Can antibiotic-resistant nosocomial infections be controlled?

• Published in: The Lancet infectious diseases Vol. 1; no. 1; pp. 38 - 45
• Main Authors: Farr, Barry M, Salgado, Cassandra D, Karchmer, Tobi B, Sherertz, Robert J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.08.2001; Elsevier Limited
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Cross Infection - microbiology; Cross Infection - prevention & control; Cross Infection - transmission; Drug Resistance, Microbial; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - prevention & control; Gram-Positive Bacterial Infections - transmission; Humans; Infection Control - economics; Infection Control - methods; Infection Control - standards; Infectious diseases; Methicillin Resistance; Nosocomial infection; Pathogens; Personal hygiene; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Staphylococcal Infections - transmission; Vancomycin Resistance
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(01)00020-2

Three decades ago infection-control programmes were created to control antibiotic-resistant nosocomial infections, but numbers of these infections have continued to increase, leading many to question whether control is feasible. Meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci were major problems during the 1990s. Many hospitals have tried antibiotic control but with limited efficacy against these pathogens. Studies of antibiotic restriction, substitution, and cycling have been promising, but more definitive data are needed. Increased compliance with hand hygiene would help but is unlikely to control this problem alone as a result of frequent contamination of other surfaces even when hands are cleansed and high transmission rates when hand hygiene is neglected. For 17 years, the Centers for Disease Control and Prevention have recommended contact precautions for preventing nosocomial spread of important antibiotic-resistant pathogens. Many studies confirm that this approach works when sufficient active-surveillance cultures are undertaken to detect the reservoir for spread. However, most health care facilities have not yet tried this approach.