Epidemiologic surveillance of multidrug-resistant bacteria in a teaching hospital: A 3-year experience

Publication date: Available online 6 December 2017
Source:American Journal of Infection Control
Author(s): Mirian Nicéa Zarpellon, Giselle Fukita Viana, Cecília Saori Mitsugui, Bruno Buranello Costa, Nathalie Kira Tamura, Elisabeth Eyko Aoki, Cesar Helbel, Sheila Alexandra Belini Nishiyama, Silvia Maria dos Santos Saalfeld, Maria Cristina Bronharo Tognim
BackgroundThe objective of this prospective study was to verify the effectiveness of a multidisciplinary surveillance program that was implemented in a teaching hospital in southern Brazil, to prevent and control the spread of multidrug-resistant organisms.MethodsThe program implemented involved establishment of prevention guidelines, hand-hygiene promotion, isolation of patients colonized or infected by such organisms, enforced contact precautions, and terminal cleaning and disinfection of isolation rooms. A microbiology service, previously provided by an external laboratory, was established in the hospital. Detection of bacteria-resistant genes and molecular typing were performed also.ResultsStatistically significant differences were observed between the pre- and post-intervention periods (P = .00198). Control measures were effective in blocking the dissemination of a previously endemic clone of Acinetobacter baumannii. Changes were observed in the dissemination pattern, from a monoclonal to a polyclonal mode. The incidence of vancomycin-resistant Enterococcus during the surveillance period was low. Only 2 isolates of BLAKPC-positive Klebsiella pneumoniae (distinct profiles), and 5 isolates of BLASPM-positive Pseudomonas aeruginosa (a single cluster), were detected.ConclusionsThese results indicate that the surveillance program implemented was effective in preventing the spread of multidrug-resistant organisms in the hospital.



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