measures utilized to prevent MDRO transmission, signage was the most common across all organisms( 41 percent) followed by enhanced room cleaning after discharge( 28 percent).
As the researchers observe, the data from the 2026 survey“ reveal a shifting trend in application of AS and CP but a persistence of heterogenous practices to discontinue CP by MDRO. This survey showed that AS is more commonly applied to specific units rather than to all admissions. More than half of respondents reported performing AS for at least one MDRO on admission to a specific unit compared to less than a quarter on all admissions. Facilities most frequently applied AS to the ICU patient population. The practice of AS in the ICU appears to be relatively stable but preemptive CP appears to be decreasing compared to a 2008 survey. In that survey of National Healthcare Safety Network hospitals, 40 percent of ICU admissions were screened for at least one MDRO, and 31 percent employed preemptive CP pending screen results. In our survey, only 16 percent of facilities reported using preemptive CP. Further investigation is needed to determine the reason that preemptive CP use was low. Potential motivations include material constraints, throughput concerns, environmental impact considerations, and availability and rapid turnaround of AS tests. We surmise that a combination of these factors may contribute.”
The 2026 survey authors note that in this survey, CP were employed more often for infection than colonization, and they observe,“ It has been shown that both infected and colonized patients transmit MDRO. While patients with active infections are presumed to have a higher bacterial load and therefore shed more into the environment, colonized patients have been shown to readily and equally contribute
to environmental contamination. It is possible that this shift was driven by healthcare worker fatigue of CP, as the overall number and combined prevalence of MDRO have increased. Most of the published literature, however, does not make a distinction between CP for infection versus colonization in transmission pathways. A growing body of evidence demonstrates an increased infection risk following colonization with an MDRO, indicating the importance of transmission interruption.”
The 2026 survey authors also point to what they call an interesting juxtaposition of reported practices existing between CP implementation and AS screening:“ When facilities reported using CP for a targeted MDRO, CP tended to be used across all patient types and locations. But AS was limited to specific patient populations, such as ICU and oncology or transplant units. In practice, this may be another example of the previously noted dichotomy of CP practices for infection versus colonization. If so, this would suggest an implicit tolerance for transmission risk in certain populations and / or a competing desire to avoid CP when able. Alternatively, this may be the result of pragmatic implementation recognizing that AS is labor- and cost-intensive and targeting AS to high-risk populations to optimize the cost-benefit ratio.”
Surveillance
An important distinction when considering the results of the 2026 survey is that facilities were asked about screening practices in the context of routine surveillance, not outbreak response. Active surveillance( AS) was defined as screening tests used to identify asymptomatic colonization for the purpose of identifying carriers. Most facilities,( 70 percent), performed AS for at least one MDRO. Active surveillance for MRSA was performed by 59 percent of facilities
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22 • www. healthcarehygienemagazine. com • march-april 2026