A Pilot Study to Delineate Factors Contributing to Multi-Drug Resistant Organism (MDRO) Outbreak and Control at the Sangre Grande Hospital

Abstract

BACKGROUND The Sangre Grande Hospital (SGH) experienced several Multi Drug Resistant Organism (MDRO) outbreaks for 2015. In this regard, a study was conducted to understand factors contributing to MDRO acquisition and control, for policy and implementation of prevention and control measures. METHODOLOGY A Case-Control Study Design was chosen to execute this research project in order to determine risk factors and factors associated with control of the outbreaks. This was done retrospectively from January to March 2015. Cases and controls were unmatched. Cases were defined as patients admitted to wards with a contracted MDRO, discharged or died and had a medical or surgical diagnosis. MDROs included Methicillin resistant Staphylococcus aureus (MRSA) and Multi Drug Resistant Gram-Negative Bacilli (MDRGNB). Controls were any other patients on the wards with similar demographics and diagnosis and disposition, not infected or colonized with a MDRO and had a medical or surgical diagnosis. RESULTS Eight (8) cases and ten (10) Controls were incorporated in the study. Patients recently hospitalized had 14 times the odds of the group not recently hospitalized, of developing a MDRO, 95% CI: 1.1352 – 172.6502, p = 0.05. Length of Stay (LOS) on the ward for a minimum of five days showed a significant association with MDRO acquisition (p < 0.036). The main contributory factors to increased MDRO acquisition: greater than one (1) invasive devices, urinary catheter and/or central venous catheter (p < 0.043 and p < 0.007 respectively). Most MDRO cases had at least one invasive device attached to them during their stay on the ward: Central Venous Catheter (CVC), a Urinary Catheter or both. MDRO cases mean LOS: 29.5 days (19.27 S.D.) as opposed to the controls with 5.2 days (4.29 S.D.). CONCLUSION There is a significant association between recent hospitalization and developing an MDRO. Patients with an MDRO also stayed a mean of 29.5 days compared to 5.2 days for controls.