Refocusing On Standard Precautions And Other Non-pathogen-specific Initiatives To Prevent Nosocomial Transmission Of Bacterial Pathogens In The Acute Healthcare Settings | 102521
Journal of Infectious Diseases & Therapy
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Prevention of Healthcare Associated Infections has been the focus of Infection Prevention and Quality Initiatives for more than two
decades, and multidrug resistant organisms are responsible for many of these infections, further complicating their treatment.
In addition to strengthening antimicrobial stewardship practices, and improving adherence to standard precautions (including
hand hygiene), contact precautions for patients colonized or infected with multidrug resistant organisms have been recommended
and widely adopted to prevent horizontal transmission in the acute care healthcare setting. However, the data supporting these
recommendations derives predominantly from epidemic rather than endemic settings, where the burden of transmission as well
as the transmission rate is by definition high. Guidelines underscore the importance of a basic multiprong approach that includes
education around epidemiologically important organisms, hand hygiene, contact precautions, environmental cleaning and
antimicrobial stewardship. Additional measures recommended in the outbreak setting, such as active screening for MDR GNR,
MRSA and VRE, alerts for previous positives with pre-emptive CP, and cohorting of patients and staff, etc have also been proposed
on occasion. The presenter will discuss the strengths and weaknesses of these strategies when used alone or in conjunction, and will
argue that the focus on the primacy of contact precautions in acute care settings is misplaced for most MDR organisms. Alternative
focus and practices will be proposed.
Francesca J Torriani, is a Professor of Medicine in the Division of Infectious Diseases (ID) at the University of California, San Diego (UCSD). She received her M.D. in 1985 from the University Medical School in Lausanne, Switzerland and joined UCSD’s faculty in 1995.In addition to her clinical work, she serves as the Medical Director of the UCSD Health IPCE. Dr. Torriani helped create the legislation on HAI and Antimicrobial Stewardship reporting in California. She continues on the Metrics Group for CA HAI Reporting, an independent group of experts on best standards and methods for HAI prevention. She is well published (>75).