Educational intervention to improve infection prevention and control practices in four companion animal clinics in Switzerland

Abstract

Infection prevention and control (IPC) practices vary among companion animal clinics and outbreaks with carbapenemase-producing Enterobacterales (CPE) have been described. This study investigates the effect of an IPC intervention (introduction of IPC protocols, IPC lectures, hand hygiene campaign) in four companion animal clinics. IPC practices, environmental and hand contamination with antimicrobial-resistant microorganisms (ARM) and hand hygiene (HH) were assessed at baseline and one and five months after intervention. IPC scores (% maximum score) improved from (median, range) 57.8% (48.0-59.8%) to 82.9% (81.4-86.3%) one month after intervention. Cleaning frequency assessed by fluorescent tagging increased from (median, range) 16.7% (8.9-18.9%) to 30.6% (27.8-52.2%) one months and 32.8% (32.2-33.3%) five months after intervention. ARM contamination was low in three clinics at baseline and undetectable after intervention. One clinic showed extensive contamination with ARM including CPE before and after intervention (7.5-15.5% ARM-positive and 5.0-11.5% CPE-positive samples). Mean HH compliance [95% CI] improved from 20.9% [19.2-22.8%] to 42.5% [40.4-44.7%] one and 38.7% [35.7-41.7%] five months after intervention. Compliance was lowest in the pre-operating preparation area at baseline (11.8% [9.3-14.8%]) and in the ICU after intervention (28.8% [23.3-35.1%]). HH compliance was similar in veterinarians (21.5% [19.0-24.3%]) and nurses (20.2% [17.9-22.7%]) at baseline but higher in veterinarians (46.0% [42.9-49.1%]) than nurses (39.0% [36.0-42.1%]) one month after intervention. The IPC intervention improved IPC scores, cleaning frequency and HH compliance in all clinics. Adapted approaches might be needed in outbreak situations.