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Management of Inpatients Colonized or Infected With Antimicrobial-Resistant Bacteria in Hospitals in the United States

Published online by Cambridge University Press:  21 June 2016

Rebecca H. Sunenshine ,
Laura A. Liedtke ,
Scott K. Fridkin ,
Larry J. Strausbaugh  and
The Infectious Diseases Society of America Emerging Infections Network
Rebecca H. Sunenshine
Affiliation:
Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon
Laura A. Liedtke
Affiliation:
Research Service, Veterans' Affairs Medical Center, Portland, Oregon
Scott K. Fridkin
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Larry J. Strausbaugh*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon Research Service, Veterans' Affairs Medical Center, Portland, Oregon School of Medicine, Oregon Health & Science University, and the Infectious Disease Section, Division of Hospital and Specialty Medicine, Veterans' Affairs Medical Center, Portland, Oregon
*
Division of Hospital & Specialty Medicine (P3-ID), Veterans' Affairs Medical Center, 3710 SWVeterans Hospital Road, Portland, OR 97239.[email protected]
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Abstract

Background:

Although guidelines for multidrug-resistant organisms generally include recommendations for contact precautions and surveillance cultures, it is not known how frequently U.S. hospitals implement these measures on a routine basis and whether infectious diseases consultants endorse their use.

Methods:

The Emerging Infections Network surveyed its members, infectious diseases consultants, to assess their use of and support for contact precautions and surveillance cultures for routine management of multidrug-resistant organisms in their principal inpatient workplace. Specifically, members were asked about use of these strategies for methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and multidrug-resistant, gram-negative bacilli on general wards, ICUs, and transplant units.

Results:

Overall, 400 (86%) of 463 respondents supported the routine use of contact precautions to control one or more multidrug-resistant organisms in at least one unit, and 89% worked in hospitals that use them. In contrast, 50% of respondents favored routine use of surveillance cultures to manage at least one multidrug-resistant organism in any unit, and 30% of respondents worked in hospitals that use them routinely in any unit. Members favored routine use of surveillance cultures significantly more in ICUs and transplant units than in general wards for each multidrug-resistant organism (P <.001).

Conclusions:

Most of the infectious diseases consultants endorsed the use of contact precautions for routine management of patients colonized or infected with multidrug-resistant organisms and work in hospitals that have implemented them. In contrast, infectious diseases consultants are divided about the role of routine surveillance cultures in multidrug-resistant organism management, and few work in hospitals that use them.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 2 , February 2005 , pp. 138 - 143
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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