Strategic goals outlined for resistant pathogens
A 1994 workshop on emerging antimicrobial resistance in hospitals at the Centers for Disease Control in Prevention in Atlanta resulted in the recent publication of the following recommendations to meet the threat through antibiotic controls and enhanced infection control.1 According to the authors, the following should be viewed as general approaches, but refined and adapted to needs at the local level. The strategies advise addressing the following critical areas:
* Improve antimicrobial prescribing practices by educational and administrative means, including prophylaxis for operative procedures and the choice and duration of empiric antimicrobial therapy.
* Establish a system to monitor and provide feedback on the occurrence and impact of antibiotic resistance.
* Develop a system to recognize and promptly report significant changes and trends in antimicrobial resistance to hospital and physician leaders, and medical, nursing, infection control, and pharmacy staffs.
* Develop methods for rapid detection and reporting of resistant microorganisms in individual patients to both caregivers and infection control staff.
* Increase adherence to policies and procedures, especially hand hygiene, barrier precautions, and environmental control measures.
* Incorporate the detection, prevention, and control of antimicrobial resistance into institutional strategic goals and provide required resources. Examples may include providing adequate facilities and resources for hand washing, isolation, and environmental hygiene; funding ongoing monitoring and data collection, including infection control/hospital epidemiology and quality improvement in the planning process; and setting managerial goals and accountability for reductions in colonization and infection with resistant microorganisms.
* Develop a plan for identifying, transferring, discharging, and readmitting patients colonized with specified antimicrobial-resistant microorganisms.
1. Goldmann, DA, Weinstein RA, Wenzel RP, et al. Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals: A challenge to hospital leadership. JAMA 1996; 275:234-240. *