Implementation of ``significant organism precaution'' in a teaching hospital: first experience in Iran
Abstract number: 1734_150
Nateghian A., Mehrali L., Hamdarsi N.
Introduction: nosocomial infection due to multiple drug resistant organisms is a concerning problem in Iran, particularly in large teaching hospitals. A specific type of contact isolation termed as ``significant organism precaution (SOP)'' has been proposed to limit the extent of problem, however, no previous experience in terms of such an isolation programme, coordination for it's implementation and executive barriers was available in our country.
Methods and Patients: After holding three workshops for introducing SOP to physicians, nurses and other healthcare workers, we decided to start SOP for all cases with MRSA, VRE & MDR Gram-negative bacilli (defined as resistant by disk diffusion methods to all members of three major groups of antibiotics usually effective in their therapy (i.e., aminoglycosides, new quinolones and 3th generation cephalosporins) in Rasul Akram hospital, a 800 beds teaching hospital in Tehran during 2004. For all cases of SOP, data regarding the demographic issues and type of organisms as well as sites of colonisation or infections, availability of required items for SOP and rate of compliance were recorded by an observer throughout their admission.
Results: 183 cases needed SOP during a 6 months period of study and observation.60 cases (33%) were female.mean age of cases was 43.5 (± 16) and most common sites of isolation were urinary tract, ulcers or incisions & blood stream (23%, 19% & 13.5% respectively). MDR Gram-negative bacilli were the most common isolates for which SOP was necessary (86%) followed by MRSA (13%) and VRE (1%). Except for disposable gloves and individual thermometer for each case which were available for most cases, scrub betadine, gowns, masks, personal stethoscopes and isolated rooms were not present or could not provided for most of cases in non intensive care wards and units. For most of these cases, physicians and nurses believed that such interventions and programmes were necessary, however just in 12% of cases they were fully compliant to SOP programme. Rates of availability of required items and compliance were much better for cases admitted to various intensive care units.
Conclusion: SOP programme is a necessary item at least in large teaching hospital in Iran particularly for large number of MDR Gram-negative bacilli but more educational efforts, budget and facilities should be provided if proper implementation of such a programme is to be happen.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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