Clinicians’ Knowledge, Attitudes, and Practices Regarding Infections with Multidrug-Resistant Gram-Negative Bacilli in Intensive Care Units
Published Date:Jan 24 2013
Source:Infect Control Hosp Epidemiol. 34(3):274-283.
Attitude Of Health Personnel
Drug Resistance, Multiple, Bacterial
Gram-Negative Bacterial Infections
Intensive Care Units
Microbial Sensitivity Tests
Physician's Practice Patterns
Pubmed Central ID:PMC4494664
Funding:5R01CI000537-02/CI/NCPDCID CDC HHS/United States
R01 CI000537/CI/NCPDCID CDC HHS/United States
To assess how healthcare professionals caring for patients in intensive care units (ICUs) understand and use antimicrobial susceptibility testing (AST) for multidrug-resistant gram-negative bacilli (MDR-GNB).
A knowledge, attitude and practice survey assessed ICU clinicians knowledge of antimicrobial resistance, confidence interpreting susceptibility testing, and beliefs regarding the impact of susceptibility testing on patient outcomes.
16 ICUs affiliated with New York-Presbyterian Hospital.
Attending physicians and subspecialty residents with primary clinical responsibilities in adult or pediatric ICUs and infectious diseases (ID) subspecialists and clinical pharmacists.
Participants completed an anonymous electronic survey. Responses included 4-level Likert scales dichotomized for analysis. Multivariate analyses were performed using Generalized Estimating Equations logistic regression to account for correlation of respondents from the same ICU.
The response rate was 51% (178/349 eligible participants) of whom 120 (67%) were ICU physicians. Those caring for adult patients were more knowledgeable about antimicrobial activity and more familiar with MDR-GNB infections. Only 33% and 12% of ICU physicians were familiar with standardized and specialized AST methods, respectively, but >95% believed AST improved patient outcomes. When adjusted for demographic and healthcare provider characteristics, those familiar with treatment of MDR-GNB bloodstream infections, those aware of resistance mechanisms, and those aware of AST methods were more confident they could interpret AST and/or request additional in vitro testing.
Our study uncovered knowledge gaps and educational needs that could serve as the foundation for future interventions. Familiarity with MDR-GNB increased overall knowledge and familiarity with AST increased confidence interpreting these results.
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