Wall painting following terminal cleaning with a chlorine solution as part of an intervention to control an outbreak of carbapenem-resistant Acinetobacter baumannii in a neurosurgical intensive care unit in Israel

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2021-10, Vol.27 (10), p.1423-1428
• Main Authors: Dickstein, Yaakov, Eluk, Orna, Warman, Sigal, Aboalheja, Worood, Alon, Tamar, Firan, Ibrahim, Putler, Rosemary K.B., Hussein, Khetam
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii; Carbapenem-resistant enterobacteriaceae (CRE); Intensive care unit (ICU); Outbreak; Paint; Wall
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2021.05.017

To describe the use of wall painting as part of an intervention to control an outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB). An interrupted time-series analysis was performed analyzing an intervention in a neurosurgical intensive care unit (NSICU) and an inpatient hematology department in a tertiary level medical center in Israel. The intervention involved wall painting using a water based acrylic paint following patient discharge and terminal cleaning with sodium troclosene as part of an infection control bundle for an outbreak of CRAB in a NSICU and concurrent outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) colonization/infection in the same NSICU and the hematology department. Between January 2013 and December 2018, 122 patients hospitalized in the NSICU were identified with new CRAB colonization/infection. The median incidence in the periods prior to/post intervention were 2.24/1000 HD (interquartile range [IQR] 0.84–2.90/1000) vs. 0/1000 HD (IQR 0–0.49/1000), respectively. Poisson regression indicated a decrease of 92% in the CRAB incidence following the intervention onset (relative risk [RR] 0.080, 95% confidence interval [CI] 0.037–0.174, p