Experiences of carriers of multidrug-resistant organisms: a systematic review
1National Coordination Centre for Communicable Disease Control, RIVM-Centre for Communicable Diseases, Bilthoven, the Netherlands.
Objectives:
A comprehensive overview of the ways control measures directed at carriers of multidrug-resistant organisms (MDRO) affect daily life of carriers is lacking. In this systematic literature review, we sought to explore how carriers experience being a carrier and how they experience being subjected to control measures by looking at the impact on basic capabilities.
Methods:
We searched Medline, Embase and PsychINFO until 26 May 2016 for studies addressing experiences of MDRO carriers. Twenty-seven studies were included, addressing experiences with methicillin-resistant Staphylococcus aureus (n = 21), ESBL (n = 1), multiple MDRO (n = 4) and other (n = 1, not specified). We categorized reported experiences according to Nussbaum's capability approach.
Results:
Carriage and control measures were found to interfere with quality of care, cause negative emotions, limit interactions with loved ones, cause stigmatization, limit recreational activities and create financial and professional insecurity. Further, carriers have difficulties with full comprehension of the problem of antimicrobial resistance, thus affecting six out of ten basic capabilities.
Conclusions:
Applying Nussbaum's capability approach visualizes an array of unintended consequences of control measures. Carriers experience stigmatization, especially in healthcare settings, and have limited understanding of their situation and the complexities of antimicrobial resistance.
Insights
Control measures for multidrug-resistant organisms (MDRO) carriers impact daily life, causing stigma and limiting activities. Understanding these effects is crucial for improving care and support for MDRO carriers.
Area of Science:
- Medical Microbiology
- Public Health
- Sociology
Background:
- Control measures for multidrug-resistant organisms (MDRO) carriers are essential but their impact on carriers' daily lives is not well understood.
- A gap exists in understanding the lived experiences of individuals carrying MDRO and the consequences of implemented control strategies.
Purpose of the Study:
- To systematically review and explore how individuals experience being an MDRO carrier.
- To investigate the impact of control measures on the daily lives and basic capabilities of MDRO carriers.
Main Methods:
- Systematic literature review of studies on MDRO carrier experiences.
- Searched Medline, Embase, and PsychINFO databases until May 2016.
- Analyzed 27 studies using Nussbaum's capability approach to categorize experiences.
Main Results:
- MDRO carriage and control measures negatively affect quality of care, emotional well-being, social interactions, and lead to stigmatization.
- Carriers face limitations in recreational activities, financial, and professional security.
- Difficulties in comprehending antimicrobial resistance impact six basic capabilities.
Conclusions:
- Nussbaum's capability approach highlights unintended consequences of control measures for MDRO carriers.
- Carriers experience significant stigmatization, particularly in healthcare settings.
- Limited understanding of antimicrobial resistance and their carrier status is a key issue.
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