Cohorting for preventing the nosocomial spread of carbapenemase-producing Enterobacterales in non-epidemic settings: should it be mandatory?

Hilliquin, Delphine; Lomont, Alexandra; Zahar, Jean‐Ralph

doi:10.1016/j.jhin.2020.04.022

Cited by 5 publications

(1 citation statement)

References 107 publications

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“…Cohorting is defined as grouping together those patients colonized or infected with the same MDRO in one care area in order to avoid contact with other susceptible patients [ 97 ]. The purpose of cohorting is to prevent cross-transmission from the hands of healthcare workers or from the environment [ 98 ].…”

Section: International Policies To Limit the Spread Of Mdrosmentioning

confidence: 99%

Limiting the Spread of Multidrug-Resistant Bacteria in Low-to-Middle-Income Countries: One Size Does Not Fit All

et al. 2023

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The spread of multidrug-resistant organisms (MDRO) is associated with additional costs as well as higher morbidity and mortality rates. Risk factors related to the spread of MDRO can be classified into four categories: bacterial, host-related, organizational, and epidemiological. Faced with the severity of the MDRO predicament and its individual and collective consequences, many scientific societies have developed recommendations to help healthcare teams control the spread of MDROs. These international recommendations include a series of control measures based on surveillance cultures and the application of barrier measures, ranging from patients’ being isolated in single rooms, to the reinforcement of hand hygiene and implementation of additional contact precautions, to the cohorting of colonized patients in a dedicated unit with or without a dedicated staff. In addition, most policies include the application of an antimicrobial stewardship program. Applying international policies to control the spread of MDROs presents several challenges, particularly in low-to-middle-income countries (LMICs). Through a review of the literature, this work evaluates the real risks of dissemination linked to MDROs and proposes an alternative policy that caters to the means of LMICs. Indeed, sufficient evidence exists to support the theory that high compliance with hand hygiene and antimicrobial stewardship reduces the risk of MDRO transmission. LMICs would therefore be better off adopting such low-cost policies without necessarily having to implement costly isolation protocols or impose additional contact precautions.

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Section: International Policies To Limit the Spread Of Mdrosmentioning

confidence: 99%