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CDC guidelines for MDRO prevention in long-term care
The Centers for Disease Control and Prevention recommendations on multidrug-resistant organisms (MDROs) relevant to long-term care facilities (LTCFs) include the following measures:
• When single-patient rooms are available, assign priority for these rooms to patients with known or suspected MDRO colonization or infection. Give highest priority to those patients who have conditions that may facilitate transmission, e.g., uncontained secretions or excretions. Category IB (Strongly recommended for implementation and supported by some experimental, clinical, or epidemiologic studies and a strong theoretical rationale.)1
• When single-patient rooms are not available, cohort patients with the same MDRO in the same room or patient care area. Category IB. When cohorting patients with the same MDRO is not possible, place MDRO patients in rooms with patients who are at low risk for acquisition of MDROs and associated adverse outcomes from infection and are likely to have short lengths of stay. Category II (Suggested for implementation and supported by suggestive clinical or epidemiologic studies or a theoretical rationale.)
• In LTCFs, consider the individual patient's clinical situation and prevalence or incidence of MDRO in the facility when deciding whether to implement or modify Contact Precautions in addition to Standard Precautions for a patient infected or colonized with a target MDRO. Category II.
• For relatively healthy residents (e.g., mainly independent) follow Standard Precautions, making sure that gloves and gowns are used for contact with uncontrolled secretions, pressure ulcers, draining wounds, stool incontinence, and ostomy tubes/bags. Category II.