Your SlideShare is downloading. ×
Isolation Precautions for MDROs
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Isolation Precautions for MDROs

6,123
views

Published on

Isolation Precautions for Multi-Drug Resistant Organisms

Isolation Precautions for Multi-Drug Resistant Organisms


0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
6,123
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Isolation P recautions for Preventing T ransmission of MDROs Anuj Sharma Senior Consultant Clinical Microbiology Sir Ganga Ram Hospital
  • 2. MDROs
    • Microorganisms – predominantly bacteria – that are resistant to one or more classes of antimicrobial agents
    • MRSA, VRE, MDRGNB (+ESBL), MDRSP, VISA, VRSA
    • Usually R to all except few ABs – epidemiologically important
      • Acinetobacter, Burkholderia cepacia, Klebsiella, Enterobacter, Pseudomonas aeruginosa,
    • Transmission
      • Same routes as antimicrobial S organisms
      • Patient-to-patient transmission, usually via hands of HCWs, especially for MRSA and VRE
  • 3. MDROs
    • Progressive increase esp. in acute care settings
    • Prevalence variation - geographic, institutional, patient care unit, temporal
    • Impact variation
      • Colonisation , infection >> treatment (more difficult & prolonged) L o S, morbidity, mortality, cost
    • Relationship to antimicrobial exposure, especially for GNBs
  • 4. MDRO Control
    • Standard / Contact precautions
    • Strategies
      • Infection prevention
      • Accurate / prompt diagnosis & treatment
      • Prudent use of ABs
      • Prevention of transmission
    CDC Guidelines for Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006 http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf
  • 5. Control of MDROs
    • Two- tiered approach
      • First Tier : Baseline activities for all settings
      • Second Tier : More intense and focused control efforts
    • Triggers to escalate to second tier
      • MDRO identification in high - risk patients or unit
      • Failure to reduce MDRO despite first tier efforts
  • 6. Pg 73
  • 7. Pg 74
  • 8. Control interventions
    • Administrative measures
    • MDRO education
    • Judicious use of antimicrobials
    • Surveillance
    • Infection control precautions
    • Environmental measures
    • Decolonisation
  • 9. Top 4 control measures
    • MRSA
      • Surveillance cultures of patients
      • Contact precautions
      • Decolonisation
      • Hand hygiene
    • VRE
      • Surveillance cultures of patients
      • Contac t precautions
      • Extra cleaning and disinfection
      • Education of staff, patients or visitors
    • MDR GNB
      • Contact precautions
      • Surveillance cultures
      • Education of staff, patients or visitors
      • Hand hygiene
  • 10. Isolation guidelines
    • Contact precautions
      • Patient placement Category II
        • Single pt. room preferred; prioritize for single room based on presence of conditions that facilitate transmission
        • Cohort in one room patients with same pathogen, but maintain separation >3 feet, change protective attire, use hand hygiene between different patients
      • Don gowns & gloves upon room entry Category IB
    • Droplet precautions
      • Don surgical mask upon room entry Category IB
  • 11. C linical microbiology lab
    • Antimicrobial ST testing & interpretation
    • Surveillance cultures
      • Antibiogrammes, MDRO incidence / infection rates
      • Colonisation / Infection
    • Molecular typing
    • Rapid diagnostic tests
    • Detection & rapid reporting of MDROs
    • QC programme
    • Multidisciplinary approach for judicious use of ABs