Methods: Between January and March of 2015, 7 hospitalized patients in the unit had urine or respiratory cultures growing MDR-ACB of 2 sensitivity patterns, labeled as “A” and “B”. The cases were identified through daily electronically distributed Isolation List. The Infection Practitioners (IPs) collected and analyzed information on each patient with culture growing MDR-ACB. Only 1 of 7 cases was a HAI, the others represented colonization. There was no identified commonality toward a room/person. The most consistent common denominator was respiratory support, either through Endotracheal Tube (2) or tracheostomy (5). The implementation of Infection Control (IC) strategies was directed and monitored by the collaborative leadership team. Surveillance cultures from tracheostomy site, as well as rectal and nasal swabs were done on admission and on day 3 of stay or later in patients on respiratory support.
Results: All patients with MDR-ACB-positive cultures were placed on contact isolation, with dedicated room equipment and cohorted nursing care. The infusion and feeding pumps and ventilators were wiped down every shift with germicidal disposable cloth. High touched surfaces were daily cleaned with 1:10 Hypochlorite solution. Hand Hygiene was closely monitored by Head Nurse and IPs. Two additional patients were identified with MDR-ACB colonization between 4/19 and 4/23. After terminal cleaning of the unit, none of the14 patients with surveillance cultures obtained on day 3 of stay in the unit, or later were positive for MDR-ACB between 4/25 and 5/25. Another 51 surveillance cultures were negative for this microorganism at the time of admission. There were no additional cases of MDR-ACB infection diagnosed.
Conclusion: Proactive containment of spread of MDR-ACB was accomplished by cohorting of care, compulsive hand hygiene and environmental cleaning, led by collaborative multidisciplinary leadership team.
S. Jahan, None
C. Kirton, None
Y. Sitnitskaya, None