Current recommendations indicate that patients who are coughing and have multidrug-resistant organisms (MDROs) in their sputum are considered to be shedders and should be cared for in single-room isolation at least until symptoms resolve. Airborne spread and subsequent contamination of surfaces adjacent to patients may contribute to transmission. Hence, isolation measures for patients colonized or infected with MDROs in their respiratory tract are intended to interrupt such transmission. However, the potential for microbial shedding in patients with MDRO-positive microbiological reports from their respiratory tract and factors justifying the need for single room isolation are viewed controversially.
Cough aerosol produced by patients colonized with MDROs was measured for viable counts. Diab-Elschahawi, et al. (2014) performed descriptive analysis together with logistic regression analysis to assess the impact of strength of cough on growth of MDRO on culture plates.
In 18 percent (23/128) MDRO were transmitted. Multivariate analysis revealed that strength of cough significantly predicts the yield of MDRO on culture plates (P?=?0.012). Based on these results it can be concluded that risk stratification for decision of single room isolation of patients colonized or infected with MDROs at their respiratory tract may also take the severity of cough into consideration. However, more work is required in order to assess the severity of cough objectively. Their research was published in Antimicrobial Resistance and Infection Control.
Reference: Diab-Elschahawi M, Lusignani LS, Starzengruber P, Mitteregger D, Wagner A, Assadian O and Presterl E. The strength of coughing may forecast the likelihood of spread of Multi-Drug Resistant Microorganisms from the respiratory tract of colonized patients. Antimicrobial Resistance and Infection Control 2014, 3:38 doi:10.1186/s13756-014-0038-z