The use of active surveillance cultures in adult intensive care units to reduce methicillin-resistant Staphylococcus aureus-related morbidity, mortality, and costs: a systematic review

Clin Infect Dis. 2008 Jun 1;46(11):1717-25. doi: 10.1086/587901.


Active surveillance cultures (ASCs) are universal or targeted microbiological screening cultures for patients admitted to a hospital. ASCs have been proposed to control the increasing numbers of infections due to multidrug-resistant organisms, but their efficacy and cost-effectiveness are unproven. We conducted a systematic review of the literature pertaining to the use of ASCs and control of methicillin-resistant Staphylococcus aureus (MRSA). We searched relevant journals and the PubMed Medline, Web of Science, CINAHL, and Cochrane Library databases. No randomized, controlled trials were identified. Sixteen observational studies and 4 economic analyses were reviewed. Only 2 of the observational studies had a control group. None of the studies were of good quality. Thus, we identified important gaps in the literature, including a need for a clear definition of ASCs, a clear implementation protocol, and rigorous economic evaluations. Existing evidence may favor the use of ASCs, but the evidence is of poor quality, and definitive recommendations cannot be made.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Humans
  • Intensive Care Units*
  • Methicillin Resistance*
  • Morbidity
  • Staphylococcal Infections* / economics
  • Staphylococcal Infections* / epidemiology
  • Staphylococcal Infections* / mortality
  • Staphylococcal Infections* / prevention & control
  • Staphylococcus aureus / drug effects*