Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience
Background: A widely-accepted standardized preventive bundle targeting multidrug-resistant organisms (MDROs) is lacking. The objective was to describe the components, implementation, compliance, and impact of a novel MDROs bundle in intensive care units (ICUs). Methods: Cohort study of surveillance...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024041033 |
| _version_ | 1797248260169007104 |
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| author | Majid M. Alshamrani Aiman El-Saed Mohammed Al Zunitan Mohammed Abalkhail Doris Abagguey Fayssal M. Farahat |
| author_facet | Majid M. Alshamrani Aiman El-Saed Mohammed Al Zunitan Mohammed Abalkhail Doris Abagguey Fayssal M. Farahat |
| author_sort | Majid M. Alshamrani |
| collection | DOAJ |
| description | Background: A widely-accepted standardized preventive bundle targeting multidrug-resistant organisms (MDROs) is lacking. The objective was to describe the components, implementation, compliance, and impact of a novel MDROs bundle in intensive care units (ICUs). Methods: Cohort study of surveillance activities on the components of MDROs bundle (July 2019 to June 2022) and the incidence of MDROs (April 2016 to June 2022). The implementation of MDROs bundle were preceded by ICPs-led education of the staff working in target ICUs about the importance and components of the MDROs bundle. These included the overall use of antimicrobials, appropriate environmental cleaning, appropriate contact precautions, and hand hygiene compliance. Results: During implementation, the overall use of antimicrobials was 57.8 days of therapy per 100 patient-days (44,492/76,933). It was higher in adult compared with pediatric/neonatal ICUs (p < 0.001). Appropriate environmental cleaning was 74.8% (12,409/16,582), appropriate contact precautions was 83.8% (10,467/12,497), and hand hygiene compliance was 86.9% (27,023/31,096). The three components were significantly higher in pediatric/neonatal compared with adult ICUs (p = 0.027, p < 0.001, p = 0.006, respectively). The MDROs rates per 10,000 patient-days were 71.8 before (April 2016 to June 2019) and 62.0 during (July 2019 to June 2022) the bundle implementation (858/119,565 versus 891/143,649 p = 0.002). The reduction in MDROs rates were replicated in adult (p = 0.001) but not pediatric/neonatal ICUs (p = 0.530). Conclusions: The finding of this study indicate that the implementation of the current bundle was associated with a modest decrease in MDROs rates in adult ICUs. The provided detailed definitions and methodology will facilitate its use by other healthcare facilities. |
| first_indexed | 2024-04-24T20:11:45Z |
| format | Article |
| id | doaj.art-214e7c802499490888cd564e153756c6 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T20:11:45Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-214e7c802499490888cd564e153756c62024-03-23T06:25:18ZengElsevierHeliyon2405-84402024-04-01107e28072Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experienceMajid M. Alshamrani0Aiman El-Saed1Mohammed Al Zunitan2Mohammed Abalkhail3Doris Abagguey4Fayssal M. Farahat5Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Corresponding author. Infection Prevention and Control, King Abdualziz Medical city , Adult Infectious Disease, King Saud bin Abdulaziz University for Health Sciences Riyadh, Saudi ArabiaP.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia.Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, EgyptInfection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Infection Prevention and Control Department, King Abdullah Specialist Children Hospital, Riyadh, Saudi ArabiaInfection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi ArabiaInfection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaBackground: A widely-accepted standardized preventive bundle targeting multidrug-resistant organisms (MDROs) is lacking. The objective was to describe the components, implementation, compliance, and impact of a novel MDROs bundle in intensive care units (ICUs). Methods: Cohort study of surveillance activities on the components of MDROs bundle (July 2019 to June 2022) and the incidence of MDROs (April 2016 to June 2022). The implementation of MDROs bundle were preceded by ICPs-led education of the staff working in target ICUs about the importance and components of the MDROs bundle. These included the overall use of antimicrobials, appropriate environmental cleaning, appropriate contact precautions, and hand hygiene compliance. Results: During implementation, the overall use of antimicrobials was 57.8 days of therapy per 100 patient-days (44,492/76,933). It was higher in adult compared with pediatric/neonatal ICUs (p < 0.001). Appropriate environmental cleaning was 74.8% (12,409/16,582), appropriate contact precautions was 83.8% (10,467/12,497), and hand hygiene compliance was 86.9% (27,023/31,096). The three components were significantly higher in pediatric/neonatal compared with adult ICUs (p = 0.027, p < 0.001, p = 0.006, respectively). The MDROs rates per 10,000 patient-days were 71.8 before (April 2016 to June 2019) and 62.0 during (July 2019 to June 2022) the bundle implementation (858/119,565 versus 891/143,649 p = 0.002). The reduction in MDROs rates were replicated in adult (p = 0.001) but not pediatric/neonatal ICUs (p = 0.530). Conclusions: The finding of this study indicate that the implementation of the current bundle was associated with a modest decrease in MDROs rates in adult ICUs. The provided detailed definitions and methodology will facilitate its use by other healthcare facilities.http://www.sciencedirect.com/science/article/pii/S2405844024041033BundleMultidrug-resistant organismsAntimicrobial useEnvironmental cleaningContact isolationHand hygiene |
| spellingShingle | Majid M. Alshamrani Aiman El-Saed Mohammed Al Zunitan Mohammed Abalkhail Doris Abagguey Fayssal M. Farahat Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience Heliyon Bundle Multidrug-resistant organisms Antimicrobial use Environmental cleaning Contact isolation Hand hygiene |
| title | Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience |
| title_full | Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience |
| title_fullStr | Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience |
| title_full_unstemmed | Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience |
| title_short | Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience |
| title_sort | novel preventive bundle for multidrug resistant organisms in intensive care setting tertiary care experience |
| topic | Bundle Multidrug-resistant organisms Antimicrobial use Environmental cleaning Contact isolation Hand hygiene |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024041033 |
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