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Updated: Jun 8, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Active surveillance culturing impacts methicillin-resistant Staphylococcus aureus acquisition in a pediatric
Galit Holzmann-Pazgal1, Charles Monney, Koya Davis
1University of Texas Medical School at Houston, Houston, TX, USA. Galit.Holzmann-Pazgal@uth.tmc.edu
Objective:
To determine whether active surveillance culturing for methicillin-resistant Staphylococcus aureus (MRSA) decreases nosocomial MRSA acquisition in the pediatric intensive care unit.
Design:
Before and after observational study.
Setting:
A tertiary care, 20-bed, pediatric intensive care unit.
Patients:
All patients admitted to the pediatric intensive care unit.
Interventions:
Anterior nares cultures for MRSA were obtained on admission and weekly in the pediatric intensive care unit from January 2007 to December 2009 as part of a hospital quality improvement project.
Measurements And Main Results:
MRSA admission prevalence and nosocomial incidence density were determined retrospectively for 2006 and prospectively for 2007-2009. Nosocomial MRSA incidence density during the intervention period was determined monthly and analyzed by trend analysis by using a general linear model. The correlation of active surveillance culturing compliance with nosocomial acquisition of MRSA was analyzed. Possible confounding by healthcare worker hand hygiene compliance observed during the intervention period was also analyzed by multivariate linear regression analysis. The yearly MRSA incidence density significantly decreased from 2006 to 2009 (6.88 per 1,000 patient days to 1.45 per 1,000 patient days, p < .001) and from 2007 to 2009 (7.32 per 1,000 patient days to 1.45 per 1,000 patient days, p < .001). Trend analysis demonstrated a significant decline in MRSA acquisition over time following the introduction of active surveillance culturing (p < .001). Surveillance culturing was significantly associated with the decline in MRSA acquisition observed in the pediatric intensive care unit by multivariate regression analysis when controlling for hand hygiene (p = .01).
Conclusions:
Active surveillance culturing resulted in significantly decreased nosocomial acquisition of MRSA in a pediatric intensive care unit setting. Admission and weekly active surveillance culturing appears to be an effective tool to decrease the spread of MRSA in the pediatric intensive care unit, independent of improvement in hand hygiene compliance. The impact on hospital-acquired MRSA infections and the cost benefit of active surveillance culturing require further study.
Insights
Active surveillance culturing for methicillin-resistant Staphylococcus aureus (MRSA) significantly reduced nosocomial MRSA acquisition in pediatric intensive care units. This strategy proved effective in decreasing MRSA spread, independent of hand hygiene improvements.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Nosocomial infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA), pose a significant threat in pediatric intensive care units (PICUs).
- Effective strategies are needed to reduce the acquisition and transmission of MRSA within these vulnerable patient populations.
Purpose of the Study:
- To evaluate the impact of active surveillance culturing for MRSA on reducing nosocomial MRSA acquisition in a PICU.
- To assess the effectiveness of this intervention independently of other infection control measures.
Main Methods:
- A before-and-after observational study was conducted in a 20-bed tertiary care PICU.
- Active surveillance involved weekly anterior nares cultures for MRSA from January 2007 to December 2009.
- Data on MRSA acquisition and hand hygiene compliance were collected and analyzed.
Main Results:
- Yearly MRSA incidence density significantly decreased from 6.88 to 1.45 per 1,000 patient days between 2006 and 2009.
- Trend analysis showed a significant decline in MRSA acquisition following the implementation of active surveillance culturing (p < .001).
- Active surveillance culturing compliance was significantly associated with reduced MRSA acquisition, even after controlling for hand hygiene compliance (p = .01).
Conclusions:
- Active surveillance culturing is an effective strategy for decreasing nosocomial MRSA acquisition in PICUs.
- This method can reduce MRSA spread independently of improvements in hand hygiene.
- Further research is warranted to investigate the impact on hospital-acquired infections and cost-effectiveness.
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