Politically Incorrect: Legislation Must Not Mandate Specific Healthcare Epidemiology and Infection Prevention and Control Practices

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In this issue of the journal, Dr. Farr offers his perspective on the recent position statement from the Joint SHEA and APIC Task Force regarding legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The position statement specifically addresses the issue of whether the use of MRSA and VRE surveillance cultures in healthcare settings should be mandated by legislation. It does not attempt to address whether or not, when, or for whom active surveillance cultures should be performed. A broad range of experts and the Boards of Directors of the Society for Healthcare Epidemiology (SHEA) and the Association of Professionals in Infection Control (APIC) reviewed this position statement, which summarizes the effectiveness of active surveillance culturing as it pertains to potential legislation. Both Boards agree the position statement represents a well-reasoned, systematic, and fair review of the literature. Of course, no single document, group, or individual should ever be viewed as having the final word on this or any subject. Thoughtful debate regarding the scientific evidence, when conducted in a professional and constructive manner, is a critical and necessary step in the translation of research and clinical observations into bedside practices. Such debate should also lead to a research agenda that will help fill gaps in knowledge that become apparent in the discussion.