title: Wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: a national study.
abstract: BACKGROUND
  We performed a survey of National Healthcare Safety Network hospitals in 2008 to describe adoption of screening and infection control policies aimed at multidrug-resistant organisms (MDRO) in intensive care units (ICUs) and identify predictors of their presence, monitoring, and implementation.
  
  
  METHODS
  Four hundred forty-one infection control directors were surveyed using a modified Dillman technique. To explore differences in screening and infection control policies by setting characteristics, bivariate and multivariable logistic regression models were constructed.
  
  
  RESULTS
  In total, 250 hospitals participated (57% response rate). Study ICUs (n = 413) routinely screened for methicillin-resistant Staphylococcus aureus (59%); vancomycin-resistant Enterococcus (22%); multidrug-resistant, gram-negative rods (12%); and Clostridium difficile (11%). Directors reported ICU policies to screen all admissions for any MDRO (40%), screen periodically (27%), utilize presumptive isolation/contact precautions pending a screen (31%), and cohort colonized patients (42%). Several independent predictors of the presence and implementation of different interventions including mandatory reporting and teaching status were identified.
  
  
  CONCLUSIONS
  This study found wide variation in adoption of MDRO screening and infection control interventions, which may reflect differences in published recommendations or their interpretation. Further research is needed to provide additional insight on effective strategies and how best to promote compliance.
authors.affiliation: Columbia University School of Nursing, New York, NY 10032, USA. Mp2422@columbia.edu
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
mesh_terms: D016360:Clostridioides difficile / Q000302:isolation & purification*; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000302:isolation & purification*; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D006235:Hand Disinfection; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data; D007362:Intensive Care Units; D008403:Mass Screening / Q000706:statistics & numerical data*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015999:Multivariate Analysis; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D020713:Vancomycin Resistance