Multi-Drug Resistant Gram-Negative Rods

About the organism

Multi-drug resistant organisms (MDROs) present significant risk to patients because of their limited therapeutic options for the infections they cause. Common MDROs include:

  • Vancomycin Resistant Enterococci (VRE)
  • Methicillin Resistant Staphylococcus aureus (MRSA)
  • Extended spectrum β-lactamse (ESBLs) producing Gram-negative bacteria
  • Klebsiella pneumonia carbapenemase (KPC) producing Gram-negative bacteria
  • Imipenem resistant or multi-drug resistant Acinetobacter species
  • Imipenem resistant or multi-drug resistant Pseudomonas species
  • Burkohlderia cepacia

 Infection prevention and control

If you see the Epic MDRO FYI alert screen in the patient's chart, please make sure the patient is on contact precautions. Clinicians should notify Infection Control if there is no FYI alert for an MDRO positive patient.

For MDRO patients, contact precautions means:

  • Placing patient in a private room (or in a room with another MDRO patient)
  • Following hand hygiene
  • Maintaining clean patient environment/ equipment,
  • Wearing personal protective equipment (PPE) when entering room (gowns and gloves)
  • Only transporting patient out of room for essential tests/ services
  • See the multi-drug resistant organisms policy for more information.

For patients in the ambulatory setting, staff needs to follow standard precautions when caring for patients with MDRO. Standard precautions for outpatients with MDRO means:

  • Following hand hygiene at all times
  • Wearing PPE if there is risk/ potential for exposure to infectious substances
  • Provide covering or dressing for the patient in order to cover and contain draining lesions
  • Prioritize the placement of these patients into the examination/ procedure room so as to minimize the risk of transmission in shared areas
  • See the standard precautions policy for more information.

If you have questions about a patient's MDRO status, you can call the Infection Prevention and Control Department's mainline at 503 494-6694.

More information can be found on the following pages:

The Center for Disease Control (CDC)

John Hopkins Hospital epidemiology/infection control