BACKGROUND: We sought to determine the long-term effect of a multifaceted infection-control intervention to reduce the incidence of pandrug-resistant Acinetobacter baumannii infection in a Thai tertiary care center. METHODS: A 3-year, prospective, controlled, quasi-experimental study was conducted in medical intensive care, surgical intensive care, and coronary care units for a 1-year period before intervention (period 1), a 1-year period after intervention (period 2), and a 1-year follow-up period (period 3). The interventions in period 2 included strictly implementing contact isolation precautions and appropriate hand hygiene, active surveillance, cohorting patients who were colonized or infected with pandrug-resistant A. baumannii, and environmental cleaning with 1:100 sodium hypochlorite solution. All interventions were continued in period 3, but environmental cleaning solutions were changed to detergent and phenolic agents. RESULTS: Before the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection was 3.6 cases per 1000 patient-days. After the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection decreased by 66% in period 2 (to 1.2 cases per 1000 patient-days; P < .001) and by 76% in period 3 (to 0.85 cases per 1000 patient-days; P < .001). The monthly hospital antibiotic cost of treating pandrug-resistant A. baumannii colonization and/or infection and the hospitalization cost for each patient in the intervention units were also reduced by 36%-42% (P < .001) and 25%-36% (P < .001), respectively, during periods 2 and 3. CONCLUSIONS: A multifaceted intervention featuring active surveillance and environmental cleaning resulted in sustained reductions in the rate of pandrug-resistant A. baumannii colonization and infection, the cost of antibiotic therapy, and the cost of hospitalization among intensive care unit patients in a developing country.
BACKGROUND: We sought to determine the long-term effect of a multifaceted infection-control intervention to reduce the incidence of pandrug-resistant Acinetobacter baumannii infection in a Thai tertiary care center. METHODS: A 3-year, prospective, controlled, quasi-experimental study was conducted in medical intensive care, surgical intensive care, and coronary care units for a 1-year period before intervention (period 1), a 1-year period after intervention (period 2), and a 1-year follow-up period (period 3). The interventions in period 2 included strictly implementing contact isolation precautions and appropriate hand hygiene, active surveillance, cohorting patients who were colonized or infected with pandrug-resistant A. baumannii, and environmental cleaning with 1:100 sodium hypochlorite solution. All interventions were continued in period 3, but environmental cleaning solutions were changed to detergent and phenolic agents. RESULTS: Before the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection was 3.6 cases per 1000 patient-days. After the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection decreased by 66% in period 2 (to 1.2 cases per 1000 patient-days; P < .001) and by 76% in period 3 (to 0.85 cases per 1000 patient-days; P < .001). The monthly hospital antibiotic cost of treating pandrug-resistant A. baumannii colonization and/or infection and the hospitalization cost for each patient in the intervention units were also reduced by 36%-42% (P < .001) and 25%-36% (P < .001), respectively, during periods 2 and 3. CONCLUSIONS: A multifaceted intervention featuring active surveillance and environmental cleaning resulted in sustained reductions in the rate of pandrug-resistant A. baumannii colonization and infection, the cost of antibiotic therapy, and the cost of hospitalization among intensive care unit patients in a developing country.
Authors: Ji Hoon Baang; Peter Axelrod; Brooke K Decker; Andrea M Hujer; Georgia Dash; Allan R Truant; Robert A Bonomo; Thomas Fekete Journal: Am J Infect Control Date: 2011-08-11 Impact factor: 2.918
Authors: Amy Ray; Federico Perez; Amanda M Beltramini; Marta Jakubowycz; Patricia Dimick; Michael R Jacobs; Kathy Roman; Robert A Bonomo; Robert A Salata Journal: Infect Control Hosp Epidemiol Date: 2010-10-25 Impact factor: 3.254
Authors: José Garnacho-Montero; George Dimopoulos; Garyphallia Poulakou; Murat Akova; José Miguel Cisneros; Jan De Waele; Nicola Petrosillo; Harald Seifert; Jean François Timsit; Jordi Vila; Jean-Ralph Zahar; Matteo Bassetti Journal: Intensive Care Med Date: 2015-10-05 Impact factor: 17.440
Authors: Yohei Doi; Ezenwa O Onuoha; Jennifer M Adams-Haduch; Diana L Pakstis; Traci L McGaha; Carly A Werner; Bridget N Parker; Maria M Brooks; Kathleen A Shutt; Anthony W Pasculle; Carlene A Muto; Lee H Harrison Journal: J Clin Microbiol Date: 2010-10-27 Impact factor: 5.948
Authors: Jesús Rodríguez-Baño; Lola García; Encarnación Ramírez; Luis Martínez-Martínez; Miguel A Muniain; Felipe Fernández-Cuenca; Margarita Beltrán; Juan Gálvez; Jose M Rodríguez; Carmen Velasco; Concepción Morillo; Federico Perez; Andrea Endimiani; Robert A Bonomo; Alvaro Pascual Journal: Am J Infect Control Date: 2009-05-19 Impact factor: 2.918