Patient isolation strategies for extended spectrum beta lactamase (ESBL) carriers in medical and surgical hospital wards

Conditions

Nosocomial transmission of ESBL-producing Enterobacteriaceae Infections and Infestations

Friederike Maechler, Frank Schwab, Sonja Hansen, Michael Behnke, Marc J. M. Bonten et al. (12 authors)

Infection Control and Hospital Epidemiology2023-03-132 citations

10.1017/ice.2022.285

Contact isolation versus standard precautions to decrease acquisition of extended-spectrum β-lactamase-producing Enterobacterales in non-critical care wards: a cluster-randomised crossover trial.

Maechler F, Schwab F, Hansen S, Fankhauser C, Harbarth S, Huttner BD, Diaz-Agero C, Lopez N, Canton R, Ruiz-Garbajosa P, Blok H, Bonten MJ, Kloosterman F, Schotsman J, Cooper BS, Behnke M, Golembus J, Kola A, Gastmeier P, R-GNOSIS WP5 study group.

2020-02-1949 citations

10.1016/s1473-3099(19)30626-7

Quantifying Hospital-Acquired Carriage of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Among Patients in Dutch Hospitals

Marjolein Kluytmans-van den Bergh, Suzan P. van Mens, Manon Haverkate, Martin Bootsma, Jan Kluytmans et al. (7 authors)

Infection Control and Hospital Epidemiology2017-12-0722 citations

10.1017/ice.2017.241

Interventions

Two different interventions: 1. Contact Isolation (CI) according to Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC).

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Peripheral medical and surgical wards

Exclusion criteria

Exclusion criteria: 1. Haematological wards 2. Oncologic wards 3. Transplant wards 4. Paediatric wards

Design outcomes

Primary

Measure	Time frame
ESBL acquisition rate per 1,000 patient days. This will be measured at the end of each intervention period. Isolates will be analysed microbiologically and acquisition of ESBL-carriage will be defined as recovery of ESBL isolates from clinical and/or screening specimens >3 days after hospital admission (admission day = day 1) from patients with negative admission screening results.	—

Secondary

Measure	Time frame
1. New events of nosocomial ESBL infections: New events of nosocomial ESBL infections will be obtained by a continuous surveillance on the participating wards according to the Centers for Disease Control and Prevention (CDC) definitions for HAI. 2. Episodes of hand hygiene and use of gloves and gowns/aprons by healthcare workers during patient care: will be assessed in all participating wards for both intervention periods by novel electronic counting devices integrated into alcoholic handrub dispensers as well as by direct observations performed by trained monitors using a standardized observation procedure in months 3, 9, 16 and 22. 3. The antibiotic use of the wards will be collected monthly, preferably in defined daily dose (DDD) per 1000 patient-days. 4. Alcohol-based handrub consumption: Data of total handrub consumption on the ward will be obtained by the end of each intervention period.	—

Measure

Time frame

1. New events of nosocomial ESBL infections: New events of nosocomial ESBL infections will be obtained by a continuous surveillance on the participating wards according to the Centers for Disease Control and Prevention (CDC) definitions for HAI. 2. Episodes of hand hygiene and use of gloves and gowns/aprons by healthcare workers during patient care: will be assessed in all participating wards for both intervention periods by novel electronic counting devices integrated into alcoholic handrub dispensers as well as by direct observations performed by trained monitors using a standardized observation procedure in months 3, 9, 16 and 22. 3. The antibiotic use of the wards will be collected monthly, preferably in defined daily dose (DDD) per 1000 patient-days. 4. Alcohol-based handrub consumption: Data of total handrub consumption on the ward will be obtained by the end of each intervention period.

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Countries

Germany, Netherlands, Spain, Switzerland

Outcome results

None listed