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Infection control policies for MDR organisms vary in US hospitals
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The adoption of policies regarding screening for multidrug-resistant organisms and infection control varied across intensive care units in the United States, researchers from Columbia University found.
“There is variation in the types of activities that hospitals use to prevent and control multidrug-resistant infections in ICUs and the specific types of infections they screen for,” Monika Pogorzelska, PhD, MPH, associate research scientist at Columbia University School of Nursing, told Infectious Disease News. “The use of these policies and practices differs by several characteristics of the hospital, such as hospital size and location, whether the hospital is located in a state with mandatory reporting and staffing of the hospital in terms of infection control personnel.”
Monika Pogorzelska
For the study, 441 infection control directors at hospitals involved with the National Health Care Safety Network were invited to participate in a survey. Of these, 250 participated and provided data on 413 ICUs. The first aim of the study was to determine whether hospitals adopted screening and infection control measures. The second aim was to determine whether these interventions vary by setting.
According to the surveys, 59% of the study ICUs routinely screen for methicillin-resistant Staphylococcus aureus, 22% screen for vancomycin-resistant enterococci, 12% screen for MDR gram-negative rods and 11% screen for C. difficile. Only 40% of ICUs had a written policy for screening admissions for any of these organisms and 27% had a policy to screen periodically after admission. In addition, 31% of hospitals had a policy requiring isolation/contact precautions and 42% had a policy of cohorting of colonized patients.
State mandatory reporting, teaching status, hospital bed size of 201 to 500 beds and location in the West were associated with policies to screen all admissions for MDR organisms. Mandatory reporting, teaching status and use of electronic surveillance systems were associated with policies to screen periodically after admission.
“It is important to note that there are some differences in recommended practices in national guidelines put forth by different organizations and that some questions still remain as to the effectiveness and cost-effectiveness of these practices, which may contribute to the variation we see in hospital use of these policies,” Pogorzelska said. “This study highlights the fact that additional work needs to be done to strengthen the evidence base on the effectiveness of these interventions, to facilitate more standardized guidelines for hospitals.”
Disclosure: This study was funded by the National Institute of Nursing Research
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