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Transmission of antibiotic-resistant bacteria linked to previous intensive care unit room occupants

he prior occupant had VRE. Those who stayed in rooms after patients with one of the types of bacteria were more likely to acquire that type of bacteria than those who stayed in rooms following patients who did not test positive for that bacteria (4.5 percent vs. 2.8 percent for VRE and 3.9 percent vs. 2.9 percent for MRSA). The excess risk associated with an infected prior occupant accounted for 5.1 percent of all new cases of MRSA and 6.8 percent of all new cases of VRE.

This additional risk occurred despite the fact that the room cleaning procedures of the hospital in the study exceed national guidelines, indicating that such guidelines do not prevent transmission of disease-causing bacteria. However, the low overall risk among patients exposed to the bacteria "suggests that levels of contamination do not pose a high risk for transmission or that current cleaning methods generally reduce contamination below levels required for transmission," the authors write. "Based on our findings, the prevention of one case of acquisition due to room contamination could require more intensive cleaning of 94 rooms vacated by MRSA carriers and of 59 rooms vacated by VRE carriers."

Though the number of cases attributed to previous room occupants was small, this type of transmission could become more common as the prevalence of treatment-resistant bacteria continues to rise. "Additional data are needed to determine whether more intensive cleaning practices can reduce the risk further and, if so, whether this is worthwhile in a resource-limited system," the authors conclude.
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Source:JAMA and Archives Journals


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