TY - JOUR
T1 - Regional variation in the interpretation of contact precautions for multi-drug-resistant Gram-negative bacteria
T2 - a cross-sectional survey
AU - van Veen, A.
AU - de Goeij, I.
AU - Damen, M.
AU - the Infection Prevention and Antimicrobial Resistance Care Network South-western Netherlands
AU - Huijskens, E. G.W.
AU - Paltansing, S.
AU - van Rijn, M.
AU - Bentvelsen, R. G.
AU - Veenemans, J.
AU - van der Linden, M.
AU - Vos, M. C.
AU - Severin, J. A.
N1 - Publisher Copyright: © 2024 The Author(s)
PY - 2024/10
Y1 - 2024/10
N2 - Background: Contact precautions are recommended when caring for patients with carbapenemase-producing Enterobacterales (CPE), carbapenemase-producing Pseudomonas aeruginosa (CPPA), and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Aim: Our aim was to determine the interpretation of contact precautions and associated infection prevention and control (IPC) measures in the non-ICU hospital setting for patients with CPE, CPPA or ESBL-E in 11 hospitals in the Southwest of the Netherlands. Methods: A cross-sectional survey was developed to collect information on all implemented IPC measures, including use of personal protective equipment, IPC measures for visitors, cleaning and disinfection, precautions during outpatient care and follow-up strategies. All 11 hospitals were invited to participate between November 2020 and April 2021. Findings: The survey was filled together with each hospital. All hospitals installed isolation precautions for patients with CPE and CPPA during inpatient care and day admissions, whereas 10 hospitals (90.9%) applied isolation precautions for patients with ESBL-E. Gloves and gowns were always used during physical contact with the patient in isolation. Large variations were identified in IPC measures for visitors, cleaning and disinfection products used, and precautions during outpatient care. Four hospitals (36.4%) actively followed up on CPE or CPPA patients with the aim of declaring them CPE- or CPPA-negative as timely as possible, and two hospitals (20.0%) actively followed up on ESBL-E patients. Conclusion: Contact precautions are interpreted differently between hospitals, leading to regional differences in IPC measures applied in clinical settings. Harmonizing infection-control policies between the hospitals could facilitate patient transfers and benefit collective efforts of preventing transmission of multi-drug-resistant Gram-negative bacteria.
AB - Background: Contact precautions are recommended when caring for patients with carbapenemase-producing Enterobacterales (CPE), carbapenemase-producing Pseudomonas aeruginosa (CPPA), and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Aim: Our aim was to determine the interpretation of contact precautions and associated infection prevention and control (IPC) measures in the non-ICU hospital setting for patients with CPE, CPPA or ESBL-E in 11 hospitals in the Southwest of the Netherlands. Methods: A cross-sectional survey was developed to collect information on all implemented IPC measures, including use of personal protective equipment, IPC measures for visitors, cleaning and disinfection, precautions during outpatient care and follow-up strategies. All 11 hospitals were invited to participate between November 2020 and April 2021. Findings: The survey was filled together with each hospital. All hospitals installed isolation precautions for patients with CPE and CPPA during inpatient care and day admissions, whereas 10 hospitals (90.9%) applied isolation precautions for patients with ESBL-E. Gloves and gowns were always used during physical contact with the patient in isolation. Large variations were identified in IPC measures for visitors, cleaning and disinfection products used, and precautions during outpatient care. Four hospitals (36.4%) actively followed up on CPE or CPPA patients with the aim of declaring them CPE- or CPPA-negative as timely as possible, and two hospitals (20.0%) actively followed up on ESBL-E patients. Conclusion: Contact precautions are interpreted differently between hospitals, leading to regional differences in IPC measures applied in clinical settings. Harmonizing infection-control policies between the hospitals could facilitate patient transfers and benefit collective efforts of preventing transmission of multi-drug-resistant Gram-negative bacteria.
UR - http://www.scopus.com/inward/record.url?scp=85201306520&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2024.06.020
DO - 10.1016/j.jhin.2024.06.020
M3 - Article
C2 - 39069006
AN - SCOPUS:85201306520
SN - 0195-6701
VL - 152
SP - 1
EP - 12
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
ER -
