Mrs. Lilieta Frances-snoddy1, Mr Jake Nasa2, Mr Johnny Choban2, Mr Mark Durand2
1Mohhs, Ebeye, Marshall Islands, 2Mohhs, Ebeye, Marshall Islands
Biography:
Lilieta works with the Ministry of Health and Human Services in the Republic of the Marshall Islands as a clinical nurse responsible for Infection Prevention and Control (IPC). Recently completed the Foundations for IPC – International through ACIPC.
Abstract:
Background
The Infection Prevention and Control Program (2022) guidelines call for the institution of appropriate infection control measures (based on the organism identified and site of infection) and adjustment, when needed, of patients’ antibiotic regimen within 24 hours of release of multidrug-resistant organism culture results.
This study examines laboratory-confirmed multidrug-resistant organism cases among inpatients since the program's inception. We will evaluate whether infection control measures were promptly applied to each case and whether antibiotic regimens were changed promptly based on culture sensitivity reports following the National Antimicrobial Guidelines 2018.
Methods
A descriptive cohort study of multidrug-resistant organisms positive laboratory-confirmed cases of hospital inpatients was performed using program data from October 25th, 2022, to December 31st, 2023. Each multidrug-resistant organism case was reviewed for a) timeliness of the institution of infection control measures, and b) timeliness and appropriate selection of antibiotic regimen according to the National Antimicrobial Guidelines 2018.
Results
The multidrug-resistant organism (n=58) cases with a variety of organisms were seen across all clinical wards. Infection prevention and control standards were met at 35 (60%). Reasons for not meeting standards are a lack of isolation rooms 10 (44%) and 13 (56%) due to not meeting the infection prevention and control initiation criterion (working definition). Those meeting antibiotic usage guidelines were 8 (14%), and highest reason for failure was prolonged duration, 19 (38%), and 16 (32%) of shorter duration.
Conclusions
Management of a substantial proportion of multidrug-resistant cases at Ebeye Hospital failed to meet standards. Several areas for improvement are identified.