Nosocomial Transmission of Highly Resistant Microorganisms on a Spinal Cord Rehabilitation Ward

J Spinal Cord Med, 2009 · DOI: · Published: August 1, 2009

Spinal Cord Injury Immunology Healthcare

Simple Explanation

The study aimed to understand how highly resistant microorganisms (HRMOs) spread within a spinal cord rehabilitation ward. Researchers collected urine and stool samples from patients to identify the presence of HRMOs. The study found a strong link between catheter use and the presence of HRMOs in urine samples. Also, previous antibiotic use correlated with the colonization of the urinary tract.

Study Duration

3 Months

Participants

46 patients admitted to a spinal cord rehabilitation ward

Evidence Level

Prospective observational study

Key Findings

1
Nine different HRMOs were isolated from urine samples of 15 patients, with E. coli being the most prevalent.
2
Catheterization was significantly more prevalent in patients with HRMOs, suggesting a strong association between catheter use and HRMO presence.
3
A close correlation was found between prior use of antibiotics and colonization of the urinary tract.

Research Summary

This prospective observational study investigated the nosocomial transmission of highly resistant microorganisms (HRMOs) in a spinal cord rehabilitation ward. The study found a strong correlation between catheterization and the presence of HRMOs in urine samples, as well as a link between prior antibiotic use and colonization of the urinary tract with HRMOs. The findings suggest that antibiotic use creates a niche for resistant organisms to establish themselves in the gut, leading to colonization of the periurethral area and subsequent introduction into the bladder via catheterization.

Practical Implications

Infection Control Measures

Emphasize strict adherence to hygiene protocols to minimize the spread of resistant bacteria, especially in shared facilities.

Antibiotic Stewardship

Implement stringent antibiotic stewardship programs to reduce unnecessary antibiotic use, thereby minimizing the selective pressure that promotes antibiotic resistance.

Catheterization Practices

Review and optimize catheterization techniques and protocols to minimize the risk of introducing bacteria into the bladder.

Study Limitations

1
The study was conducted in a single rehabilitation center, which may limit the generalizability of the findings.
2
The study period was limited to three months.
3
Fecal carriage was only assessed at the conclusion of the study, limiting insight into the temporal dynamics of colonization.

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