Effectiveness of barrier precautions and surveillance cultures to control transmission of multidrug-resistant organisms: a systematic review of the literature.
BACKGROUND
Despite the priority placed on preventing transmission of multidrug-resistant organisms (MDROs) in health care facilities, there is a lack of consensus among recommended infection control guidelines. We focused on control measures that have a great potential to affect patient care, patient services, and hospital cost/resources: barrier precautions/patient isolation and surveillance cultures.


METHODS
We conducted a systematic review of the literature and published English-language guidelines pertaining to the use of barrier precautions/patient isolation and surveillance cultures to prevent the transmission of MDROs. The recommendations made by the published guidelines were summarized and compared. The primary research studies identified through our literature search were evaluated for study quality. We then summarized the outcomes of the studies with the highest quality scores and made recommendations for future work.


RESULTS
A total of 29 studies were included in our assessment of study quality; of those, 7 studies were of high quality.


CONCLUSIONS
This systematic review identified key gaps in the literature including a need for greater monitoring of implementation of the interventions, more cost analyses of interventions, determining the independent contribution of specific interventions, and identifying the minimum interventions needed to reduce transmission.
Aboelela
Sally W
SW
Center for Interdisciplinary Research on Antimicrobial Resistance, Columbia University School of Nursing, New York, NY 10032, USA. sa2242@columbia.edu <sa2242@columbia.edu>
Saiman
Lisa
L
Stone
Patricia
P
Lowy
Franklin D
FD
Quiros
Dave
D
Larson
Elaine
E
D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D017053:Infection Control / Q000379:methods*; D011159:Population Surveillance; D017410:Practice Guidelines as Topic