Disparity in infection control practices for multidrug-resistant Enterobacteriaceae

Am J Infect Control. 2012 Nov;40(9):836-9. doi: 10.1016/j.ajic.2011.11.008. Epub 2012 Feb 22.

Abstract

Background: There is a lack of empiric evidence regarding the optimal approach to controlling the transmission of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) and carbapenem-resistant Enterobacteriaceae (CRE). In this context, we expect that infection control practices for these organisms vary widely between hospitals.

Methods: A survey examining infection control practices for ESBL-E and CRE was distributed to 6 academic and 9 community hospitals in Toronto, Canada.

Results: All hospitals responded to the survey. Among 15 hospitals in 1 geographic area, 8 different approaches to the management of ESBL-E were utilized. There was wide variation in the use infection control practices including admission screening (53% and 53%), contact precautions (53% and 100%), and isolation (60% and 100%) for ESBL-E and CRE, respectively. Of hospitals performing admission screening, 75% used risk factor-based screening for ESBL-E and CRE.

Conclusion: Even within a single geographic area, there is wide variation in infection control strategies to contain or control ESBL-E and CRE. These results are concerning given evidence that a coordinated approach may be required to prevent or limit the emergence of CRE.

MeSH terms

  • Canada / epidemiology
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / prevention & control*
  • Health Services Research
  • Hospitals, Community
  • Hospitals, University
  • Humans
  • Infection Control / methods*