Hazard

Exposure of staff and patients to Multidrug Resistant Organisms (MDROs) resulting in nosocomial (hospital-acquired) infections. Common examples of these organisms include:

• Carbapenem-resistant Enterobacteriaceae (CRE) are a family of germs that can become carbapenem-resistant, including Klebsiella pneumoniae and Escherichia coli (E. coli).
• Clostridium difficile (C. Diff). Clostridium difficile is a spore-forming, Gram-positive anaerobic bacillus. It is a common cause of antibiotic-associated diarrhea
• Extended-spectrum beta-lactamases (ESBLs). ESBLs of concern are resistant to cephalosporins and monobactams.
• Methicillin/Oxacillin-resistant Staphylococcus aureus (MRSA), which includes Vancomycin-intermediate Staphylococcus aureus (VISA) and Vancomycin-resistant Staphylococcus aureus (VRSA) is addressed below and also in Hospital Wide Hazards – MRSA.
• Multidrug-resistant Acinetobacter baumannii (MDR-Ab) is a gram-negative bacterium that can colonize the skin of infected patients.
• Multi-drug-resistant Tuberculosis (MDR-TB) is addressed in Hospital-Wide Hazards – Tuberculosis.
• Penicillin-resistant Streptococcus pneumoniae (PRSP). Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacteria, sometimes referred to as pneumococcus. Pneumococcus can cause many types of illnesses, including ear infections and meningitis.
• Vancomycin-resistant enterococci (VRE). Enterococci are bacteria that can live in the human intestines and female genital tract without causing disease or infection (often called colonization). However, enterococci can cause infections of the urinary tract, the bloodstream, or of wounds associated with catheters or surgical procedures. Vancomycin is usually the drug of choice for treating these bacteria. However, VRE are resistant to Vancomycin.

The CDC provides guidelines and recommends controls for MDRO hazards.

Additional Information

• Management of Multidrug-Resistant Organisms in Healthcare Settings. Centers for Disease Control and Prevention (CDC).
• Healthcare: Infectious Diseases. OSHA Safety and Health Topics Page.
• Healthcare-associated Infections (HAI). Centers for Disease Control and Prevention (CDC).
• Antibiotic / Antimicrobial Resistance. Centers for Disease Control and Prevention (CDC).
• Understanding Antimicrobial (Drug) Resistance. National Institute of Allergy and Infectious Diseases (NIAID).
• Also see Hospital-wide Hazards - MDRO - Multidrug-Resistant Organisms and Infection.