Multidrug resistant organisms in a tertiary care university hospital in North West bank : a Descriptive study
Publication Type
Conference Paper


Introduction: The prevalence of multidrug-resistant organisms (MDROs) in acute healthcare settings is increasing worldwide. Active Screening for MDROs carriers on admission permits the prompt implementation of the appropriate precautions to decrease the probability of cross transmission to other inpatients. The objective of this study is to report the spectrum of bacterial nasal, axilla and perianal colonization among in patients at NNUH during 2018.

Method: A retrospective observational study was performed in NNUH, a tertiary care referral university hospital located in Nablus, north of Palestine that includes medical and surgical ICus for both adults and children for a period from January to August, 2018. Nasal, axilla and Perianal swabs were collected within the first 24h hours of admission as per hospital policy. Patients who were referred from other hospital, who were admitted to a hospital for at least 2 nights during the previous 8 months and those who are known to have an MDROs in the past were included. Swab samples were processed for isolation and identification of these resistant multidrug strains. Transmission based precautions are implemented if positive results were reported (contact isolation) and decolonization regimens were applied according to CDC recommendations (Muporocin ointment for nasal MRSA, daily bathing with clorhexidin 2% soap for the rest). Daily isolation list is circulated among bed managers and senior nurses and head of departments for appropriate management of beds and reallocation of patients. The antibiotic susceptibility pattern was assessed by disc diffusion method on Mueller–Hinton agar and Vitek-2.

Result: During the period of the study, a total of 1425 nasal swabs, 1245 axilla swabs and 300 perianal swabs were collected according to the inclusion criteria. Positive results were reported in 7%, 4% and 44% for nasal, axilla and perianal specimens respectively. Regarding the distribution of bacterial colonization in the nasal swab, 73% were MRSA while for the axial, 29% were Pseudomonas and from the perianal swab, the most prevalent pathogen was ESBL (56%) (Figures 1 to 3). A discrepancy between the number of nasal/axilla and perianal swabs was observed which was mainly due to the refusal of many patients to have the sample collected by the nurse.

Conclusion: Colonization of the skin and mucous membranes of inpatients with MDROs is considered a risk factor for developing future infections. Therefore, active screening for those pathogens is critical for infection prevention and control programs and patient safety in acute care settings

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Conference Title
SHEA/CDC 6th Decennial International Conference on Healthcare Associated Infections
Conference Country
United States of America
Conference Date
March 26, 2020 - March 30, 2020
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