Carbapenem-Resistant Enterobacteriaceae on a Cardiac Surgery ICU: Successful Measures for Infection Control

• Published in: The Journal of hospital infection 2016
• Main Authors: Abboud, Cely S., MD, de Souza, Ercilia E, Zandonadi, Eliana C, Borges, Luciana S, Miglioli, Lisia, Monaco, Fernanda C, Barbosa, Vera Lucia, Cortez, Doralice, Bianco, Antonio Carlos, Braz, Andrea, Monteiro, Jussimara
• Format: Article
• Language: English
• Subjects: Infectious Disease
• ISSN: 0195-6701
• DOI: 10.1016/j.jhin.2016.06.010

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) cause surgical site infections on the intensive care unit (ICU). The aim of this study was to evaluate the impact of the intervention and control measures to reduce the rates of colonization and infection of patients by CRE on the ICU of a cardiac surgery hospital after a CRE outbreak. Methods An observational study of the pre- and post-intervention status of a cohort of colonized or infected patients in the postoperative adult cardiac surgery ICU was performed between April 2013 and December 2014. In addition to usual measures of screening and cohort nursing, the control bundle was enhanced during the interventional period by providing alcohol gel at bedside, daily bathing with no-rinse 2% chlorhexidine-impregnated wash cloths and the disinfection of surfaces around the patient three times a day. Results In the post-intervention period we observed a significant reduction in the rate of CRE colonization in patients ( P < 0.001), of primary central line-associated bloodstream infection (CLABSI) ( P < 0.002) and of surgical site infection (SSI) with CRE ( P < 0.003). Conclusion The implemented measures were effective in controlling colonization and infection with CRE on the cardiac surgery ICU.