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Association of Private Isolation Rooms with Ventilator-Associated Acinetobacter baumanii Pneumonia in a Surgical Intensive-Care Unit

Published online by Cambridge University Press:  02 January 2015

Blandine Mulin ,
Claude Rouget ,
Charles Clément ,
Pascale Bailly ,
Maríe-Christine Julliot ,
Jean-Françon F. Viel ,
Michelle Thouverez ,
Isabelle Vieille ,
Françon Barale  and
Daniel Talon
Blandine Mulin
Affiliation:
Unité d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Claude Rouget
Affiliation:
Service de Réanimation, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Charles Clément
Affiliation:
Service de Réanimation, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Pascale Bailly
Affiliation:
Unité d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Maríe-Christine Julliot
Affiliation:
Service de Réanimation, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Jean-Françon F. Viel
Affiliation:
Département de Santé Publique, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Michelle Thouverez
Affiliation:
Unité d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Isabelle Vieille
Affiliation:
Unité d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Françon Barale
Affiliation:
Service de Réanimation, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
Daniel Talon*
Affiliation:
Unité d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, Hôpital Jean Minjoz, Faculté de Médecine, 25030 Besançon, France
*
Laboratoire de Bactériologie-Hygiène, Hôpital Jean Minjoz, 25030 Besançon, Françe
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Abstract

Objective:

To determine the rates and routes of Acinetobacter baumanii colonization and pneumonia among ventilated patients in a surgical intensive-care unit (SICU) before and after architectural modifications.

Design:

A nonsequential study comparing two groups of patients. All isolates from systematic and clinical samples were genotyped by pulsed-field gel electrophoresis (PFGE). Records of patients hospitalized during the first and second periods were reviewed and findings were compared. Between the two periods, the SICU was remodeled from enclosed isolation rooms and open rooms to only enclosed isolation rooms with handwashing facilities in each room.

Setting and Patients:

All patients hospitalized and mechanically ventilated for more than 48 hours in the 15-bed SICU of the University Hospital of Besançon (France).

Results:

For the first and second periods, the rates of colonization were, respectively, 28.1% and 5.0% of patients (P<10−7; relative risk [RR], 2.23; 95% confidence interval [CI95], 1.8-2.75) and the specific rates of bronchopulmonary (BP) colonization were, respectively, 9.1 and 0.5 per 1,000 days of mechanical ventilation (P<10−5). Seven major PFGE isolate types were identified, 4 of which were isolated from 44 of the 47 colonized or infected patients. Logistic regression analysis showed that colonization was not associated with patient characteristics.

Conclusion:

Conversion from open rooms to isolation rooms may help control nosocomial BP tract acquisition of A baumanii in mechanically ventilated patients hospitalized in an SICU.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 7 , July 1997 , pp. 499 - 503
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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