Effectiveness of infection prevention measures featuring advanced source control and environmental cleaning to limit transmission of extremely-drug resistant Acinetobacter baumannii in a Thai intensive care unit: An analysis before and after extensive flooding

Effectiveness of Chlorhexidine Wipes for the Prevention of Multidrug-Resistant Bacterial Colonization and Hospital-Acquired Infections in Intensive Care Unit Patients: A Randomized Trial in Thailand

“…Several studies have demonstrated that oncedaily bathing and 4-times-daily oral care with 2% chlorhexidine aqueous solution, environmental cleaning, contact precautions, cohorting of patients, and antibiotic stewardship collectively could limit colonization and infection with extremely drug-resistant A. baumannii and carbapenemaseproducing K. pneumoniae in medical ICUs and in longterm acute care hospitals. 27,28 Therefore, no-rinse 2% chlorhexidine-impregnated washcloths alone may be inadequate to control MDR gram-negative bacteria colonization in ICU patients.…”

Effect of daily chlorhexidine bathing on acquisition of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit with CRAB endemicity

“…[1][2][3][4][5] However, there is insufficient evidence for daily chlorhexidine bathing to reduce nosocomial spread of CRAB in endemic situations. 6,7 Also, some nonfermenting gram-negative organisms may be resistant to chlorhexidine. [8][9][10] Therefore, we investigated whether daily chlorhexidine bathing could prevent the acquisition of CRAB in a medical ICU with CRAB endemicity.…”

Antibiotic stewardship programmes in intensive care units: Why, how, and where are they leading us

“…This of course depends on the outcome measured, but in regards decreased antibiotic duration, and cumulative prescribed burden, the results are favourable when PCT is used to guide antibiotic stop decisions. These reductions in antibiotic use have been verified in many PCT guided protocol based RCTs, but not as an antibiotic escalation trigger alone [52,53,98] .…”

“…It is relatively unhindered by the issues of slow kinetics and nonspecificity faced by the latters [95][96][97] . Effective infection control and source control remain fundamental to successful ASPs [98] . As has been demonstrated by the systematic review, there is a clear signal [53] 2013 23418298 Multi-centred RCT suggesting the potential benefits of ASP, even in non protocolised observational studies.…”

“…Further evidence of practical difficulties in implementation of ASPs is the recent RCT of a PCTbased ASP. This was terminated prematurely due to poor clinician adherence to the algorithm [98] .…”