A Risk-Based Isolation Strategy for MDR-Endemic Facilities with Limited Resources
Infectious Disease Reports, vol.18, no.3, 2026 (ESCI, Scopus)
- Publication Type: Article / Review
- Volume: 18 Issue: 3
- Publication Date: 2026
- Doi Number: 10.3390/idr18030044
- Journal Name: Infectious Disease Reports
- Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Keywords: contact isolation, CRE, ESBL, infection control, multidrug resistance, Risk Classification, VRE
- Ankara Yıldırım Beyazıt University Affiliated: Yes
Abstract
Background/Objectives: The increasing burden of multidrug-resistant (MDR) microorganisms and limited resources in healthcare settings are making traditional strategies based on routine isolation of all carriers unsustainable. Methods: A clinical narrative review was conducted by searching PubMed, Web of Science, and Google Scholar for studies published between 2011 and 2025. International guidelines were analyzed to synthesize a sustainable infection control strategy. Results: High-quality evidence, including cluster-randomized trials, indicates that routine contact isolation for endemic ESBL-producing Enterobacterales (IRR: 0.99) and VRE (RR: 0.93) provides no additional benefit over standard precautions. In contrast, strict isolation remains vital for high-threat pathogens such as Carbapenem-Resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Candidozyma auris due to their high environmental resilience and limited treatment options. Prioritization should be guided by pathogen biology, patient-specific transmission traits (e.g., diarrhea), and facility infrastructure. Conclusions: Traditional one-size-fits-all infection control is increasingly unsustainable under resource constraints. A risk-based approach prioritizing horizontal measures for low-risk pathogens enables a more balanced allocation of limited resources toward high-threat containment.