Hospitals' lack of standardized infection control practices for multidrug-resistant gram-negative bacteria (MDR-GNB) may contribute to an increase in multidrug-resistant bacteria, according to a study from the the Society for Healthcare Epidemiology of America Research Network published in Infection Control and Hospital Epidemiology.
Researchers analyzed the results of an online survey of 70 hospitals in 26 states and15 foreign nations, measuring criteria such as how hospitals defined MDR-GNB, and whether and how long they treated patients under contact precautions. Although hospitals often isolated patients for vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteriaceae (CRE), one in five hospitals did not isolate patients for MDR Pseudomonas or Acinetobacter, according to the study.
"Differences in definitions and practices for multidrug-resistant bacteria confuse healthcare workers and hinder communication when patients are transferred between hospitals," lead author Marci Drees, M.D., said in a statement. "The danger these inconsistencies represent affects not only individual hospitals, but the broader community because patients are frequently transferred between healthcare centers, including long-term care facilities, furthering their spread."
Specific isolation protocols also varied widely. Some respondents isolated patients when they found bacteria resistant to at least three antimicrobial classes, while others isolated them if there was resistance to only one. Furthermore, the hospitals surveyed had up to 22 unique definitions of "multi-drug resistant," according to the study.
"This confusion makes communication difficult, and varied use of isolation may contribute to emergence of these organisms," Drees wrote in the study conclusion. "Public health agencies need to promote standard definitions and management to enable broader initiatives to limit emergence of MDR-GNB."
Doctors nationwide try to combat drug-resistant superbugs through initiatives like community education and antibiotic stewardship programs. A 2013 Centers for Disease Control & Prevention study found that drug-resistant infections kill about 23,000 people a year, FierceHealthcare previously reported.