Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-28T06:33:35.175Z Has data issue: false hasContentIssue false
  • English
  • Français

Status of the Prevention of Multidrug-Resistant Organisms in International Settings: A Survey of the Society for Healthcare Epidemiology of America Research Network

Part of: SHEA Research Network Collection

Published online by Cambridge University Press:  07 November 2016

Nasia Safdar ,
Sharmila Sengupta ,
Jackson S. Musuuza ,
Manisha Juthani-Mehta ,
Marci Drees ,
Lilian M Abbo ,
Aaron M. Milstone ,
Jon P. Furuno ,
Meera Varman  and
Deverick J. Anderson
...Show all authors
Nasia Safdar*
Affiliation:
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Infectious Disease, University of Wisconsin Hospital and Clinics, Madison, Wisconsin William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
Sharmila Sengupta
Affiliation:
Medanta–The Medicity, Sector 38, Gurgaon, Haryana, India
Jackson S. Musuuza
Affiliation:
Institute of Clinical and Translational Research, University of Wisconsin, Madison, Wisconsin
Manisha Juthani-Mehta
Affiliation:
Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut
Marci Drees
Affiliation:
Department of Medicine, Christiana Care Health System, Newark, Delaware Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
Lilian M Abbo
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
Aaron M. Milstone
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Jon P. Furuno
Affiliation:
Department of Pharmacy Practice, Oregon State University/Oregon Health & Science University College of Pharmacy, Portland, Oregon
Meera Varman
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Creighton University Medical Center, Omaha, Nebraska
Deverick J. Anderson
Affiliation:
Department of Medicine, Duke University School of Medicine, Durham, North Carolina
Daniel J. Morgan
Affiliation:
Veterans Affairs Maryland Healthcare System, University of Maryland School of Medicine, Baltimore, Maryland Center for Disease Dynamics, Economics & Policy, Washington, DC
Loren G. Miller
Affiliation:
Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, California
Graham M. Snyder
Affiliation:
Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts
*
Address correspondence to Nasia Safdar, MD, PhD, UWMF Centennial Building, 1685 Highland Ave, Madison, WI 53705 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To examine self-reported practices and policies to reduce infection and transmission of multidrug-resistant organisms (MDRO) in healthcare settings outside the United States.

DESIGN

Cross-sectional survey.

PARTICIPANTS

International members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.

METHODS

Electronic survey of infection control and prevention practices, capabilities, and barriers outside the United States and Canada. Participants were stratified according to their country’s economic development status as defined by the World Bank as low-income, lower-middle-income, upper-middle-income, and high-income.

RESULTS

A total of 76 respondents (33%) of 229 SHEA members outside the United States and Canada completed the survey questionnaire, representing 30 countries. Forty (53%) were high-, 33 (43%) were middle-, and 1 (1%) was a low-income country. Country data were missing for 2 respondents (3%). Of the 76 respondents, 64 (84%) reported having a formal or informal antibiotic stewardship program at their institution. High-income countries were more likely than middle-income countries to have existing MDRO policies (39/64 [61%] vs 25/64 [39%], P=.003) and to place patients with MDRO in contact precautions (40/72 [56%] vs 31/72 [44%], P=.05). Major barriers to preventing MDRO transmission included constrained resources (infrastructure, supplies, and trained staff) and challenges in changing provider behavior.

CONCLUSIONS

In this survey, a substantial proportion of institutions reported encountering barriers to implementing key MDRO prevention strategies. Interventions to address capacity building internationally are urgently needed. Data on the infection prevention practices of low income countries are needed.

Infect Control Hosp Epidemiol. 2016:1–8

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 1 , January 2017 , pp. 53 - 60
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Allegranzi, B, Bagheri Nejad, S, Combescure, C, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377:228–241.Google Scholar
2. Sirinavin, S, Dowell, SF. Antimicrobial resistance in countries with limited resources: unique challenges and limited alternatives. Semin Pediatr Infect Dis 2004;15:94–98.CrossRefGoogle ScholarPubMed
3. Center for Disease Dynamics Economics & Policy. The State of the World’s Antibiotics 2015. Washington, DC: CDDEP; 2015.Google Scholar
4. Drees, M, Pineles, L, Harris, AD, Morgan, DJ. Variation in definitions and isolation procedures for multidrug-resistant gram-negative bacteria: a survey of the Society for Healthcare Epidemiology of America Research Network. Infect Control Hosp Epidemiol 2014;35:362–366.CrossRefGoogle Scholar
5. Fowler, F Jr. Survey Research Methods. Applied Social Research Methods Series, No. 1. Thousand Oaks, CA: Sage; 2009.Google Scholar
6. The World Bank. New country classifications. World Bank website. http://data.worldbank.org/news/new-country-classifications-2015. Published 2015. Accessed December 22, 2015.Google Scholar
7. Muto, CA, Jernigan, JA, Ostrowsky, BE, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus . Infect Control Hosp Epidemiol 2003;24:362–386.Google Scholar
8. Freire-Moran, L, Aronsson, B, Manz, C, et al. Critical shortage of new antibiotics in development against multidrug-resistant bacteria: time to react is now. Drug Resist Updat 2011;14:118–124.CrossRefGoogle ScholarPubMed
9. Hidron, AI, Edwards, JR, Patel, J, et al. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008;29:996–1011.Google Scholar
10. Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370:1198–1208.CrossRefGoogle ScholarPubMed
11. Ziakas, PD, Anagnostou, T, Mylonakis, E. The prevalence and significance of methicillin-resistant Staphylococcus aureus colonization at admission in the general ICU setting: a meta-analysis of published studies. Crit Care Med 2014;42:433–444.CrossRefGoogle ScholarPubMed
12. Rogers, BA, Havers, SM, Harris-Brown, TM, Paterson, DL. Predictors of use of infection control precautions for multiresistant gram-negative bacilli in Australian hospitals: analysis of a national survey. Am J Infect Control 2014;42:963–969.Google Scholar
13. Lowe, C, Katz, K, McGeer, A, Muller, MP, Group, TEW. Disparity in infection control practices for multidrug-resistant Enterobacteriaceae. Am J Infect Control 2012;40:836–839.CrossRefGoogle ScholarPubMed
14. Nazeer, A, Al-Tawfiq, JA. Methicillin-resistant Staphylococcus aureus metrics for patients in Saudi Arabia. J Infect Dev Ctries 2012;6:223–233.Google Scholar
15. Howard, P, Pulcini, C, Levy Hara, G, et al. An international cross-sectional survey of antimicrobial stewardship programmes in hospitals. J Antimicrob Chemother 2015;70:1245–1255.CrossRefGoogle ScholarPubMed
16. Horn, PSV, Green, KE, Martinussen, M. Survey response rates and survey administration in counseling and clinical psychology: a meta-analysis. Educ Psychol Meas 2009;69:389–403.CrossRefGoogle Scholar
17. Watt, S, Simpson, C, McKillop, C, Nunn, V. Electronic course surveys: does automating feedback and reporting give better results? Assessment & Evaluation in Higher Education 2002;27:325–337.Google Scholar
18. Nulty, DD. The adequacy of response rates to online and paper surveys: what can be done? Assessment & Evaluation in Higher Education 2008;33:301–314.Google Scholar
Supplementary material: PDF

Safdar supplementary material

Safdar supplementary material

Download Safdar supplementary material(PDF)
PDF 142 KB