scholarly journals Policies for Controlling Multidrug-Resistant Organisms in US Healthcare Facilities Reporting to the National Healthcare Safety Network, 2014

2016 ◽  
Vol 37 (9) ◽  
pp. 1105-1108 ◽  
Author(s):  
Lindsey M. Weiner ◽  
Amy K. Webb ◽  
Maroya S. Walters ◽  
Margaret A. Dudeck ◽  
Alexander J. Kallen
Keyword(s):  
Acute Care ◽  
Multidrug Resistant ◽  
Healthcare Facilities ◽  
Contact Precautions ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Chlorhexidine Bathing ◽  
Multidrug Resistant Organisms ◽  
Using Data ◽  
Facility Survey

We examined reported policies for the control of common multidrug-resistant organisms (MDROs) in US healthcare facilities using data from the National Healthcare Safety Network Annual Facility Survey. Policies for the use of Contact Precautions were commonly reported. Chlorhexidine bathing for preventing MDRO transmission was also common among acute care hospitals.Infect Control Hosp Epidemiol 2016:1–4

scholarly journals Hospital microbiology laboratory practices for Enterobacteriaceae: Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) annual survey, 2015 and 2016

2018 ◽  
Vol 39 (9) ◽  
pp. 1115-1117 ◽  
Author(s):  
Alicia Shugart ◽  
Maroya Spalding Walters ◽  
Lindsey M. Weiner ◽  
David Lonsway ◽  
Alexander J. Kallen
Keyword(s):  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
National Healthcare ◽  
Annual Survey ◽  
National Healthcare Safety Network ◽  
Control And Prevention ◽  
Using Data ◽  
Facility Survey

AbstractWe analyzed clinical microbiology laboratory practices for detection of multidrug-resistant Enterobacteriaceae in US short-stay acute-care hospitals using data from the National Healthcare Safety Network (NHSN) Annual Facility Survey. Half of hospitals reported testing for carbapenemases, and 1% performed routine polymyxin susceptibility testing using reference broth microdilution.

scholarly journals Regional Infection Control Assessment of Antibiotic Resistance Knowledge and Practice

2015 ◽  
Vol 36 (4) ◽  
pp. 381-386 ◽  
Author(s):  
Stephanie R. Black ◽  
Kingsley N. Weaver ◽  
Robert A. Weinstein ◽  
Mary K. Hayden ◽  
Michael Y. Lin ◽  
...  
Keyword(s):  
Infection Control ◽  
Acute Care ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
Nursing Facilities ◽  
Policy And Practice ◽  
Healthcare Facilities ◽  
Carbapenem Resistant ◽  
Perceived Importance ◽  
Multidrug Resistant Organisms

OBJECTIVEMultidrug-resistant organisms (MDROs) are an increasing burden among healthcare facilities. We assessed facility-level perceived importance of and responses to various MDROs.DESIGNA pilot survey to assess staffing, knowledge, and the perceived importance of and response to various multidrug resistant organisms (MDROs)SETTINGAcute care and long-term healthcare facilitiesMETHODSIn 2012, a survey was distributed to infection preventionists at ~300 healthcare facilities. Pathogens assessed were Clostridium difficile, carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, multidrug-resistant (defined as bacterial resistance to ≥3 antibiotic classes) Pseudomonas, and extended-spectrum β-lactamase-producing Escherichia coli.RESULTSA total of 74 unique facilities responded, including 44 skilled nursing facilities (SNFs) and 30 acute care facilities (ACFs). While ACFs consistently isolated patients with active infections or colonization due to these MDROs, SNFs had more variable responses. SNFs had more multi-occupancy rooms and reported less specialized training in infection control and prevention than did ACFs. Of all facilities with multi-occupancy rooms, 86% employed a cohorting practice for patients, compared with 50% of those without multi-occupancy rooms; 20% of ACFs and 7% of SNFs cohorted staff while caring for patients with the same MDRO. MRSA and C. difficile were identified as important pathogens in ACFs and SNFs, while CRE importance was unknown or was considered important in <50% of SNFs.CONCLUSIONWe identified stark differences in human resources, knowledge, policy, and practice between ACFs and SNFs. For regional control of emerging MDROs like CRE, there is an opportunity for public health officials to provide targeted education and interventions. Education campaigns must account for differences in audience resources and baseline knowledge.Infect Control Hosp Epidemiol 2015;00(0): 1–6

scholarly journals Optimizing Sentinel Surveillance to Target Containment of Emerging Multidrug-Resistant Organisms in Regional Networks

2020 ◽  
Vol 41 (S1) ◽  
pp. s336-s337
Author(s):  
Prabasaj Paul ◽  
Rachel Slayton ◽  
Alexander Kallen ◽  
Maroya Walters ◽  
John Jernigan
Keyword(s):  
At Risk ◽  
Acute Care ◽  
Deterministic Model ◽  
Healthcare Facility ◽  
Multidrug Resistant ◽  
Sentinel Surveillance ◽  
Outbreak Detection ◽  
Care Hospital ◽  
Healthcare Facilities ◽  
Multidrug Resistant Organisms

Background: Successful containment of regional outbreaks of emerging multidrug-resistant organisms (MDROs) relies on early outbreak detection. However, deploying regional containment is resource intensive; understanding the distribution of different types of outbreaks might aid in further classifying types of responses. Objective: We used a stochastic model of disease transmission in a region where healthcare facilities are linked by patient sharing to explore optimal strategies for early outbreak detection. Methods: We simulated the introduction and spread of Candida auris in a region using a lumped-parameter stochastic adaptation of a previously described deterministic model (Clin Infect Dis 2019 Mar 28. doi:10.1093/cid/ciz248). Stochasticity was incorporated to capture early-stage behavior of outbreaks with greater accuracy than was possible with a deterministic model. The model includes the real patient sharing network among healthcare facilities in an exemplary US state, using hospital claims data and the minimum data set from the CMS for 2015. Disease progression rates for C. auris were estimated from surveillance data and the literature. Each simulated outbreak was initiated with an importation to a Dartmouth Atlas of Health Care hospital referral region. To estimate the potential burden, we quantified the “facility-time” period during which infectious patients presented a risk of subsequent transmission within each healthcare facility. Results: Of the 28,000 simulated outbreaks initiated with an importation to the community, 2,534 resulted in patients entering the healthcare facility network. Among those, 2,480 (98%) initiated a short outbreak that died out or quickly attenuated within 2 years without additional intervention. In the simulations, if containment responses were initiated for each of those short outbreaks, facility time at risk decreased by only 3%. If containment responses were initiated for the 54 (2%) outbreaks lasting 2 years or longer, facility time at risk decreased by 79%. Sentinel surveillance through point-prevalence surveys (PPSs) at the 23 skilled-nursing facilities caring for ventilated patients (vSNF) in the network detected 50 (93%) of the 54 longer outbreaks (median, 235 days to detection). Quarterly PPSs at the 23 largest acute-care hospitals (ie, most discharges) detected 48 longer outbreaks (89%), but the time to detection was longer (median, 716 days to detection). Quarterly PPSs also identified 76 short-term outbreaks (in comparison to only 14 via vSNF PPS) that self-terminated without intervention. Conclusions: A vSNF-based sentinel surveillance system likely provides better information for guiding regional intervention for the containment of emerging MDROs than a similarly sized acute-care hospital–based system.Funding: NoneDisclosures: None

Contact precautions for colonisation with multidrug-resistant organisms and haemodialysis patient quality of life and mood: a pilot case-control study

2019 ◽  
pp. 19-25 ◽  
Author(s):  
Rathika Krishnasamy
Keyword(s):  
Quality Of Life ◽  
Qualitative Interviews ◽  
Social Function ◽  
Multidrug Resistant ◽  
Contact Precautions ◽  
Dialysis Vintage ◽  
Multidrug Resistant Organisms ◽  
And Gender ◽  
The Impact

Background: The rate of multidrug-resistant organisms (MDRO) colonisation in dialysis populations has increased over time. This study aimed to assess the effect of contact precautions and isolation on quality of life and mood for haemodialysis (HD) patients colonised with MDRO. Methods: Patients undergoing facility HD completed the Kidney Disease Quality of Life (KDQOL–SFTM), Beck Depression Inventory (BDI) and Personal Wellbeing-Index Adult (PWI-A). Patients colonised with MDRO were case-matched by age and gender with patients not colonised. Results: A total of 16 MDRO-colonised patients were matched with 16 controls. Groups were well matched for demographics and co-morbidities, other than a trend for older dialysis vintage in the MDRO group [7.2 years (interquartile range 4.6–10.0) compared to 3.2 (1.4–7.6) years, p=0.05]. Comparing MDRO-positive with negative patients, physical (30.5±10.7 vs. 34.6±7.3; p=0.2) and mental (46.5±11.2 vs. 48.5±12.5; p = 0.6) composite scores were not different between groups. The MDRO group reported poorer sleep quality (p=0.01) and sleep patterns (p=0.05), and lower social function (p=0.02). BDI scores were similar (MDRO-positive 10(3.5–21.0) vs. MDRO-negative 12(6.5–16.0), p=0.6). PWI-A scores were also similar in both groups; however, MDRO patients reported lower scores for “feeling safe”, p=0.03. Conclusion: While overall scores of quality of life and depression were similar between groups, the MDRO group reported poorer outcomes in sleep and social function. A larger cohort and qualitative interviews may give more detail of the impact of contact precautions and isolation on HD patients. The necessity for contact precautions for different MDRO needs consideration.

scholarly journals Changes in the Number of Intensive Care Unit Beds in U.S. Hospitals During the Early Months of the COVID-19 Pandemic, as reported to the National Healthcare Safety Network’s COVID-19 Module

2021 ◽  
pp. 1-12
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
Raymund Dantes ◽  
Cindy Gross ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Type ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Bed Capacity ◽  
Using Data

Abstract Using data from the National Healthcare Safety Network (NHSN), we assessed changes to intensive care unit (ICU) bed capacity during the early months of the COVID-19 pandemic. Changes in capacity varied by hospital type and size. ICU beds increased by 36%, highlighting the pressure placed on hospitals during the pandemic.

scholarly journals Public Health Oversight of Interfacility Transfers During a Candida auris Outbreak—Orange County, California, 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s76-s77
Author(s):  
Kathleen O'Donnell ◽  
Ellora Karmarkar ◽  
Brendan R Jackson ◽  
Erin Epson ◽  
Matthew Zahn
Keyword(s):  
Public Health ◽  
Acute Care ◽  
Orange County ◽  
Acute Care Hospitals ◽  
Nursing Facilities ◽  
Candida Auris ◽  
Retrospective Case ◽  
California Department ◽  
Healthcare Facilities ◽  
Contact Precautions

Background: In February 2019, the Orange County Health Care Agency (OCHCA) identified an outbreak of Candida auris, an emerging fungus that spreads rapidly in healthcare facilities. Patients in long-term acute-care hospitals (LTACHs) and skilled nursing facilities that provide ventilator care (vSNFs) are at highest risk for C. auris colonization. With assistance from the California Department of Public Health and the Centers for Disease Control and Prevention, OCHCA instituted enhanced surveillance, communication, and screening processes for patients colonized with or exposed to C. auris. Method: OCHCA implemented enhanced surveillance by conducting point-prevalence surveys (PPSs) at all 3 LTACHs and all 14 vSNFs in the county. Colonized patients were identified through axilla/groin skin swabbing with C. auris detected by PCR and/or culture. In facilities where >1 C. auris colonized patient was found, PPSs were repeated every 2 weeks to identify ongoing transmission. Retrospective case finding was instituted at 2 LTACHs with a high burden of colonized patients; OCHCA contacted patients discharged after January 1, 2019, and offered C. auris screening. OCHCA tracked the admission or discharge of all colonized patients, and facilities with ongoing transmission were required to report transfers of any patient, regardless of colonization status. OCHCA tracked all patients discharged from facilities with ongoing transmission to ensure that accepting facilities conducted admission surveillance testing of exposed patients and implemented appropriate environmental and contact precautions. Result: From February–October 2019, 192 colonized patients were identified. All 3 LTACHs and 6 of 14 VSNFs had at least 1 C. auris–colonized patient identified on initial PPS, and 2 facilities had ongoing transmission identified on serial PPS. OCHCA followed 96 colonized patients transferred a total of 230 times (an average of 2.4 transfers per patient) (Fig. 1) and 677 exposed patients discharged from facilities with ongoing transmission (Fig. 2). Admission screening of 252 exposed patients on transfer identified 13 (5.2%) C. auris–colonized patients. As of November 1, 2019, these 13 patients were admitted 21 times to a total of 6 acute-care hospitals, 2 LTACHs, and 3 vSNFs. Transferring facilities did not consistently communicate the colonized patient’s status and the requirements for isolation and testing of exposed patients. Conclusion: OCHCA oversight of interfacility transfer, though labor-intensive, improved identification of patients colonized with C. auris and implementation of appropriate environmental and contact precautions, reducing the risk of transmission in receiving healthcare facilities.Funding: NoneDisclosures: None

A controlled trial of universal gloving versus contact precautions for preventing the transmission of multidrug-resistant organisms

2007 ◽  
Vol 35 (10) ◽  
pp. 650-655 ◽  
Author(s):  
Gonzalo M.L. Bearman ◽  
Alexandre R. Marra ◽  
Curtis N. Sessler ◽  
Wally R. Smith ◽  
Adriana Rosato ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Multidrug Resistant ◽  
Contact Precautions ◽  
Multidrug Resistant Organisms

scholarly journals Long-Term Impact of Universal Contact Precautions on Rates of Multidrug-Resistant Organisms in ICUs: A Comparative Effectiveness Study

2018 ◽  
Vol 39 (5) ◽  
pp. 534-540 ◽  
Author(s):  
E. Yoko Furuya ◽  
Bevin Cohen ◽  
Haomiao Jia ◽  
Elaine L. Larson
Keyword(s):  
Comparative Effectiveness ◽  
Baseline Period ◽  
Multidrug Resistant ◽  
Incidence Density ◽  
Research Database ◽  
Longitudinal Impact ◽  
Contact Precautions ◽  
Significant Difference ◽  
Multidrug Resistant Organisms ◽  
The Impact

OBJECTIVETo evaluate the impact of universal contact precautions (UCP) on rates of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) over 9 yearsDESIGNRetrospective, nonrandomized observational studySETTINGAn 800-bed adult academic medical center in New York CityPARTICIPANTSAll patients admitted to 6 ICUs, 3 of which instituted UCP in 2007METHODSUsing a comparative effectiveness approach, we studied the longitudinal impact of UCP on MDRO incidence density rates, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Klebsiella pneumoniae. Data were extracted from a clinical research database for 2006–2014. Monthly MDRO rates were compared between the baseline period and the UCP period, utilizing time series analyses based on generalized linear models. The same models were also used to compare MDRO rates in the 3 UCP units to 3 ICUs without UCPs.RESULTSOverall, MDRO rates decreased over time, but there was no significant decrease in the trend (slope) during the UCP period compared to the baseline period for any of the 3 intervention units. Furthermore, there was no significant difference between UCP units (6.6% decrease in MDRO rates per year) and non-UCP units (6.0% decrease per year; P=.840).CONCLUSIONThe results of this 9-year study suggest that decreases in MDROs, including multidrug-resistant gram-negative bacilli, were more likely due to hospital-wide improvements in infection prevention during this period and that UCP had no detectable additional impact.Infect Control Hosp Epidemiol 2018;39:534–540

Sign in / Sign up

Export Citation Format

Share Document