Background and Objective:
In november 2021 there was a steady increase of Multidrug-Resistant Microorganisms (MDRO) colonized patients in a medical department of san bortolo hospital (Vicenza, Italy): 6 Vancomycin-Resistant Enterococcus (VRE), 1 pseudomonas aeruginosa MDR. MDRO active surveillance with rectal swabs was already performed to patients at admission and every 7 days (patients with known MDRO excluded). Therefore, targeted interventions were planned.

Methods:
The implementation of an infection Prevention and Control (IPC) intervention was planned by the Infection Control Team (ICT) in order to analyze, contain and manage the phenomenon. Measures implemented by ICT with staff ward included a hand hygiene observation session, onsite training meetings with healthcare staff, environmental screening by performing swabs in colonized patients’ rooms, analysis and revision of sanitizing protocols for electro-medical equipment and flusher disinfectors.

Results:
The 3 inspections carried on revealed some critical issues, in particular: poor hand hygiene adherence, double gloves use, unclear dirty/clean pathways, uncorrect Personal Protective Equipment (PPE) removal sequence, presence of too much equipment in isolation rooms. Environmental swabs showed vre contamination on 1 bedside, 1 monitor, and 1 colonized patient garrison. The 3 onsite training meetings allowed the engagement of staff with focus on: proper hand hygiene, principles of antibiotic resistance, standard and contact precautions, proper use of PPE.

Conclusions:
The IPC intervention allowed an improvement in the equipment arrangement in colonized patients rooms, a review of sanitization protocols and an improvement in PPE use procedures; staff engagement led to an increase in responsibility and knowledge, allowing the cluster to be contained and resolved within a month.