Efficacy of Infection Control Measures in Managing Outbreaks of Multidrug-Resistant Organisms in Burn Units
Chunyang Wang, Feng Zhang1, Andrew Breland1
1From the Joseph M. Still Burn and Reconstruction Center, Jackson, MS.
Background:
Multidrug-resistant organisms (MDROs) pose a significant threat to severe burn victims and represents a clear epidemic hazard in burn units. Several infection control measures have been implemented to control and manage the outbreaks of MDRO. The efficiency of those measures, however, remains controversial and an area of debate. A systematic review was conducted to evaluate the efficacy of infection control measures and the necessity of closing burn units in dealing with MDRO outbreaks.
Methods:
Peer-reviewed articles were identified using PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases, focusing on infection control measures to manage MDRO outbreaks in burn units.
Results:
Twenty-one studies that reported MDRO outbreaks in burn units met the inclusion criteria. The outbreaks were successfully controlled with interventions in 17 units (81%), partially controlled in 1 unit (4.7%), and uncontrolled in 3 units (14.3%). Infection control measures were implemented by screening patient (19 units), screening health care worker (17 units), obtaining environmental cultures (16 units), providing ongoing staff education (13 units), cohort or isolation (17 units), preemptive barrier precautions (10 units), improving hand hygiene (15 units), and enhanced cleaning and environmental disinfection (17 units). Closure of burn units occurred in 8 units, with outbreaks controlled in 6 of the units (75%). The reasons for unit closure include decontamination (4 units; 50%), outbreak investigation (1 unit; 12.5%), and uncontrolled outbreaks (3 units; 37.5%). The incidence of infection was significantly decreased in 4 units after the closure but rose again after reopening in 1 of the units. In 3 units, the spread was halted by other control measures, including change of hydrotherapy facilities, identification of staff transmission, and unit structure remodeling.
Conclusions:
Proper infection control measures play an important role in managing MDRO outbreaks in burn units. Temporary closure of burn units may be necessary to control the spread of nosocomial, and this option should be considered when other measures are ineffective.
Insights
Multidrug-resistant organism (MDRO) outbreaks in burn units can be managed with infection control measures. In some cases, temporary closure of burn units may be necessary to control MDRO spread.
Area of Science:
- Infectious Diseases
- Public Health
- Critical Care Medicine
Background:
- Multidrug-resistant organisms (MDROs) are a significant threat to severe burn victims.
- MDRO outbreaks in burn units pose an epidemic hazard.
- The efficacy of infection control measures for MDROs is debated.
Purpose of the Study:
- To systematically review the efficacy of infection control measures in managing MDRO outbreaks in burn units.
- To evaluate the necessity of burn unit closure for controlling MDRO outbreaks.
Main Methods:
- A systematic review of peer-reviewed articles was conducted.
- Databases searched included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials.
- Studies focused on infection control measures for MDRO outbreaks in burn units.
Main Results:
- Twenty-one studies met inclusion criteria, reporting on MDRO outbreaks in burn units.
- Interventions successfully controlled outbreaks in 81% of units.
- Burn unit closure was implemented in 8 units, controlling outbreaks in 75% of those cases.
- Other measures like hydrotherapy changes and staff transmission identification also halted spread.
Conclusions:
- Effective infection control measures are crucial for managing MDRO outbreaks in burn units.
- Temporary closure of burn units can be a necessary option when other measures fail.
- A comprehensive approach to infection control is vital for patient safety.
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