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Influence of patient isolation due to colonization with multidrug-resistant organisms on functional recovery after

Peter Prang1, Christian Schuld1, Ruediger Rupp1

  • 1Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany.

Plos One
|March 26, 2021
PubMed
Abstract

Insights

Strict physical isolation for patients with multidrug-resistant organisms (MDROs) after spinal cord injury (SCI) did not negatively impact neurological recovery or functional outcomes within the first year. Outcomes were comparable between isolated MDRO-positive and non-isolated MDRO-negative patients.

Area of Science:

  • Neurology
  • Infectious Disease Control
  • Rehabilitation Medicine

Background:

  • Multidrug-resistant organisms (MDROs) are a significant concern in healthcare settings.
  • Isolation precautions are standard for MDRO-positive patients to prevent transmission.
  • The impact of prolonged isolation on neurological recovery after acute spinal cord injury (SCI) is not well understood.

Purpose of the Study:

  • To investigate whether strict physical isolation of MDRO-positive patients affects neurological recovery and functional outcomes in the first year post-acute SCI.
  • To compare outcomes between isolated MDRO-positive patients and a matched cohort of MDRO-negative patients.

Main Methods:

  • A prospective study combining chart reviews with neurological and functional outcome data from the European Multicenter Study on Spinal Cord Injury (EMSCI).
  • Included individuals with acute traumatic or ischemic SCI.
  • Compared 13 isolated MDRO-positive patients with 13 matched MDRO-negative controls based on functional (Spinal Cord Independence Measure-SCIM) and neurological impairment (International Standards for Neurological Classification of Spinal Cord Injury-ISNCSCI motor scores) early after SCI.

Main Results:

  • Both isolated MDRO-positive and non-isolated MDRO-negative patients demonstrated functional and neurological improvements.
  • No statistically significant differences in outcomes were observed between the groups at intermediate (12 weeks) and late (24-48 weeks) stages.
  • MDRO-positive patients experienced a median hospitalization of 175 days, with 39% under isolation, compared to 161 days for controls.

Conclusions:

  • Prolonged isolation due to MDRO colonization, even for over a third of the inpatient comprehensive care period, does not appear to hinder neurological recovery or functional outcomes within the first year after SCI.
  • These findings suggest that isolation protocols for MDROs in SCI patients may not adversely affect their rehabilitation trajectory.

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