Abstract
BACKGROUND/OBJECTIVES: Multiple studies have demonstrated the utility of ASC, along with initiation of empiric contact precautions, in limiting the nosocomial spread of multi-drug resistant organisms (MDROs). Although the 2003 SHEA guideline acknowledges the effectiveness of similar measures in limiting the spread of MDR-GNB, its recommendations mostly focus on preventing nosocomial transmission of Methicillin-resistant S. aureus (MRSA) and Vancomycin-resistant Enterococcus (VRE). While the stool cultures or rectal/peri-rectal swabs are critical for identification of VRE colonization, they have also been shown to increase the sensitivity of MRSA identification in conjunction with nasal swabs or respiratory specimens. Despite the knowledge that the rectum is a common site of colonization with VRE and MDR-GNB, the utility of stool cultures or rectal/peri-rectal swabs for identification of MDR-GNB remains controversial because the process is time consuming, cumbersome, and adds significant costs to the ASC protocol.
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