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Long-term control of hospital-wide, endemic multidrug-resistant Acinetobacter baumannii through a comprehensive "bundle" approach.
- Source :
-
American journal of infection control [Am J Infect Control] 2009 Nov; Vol. 37 (9), pp. 715-22. Date of Electronic Publication: 2009 May 19. - Publication Year :
- 2009
-
Abstract
- Background: Acinetobacter baumannii (Ab) is emerging as a multidrug-resistant (MDR) nosocomial pathogen of considerable clinical importance. Data on the efficacy of infection control measures in endemic situations are lacking. Here, we investigated the impact of a long-term multifaceted "bundle" approach in controlling endemic MDR Ab in a 950-bed tertiary care center.<br />Methods: Ongoing staff education, promotion of hand hygiene, strict Contact and Isolation Precautions, environmental cleaning, and targeted active surveillance in high-risk areas during periods of likely transmission and contamination were initiated in this program. To assess the efficacy of our interventions, we recorded (before and after the intervention) the epidemiologic and clinical features of MDR Ab infections and determined the clonal relationship among MDR Ab bloodstream isolates by pulsed-field gel electrophoresis.<br />Results: Before the "bundle" was instituted, the rate of colonization/infection was 0.82 cases per 100 admissions (1994-1995). Colonization/infection rates showed a sustained decrease after implementation of the control program in 1995 to 0.46 in 1996-1997 and to 0.21 in 1998-2003 (P < .001). Coincident with the institution of this program, the rate of bacteremia because of MDR Ab decreased 6-fold during the 8-year observation period. A notable change in the clonal distribution of the MDR Ab isolates was also demonstrated.<br />Conclusion: The implementation of a comprehensive and multifaceted infection control program ("bundle") in a tertiary care center effectively controlled the spread and clinical impact of MDR Ab.
- Subjects :
- Acinetobacter Infections epidemiology
Acinetobacter Infections microbiology
Acinetobacter baumannii classification
Acinetobacter baumannii genetics
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia microbiology
Bacterial Typing Techniques
Cluster Analysis
Cross Infection epidemiology
Cross Infection microbiology
DNA Fingerprinting
Education
Electrophoresis, Gel, Pulsed-Field
Female
Genotype
Hand Disinfection
Health Services Research
Hospitals
Housekeeping, Hospital
Humans
Male
Middle Aged
Young Adult
Acinetobacter Infections prevention & control
Acinetobacter baumannii drug effects
Acinetobacter baumannii isolation & purification
Cross Infection prevention & control
Drug Resistance, Multiple, Bacterial
Infection Control methods
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3296
- Volume :
- 37
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- American journal of infection control
- Publication Type :
- Academic Journal
- Accession number :
- 19457584
- Full Text :
- https://doi.org/10.1016/j.ajic.2009.01.008