Implementation of active screening for preventing and controlling the spread of multidrugresistant organisms in intensive care unit

Abstract:

ObjectiveTo implement active screening measures for patients in intensive care unit (ICU), early detect patients with multidrugresistant organism (MDRO) colonization, implement contact isolation measures,  prevent and control MDRO cross transmission. MethodsThe nasal and rectal swabs of 240 patients who were admitted to ICU from September 2012 to May 2013 were performed bacterial culture, patients with colonization of methicillin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. ResultsOf 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 during 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］）.ConclusionMDRO 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.