Surveillance and Stewardship: Where Infection Prevention and Antimicrobial Stewardship Intersect

Area of Science:

• Infectious Diseases
• Antimicrobial Stewardship
• Infection Control

Background:

• Colonization with multidrug-resistant organisms (MDROs) increases infection risk.
• Hospital surveillance identifies MDROs like MRSA, VRE, ESBL-producing Enterobacterales, and carbapenemase-producing organisms.
• Current practices often overlook MDRO colonization data when selecting antimicrobial therapy.

Purpose of the Study:

• To explore the integration of MDRO colonization data into antimicrobial therapy selection.
• To examine the role of colonization data in guiding treatment for drug-resistant infections.
• To assess the utility of colonization data for antimicrobial prophylaxis, such as before prostate biopsies.

Main Methods:

• This perspective reviews existing literature and clinical practices.
• It analyzes the intersection of infection control surveillance and antimicrobial stewardship.
• The discussion considers the predictive value of MDRO colonization tests.

Main Results:

• Conflicting data exist regarding the predictive value of colonization tests for guiding therapy.
• Antimicrobial stewardship teams often define strategies for complicated infections and prophylaxis.
• Routine MDRO surveillance data are frequently available but underutilized.

Conclusions:

• Integrating MDRO colonization data into clinical decision-making is crucial.
• This approach can optimize antimicrobial use and improve patient outcomes.
• Bridging infection control and antimicrobial stewardship enhances comprehensive patient care.