ICU Patients Susceptible to Drug-Resistant Germs

A troubling new study reports that ICU patients may face an increased risk of hazardous infection if they occupy rooms that have been used by patients who were afflicted by antibiotic-resistant bacteria. Of greatest concern is the fact that standard room-cleaning and bed-cleaning procedures do not seem to mitigate the risks of infection in the new patient, calling into question whether hospitals are doing enough (or are even able to do enough) to control the spread of these germs.

The germs in question–methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE)–are known to be significant sources of illness and fatality in hospitals. However, researchers from Brigham and Women’s Hospital and Harvard Medical School have now found that the risk of contracting these bacteria is greater if you are assigned to a room where previous cases were reported. Put another way, this raises the notion of whether “contaminated beds” can be cleaned sufficiently enough to protect incoming patients.

In the October 9 issue of the Archives of Internal Medicine, researchers Susan S. Huang, Rupak Datta, and Richard Platt reported these conclusions: “Admission to a room previously occupied by an MRSA-positive patient or a VRE-positive patient significantly increased the odds of acquisition for MRSA and VRE. However, this route of transmission was a minor contributor to overall transmission. The effect of current cleaning practices in reducing the risk to the observed levels and the potential for further reduction are unknown.” They also noted that “acquisition was significantly associated with longer post–intensive care unit length of stay.”

The study looked at 11,528 intensive care unit room stays in eight locations and found that “among patients whose prior room occupant was MRSA positive, 3.9 percent acquired MRSA, compared with 2.9 percent of patients whose prior room occupant was MRSA negative…. Among patients whose prior room occupant was VRE positive, these values were 4.5 percent and 2.8 percent respectively.” According to their findings, the heightened risk of sleeping in contaminated beds accounted for 5.1 percent of all MRSA cases and 6.8 percent of all VRE cases.

The implications for the hospital industry may be devastating. Researchers must first conclude whether or not more exhaustive cleaning practices would have an impact on the spread of <"">drug-resistant germs. Even if this is proven to be true, it’s uncertain whether hospitals currently have the resources to adhere to more stringent standards.

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