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In March of 1978 a patient was admitted to the University of Virginia (UVA) Medical Center who was infected with MRSA, a type of antibiotic-resistant staph. The hospital found that this then-new “superbug” was a formidable and persistent foe - they couldn’t get rid of it, and it spread quickly. In 1980 almost half of the staph infections in the hospital were due to MRSA. In 1980, epidemiologist Dr. Barry Farr was a member of the hospital’s infection control committee. Most US hospitals isolate only patients known to have MRSA from a clinical microbiology culture, which means that most colonized (and contagious) patients have never been isolated. The UVA infection control committee approved an approach that was new in the US: they began testing high-risk patients and isolating them if they carried MRSA. This practice is called “active surveillance testing,” and it worked at UVA, where MRSA rates dropped immediately. About a decade later, UVA began to see the rates of MRSA in the hospital rise sharply. Dr. Farr’s team determined that the cause was patients who were moved to UVA from other healthcare facilities – MRSA had begun permeating the entire healthcare system. UVA started active surveillance testing on patients transferred from other facilities, which helped somewhat, but the increasing permeation of other facilities means that the low UVA rates maintained from 1980 to 1990 can’t be achieved until the rest of the healthcare system starts controlling spread. The UVA Medical Center has demonstrated over more than two decades that resistant infections can be controlled in hospitals. Despite their success and 14 studies reporting cost savings from active detection and isolation, many assume without data that attempting control this way would be too expensive. According to Dr. Farr, “UVA hospital staff could see that this approach worked, and they took infection control to heart.”