First Department of Medicine, Medical School, "Laiko" General Hospital, National and Kapodistrian University of Athens, 75, 11527, Athens, Greece.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Antimicrob Resist Infect Control. 2020 Jul 6;9(1):102. doi: 10.1186/s13756-020-00766-x.
Carbapenemase-producing K. pneumoniae (CP-Kp) has been established as important nosocomial pathogen in most tertiary care hospitals in Greece. The aim of the present study was to examine the impact of an enhanced infection control program on the containment of CP-Kp in a haematology unit where the incidence of CP-Kp infections was high.
The study was conducted from June 2011 to December 2014 in a haematology unit of a tertiary-care 500-bed hospital located in Athens, Greece. A bundled intervention (active surveillance cultures, separation of carriers from non-carriers, assignment of dedicated nursing staff, contact precautions, environmental cleaning, and promotion of hand hygiene) was tested whether would reduce colonization and infection caused by CP-Kp.
A total of 2507 rectal swabs were obtained; 1199 upon admission from June 2011 to June 2013 and 1307 during hospitalization from June 2011 to December 2012. During intervention the admission prevalence of CP-Kp colonization (p < 0.001 for linear trend), the hospitalization prevalence (p = 0.001 for linear trend) and the incidence rate of CP-Kp colonization (p = 0.072 for linear trend) were declining. Application of segmented linear regression revealed that both the change in the level of CP-Kp BSI incidence rates (p = 0.001) as well as the difference between pre- and post-intervention slopes were statistically significant (p < 0.001).
A bundled intervention including active surveillance cultures on admission can attain maximum containment of CP-Kp colonization and infection in endemic acute healthcare settings.
产碳青霉烯酶肺炎克雷伯菌（CP-Kp）已成为希腊大多数三级保健医院中重要的医院获得性病原体。本研究旨在探讨强化感染控制方案对血液科 CP-Kp 感染高发单位中 CP-Kp 控制的影响。
本研究于 2011 年 6 月至 2014 年 12 月在希腊雅典一家拥有 500 张床位的三级保健医院的血液科进行。采用集束干预措施（主动监测培养、将携带者与非携带者隔离、指定专门护理人员、接触预防、环境清洁和促进手卫生），以评估其是否能减少 CP-Kp 定植和感染。
共采集了 2507 份直肠拭子，2011 年 6 月至 2013 年 6 月入院时采集了 1199 份，2011 年 6 月至 2012 年 12 月住院期间采集了 1307 份。在干预期间，CP-Kp 定植的入院流行率（线性趋势，p<0.001）、住院流行率（线性趋势，p=0.001）和 CP-Kp 定植的发病率（线性趋势，p=0.072）均呈下降趋势。分段线性回归分析显示，CP-Kp 血流感染发生率的变化水平（p=0.001）以及干预前后斜率的差异均具有统计学意义（p<0.001）。
包括入院时主动监测培养在内的集束干预措施可最大限度地控制 CP-Kp 定植和感染，在地方性急性医疗机构中效果良好。
