Universal versus targeted additional contact precautions for multidrug-resistant organism carriage for patients admitted to an intensive care unit
| Autor: | Pierre Le Guen, Antoine Parrot, Samuel Fedun, Mehdi Hafiani, Muriel Fartoukh, Jean-Pierre Fulgencio, Michel Djibré, Michel Denis, Sophie Vimont |
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| Přispěvatelé: | CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Réanimation et USC Médico-Chirurgicale [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Bactériologie-Hygiène [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service des maladies infectieuses et tropicales [CHU Tenon] |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male Pediatrics medicine.medical_specialty Isolation (health care) Epidemiology 030106 microbiology Multidrug resistant organism law.invention Isolation 03 medical and health sciences 0302 clinical medicine law Drug Resistance Multiple Bacterial medicine Disease Transmission Infectious Humans 030212 general & internal medicine Risk factor Aged Infection Control business.industry Health Policy Public Health Environmental and Occupational Health Bacterial Infections Middle Aged Intensive care unit 3. Good health Icu admission Intensive Care Units Infectious Diseases Carriage Contact precautions Acquisition Emergency medicine Carrier State Screening Observational study Female France business Infection [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | American Journal of Infection Control American Journal of Infection Control, 2017, ⟨10.1016/j.ajic.2017.02.001⟩ American Journal of Infection Control, Elsevier, 2017, ⟨10.1016/j.ajic.2017.02.001⟩ |
| ISSN: | 0196-6553 |
| DOI: | 10.1016/j.ajic.2017.02.001⟩ |
| Popis: | International audience; BackgroundAlthough additional contact precautions (ACPs) are routinely used to reduce cross-transmission of multidrug-resistant organisms (MDROs), the relevance of isolation precautions remains debated. We hypothesized that the collection of recognized risk factors for MDRO carriage on intensive care unit (ICU) admission might be helpful to target ACPs without increasing MDRO acquisition during ICU stays, compared with universal ACPs.Materials and MethodsThis is a sequential single-center observational study performed in consecutive patients admitted to a French medical and surgical ICU. During the first 6-month period, screening for MDRO carriage and ACPs were performed in all patients. During the second 6-month period, screening was maintained, but ACP use was guided by the presence of at least 1 defined risk factor for MDRO.ResultsDuring both periods, 33 (10%) and 30 (10%) among 327 and 297 admissions were, respectively, associated with a positive admission MDRO carriage. During both periods, a second screening was performed in 147 (45%) and 127 (43%) patients. Altogether, the rate of acquired MDRO (positive screening or clinical specimen) was similar during both periods (10% [n = 15] and 11.8% [n = 15], respectively; P = .66).ConclusionsThe results of our study contribute to support the safety of an isolation-targeted screening policy on ICU admission compared with universal screening and isolation regarding the rate of ICU-acquired MDRO colonization or infection. |
| Databáze: | OpenAIRE |
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