Page 195 - policy and procedure infection control

Policies and Procedures on Infection Control

13.3.5 Treatment
• Antibiotics used include linezolid, teicoplanin, carbapenems, quinopristin/
dalfopristine and tigecycline.
13.3.6 General Recommendations For The Control Of VRE Transmission
13.3.6.1 Patient Screening
• Feaces is the most useful screening specimen. Where a feaces
sample is unobtainable a rectal swab may be taken.
• Screening to identify colonised patients is recommended during
outbreaks.
• Other colonised patients may be identified by screening other
sites e.g. wounds and vascular catheter sites.
13.3.6.2 Patient Placement
• Place VRE infected or colonised patients in a single room with
own toilet facilities or cohort with other affected patients.
• STRICT ADHERENCE TO CONTACT BASED PRECAUTION
MUST BE PRACTICE AT ALL TIMES.
• Patients with diarrhoea or incontinence due to or suspected of
VRE pose a high risk of transmission to other patients and MUST
be isolated.
Isolation may be discontinued when the patient is well and
diarrhoea-free and capable of self caring and good hygiene.
13.3.6.3 Treatment
• As colonisation with VRE is more frequent than infection patients
must be assessed before commencing treatment.
• Attempts at clearance by oral therapy are usually unsuccessful
and not recommended.
13.3.6.4 Hand Hygiene
• Thorough hand washing by staff before and after patient contact,
after handling incontinence material or feaces.
• Wash hands after glove removal.
• Alcoholic hand rub are effective if hands are physically clean.
• Patients with VRE should be educated to wash their hands after
using the toilet.
13.3.6.5 Gloves/Aprons
• When carrying out-patient procedures wear disposable gloves.
Wash hands after removal.

184 Ministry of Health Malaysia