• Jon P Furuno, Anthony D Harris, Marc-Oliver Wright, Jessina C McGregor, Richard A Venezia, Jingkun Zhu, and Eli N Perencevich.
• Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 100 N. Greene Street, Baltimore, MD 21201, USA. jfuruno@epi.umaryland.edu
• Am J Infect Control. 2004 Dec 1; 32 (8): 436-40.

BackgroundIn 2003, the Society of Healthcare Epidemiology of America (SHEA) recommended surveillance cultures upon hospital admission for patients at high risk for carriage of vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA). The aim of this study was to assess the validity of factors from past medical history in defining patients at high risk for subsequent positive cultures with VRE or MRSA upon hospital admission.MethodsSubjects were adult inpatients admitted to nonintensive care wards of the index hospital during 2001-2002. Cases had MRSA or VRE positive clinical cultures within 48 hours of hospital admission. Patients with previous history of MRSA or VRE were excluded.ResultsNineteen thousand three hundred ninety-nine patients were included, with 273 cases of VRE or MRSA. Previous admission within 1 year of current admission had a sensitivity of 56.8% and a specificity of 88.4% for predicting a case of MRSA or VRE. Individually, the sensitivity and specificity for admission within the past year were 50.5% and 88.4%, respectively, for MRSA and 76.9% and 88.4%, respectively, for VRE.ConclusionsPatients with a previous hospital admission represent a high-risk population for positive culture for VRE and MRSA and may be a group of which active surveillance is indicated.

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