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Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection

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Abstract

Objective

Contact precautions, especially the initiation of isolation, are important measures to prevent and control multidrug-resistant organisms (MDROs). However, the implementation in clinical practice remains weak. This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection, and determine the factors that affect the implementation of isolation measures.

Methods

A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1, 2018. The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected. Then, the issuance of isolation orders was retrospectively analyzed. Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.

Results

The overall issuance rate of isolation orders was 61.21%, which increased from 33.12% to 75.88% (P<0.001) after the implementation of the multidisciplinary collaborative intervention. The intervention (P<0.001, OR=0.166) was a promoting factor for the issuance of isolation orders, in addition to the length of stay (P=0.004, OR=0.991), department (P=0.004), and microorganism (P=0.038).

Conclusion

The isolation implementation remains far lower than policy standards. Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors, thereby promoting the standardized management of MDROs, and providing reference for further improving the quality of hospital infection management.

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References

  1. López-Montesinos I, Domínguez-Guasch A, Gómez-Zorrilla S, et al. Clinical and economic burden of community-onset multidrug-resistant infections requiring hospitalization. J Infect, 2020,80(3):271–278

    Article  PubMed  Google Scholar 

  2. Yam ELY, Hsu LY, Yap EP, et al. Antimicrobial Resistance in the Asia Pacific region: a meeting report. Antimicrob Resist Infect Control, 2019,8:202

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cerceo E, Deitelzweig SB, Sherman BM, et al. Multidrug-Resistant Gram-Negative Bacterial Infections in the Hospital Setting: Overview, Implications for Clinical Practice, and Emerging Treatment Options. Microb Drug Resist, 2016,22(5):412–431

    Article  CAS  PubMed  Google Scholar 

  4. Siegel JD, Rhinehart E, Jackson M, et al. Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control, 2007,35(10 Suppl 2):S165–S193

    Article  PubMed  Google Scholar 

  5. Siegel JD, Rhinehart E, Jackson M, et al. Health Care Infection Control Practices Advisory Committee. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control, 2007,35(10 Suppl 2):S65–S164

    Article  PubMed  PubMed Central  Google Scholar 

  6. Smith PW, Bennett G, Bradley S, et al. SHEA/APIC Guideline: Infection prevention and control in the long-term care facility. Am J Infect Control, 2008,36(7):504–535

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tacconelli E, Cataldo MA, Dancer SJ, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect, 2014,20(Suppl 1):1–55

    Article  PubMed  Google Scholar 

  8. Link T. Guideline Implementation: Transmission-Based Precautions. AORN J, 2019,110(6):637–649

    Article  PubMed  Google Scholar 

  9. Cohen CC, Cohen B, Shang J. Effectiveness of contact precautions against multidrug-resistant organism transmission in acute care: a systematic review of the literature. J Hosp Infect, 2015,90(4):275–284

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Durand A, Dupre C, Robriquet L. Should contact precautions for multidrug resistant organism transmission be used? Reanimation, 2016,25(3):318–327

    Article  Google Scholar 

  11. Gysin DV, Cookson B, Saenz H, et al. Variability in contact precautions to control the nosocomial spread of multi-drug resistant organisms in the endemic setting: a multinational cross-sectional survey. Antimicrob Resist Infect Control, 2018,7:81

    Article  PubMed  PubMed Central  Google Scholar 

  12. Clock SA, Cohen B, Behta M, et al. Contact precautions for multidrug-resistant organisms: Current recommendations and actual practice. Am J Infect Control, 2010,38(2):105–111

    Article  PubMed  Google Scholar 

  13. Abdulrahman GO. The effect of multidisciplinary team care on cancer management. Pan Afr Med J, 2011,9:20

    PubMed  Google Scholar 

  14. Fleissig A, Jenkins V, Catt S, et al. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol, 2006,7(11):935–943

    Article  PubMed  Google Scholar 

  15. Waqar S, Nigh K, Sisler L, et al. Multidisciplinary performance improvement team for reducing health care.associated Clostridium difficile infection. Am J Infect Control, 2016,44(3):352–354

    Article  PubMed  Google Scholar 

  16. Davidson PD, Newton PJ, Tankumpuan T, et al. Multidisciplinary Management of Chronic Heart Failure: Principles and Future Trends. Clin Ther, 2015,37(10):2225–2233

    Article  PubMed  Google Scholar 

  17. Zhang FF, Wu XQ, Liao SJ, et al. Meta-analysis of the effect of multidisciplinary intervention on the prevention and control of multi-drug resistant bacteria infection. Zhongguo Shequ Yisheng (Chinese), 2019,35(25):41–43

    Google Scholar 

  18. Boyce JM, Potter-Bynoe G, Chenevert C, et al. Environmental contamination due to methicillinresistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol, 1997,18(9):622–627

    Article  CAS  PubMed  Google Scholar 

  19. McConville TH, Sullivan SB, Gomez-Simmonds A, et al. Carbapenem-resistant Enterobacteriaceae colonization (CRE) and subsequent risk of infection and 90-day mortality in critically ill patients, an observational study. PLoS One, 2017,12(10):e0186195

    Article  PubMed  PubMed Central  Google Scholar 

  20. Siegel JD, Rhinehart E, Jackson M, et al. Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control, 2007,35(10 Suppl 2):S165–S193

    Article  PubMed  Google Scholar 

  21. Huang X, Deng ZD, Ni YX, et al. Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare-associated infection. Chin J Infect Control (Chinese), 2015,14(1):1–9

    Google Scholar 

  22. Xu C, Xiong W, Xu M, et al. Effect of multidisciplinary team management on control of multidrug-resistant organism infections. Chin J Nosocomiol (Chinese), 2018,28(18):2834–2838

    Google Scholar 

  23. Liang YF, Lai XQ, Tan L, et al. Application of Multidisciplinary Team Mode in the Management of Multidrug-resistant Organism Infection. Chin J Soc Med (Chinese), 2019,36(04):402–406

    Google Scholar 

  24. Caroline L, Leonardo P, Stephan H. Is patient isolation the single most important measure to prevent the spread of multidrug-resistant pathogens? Virulence, 2013,4(2):163–171

    Article  Google Scholar 

  25. Chantal B, Geoffrey T, Anne S, et al. An integrative review of infection prevention and control programs for multidrug-resistant organisms in acute care hospitals: a socio-ecological perspective. Am J Infect Control, 2011,39(5):368–378

    Article  Google Scholar 

  26. Tacconelli E. Screening and isolation for infection control. J Hosp Infect, 2009,73(4):371–377

    Article  CAS  PubMed  Google Scholar 

  27. Cooper BS, Stone SP, Kibbler CC, et al. Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature. BMJ, 2004,329(7465):533

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Liu Q, Li W, Du X, et al. Risk and Prognostic Factors for Multidrug-Resistant Acinetobacter Baumannii Complex Bacteremia: A Retrospective Study in a Tertiary Hospital of West China. PLoS One, 2015,10(6): e0130701

    Article  PubMed  PubMed Central  Google Scholar 

  29. Guo N, Xue W, Tang D, et al. Risk factors and outcomes of hospitalized patients with blood infections caused by multidrug-resistant Acinetobacter baumannii complex in a hospital of Northern China. Am J Infect Control, 2016,44(4):e37–e39

    Article  PubMed  Google Scholar 

  30. Jia H, Li L, Li W, et al. Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China. Biomed Res Int, 2019,2019:2590563

    Article  PubMed  PubMed Central  Google Scholar 

  31. van Langeveld I, Gagnon RC, Conrad PF, et al. Multiple-Drug Resistance in Burn Patients: A Retrospective Study on the Impact of Antibiotic Resistance on Survival and Length of Stay. J Burn Care Res, 2017,38(2):99–105

    Article  PubMed  Google Scholar 

  32. World Health Organization. Antimicrobial Resistance Global Report on Surveillance. Geneva: World Health Organization. 2014.

    Google Scholar 

  33. Benet T, Girard R, Gerbier-Colomban S, et al. Determinants of Implementation of Isolation Precautions Against Infections by Multidrug-Resistant Microorganisms: A Hospital-Based, Multicenter, Observational Study. Infect Control Hosp Epidemiol, 2017,38(10):1188–1195

    Article  PubMed  Google Scholar 

  34. de Kraker ME, Jarlier V, Monen JC, et al. The changing epidemiology of bacteraemias in Europe: trends from the European Antimicrobial Resistance Surveillance System. Clin Microbiol Infect, 2013,19(9):860–868

    Article  CAS  PubMed  Google Scholar 

  35. Schwaber MJ, Carmeli Y. Mortality and delay in effective therapy associated with extended-spectrum beta-lactamase production in Enterobacteriaceae bacteraemia: a systematic review and meta-analysis. J Antimicrob Chemother, 2007,60(5):913–920

    Article  CAS  PubMed  Google Scholar 

  36. Wang Y, Zhang XP, Lai XQ, et al. Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in the Prevention and Control of Multidrug Resistance Infection—A Retrospective Study. June 12, 2020, PREPRINT (version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-34699/vl]

    Book  Google Scholar 

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Author information

Authors and Affiliations

  1. Naning Drum Tower Hospital Affiated to Nanjing University Medical School, Nanjing, 210008, China

    Ying Wang & Xue-mei Wang

  2. School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Xin-ping Zhang

  3. Department of Nosocomial Infection Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Xiao-quan Lai

Authors
  1. Ying Wang
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  2. Xin-ping Zhang
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  3. Xiao-quan Lai
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  4. Xue-mei Wang
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Corresponding author

Correspondence to Xin-ping Zhang.

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The authors declare that they have no conflicts of interests.

Additional information

This project was supported by the National Natural Science Foundation of China (No. 71473098).

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Wang, Y., Zhang, Xp., Lai, Xq. et al. Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection. CURR MED SCI 43, 198–205 (2023). https://doi.org/10.1007/s11596-023-2709-6

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  • DOI: https://doi.org/10.1007/s11596-023-2709-6

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