The strength of coughing may forecast the likelihood of spread of multi-drug resistant microorganisms from the respiratory tract of colonized patients

Magda Diab-Elschahawi, Luigi Segagni Lusignani, Peter Starzengruber, Dieter Mitteregger, Andrea Wagner, Ojan Assadian, Elisabeth Presterl

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Current recommendations indicate that patients who are coughing and have multidrug resistant microorganisms (MDROs) in their sputum are considered to be shedders and should be cared for in single room isolation at least until symptoms resolve. Airborne spread and subsequent contamination of surfaces adjacent to patients may contribute to transmission. Hence, isolation measures for patients colonized or infected with MDRO at their respiratory tract are intended to interrupt such transmission. However, the potential for microbial shedding in patients with MDRO-positive microbiological reports from their respiratory tract and factors justifying the need for single room isolation are viewed controversially. Methods: Cough aerosol produced by patients colonized with MDROs was measured for viable counts. Descriptive analysis together with logistic regression analysis was performed to assess the impact of strength of cough on growth of MDRO on culture plates. Results: In 18% (23/128) MDRO were transmitted. Multivariate analysis revealed that strength of cough significantly predicts the yield of MDRO on culture plates (P = 0.012). Conclusion: Based on these results it can be concluded that risk stratification for decision of single room isolation of patients colonized or infected with MDROs at their respiratory tract may also take the severity of cough into consideration. However, more work is required in order to assess the severity of cough objectively.

Original languageEnglish
Article number38
Number of pages4
JournalAntimicrobial Resistance and Infection Control
Volume3
DOIs
Publication statusPublished - 12 Dec 2014
Externally publishedYes

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Cough
Respiratory System
Patient Isolation
Pharmaceutical Preparations
Patients' Rooms
Aerosols
Sputum
Multivariate Analysis
Logistic Models
Regression Analysis
Growth

Cite this

Diab-Elschahawi, Magda ; Lusignani, Luigi Segagni ; Starzengruber, Peter ; Mitteregger, Dieter ; Wagner, Andrea ; Assadian, Ojan ; Presterl, Elisabeth. / The strength of coughing may forecast the likelihood of spread of multi-drug resistant microorganisms from the respiratory tract of colonized patients. In: Antimicrobial Resistance and Infection Control. 2014 ; Vol. 3.
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The strength of coughing may forecast the likelihood of spread of multi-drug resistant microorganisms from the respiratory tract of colonized patients. / Diab-Elschahawi, Magda; Lusignani, Luigi Segagni; Starzengruber, Peter; Mitteregger, Dieter; Wagner, Andrea; Assadian, Ojan; Presterl, Elisabeth.

In: Antimicrobial Resistance and Infection Control, Vol. 3, 38, 12.12.2014.

Research output: Contribution to journalArticle

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T1 - The strength of coughing may forecast the likelihood of spread of multi-drug resistant microorganisms from the respiratory tract of colonized patients

AU - Diab-Elschahawi, Magda

AU - Lusignani, Luigi Segagni

AU - Starzengruber, Peter

AU - Mitteregger, Dieter

AU - Wagner, Andrea

AU - Assadian, Ojan

AU - Presterl, Elisabeth

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AB - Background: Current recommendations indicate that patients who are coughing and have multidrug resistant microorganisms (MDROs) in their sputum are considered to be shedders and should be cared for in single room isolation at least until symptoms resolve. Airborne spread and subsequent contamination of surfaces adjacent to patients may contribute to transmission. Hence, isolation measures for patients colonized or infected with MDRO at their respiratory tract are intended to interrupt such transmission. However, the potential for microbial shedding in patients with MDRO-positive microbiological reports from their respiratory tract and factors justifying the need for single room isolation are viewed controversially. Methods: Cough aerosol produced by patients colonized with MDROs was measured for viable counts. Descriptive analysis together with logistic regression analysis was performed to assess the impact of strength of cough on growth of MDRO on culture plates. Results: In 18% (23/128) MDRO were transmitted. Multivariate analysis revealed that strength of cough significantly predicts the yield of MDRO on culture plates (P = 0.012). Conclusion: Based on these results it can be concluded that risk stratification for decision of single room isolation of patients colonized or infected with MDROs at their respiratory tract may also take the severity of cough into consideration. However, more work is required in order to assess the severity of cough objectively.

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