Antibiotic Resistant Infection
Conditions
Brief summary
1. Objective of study The purpose of this study was to investigate whether the active surveillance and preemptive isolation of multidrug-resistant Gram-negative bacteria in the intensive care unit affected the reduction of the rate of acquisition of multidrug- resistant Gram-negative bacteria (MDRGNB). 2. Background Treatment option for MDRGNB (Carbapenem-resistant P. aeruginosa, Carbapenem-resistant A. baumannii, Carbapenem-resistant Enterobacteriaceae) is limited. Development of infection due to MDRGNB is common in ICU. Strategy to prevent transmission of MDRGNB is needed, and there is two approaches; First, antimicrobial stewardship program, and second, infection control strategy.The investigators aimed to figure out the role of active surveillance test and preemptive isolation of MDRGNB in reduction of acquisition rate of MDRGNB. 3. Methods Pragmatic cluster randomized, crossover, controlled trial During first period (6 months), intervention group (randomized 3 ICUs) perform daily chlorhexidine bathing, active surveillance test and preemptive isolation and contact precaution. Control group (randomized 3 ICUs) perform standard precaution with daily chlorhexidine bathing, and start contact precaution when clinical isolates reveals MDRGNB. After 1 month washout period, intervention group and control group cross over for next 6 months.
Interventions
OTHERActive surveillance and preemptive isolation
Active surveillance test and preemptive isolation is performed. If MDRO is isolated in surveillance test, contact precaution is needed.
OTHERControl
No active surveillance and preemptive isolation. If clinical isolates are positive for MDRGNB, start contact precaution
Sponsors
Sung-Han Kim
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* Enroll all patients who admit to the ICUs during the study period
Exclusion criteria
* Patients who discharge within 2 days after admission to ICUs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The number of patients who acquired MDRGNB in ICU per 1000 patient-days | through study completion, an average 6 months | The number of patients who acquired MDRGNB in ICU per 1000 patient-days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of bloodstream infection due to MDRGNB | through study completion, an average 6 months | Rate of bloodstream infection due to MDRGNB |
| Hand hygiene compliance rates (%) of healthcare workers | through study completion, an average 1 year | number of Hand hygiene compliance/number of opportunicities for hand hygiene of healthcare workers \*100 |
| Days of ICU stay | through study completion, an average 6 months | Days of ICU stay |
| 28-day mortality rate | 28-days | 28-day mortality rate |
Countries
South Korea
Contacts
Primary ContactJiwon Jung, MD
Backup ContactSung-Han Kim, MD
Outcome results
None listed