A Multifaceted Intervention to Reduce Pandrug‐Resistant<i>Acinetobacter baumannii</i>Colonization and Infection in 3 Intensive Care Units in a Thai Tertiary Care Center: A 3‐Year Study

Apisarnthanarak, Anucha; Pinitchai, Uayporn; Thongphubeth, Kanokporn; Yuekyen, Chananart; Warren, David K.; Fraser, Victoria J.

doi:10.1086/591134

Cited by 92 publications

(74 citation statements)

References 39 publications

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“…In our study, we identified the PICU stay as a risk factor predisposing to acquisition of MDR during hospitalization. While, large studies [17,18] conducted have shed some light on this risk factor in intensive care units, the situation in PICU needs to be more thorough.…”

Section: Discussionmentioning

confidence: 99%

Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia

Tfifha

Ferjani

Mallouli

et al. 2017

Libyan Journal of Medicine

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The pandemic spread of multidrug-resistant (MDR) bacteria (i.e., methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBLPE), vancomycin-resistant enterococci, carbapenemase-producing Enterobacteriaceae (CPE), multiresistant Pseudomonas aeruginosa and multiresistant Acinetobacter baumannii) pose a threat to healthcare Worldwide. We found limited data of MDR bacteria in pediatric patients hospitalized in Tunisian tertiary healthcare.The aim of the study is to evaluate the acquisition rate of MDR acquisition during hospitalization and to explore some of the associated risk factors for both carriage and acquisition at the pediatric department, Sahloul University Hospital. During September and October 2016, newly admitted patients were screened, at admission, during care and at discharge. Risk factors for colonization were explored by multivariate analysis. Of 112 newly admitted patients, 8.92% were colonized with at least one MDR. No risk factor was identified at admission. During hospitalization, five newly acquisition MDR (4.9%) were detected and eight (7.84%) at discharge. The specie most frequently detected on admission was Escherichia coli (50%), whereas, on discharge, Escherichia coli and K. pneumoniae were the species most frequently detected (52.7%). The pediatric intensive care unit (PICU) hospitalization, the length of hospital stay (more than 3days) and age under 2 years were identified as risk factor for acquisition of MDR during hospitalization. We identified several independent risk factors for contracting MDR bacteria during hospitalization in a tertiary pediatric department. The incidence of symptomatic MDR Infection among those colonized should be under close surveillance and long-term screening for those children is required. An institutional screening program for MDR especially in PICU might be discussed in regards to cost effectiveness.

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Section: Discussionmentioning

confidence: 99%

Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia

Tfifha

Ferjani

Mallouli

et al. 2017

Libyan Journal of Medicine

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“…The rate of A. baumannii colonization and/or infection was 3.6 cases per 1,000 patient-days before the interventions were introduced, with the rate then decreasing by 66% to 1.2 cases per 1,000 patient-days (P Ͻ 0.001) by the end of the first year. The rate was further reduced by 76% to 0.85 cases per 1,000 patient-days (P Ͻ 0.001) 2 years later (77).…”

Section: Acinetobactermentioning

confidence: 92%

“…A 3-year prospective study took place in intensive and coronary care units in order to evaluate a bundle of interventions aimed at reducing long-term drug-resistant Acinetobacter (77). The interventions included a hand hygiene program, patient surveillance, barrier precautions, contact isolation, cohorting affected patients, and intensive cleaning with sodium hypochlorite (1:100) (77).…”

Section: Acinetobactermentioning

confidence: 99%

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.

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“…This risk of nosocomial infection is further escalated by the increasing prevalence of antibiotic-resistant pathogens such as methicillin (oxacillin)-resistant S. aureus (MRSA) and vancomycin-resistant Enterococci (VRE) among Gram-positive organisms, and multi-drug resistant (MDR) Pseudomonas aeruginosa and Acinetobacter among Gramnegative organisms. Especially, Acinetobacter baumannii is becoming a major hospital-acquired infection issue because it is often multi-drug resistant (Wang et al, 2003;Marais et al, 2004;Pimentel et al, 2005;Wilks et al, 2006;Apisarnthanarak et al, 2008). This contributes to the increase of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Airborne and Surface-Bound Microbial Contamination in Two Intensive Care Units of a Medical Center in Central Taiwan

Huang

Shi

Chen

et al. 2013

Aerosol Air Qual. Res.

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Samples of airborne and surface-bound microbial contamination were taken in two intensive care units of a large-scale medical center. Microbial analyses included total bacterial and fungal loads, as well as the four bacterial species of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii. Among the 114 surface samples taken from seven designated surface locations of room and equipment for each patient, P. aeruginosa was the most frequently detected (19.3%) and most abundant (mean count: 4.18 cfu/plate) bacterium, whereas the respirator represented the most heavily contaminated surface location in both total pathogenic bacteria colony counts (272 cfu) and frequency of positive detection (38.2%). P. aeruginosa also represented the most frequently detected (39.1%, n = 46) and abundant (11.52 ± 17.16 cfu/m 3 ) bacterium in the air samples (n = 46), and was the only bacterium exhibiting a positive correlation of the mean counts between air and surface samples. The data analysis results further suggested a higher value of relative risk among the infected patients in the presence of the pathogens as compared to those in the absence of them, although the evidence of a of correlation for the individual bacterial species between the environmental samples and infected patients was inconclusive. This study also found that the mean airborne counts and the detection frequencies of these bacteria after patient visitation periods were higher than those before visitation, and that the installation of local air ionizers did not lead to any discernible differences in total bacterial and fungal concentrations.

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A Multifaceted Intervention to Reduce Pandrug‐ResistantAcinetobacter baumanniiColonization and Infection in 3 Intensive Care Units in a Thai Tertiary Care Center: A 3‐Year Study

Cited by 92 publications

References 39 publications

Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia

Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Airborne and Surface-Bound Microbial Contamination in Two Intensive Care Units of a Medical Center in Central Taiwan

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