Infection Control of Multi-drug Resistant Gram-negative Bacteria(MDR-GNB)

Background and Aim : According to the World Health Organization, Infection prevention andcontrol (IPC) is a scientific approach and practical solution designed to prevent patients and healthworkers from being harmed by avoidable infection and as a result of antimicrobial resistance.Infections caused by MDR Gram-negative bacteria are difficult to treat, and can cause additionalpain to patients and can prolong the length of stay in hospital and even lead to death.Methods : IPC Assessment Framework, published by WHO, states the core components ofinfection prevention and control include: IPC program, guidelines, training, surveillance, multimodalstrategies, monitoring of practices, feedback, staffing, environmental health, and equipmentfor IPC at the facility level.Results : Definitions: MDR (multidrug-resistant): non-susceptibility to at least one agent in threeor more antibiotic categories; XDR (Extensive drug-resistant): susceptible to only one or twoantibiotic categories; PDR (Pan drug-resistant): non-susceptibility to all agents in all antibioticcategories. Epidemiology: healthcare-associated infection (HAIs) pooled prevalence in highincomecountries is ۷.۶% vs. low- and middle-income countries ۱۰.۱% to ۱۵.۵%. In Iran, the mostcommon organisms according to the national report are gram-negative bacteria such as Klebsiella,Acinetobacter, E.coli, etc. More than half of the organisms are MDR. Infection control principlesare general or specific; general ones like hand hygiene, proper ward’s physical structure,optimizing patient nutritional status, glycemic control, system-based practices, adequate staff,education, environmental health, patient screening and decolonization, isolation measures,antibiotic stewardship and etc. And specific IPC measures like device-associated infection (DAIs)preventive bundles for ventilator-associated pneumonia, central line bloodstream infection, andcatheter-associated urinary tract infection.Conclusion : A successful infection control of MDR-GNB within a hospital needs teamwork anda multi-disciplinary approach. It’s of utmost importance knowing the related definitions,epidemiology, history, and general/specific IPC principles.

کلیدواژه ها:

Infection Control ، Multi-Drug Resistance ، Gram-Negative Bacteria