We aim to compare the impact of open vs close layout ICU in the differential degree of air and environmental surfaces contamination among patients (pts) with carbapenem-resistant Acinetobacter baumannii (CRAB).
This study was performed at a large hospital in Miami in 6 adult ICUs, 3 with an open layout and 3 with single rooms. Units with open layout were TICU (one large 8-bed pod and four 4-bed pods), SICU A (five 4-bed pods), and MICU A (four 4-bed pods and two 2-bed pods). Close units include MICU B, SICU B, and NSICU with 8, 20 and 24 single rooms respectively.
All consecutive adult ICU pts detected to have CRAB on clinical or surveillance cultures (rectal cultures, and if intubated-tracheal cultures) were included. Air and environmental samples were obtained daily for up to 10 consecutive days or until unit discharge. Air was sampled using open blood agar plates (exchanged daily) placed above their headboards (2-ft from roof-tiles). Environmental surfaces sampled included bed rails, bedside tables, ventilator panels, and intravenous pumps. Sterile Q-tips used to swab blood agar plates and environmental surfaces were placed in 2mL TSB, incubated overnight, and then plated on MacConkey. Organisms were identified based on colony color and morphology. Final identification was done by Vitek II. Carbapenem susceptibility for AB was checked using meropenem disks, and results were interpreted based on CLSI criteria.
During 5-months, 28 CRAB+ pts were identified, 15 in open layout ICU and 13 in closed layout ICUs. In the open ICUs, 22 (19%) out of the 116 air samples grew CRAB. In the closed ICUs, 16 (18.4%) out of the 87 air samples tested grew CRAB (p=0.91). Regarding environmental surfaces, the percentages of positive samples were 10.6% for open layout ICU, compared to 12.8% for closed layout ICUs (p=0.91).
Contamination of the ambient air and environmental surfaces with CRAB seems to be similar between patients admitted to open and closed layout ICUs.
A. Berbel Caban, None
M. Sfeir, None
M. X. Bueno, None
D. Depascale, None
T. Cleary, None
Y. Doi, Shionogi: Scientific Advisor , Consulting fee
Merck: Investigator , Research grant
Melinta: Consultant , Consulting fee
L. S. Munoz-Price, None