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Regional Infection Control Assessment of Antibiotic Resistance Knowledge and Practice

Published online by Cambridge University Press:  13 January 2015

Stephanie R. Black ,
Kingsley N. Weaver ,
Robert A. Weinstein ,
Mary K. Hayden ,
Michael Y. Lin ,
Mary Alice Lavin  and
Susan I. Gerber
Stephanie R. Black*
Affiliation:
Communicable Disease Program, Chicago Department of Public Health, Chicago, Illinois
Kingsley N. Weaver
Affiliation:
Communicable Disease Program, Chicago Department of Public Health, Chicago, Illinois
Robert A. Weinstein
Affiliation:
Division of Infectious Diseases, Cook County Health and Hospitals System, Chicago, Illinois Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois
Mary K. Hayden
Affiliation:
Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois
Michael Y. Lin
Affiliation:
Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois
Mary Alice Lavin
Affiliation:
Infection Prevention and Control, Rush University Medical Center, Chicago, Illinois (during the time of the survey; current affiliation is Illinois Department of Public Health, Office of Health Protection, Chicago, Illinois)
Susan I. Gerber
Affiliation:
Communicable Disease Program, Cook County Department of Public Health, Oak Forest, Illinois (during the time of the survey; current affiliation is Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia)
*
Address correspondence to Stephanie R. Black, MD, MSc, 2160 W. Ogden Ave., Chicago, IL 60612 (stephanie.black@cityofchicago.org).
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Abstract

OBJECTIVE

Multidrug-resistant organisms (MDROs) are an increasing burden among healthcare facilities. We assessed facility-level perceived importance of and responses to various MDROs.

DESIGN

A pilot survey to assess staffing, knowledge, and the perceived importance of and response to various multidrug resistant organisms (MDROs)

SETTING

Acute care and long-term healthcare facilities

METHODS

In 2012, a survey was distributed to infection preventionists at ~300 healthcare facilities. Pathogens assessed were Clostridium difficile, carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, multidrug-resistant (defined as bacterial resistance to ≥3 antibiotic classes) Pseudomonas, and extended-spectrum β-lactamase-producing Escherichia coli.

RESULTS

A total of 74 unique facilities responded, including 44 skilled nursing facilities (SNFs) and 30 acute care facilities (ACFs). While ACFs consistently isolated patients with active infections or colonization due to these MDROs, SNFs had more variable responses. SNFs had more multi-occupancy rooms and reported less specialized training in infection control and prevention than did ACFs. Of all facilities with multi-occupancy rooms, 86% employed a cohorting practice for patients, compared with 50% of those without multi-occupancy rooms; 20% of ACFs and 7% of SNFs cohorted staff while caring for patients with the same MDRO. MRSA and C. difficile were identified as important pathogens in ACFs and SNFs, while CRE importance was unknown or was considered important in <50% of SNFs.

CONCLUSION

We identified stark differences in human resources, knowledge, policy, and practice between ACFs and SNFs. For regional control of emerging MDROs like CRE, there is an opportunity for public health officials to provide targeted education and interventions. Education campaigns must account for differences in audience resources and baseline knowledge.

Infect Control Hosp Epidemiol 2015;00(0): 1–6

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 4 , April 2015 , pp. 381 - 386
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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