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Bak, Cho, Baek, Kim, and Bae: 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
Original Article

Korean J Nosocomial Infect Control 2013;18(1):1-6.

Published online: 5 January 2013

DOI: https://doi.org/10.14192/kjnic.2013.18.1.1

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 Hospital, Gyeongsang National University, Jinju, Korea

Departments of Internal Medicine, Gyeongsang National University, Jinju, Korea

Laboratory Medicine, Gyeongsang National University, Jinju, Korea

Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Korea

Correspondence: In-Gyu Bae, Infection Control Office, Gyeongsang National University Hospital, 79, Gangnam-ro, Jinju 660-702, Korea Tel: 055-750-8055, Fax: 055-758-9122 E-mail: ttezebae@gmail.com

Received 2 June 2012       Accepted 8 January 2013

Copyright © 2013 Korean Society for Nosocomial Infection Control

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) 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

References

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Fig. 1.
Quarterly methicillin-resistant Staphylococcus aureus isolation rates (No. of isolates/1,000 patient-days). Abbreviation: MRSA, Methicillin-resistant Staphylococcus aureus.
kjnic-18-1f1.tif
Fig. 2.
Quarterly multidrug-resistant Acinetobacter baumannii isolation rates (No. of isolates/1,000 patient-days). Abbreviation: MDR-AB, Multidrug-resistant Acinetobacter baumannii.
kjnic-18-1f2.tif
Fig. 3.
Quarterly antimicrobial use density of glycopeptides. Abbreviation: AUD, antimicrobial use density.
kjnic-18-1f3.tif
Fig. 4.
Quarterly antimicrobial use density of carbapenems. Abbreviation: AUD, antimicrobial use density.
kjnic-18-1f4.tif
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