Korean J Nosocomial Infect Control.  2013 Jun;18(1):1-6. 10.14192/kjnic.2013.18.1.1.

Effect of Isolation Policy Using Cohorting Rooms on Isolation Rate of Multidrug-resistant Organisms and Antimicrobial Use Density: Focusing on Methicillin-Resistant Staphylococcus aureus and Multidrug-resistant Acinetobacter baumannii

• Bak MH
• Cho OH
• Baek EH
• Kim S
• Bae IG

• KMID: 1428635
• DOI: http://doi.org/10.14192/kjnic.2013.18.1.1

Abstract

BACKGROUND
We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB).
METHODS
Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB.
RESULTS
After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17+/-6.80 and 19.5+/-7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB.
CONCLUSION
This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.

Keyword

Acinetobacter baumannii; Drug resistance; Methicillin-Resistant Staphylococcus aureus; Multiple; Patient Isolation

MeSH Terms

Acinetobacter
Acinetobacter baumannii
Carbapenems
Cohort Studies
Colon
Drug Resistance
Glycopeptides
Humans
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Patient Isolation
Patients' Rooms
Prospective Studies
Carbapenems
Glycopeptides

Figure

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  Fig. 1. Quarterly methicillin-resistant Staphylococcus aureus isolation rates (No. of isolates/1,000 patient-days). Abbreviation: MRSA, Methicillin-resistant Staphylococcus aureus.

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  Fig. 2. Quarterly multidrug-resistant Acinetobacter baumannii isolation rates (No. of isolates/1,000 patient-days). Abbreviation: MDR-AB, Multidrug-resistant Acinetobacter baumannii.

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  Fig. 3. Quarterly antimicrobial use density of glycopeptides. Abbreviation: AUD, antimicrobial use density.

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  Fig. 4. Quarterly antimicrobial use density of carbapenems. Abbreviation: AUD, antimicrobial use density.

Reference

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