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

Published:December 04, 2017DOI:https://doi.org/10.1016/j.ajic.2017.10.012

      Highlights

      • The implemented surveillance program helped to control multidrug-resistant organisms.
      • The dissemination of endemic Acinetobacter baumannii was effectively blocked.
      • This study helped to better ascertain the effectiveness of the surveillance program.

      Background

      The 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.

      Methods

      The 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.

      Results

      Statistically 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.

      Conclusions

      These results indicate that the surveillance program implemented was effective in preventing the spread of multidrug-resistant organisms in the hospital.

      Key Words

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