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Active Surveillance Program

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Active Surveillance

The Active Surveillance Program was developed to detect patients colonized with MRSA and VRE so that precautions may be taken to reduce the transmission of the organisms. The current program targets two populations:

  1. All new patients are screened for MRSA upon admission.
  2. High risk patients are screened weekly for MRSA and VRE using a set of pre-defined criteria.

What is active surveillance?
Why active surveillance?
Where will active surveillance occur?
How will active surveillance be instituted?
How do I have a patient removed from resistant organism precautions?
When will active surveillance begin?
Who do I contact to find out more information?

What is active surveillance?
Active surveillance involves the detection and tracking of patients who are asymptomatically colonized with methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE).  Strong data in the medical literature support identifying carriers and the use of Contact Precautions for both carriers and infected patients to reduce spread of MRSA and VRE in the hospital and decrease hospital acquired infections due to these organisms. 

Why active surveillance?
Over the last 2 decades there has been a continuous rise in the number and proportion of nosocomial infections due to MRSA and VRE. These infections increase morbidity mortality, hospital length of stay, and cost of health care. Isolation precautions are instituted for patients that have been identified as infected or colonized with MRSA and/or VRE through routine clinical cultures as well as active surveillance.  Precautions involve the use of gloves, gowns, and enhanced hand washing in order to minimize spread of these pathogens to other patients. Despite these measures, however, significant nosocomial dissemination of MRSA and VRE continues silently from unidentified patients colonized with resistant organisms.

Where will active surveillance occur? 
Active surveillance will be conducted throughout the inpatient care areas.

How will active surveillance be instituted?
All new patients are screened for MRSA upson admission. Patients at high-risk for colonization with MRSA and VRE are cultured while in the hospital.  Patients are determined to be high risk based on their previous exposure to acute care hospitals or long-term care institutions, length of stay in the hospital, location while in the hospital (e.g. ICU), and prior antibiotic exposure.  Cultures are collected from the nose and wounds (if present) for MRSA and from the perirectal area for VRE.  These cultures will be done at no cost to the patients.  Culture results will be available in CareCast and are labeled “Surveillance Culture” in the microbiology lab section.  Patients identified as positive for MRSA and/or VRE are placed on Contact Precautions and notified through the CareCast system.  Patients’ whose cultures are negative will not be informed of their results.

How do I have someone removed from resistance organism isolation?
There are now criteria for removing patients who have previously been identified as being colonized with MRSA and VRE from Resistant Organism Precautions.  Infection Control Policy 117: Isolation Precations provides criteria for removal.  Please call Infection Control 336-716-5704336-716-5704 to find out if they meet criteria.

When will active surveillance begin?
The program began with a prevalence sweep, conducted on January 23, 2002.  Since then, rapid testing using PCR technology was instituted in 2006. In 2009, the program expanded from targeted surveillance to housewide surveillance of new admissions.

Who do I contact to find out more information?
A video overview, as well as a video of the nursing education, are available through the Department of Infection Control 336-716-3482336-716-3482.  If you have questions, please contact the Infection Control Practitioner for your area of the hospital or call Dr. Sherertz 336-716-3482336-716-3482.




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Last Updated: 09-20-2016
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