Guidelines for the Management of Multidrug-Resistant
Organisms (MDRO) in Healthcare Settings, 2006

PART I

In October, 2006, the Centers for Disease Control and Prevention released the guidelines “Management of Multidrug-Resistant Organisms in Healthcare Settings”. This guideline will replace the guidelines related to methicillin resistant Staphylococcus aureus and Vancomycin resistant Enterococcus on the EDCP web site, Guidelines section.

These new guidelines provide a template for an individual facility’s MDRO plan. Each facility should have, as part of their overall infection control plan, a strategy for implementing these guidelines.

Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006

To assist Infection Control Professionals in their education efforts related to these new Guidelines, we have prepared a set of slides that reflects the content of these Guidelines. These slides are in PDF format so that the content may not be changed on the Web site.  Click here for access to these slides.

Please call the Office of Epidemiology and Disease Control Programs at 410-767-6700 if you need assistance with implementing these guidelines.

Part II

The introductory paragraph of these new CDC guidelines explains why this change from very specific procedures to general strategies is necessary.

Multidrug-resistant organisms(MDROs), including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and certain gram-negative bacilli (GNB) have important infection control implications that either have not been addressed or received only limited consideration in previous isolation guidelines. Increasing experience with these organisms is improving understanding of the routes of transmission and effective preventive measures. Although transmission of MDROs is most frequently documented in
acute care facilities, all healthcare settings are affected by the emergence and transmission of antimicrobial-resistant microbes. The severity and extent of disease caused by these pathogens varies by the population(s) affected and by the institution(s) in which they are found. Institutions, in turn, vary widely in physical and functional characteristics, ranging from long-term care facilities (LTCF) to specialty units (e.g., intensive care units [ICU], burn units, neonatal ICUs [NICUs]) in tertiary care facilities. Because of this, the approaches to
prevention and control of these pathogens need to be tailored to the specific needs of each population and individual institution.  (Emphasis added). The prevention and control of MDROs is a national priority - one that requires that all healthcare facilities and agencies assume responsibility.

The following discussion and recommendations are provided to guide the
implementation of strategies and practices to prevent the transmission of MRSA, VRE, and other MDROs. The administration of healthcare organizations and institutions should ensure that appropriate strategies are fully implemented, regularly evaluated for effectiveness, and adjusted such that there is a consistent decrease in the incidence of targeted MDROs. Successful prevention and control of MDROs requires administrative and scientific leadership and a financial and human resource commitment. Resources must be made available for infection prevention and control, including expert consultation, laboratory
support, adherence monitoring, and data analysis. Infection prevention and control professionals have found that healthcare personnel (HCP) are more receptive and adherent to the recommended control measures when organizational leaders participate in efforts to reduce MDRO transmission.

(From “Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006”, Centers for Disease Control and Prevention)