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Viewpoint: The impending pandemic of resistant organisms - a paradigm shift towards source control is needed.
Kavanagh, Kevin T; Maiwald, Matthias; Cormier, Lindsay E.
Afiliación
  • Kavanagh KT; Health Watch USA, Lexington, KY.
  • Maiwald M; Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore.
  • Cormier LE; Department of Microbiology and Immunology, National University of Singapore; and Duke-National University of Singapore Graduate Medical School, Singapore.
Medicine (Baltimore) ; 103(31): e39200, 2024 Aug 02.
Article en En | MEDLINE | ID: mdl-39093771
ABSTRACT
The United States needs a paradigm shift in its approach to control infectious diseases. Current recommendations are often made in a siloed feedback loop. This may be the driver for such actions as the abandonment of contact precautions in some settings, the allowance of nursing home residents who are carriers of known pathogens to mingle with others in their facility, and the determination of an intervention's feasibility based upon budgetary rather than health considerations for patients and staff. Data from both the U.S. Veterans Health Administration and the U.K.'s National Health Service support the importance of carrier identification and source control. Both organizations observed marked decreases in methicillin-resistant Staphylococcus aureus (MRSA), but not methicillin-susceptible Staphylococcus aureus infections with the implementation of MRSA admission screening measures. Facilities are becoming over-reliant on horizontal prevention strategies, such as hand hygiene and chlorhexidine bathing. Hand hygiene is an essential practice, but the goal should be to minimize the risk of workers' hands becoming contaminated with defined pathogens, and there are conflicting data on the efficacy of chlorhexidine bathing in non-ICU settings. Preemptive identification of dedicated pathogens and effective source control are needed. We propose that the Centers for Disease Control and Prevention should gather and publicly report the community incidence of dedicated pathogens. This will enable proactive rather than reactive strategies. In the future, determination of a patient's microbiome may become standard, but until then we propose that we should have knowledge of the main pathogens that they are carrying.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Infección Hospitalaria / Control de Infecciones / Staphylococcus aureus Resistente a Meticilina Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Medicine (Baltimore) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Infección Hospitalaria / Control de Infecciones / Staphylococcus aureus Resistente a Meticilina Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Medicine (Baltimore) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos