Clusters of emerging multidrug-resistant organisms in US health care facilities during the initial months of the SARS-CoV-2 pandemic.

Autor: Ham DC; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: Ink4@CDC.gov., Li R; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA., Mitsunaga T; Healthcare-Associated Infections Program, California Department of Public Health, Sacramento, CA., Czaja C; Healthcare-Associated Infections and Antimicrobial Resistance Program, Communicable Disease Branch, Colorado Department of Public Health and Environment, Denver, CO., Prestel C; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA., Bhaurla S; Healthcare Outreach Unit, Acute Communicable Disease Control, Los Angeles County Department of Public Health, Los Angeles, CA., Cumming M; Healthcare-Associated Infections and Antimicrobial Resistance Program, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA., Brennan B; Surveillance for Healthcare-Associated & Resistant Pathogens (SHARP) Unit, Michigan Department of Health and Human Services, Lansing, MI., Innes G; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA., Carrico S; Communicable Disease Branch, North Carolina Division of Public Health, Raleigh, NC., Chan A; Healthcare Associated Infections and Antimicrobial Resistance Program, Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, TN., Merengwa E; Healthcare Safety Unit, Texas Department of State Health Services, Austin, TX., Stahl A; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA., Ostrowsky B; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Health Care Epidemiology & Infection Control (HEIC), Program Metropolitan Regional Area Office (MARO), New York State Department of Health, Albany, NY., de Perio MA; Office of the Director, National Institute for Occupational Safety and Health, Washington, DC., Walters MS; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2024 Dec; Vol. 52 (12), pp. 1390-1396. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1016/j.ajic.2024.07.013
Abstrakt: Background: Outbreaks of emerging multidrug-resistant organisms (eMDROs), including carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, and Candida auris, have been reported among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. We describe eMDRO clusters in SARS-CoV-2 units and associated infection control (IC) practices early in the SARS-CoV-2 pandemic.
Methods: We conducted a retrospective survey of a convenience sample of health departments in 11 states to describe clusters of eMDROs that began before November 1, 2020 and involved SARS-CoV-2 units. Cluster characteristics and IC practices during the cluster period were assessed using a standardized outbreak report form, and descriptive analyses were performed.
Results: Overall, 18 eMDRO clusters (10 carbapenem-resistant Enterobacterales, 6 C auris, 1 carbapenem-resistant Pseudomonas aeruginosa, and 1 carbapenem-resistant A baumannii) in 18 health care facilities involving 397 patients were reported from 10 states. During the cluster period, 60% of facilities reported a shortage of isolation gowns, 69% extended use of gowns, and 67% reported difficulty obtaining preferred disinfectants. Reduced frequency of hand hygiene audits was reported in 85% of acute care hospitals during the cluster period compared with before the pandemic.
Conclusions: Changes in IC practices and supply shortages were identified in facilities with eMDRO outbreaks during the SARS-CoV-2 pandemic and might have contributed to eMDRO transmission.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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