[Effectiveness and risks of isolation precautions in patients with MRSA and other multidrug-resistant bacteria].
The transmission of multidrug-resistant organisms (MRSA, VRE and ESBL producing bacteria) occurs predominantly if health-care workers are not compliant with hand hygiene procedures. The impact of single-room isolation in transmission prevention is often overestimated. As long as hand disinfection is not performed before and after patient contact and gloves are not removed, a single room will not prevent transmission by -itself. Understaffing is additionally worsening the situation. There is no consistent evidence sup-port-ing strict single-room isolation even though data show supportive tendencies. Social isolation is one of the risks that should be considered as well as the economic impact of using shared rooms as a single room. Up-to-date, evidence-based standard operating procedures and individual infection control recommendations should take these considerations into account. In general, contact precautions including isolation in a single room are performed in MRSA and VRE-positive patients. If a single room cannot be provided in a given case (a common problem in intensive care units), contact precautions can be performed in a shared room as an alternative. The problem of establishing an optimal compliance with standard precautions (especially hand hygiene) throughout all professional groups should be addressed. Additional precautions, including single-room isolation, should be implemented critically if indicated.
Dettenkofer
M
M
Universitätsklinikum Freiburg, Institut für Umweltmedizin und Krankenhaushygiene, Freiburg, Deutschland.
Utzolino
S
S
Luft
D
D
Lemmen
S
S
D016358:Contact Tracing; D003422:Critical Care; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000517:prevention & control* / Q000635:transmission*; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control* / Q000635:transmission*; D017408:Guidelines as Topic; D006235:Hand Disinfection; D006801:Humans; D008403:Mass Screening; D055624:Methicillin-Resistant Staphylococcus aureus; D010356:Patient Isolation; D010362:Patients' Rooms; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000517:prevention & control* / Q000635:transmission*; D016635:Universal Precautions; D020713:Vancomycin Resistance; D018440:beta-Lactam Resistance