03/28/2024
You Asked... We Answered
You Asked...
What is the specific CDC-targeted multidrug-resistant organisms (MDRO) that require enhanced barrier precautions (EBP)?
We Answered…
CMS provides this guidance in the QSO-24-08-NH memo on page 4 which directs providers to the CDC’s webpage, “Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs).”
CDC notes that the MDROs for which the use of EBP applies, and do not otherwise require contact precautions, are based on local epidemiology. At a minimum, they should include resistant organisms targeted by CDC but can also include other epidemiologically important MDROs as listed below:
Examples of MDROs Targeted by CDC include:
- Pan-resistant organisms,
- Carbapenemase-producing carbapenem-resistant Enterobacterales,
- Carbapenemase-producing carbapenem-resistant Pseudomonas spp.,
- Carbapenemase-producing carbapenem-resistant Acinetobacter baumannii, and
- Candida auris.
Additional epidemiologically important MDROs may include, but are not limited to:
- Methicillin-resistant Staphylococcus aureus (MRSA),
- ESBL-producing Enterobacterales,
- Vancomycin-resistant Enterococci (VRE),
- Multidrug-resistant Pseudomonas aeruginosa, and
- Drug-resistant Streptococcus pneumoniae.
CDC isolation guidance states the following situations require contact precautions situations when residents infected or colonized with an MDRO:
- Presence of acute diarrhea, draining wounds or other sites of secretions or excretions that are unable to be covered or contained.
- For a limited time period, as determined in consultation with public health authorities, on units or in facilities during the investigation of a suspected or confirmed MDRO outbreak.
- When otherwise directed by public health authorities.
