Infection Control and Hospital Epidemiology Publication Info
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Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America
Article DOI: 10.1086/502213
Stable URL: http://www.jstor.org/stable/10.1086/502213
SHEA Guideline for Preventing Nosocomial Transmission of Multidrug‐Resistant Strains of Staphylococcus aureus and Enterococcus •
Infection Control and Hospital Epidemiology
,
Vol. 24, No. 5 (May 2003), pp. 362-386
Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America
Article DOI: 10.1086/502213
Article Stable URL: http://www.jstor.org/stable/10.1086/502213
Special Report
SHEA Guideline for Preventing Nosocomial Transmission of Multidrug‐Resistant Strains of Staphylococcus aureus and Enterococcus
Formats Available in JSTOR: PDF
Abstract(back to top)
BACKGROUND. Infection control programs were created three decades ago to control antibiotic‐resistant healthcare‐associated infections, but there has been little evidence of control in most facilities. After long, steady increases of MRSA and VRE infections in NNIS System hospitals, the Society for Healthcare Epidemiology of America (SHEA) Board of Directors made reducing antibiotic‐resistant infections a strategic SHEA goal in January 2000. After 2 more years without improvement, a SHEA task force was appointed to draft this evidence‐based guideline on preventing nosocomial transmission of such pathogens, focusing on the two considered most out of control: MRSA and VRE.
METHODS. Medline searches were conducted spanning 1966 to 2002. Pertinent abstracts of unpublished studies providing sufficient data were included.
RESULTS. Frequent antibiotic therapy in healthcare settings provides a selective advantage for resistant flora, but patients with MRSA or VRE usually acquire it via spread. The CDC has long‐recommended contact precautions for patients colonized or infected with such pathogens. Most facilities have required this as policy, but have not actively identified colonized patients with surveillance cultures, leaving most colonized patients undetected and unisolated. Many studies have shown control of endemic and/or epidemic MRSA and VRE infections using surveillance cultures and contact precautions, demonstrating consistency of evidence, high strength of association, reversibility, a dose gradient, and specificity for control with this approach. Adjunctive control measures are also discussed.
CONCLUSION. Active surveillance cultures are essential to identify the reservoir for spread of MRSA and VRE infections and make control possible using the CDC’s long‐recommended contact precautions.
Bibliographic Information(back to top)
- SHEA Guideline for Preventing Nosocomial Transmission of Multidrug‐Resistant Strains of Staphylococcus aureus and Enterococcus
- Carlene A. Muto , MD, MS, John A. Jernigan , MD, MS, Belinda E. Ostrowsky , MD, MPH, Hervé M. Richet , MD, William R. Jarvis , MD, John M. Boyce , MD and Barry M. Farr , MD, MSc
- Infection Control and Hospital Epidemiology
- Vol. 24, No. 5 (May 2003) (pp. 362-386)
Notes and References(back to top)
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Notes
Dr. Muto is from the Division of Hospital Epidemiology and Infection Control, UPMC‐P, and the Infectious Diseases Epidemiology Research Unit, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania. Dr. Jernigan is from the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. Dr. Ostrowsky is from the Virginia Commonwealth University, Richmond, Virginia. Dr. Richet is from the Hospital of Nantes, Nantes, France. Dr. Jarvis is from the National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. Dr. Boyce is from the Division of Hospital Epidemiology, Hospital of St. Raphael, and Infectious Diseases, Yale University, New Haven, Connecticut. Dr. Farr is from the University of Virginia Health System, Charlottesville, Virginia. This article was coauthored by William Jarvis and John Jernigan in their private capacities. No official support or endorsement by the Centers for Disease Control and Prevention is intended or should be inferred. Dr. Ostrowsky is currently with the Westchester County Department of Health, Westchester, New York.Address reprint requests to Carlene A. Muto, MD, MS, Director of Infection Control and Hospital Epidemiology, University of Pittsburgh Medical Center ‐ Presbyterian, 3471 Fifth Street, 1215 Kaufmann Building, Pittsburgh, PA 15213.The authors thank the following reviewers for their time and expert advice: Marc Bonten, MD, University Medical Centre Utrecht, Utrecht, the Netherlands; Stephan Harbarth, MD, MS, University of Geneva Hospitals, Geneva, Switzerland; William J. Martone, MD, National Foundation for Infectious Diseases, Bethesda, Maryland; Didier Pittet, MD, MS, University of Geneva Hospitals, Geneva, Switzerland; Andrew E. Simor, MD, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; and Andreas Widmer, MD, MS, Kantonspital Basel University Hospital, Basel, Switzerland.
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- Phillip D. Levin , MB, BChir; Robert A. Fowler , MD; Cameron Guest , MD; William J. Sibbald , MD; Alex Kiss , PhD; Andrew E. Simor , MDVol. 28, No. 3 (March 2007) pp. 331-336Stable URL: http://www.jstor.org/stable/10.1086/511701
- Stephen G. Weber , MD, MS; Susan S. Huang , MD, MPH; Shannon Oriola , RN, CIC, COHN; W. Charles Huskins , MD, MSc; Gary A. Noskin , MD; Kathleen Harriman , PhD, MPH, RN; Russell N. Olmsted , MPH, CIC; Marc Bonten , MD, PhD; Tammy Lundstrom , MD, JD; Michael W. Climo , MD; Mary‐Claire Roghmann , MD, MS; Cathryn L. Murphy , MPH, PhD, CIC; Tobi B. Karchmer , MD, MSVol. 28, No. 3 (March 2007) pp. 249-260Stable URL: http://www.jstor.org/stable/10.1086/512261
- Bonnie L. Zell , MD, MS; Donald A. Goldmann , MDVol. 28, No. 3 (March 2007) pp. 261-264Stable URL: http://www.jstor.org/stable/10.1086/513722
- W. Charles Huskins , MD, MSc; Naomi P. O’Grady , MD; Matthew Samore , MD; Dennis Wallace , PhD; Donald A. Goldmann , MD; Peter G. Pappas , MDVol. 28, No. 2 (February 2007) pp. 245-246Stable URL: http://www.jstor.org/stable/10.1086/510988
- Laura Gavaldà , MD; Cristina Masuet , MD; Juan Beltran , MD; Maria Garcia , MD, PhD; Delia Garcia , MD; Josep M. Sirvent , MD, PhD; Josep M. Ramon , MD, PhDVol. 27, No. 11 (November 2006) pp. 1264-1266Stable URL: http://www.jstor.org/stable/10.1086/507968
- Jonas Marschall , MD; Kathrin Mühlemann , MD, PhDVol. 27, No. 11 (November 2006) pp. 1206-1212Stable URL: http://www.jstor.org/stable/10.1086/507917
- Susan S. Huang, Deborah S. Yokoe, Virginia L. Hinrichsen, Laura S. Spurchise, Rupak Datta, Irina Miroshnik, Richard PlattVol. 43, No. 8 (Oct. 15, 2006) pp. 971-978Stable URL: http://www.jstor.org/stable/4485008
- Barry M. Farr , MD, MScVol. 27, No. 10 (October 2006) pp. 999-1003Stable URL: http://www.jstor.org/stable/10.1086/508672
- Megan Clancy , MD; Amy Graepler , MT; Michael Wilson , MD; Ivor Douglas , MD, MRCP(UK); Jeff Johnson , MD; Connie Savor Price , MDVol. 27, No. 10 (October 2006) pp. 1009-1017Stable URL: http://www.jstor.org/stable/10.1086/507915
- Ralf‐Peter Vonberg , MD; Sabine Stamm‐Balderjahn , MD; Sonja Hansen , MD; Irina Zuschneid , MD; Henning Rüden , MD; Michael Behnke , PhD; Petra Gastmeier , MDVol. 27, No. 10 (October 2006) pp. 1123-1127Stable URL: http://www.jstor.org/stable/10.1086/507922
- Barry M. Farr , MD, MScVol. 27, No. 10 (October 2006) pp. 1096-1106Stable URL: http://www.jstor.org/stable/10.1086/508759
- Brooke N. Shadel , PhD, MPH; Laura A. Puzniak , PhD, MPH; Kathleen N. Gillespie , PhD; Steven J. Lawrence , MD; Marin Kollef , MD; Linda M. Mundy , MDVol. 27, No. 10 (October 2006) pp. 1068-1075Stable URL: http://www.jstor.org/stable/10.1086/507960
- Carlene A. Muto, William R. Jarvis, Barry M. Farr, Larry J. Strausbaugh, Jane D. Siegel, Robert A. WeinsteinVol. 43, No. 6 (Sep. 15, 2006) pp. 796-798Stable URL: http://www.jstor.org/stable/4463941
- Carolyn V. Gould , MD, MSc; Richard Rothenberg , MD, MPH; James P. Steinberg , MDVol. 27, No. 9 (September 2006) pp. 920-925Stable URL: http://www.jstor.org/stable/10.1086/507280
- Bryndis Sigurdardottir , MD; Jeffery Vande Berg , MS; Jianfang Hu , MS; Josiah Alamu , MS; Louise‐Anne McNutt , PhD; Daniel J. Diekema , MD, MS; Loreen A. Herwaldt , MDVol. 27, No. 9 (September 2006) pp. 913-919Stable URL: http://www.jstor.org/stable/10.1086/507278
- Anthony D. Harris, Jessina C. McGregor, Jon P. FurunoVol. 43, Supplement 2. Serious Infections in the Intensive Care Unit: Pseudomonas aeruginosa and Acinetobacter baumanni (Sep. 1, 2006) pp. S57-S61Stable URL: http://www.jstor.org/stable/4463898
- Jennifer Tuboku‐Metzger Blakely , MPH; Ronda L. Sinkowitz‐Cochran , MPH; William R. Jarvis , MDVol. 27, No. 8 (August 2006) pp. 873-875Stable URL: http://www.jstor.org/stable/10.1086/505922
- Mehrdad Askarian , MD, MPH; Ramin Shiraly , MD, MPH; Kiarash Aramesh , MD, MPH; Mary‐Louise McLaws , DPHTM, MPH, PhDVol. 27, No. 8 (August 2006) pp. 868-872Stable URL: http://www.jstor.org/stable/10.1086/506411
- Carlene A. Muto, Margreet C. Vos, William R. Jarvis, Barry M. FarrVol. 43, No. 3 (Aug. 1, 2006) pp. 387-388Stable URL: http://www.jstor.org/stable/4484958
- Mary K. Hayden, Marc J. M. Bonten, Donald W. Blom, Elizabeth A. Lyle, David A. M. C. van de Vijver, Robert A. WeinsteinVol. 42, No. 11 (Jun. 1, 2006) pp. 1552-1560Stable URL: http://www.jstor.org/stable/4484791
- Larry J. Strausbaugh, Jane D. Siegel, Robert A. WeinsteinVol. 42, No. 6 (Mar. 15, 2006) pp. 828-835Stable URL: http://www.jstor.org/stable/4463722
- Timothy E. West , MD; Cile Guerry , RN; Mary Hiott , MT; Nancy Morrow , RN; Katherine Ward , RN; Cassandra D. Salgado , MD, MSVol. 27, No. 3 (March 2006) pp. 233-238Stable URL: http://www.jstor.org/stable/10.1086/500372
- Glenn A. Ridenour , MD; Edward S. Wong , MD; Mark A. Call , MD; Michael W. Climo , MDVol. 27, No. 3 (March 2006) pp. 271-278Stable URL: http://www.jstor.org/stable/10.1086/500649
- Adam D. Lipworth , BA; Emily P. Hyle , BS; Neil O. Fishman , MD; Irving Nachamkin , DrPH, MPH; Warren B. Bilker , PhD; Ann Marie Marr , PharmD; Lori A. Larosa , PharmD; Nishaminy Kasbekar , PharmD; Ebbing Lautenbach , MD, MPH, MSCEVol. 27, No. 3 (March 2006) pp. 279-286Stable URL: http://www.jstor.org/stable/10.1086/503016
- Ulrich Seybold, Ekaterina V. Kourbatova, James G. Johnson, Sue J. Halvosa, Yun F. Wang, Mark D. King, Susan M. Ray, Henry M. BlumbergVol. 42, No. 5 (Mar. 1, 2006) pp. 647-656Stable URL: http://www.jstor.org/stable/4484677
- Philip M. Polgreen , MD; Susan E. Beekmann , MPH; Yi Yi Chen; Gary V. Doern , PhD; Michael A. Pfaller , MD; Angela B. Brueggemann , DPhil; Loreen A. Herwaldt , MD; Daniel J. Diekema , MDVol. 27, No. 3 (March 2006) pp. 252-256Stable URL: http://www.jstor.org/stable/10.1086/501537
- August J. Valenti , MD, FACPVol. 27, No. 3 (March 2006) pp. 225-227Stable URL: http://www.jstor.org/stable/10.1086/503178
- Carlene A. Muto , MD, MSVol. 27, No. 2 (February 2006) pp. 111-115Stable URL: http://www.jstor.org/stable/10.1086/501489
- R. Monina Klevens, Jonathan R. Edwards, Fred C. Tenover, L. Clifford McDonald, Teresa Horan, Robert Gaynes, The National Nosocomial Infections Surveillance SystemVol. 42, No. 3 (Feb. 1, 2006) pp. 389-391Stable URL: http://www.jstor.org/stable/4484611
- Philip C. Carling, Janet L. Briggs, Jeanette Perkins, Deborah HighlanderVol. 42, No. 3 (Feb. 1, 2006) pp. 385-388Stable URL: http://www.jstor.org/stable/4484610
- Susan I. Gerber , MD; Roderick C. Jones , MPH; Mary V. Scott; Joel S. Price , MS; Mark S. Dworkin , MD, MPHTM; Mala B. Filippell , RN, BSN, CIC; Terri Rearick , RN, BS, CIC; Stacy L. Pur , RN, BSN; James B. McAuley , MD, MPH; Mary Alice Lavin , RN, MJ, CIC; Sharon F. Welbel , MD; Sylvia Garcia‐Houchins , CIC; Judith L. Bova , BS; Stephen G. Weber , MD, MSc; Paul M. Arnow , MD; Janet A. Englund , MD; Patrick J. Gavin , MD; Adrienne G. Fisher , MT; Richard B. Thomson , PhD; Thomas Vescio , MD; Teresa Chou , MPH; Daniel C. Johnson , MD; Mary Beth Fry , BS, CIC; Anne H. Molloy , MSN, CIC; Laura Bardowski , RN; Gary A. Noskin , MDVol. 27, No. 2 (February 2006) pp. 139-145Stable URL: http://www.jstor.org/stable/10.1086/501216
- Angelo Pan , MD; Silvia Lorenzotti , MD; Lucio Ferrari , PhD; Luisa Granata , RN; Liana Signorini , MD; Giuseppe Carnevale , MDVol. 27, No. 2 (February 2006) pp. 218-220Stable URL: http://www.jstor.org/stable/10.1086/501152
- Karl J. Madaras‐Kelly , PharmD; Richard E. Remington , MS; Pamela G. Lewis , BSN, MS; Dennis L. Stevens , MD, PhDVol. 27, No. 2 (February 2006) pp. 155-169Stable URL: http://www.jstor.org/stable/10.1086/500060
- David M. Hartley , PhD; Jon P. Furuno , PhD; Marc O. Wright , MS, MT (ASCP); David L. Smith , PhD; Eli N. Perencevich , MD, MSVol. 27, No. 2 (February 2006) pp. 170-174Stable URL: http://www.jstor.org/stable/10.1086/501052
- Cassandra D. Salgado , MD, MS; Barry M. Farr , MD, MScVol. 27, No. 2 (February 2006) pp. 116-121Stable URL: http://www.jstor.org/stable/10.1086/500624
- J. Grant , MDCM, FRCPC; L. Ramman‐Haddad , BScN, CIC; N. Dendukuri , PhD; M. D. Libman , MDCM, FRCPCVol. 27, No. 2 (February 2006) pp. 191-194Stable URL: http://www.jstor.org/stable/10.1086/500623
- C. Wendt , MD, MS; D. Svoboda , MD; C. Schmidt , MD; O. Bock‐Hensley , MD; H. von Baum , MDVol. 26, No. 10 (October 2005) pp. 816-821Stable URL: http://www.jstor.org/stable/10.1086/502499
- Sophie Clement, Pierre Vaudaux, Patrice Francois, Jacques Schrenzel, Elzbieta Huggler, Sandy Kampf, Christine Chaponnier, Daniel Lew, Jean-Silvain LacroixVol. 192, No. 6 (Sep. 15, 2005) pp. 1023-1028Stable URL: http://www.jstor.org/stable/30086323
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- Menno R. Vriens , MD, PhD; Hetty E. M. Blok , MSc; Ada C. M. Gigengack‐Baars , BSc; Ellen M. Mascini , MD, PhD; Chris van der Werken , MD, PhD; Jan Verhoef , MD, PhD; Annet Troelstra , MD, PhDVol. 26, No. 7 (July 2005) pp. 629-633Stable URL: http://www.jstor.org/stable/10.1086/502592
- Janet Raboud , PhD; Refik Saskin , MSc; Andrew Simor , MD; Mark Loeb , MD, MSc; Karen Green , RN; Don E. Low , MD; Allison McGeer , MD, MScVol. 26, No. 7 (July 2005) pp. 607-615Stable URL: http://www.jstor.org/stable/10.1086/502589
- Keith S. Kaye , MD, MPH; Anthony D. Harris , MD, MPH; Matthew Samore , MD; Yehuda Carmeli , MD, MPHVol. 26, No. 4 (April 2005) pp. 346-351Stable URL: http://www.jstor.org/stable/10.1086/502550
- Rebecca H. Sunenshine , MD; Laura A. Liedtke , MS; Scott K. Fridkin , MD; Larry J. Strausbaugh , MD; TheVol. 26, No. 2 (February 2005) pp. 138-143Stable URL: http://www.jstor.org/stable/10.1086/502517
- Susan M. Poutanen , MD, MPH; Mary Vearncombe , MD; Allison J. McGeer , MD, MSc; Michael Gardam , MD, MSc; Grant Large , ART; Andrew E. Simor , MDVol. 26, No. 2 (February 2005) pp. 134-137Stable URL: http://www.jstor.org/stable/10.1086/502516
- Angelo Pan , MD; Giuseppe Carnevale , MD; Patrizia Catenazzi; Paolo Colombini , MD; Luciano Crema , MD; Lucia Dolcetti , MD; Lucio Ferrari , PhD; Placido Mondello , MD; Liana Signorini , MD; Carmine Tinelli , MD; Eugenia Quiros Roldan , MD; Giampiero Carosi , MDVol. 26, No. 2 (February 2005) pp. 127-133Stable URL: http://www.jstor.org/stable/10.1086/502515
- Jean‐Christophe Lucet , MD; Karine Grenet , PharmD; Laurence Armand‐Lefevre , PharmD; Marion Harnal , RT; Elisabeth Bouvet , MD; Bernard Regnier , MD; Antoine Andremont , MD, PhDVol. 26, No. 2 (February 2005) pp. 121-126Stable URL: http://www.jstor.org/stable/10.1086/502514
- Tjasa Zohar Cretnik , MD; Petra Vovko , BSc; Matjaz Retelj , BSc; Borut Jutersek , BSc; Tatjana Harlander , MD; Jana Kolman , MD; Marija Gubina , PhD, MDVol. 26, No. 2 (February 2005) pp. 184-190Stable URL: http://www.jstor.org/stable/10.1086/502524
- Petra Vovko , BSc; Matjaz Retelj , BSc; Tjasa Zohar Cretnik , MD; Borut Jutersek , BSc; Tatjana Harlander , MD; Jana Kolman , MD; Marija Gubina , PhD, MDVol. 26, No. 2 (February 2005) pp. 191-195Stable URL: http://www.jstor.org/stable/10.1086/502525
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- Todd A. Lee , PharmD, PhD; Donna M. Hacek , MT (ASCP); Kevin T. Stroupe , PhD; Susan M. Collins , MT (ASCP); Lance R. Peterson , MDVol. 26, No. 1 (January 2005) pp. 39-46Stable URL: http://www.jstor.org/stable/10.1086/502485
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- Erika M. C. D’Agata , MD, MPHVol. 25, No. 10 (October 2004) pp. 842-846Stable URL: http://www.jstor.org/stable/10.1086/502306
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- Jon Rosenberg , MD; William R. Jarvis , MD; Sharon L. Abbott , MS; Duc J. Vugia , MD, MPH; for theVol. 25, No. 5 (May 2004) pp. 408-412Stable URL: http://www.jstor.org/stable/10.1086/502414
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- Edward J. Bottone , PhD, D, ABMM, CIC; Mark Cheng , BS; Saul Hymes , BSVol. 25, No. 3 (March 2004) pp. 262-264Stable URL: http://www.jstor.org/stable/10.1086/502388
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- Didier Lepelletier , MD; Stéphanie Perron , PhD; Hélène Huguenin , PhD; Monique Picard; Pascale Bemer , MD; Jocelyne Caillon , PhD; Marie‐Emmanuelle Juvin , PhD; Henri Bernard Drugeon , MDVol. 25, No. 2 (February 2004) pp. 162-164Stable URL: http://www.jstor.org/stable/10.1086/502368
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- Marc‐Oliver Wright , BS, MT; Joan N. Hebden , RN, MS; Anthony D. Harris , MD, MPH; Carl B. Shanholtz , MD; Harold C. Standiford , MD; Jon P. Furuno , MS; Eli N. Perencevich , MD, MSVol. 25, No. 2 (February 2004) pp. 167-168Stable URL: http://www.jstor.org/stable/10.1086/502370
- Nasal Carriage of Methicillin‐Resistant Staphylococcus aureus Among Hospital Staff and Outpatients •Salih Cesur , MD; Fügen Çokça , MDVol. 25, No. 2 (February 2004) pp. 169-171Stable URL: http://www.jstor.org/stable/10.1086/502371
- Allison McGeer , MDVol. 25, No. 2 (February 2004) pp. 97-98Stable URL: http://www.jstor.org/stable/10.1086/502356
- Anthony D. Harris , MD, MPH; Lucia Nemoy , MD; Judith A. Johnson , PhD; Amy Martin‐Carnahan , PhD; David L. Smith , PhD; Hal Standiford , MD; Eli N. Perencevich , MD, MSVol. 25, No. 2 (February 2004) pp. 105-108Stable URL: http://www.jstor.org/stable/10.1086/502358
- Kurt B. Stevenson , MD, MPH; Mark Loeb , MD, MScVol. 25, No. 1 (January 2004) pp. 72-79Stable URL: http://www.jstor.org/stable/10.1086/502296
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- William R. Jarvis , MD; Belinda Ostrowsky , MD, MPHVol. 24, No. 6 (June 2003) pp. 392-396Stable URL: http://www.jstor.org/stable/10.1086/502220
- Stephan Harbarth , MD, MS; Didier Pittet , MD, MSVol. 24, No. 5 (May 2003) pp. 314-316Stable URL: http://www.jstor.org/stable/10.1086/502211
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