2186. High adherence to contact precautions of patients with multidrug resistant organisms (MDRO) and low in-hospital transmission of MDROs
Session: Poster Abstract Session: Healthcare Epidemiology: HAI Surveillance
Saturday, October 6, 2018
Room: S Poster Hall
High adherence to contact precautions of patients with multidrug resistant organisms (MDRO) and low in-hospital transmission of MDROs Andrea C. Büchler1, Marc Dangel1, Sarah Tschudin-Sutter1, Andreas F. Widmer1 1University Hospital Basel, Division of Infectious Diseases & Hospital Epidemiology, Basel, Switzerland Background: Conflicting results have been published on the impact of contact precautions, as outlined by CDC, HIPAC and ESCMID guidelines, on reduction of transmission of multidrug resistant organisms (MDRO). Ambiguous definitions coupled with low adherence to these partly explain the differences on impact of contact precautions on transmission of MDROs. We therefore monitored compliance with contact precautions and correlated the level of adherence with in-hospital transmission of MDROs. Methods: Between 1/2016-3/2018, all patients under contact precautions underwent routine monitoring of adherence to contact precautions by routine on site visits on day 0 (+1), 3 (+/-1) and 7(+/-3) after initiating of contact precautions using a predefined standardized checklist. The protocol includes 10 interventions that are routinely checked such as contact precaution sign at the door and wearing gowns and gloves before entering the room. Patients requiring contact precautions were defined as colonized or infected with MDROs (MRSA, non-E.coli ESBL-Enterobacteriaceae (NEC-ESBL), VRE and Carbapenemase-producing organisms) as well as patients infected with RSV, Norovirus and hypervirulent strains of C. difficile. Results: Overall, data of 1414 visits of 812 patients under contact precautions were assessed. During the observation period, overall adherence was between 93-99% for each intervention, except for separate space for contaminated material with a very low adherence between 5.4-6.1%. The incidence of in-hospital transmission was extremely low for MRSA, VRE and NEC-ESBL with 0.02-0.1/100’000 patient days. Conclusion: Continuous monitoring of the quality of contact precautions showed excellent overall adherence correlating with a very low in-hospital transmission of MDROs, encouraging monitoring as an integrated part of contact precautions.
Andrea C. Büchler, MD, Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland, Marc Dangel, MPH, Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland, Sarah Tschudin-Sutter, MD MSc, Division of Infectious Diseases & Hospital Epidemiology, Basel, Switzerland; Department of Clinical Research, Basel, Switzerland and Andreas F. Widmer, MD, MS, Infectious Diseases, University of Basel Hospitals and Clinics, Basel, Switzerland

Disclosures:

A. C. Büchler, None

M. Dangel, None

S. Tschudin-Sutter, None

A. F. Widmer, None

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