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J Hosp Infect. 2022;121:14-21.

Reduction in the acquisition rate of carbapenem-resistant Acinetobacter baumannii (CRAB) after room privatization in an intensive care unit.

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제1저자 정종탁 · 교신저자 최평균

소속 (5)
  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control and Prevention, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: draver@snu.ac.kr.
  3. Center for Infection Control and Prevention, Seoul National University Hospital, Seoul, Republic of Korea.
  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control and Prevention, Seoul National University Hospital, Seoul, Republic of Korea.
  5. Center for Infection Control and Prevention, Seoul National University Hospital, Seoul, Republic of Korea; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.

Abstract

BACKGROUND Acinetobacter baumannii is one of the major pathogens responsible for healthcare-associated infections, especially in intensive care units (ICUs).

AIM To evaluate the effect of room privatization in an ICU on the acquisition of carbapenem-resistant A. baumannii (CRAB).

METHODS Between March and August 2017, a medical ICU was renovated from a multi-bed bay room to single rooms. Acquisition of CRAB was compared between patients admitted to the ICU over 18 months pre-renovation (September 2015 to February 2017) and post-renovation (September 2017 to February 2019). A Cox proportional hazard model was used with adjustment for demographics and comorbidities.

FINDINGS Of the 901 patients, who contributed 8276 patient-days, 95 (10.5%) acquired CRAB during their ICU stay. The CRAB acquisition rate was significantly higher during the pre-renovation period (1.87 per 100 patient-days) than during the post-renovation period (0.39 per 100 patient-days) (P<0.001). In the multi-variable Cox regression model, CRAB acquisition was significantly associated with the presence of a feeding tube (adjusted hazard ratio (aHR), 6.08; 95% confidence interval (CI), 2.46-15.06; P<0.001), continuous renal replacement therapy (aHR, 1.66; 95% CI, 1.09-2.53; P=0.019) and admission after renovation of the ICU to single rooms (aHR, 0.23; 95% CI, 0.12-0.41; P<0.001).

CONCLUSIONS Renovation of ICUs to single rooms is an efficient strategy to prevent transmission of multi-drug-resistant organisms and hospital-acquired infections.

Copyright © 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Keywords

Acinetobacter baumanniiICUInfection controlMulti-drug resistance

그 밖의 정보
출판 형태
Journal Article
저널
The Journal of hospital infection · eISSN 1532-2939
전자 출판
2021-12-17
MeSH
Acinetobacter Infections* / drug therapy / epidemiology / prevention & control · Acinetobacter baumannii* · Anti-Bacterial Agents / pharmacology / therapeutic use · Carbapenems / pharmacology · Cross Infection* / drug therapy / epidemiology / prevention & control · Humans · Intensive Care Units · Privatization
Substances
Anti-Bacterial Agents · Carbapenems