Nation-wide survey of screening practices to detect carriers of multi-drug resistant organisms upon admission to Swiss healthcare institutions

Article Article scientifique Article Nation-wide survey of screening practices to detect carriers of multi-drug resistant organisms upon admission to Swiss healthcare institutions eng 2019 author Martischang Romain 765069 author Buetti Niccolo author Balmelli Carlo author Saam Mirko 89902 author Widmer Andreas author Harbarth Stéphan Juergen 0000-0002-3551-1025 93885 37 10.1186/s13756-019-0479-5 30809380 2047-2994 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375162/ As emergence and spread of multi-drug resistant organisms (MDRO) requires a standardized preventive approach, we aimed to evaluate current MDRO admission screening practices in Swiss hospitals and to identify potential barriers impeding their implementation. In early 2018, all Swiss public and private healthcare institutions providing inpatient care were contacted with a 34-item questionnaire to investigate current MDRO admission screening policies. Among 139 respondents representing 180 institutions (response rate, 79%), 83% (149) of institutions implemented MDRO admission screening, while 28% of private and 9% of public institutions did not perform any screening. Targeted high-risk screening included carbapenemase producers, extended-spectrum beta-lactamase producers and methicillin-resistant Staphylococcus aureus at the institutional level for respectively 78% (115), 81% (118) and 98% (145) of screening institutions. Vancomycin-resistant enterococci (44% of institutions), multi-resistant Acinetobacter baumanii (41%) and Pseudomonas aeruginosa (37%) were systematically searched only by a minority of screening institutions. A large diversity of risk factors for targeted screening and some heterogeneity in body sites screened were also observed. Admission-screening practices were mostly impeded by a difficulty to identify high-risk patients (44%) and non-compliance of healthcare workers (35%). Heterogeneous practices and gaps in small and privately-owned institutions, as well as a mismatch between current epidemiologic MDRO trends and screening practices were noticed. These results highlight the need for uniform national MDRO screening standards. Admission screening Carbapenem-resistant Contact isolation Cross-infection Enterobacteriaceae Extended-spectrum beta-lactamase Infection prevention and control Multi-drug resistant Survey Dewey 616 Swiss National Science Foundation An interventional study to evaluate the impact of a rapid screening strategy in improving nosocomial ESBL and CPE control in critically ill patients 177454 CH Programmes 56 Département de médecine 221 false 526 Résistance aux antibiotiques 866 Antimicrobial Resistance and Infection Control 8 4 3309f77f-6ef8-4fb0-a839-30d47d3cc9a3 Article (Published version) Public 13756_2019_Article_479.pdf 339554 application/pdf CC BY 822e12de-1ec1-47eb-904e-8d9655238021 Supplemental data Public 13756_2019_479_MOESM1_ESM.pdf 357980 application/pdf CC BY 2770dddd-56d1-4d0b-8192-132398da5e7f Supplemental data Public 13756_2019_479_MOESM2_ESM.pdf 356992 application/pdf CC BY openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Nation-wide survey of screening practices to detect carriers of multi-drug resistant organisms upon admission to Swiss healthcare institutions	Antimicrobial Resistance and Infection Control			2019	309	204

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Saam, Mirko