North West Neonatal Operational Delivery Network Working together to provide the highest standard of care for babies and families

Size: px
Start display at page:

Download "North West Neonatal Operational Delivery Network Working together to provide the highest standard of care for babies and families"

Transcription

1 Document Title and Reference : Guideline for the management of multi-drug resistant organisms (MDRO) Main Author (s) Simon Power Ratified by: GM NSG Date Ratified: February 2012 Review Date: March 2017 Simon Power Version: V3 Document status: GM approved guideline The North West Neonatal Network (NWNODN) consists of 3 locality neonatal networks, Cheshire and Merseyside (CM) Lancashire and South Cumbria (LSC) and Greater Manchester (GM). This document has agreed by locality Clinical Effective Groups (CEG) and can be adapted for local use. Please acknowledge source if this document is adapted for local use.

2 Management of Multi-Drug Resistant Organisms (MDRO) Neonatal units are high risk clinical areas for the emergence of MDRO. This policy addresses prevention, surveillance and treatment measures that must be maintained to prevent or control MDRO on the Neonatal Unit. Methicillin Resistant Staphylococcus Aureus (MRSA) Methicillin-resistant S. aureus (MRSA) refers to a strain of S. aureus that has acquired the meca gene. This gene renders MRSA resistant to all beta-lactam antibiotics. MRSA strains are often resistant to other classes of antibiotics as well. The Health Protection Agency analysed all reports of Staphylococcus aureus bacteraemia from 1990 to There were 376 cases of MRSA bacteraemia in children <15 years over this time. The proportion of Staphylococcus aureus bacteraemia due to MRSA increased steadily from 0.9% in 1990 to 13% in The proportion was higher in infants 1. There is currently a lack of demographic and epidemiological data in the neonatal group on specific rates of MRSA septicaemia in this population. Recently the MIC sensitivity to Vancomycin of Staphylococcus Aureus including MRSA organisms has been reduced nationally and this is likely to increase the numbers of organisms that are resistant to vancomycin also. Early consultation with the Trusts microbiology department will be important in such cases. Extended Spectrum Beta-Lactamase (ESBL) producing organisms These are organisms (most commonly E. coli and Klebsiella species) that produce a beta-lactamase, an enzyme that breaks down beta-lactam antibiotics. As a result these ESBL producing organisms are resistant to all penicillin and cephalosporin antibiotics. These organisms are also frequently resistant to other classes of antibiotics. A recent survey identified 26% of neonatal units in England and Wales reporting cases of colonisation or infection with these organisms over a 2-year period between 2008 and Carbapenemase producing coliforms Organisms (most frequently Klebsiella sp., E. coli and Enterobacter sp.) producing these enzymes are resistant to all beta-lactam antibiotics. They are frequently also resistant to other classes of antibiotic, severely limiting therapeutic choices. First identified on the eastern seaboard of the USA in the early 2000 s, they are now found across the USA and have been reported in a number of other countries with Greece and Israel having notable incidence. They have been uncommon in the UK until recently, however their incidence is rising, particularly in the North West. Vancomycin-resistant Enterococci (VRE) Enterococci are commonly found in the gastro-intestinal tract. There are a number of sub-types of these organisms with a spectrum of resistance to Vancomycin. These resistant organisms can be pathogenic for infants on neonatal units 3. Enterococci can remain viable in the environment for extended periods of time.

3 Prevention (for all MDRO) Isolation* of all cases with MDRO Promoting and maintaining effective hand hygiene Maintain cleanliness of environment and patient shared equipment Use of disposable gloves and aprons for affected patients and when handling body fluids Updating and training of staff via Infection Control Teams Surveillance (for MRSA only discuss with local Infection Control Team regarding other MDRO) Screening, using skin swabs, all babies admitted to the unit and babies of known MRSA positive mothers. Swabs include: umbilicus, perineum, axillae, broken down areas of skin and any invasive lines. Depending on the size of the baby some units may also wish to swab nose (one swab from both nares). Targeted screening of other babies may be required after discussion with Local Infection Control Team. Treatment once a case is identified (for all MDRO) Inform Consultant and Nursing Shift Co-ordinator Inform Infection Control Team Isolate* *If there is the facility and staff resources to do so the MDRO positive baby should be nursed in a single room or alone in a bay using standard isolation procedures. If this is not available a baby may be cohort-nursed within an incubator. (for MRSA only) Institute the Integrated Care Pathway (ICP) for MRSA Take swabs from baby (as per ICP) and commence topical treatment (as per ICP) Topical or systemic antibiotics and/or topical antiseptics may be required to eradicate MRSA. There is no demonstrable superiority of either topical or systemic therapy, or of combinations of topical and systemic agents 4. These topical agents should only be used on intact skin. They should also not be used on extreme preterm babies whose skin is quite thin and porous. Each case must be continually reviewed on an individual basis. Specific treatment may be required. In an unwell baby with MDRO colonization and/or bacteraemia: Discuss choice of systemic antibiotics with Microbiology Team - Vancomycin is the main antibiotic used for MRSA sepsis 5, but other staphylococcal agents are often added for deep infections e.g. bone/joint or endocarditis, such as Gentamicin, Rifampicin or Fusidic acid.

4 If sputum / ET secretion is positive for MRSA consider using intravenous Vancomycin. If eye swab is positive for MRSA commence Choramphenicol or Gentamicin eye ointment/drops. For treatment of ESBL-producing organisms and VRE, discussions with Microbiology will guide decisions. Network transfer of Infants The following principles regarding the transfer of neonates between neonatal units, and implications of potential MDRO have also been endorsed by the Greater Manchester Neonatal Network Board: Babies should be accepted on to a neonatal unit even if positive for a MDRO. Screening should not impede the flow/transfer of babies MRSA screening should be performed on all babies on admission to a neonatal unit and the Neonatal Network MRSA guidelines would reflect this. MRSA swabs on admission to the neonatal unit should be taken from all infants, including newborns Any baby shown to be MRSA positive should have regular screening swabs at minimum once per week until three negative swabs have been obtained Swabs should be taken prior to any transfer although the transfer should not be delayed until the results are available If an infant is known to be MDRO positive this is not a contraindication for transfer - the receiving unit should use standard procedures agreed within their Trust to prevent spread and facilitate eradication of the infection when possible. The neonatal transport team should routinely collect information regarding MDRO status of infants at the time of transfer Both transferring and receiving units should ensure that MDRO results are communicated. Neonatal Lead Consultants and Senior Nurses in each Trust should inform all staff and monitor local compliance with the policy. References 1. Khairulddin N, Bishop L, Lamagni TL, et al. Emergence of Methicillin resistant Staphylococcus aureus (MRSA) bacteraemia among children in England and Wales, Arch Dis Child 2004;89: Mitra S, Sivakumar P, Oughton J, Ossuetta I. National surveillance study of extended spectrum beta lactamase (ESBL) producing organism infection in neonatal units of England and Wales. Arch Dis Child 2011;96(Suppl 1):A Singh N, Leger MM, Campbell J, Short B, Campos JM. Control of Vancomycin-resistant enterococci in the neonatal intensive care unit. Infect Control Hosp Epidemiol 2005 Jul;26(7):646-9.

5 4. Loeb M, Main C, Walker-Dilks C, Eady A. Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. The Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD DOI: / CD Working Party Report. Revised guidelines for the control of methicillinresistant Staphylococcus aureus infection in hospitals. J Hosp Infect 1998;39:

MRSA in the United Kingdom status quo and future developments

MRSA in the United Kingdom status quo and future developments MRSA in the United Kingdom status quo and future developments Dietrich Mack Chair of Medical Microbiology and Infectious Diseases The School of Medicine - University of Wales Swansea P R I F Y S G O L

More information

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University

More information

Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED Printed copies must not be considered the definitive version

Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED Printed copies must not be considered the definitive version Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED 2018 Printed copies must not be considered the definitive version DOCUMENT CONTROL POLICY NO. IC-122 Policy Group Infection Control

More information

Two (II) Upon signature

Two (II) Upon signature Page 1/5 SCREENING FOR ANTIBIOTIC RESISTANT ORGANISMS (AROS) IN ACUTE CARE AND LONG TERM CARE Infection Prevention and Control IPC 050 Issuing Authority (sign & date) Office of Administrative Responsibility

More information

MICRONAUT MICRONAUT-S Detection of Resistance Mechanisms. Innovation with Integrity BMD MIC

MICRONAUT MICRONAUT-S Detection of Resistance Mechanisms. Innovation with Integrity BMD MIC MICRONAUT Detection of Resistance Mechanisms Innovation with Integrity BMD MIC Automated and Customized Susceptibility Testing For detection of resistance mechanisms and specific resistances of clinical

More information

Carbapenemase-Producing Enterobacteriaceae Multi Drug Resistant Organism Management Procedure. (IPC Manual)

Carbapenemase-Producing Enterobacteriaceae Multi Drug Resistant Organism Management Procedure. (IPC Manual) Carbapenemase-Producing Enterobacteriaceae Multi Drug Resistant Organism Management Procedure (IPC Manual) DOCUMENT CONTROL: Version: 1 Ratified by: Clinical Policies Review and Approval Group Date ratified:

More information

Multi-Drug Resistant Organisms (MDRO)

Multi-Drug Resistant Organisms (MDRO) Multi-Drug Resistant Organisms (MDRO) 2016 What are MDROs? Multi-drug resistant organisms, or MDROs, are bacteria resistant to current antibiotic therapy and therefore difficult to treat. MDROs can cause

More information

Carbapenemase-Producing Enterobacteriaceae (CPE)

Carbapenemase-Producing Enterobacteriaceae (CPE) Carbapenemase-Producing Enterobacteriaceae (CPE) September 21, 2017 Maryam Khan Peel Public Health Madeleine Ashcroft Public Health Ontario Objectives Differentiate the acronyms related to CPE (CPE,CPO,CRE,CRO)

More information

Original Articles. K A M S W Gunarathne 1, M Akbar 2, K Karunarathne 3, JRS de Silva 4. Sri Lanka Journal of Child Health, 2011; 40(4):

Original Articles. K A M S W Gunarathne 1, M Akbar 2, K Karunarathne 3, JRS de Silva 4. Sri Lanka Journal of Child Health, 2011; 40(4): Original Articles Analysis of blood/tracheal culture results to assess common pathogens and pattern of antibiotic resistance at medical intensive care unit, Lady Ridgeway Hospital for Children K A M S

More information

03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline

03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline Infection Prevention and Control A Foundation Course 2014 What is healthcare-associated infection (HCAI), antimicrobial resistance (AMR) and multi-drug resistant organisms (MDROs)? Why we should be worried?

More information

Antibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship

Antibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship Antibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship J. Hudson Garrett Jr., PhD, MSN, MPH, FNP-BC, PLNC, CDONA, IP-BC, GDCN, CDP, CADDCT, CALN, VA-BC, AS-BC,

More information

Approval Signature: Original signed by Dr. Michel Tetreault Date of Approval: July Review Date: July 2017

Approval Signature: Original signed by Dr. Michel Tetreault Date of Approval: July Review Date: July 2017 WRHA Infection Prevention and Control Program Operational Directives Admission Screening for Antibiotic Resistant Organisms (AROs): Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistant

More information

Horizontal vs Vertical Infection Control Strategies

Horizontal vs Vertical Infection Control Strategies GUIDE TO INFECTION CONTROL IN THE HOSPITAL Chapter 14 Horizontal vs Vertical Infection Control Strategies Author Salma Abbas, MBBS Michael Stevens, MD, MPH Chapter Editor Shaheen Mehtar, MBBS. FRC Path,

More information

Risk of organism acquisition from prior room occupants: A systematic review and meta analysis

Risk of organism acquisition from prior room occupants: A systematic review and meta analysis Risk of organism acquisition from prior room occupants: A systematic review and meta analysis A/Professor Brett Mitchell 1-2 Dr Stephanie Dancer 3 Dr Malcolm Anderson 1 Emily Dehn 1 1 Avondale College;

More information

FIS Resistance Surveillance: The UK Landscape. Alasdair MacGowan Chair BSAC Working Party on Antimicrobial Resistance Surveillance

FIS Resistance Surveillance: The UK Landscape. Alasdair MacGowan Chair BSAC Working Party on Antimicrobial Resistance Surveillance FIS 2013 Resistance Surveillance: The UK Landscape Alasdair MacGowan Chair BSAC Working Party on Antimicrobial Resistance Surveillance A statement of the obvious Good quality surveillance data on resistant

More information

Hospital Acquired Infections in the Era of Antimicrobial Resistance

Hospital Acquired Infections in the Era of Antimicrobial Resistance Hospital Acquired Infections in the Era of Antimicrobial Resistance Datuk Dr Christopher KC Lee Infectious Diseases Unit Department of Medicine Sungai Buloh Hospital Patient Story 23 Year old female admitted

More information

Taking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 1 Reviewing the organisms

Taking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 1 Reviewing the organisms Taking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 1 Reviewing the organisms Nimalie D. Stone, MD,MS Division of Healthcare Quality Promotion National

More information

Preventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal

Preventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal 07.03.01 2009 Methicillin Resistant Staphlococcus aureus (MRSA) About 3-8% of the population at large is a carrier

More information

1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection

1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection Surveillance, Outbreaks, and Reportable Diseases, Oh My! Assisted Living Facility, Nursing Home and Surveyor Infection Prevention Training February 2015 A.C. Burke, MA, CIC Health Care-Associated Infection

More information

MRSA CROSS INFECTION RISK: IS YOUR PRACTICE CLEAN ENOUGH?

MRSA CROSS INFECTION RISK: IS YOUR PRACTICE CLEAN ENOUGH? Vet Times The website for the veterinary profession https://www.vettimes.co.uk MRSA CROSS INFECTION RISK: IS YOUR PRACTICE CLEAN ENOUGH? Author : CATHERINE F LE BARS Categories : Vets Date : February 25,

More information

Glycopeptide Resistant Enterococci (GRE) Policy IC/292/10

Glycopeptide Resistant Enterococci (GRE) Policy IC/292/10 BASINGSTOKE AND NORTH HAMPSHIRE NHS FOUNDATION TRUST Glycopeptide Resistant Enterococci (GRE) Policy IC/292/10 Supersedes: IC/292/07 Owner Name Dr Nicki Hutchinson Job Title Consultant Microbiologist,

More information

Summary of the latest data on antibiotic resistance in the European Union

Summary of the latest data on antibiotic resistance in the European Union Summary of the latest data on antibiotic resistance in the European Union EARS-Net surveillance data November 2017 For most bacteria reported to the European Antimicrobial Resistance Surveillance Network

More information

Infection control: Need for robust guidelines

Infection control: Need for robust guidelines Infection control: Need for robust guidelines Hans Jørn Kolmos MD DMSc Professor, consultant Department of Clinical Microbiology Odense University Hospital hans.joern.kolmos@ouh.regionsyddanmark.dk Combating

More information

Infection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention

Infection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Highlights for the Medical Staff Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Standard Precautions every patient every time a. Hand Hygiene b. Use of Personal Protective Equipment (PPE)

More information

Hand washing/hand hygiene reduces the number of microorganisms on the hands and is the most important practice to prevent the spread of infection.

Hand washing/hand hygiene reduces the number of microorganisms on the hands and is the most important practice to prevent the spread of infection. 1. Hand Hygiene Quick Reference Chart Hand washing/hand hygiene reduces the number of microorganisms on the hands and is the most important practice to prevent the spread of infection. WHEN Before: Direct

More information

Infection Prevention and Control Policy

Infection Prevention and Control Policy Infection Prevention and Control Policy Control of Multi-Drug-Resistant Gram-Negative Bacilli N.B. Staff should be discouraged from printing this document. This is to avoid the risk of out of date printed

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIII NUMBER 1 July 2008 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell, SM (ASCP), Marti Roe SM (ASCP), Ann-Christine Nyquist MD, MSPH Are the bugs winning? The 2007

More information

Infection Control Priorities for Antibiotics Resistance - The Search and Destroy Strategy. WH Seto Hong Kong China

Infection Control Priorities for Antibiotics Resistance - The Search and Destroy Strategy. WH Seto Hong Kong China Infection Control Priorities for Antibiotics Resistance - The Search and Destroy Strategy WH Seto Hong Kong China WHD 2011 slogan Tier 1 Education Surveillance Environment Administration Usage IC isolation

More information

Florida Health Care Association District 2 January 13, 2015 A.C. Burke, MA, CIC

Florida Health Care Association District 2 January 13, 2015 A.C. Burke, MA, CIC Florida Health Care Association District 2 January 13, 2015 A.C. Burke, MA, CIC 11/20/2014 1 To describe carbapenem-resistant Enterobacteriaceae. To identify laboratory detection standards for carbapenem-resistant

More information

Microbiology. Multi-Drug-Resistant bacteria / MDR: laboratory diagnostics and prevention. Antimicrobial resistance / MDR:

Microbiology. Multi-Drug-Resistant bacteria / MDR: laboratory diagnostics and prevention. Antimicrobial resistance / MDR: Microbiology Multi-Drug-Resistant bacteria / MDR: laboratory diagnostics and prevention June 2017 MeshHp (VS) Medical Care Center Dr. Eberhard & Partner Dortmund (ÜBAG) www.labmed.de MVZ Dr. Eberhard &

More information

Antibiotics: mode of action and mechanisms of resistance. Slides made by Special consultant Henrik Hasman Statens Serum Institut

Antibiotics: mode of action and mechanisms of resistance. Slides made by Special consultant Henrik Hasman Statens Serum Institut Antibiotics: mode of action and mechanisms of resistance. Slides made by Special consultant Henrik Hasman Statens Serum Institut This presentation Definitions needed to discuss antimicrobial resistance

More information

INCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS

INCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS INCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS 1 Research Associate, Drug Utilisation Research Unit, Nelson Mandela University 2 Human Sciences Research Council,

More information

Antimicrobial Cycling. Donald E Low University of Toronto

Antimicrobial Cycling. Donald E Low University of Toronto Antimicrobial Cycling Donald E Low University of Toronto Bad Bugs, No Drugs 1 The Antimicrobial Availability Task Force of the IDSA 1 identified as particularly problematic pathogens A. baumannii and

More information

PVL Staph aureusjust a skin/soft tissue problem? Layla Mohammadi Lead Pharmacist, Antimicrobials Lewisham Healthcare NHS Trust

PVL Staph aureusjust a skin/soft tissue problem? Layla Mohammadi Lead Pharmacist, Antimicrobials Lewisham Healthcare NHS Trust PVL Staph aureusjust a skin/soft tissue problem? Layla Mohammadi Lead Pharmacist, Antimicrobials Lewisham Healthcare NHS Trust Neonatal Case History Neonate born at 26 +2 gestation Spontaneous onset of

More information

EARS Net Report, Quarter

EARS Net Report, Quarter EARS Net Report, Quarter 4 213 March 214 Key Points for 213* Escherichia coli: The proportion of patients with invasive infections caused by E. coli producing extended spectrum β lactamases (ESBLs) increased

More information

Protocol for exit-site care and treatment of exit-site infections in peritoneal dialysis CONTROLLED DOCUMENT

Protocol for exit-site care and treatment of exit-site infections in peritoneal dialysis CONTROLLED DOCUMENT CONTROLLED DOCUMENT Protocol for exit-site care and treatment of exit-site infections in peritoneal dialysis CATEGORY: CLASSIFICATION: PURPOSE Controlled Document Number: Guideline Clinical The purpose

More information

Antimicrobial susceptibility

Antimicrobial susceptibility Antimicrobial susceptibility PATTERNS Microbiology Department Canterbury ealth Laboratories and Clinical Pharmacology Department Canterbury District ealth Board March 2011 Contents Preface... Page 1 ANTIMICROBIAL

More information

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes

More information

Prevalence & Risk Factors For MRSA. For Vets

Prevalence & Risk Factors For MRSA. For Vets For Vets General Information Staphylococcus aureus is a Gram-positive, aerobic commensal bacterium of humans that is carried in the anterior nares of approximately 30% of the general population. It is

More information

Rise of Resistance: From MRSA to CRE

Rise of Resistance: From MRSA to CRE Rise of Resistance: From MRSA to CRE Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine SUPERBUGS (AKA MDROs) MRSA Methicillin-resistant S. aureus Evolution of Drug Resistance

More information

Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland

Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland A report by the Hospital Antimicrobial Stewardship Working Group, a subgroup of the

More information

MRSA Screening (Elective Patients)

MRSA Screening (Elective Patients) What is MRSA? MRSA stands for Meticillin resistant Staphylococcus aureus. It is a type of Staphylococcus aureus bacteria (germ) that is very resistant to antibiotics so infections due to MRSA can be quite

More information

New Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs

New Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs New Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs Patrick R. Murray, PhD Senior Director, WW Scientific Affairs 2017 BD. BD, the BD Logo and all other trademarks

More information

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing These suggestions are intended to indicate minimum sets of agents to test routinely in a diagnostic laboratory

More information

Your Guide to Managing. Multi Drug-resistant Organisms (MDROs)

Your Guide to Managing. Multi Drug-resistant Organisms (MDROs) Agency for Integrated Care 5 Maxwell Road #10-00 Tower Block MND Complex Singapore 069110 Singapore Silver Line: 1800-650-6060 Email: enquiries@aic.sg Website: www.silverpages.sg Facebook: www.facebook.com/carerssg

More information

About MRSA. MRSA (sometimes referred to as a superbug) stands for meticillin resistant Staphylococcus aureus.

About MRSA. MRSA (sometimes referred to as a superbug) stands for meticillin resistant Staphylococcus aureus. About MRSA Other formats If you need this information in another format such as audio tape or computer disk, Braille, large print, high contrast, British Sign Language or translated into another language,

More information

Multidrug-Resistant Organisms: How Do We Define them? How do We Stop Them?

Multidrug-Resistant Organisms: How Do We Define them? How do We Stop Them? Multidrug-Resistant Organisms: How Do We Define them? How do We Stop Them? Roberta B. Carey, PhD Centers for Disease Control and Prevention Division of Healthcare Quality Promotion Why worry? MDROs Clinical

More information

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse

More information

Antibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011

Antibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011 Antibiotic Resistance Antibiotic Resistance: A Growing Concern Judy Ptak RN MSN Infection Prevention Practitioner Dartmouth-Hitchcock Medical Center Lebanon, NH Occurs when a microorganism fails to respond

More information

Consequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered

Consequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length

More information

MID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance

MID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance Antimicrobial Resistance Molecular Genetics of Antimicrobial Resistance Micro evolutionary change - point mutations Beta-lactamase mutation extends spectrum of the enzyme rpob gene (RNA polymerase) mutation

More information

Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs?

Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control and

More information

Antimicrobial Resistance

Antimicrobial Resistance Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length

More information

Antimicrobial Resistance Acquisition of Foreign DNA

Antimicrobial Resistance Acquisition of Foreign DNA Antimicrobial Resistance Acquisition of Foreign DNA Levy, Scientific American Horizontal gene transfer is common, even between Gram positive and negative bacteria Plasmid - transfer of single or multiple

More information

A patient s guide to. MRSA - Methicillin Resistant Staphylococcus Aureus

A patient s guide to. MRSA - Methicillin Resistant Staphylococcus Aureus A patient s guide to MRSA - Methicillin Resistant Staphylococcus Aureus 1 What is MRSA? There are lots of micro-organisms (germs) on our skin. They are in the air we breathe, the water we drink, and the

More information

European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004

European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004 European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004 SECOND ANNUAL REPORT MJ Coyne 1, SJ Dancer 1, G Edwards 2, 3, D Morrison 2. 1 Health Protection Scotland, 2 Scottish MRSA

More information

WHY IS THIS IMPORTANT?

WHY IS THIS IMPORTANT? CHAPTER 20 ANTIBIOTIC RESISTANCE WHY IS THIS IMPORTANT? The most important problem associated with infectious disease today is the rapid development of resistance to antibiotics It will force us to change

More information

Healthcare-associated Infections Annual Report December 2018

Healthcare-associated Infections Annual Report December 2018 December 2018 Healthcare-associated Infections Annual Report 2011-2017 TABLE OF CONTENTS INTRODUCTION... 1 METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS... 2 MRSA SURVEILLANCE... 3 CLOSTRIDIUM

More information

Antibiotic Prophylaxis Update

Antibiotic Prophylaxis Update Antibiotic Prophylaxis Update Choosing Surgical Antimicrobial Prophylaxis Peri-Procedural Administration Surgical Prophylaxis and AMS at Epworth HealthCare Mr Glenn Valoppi Dr Trisha Peel Dr Joseph Doyle

More information

Why should we care about multi-resistant bacteria? Clinical impact and

Why should we care about multi-resistant bacteria? Clinical impact and Why should we care about multi-resistant bacteria? Clinical impact and public health implications Prof. Stephan Harbarth Infection Control Program Geneva, Switzerland and Ebola (in 2014/2015) Increased

More information

Stratégie et action européennes

Stratégie et action européennes Résistance aux antibiotiques : une impasse thérapeutique? Implications nationales et internationales Stratégie et action européennes Dominique L. Monnet, Senior Expert and Head of Disease Programme Antimicrobial

More information

Antimicrobial Resistance

Antimicrobial Resistance Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of Change in the approach to the administration of empiric antimicrobial therapy Increased

More information

How is Ireland performing on antibiotic prescribing?

How is Ireland performing on antibiotic prescribing? European Antibiotic Awareness Campaign 2016 November Webinar Series on Antibiotic Prescribing How is Ireland performing on antibiotic prescribing? Dr Rob Cunney National Clinical Lead HCAI AMR Clinical

More information

Multi-drug resistant microorganisms

Multi-drug resistant microorganisms Multi-drug resistant microorganisms Arzu TOPELI Director of MICU Hacettepe University Faculty of Medicine, Ankara-Turkey Council Member of WFSICCM Deaths in the US declined by 220 per 100,000 with the

More information

Version Control Sheet

Version Control Sheet PROCEDURE FOR MANAGEMENT OF PATIENTS WITH MULTI DRUG RESISTANT ORGANISMS PROCEDURE NUMBER IC/02 DATE RATIFIED OCTOBER 2018 NEXT REVIEW DATE OCTOBER 2020 POLICY AUTHOR Infection Control Nurse ACCOUNTABLE

More information

TITLE: NICU Late-Onset Sepsis Antibiotic Practice Guideline

TITLE: NICU Late-Onset Sepsis Antibiotic Practice Guideline Site: Saint Joseph Hospital - NICU Original Effective Date: 6/1/2016 Next Review Date: 6/1/2019 TITLE: Practice Guideline Purpose: Timely and appropriate treatment of late-onset sepsis with antibiotic

More information

Other Enterobacteriaceae

Other Enterobacteriaceae GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER NUMBER 50: Other Enterobacteriaceae Author Kalisvar Marimuthu, MD Chapter Editor Michelle Doll, MD, MPH Topic Outline Topic outline - Key Issues Known

More information

Antimicrobial Resistance Strains

Antimicrobial Resistance Strains Antimicrobial Resistance Strains Microbiologics offers a wide range of strains with characterized antimicrobial resistance mechanisms including: Extended-Spectrum β-lactamases (ESBLs) Carbapenamases Vancomycin-Resistant

More information

Screening programmes for Hospital Acquired Infections

Screening programmes for Hospital Acquired Infections Screening programmes for Hospital Acquired Infections European Diagnostic Manufacturers Association In Vitro Diagnostics Making a real difference in health & life quality June 2007 HAI Facts Every year,

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control as recommended by EUCAST Version 5.0, valid from 015-01-09 This document should be cited as "The

More information

Antibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents

Antibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents Antibiotic Prophylaxis in Spinal Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique

More information

Birgit Ross Hospital Hygiene University Hospital Essen Essen, Germany. Should we screen for multiresistant gramnegative Bacteria?

Birgit Ross Hospital Hygiene University Hospital Essen Essen, Germany. Should we screen for multiresistant gramnegative Bacteria? Birgit Ross Hospital Hygiene University Hospital Essen Essen, Germany Should we screen for multiresistant gramnegative Bacteria? CONCLUSIONS: A program of universal surveillance, contact precautions,

More information

Antimicrobial Stewardship Strategy: Antibiograms

Antimicrobial Stewardship Strategy: Antibiograms Antimicrobial Stewardship Strategy: Antibiograms A summary of the cumulative susceptibility of bacterial isolates to formulary antibiotics in a given institution or region. Its main functions are to guide

More information

Imagine. Multi-Drug Resistant Superbugs- What s the Big Deal? A World. Without Antibiotics. Where Simple Infections can be Life Threatening

Imagine. Multi-Drug Resistant Superbugs- What s the Big Deal? A World. Without Antibiotics. Where Simple Infections can be Life Threatening Multi-Drug Resistant Superbugs- What s the Big Deal? Toni Biasi, RN MSN MPH CIC Infection Prevention Indiana University Health Imagine A World Without Antibiotics A World Where Simple Infections can be

More information

Surveillance of Multi-Drug Resistant Organisms

Surveillance of Multi-Drug Resistant Organisms Surveillance of Multi-Drug Resistant Organisms Karen Hoffmann, RN, MS, CIC Associate Director Statewide Program for Infection Control and Epidemiology (SPICE) University of North Carolina School of Medicine

More information

A retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya

A retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya A retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya LU Edirisinghe 1, D Vidanagama 2 1 Senior Registrar in Medicine, 2 Consultant Microbiologist,

More information

Health Service Executive Parkgate St. Business Centre, Dublin 8 Tel:

Health Service Executive Parkgate St. Business Centre, Dublin 8 Tel: Health Service Executive Parkgate St. Business Centre, Dublin 8 Tel: 01 635 2500 www.hse.ie Health Service Executive Oak House, Millennium Park, Naas, Co. Kildare Tel: 045 880 400 www.hse.ie The prevention

More information

Infectious Disease in PA/LTC an Update. Karyn P. Leible, MD, CMD, FACP October 2015

Infectious Disease in PA/LTC an Update. Karyn P. Leible, MD, CMD, FACP October 2015 Infectious Disease in PA/LTC an Update Karyn P. Leible, MD, CMD, FACP October 2015 Disclosures Dr. Leible has no financial disclosures relevant to this presentation. Introduction Objectives The participant

More information

ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES

ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES ANTIMICROBIAL STEWARDSHIP COLLABORATIVE COLORADO HOSPITAL ASSOCIATION MARCH 23, 2016 Bridget Olson, RPh Infectious Disease Pharmacist, Sharp Coronado

More information

Diagnosis: Presenting signs and Symptoms include:

Diagnosis: Presenting signs and Symptoms include: PERITONITIS TREATMENT PROTOCOL CARI - Caring for Australasians with Renal Impairment - CARI Guidelines complete list ISPD Guidelines: http://www.ispd.org/lang-en/treatmentguidelines/guidelines Objective

More information

Clinical Guideline. District Infectious Diseases Management. Go to Guideline. District Infectious Diseases Management CG 18_24

Clinical Guideline. District Infectious Diseases Management. Go to Guideline. District Infectious Diseases Management CG 18_24 Clinical Guideline District Infectious Diseases Management Sites where Clinical Guideline applies All facilities This Clinical Guideline applies to: 1. Adults Yes 2. Children up to 16 years Yes 3. Neonates

More information

Methicillin-Resistant Staphylococcus aureus

Methicillin-Resistant Staphylococcus aureus Methicillin-Resistant Staphylococcus aureus By Karla Givens Means of Transmission and Usual Reservoirs Staphylococcus aureus is part of normal flora and can be found on the skin and in the noses of one

More information

Overview of Infection Control and Prevention

Overview of Infection Control and Prevention Overview of Infection Control and Prevention Review of the Cesarean-section Antibiotic Prophylaxis Program in Jordan and Workshop on Rational Medicine Use and Infection Control Terry Green and Salah Gammouh

More information

Antimicrobial stewardship in companion animals: Welcome to a whole new era

Antimicrobial stewardship in companion animals: Welcome to a whole new era Antimicrobial stewardship in companion animals: Welcome to a whole new era John F. Prescott, University Professor Emeritus, Department of Pathobiology, University of Guelph, Guelph, Ontario NG 2W1 prescott@uoguelph.ca

More information

ARCH-Vet. Summary 2013

ARCH-Vet. Summary 2013 Federal Department of Home Affairs FDHA FSVO ARCH-Vet Report on sales of antibiotics in veterinary medicine and antibiotic resistance monitoring of livestock in Switzerland Summary 2013 Published by Federal

More information

Implementation and Optimization of Antibiotic Stewardship in Acute Care Hospitals: A Clinical Microbiology Laboratory Perspective

Implementation and Optimization of Antibiotic Stewardship in Acute Care Hospitals: A Clinical Microbiology Laboratory Perspective Implementation and Optimization of Antibiotic Stewardship in Acute Care Hospitals: A Clinical Microbiology Laboratory Perspective James E. Kirby, MD D(ABMM) Medical Director, Clinical Microbiology Beth

More information

Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance. evolution of antimicrobial resistance

Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance. evolution of antimicrobial resistance Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance evolution of antimicrobial resistance Mechanism of bacterial genetic variability Point mutations may occur in a nucleotide base pair,

More information

EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update

EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain

More information

DR. MICHAEL A. BORG DIRECTOR OF INFECTION PREVENTION & CONTROL MATER DEI HOSPITAL - MALTA

DR. MICHAEL A. BORG DIRECTOR OF INFECTION PREVENTION & CONTROL MATER DEI HOSPITAL - MALTA DR. MICHAEL A. BORG DIRECTOR OF INFECTION PREVENTION & CONTROL MATER DEI HOSPITAL - MALTA The good old days The dread (of) infections that used to rage through the whole communities is muted Their retreat

More information

Hospital ID: 831. Bourguiba Hospital. Tertiary hospital

Hospital ID: 831. Bourguiba Hospital. Tertiary hospital Global Point Prevalence Survey of Antimicrobial Consumption and Resistance in hospitals worldwide Hospital ID: 831 Habib Bourguiba Hospital Tertiary hospital Tunisia Point Prevalence Survey Habib 2017

More information

Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems

Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems Micro 301 Antimicrobial Drugs 11/7/12 Significance of antimicrobial drugs Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems Definitions Antibiotic Selective

More information

Multi-drug resistant Acinetobacter (MDRA) Surveillance and Control. Alison Holmes

Multi-drug resistant Acinetobacter (MDRA) Surveillance and Control. Alison Holmes Multi-drug resistant Acinetobacter (MDRA) Surveillance and Control Alison Holmes The organism and it s epidemiology Surveillance Control What is it? What is it? What is it? What is it? Acinetobacter :

More information

Lindsay E. Nicolle University of Manitoba Winnipeg, CANADA

Lindsay E. Nicolle University of Manitoba Winnipeg, CANADA Lindsay E. Nicolle University of Manitoba Winnipeg, CANADA Long Term Care Facilities: Spectrum low acuity assisted living mobile independent Not LTAC high acuity complete functional disability dialysis

More information

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine 2012 ANTIBIOGRAM Central Zone Former DTHR Sites Department of Pathology and Laboratory Medicine Medically Relevant Pathogens Based on Gram Morphology Gram-negative Bacilli Lactose Fermenters Non-lactose

More information

Liofilchem Chromatic Chromogenic culture media for microbial identification and for the screening of antimicrobial resistance mechanisms

Liofilchem Chromatic Chromogenic culture media for microbial identification and for the screening of antimicrobial resistance mechanisms Liofilchem Chromatic Chromogenic culture media for microbial identification and for the screening of antimicrobial resistance mechanisms Microbiology Products since 1983 Liofilchem Chromatic ESBL Selective

More information

Infection Control Manual Residential Care Part 3 Infection Control Standards IC7: 0100 Methicillin Resistant Staphylococcus aureus

Infection Control Manual Residential Care Part 3 Infection Control Standards IC7: 0100 Methicillin Resistant Staphylococcus aureus Infection Control Manual Residential Care Part 3 Infection Control Standards IC7: 0100 Methicillin Resistant Staphylococcus aureus IC7: 0100 MRSA 1. Purpose To outline the assessment, management, room

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXVII NUMBER 6 July 2012 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine B. Dowell SM, MLS (ASCP); Sarah K. Parker, MD; James K. Todd, MD Each year the Children s Hospital Colorado

More information

Hand Hygiene and MDRO (Multidrug-resistant Organisms) - Science and Myth PROF MARGARET IP DEPT OF MICROBIOLOGY

Hand Hygiene and MDRO (Multidrug-resistant Organisms) - Science and Myth PROF MARGARET IP DEPT OF MICROBIOLOGY Hand Hygiene and MDRO (Multidrug-resistant Organisms) - Science and Myth PROF MARGARET IP DEPT OF MICROBIOLOGY MDROs and Hand Hygiene Guidelines HH Apr14 The Science of Hand Hygiene in Healthcare Settings

More information

Antimicrobial Resistance Surveillance from sentinel public hospitals, South Africa, 2013

Antimicrobial Resistance Surveillance from sentinel public hospitals, South Africa, 2013 Antimicrobial Resistance Surveillance from sentinel public s, South Africa, 213 Authors: Olga Perovic 1,2, Melony Fortuin-de Smidt 1, and Verushka Chetty 1 1 National Institute for Communicable Diseases

More information

The relevance of Gram-negative pathogens for public health situation in India

The relevance of Gram-negative pathogens for public health situation in India The relevance of Gram-negative pathogens for public health situation in India Dr. Sanjay Bhattacharya MD, DNB, DipRCPath, FRCPath, CCT (UK) Consultant Microbiologist Tata Medical Center www.tmckolkata.com

More information