Disparity in infection control practices for multidrug-resistant Enterobacteriaceae

Background: There is a lack of empiric evidence regarding the optimal approach to controlling the transmission of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) and carbapenem-resistant Enterobacteriaceae (CRE). In this context, we expect that infection control practices for these organisms vary widely between hospitals. Methods: A survey examining infection control practices for ESBL-E and CRE was distributed to 6 academic and 9 community hospitals in Toronto, Canada. Results: All hospitals responded to the survey. Among 15 hospitals in 1 geographic area, 8 different approaches to the management of ESBL-E were utilized. There was wide variation in the use infection control practices including admission screening (53% and 53%), contact precautions (53% and 100%), and isolation (60% and 100%) for ESBL-E and CRE, respectively. Of hospitals performing admission screening, 75% used risk factor-based screening for ESBL-E and CRE. Conclusion: Even within a single geographic area, there is wide variation in infection control strategies to contain or control ESBL-E and CRE. These results are concerning given evidence that a coordinated approach may be required to prevent or limit the emergence of CRE. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.