Implementation of contact precautions for multidrug-resistant organisms in the post-COVID-19 pandemic era: An updated national Emerging Infections Network (EIN) survey.

IF 2.9 4区 医学 Q2 INFECTIOUS DISEASES Infection Control and Hospital Epidemiology Pub Date : 2024-06-01 Epub Date: 2024-02-14 DOI:10.1017/ice.2024.11
Jessica R Howard-Anderson, Lindsey B Gottlieb, Susan E Beekmann, Philip M Polgreen, Jesse T Jacob, Daniel Z Uslan
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Abstract

Objective: To understand how healthcare facilities employ contact precautions for patients with multidrug-resistant organisms (MDROs) in the post-coronavirus disease 2019 (COVID-19) era and explore changes since 2014.

Design: Cross-sectional survey.

Participants: Emerging Infections Network (EIN) physicians involved in infection prevention or hospital epidemiology.

Methods: In September 2022, we sent via email an 8-question survey on contact precautions and adjunctive measures to reduce MDRO transmission in inpatient facilities. We also asked about changes since the COVID-19 pandemic. We used descriptive statistics to summarize data and compared results to a similar survey administered in 2014.

Results: Of 708 EIN members, 283 (40%) responded to the survey and 201 reported working in infection prevention. A majority of facilities (66% and 69%) routinely use contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) respectively, compared to 93% and 92% in 2014. Nearly all (>90%) use contact precautions for Candida auris, carbapenem-resistant Enterobacterales (CRE), and carbapenem-resistant Acinetobacter baumannii. More variability was reported for carbapenem-resistant Pseudomonas aeruginosa and extended-spectrum β-lactamase-producing gram-negative organisms. Compared to 2014, fewer hospitals perform active surveillance for MRSA and VRE. Overall, 90% of facilities used chlorhexidine gluconate bathing in all or select inpatients, and 53% used ultraviolet light or hydrogen peroxide vapor disinfection at discharge. Many respondents (44%) reported changes to contact precautions since COVID-19 that remain in place.

Conclusions: Heterogeneity exists in the use of transmission-based precautions and adjunctive infection prevention measures aimed at reducing MDRO transmission. This variation reflects a need for updated and specific guidance, as well as further research on the use of contact precautions in healthcare facilities.

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后 COVID-19 大流行时代针对耐多药生物的接触预防措施的实施情况:全国新发感染网络 (EIN) 最新调查。
目的:了解在2019年后冠状病毒病(COVID-19)时代,医疗机构如何对耐多药病菌(MDRO)患者采取接触预防措施,并探讨自2014年以来的变化:横断面调查:新发感染网络(EIN)中从事感染预防或医院流行病学的医生:2022 年 9 月,我们通过电子邮件发送了一份包含 8 个问题的调查问卷,内容涉及接触预防措施和辅助措施,以减少 MDRO 在住院设施中的传播。我们还询问了自 COVID-19 大流行以来的变化情况。我们使用描述性统计来总结数据,并将结果与 2014 年进行的类似调查进行比较:在 708 名 EIN 成员中,有 283 人(40%)对调查做出了回应,其中 201 人称自己从事感染预防工作。大多数医疗机构(66%和69%)分别对耐甲氧西林金黄色葡萄球菌(MRSA)和耐万古霉素肠球菌(VRE)采取常规接触预防措施,而2014年这一比例分别为93%和92%。几乎所有人(>90%)都对念珠菌、耐碳青霉烯类肠杆菌(CRE)和耐碳青霉烯类鲍曼不动杆菌采取接触预防措施。耐碳青霉烯类铜绿假单胞菌和产扩展谱β-内酰胺酶革兰阴性菌的报告差异较大。与 2014 年相比,对 MRSA 和 VRE 进行主动监测的医院数量有所减少。总体而言,90%的医院对所有或部分住院患者使用洗必泰葡萄糖酸盐擦浴,53%的医院在出院时使用紫外线或过氧化氢蒸汽消毒。许多受访者(44%)报告了自 COVID-19 以来对接触性预防措施所做的更改,这些更改仍在实施中:结论:在使用基于传播的预防措施和辅助感染预防措施以减少 MDRO 传播方面存在差异。这种差异反映出需要更新具体的指南,并进一步研究医疗机构中接触预防措施的使用情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
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