Case Definition: A culture yielding a bacterium or fungus (colonization or infection) that exhibits non-susceptibility to ALL antibacterial or ALL anti-fungal agents tested through routine antimicrobial susceptibility testing (AST) assays (i.e., all drugs tested for susceptibility are either intermediate or resistant).
Diagnostics and Treatment
PDRO infection is diagnosed through a culture from the affected body site. By definition, PDRO infections are resistant to most commonly used antimicrobial drugs and treatment options may be limited. Providers should order AST to determine the appropriate drug for treatment.
PDPH can coordinate testing for some novel drugs that are not yet commercially available through the Antibiotic Resistance Lab Network (ARLN). Please email the HAI/AR team at HAI.PDPH@Phila.gov or call at (215) 685-4501 for details.
CDC does not recommend treatment of PDROs identified from noninvasive sites (such as upper respiratory tract, urine, and skin colonization) when there is no evidence of infection.
Isolates should be retained for one month. PDPH will follow up to coordinate further testing as needed.
Reporting to PDPH
Report PDRO cases (colonization or infection) within 24 hours by calling 215-685-6748 [after business hours (215) 685-4514]. Complete a PDRO case report form after reporting the case via phone. Completed forms can be faxed to (215) 238-6947.
PDRO patients shall be placed on contact precautions and in a private room for the duration of all current and future healthcare stays.
Because patients may remain colonized for more than one year, do not discontinue precautions when the infection clears.
There is not enough evidence to make a firm recommendation about when to discontinue use of Contact Precautions for infected or colonized patients.
Prior to patient transfer, the transferring facility should notify the receiving facility of the PDRO colonization or infection.
Long Term Care Facilities Residents:
PDRO patients shall be placed on contact precautions or enhanced barrier precautions and placed in a private room, if available, for the duration of all current and future healthcare stays.
If PDRO patients cannot be placed in a private room, in room isolation precautions should be implemented.
Because patients may remain colonized for more than one year, do not discontinue precautions when the infection clears, or antibiotic course is completed.
Prior to patient transfer, the transferring facility should notify the receiving facility of the PDRO colonization or infection.
Disinfection Guidance:
Equipment should be dedicated to the colonized or infected patient whenever possible.
Shared medical equipment should be disinfected immediately after use.
Daily disinfection, with products appropriate for the identified PDRO, that includes areas in close proximity to the patient, high-touch surfaces in the room, as well as surfaces around sinks and toilets.
Immediate cleaning and disinfection of equipment or surfaces contaminated with blood, serum, urine, purulent discharges, feces, and other bodily fluids or infectious materials.
Terminal cleaning shall consist of thorough wet cleaning and disinfection. Specific products should be utilized based on the identified organism.