Battling MDROs with evidence and initiative
Judy Warren, RN, MS, CIC, CPHQ
Al Ain, United Arab Emirates
A San Antonio transplant who has lived in the United Arab Emirates for 12 years, Judy Warren actively leverages research and evidence-based practice to create new infection prevention programs. “Integrating American infection prevention standards with Arab culture can be challenging,” Warren said, “but every day I feel like I’m making a difference.”
In February 2008, the adult ICU in her hospital experienced an outbreak of multidrug-resistant Acinetobacter baumanii (MRAB).The outbreak was quelled, but re-emerged seven months later. While discussing the situation with a local microbiology professor, she learned that MRAB love low levels of alcohol. Further research revealed this fact was well-documented, and Warren went to work.
She discovered three sources of alcohol in the Tawam Hospital ICU: hand rub, cleaning agents, and 70 percent alcohol soak for flow sensors and cuvettes. By December 2008, the hospital had eliminated alcohol-based hand rub and cleaning agents in favor of soap-and-water and non-alcohol cleaning agents. All flow sensors and cuvettes were sent to central sterilization. Warren also instituted aggressive multidrug-resistant organism (MDRO) screening, chlorhexidine baths for all admissions, and contact precautions.
By the end of the following month, the outbreak was vanquished. In 2011, the Tawam Hospital infection rate for MRAB was only 0.17. In recognition of their work, Warren and her team received an Outstanding Achievement in Arab Health Award.
Warren is excited to help her peers learn more about how to battle MDROs. “These organisms are a global problem, and resistance patterns keep changing. We must continually review new research and modify our practices accordingly,” she said.
Infection preventionists and patients around the globe can count on Judy Warren to be part of the fight.