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Disparity in infection control practices for multidrug-resistant Enterobacteriaceae
Christopher Lowe1, Kevin Katz, Allison McGeer
1Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
American Journal of Infection Control
|February 25, 2012
Summary
Infection control practices for extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) and carbapenem-resistant Enterobacteriaceae (CRE) vary significantly among hospitals. A coordinated approach is needed to effectively control the spread of these resistant bacteria.
Area of Science:
- Infectious Diseases
- Public Health
- Hospital Epidemiology
Background:
- Limited empirical evidence exists on optimal control strategies for ESBL-E and CRE transmission.
- Hospital infection control practices for these resistant organisms are expected to vary widely.
Purpose of the Study:
- To survey and analyze infection control practices for ESBL-E and CRE in Toronto-area hospitals.
- To identify variations in strategies for managing and controlling resistant Enterobacteriaceae.
Main Methods:
- A survey was distributed to 15 hospitals (6 academic, 9 community) in Toronto, Canada.
- Practices examined included admission screening, contact precautions, and isolation for ESBL-E and CRE.
Main Results:
- All 15 hospitals responded, revealing 8 different management approaches for ESBL-E.
- Significant variation was observed in admission screening (53%), contact precautions (53%-100%), and isolation (60%-100%) for ESBL-E and CRE.
- 75% of hospitals using admission screening employed a risk factor-based approach for both pathogens.
Conclusions:
- Wide variation in infection control strategies for ESBL-E and CRE exists even within a single geographic area.
- These findings are concerning, highlighting the need for coordinated efforts to prevent the emergence and spread of CRE.
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