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Status of the Prevention of Multidrug-Resistant Organisms in International Settings: A Survey of the Society for Healthcare Epidemiology of America Research Network

Part of: SHEA Research Network Collection

Published online by Cambridge University Press:  07 November 2016

Nasia Safdar ,
Sharmila Sengupta ,
Jackson S. Musuuza ,
Manisha Juthani-Mehta ,
Marci Drees ,
Lilian M Abbo ,
Aaron M. Milstone ,
Jon P. Furuno ,
Meera Varman  and
Deverick J. Anderson
...Show all authors
Nasia Safdar*
Affiliation:
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Infectious Disease, University of Wisconsin Hospital and Clinics, Madison, Wisconsin William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
Sharmila Sengupta
Affiliation:
Medanta–The Medicity, Sector 38, Gurgaon, Haryana, India
Jackson S. Musuuza
Affiliation:
Institute of Clinical and Translational Research, University of Wisconsin, Madison, Wisconsin
Manisha Juthani-Mehta
Affiliation:
Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut
Marci Drees
Affiliation:
Department of Medicine, Christiana Care Health System, Newark, Delaware Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
Lilian M Abbo
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
Aaron M. Milstone
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Jon P. Furuno
Affiliation:
Department of Pharmacy Practice, Oregon State University/Oregon Health & Science University College of Pharmacy, Portland, Oregon
Meera Varman
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Creighton University Medical Center, Omaha, Nebraska
Deverick J. Anderson
Affiliation:
Department of Medicine, Duke University School of Medicine, Durham, North Carolina
Daniel J. Morgan
Affiliation:
Veterans Affairs Maryland Healthcare System, University of Maryland School of Medicine, Baltimore, Maryland Center for Disease Dynamics, Economics & Policy, Washington, DC
Loren G. Miller
Affiliation:
Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, California
Graham M. Snyder
Affiliation:
Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts
*
Address correspondence to Nasia Safdar, MD, PhD, UWMF Centennial Building, 1685 Highland Ave, Madison, WI 53705 (ns2@medicine.wisc.edu).
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Abstract

OBJECTIVE

To examine self-reported practices and policies to reduce infection and transmission of multidrug-resistant organisms (MDRO) in healthcare settings outside the United States.

DESIGN

Cross-sectional survey.

PARTICIPANTS

International members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.

METHODS

Electronic survey of infection control and prevention practices, capabilities, and barriers outside the United States and Canada. Participants were stratified according to their country’s economic development status as defined by the World Bank as low-income, lower-middle-income, upper-middle-income, and high-income.

RESULTS

A total of 76 respondents (33%) of 229 SHEA members outside the United States and Canada completed the survey questionnaire, representing 30 countries. Forty (53%) were high-, 33 (43%) were middle-, and 1 (1%) was a low-income country. Country data were missing for 2 respondents (3%). Of the 76 respondents, 64 (84%) reported having a formal or informal antibiotic stewardship program at their institution. High-income countries were more likely than middle-income countries to have existing MDRO policies (39/64 [61%] vs 25/64 [39%], P=.003) and to place patients with MDRO in contact precautions (40/72 [56%] vs 31/72 [44%], P=.05). Major barriers to preventing MDRO transmission included constrained resources (infrastructure, supplies, and trained staff) and challenges in changing provider behavior.

CONCLUSIONS

In this survey, a substantial proportion of institutions reported encountering barriers to implementing key MDRO prevention strategies. Interventions to address capacity building internationally are urgently needed. Data on the infection prevention practices of low income countries are needed.

Infect Control Hosp Epidemiol. 2016:1–8

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 1 , January 2017 , pp. 53 - 60
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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