Epidemiological surveillance of multidrug‐resistant gram‐negative bacteria in a solid organ transplantation department

• Published in: Transplant infectious disease 2017-06, Vol.19 (3), p.n/a
• Main Authors: Geladari, Anastasia, Karampatakis, Theodoros, Antachopoulos, Charalampos, Iosifidis, Elias, Tsiatsiou, Olga, Politi, Lida, Karyoti, Aggeliki, Papanikolaou, Vasilios, Tsakris, Athanassios, Roilides, Emmanuel
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii; Acinetobacter baumannii - isolation & purification; Acinetobacter baumannii - physiology; active surveillance; Bacteria; Bundling; Carbapenems - pharmacology; Carbapenems - therapeutic use; carbapenem‐resistant gram‐negative bacteria; Cleaning; Colonization; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Drug Resistance, Multiple, Bacterial; Education; Environmental monitoring; Epidemiological Monitoring; Epidemiology; Gram-negative bacteria; Guideline Adherence; Health care; Humans; Hygiene; Incidence; infection control; Infection Control - methods; Infections; Intervention; Klebsiella; Klebsiella pneumoniae; Klebsiella pneumoniae - isolation & purification; Klebsiella pneumoniae - physiology; Medical personnel; Multidrug resistance; Multidrug resistant organisms; Non-Randomized Controlled Trials as Topic; Organ Transplantation - adverse effects; Pathogens; Personal hygiene; Pneumonia; Practice Guidelines as Topic; Prospective Studies; Pseudomonas; Pseudomonas aeruginosa; Pseudomonas aeruginosa - isolation & purification; Pseudomonas aeruginosa - physiology; Retrospective Studies; solid organ transplantation; Surveillance; Transplantation
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/tid.12686

Background We assessed the impact of intensified infection control measures (ICM) on colonization and infection caused by carbapenem‐resistant (CR) Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii in a solid organ transplantation (SOT) department. Methods A quasi‐experimental methodology was followed. The study was divided into three periods: pre‐intervention, intervention with implementation of an ICM bundle including active surveillance program (ASP) and gradually enhanced measures, and post‐ASP without ASP. The bundle included active surveillance cultures, contact precautions, hand hygiene, education of health care workers (HCWs), monitoring of compliance, and environmental cleaning. Incidence of colonization and infection caused by CR gram‐negative bacteria was recorded. Molecular analysis of CR bacteria was performed for a certain period. Results During the intervention, incidence of colonization reduced from 19% to 9% (P