed surgical intensive care unit (ICU).
Patients:
All patients admitted to the surgical ICU.
Interventions:
Nasal cultures for MRSA were performed at admission to a surgical ICU for 19 months. Patients admitted>48 hrs also received weekly and discharge nasal cultures.
Measurements And Main Results:
Clinical data, including start date and initial indication for contact precautions, were prospectively collected. Of 1,893 admissions, 253 (13%) were found to be MRSA-positive during their ICU stay. One hundred forty-six (58%) were identified by nasal culture alone. Compared with the first 10 months of study, the prevalence of MRSA on admission to the ICU during the last 9 months of the study period significantly increased (7.2% vs. 11.4%, p<.001). Acquisition of MRSA by noncolonized patients remained constant between the first 10 months and last 9 months of study (7.0 vs. 5.5 cases per 1000 patient days, p=.29). Two hundred fourteen (6%) of 3461 total contact precaution days in the ICU were attributable to MRSA active surveillance. In sensitivity analyses, the implementation of rapid, same-day results for MRSA active surveillance would increase contact precaution days by 15% compared with no surveillance. If the total number of vancomycin-resistant enterococci patients in the ICU were reduced by 50%, the contact precaution days attributable to active surveillance would increase to 9%.
Conclusions:
MRSA active surveillance increased total contact precaution days in this ICU by 6% yet detected 58% of MRSA cases that would have been otherwise missed. Despite an increasing prevalence of MRSA on admission to the ICU, the acquisition rate has remained constant.
Insights
Active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) increased contact precaution days by 6% but identified 58% of MRSA cases. MRSA acquisition rates remained stable despite rising prevalence.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Effective surveillance and control strategies are crucial to limit MRSA transmission in intensive care units (ICUs).
Purpose of the Study:
- To evaluate the impact of active MRSA surveillance on contact precaution utilization within a surgical ICU.
- To quantify the additional contact precaution days attributed to the MRSA active surveillance program.
Main Methods:
- A prospective cohort study was conducted in a 24-bed surgical ICU.
- Nasal cultures for MRSA were performed on all admitted patients, with additional cultures for those with extended stays.
- Clinical data on contact precaution use were prospectively collected.
Main Results:
- MRSA active surveillance accounted for 6% of total contact precaution days.
- The program identified 58% of MRSA cases that might have otherwise been missed.
- While MRSA prevalence on admission increased, patient acquisition rates remained constant.
Conclusions:
- Active MRSA surveillance is effective in identifying colonized patients, contributing to infection control efforts.
- The study demonstrates a modest increase in contact precaution days, balanced by the detection of a significant proportion of MRSA cases.
- Sustained MRSA acquisition control is achievable even with rising admission prevalence.
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