New federal guidance on how to deal with the spread of multidrug-resistant organisms, so-called "superbugs," may prove to be a divisive and controversial issue among providers, several infection-control practitioners said.
The Centers for Disease Control and Prevention last week called on hospitals to step up their administrative support of infection-control practices to deal with the superbugs, including methicillin-resistant staphylococcus aureus, or MRSA. In a 73-page paper released last week on managing multidrug-resistant organisms in healthcare settings, the CDC advised healthcare administrators to sponsor both facilitywide and unit-specific educational programs on drug resistance, among other steps.
For patients in high-risk populations, the CDC wants practitioners to boost their normal monitoring of patients and to use swabs to collect samples for testing.
The steps come at a time when an estimated 90,000 patients die each year because of hospital-acquired infections, said Kathy Warye, chief executive officer of the Association for Professionals in Infection Control and Epidemiology, also known as APIC. The group has also just launched a study to gather national data on MRSA in hospitals.
The problem has spawned a slew of new methods and products aimed at the problem (July 24, p. 30).
But the CDC's guidance could run headlong into a set of 3-year-old recommendations that have largely become the industry standard for infection-control practitioners. Differences in the monitoring of infections between the new CDC guidelines and ones developed by the Society for Healthcare Epidemiology of America may lead to disputes about who pays for what, according to infection-control experts.
Epidemiology society guidelines as a way to corral drug-resistant organisms, said SHEA's Executive Director Annette Mucha.
The CDC's guidance, however, is less upfront in its recommendations, instead calling for a tiered approach to monitoring.
Regardless, infection containment in hospitals is no easy task, said Cheryl Herbert, director of infection prevention and control at 426-bed Allegheny General Hospital in Pittsburgh. Allegheny started a zero-tolerance initiative about four years ago to prevent the development of central-line infections in its intensive-care units. After staff educational in-services -- and the diligence of a physician championing the effort -- the unit eventually cut infection rates from about four a month to almost zero, Herbert said.