Journal Article

A Multifaceted Intervention to Reduce Pandrug-Resistant <i>Acinetobacter baumannii</i> 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 and Victoria J. Fraser

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 47, issue 6, pages 760-767
Published in print September 2008 | ISSN: 1058-4838
Published online September 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/591134
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

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

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.

Journal Article.  4622 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.