Successful control of carbapenem-resistant Acinetobacter baumannii in a Korean university hospital: A 6-year perspective

Abstract

This study evaluated the effect of infection control interventions on the incidence of carbapenem-resistant Acinetobacter baumannii (CRAB) in a tertiary hospital over a 6-year period. Multiple interventions, including cohorting, promotion of hand hygiene, active surveillance in the intensive care units, and environmental cleaning, were implemented from 2007 through 2009 (period 1). From 2009 through 2012 (period 2), infection control programs were enhanced by the introduction of an onsite education and hand hygiene campaign in preparation for hospital accreditation. To assess the efficacy of the infection control intervention programs, the nosocomial incidence density of CRAB, consumption of alcohol-based hand gel, and consumption of antimicrobials during the study period were measured. The incidence density of CRAB increased from 0.35 to 0.46 per 1000 patient-days (PD) during period 1, but decreased to 0.06 per 1000 PD in period 2 (P = .011). The consumption of alcohol-based hand gel increased from 5.6 L to 11.9 L per 1000 PD during the study period (P < .001). There was a significant association between the incidence density of CRAB and carbapenem use (P = .008). Education for infection control programs, hand hygiene campaign, and the judicious use of carbapenem may decrease the nosocomial incidence of CRAB.