Laura Gavaldà1, Ana M Soriano2, Jordi Cámara3, Rosa Gasull4, Olga Arch5, Montserrat Ferrer4, Evelyn Shaw5, Rosa M Granada4, M Angeles Dominguez3, Miquel Pujol5. 1. Preventive Medicine Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: lgavalda@bellvitgehospital.cat. 2. Preventive Medicine Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 3. Microbiology Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 4. Intensive Care Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 5. Infectious Diseases Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
BACKGROUND: Our institution experienced an endemic situation with extensively drug-resistant (XDR) Acinetobacter baumannii in the intensive care units (ICUs). Here, we describe the long-term results of the implementation of a screening and cohorting policy and new cleaning techniques based on a procedure that we call the 1 room, 1 wipe approach. METHODS: We conducted a 4-year quasi-experimental study in the ICUs of an 800-bed teaching hospital. The main actions implemented were active surveillance of XDR A baumannii and cohorting of carriers and introducing new cleaning techniques intended to avoid sharing wipes between rooms. RESULTS: XDR A baumannii significantly decreased from 132 cases in 2011 to 8 cases in 2014 and from 10.78 cases per 1,000 patient days in 2011 to 0.69 cases per 1,000 patient days in 2014. Segmented regression analysis showed that after implementing the measures, the monthly rates presented a sustained negative slope, with a significant change of -0.623 (P = .002). CONCLUSIONS: The prompt identification and isolation of patients and adequate environmental cleaning are effective measures for reducing XDR A baumannii in ICUs. The 1 wipe, 1 room approach should be considered a standard measure for cleaning hospital facilities to avoid cross-transmission as a result of reusable cleaning wipes.
BACKGROUND: Our institution experienced an endemic situation with extensively drug-resistant (XDR) Acinetobacter baumannii in the intensive care units (ICUs). Here, we describe the long-term results of the implementation of a screening and cohorting policy and new cleaning techniques based on a procedure that we call the 1 room, 1 wipe approach. METHODS: We conducted a 4-year quasi-experimental study in the ICUs of an 800-bed teaching hospital. The main actions implemented were active surveillance of XDR A baumannii and cohorting of carriers and introducing new cleaning techniques intended to avoid sharing wipes between rooms. RESULTS: XDR A baumannii significantly decreased from 132 cases in 2011 to 8 cases in 2014 and from 10.78 cases per 1,000 patient days in 2011 to 0.69 cases per 1,000 patient days in 2014. Segmented regression analysis showed that after implementing the measures, the monthly rates presented a sustained negative slope, with a significant change of -0.623 (P = .002). CONCLUSIONS: The prompt identification and isolation of patients and adequate environmental cleaning are effective measures for reducing XDR A baumannii in ICUs. The 1 wipe, 1 room approach should be considered a standard measure for cleaning hospital facilities to avoid cross-transmission as a result of reusable cleaning wipes.