Key messages

  • The risk of transmission of multi-resistant organisms (MROs) depends on factors associated with the organism, risk factors in the source patient, the patient setting and the environment.
  • The Australian Commission on Safety and Quality in the Australian guidelines for the prevention and control of infection in healthcare (2010) recommend that each healthcare facility conduct its own risk assessment and manage patients colonised or infected with MROs in the local context.
  • The Patient-centred risk management strategy for multi-resistant organisms (2011) is designed to assist health services in risk assessment of individual patients with an MRO and their settings.
  • The Victorian guideline on Carbapenemase-producing Enterobacteriaceae (CPE) for health services (2017) supersedes the Patient-centred risk management strategy for MROs with respect to CPE and must be followed for all cases of CPE. 

Multi-resistant organisms

New mechanisms of antimicrobial resistance and increasing numbers of patients with multi-resistant organisms (MRO) present constant challenges to health services. Routine isolation practices present psychological and medical care access issues for patients and financial costs in consumables and resources for health services.

The level of risk and specific type of MROs will differ between facilities; however, all health services need to consider the risks of transmission of MROs and implement infection prevention and control strategies according to their specific circumstances. Understanding the modes of transmission of infectious agents and knowing how and when to apply the basic principles of infection prevention and control is critical to the success of an infection prevention and control program.

Carbapenemase-producing Enterobacteriaceae (CPE)

Victoria has identified increasing numbers of bacteria resistant to carbapenem antibiotics, described as a last-line of defence against these bacteria. While these bacteria have been limited to a few healthcare facilities, and responses to date have helped to contain outbreaks, the threat remains. The actions and interventions outlined in the Victorian guideline on CPE for health services are to be followed for all cases of CPE.

Contact details