OPEN IN READ APP
JOURNAL ARTICLE

A multifaceted intervention to reduce pandrug-resistant Acinetobacter baumannii colonization and infection in 3 intensive care units in a Thai tertiary care center: a 3-year study

Anucha Apisarnthanarak, Uayporn Pinitchai, Kanokporn Thongphubeth, Chananart Yuekyen, David K Warren, Victoria J Fraser et al.
Clinical Infectious Diseases 2008 September 15, 47 (6): 760-7
18684100

BACKGROUND: We sought to determine the long-term effect of a multifaceted infection-control intervention to reduce the incidence of pandrug-resistant Acinetobacter baumannii infection in a Thai tertiary care center.

METHODS: A 3-year, prospective, controlled, quasi-experimental study was conducted in medical intensive care, surgical intensive care, and coronary care units for a 1-year period before intervention (period 1), a 1-year period after intervention (period 2), and a 1-year follow-up period (period 3). The interventions in period 2 included strictly implementing contact isolation precautions and appropriate hand hygiene, active surveillance, cohorting patients who were colonized or infected with pandrug-resistant A. baumannii, and environmental cleaning with 1:100 sodium hypochlorite solution. All interventions were continued in period 3, but environmental cleaning solutions were changed to detergent and phenolic agents.

RESULTS: Before the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection was 3.6 cases per 1000 patient-days. After the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection decreased by 66% in period 2 (to 1.2 cases per 1000 patient-days; P < .001) and by 76% in period 3 (to 0.85 cases per 1000 patient-days; P < .001). The monthly hospital antibiotic cost of treating pandrug-resistant A. baumannii colonization and/or infection and the hospitalization cost for each patient in the intervention units were also reduced by 36%-42% (P < .001) and 25%-36% (P < .001), respectively, during periods 2 and 3.

CONCLUSIONS: A multifaceted intervention featuring active surveillance and environmental cleaning resulted in sustained reductions in the rate of pandrug-resistant A. baumannii colonization and infection, the cost of antibiotic therapy, and the cost of hospitalization among intensive care unit patients in a developing country.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
18684100
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"