scholarly journals Does Enhanced Environmental Cleaning Reduce Carbapenem-Resistant Acinetobacter baumannii Colonization in the Intensive Care Unit?

2021 ◽  
Author(s):  
Hyeri Seok ◽  
Ji Hoon Jeon ◽  
Ji Hye Jung ◽  
Sang Hee Ahn ◽  
Minji Seo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Environmental Cleaning ◽  
Carbapenem Resistant

Intervention to reduce carbapenem-resistant Acinetobacter baumannii in a neonatal intensive care unit

2020 ◽  
Vol 41 (6) ◽  
pp. 710-715
Author(s):  
Anucha Thatrimontrichai ◽  
Pia S. Pannaraj ◽  
Waricha Janjindamai ◽  
Supaporn Dissaneevate ◽  
Gunlawadee Maneenil ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Acinetobacter Baumannii ◽  
Sodium Hypochlorite ◽  
Neonatal Intensive Care ◽  
Antimicrobial Use ◽  
Segmented Regression ◽  
Environmental Cleaning ◽  
Carbapenem Resistant

AbstractObjective:To investigate the effects of environmental cleaning and the installation of heat and moisture exchangers (HMEs) to reduce neonatal carbapenem-resistant Acinetobacter baumannii (CRAB) sepsis and colonization as well as antimicrobial use.Design:We conducted a 7-year, quasi-experimental study.Setting and patients:All neonates admitted to a neonatal intensive care unit (NICU).Methods:We compared the trends for CRAB sepsis and colonization before (period 1, 2011–2013) and after (period 3, 2015–2017) a 12-month intervention period in 2014 (period 2) to incorporate a combination of HME use and sodium hypochlorite cleaning (5,000 ppm in the NICU and 500 ppm in the neonatal environment) using interrupted time series analysis with segmented regression.Results:During the 7-year study period, 3,367 neonates were admitted to the NICU; the prevalence rates of CRAB sepsis and endotracheal CRAB colonization were 0.5 per 1,000 patient days, and 19.4 per 1,000 ventilator days. A comparison of period 1 to period 3 showed significant decreases in the percentages of both CRAB of A. baumannii sepsis (100% versus 11%) and endotracheal colonization (76% vs 52%) following the introduction of disposable HMEs and sodium hypochlorite cleaning (both P < .001). In period 3, compared with period 1, segmented regression analysis showed significant reductions in endotracheal CRAB colonization per 1,000 ventilator days (ie, change in level) and both carbapenem and colistin use (changes in both level and slope) (P < .001).Conclusions:Interventions featuring environmental cleaning and use of HMEs led to a sustainable reduction of CRAB colonization coupled with a reduction in broad-spectrum antimicrobial use in the NICU.

scholarly journals Control of an Outbreak of Carbapenem-ResistantAcinetobacter baumanniiin Australia after Introduction of Environmental Cleaning with a Commercial Oxidizing Disinfectant

2010 ◽  
Vol 31 (4) ◽  
pp. 418-420 ◽  
Author(s):  
Michelle Doidge ◽  
Anthony M. Allworth ◽  
Marion Woods ◽  
Penelope Marshall ◽  
Michael Terry ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Alkyl Benzene ◽  
Environmental Cleaning ◽  
Carbapenem Resistant ◽  
Sulphamic Acid

In the midst of an outbreak, carbapenem-resistantAcinetobacter baumanniiwas grown from samples of multiple environmental sites in an intensive care unit. A commercial oxidizing disinfectant (potassium peroxomonosulphate 50%, sodium alkyl benzene sulphonate 15%, and sulphamic acid 5%) was introduced throughout the intensive care unit, and its use coincided with cessation of the outbreak.

scholarly journals A five-component infection control bundle to permanently eliminate a carbapenem-resistant Acinetobacter baumannii spreading in an intensive care unit

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Marianna Meschiari ◽  
José-María Lòpez-Lozano ◽  
Vincenzo Di Pilato ◽  
Carola Gimenez-Esparza ◽  
Elena Vecchi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Acinetobacter Baumannii ◽  
Incidence Density ◽  
Sequencing Analysis ◽  
Primary Role ◽  
Environmental Cleaning ◽  
Contact Precautions ◽  
Carbapenem Resistant

Abstract Background Carbapenem-resistant Acinetobacter baumannii (CRAB) infection outbreaks are difficult to control and sometimes require cohorting of CRAB-positive patients or temporary ward closure for environmental cleaning. We aimed at controlling the deadly 2018 CRAB outbreak in a 12 bed- intensive care unit (ICU) including 9 beds in a 220 m2 open space. We implemented a new multimodal approach without ward closure, cohorting or temporarily limiting admissions. Methods A five-component bundle was introduced in 2018 including reinforcement of hand hygiene and sample extension of screening, application of contact precautions to all patients, enhanced environmental sampling and the one-time application of a cycling radical environmental cleaning and disinfection procedure of the entire ICU. The ICU-CRAB incidence density (ID), ICU alcohol-based hand rub consumption and antibiotic use were calculated over a period of 6 years and intervention time series analysis was performed. Whole genome sequencing analysis (WGS) was done on clinical and environmental isolates in the study period. Results From January 2013, nosocomial ICU-CRAB ID decreased from 30.4 CRAB cases per 1000 patients-days to zero cases per 1000 patients-days. Our intervention showed a significant impact (-2.9 nosocomial ICU-CRAB cases per 1000 bed-days), while no influence was observed for antibiotic and alcohol-based hand rub (AHR) consumption. WGS demonstrated that CRAB strains were clonally related to an environmental reservoir which confirms the primary role of the environment in CRAB ICU spreading. Conclusion A five-component bundle of continuous hand hygiene improvement, extended sampling at screening including the environment, universal contact precautions and a novel cycling radical environmental cleaning and disinfection procedure proved to be effective for permanently eliminating CRAB spreading within the ICU. Cohorting, admission restriction or ICU closure were avoided.

Management and control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit

2014 ◽  
Vol 44 (5) ◽  
pp. 229-231 ◽  
Author(s):  
S. Alfandari ◽  
J. Gois ◽  
P.-Y. Delannoy ◽  
H. Georges ◽  
N. Boussekey ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Carbapenem Resistant ◽  
And Control

Role of tigecycline in the control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit

2009 ◽  
Vol 72 (3) ◽  
pp. 234-242 ◽  
Author(s):  
W. Jamal ◽  
M. Salama ◽  
N. Dehrab ◽  
G. Al Hashem ◽  
M. Shahin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Carbapenem Resistant

scholarly journals Impact of environmental cleaning on the colonization and infection rates of multidrug-resistant Acinetobacter baumannii in patients within the intensive care unit in a tertiary hospital

2020 ◽  
Author(s):  
Yang Li ◽  
Hai Ge ◽  
Hui Zhou ◽  
Wanqing Zhou ◽  
Jie Zheng ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Acinetobacter Baumannii ◽  
Clearance Rate ◽  
Genetic Relatedness ◽  
Multidrug Resistant ◽  
Fluorescence Labeling ◽  
Infection Rates ◽  
Environmental Cleaning

Abstract Objective: To continuously evaluate the effect of environmental cleaning on the colonization and infection rates of multidrug-resistant Acinetobacter baumannii (MDR-AB) in the patients within an intensive care unit (ICU). Methods: Environmental cleaning on the high-touch clinical surfaces (HTCS) within a comprehensive ICU was evaluated through monitoring fluorescent marks when the overall compliance with hand hygiene during 2013-2014 was monitored. Meanwhile, samples from the HTCS and inpatients were collected and sent for bacterial culture and identification. The drug susceptibility testing was further implemented to monitor the prevalence of MDR-AB. The genetic relatedness of MDR-AB collected either from the HTCS or inpatients was analyzed by pulsed field gel electrophoresis (PFGE) when an outbreak was doubted. Results: The overall compliance with hand hygiene remained relatively stable during 2013-2014. Under this circumstance, the clearance rate of fluorescence marks on the environmental surfaces within ICUs significantly increased from 21.9% to 85.7%, and accordingly the colonization and infection rates of MDR-AB decreased from 16.5‰ to 6.6‰ and from 7.4‰ to 2.8‰, respectively, from the beginning to the end of 2013. However, during the year 2014, because of frequent change and movement of cleaning workers, the clearance rate of fluorescence marks decreased below 50%, and the overall colonization and infection rates of MDR-AB correspondingly increased from 9.1‰ to 11.1‰ and from 1.5‰ to 3.9‰, respectively. PFGE displayed a high genetic relatedness between the MDR-AB strains analyzed, indicating a dissemination of MDR-AB during the surveillance period. Conclusion. For the easily disseminated MDR-AB within ICUs , the clearance rates of fluorescence labeling on HTCS is negatively corelated with the hospital infection rates of MDR-AB. Such an invisible fluorescence labelling is an effective and convenient method to continuously monitor cleanness of medical environment within hospitals.

scholarly journals Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

2013 ◽  
Vol 18 (31) ◽  
Author(s):  
J W Decousser ◽  
C Jansen ◽  
P Nordmann ◽  
A Emirian ◽  
R A Bonnin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Index Patient ◽  
Imported Case ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene

We report the first outbreak of carbapenem-resistant NDM-1-producing Acinetobacter baumannii in Europe, in a French intensive-care unit in January to May 2013. The index patient was transferred from Algeria and led to the infection/colonisation of five additional patients. Concurrently, another imported case from Algeria was identified. The seven isolates were genetically indistinguishable, belonging to ST85. The blaNDM-1 carbapenemase gene was part of the chromosomally located composite transposon Tn125. This report underscores the growing concern about the spread of NDM-1-producing A. baumannii in Europe.

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