Clusters of emerging multidrug-resistant organisms in US health care facilities during the initial months of the SARS-CoV-2 pandemic

IF 3.8 3区 医学 Q2 INFECTIOUS DISEASES
D. Cal Ham MD, MPH , Ruoran Li PhD , Tisha Mitsunaga DrPH, ScM , Christopher Czaja MD, DrPH , Christopher Prestel MD , Sandeep Bhaurla MPH , Melissa Cumming MS , Brenda Brennan MSPH , Gabriel Innes VMD, PhD , Savannah Carrico MPH , Allison Chan MPH , Enyinnaya Merengwa MD, DrPH , Anna Stahl MPH , Belinda Ostrowsky MD , Marie A. de Perio MD , Maroya Spalding Walters PhD
{"title":"Clusters of emerging multidrug-resistant organisms in US health care facilities during the initial months of the SARS-CoV-2 pandemic","authors":"D. Cal Ham MD, MPH ,&nbsp;Ruoran Li PhD ,&nbsp;Tisha Mitsunaga DrPH, ScM ,&nbsp;Christopher Czaja MD, DrPH ,&nbsp;Christopher Prestel MD ,&nbsp;Sandeep Bhaurla MPH ,&nbsp;Melissa Cumming MS ,&nbsp;Brenda Brennan MSPH ,&nbsp;Gabriel Innes VMD, PhD ,&nbsp;Savannah Carrico MPH ,&nbsp;Allison Chan MPH ,&nbsp;Enyinnaya Merengwa MD, DrPH ,&nbsp;Anna Stahl MPH ,&nbsp;Belinda Ostrowsky MD ,&nbsp;Marie A. de Perio MD ,&nbsp;Maroya Spalding Walters PhD","doi":"10.1016/j.ajic.2024.07.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Outbreaks of emerging multidrug-resistant organisms (eMDROs), including carbapenem-resistant Enterobacterales, carbapenem-resistant <em>Acinetobacter baumannii</em>, and <em>Candida auris</em>, have been reported among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. We describe eMDRO clusters in SARS-CoV-2 units and associated infection control (IC) practices early in the SARS-CoV-2 pandemic.</div></div><div><h3>Methods</h3><div>We conducted a retrospective survey of a convenience sample of health departments in 11 states to describe clusters of eMDROs that began before November 1, 2020 and involved SARS-CoV-2 units. Cluster characteristics and IC practices during the cluster period were assessed using a standardized outbreak report form, and descriptive analyses were performed.</div></div><div><h3>Results</h3><div>Overall, 18 eMDRO clusters (10 carbapenem-resistant Enterobacterales, 6 <em>C auris</em>, 1 carbapenem-resistant <em>Pseudomonas aeruginosa</em>, and 1 carbapenem-resistant <em>A baumannii</em>) in 18 health care facilities involving 397 patients were reported from 10 states. During the cluster period, 60% of facilities reported a shortage of isolation gowns, 69% extended use of gowns, and 67% reported difficulty obtaining preferred disinfectants. Reduced frequency of hand hygiene audits was reported in 85% of acute care hospitals during the cluster period compared with before the pandemic.</div></div><div><h3>Conclusions</h3><div>Changes in IC practices and supply shortages were identified in facilities with eMDRO outbreaks during the SARS-CoV-2 pandemic and might have contributed to eMDRO transmission.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"52 12","pages":"Pages 1390-1396"},"PeriodicalIF":3.8000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of infection control","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0196655324006308","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Outbreaks of emerging multidrug-resistant organisms (eMDROs), including carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, and Candida auris, have been reported among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. We describe eMDRO clusters in SARS-CoV-2 units and associated infection control (IC) practices early in the SARS-CoV-2 pandemic.

Methods

We conducted a retrospective survey of a convenience sample of health departments in 11 states to describe clusters of eMDROs that began before November 1, 2020 and involved SARS-CoV-2 units. Cluster characteristics and IC practices during the cluster period were assessed using a standardized outbreak report form, and descriptive analyses were performed.

Results

Overall, 18 eMDRO clusters (10 carbapenem-resistant Enterobacterales, 6 C auris, 1 carbapenem-resistant Pseudomonas aeruginosa, and 1 carbapenem-resistant A baumannii) in 18 health care facilities involving 397 patients were reported from 10 states. During the cluster period, 60% of facilities reported a shortage of isolation gowns, 69% extended use of gowns, and 67% reported difficulty obtaining preferred disinfectants. Reduced frequency of hand hygiene audits was reported in 85% of acute care hospitals during the cluster period compared with before the pandemic.

Conclusions

Changes in IC practices and supply shortages were identified in facilities with eMDRO outbreaks during the SARS-CoV-2 pandemic and might have contributed to eMDRO transmission.
SARS-CoV-2 大流行最初几个月美国医疗机构中新出现的耐多药生物群。
背景:据报道,SARS-CoV-2患者中爆发了新出现的多重耐药菌(eMDRO),包括耐碳青霉烯类肠杆菌(CRE)、耐碳青霉烯类鲍曼不动杆菌(CRAB)和白色念珠菌。我们描述了在 SARS-CoV-2 大流行早期,SARS-CoV-2 病房中的 eMDRO 群和相关的感染控制(IC)措施:我们对 11 个州的卫生部门进行了回顾性抽样调查,以描述 2020 年 11 月 1 日前开始的涉及 SARS-CoV-2 单位的 eMDRO 群组。使用标准化的疫情报告表对群集特征和群集期间的集成电路实践进行了评估,并进行了描述性分析:结果:10 个州共报告了 18 家医疗机构的 18 例 eMDRO 群体(10 例 CRE、6 例 C.auris、1 例耐碳青霉烯类铜绿假单胞菌和 1 例 CRAB),涉及 397 名患者。在群集期间,60% 的医疗机构报告隔离衣短缺,69% 的医疗机构延长了隔离衣的使用时间,67% 的医疗机构报告难以获得首选消毒剂。据报告,与大流行之前相比,85%的急症护理医院在大流行期间减少了手部卫生审核的频率:结论:在SARS-CoV-2大流行期间,在爆发eMDRO疫情的机构中发现了IC操作方法的改变和供应短缺,这可能是导致eMDRO传播的原因之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
7.40
自引率
4.10%
发文量
479
审稿时长
24 days
期刊介绍: AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信