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Background@#Multidrug- resistant organisms (MDRO) are a serious concern in healthcareassociated infections. Hand hygiene (HH) is essential to prevent the spread of MDRO in the healthcare institutes. The aim of this study was to investigate the relationship between the incidence of MDRO and hand hygiene compliance and the experimental effectiveness of alcohol-gel hand hygiene practice. @*Methods@#From March 2016 to September 2018, we analyzed the cross-correlation between the incidence of MDRO and the HH compliance each month at Gyeongsang National University Changwon Hospital. We employed an experiment to observe the effect of alcohol gel hand hygiene practice on the reduction of organisms on the hand surface using the handagar plates. @*Results@#Among the MDRO, only vancomycin-resistant enterococci (VRE) showed a moderate correlation with the HH rate (r = 0.55). The hand-agar plate experiment showed a significant bacterial reduction for inadequate HH (mean 3.47 CFU) and optimal HH (mean, 0.84 CFU) than before HH (mean, 11.56 CFU) (n = 32, P = 0.006). @*Conclusion@#The incidence of VRE showed a moderate correlation with HH among MDRO in the longitudinal analysis. HH practice was more effective in preventing the spread of VRE compared with other MDRO in our institute. Optimal alcohol-gel HH practice can effectively remove bacteria on the hand surface.
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Background@#Multidrug- resistant organisms (MDRO) are a serious concern in healthcareassociated infections. Hand hygiene (HH) is essential to prevent the spread of MDRO in the healthcare institutes. The aim of this study was to investigate the relationship between the incidence of MDRO and hand hygiene compliance and the experimental effectiveness of alcohol-gel hand hygiene practice. @*Methods@#From March 2016 to September 2018, we analyzed the cross-correlation between the incidence of MDRO and the HH compliance each month at Gyeongsang National University Changwon Hospital. We employed an experiment to observe the effect of alcohol gel hand hygiene practice on the reduction of organisms on the hand surface using the handagar plates. @*Results@#Among the MDRO, only vancomycin-resistant enterococci (VRE) showed a moderate correlation with the HH rate (r = 0.55). The hand-agar plate experiment showed a significant bacterial reduction for inadequate HH (mean 3.47 CFU) and optimal HH (mean, 0.84 CFU) than before HH (mean, 11.56 CFU) (n = 32, P = 0.006). @*Conclusion@#The incidence of VRE showed a moderate correlation with HH among MDRO in the longitudinal analysis. HH practice was more effective in preventing the spread of VRE compared with other MDRO in our institute. Optimal alcohol-gel HH practice can effectively remove bacteria on the hand surface.
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BACKGROUND/AIMS: We evaluated the effects of a multifaceted intervention for controlling a carbapenem-resistant Acinetobacter baumannii (CRAB) epidemic in an intensive care unit (ICU) with no restrictions on carbapenem use. METHODS: This study was conducted in a medical ICU between April 2012 and June 2016. The baseline infection control programs included surveillance cultures, contact precautions, and environmental cleaning. However, increases in the detection of CRAB isolates beginning in May 2013 led to the implementation of a new protocol, consisting of universal glove and gown use with daily chlorhexidine bathing for all patients in combination with baseline programs. The efficacy of the intervention was subjected to interrupted time series (ITS) analysis. RESULTS: The multifaceted intervention led to a decrease in the incidence of CRAB from 17.65 to 0.89 cases per 1,000 patient-days, during the study period (p < 0.001). ITS analysis revealed a significant change in the trend of CRAB incidence (–0.413, p < 0.001). Over this same period, mean monthly use of carbapenems increased from 143.54 ± 95.73 to 204.95 ± 78.43 doses per 1,000 patient-days (p = 0.018). CONCLUSIONS: Our multifaceted intervention reduced the incidence of CRAB acquisition in an ICU where carbapenem use was not restricted.
Assuntos
Humanos , Acinetobacter baumannii , Acinetobacter , Banhos , Carbapenêmicos , Clorexidina , Cuidados Críticos , Farmacorresistência Bacteriana , Incidência , Controle de Infecções , Unidades de Terapia Intensiva , Análise de Séries Temporais InterrompidaRESUMO
BACKGROUND: We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB). METHODS: Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB. RESULTS: After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17+/-6.80 and 19.5+/-7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB. CONCLUSION: This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.