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Multidrug-resistant organisms (MDRO)

Multidrug-resistant organisms (MDROs) are organisms, usually bacteria, that are resistant to more than 1 class of antimicrobial agents. When organisms become resistant to multiple antimicrobials, fewer options are available to safely and effectively treat the patient. Also, MDROs have been associated with increased lengths of hospital stay, costs, and mortality.

Interfacility transfer form

We recommend facilities use the linked interfacility transfer form when you transfer a patient or resident to another healthcare facility. This can also be used for outpatient visits. By using this form, the receiving facilities will be able to determine appropriate precautions for a resident or patient.

Screening availability

The Utah Public Health Lab (UPHL) can provide healthcare facilities with screening for MDROs free of charge. If you are interested in screening, please contact the UPHL at arlnutah@utah.gov.

Resources

One of the more common MDROs the DHHS works with are carbapenem resistant organisms (CROs). The 3 main categories we work with are carbapenem resistant; Acinetobacter, Pseudomonas aeruginosa, and Enterobacterales. These organisms are resistant to a specific class of antibiotics, carbapenems, which are often used as last line treatments. While resistant to carbapenems, these organisms are often resistant to many other more traditional antibiotics as well, which leaves very few treatment options.

Candida auris (C. auris) is a fungal organism that is of concern for 3 main reasons:

  1. It is often multidrug resistant and since it is a fungus, antibiotics are ineffective which further limits the available treatment options
  2. It can be difficult to identify with standard lab methods and misclassification may occur
  3. It often spreads in healthcare facilities and can be associated with a high mortality rate if it becomes an invasive infection

Information for healthcare providers and transmission-based precautions can be found here.

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to multiple antibiotics, including methicillin. In community settings, MRSA often results in skin infections but could potentially cause pneumonia and other infections. If left untreated, sepsis could occur. For healthcare settings, such as hospitals or nursing homes, MRSA can become more severe and cause issues such as:

  • Bloodstream infections
  • Pneumonia
  • Surgical site infections
  • Sepsis
  • Death

In both community and healthcare settings, MRSA can be spread by coming into direct contact with infected individuals or objects which carry the bacteria. Spread is more common in healthcare settings due to prolonged medical visits, antibiotic exposure, and shared common objects, etc.

Information for healthcare providers and other resources can be found here.

Vancomycin-resistant Enterococcus (VRE) is a type of bacteria that is resistant to many antibiotics, including vancomycin. These organisms are often resistant to many, if not all, antibiotic treatment options that can be used to treat Enterococcus infections. Those most at risk include:

  • Long periods of antibiotic use (especially vancomycin)
  • Those with indwelling medical devices, long hospital stays, or those who have undergone surgical procedures
  • Those with weakened immune systems

VRE can be transmitted via person to person contact or through environmental contamination. VRE can affect a patient in 2 distinct ways: colonization and infection. A person who is colonized displays no signs or symptoms of a VRE infection but can still spread the disease. Those who are infected do display signs or symptoms and can also still transmit the disease.

Information for healthcare providers and other resources can be found here.

Vancomycin-resistant Staphylococcus aureus (VRSA) or Vancomycin-intermediate Staphylococcus aureus (VISA) is a species of bacteria that is resistant or intermediate in susceptibility to vancomycin, an antibiotic. Vancomycin is 1 of the more commonly used antibiotics to treat the highly resistant Methicillin-resistant Staphylococcus aureus (MRSA) so if the Staphylococcus aureus organism is also resistant to vancomycin, there are not many treatment options left. Staphylococcus aureus is commonly found on the skin and nose in about 30% of individuals. However, Staphylococcus aureus can become dangerous is it gets into the bloodstream and can cause:

  • Pneumonia
  • Bacteremia or sepsis
  • Infection of the heart valve(s)
  • Bone infections

Information for healthcare providers and other resources can be found here.