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Korean J healthc assoc Infect Control Prev 2013; 18(1): 1-6

Published online June 30, 2013 https://doi.org/10.14192/kjnic.2013.18.1.1

Copyright © Korean Society for Healthcare-associated infection Control and Prevention

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Effect of Isolation Policy Using Cohorting Rooms on Isolation Rate of Multidrug-resistant Organisms and Antimicrobial Use Density: Focusing on Methicillin-Resistant Staphylococcus aureus and Multidrug-resistant Acinetobacter baumannii

Mi Hui Bak1, Oh Hyun Cho1,2, Eun Hwa Baek1, Sunjoo Kim3,4, In-Gyu Bae1,2,4

Infection Control Office, Gyeongsang National University Hospital1, Departments of Internal Medicine2, Laboratory Medicine3, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Sciences4, Gyeongsang National University, Jinju, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB).

Methods: Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB.

Results: After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17±6.80 and 19.5±7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB.

Conclusion: This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.

Keywords: Acinetobacter baumannii, Drug resistance, Methicillin-Resistant Staphylococcus aureus, Multiple, Patient Isolation

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