Status of the Prevention of Multidrug-Resistant Organisms in International Settings: A Survey of the Society for Healthcare Epidemiology of America Research Network.
OBJECTIVE To examine self-reported practices and policies to reduce infection and transmission of multidrug-resistant organisms (MDRO) in healthcare settings outside the United States. DESIGN Cross-sectional survey. PARTICIPANTS International members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. METHODS Electronic survey of infection control and prevention practices, capabilities, and barriers outside the United States and Canada. Participants were stratified according to their country's economic development status as defined by the World Bank as low-income, lower-middle-income, upper-middle-income, and high-income. RESULTS A total of 76 respondents (33%) of 229 SHEA members outside the United States and Canada completed the survey questionnaire, representing 30 countries. Forty (53%) were high-, 33 (43%) were middle-, and 1 (1%) was a low-income country. Country data were missing for 2 respondents (3%). Of the 76 respondents, 64 (84%) reported having a formal or informal antibiotic stewardship program at their institution. High-income countries were more likely than middle-income countries to have existing MDRO policies (39/64 [61%] vs 25/64 [39%], P=.003) and to place patients with MDRO in contact precautions (40/72 [56%] vs 31/72 [44%], P=.05). Major barriers to preventing MDRO transmission included constrained resources (infrastructure, supplies, and trained staff) and challenges in changing provider behavior. CONCLUSIONS In this survey, a substantial proportion of institutions reported encountering barriers to implementing key MDRO prevention strategies. Interventions to address capacity building internationally are urgently needed. Data on the infection prevention practices of low income countries are needed. Infect Control Hosp Epidemiol. 2016:1-8.
1Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin.
Nasia
N
Safdar
4Medanta-The Medicity,Sector 38,Gurgaon,Haryana,India.
Sharmila
S
Sengupta
5Institute of Clinical and Translational Research,University of Wisconsin,Madison,Wisconsin.
Jackson S
JS
Musuuza
6Department of Internal Medicine,Section of Infectious Diseases,Yale University School of Medicine,New Haven,Connecticut.
Manisha
M
Juthani-Mehta
7Department of Medicine,Christiana Care Health System,Newark,Delaware.
Marci
M
Drees
9Division of Infectious Diseases,Department of Medicine,University of Miami Miller School of Medicine,Miami,Florida.
Lilian M
LM
Abbo
10Division of Infectious Diseases,Department of Pediatrics,Johns Hopkins University School of Medicine,Baltimore,Maryland.
Aaron M
AM
Milstone
11Department of Pharmacy Practice,Oregon State University/Oregon Health & Science University College of Pharmacy,Portland,Oregon.
Jon P
JP
Furuno
12Division of Infectious Diseases,Department of Pediatrics,Creighton University Medical Center,Omaha,Nebraska.
Meera
M
Varman
13Department of Medicine,Duke University School of Medicine,Durham,North Carolina.
Deverick J
DJ
Anderson
14Veterans Affairs Maryland Healthcare System,University of Maryland School of Medicine,Baltimore,Maryland.
Daniel J
DJ
Morgan
16Division of Infectious Diseases,Harbor-UCLA Medical Center,Torrance,California.
Loren G
LG
Miller
17Division of Infectious Disease,Beth Israel Deaconess Medical Center,Boston,Massachusetts.
Graham M
GM
Snyder
D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D003430:Cross-Sectional Studies; D018432:Drug Resistance, Multiple; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007391:International Cooperation; D010356:Patient Isolation; D057566:Self Report; D012955:Societies, Medical