Disparity of the "screen-and-isolate" policy for multidrug-resistant organisms: A national survey in French adult ICUs

Am J Infect Control. 2018 Dec;46(12):1322-1328. doi: 10.1016/j.ajic.2018.05.025. Epub 2018 Jul 3.

Abstract

Background: The prevalence of multidrug-resistant organisms (MDROs) has dramatically increased. The aim of this survey was to describe and analyze the different screening and isolation policies regarding MDROs in French adult intensive care units (ICUs).

Materials and methods: A multicenter online survey was performed among French ICUs, including 63 questions distributed into 4 parts: characteristics of the unit, MDRO screening policy, policy regarding contact precautions, and ecology of the unit.

Results: From April 2015 to June 2016, 73 of 301 ICUs (24%) participated in the survey. MDRO screening was performed on admission in 96% of ICUs, for at least 1 MDRO (78%). MDRO screening was performed weekly during ICU stay in 83% of ICUs. Preemptive isolation was initiated on admission in 82% of ICUs, mostly in a targeted way (71%). Imported and acquired MDRO rates >10% were reported in 44% and 27% of ICUs, respectively. An MDRO outbreak had occurred within the past 3 years in 48% of cases.

Conclusion: French ICUs have variable screening and isolation approaches for MDROs, as up to 10 combinations were met. Discrepancies with the 2009 national guidelines were observed. Very few ICUs practice without some form of screening and isolation of patients upon admission.

Keywords: Intensive care unit; Isolation; Multidrug-resistant organisms (MDROs); Screening; Survey.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology*
  • Data Collection
  • Drug Resistance, Multiple, Bacterial*
  • France / epidemiology
  • Humans
  • Infection Control / organization & administration*
  • Infection Control / standards
  • Intensive Care Units / organization & administration*
  • Intensive Care Units / standards
  • Organizational Policy
  • Surveys and Questionnaires

Substances

  • Anti-Bacterial Agents