infection in a medical intensive care unit: The impact of strict infection control.

BACKGROUND

is a waterborne organism that preferentially colonises aquatic environments. Infections usually involve organ systems that have a high fluid content. Multidrug-resistant (MDR) is recognised to be among the most difficult antimicrobial-resistant Gram-negative bacilli to prevent and treat in the nosocomial setting.

OBJECTIVES

To determine the utility of concomitant implementation of a strict antimicrobial stewardship programme and comprehensive infection control measures to control MDR in a medical intensive care unit (ICU).

METHODS

We retrospectively compared the relative incidence of infections in our unit over a 1-year period before (2012) and after (2016) the implementation of strict infection control bundles. Patients with infections were identified using the microbiology database of the National Health Laboratory Service's central data warehouse. The total number of admissions and clinical data were derived from the ICU registry.

RESULTS

was isolated from 43/263 patients (16.35%) in 2012 compared with 37/348 patients in 2016 (10.63%, p=0.03; relative risk reduction=35%). We found almost 100% sensitivity to colistin and tigecycline, but 90% resistance to carbapenem antibiotics.

CONCLUSION

The introduction of strict infection control bundles had a statistically significant and clinically meaningful impact on the incidence of nosocomial infection in the medical ICU.