Monika Pogorzelska-Maziarz, PhD, MPH, reports inconsistent screening practices for multi drug-resistant organisms in ICUs among hospitals

NEW YORK -- Screening practices for multidrug-resistant organisms (MDROs) in intensive care units (ICUs) vary widely from hospital to hospital, according to a new study by researchers at Columbia University School of Nursing and published in the October issue of the American Journal of Infection Control.

Researchers found that of the hospitals surveyed a little more than half (59 percent) routinely screened for methicillin-resistant Staphylococcus aurea, or MRSA. However, other potentially deadly MDROs were screened for far less frequently: vancomycin-resistant Enterococcus (22 percent), gram-negative rods (12 percent), and C. difficile (11 percent).

The survey found that while some hospitals follow a comprehensive screening and surveillance policy for infectious disease in the ICU, including isolating at-risk patients both during and after laboratory tests for infection, others did not. For example, almost all of the ICUs reported a policy for contact precautions following a positive culture (98 percent) but less than a third of ICUs reported a policy requiring isolation/contact precautions pending screening results.

While lead author Monika Pogorzelska-Maziarz, PhD, MPH advocates that hospitals need to tailor their response to the types and frequency of infection in their local areas, she says some measures included in her study make good sense from a precaution perspective. "It seems prudent that possibly infected patients coming into the ICU should be isolated until lab tests come back giving an 'all clear,'" she says.

The study also found that higher number of infection control staff, and infection control staffing hours were positive predictors of correct implementation of policy to isolate culture-positive patients. In addition, researchers found that mandatory reporting and use of electronic surveillance systems were also positively associated with a policy to screen periodically after admission for infection.