Surveillance Cultures
➤ No specific standard protocol exists for frequency of S. aureus
surveillance testing, specific population(s) to test, or duration of
active surveillance.
➤ For MRSA
• Consider routine active surveillance when the results can inform:
▶ Infection prevention and control measures (e.g., patient cohorting, contact
precautions, and/or decolonization), and/or
▶ Clinical management decisions (i.e., antibiotic selection if subsequent
invasive disease occurs).
• In specific situations, perform active surveillance to inform additional
infection prevention strategies when:
a. an outbreak has been identified;
b. healthcare-associated transmission is ongoing and of clinical importance; or
c. an individual patient may be at higher risk for colonization or infection
(e.g., prior to surgery, multiple gestation with differing MRSA colonization
status, parent known to be a carrier or otherwise infected with MRSA, or
outborn newborns from settings of higher prevalence).
➤ For MSSA
• Routine active surveillance has no clear benefit unless results inform infection
prevention and control measures (e.g., decolonization).
• In specific situations, consider performing active surveillance to inform
additional infection prevention strategies when:
1. an outbreak has been identified, and
2. when there is a need to identify individual patients who may be at higher
risk for infection (e.g., low birth weight or prior to surgery).
➤ Do NOT routinely perform S. aureus testing of equipment and/or
other environmental surfaces.
➤ Units:
• Should use culture-based or molecular methods for S. aureus surveillance,
with anterior nares being the preferred site to sample. If multiple sites are
sampled, consider performing a composite culture of all swabs.
➤ Units:
• Should institute contact precautions for infants with positive MRSA test
results.
Interventions
