Surveillance Cultures for Management of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci
MRSA and VRE are resistant Gram-positive micro-organisms that are frequently found in hospital-admitted patients, and probably in the healthcare-associated population. MRSA infection is associated with increased mortality, morbidity and costs compared with methicillin-susceptible S. aureus. MRSA is a more potent causative micro-organism for pneumonia than VRE, which is sometimes considered relatively harmless. As surveillance culture may early identify patients colonized with MRSA and/or VRE, subsequently implemented contact precautions and/or eradication protocols could prevent transmission and infection.
Studies concerning the usefulness of surveillance cultures in the light of MRSA and VRE are summarized in Table 2. Most studies originated from United States, where VRE and MRSA are relatively endemic, obviously limiting generalization to the European context because of marked differences in VRE and MRSA prevalence. Many studies demonstrated potential usefulness of surveillance cultures on high-risk units at admission and weekly thereafter in controlling the spread of both MRSA and VRE, and the prevention of hospital-acquired VRE or MRSA infections. Currently, there is no evidence that the implementation of surveillance cultures for the management of MRSA/VRE reduces infections or mortality.