1. Active surveillance culturing of asymptomatic individuals is a well-established and widely used patient safety practice in hospitals. However, questions remain about the cost and effectiveness of specific surveillance strategies in reducing clinical infection and transmission events.
2. Two new studies of high-risk patients (for Clostridioides difficile and carbapenem-resistant Enterobacterales) found that active surveillance culturing limited to high-risk patient populations could significantly reduce infections. However, these studies compared targeted screening to no screening. The effectiveness of targeted screening compared to universal screening remains unclear.
3. Active surveillance culturing of all patients can be labor intensive and consume substantial resources, while limiting screening to specific populations can reduce these burdens. Recent studies provide little evidence of the direct costs or other resources needed to support targeted surveillance.
4. Evidence on active surveillance culturing for Candida auris remains sparse, with no effectiveness studies identified. A pilot study provides early evidence for the feasibility of implementing Candida auris surveillance, but a survey of Canadian hospitals and laboratories revealed that most sites were not prepared to implement surveillance programs.
5. No recent toolkits are available to support implementation of active surveillance culturing—for all patients or for specific populations—for Clostridioides difficile, methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacterales, or Candida auris.

Leas BF, Pegues DA, Mull NK. Active Surveillance Culturing of Clostridioides difficile and Multi-Drug Resistant Organisms: Methicillin-Resistant Staphylococcus aureus (MRSA), Carbapenem-Resistant Enterobacterales (CRE), and Candida auris. (Prepared by the ECRI-Penn Evidence-based Practice Center under Contract No. 75Q80120D00003). AHRQ Publication No. 23(24)-EHC019-14. Rockville, MD: Agency for Healthcare Research and Quality. May 2024. DOI: https://doi.org/10.23970/AHRQEPC_MHS4CULTURING. Posted final reports are located on the Effective Health Care Program search page.