Document Detail

Priorities in the prevention and control of multidrug-resistant Enterobacteriaceae in hospitals.
MedLine Citation:
PMID:  22863084     Owner:  NLM     Status:  Publisher    
BACKGROUND: Multidrug-resistant Enterobacteriaceae (MDE) are a major public health threat due to international spread and few options for treatment. Furthermore, unlike meticillin-resistant Staphylococcus aureus (MRSA), MDE encompass several genera and multiple resistance mechanisms, including extended-spectrum beta-lactamases and carbapenemases, which complicate detection in the routine diagnostic laboratory. Current measures to contain spread in many hospitals are somewhat ad hoc as there are no formal national or international guidelines. AIM: We sought to establish what should be the priorities for the prevention and control of MDE and what is feasible for implementation. We also identify areas for further research. METHODS: We reviewed the published literature and other sources e.g. national agencies, for measures and interventions used to control MDE. FINDINGS: Certain categories of at risk patients should be screened, especially in critical care areas, using appropriate laboratory methods. Standard and contact precautions are essential and hand hygiene compliance requires continued emphasis and high compliance levels. As MDE may persist on environmental surfaces for weeks, environmental decontamination could also be an effective control intervention. There are limited options for decolonisation with inadequate studies to date and antibiotic stewardship within and outside the hospital remains important. CONCLUSION: As there is a clear deficit in the evidence base to infor guidance on prevention and control, research in key areas, such as rapid detection, is urgently required.
A S Khan; S J Dancer; H Humphreys
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-2
Journal Detail:
Title:  The Journal of hospital infection     Volume:  -     ISSN:  1532-2939     ISO Abbreviation:  J. Hosp. Infect.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007166     Medline TA:  J Hosp Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Department of Microbiology, Beaumont Hospital, Dublin, Ireland; Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Dublin, Ireland.
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