Wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: a...

Area of Science:

• Infectious Diseases
• Healthcare Epidemiology
• Public Health

Background:

• Multidrug-resistant organisms (MDROs) pose a significant threat in healthcare settings.
• Intensive care units (ICUs) are high-risk environments for MDRO transmission.
• Standardized screening and infection control policies are crucial for managing MDROs.

Purpose of the Study:

• To describe the adoption of MDRO screening and infection control policies in US ICUs in 2008.
• To identify factors predicting the presence, monitoring, and implementation of these policies.
• To understand variations in policy adoption across different hospital settings.

Main Methods:

• A national survey of infection control directors in hospitals participating in the National Healthcare Safety Network was conducted in 2008.
• A modified Dillman technique was used for survey administration.
• Bivariate and multivariable logistic regression models were employed to analyze policy differences and identify predictors.

Main Results:

• A 57% response rate was achieved with 250 hospitals participating.
• Routine screening for specific MDROs varied: MRSA (59%), VRE (22%), gram-negative rods (12%), and C. difficile (11%).
• Reported ICU policies included screening all admissions (40%), periodic screening (27%), presumptive isolation (31%), and patient cohorting (42%).
• Hospital characteristics, such as mandatory reporting and teaching status, were independent predictors of policy implementation.

Conclusions:

• Significant variation exists in the adoption and implementation of MDRO screening and infection control interventions in ICUs.
• Discrepancies may stem from differing interpretations of published guidelines.
• Further research is essential to develop effective strategies and promote compliance with infection control measures.