Key Ways to Measure Drug-Resistant Infections in Healthcare

Healthcare experts today published a position paper that provides strategies that healthcare facilities can use to monitor trends in the occurrence of emerging drug-resistant pathogens and determine the impact of local intervention efforts. “Recommendations for Metrics for Multidrug-Resistant Organisms (MDROs) in Healthcare Settings: SHEA/HICPAC Position Paper,” published online on Sept. 23 in the journal Infection Control and Hospital Epidemiology, aims to help healthcare facilities standardize monitoring of these and other dangerous pathogens within their particular institutions so that infection prevention and control teams can quickly recognize new resistance profiles and protect vulnerable patient populations.

“Many of the top experts in government and in healthcare have come together to highlight the key ways to track and recognize drug-resistant infections,” said SHEA president and HICPAC chair Patrick J. Brennan, MD. “If implemented, these metrics will go a long way toward providing solid data for hospitals to measure success in preventing emergence and transmission of these organisms.”

The Society for Healthcare Epidemiology of America (SHEA) and the CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) convened an expert working group of members with additional representation from the Association for Professionals in Infection Control and Epidemiology (APIC) and the Centers for Disease Control and Prevention (CDC) to synthesize recommendations and guidelines for MDRO measurement and surveillance. This group summarized existing evidence, identifying the best measurement tools for four common antimicrobial-resistant pathogens: MRSA, vancomycin-resistant Enterococcus (VRE), multidrug-resistant Gram-negative bacteria, and vancomycin-resistant Staphylococcus aureus (VRSA). After evaluating current practices, peer-reviewed literature, and existing guidelines, the authors narrowed down metrics to those they found most useful and practical for infection prevention and control teams working in a range of settings.

“Healthcare institutions urgently need better data to prevent patient infections. This paper shows them how to use information from their facilities and patients so that they get an accurate idea of what is happening in their facilities,” said co-author Scott K. Fridkin, MD, deputy chief of the surveillance branch of the Division for Healthcare Quality and Promotion at the CDC. “Institutions can choose the best measurement tools for their settings, and as needed ramp up prevention efforts. These metrics are all about making this process easier.”

The metrics are divided into five areas: tracking patients, monitoring vulnerability of different patient populations, quantifying whether an infection can be attributed to the healthcare facility, and estimating the burden of acquiring or being exposed to an infection.

Facilities may be monitoring MDROs in part due to state reporting requirements; however, the authors emphasize that the metrics recommended in this paper are intended only for internal monitoring rather than for comparing facilities. These metrics have been selected for their utility in evaluating the impact of local prevention efforts, and have not been evaluated for their utility as any type of external reporting or inter-facility comparisons.

Source: Society for Healthcare Epidemiology of America (SHEA)