Implementation of a guideline for the prevention of spread of peculiar resistant microorganisms (PRMOs) in a Dutch hospital

Autor: D. Bogaers-Hofman, Jan Kluytmans, Y. Hendriks
Rok vydání: 2005
Předmět:
Zdroj: American Journal of Infection Control. 33:e68-e69
ISSN: 0196-6553
DOI: 10.1016/j.ajic.2005.04.077
Popis: BACKGROUND: In 2004 the Dutch Working Party on Infection Control (WIP) published a guideline for the control of PRMOs in hospitals. PRMOs are more difficult to treat and are often associated with increased morbidity and mortality. This guideline defines the criteria for PRMOs and the measures that should be taken to prevent spread in the hospital. This guideline excludes MRSA and multidrug-resistant Mycobacterium tuberculosis, since these are described in separate guidelines. OBJECTIVE: To measure the effect of the implementation of the guideline in a large teaching hospital in The Netherlands. METHODS: During 2003, the guideline has been implemented in a 1378-bed teaching hospital with 42 intensive care unit (ICU) beds and 45 high care unit (HCU) beds. PRMOs are defined in the laboratory computer system and routinely reported to the department of infection control. Antibiotic consumption was measured by repeated prevalence surveys and by the pharmacy department. RESULTS: During 2003, 38,117 patients had been admitted for a total of 285,365 patient days. The antibiotic consumption during this year was 24.7 prescribed daily doses (PDD) per 100 patient days. In total 484 patients (1.3% of all admissions) were isolated; 33 patients were isolated because of a PRMO (7% of all isolations) for a total of 235 days of isolation. The PRMOs consisted of 25 Enterobacteriaceae, 2 Pseudomonas spp ., and 6 penicillin-resistant Streptococcus pneumoniae . Three small outbreaks were recognized, associated with patients for whom the PRMO had not been isolated before, and so no isolation measures had been taken until then. CONCLUSIONS: The implementation of a guideline to prevent spread of PRMOs resulted in only a limited number of patients that had to be isolated. This is also, in part, the result of a restrictive antibiotic policy. The maintenance of this situation consequently allows a restrictive antibiotic policy. As an example, the total amount of glycopeptides in 2003 was 400 PDD. Systematic typing of PRMOs would provide more detailed insight in the amount of spread of PRMOs and the effectiveness of this guideline.
Databáze: OpenAIRE
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