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1 June 2008

Volume 46, Number 11
Clinical Infectious Diseases 2008;46:1717–1725
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4611-0011$15.00
DOI: 10.1086/587901
REVIEW ARTICLE

The Use of Active Surveillance Cultures in Adult Intensive Care Units to Reduce Methicillin‐Resistant Staphylococcus aureus–Related Morbidity, Mortality, and Costs: A Systematic Review

Katharine L. McGinigle,1,2

Margaret L. Gourlay,1,2,3 and

Ian B. Buchanan2,4

1School of Medicine, 2Public Health Leadership Program, School of Public Health, and 3Department of Family Medicine, School of Medicine, University of North Carolina, and 4Department of Performance Improvement, UNC Health Care, Chapel Hill, North Carolina

Active surveillance cultures (ASCs) are universal or targeted microbiological screening cultures for patients admitted to a hospital. ASCs have been proposed to control the increasing numbers of infections due to multidrug‐resistant organisms, but their efficacy and cost‐effectiveness are unproven. We conducted a systematic review of the literature pertaining to the use of ASCs and control of methicillin‐resistant Staphylococcus aureus (MRSA). We searched revelant journals and the PubMed Medline, Web of Science, CINAHL, and Cochrane Library databases. No randomized, controlled trials were identified. Sixteen observational studies and 4 economic analyses were reviewed. Only 2 of the observational studies had a control group. None of the studies were of good quality. Thus, we identified important gaps in the literature, including a need for a clear definition of ASCs, a clear implementation protocol, and rigorous economic evaluations. Existing evidence may favor the use of ASCs, but the evidence is of poor quality, and definitive recommendations cannot be made.

Received 10 October 2007; accepted 9 January 2008; electronically published 17 April 2008.

Reprints or correspondence: Katharine McGinigle, Public Health Leadership Program, Health Care and Prevention Division, University of North Carolina‐Chapel Hill, Rosenau Hall, CB7469, Chapel Hill, NC 27599 ()

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