Prevention and Control of Multidrug-Resistant Organism Infections
Multidrug-resistant organisms (MDROs) are a major concern for most hospitals. Causing infections for which antibiotic therapy is limited and in some cases no longer effective, they are associated with high morbidity and mortality rates and represent a significant burden on healthcare resources.
Most frequently spread through auto-infection or cross-transmitted between patients through healthcare workers, MDRO infections are highly contagious and can be responsible for outbreaks.
Three of the most common MDROs are :
- methicillin-resistant Staphylococcus aureus (MRSA)
According to CDC data, the proportion of Staphylococcus aureus infections that are antimicrobial resistant has been growing significantly over the past few decades. In 1974, MRSA infections accounted for just two percent of the total number of S. aureus infections; in 1995 this had risen to 22%; and by 2004, over 60% of infections showed resistance in the US.
- extended spectrum ß-lactamase-producing Enterobacteria (ESBL)
Microbial resistance through extended-spectrum ß-lactamase was first reported in the 1980s, soon after the introduction of 3rd generation cepahlosporins in clinical practice. Today, ESBL-producing Enterobacteria are recognized as nosocomial pathogens of major importance.
- vancomycin-resistant enterococci (VRE)
Enterococci with acquired vancomycin resistance are responsible for 1 in 3 infections in US intensive care units and VRE outbreaks more than doubled in Europe between 2001 and 2004.1,2 Transfer of vancomycin resistance from enterococci to staphylococci (VRSA) is a major threat for the healthcare community.
Why is it essential to actively screen patients for MDROs ?
Screening for MDRO carriage on admission to hospital, together with contact isolation of colonized patients, is the most efficient measure for infection control. This strategy is today recommended by official organisms such as the Society for Healthcare Epidemiology of America.3
Using systematic screening to control the spread of MDROs is justified on both medical and economic grounds to:
- Reduce the number of MDRO infections by avoiding cross transmission between patients through isolation and auto-infection of colonized patients
- Adjust the antibiotic surgical prophylaxis depending on the patient status
- Optimize the use of isolation beds
- Control the level resistance
- Provide healthcare cost-effectiveness
bioMérieux offer for MDRO screening of patients
bioMérieux’s innovative range of chromogenic culture media includes 3 prevention media for direct isolation of multidrug-resistant bacteria :
- ChromID™ ESBL: screening of extended spectrum ß-lactamase-producing Enterobacteria
- ChromID MRSA: rapid and reliable screening of methicillin-resistant S. aureus
- ChromID VRE.: rapid and reliable screening of E. faecium and E. faecalis showing acquired vancomycin resistance
Used for screening patients for carriage of MDR bacteria, these media provide rapid results which enable isolation of colonized patients and the reinforcement of hygiene measures to control the spread of infection.
1. CDC report. Recommendations for Preventing the Spread of Vancomycin Resistance: recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC), 2006.
2.European Antimicrobial Resistance Surveillance System. EARSS Annual Report 2004
3.Muto CA, Jernigan JA, Ostrowsky BE, Richet HM, Jarvis WR, Boyce JM, Farr BR. SHEA Guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol. 2003; 24:362-386.