Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant <i>Staphylococcus aureus</i>
Authors: Lance R. Peterson, Jennifer L. Beaumont, Ari Robicsek
Journal: Annals of Internal Medicine (2008)

Letters1 July 2008Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant Staphylococcus aureusLance R. Peterson, MD, Jennifer L. Beaumont, MS, and Ari Robicsek, MDLance R. Peterson, MDFrom Evanston Northwestern Healthcare, Evanston, IL 60201.Search for more papers by this author, Jennifer L. Beaumont, MSFrom Evanston Northwestern Healthcare, Evanston, IL 60201.Search for more papers by this author, and Ari Robicsek, MDFrom Evanston Northwestern Healthcare, Evanston, IL 60201.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-1-200807010-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The letter by Dr. Diekema raises several items for discussion. We regret that he found our title misleading. As indicated in our article, the program's critical and enforced aspect was universal admission surveillance. Decolonization was at the attending physician's discretion. We routinely culture all positive polymerase chain reaction samples for MRSA and test isolates for mupirocin resistance, which occurred in 5.6% of strains before universal surveillance began and 4.1% at the end of the program's first year (1). In addition, to minimize the potential for resistance, we removed mupirocin for clinical use other than for nasal decolonization.The ...References1. Paule S, Robicsek A, Suseno M, Kaul KL, Peterson LR. Incidence of mupirocin resistance in methicillin-resistant Staphylococcus aureus (MRSA) during universal surveillance and decolonization [Abstract]. In: Program and Abstracts of the 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, 27–30 September 2006 San Francisco, California. Washington, DC: American Soc for Microbiology; 2006. Abstract C2-1149. Google Scholar2. Diekema DJ, Edmond MB. Look before you leap: active surveillance for multidrug-resistant organisms. Clin Infect Dis. 2007;44:1101-7. [PMID: 17366459] CrossrefMedlineGoogle Scholar3. Stelfox HT, Bates DW, Redelmeier DA. Safety of patients isolated for infection control. JAMA. 2003;290:1899-905. [PMID: 14532319] CrossrefMedlineGoogle Scholar4. Peterson LR, Hacek DM, Robicsek A. 5 Million Lives Campaign. Case study: an MRSA intervention at Evanston Northwestern Healthcare. Jt Comm J Qual Patient Saf. 2007;33:732-8. [PMID: 18200898] MedlineGoogle Scholar5. La Forgia C, Franke J, Hacek DM, Small M, Paule SM, O'Connor K, et al. A novel environmental cleaning intervention to curtail an outbreak of MDR-Acinetobacter baumannii in an intensive care unit [Abstract]. In: Program and Abstracts of the 16th Annual Meeting of the Society of Hospital Epidemiologists of America, 18–20 March 2006, Chicago, Illinois. Arlington, VA: Soc for Healthcare Epidemiology of America; 2006. Abstract 306. Google Scholar6. Hacek DM, Robicsek A, Ogle A, Fisher A, Peterson LR. Significant impact of terminal room cleaning with bleach on reducing nosocomial Clostridium difficile [Abstract]. In: Program and Abstracts of the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy, 17–20 September 2007, Chicago, Illinois. Washington, DC: American Soc for Microbiology; 2007. Abstract K-608. Google Scholar7. Hacek DM, Robb WJ, Paule SM, Kudrna JC, Stamos VP, Peterson LR. Staphylococcus aureus nasal decolonization in joint replacement surgery reduces infection. Clin Orthop Relat Res. 2008;:. [PMID: 18347889] CrossrefMedlineGoogle Scholar8. Harbarth S, Fankhauser C, Schrenzel J, Christenson J, Gervaz P, Bandiera-Clerc C, et al. Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA. 2008;299:1149-57. [PMID: 18334690] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Lance R. Peterson, MD; Jennifer L. Beaumont, MS; Ari Robicsek, MDAffiliations: From Evanston Northwestern Healthcare, Evanston, IL 60201.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUniversal Surveillance for Methicillin-Resistant Staphylococcus aureus in 3 Affiliated Hospitals Ari Robicsek , Jennifer L. Beaumont , Suzanne M. Paule , Donna M. Hacek , Richard B. Thomson Jr. , Karen L. Kaul , Peggy King , and Lance R. Peterson Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant Staphylococcus aureus Daniel Diekema Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant Staphylococcus aureus Rodney B. Nelson Metrics Cited byPoint-Counterpoint: To Screen or Not To Screen for Methicillin-Resistant StaphylococcusaureusMupirocin Resistance among Methicillin-Resistant Staphylococcus aureus -Colonized Patients at Admission to a Tertiary Care Medical Center 1 July 2008Volume 149, Issue 1Page: 68-69KeywordsAdverse eventsBacteremiaClostridiumDiarrheaMethicillin-resistant staphylococcus aureusPatientsRandomized trialsReproducibilityStatistical methodsVital signs ePublished: 1 July 2008 Issue Published: 1 July 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...