Abstract
Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology, Inc., (APIC) have developed this joint position statement. Both organizations are dedicated to combating health care-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, the APIC and the SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) The SHEA and the APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) The APIC and the SHEA welcome efforts by health care consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and health care-associated infections. (4) The SHEA and the APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) The APIC and the SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.
Highlights
Title Legislative mandates for use of active surveillance cultures to screen for methicillinresistant Staphylococcus aureus and vancomycin-resistant enterococci: Position statement from the Joint Society for Healthcare Epidemiology of America (SHEA) and APIC Task Force
(1) reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, the APIC and the SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens
In the sections that follow, this position statement (1) reviews the proposed legislative measures as well as the rationale for use of active surveillance cultures, (2) examines the scientific evidence supporting the use of active surveillance cultures and eradication strategies, (3) discusses potential unresolved issues and unintended consequences of legislation mandating use of active surveillance cultures, and (4) provides the consensus points of the APIC and the SHEA regarding US legislation mandating use of active surveillance cultures to screen for MRSA and VRE
Summary
Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: Position statement from the Joint SHEA and APIC Task Force. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology, Inc., (APIC) have developed this joint position statement Both organizations are dedicated to combating health care-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. In response to the proposed legislation mandating use of active surveillance cultures, the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology, Inc., (APIC) have developed this joint position statement. In the sections that follow, this position statement (1) reviews the proposed legislative measures as well as the rationale for use of active surveillance cultures, (2) examines the scientific evidence supporting the use of active surveillance cultures and eradication strategies, (3) discusses potential unresolved issues and unintended consequences of legislation mandating use of active surveillance cultures, and (4) provides the consensus points of the APIC and the SHEA regarding US legislation mandating use of active surveillance cultures to screen for MRSA and VRE. ( the utility of active surveillance cultures to screen for other pathogens has been examined, this statement will exclusively consider the use of active surveillance to reduce transmission of MRSA and VRE, the organisms addressed by the legislation proposed to date.)
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