"There are people who are really vocal advocates for doing this. I'm not sure that anything would make them change their mind," Edmond says.
Some hospitals even treat patients with antibiotics who simply test positive as carriers, even though they are not sick and risk further contributing to the problem of antibiotic overuse and the development of resistance organisms.
Some organizations have actively promoted the use of surveillance cultures with companies that manufacture MRSA testing kits, Edmond says. Companies have lobbied state legislators to try to get laws passed to require all these patients get tested for MRSA." He has argued this vociferously on a blog, "Controversies in Hospital Infection Prevention," which he writes with two other infectious disease specialists.
"You could easily say that this whole issue around active surveillance is the most polarizing issue in hospital epidemiology, maybe ever, but certainly in the last decade," he says.
Several states, such as Illinois, mandate that hospitals perform active surveillance testing on all patients admitted to the hospital.
During the past seven years that he's avoided active surveillance, Edmond says, new administrators or other hospital officials will come on board. And they will ask him "Why aren't we doing active surveillance, when other hospitals think it's so important?"
And he tells them, not only do such programs not control hospital-acquired infections, they cost money. At VCU, for example, "it would cost more than $1 million a year in lab expenses. And administrators understand dollars," he said.
But as long as he keeps showing them success—in the most recent quarter there was only one MRSA infection in the entire hospital—persuading the C-suite isn't so tough to do, he says.
This article appears in the December 2011 issue of HealthLeaders magazine.