The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

A MULTIDISCIPLINARY APPROACH TO DECREASE TRANSMISSION RATES OF MULTIPLY RESISTANT PSEUDOMONAS AERUGINOSA (MRPA) IN CYSTIC FRIBROSIS (CF) PATIENTS.

Julia Lawrence1, Elaine Whaley1, Peter Hiatt2,1, Chris Oermann2,1, Ruth Ann Luna1, Sally Mason2,1; 1Texas Children’s Hospital, Houston, TX; 2Baylor College of Medicine, Houston, TX

Background: Chronic airway colonization with Pseudomonas aeruginosa has been associated with increased morbidity and mortality among CF patients. Between 2004 and 2009, 56% of MRPA specimens collected at Texas Children’s Hospital (TCH) represented a single dominant clone. In an effort to decrease transmission of the dominant clone, a multidisciplinary team approach was taken to implement new infection control policies. Methods: Molecular typing allowed identification of patients colonized with the dominant clone and subsequent implementation of patient-specific infection control policies. These included the use of a “shuttle” process in clinic and the initiation of “contact isolation” for CF patients until a respiratory sample was obtained and no resistant organisms were identified. The shuttle process used flags to identify MRPA patients who then did not mingle with other patients. Subsequently, all patients were asked to sanitize their hands and don a mask upon arrival to clinic and care providers were asked to gown and glove for patients contact. Contact isolation on the inpatient side entailed requiring all staff members to gown and glove for patient contact. Patients were instructed to wear masks when leaving their room. Additionally, MRPA patients were not allowed to visit common areas of the hospital. All CF patients were assigned their own non-disposable respiratory care equipment that remained in their room the duration of the hospitalization. Results: After initiation of the above processes we were able to see a decline to 36% in the prevalence of the dominate clone in MRPA infected Cystic Fibrosis patients. Conclusions: Implementation of patient-specific infection control policies including inpatient and outpatient settings can decrease the prevalence of a dominant MRPA clone among CF patients. Sponsored Research - None