L Silvia Munoz-Price1, Philip Carling2, Timothy Cleary3, Yovanit Fajardo-Aquino4, Dennise DePascale4, Adriana Jimenez4, Michael Hughes4, Nicholas Namias5, Louis Pizano6, Daniel H Kett7, Kristopher Arheart8. 1. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL; Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, FL; Jackson Health System, Miami, FL. Electronic address: smunozprice@med.miami.edu. 2. Boston University, Boston, MA. 3. Department of Pathology, University of Miami Miller School of Medicine, Miami, FL. 4. Jackson Health System, Miami, FL. 5. Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, FL; Jackson Health System, Miami, FL; Department of Surgery, University of Miami Miller School of Medicine, Miami, FL. 6. Jackson Health System, Miami, FL; Department of Surgery, University of Miami Miller School of Medicine, Miami, FL. 7. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL. 8. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL; Division of Statistics, University of Miami Miller School of Medicine, Miami, FL.
Abstract
BACKGROUND: Our institution continued to experience a hyperendemic situation with carbapenem-resistant Acinetobacter baumannii despite a bundle of interventions. We aim to describe the effect of the subsequent implementation of electronic dissemination of the weekly findings of a bundle of interventions. METHODS: This was a quasiexperimental study performed at a 1,500-bed, public, teaching hospital. From January 2011 to March 2012, weekly electronic communications were sent to the hospital leadership and intensive care units (ICUs). These communications aimed to describe, interpret, and package the findings of the previous week's active surveillance cultures, environmental cultures, environmental disinfection, and hand cultures. Additionally, action plans based on these findings were shared with recipients. RESULTS: During 42 months and 1,103,900 patient-days, we detected 438 new acquisitions of carbapenem-resistant A baumannii. Hospital wide, the rate of acquisition decreased from 5.13 ± 0.39 to 1.93 ± 0.23 per 10,000 patient-days, during the baseline and postintervention periods, respectively (P < .0001). This effect was also observed in the medical and trauma ICUs, with decreased rates from 67.15 ± 10.56 to 17.4 ± 4.6 (P < .0001) and from 55.9 ± 8.95 to 14.71 ± 4.45 (P = .0004), respectively. CONCLUSION: Weekly and systematic dissemination of the findings of a bundle of interventions was successful in decreasing the rates of carbapenem-resistant A baumannii across a large public hospital.
BACKGROUND: Our institution continued to experience a hyperendemic situation with carbapenem-resistant Acinetobacter baumannii despite a bundle of interventions. We aim to describe the effect of the subsequent implementation of electronic dissemination of the weekly findings of a bundle of interventions. METHODS: This was a quasiexperimental study performed at a 1,500-bed, public, teaching hospital. From January 2011 to March 2012, weekly electronic communications were sent to the hospital leadership and intensive care units (ICUs). These communications aimed to describe, interpret, and package the findings of the previous week's active surveillance cultures, environmental cultures, environmental disinfection, and hand cultures. Additionally, action plans based on these findings were shared with recipients. RESULTS: During 42 months and 1,103,900 patient-days, we detected 438 new acquisitions of carbapenem-resistant A baumannii. Hospital wide, the rate of acquisition decreased from 5.13 ± 0.39 to 1.93 ± 0.23 per 10,000 patient-days, during the baseline and postintervention periods, respectively (P < .0001). This effect was also observed in the medical and trauma ICUs, with decreased rates from 67.15 ± 10.56 to 17.4 ± 4.6 (P < .0001) and from 55.9 ± 8.95 to 14.71 ± 4.45 (P = .0004), respectively. CONCLUSION: Weekly and systematic dissemination of the findings of a bundle of interventions was successful in decreasing the rates of carbapenem-resistant A baumannii across a large public hospital.
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: Michael J Noto; Kelli L Boyd; William J Burns; Matthew G Varga; Richard M Peek; Eric P Skaar Journal: Infect Immun Date: 2015-08-03 Impact factor: 3.441
Authors: R Valencia-Martín; V Gonzalez-Galan; R Alvarez-Marín; A M Cazalla-Foncueva; T Aldabó; M V Gil-Navarro; I Alonso-Araujo; C Martin; R Gordon; E J García-Nuñez; R Perez; G Peñalva; J Aznar; M Conde; J M Cisneros Journal: Antimicrob Resist Infect Control Date: 2019-12-04 Impact factor: 4.887