486. Active Surveillance for MRSA in Hospitalized Patients: Impact on Colonization and Bacteremia
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: There is conflicting evidence in the literature regarding the benefits of active surveillance for MRSA in hospitalized patients. The purpose of this study was to describe the impact of active surveillance on MRSA colonization and bacteremia in a VA hospital.
Methods: Active surveillance at the Louisville VA Hospital was evaluated from January 2008 through April 2009. Swabs of the anterior nares were taken on each patient on admission to the hospital and if not positive, were also taken on each transfer or discharge. PCR was used to test for the presence of MRSA. Colonization was defined as a positive MRSA PCR upon discharge or transfer with a negative MRSA PCR on admission. Statistical process control (SPC) charts were used to evaluate the trend in the number of MRSA colonization and bacteremia.
Results: The SPC chart for MRSA colonization showed an average of 1.7 colonizations per 100 patients. For the 16-month period the data was in control with no special cause variance identified. The SPC chart for MRSA bacteremia showed an average of 0.7 positive blood cultures per 100 cultures. During the last 6 months of the study, special cause variance was identified with a trend toward decreased number of positive cultures.
Conclusion: This study fails to demonstrate a beneficial effect of MRSA surveillance on the rate of colonization but indicates a positive effect in the rates of bacteremia. Since active surveillance is time consuming and costly, future evaluations of this prevention technique are necessary before its implementation can be widely recommended.
Susan Blake, RN, MBA, OCN1, Lorre Coates, RN, BSN1, Janice Lattus, RN, MPH, CIC2, Raul Nakamatsu, MD3, Paula Peyrani, MD, Joanna Sarver, RN, BSN1, Carmen Sciortino, PhD3, Timothy Wiemken, MPH3 and  T. Wiemken, None..
P. Peyrani, None..
J. Sarver, None..
J. Lattus, None..
L. Coates, None..
S. Blake, None..
C. Sciortino, None..
R. Nakamatsu, None..
C. Sciortino, None., (1)Veterans Affairs Medical Center, Louisville, KY, (2)Veterans Affair Medical Center, Louisville, KY, (3)University of Louisville, Louisville, KY