Multi-Resistant Bacteria Outbreak
OVERVIEW
- this is an infection control emergency
- notify ICU staff and ID team
PATIENT
- isolation
- assess whether coloniser or producing active infection
- determine whether patients required antibiotic changes
- remove colonised material (e.g. resite lines)
- terminal cleaning once patients discharged
PREVENT CROSS CONTAMINATION
- full cleaning of contaminated areas
- notify visitors about importance of barrier contact
ROOT CAUSE ANALYSIS
– assessment of possible vector transmission
- prescribing practices
- screen environmental reservoirs (work surfaces, ventilation ducts, ventilator tubing)
ANTIBIOTIC STEWARDSHIP
- review antibiotic practices (many multi-resistant organisms are produced because antibiotic practice)
- review biograms
- review dosing
- discuss with ID regarding cycling of antibiotics
QUALITY ASSURANCE
- review infection control procedures (hand-washing, barrier nursing, universal precautions)
- review CVL procedures (insertion, accessing, daily procedures)
- review ventilator care – scheduled tubing changes (weekly)
- education
- vigilance on line accessing behaviour, insertion techniques, when removed (Provonost)
- review issue once behaviours changed
- audit
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC