Implementation of active screening for preventing and controlling the spread of multidrug-resistant organisms in intensive care unit / 中国感染控制杂志

ABSTRACT

Objective To implement active screening measures for patients in intensive care unit (ICU),early de-tect patients with multidrug-resistant organism (MDRO)colonization,implement contact isolation measures,pre-vent and control MDRO cross transmission.Methods The nasal and rectal swabs of 240 patients who were admit-ted to ICU from September 2012 to May 2013 were performed bacterial culture,patients with colonization of methi-cillin-resistant Staphylococcus aureus (MRSA),extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli ,and ESBLs-producing Klebsiella pneumoniae were conducted contact isolation.Clinically isolated MDROs from ICU patients in September 2011-August 2012 (before active screening)and September 2012-August 2013 (after active screening)were collected and performed antimicrobial resistance analysis.Results Of 240 patients, nasal swabs screening test showed that there were 56(23.33%)patients who were colonized with MRSA,including 22(39.29%)were colonized at the admission to ICU and 34(60.71%)during the ICU stay.Rectal swabs screening test showed that there were 105(43.75%)patients who were colonized with ESBLs-producing Escherichia coli and Klebsiella pneumoniae ,72(68.57%)were colonized at the admission to ICU,and 33(31.43%)were colonized dur-ing the period of ICU stay.The incidence density of MDROs before and after implementing active screening were 28.56‰ and 13.71‰ respectively,difference was significant (P < 0.05;RR,2.08 [95%CI ,1.582 - 2.743]). Conclusion MDRO colonization rate is high among ICU inpatients,implementation of comprehensive prevention and control measures against MDROs based on active screening can reduce the spread of MDROs in ICU.