Screening for Multidrug resistant Organism colonization and associated risk factors among the critically ill patients attending Emergency Department: A targeted surveillance strategy for infection prevention

Infections caused by Multi drug resistant Organisms (MDROs) in hospitalized patients are difficult to treat and hence are associated with high morbidity and mortality. Patients with co-morbidities, long standing hospitalization, use of invasive devices and high consumption of broad-spectrum antimicrobial agents are particularly vulnerable to acquire such infections. Development of infection or invasive disease by MDROs is typically preceded by colonization of the patients with these pathogens.

In a tertiary care health care facility like AIIMS Raipur, where patients are mostly referred from other hospitals after being hospitalised for a long period of time and being exposed to multiple antimicrobial agents, it is expected that patients arriving are already infected/colonized with MDROs. These patients have the potential to spread MDRO to other non-infected patients, health care workers, and the hospital environment. Such patients, if identified early for the presence of MDRO, followed by isolation (contact precautions) from other patients, will help to reduce the spread of these pathogens. However, due to limited resources to conduct this as a regular activity in a long run, universal screening of all patients admitted to an ICU/ward may not always be feasible. On the contrary, resources can be best utilised to gain the most benefit from this activity if they are targeted to a specific group of patients and the most common MDRO causing colonisation.

In light of this, the current study is designed to collect baseline information on the most common MDRO and a group of patients at high risk of colonisation at the time of admission in emergency department of AIIMS Raipur. This type of targeted surveillance can be incorporated into the institute’s routine infection control and prevention activities and can help to control hospital acquired infections caused by emerging MDROs.