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Clinicians' Knowledge, Attitudes, and Practices regarding Infections with Multidrug-Resistant Gram-Negative Bacilli in Intensive Care Units

Published online by Cambridge University Press:  02 January 2015

Juyan Julia Zhou ,
Sameer J. Patel ,
Haomiao Jia ,
Scott A. Weisenberg ,
E. Yoko Furuya ,
Christine J. Kubin ,
Luis Alba ,
Kyu Rhee  and
Lisa Saiman
Juyan Julia Zhou*
Affiliation:
Department of Pediatrics, Columbia University, New York, New York
Sameer J. Patel
Affiliation:
Department of Pediatrics, Columbia University, New York, New York
Haomiao Jia
Affiliation:
Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, New York
Scott A. Weisenberg
Affiliation:
Alta Bates Summit Medical Center, Oakland, California
E. Yoko Furuya
Affiliation:
Department of Medicine, Columbia University, New York, New York Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, New York
Christine J. Kubin
Affiliation:
Department of Medicine, Columbia University, New York, New York
Luis Alba
Affiliation:
Department of Pediatrics, Columbia University, New York, New York
Kyu Rhee
Affiliation:
Department of Medicine, Weill Cornell Medical College, New York, New York
Lisa Saiman
Affiliation:
Department of Pediatrics, Columbia University, New York, New York Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, New York
*
Division of Infectious Diseases, Department of Pediatrics, Columbia University, College of Physicians and Surgeons, 650 West 168th Street, PH4 West Room 470, New York, NY 10032 (ls5@columbia.edu)
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Abstract

Objective.

To assess how healthcare professionals caring for patients in intensive care units (ICUs) understand and use antimicrobial susceptibility testing (AST) for multidrug-resistant gram-negative bacilli (MDR-GNB).

Design.

A knowledge, attitude, and practice survey assessed ICU clinicians' knowledge of antimicrobial resistance, confidence interpreting AST results, and beliefs regarding the impact of AST on patient outcomes.

Setting.

Sixteen ICUs affiliated with NewYork-Presbyterian Hospital.

Participants.

Attending physicians and subspecialty residents with primary clinical responsibilities in adult or pediatric ICUs as well as infectious diseases subspecialists and clinical pharmacists.

Methods.

Participants completed an anonymous electronic survey. Responses included 4-level Likert scales dichotomized for analysis. Multivariate analyses were performed using generalized estimating equation logistic regression to account for correlation of respondents from the same ICU.

Results.

The response rate was 51% (178 of 349 eligible participants); of the respondents, 120 (67%) were ICU physicians. Those caring for adult patients were more knowledgeable about antimicrobial activity and were more familiar with MDR-GNB infections. Only 33% and 12% of ICU physicians were familiar with standardized and specialized AST methods, respectively, but more than 95% believed that AST improved patient outcomes. After adjustment for demographic and healthcare provider characteristics, those familiar with treatment of MDR-GNB bloodstream infections, those aware of resistance mechanisms, and those aware of AST methods were more confident that they could interpret AST results and/or request additional in vitro testing.

Conclusions.

Our study uncovered knowledge gaps and educational needs that could serve as the foundation for future interventions. Familiarity with MDR-GNB increased overall knowledge, and familiarity with AST increased confidence interpreting the results.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 3 , March 2013 , pp. 274 - 283
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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