Decolonization strategies against multidrug resistant organisms in the ICU

Multiple-drug resistant organisms (MDRO) are a consequence of antibiotic pressure, selection, and infection control failure.Regional variation in MDRO rates is evident [1].Important however, healthcare workers rarely become colonized with MDRO, probably because of a wellbalanced microbiota offering 'colonization resistance' against new invaders.Antibiotics disrupt this equilibrium leading to an increased risk of MRDO colonization and infection, potentially taking months to restore.Additionally, through horizontal transmission, the risk of MDRO colonization goes beyond antibiotic exposure.Our aim is to present practical recommendations for bedside clinicians concerning screening for MDRO and decolonization strategies (nasal, oropharyngeal, and skin).