Abstract
BackgroundCarbapenemase-producing K. pneumoniae (CP-Kp) has been established as important nosocomial pathogen in most tertiary care hospitals in Greece. The aim of the present study was to examine the impact of an enhanced infection control program on the containment of CP-Kp in a haematology unit where the incidence of CP-Kp infections was high.MethodsThe study was conducted from June 2011 to December 2014 in a haematology unit of a tertiary-care 500-bed hospital located in Athens, Greece. A bundled intervention (active surveillance cultures, separation of carriers from non-carriers, assignment of dedicated nursing staff, contact precautions, environmental cleaning, and promotion of hand hygiene) was tested whether would reduce colonization and infection caused by CP-Kp.ResultsA total of 2507 rectal swabs were obtained; 1199 upon admission from June 2011 to June 2013 and 1307 during hospitalization from June 2011 to December 2012. During intervention the admission prevalence of CP-Kp colonization (p < 0.001 for linear trend), the hospitalization prevalence (p = 0.001 for linear trend) and the incidence rate of CP-Kp colonization (p = 0.072 for linear trend) were declining. Application of segmented linear regression revealed that both the change in the level of CP-Kp BSI incidence rates (p = 0.001) as well as the difference between pre- and post-intervention slopes were statistically significant (p < 0.001).ConclusionsA bundled intervention including active surveillance cultures on admission can attain maximum containment of CP-Kp colonization and infection in endemic acute healthcare settings.
Highlights
Carbapenemase-producing K. pneumoniae (CP-Kp) has been established as important nosocomial pathogen in most tertiary care hospitals in Greece
A high prevalence of CP-Kp is observed in many countries causing serious infections that are associated with prolonged hospitalization and increased morbidity and mortality [3, 4]
Infection and colonization rates by CP-Kp strains in Greek tertiary care hospitals are considered amongst the Spyridopoulou et al Antimicrobial Resistance and Infection Control (2020) 9:102 highest in Europe [3]
Summary
Carbapenemase-producing K. pneumoniae (CP-Kp) has been established as important nosocomial pathogen in most tertiary care hospitals in Greece. Infection and colonization rates by CP-Kp strains in Greek tertiary care hospitals are considered amongst the Spyridopoulou et al Antimicrobial Resistance and Infection Control (2020) 9:102 highest in Europe [3]. Recognizing the urgent need to reduce the dispersion of CP-pathogens, the Hellenic Center for Disease Control and Prevention has drawn up an action plan for the containment of infections caused by multi-drug resistant organisms in health-care facilities [8]. The basic aim of this plan is to implement enhanced infection control measures in all healthcare facilities in order to contain the spread of carbapenem resistant Klebsiella spp, Acinetobacter spp and Pseudomonas spp. The escalating shortages in human and financial resources in many of our hospitals do not allow the full and proper implementation of the required measures in a sustainable and timely fashion [9]
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