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Multi-Resistant Bacteria Outbreak Management
21/3/11
- this is an infection control emergency
- notify ICU staff and ID team
PATIENT
-
isolation
assess whether coloniser or producing active infection
quantify whether patients required antibiotic changes
remove colonised material (resite lines)
terminal cleaning once patients discharged
PREVENT CROSS CONTAMINATION
- full cleaning of contaminated areas
- notify visitors about importance of barrier contact
ROOT CAUSE ANALYSIS
- assessment of possible vector transmission
- prescribing practices
- screen environmental reservoirs (work surfaces, ventilation ducts, ventilator tubing)
ANTIBIOTIC STEWARDSHIP
- review antibiotic practices (many multi-resistant organisms are produced because antibiotic
practice)
- review biograms
- review dosing
- discuss with ID regarding cycling of antibiotics
QUALITY ASSURANCE
-
review infection control procedures (hand-washing, barrier nursing, universal precautions)
review CVL procedures (insertion, accessing, daily procedures)
review ventilator care – scheduled tubing changes (weekly)
education
vigilance on line accessing behaviour, insertion techniques, when removed (Provonost)
review issue once behaviours changed
audit
Jeremy Fernando (2011)
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