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 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

2021 ◽  
Vol 10 (1) ◽  
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 and hand hygiene compliance 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 2014, because of frequent change and movement of environmental services staff, the clearance rate of fluorescence marks decreased below 50.0%, 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 rate of fluorescence labeling on HTCS is negatively correlated with the hospital infection rate 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 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 and hand hygiene compliance 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 2014, because of frequent change and movement of environmental services staff, the clearance rate of fluorescence marks decreased below 50.0%, 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 rate of fluorescence labeling on HTCS is negatively correlated with the hospital infection rate 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 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

2019 ◽  
Author(s):  
Yang Li ◽  
Hai Ge ◽  
Hui Zhou ◽  
Wanqing Zhou ◽  
Jie Zheng ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Clearance Rate ◽  
Genetic Relatedness ◽  
Multidrug Resistant ◽  
Infection Rates ◽  
Surveillance Period ◽  
Frequent Change ◽  
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 a intensive care unit (ICU). Methods: Environmental cleaning on the high-touch clinical surfaces (HTCS) within a comprehensive ICU was evaluated through monitoring fluorescent marks. In the meanwhile, samples from the HTCS and inpatient 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 inpatient was analyzed by pulsed field gel electrophoresis (PFGE) when an outbreak was doubted. Results: From the beginning to the end of 2013, 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 7.4‰ to 2.8‰, respectively. 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‰, 1.5‰ to 3.9‰, respectively. PFGE displayed a genetic relatedness between the MDR-AB strains analyzed, indicating a dissemination of MDR-AB during the surveillance period. Conclusion: For MDR-AB, both the colonization rates and the infection rates of the patients within ICUs can be directly influenced by environmental cleaning, and the bad environmental cleaning may result in MDR-AB outbreak. The invisible fluorescence labelling is an effective and convenient method to continuously monitor environmental cleaning within hospitals.

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.

scholarly journals Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience

2021 ◽  
Vol 9 ◽  
pp. 205031212110011
Author(s):  
Thabit Alotaibi ◽  
Abdulrhman Abuhaimed ◽  
Mohammed Alshahrani ◽  
Ahmed Albdelhady ◽  
Yousef Almubarak ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Acinetobacter Baumannii ◽  
Care Setting ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Published Data ◽  
Tertiary Teaching ◽  
The Mean

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.

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