Infection control found to be inconsistent in ICUs

The surveillance and control of multi-drug-resistant organisms in intensive care units varies widely from hospital to hospital, according to Columbia University School of Nursing researchers.

The researchers determined that of the hospitals surveyed, 59 percent routinely screened for methicillin-resistant Staphylococcus aurea, or MRSA. Other possibly deadly MDROs were screened for far less often. C. difficile was screened for by 11 percent, gram-negative rods were screened for by 12 percent and vancomycin-resistant Enterococcus was screened for by 22 percent.

The research, published in the October issue of the American Journal of Infection Control, found that not all hospitals employ a comprehensive surveillance and screening policy for ICU infectious diseases. The lack of screening impacts at-risk patients during and after laboratory infection tests.

While 98 percent of the ICUs reported a policy for contact precautions after a positive culture, less than a third had a policy for isolation/contact precautions for screening results that were pending.

"It seems prudent to isolate possibly infected patients admitted into the ICU until lab tests come back giving an 'all clear,'" Monika Pogorzelska-Maziarz, the lead author of the study, said.

The research team found that a larger infection-control staff and longer infection-control staffing hours were connected with more effective policy implementation for the isolation of culture-positive patients. ICUs with mandatory reporting and electronic surveillance systems were more likely to include policies for periodic infection screening following admission.