Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit

Strich, Jeffrey R; Palmore, Tara N.

doi:10.1016/j.idc.2017.05.010

Cited by 66 publications

(67 citation statements)

References 78 publications

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“…Morgan and Sarah S. Jackson found that when healthcare workers (HCWs) make contact with patients with MDR bacteria, they frequently contaminate their protective gowns and gloves (3,4). Multidrug-resistant organisms normally are transmitted from patient to patient via the hands of HCWs (5). MDRO infection/colonization leads to clinical consequences, including intensive care unit (ICU) length of stay, limited treatment options, increased risk of therapeutic failure, and higher mortality and costs (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

“…In China, experts have advised that patients should have a positive screening once they are admitted to the ICU to determine whether they have colonized MDROs or not. This aims to take sequence precautions such as isolation to prevent the nosocomial cross-transmission of MDROs as early as possible, as isolation measures are recommended to reduce the transmission of MDR bacteria in the ICU (5,10).…”

Section: Introductionmentioning

confidence: 99%

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Proposing a New Strategy of Combining Machine Learning With Controlling The Cross-Transmission of Multidrug-Resistant Organisms in The ICU

Zhou

Kaihong

Mei

et al. 2020

Preprint

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Background: Multidrug-resistant organisms (MDROs) have become a global threat to public health. MDROs normally are transmitted from patient to patient via the hands of healthcare workers (HCWs). The key management of MDROs is control of dissemination as soon as possible.Method: We established a bedside prediction tool based simply on experiences. According to the result of this predictive rule, we took a series of precautions in a general intensive care unit (ICU) from January 1, 2018, to December 31, 2019, in only one ward experimentally. We retrospectively analyzed medical records of patients between two wards to assess the efficiency of the routine care practice by performing different comparisons.Results: A total of 636 patients were admitted in the ICU setting. After comparing two wards in hospital expenses and length of ICU stay, there were no significant differences. Precautions contributed to the association between room number and status of MDRO infection/colonization (p=0.033), and the infection/colonization rate of MDROs was significantly different between the two wards (p=0.006). The median of the length of clinical culture testing is 3.4 days.Conclusion: Clinical culture testing is time-consuming. Advanced routine care practice controlled the cross-transmission of MDROs to some extent. This study highlights that a predicting model of MDROs is badly needed. Future researchers can engage in updating the predictive model focusing from machine learning-based risk algorithms, refer to experts’ experiences and adopt more efficient precautions for strengthening the transmission efficiency.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proposing a New Strategy of Combining Machine Learning With Controlling The Cross-Transmission of Multidrug-Resistant Organisms in The ICU

Zhou

Kaihong

Mei

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Morgan and Sarah S. Jackson found that when Healthcare Workers (HCWs) contact patients with MDR bacteria they frequently contaminate their protective gowns and gloves [3] [4]. Multi-drug resistant organisms are normally transmitted from patients to patients via the hands of HCWs [5]. MDROs infection/colonization leads to clinical consequences: intensive care unit (ICU) length of stay, limiting treatment options, increased risk of therapeutic failure, and higher mortality and costs [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…In China, experts advised that patients should have positive screening once admitted to ICU to nd out whether they have colonized MDROs or not. It aims to take sequence precautions, like isolation, to prevent nosocomial cross-transmission of MDROs as early as possible, since solation measures are recommended to reduce transmission of MDR bacteria in the ICU [5] [10]. But growing bacterial cultures and doing a susceptibility test take a few days in China, usually, it is too late to bene t from isolation.…”

Section: Introductionmentioning

confidence: 99%

Proposing a new strategy of combining machine learning with controlling cross-transmission of multi-drug resistant organisms of ICU

zou

Kaihong

Kang

et al. 2020

Preprint

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Abstract Background Multi-drug resistant organisms (MDROs) has become a global threat to public health. MDROs are normally transmitted from patients to patients via the hands of healthcare workers (HCWs). The key management of MDROs is control dissemination as sooner as possible. Method: We established a predictive rule based simply on experiences, and according to the result of this predictive rule we take a series of precautions of a general intensive care unit (ICU) from January 1, 2018, to December 31, 2019, only in one ward experimentally. In this study, we aim to assess the efficiency of the routine care practice which include pre-discrimination by the predictive rule and sequent precautions by doing difference comparisons. Results After comparing two wards in the hospital expenses and length of ICU stay, there are no statistical differences. Precautions contribute to the association between room number and status of MDROs infection/ colonization(p = 0.033), and infection/colonization rate of MDROs is different statistically between two wards(p = 0.006). Conclusion the routine care practice had controlled the cross-transmission of MDROs in some extent. Future, studies can engage in updating the predictive model based on big data and referred to experts’ experiences and adopt more efficient precautions for strengthening the transmission efficiency.

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“…[3] Inappropriate antimicrobial use and poor prescription practices have contributed to the development of multidrug-resistant organisms, rendering treatment of HAIs very difficult. [4] In addition, failure to comply with infection-control measures has a negative impact on hospital infection rates. Overcrowding and understaffing of wards also contribute to HAIs in the developing world.…”

mentioning

confidence: 99%

Spectrum of microbial growth and antimicrobial usage in an intensive-care unit of a tertiary-care hospital in Trinidad, West Indies

2017

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Background. Intensive-care units (ICUs) are a source of multidrug-resistant organisms, owing to the indiscriminate usage of broad-spectrum antimicrobial drugs. In such settings, one must be aware of the spectrum of microbes and pattern of antibiotic usage. Objectives. To evaluate the spectrum, susceptibility and resistance patterns of microbes found in ICU patients in a tertiary-care teaching hospital in Trinidad, and to quantify antimicrobial usage. Methods. All adult patients (≥15 years of age) admitted to the ICU for ≥48 h who developed nosocomial infections conforming to the Centers for Disease Control and Prevention criteria were included. Demographic data and clinical data, including specimens sent, isolates grown, antimicrobial sensitivity and resistance patterns, the usage of antimicrobials and patient outcomes, were recorded. Variables such as age, admission white blood cell count, duration of first antibiotic used, length of ICU stay, length of hospital stay, organ support and total comorbidities were analysed. Antimicrobial usage was quantified as the defined daily dosage per 1 000 patient-days. Results. A total of 153 patients with 287 microbiological specimens were studied. The mean patient age was 48.4 years, and the mean ICU length of stay was 7.9 days. The most common admitting diagnoses were sepsis and multiple trauma. Staphylococcus aureus was the most common isolate from blood and central venous lines, and Pseudomonas aeruginosa from tracheal aspirates and wound swabs. Non-survivors had significantly higher age, leucocyte count and organ support requirements, and shorter lengths of stay. Cefuroxime was the most-used antimicrobial in the unit. Conclusion. The usage pattern of antimicrobials did not correlate with susceptibility in most instances. There is a need to improve antimicrobial usage by implementing antimicrobial-stewardship programmes to establish an antimicrobial protocol and guidelines for usage in the ICU.

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Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit

Cited by 66 publications

References 78 publications

Proposing a New Strategy of Combining Machine Learning With Controlling The Cross-Transmission of Multidrug-Resistant Organisms in The ICU

Proposing a New Strategy of Combining Machine Learning With Controlling The Cross-Transmission of Multidrug-Resistant Organisms in The ICU

Proposing a new strategy of combining machine learning with controlling cross-transmission of multi-drug resistant organisms of ICU

Spectrum of microbial growth and antimicrobial usage in an intensive-care unit of a tertiary-care hospital in Trinidad, West Indies

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