Control of Simultaneous Outbreaks of Carbapenemase-Producing Enterobacteriaceae and Extensively Drug-ResistantAcinetobacter baumanniiInfection in an Intensive Care Unit Using Interventions Promoted in the Centers for Disease Control and Prevention 2012 Carbapenemase-Resistant Enterobacteriaceae Toolkit

2014 ◽  
Vol 35 (7) ◽  
pp. 810-817 ◽  
Author(s):  
Kyle B. Enfield ◽  
Nujhat N. Huq ◽  
Megan F. Gosseling ◽  
Darla J. Low ◽  
Kevin C. Hazen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Disease Control ◽  
Control Measures ◽  
Surgical Trauma ◽  
Infection Control Measures ◽  
Resistance Plasmids ◽  
Centers For Disease Control ◽  
The Impact

ObjectiveWe describe the efficacy of enhanced infection control measures, including those recommended in the Centers for Disease Control and Prevention’s 2012 carbapenem-resistant Enterobacteriaceae (CRE) toolkit, to control concurrent outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) and extensively drug-resistantAcinetobacter baumannii(XDR-AB).DesignBefore-after intervention study.SettingFifteen-bed surgical trauma intensive care unit (ICU).MethodsWe investigated the impact of enhanced infection control measures in response to clusters of CPE and XDR-AB infections in an ICU from April 2009 to March 2010. Polymerase chain reaction was used to detect the presence ofblaKPCand resistance plasmids in CRE. Pulsed-field gel electrophoresis was performed to assess XDR-AB clonality. Enhanced infection-control measures were implemented in response to ongoing transmission of CPE and a new outbreak of XDR-AB. Efficacy was evaluated by comparing the incidence rate (IR) of CPE and XDR-AB before and after the implementation of these measures.ResultsThe IR of CPE for the 12 months before the implementation of enhanced measures was 7.77 cases per 1,000 patient-days, whereas the IR of XDR-AB for the 3 months before implementation was 6.79 cases per 1,000 patient-days. All examined CPE shared endemicblaKPCresistance plasmids, and 6 of the 7 XDR-AB isolates were clonal. Following institution of enhanced infection control measures, the CPE IR decreased to 1.22 cases per 1,000 patient-days (P= .001), and no more cases of XDR-AB were identified.ConclusionsUse of infection control measures described in the Centers for Disease Control and Prevention’s 2012 CRE toolkit was associated with a reduction in the IR of CPE and an interruption in XDR-AB transmission.

Exogenous Sources ofPseudomonas aeruginosain Intensive Care Unit Patients Implementation of Infection Control Measures and Follow-Up With Molecular Typing

2006 ◽  
Vol 27 (9) ◽  
pp. 953-957 ◽  
Author(s):  
Christiane Petignat ◽  
Patrick Francioli ◽  
Immaculée Nahimana ◽  
Aline Wenger ◽  
Jacques Bille ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Pfge Pattern ◽  
Control Measures ◽  
Icu Patients ◽  
Infection Control Measures ◽  
Exogenous Origin

Background.In 1998, a study in the intensive care unit (ICU) of our institution suggested possible transmission of Pseudomonas aeruginosa from faucet to patient and from patient to patient. Infection-control measures were implemented to reduce the degree ofP. aeruginosacolonization in faucets, to reduce the use of faucet water in certain patient care procedures, and to reduce the rate of transmission from patient to patient.Objective.To evaluate the effect of the control measures instituted in 1999 to preventP. aeruginosainfection and colonization in ICU patients.Design.Prospective, molecular, epidemiological investigation.Setting.A 870-bed, university-affiliated, tertiary care teaching hospital.Methods.The investigation was performed in a manner identical to the 1998 investigation. ICU patients with a clinical specimen positive forP. aeruginosawere identified prospectively. Swab specimens from the inner part of the ICU faucets were obtained for the culture on 9 occasions between September 1997 and December 2000. All patients and environmental isolates were typed by pulsed-field gel electrophoresis (PFGE).Results.Compared with the 1998 study, in 2000 we found that the annual incidence of ICU patients colonized or infected withP. aeruginosahad decreased by half (26.6 patients per 1,000 admissions in 2000 vs 59.0 patients per 1,000 admissions in 1998), although the populations of patients were comparable. This decrease was the result of the decreased incidence of cases in which an isolate had a PFGE pattern identical to that of an isolate from a faucet (7.0 cases per 1,000 admissions in 2000, vs 23.6 per 1,000 admissions in 1998) or from another patient (6.5 cases per 1,000 admissions in 2000 vs 16.5 cases per 1,000 admissions in 1998), whereas the incidence of cases in which the isolate had a unique PFGE pattern remained nearly unchanged (13.1 cases per 1,000 admissions in 2000 vs 15.6 cases per 1,000 admissions in 1998).Conclusions.These results suggest that infection control measures were effective in decreasing the rate ofP. aeruginosacolonization and infection in ICU patients, confirming thatP. aeruginosastrains were of exogenous origin in a substantial proportion of patients during the preintervention period.

Statins and Perioperative Cardiac Complications

2018 ◽  
pp. 60-64
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Strong Evidence ◽  
Substantial Reduction ◽  
Bloodstream Infections ◽  
Control Measures ◽  
Cardiac Complications ◽  
Infection Control Measures ◽  
Safety Initiative

This case focuses on reducing catheter-related bloodstream infections in the intensive care unit (ICU) by asking the question: Can rates of catheter-related bloodstream infections be reduced by implementing a safety initiative involving five simple infection-control measures by ICU staff? Implementation of a safety initiative involving five simple infection-control measures by ICU staff was associated with a substantial reduction in catheter-related bloodstream infections. While it is not certain that the safety initiative—rather than other factors—was responsible for the observed reduction, the study provides strong evidence that this safety initiative should be implemented widely.

scholarly journals Effects of infection control measures on acquisition of five antimicrobial drug-resistant microorganisms in a tetanus intensive care unit in Vietnam

2013 ◽  
Vol 39 (4) ◽  
pp. 661-671 ◽  
Author(s):  
Constance Schultsz ◽  
Martinus C. J. Bootsma ◽  
Huynh T. Loan ◽  
Tran T. T. Nga ◽  
Le T. P. Thao ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Antimicrobial Drug ◽  
Control Measures ◽  
Drug Resistant ◽  
Infection Control Measures

Completely Resistant Acinetobacter baumannii Strains

2002 ◽  
Vol 23 (8) ◽  
pp. 477-479 ◽  
Author(s):  
Siham Mahgoub ◽  
Jimi Ahmed ◽  
Aaron E. Glatt
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Acinetobacter Baumannii ◽  
Broad Spectrum ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Control Measures ◽  
Teaching Hospitals ◽  
Infection Control Measures

Abstract Nosocomially acquired completely resistant Acinetobacter baumannii strains are a major clinical concern. We identified completely resistant A. baumannii in 6 (4.9%) of 122 A. baumannii isolates in a retrospective chart review at two teaching hospitals. All of these patients had received broad-spectrum antibiotics and had severe underlying comorbid illnesses, long hospitalizations, or recent surgical procedures; 3 had been in the intensive care unit. Five (83%) of the 6 patients were older than 70 years. Only one death occurred. Strict infection control measures may limit further spread.

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