Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Center for Infection Control and Prevention, Seoul National University Hospital, Seoul, Republic of Korea.
J Hosp Infect. 2022 Mar;121:14-21. doi: 10.1016/j.jhin.2021.12.012. Epub 2021 Dec 17.
Acinetobacter baumannii is one of the major pathogens responsible for healthcare-associated infections, especially in intensive care units (ICUs).
To evaluate the effect of room privatization in an ICU on the acquisition of carbapenem-resistant A. baumannii (CRAB).
Between March and August 2017, a medical ICU was renovated from a multi-bed bay room to single rooms. Acquisition of CRAB was compared between patients admitted to the ICU over 18 months pre-renovation (September 2015 to February 2017) and post-renovation (September 2017 to February 2019). A Cox proportional hazard model was used with adjustment for demographics and comorbidities.
Of the 901 patients, who contributed 8276 patient-days, 95 (10.5%) acquired CRAB during their ICU stay. The CRAB acquisition rate was significantly higher during the pre-renovation period (1.87 per 100 patient-days) than during the post-renovation period (0.39 per 100 patient-days) (P<0.001). In the multi-variable Cox regression model, CRAB acquisition was significantly associated with the presence of a feeding tube (adjusted hazard ratio (aHR), 6.08; 95% confidence interval (CI), 2.46-15.06; P<0.001), continuous renal replacement therapy (aHR, 1.66; 95% CI, 1.09-2.53; P=0.019) and admission after renovation of the ICU to single rooms (aHR, 0.23; 95% CI, 0.12-0.41; P<0.001).
Renovation of ICUs to single rooms is an efficient strategy to prevent transmission of multi-drug-resistant organisms and hospital-acquired infections.
鲍曼不动杆菌是导致与医疗保健相关感染的主要病原体之一，尤其是在重症监护病房（ICU）。
评估 ICU 病房私有化对获得耐碳青霉烯鲍曼不动杆菌（CRAB）的影响。
2017 年 3 月至 8 月，将一间多床位 ICU 病房改造成单人病房。比较了在装修前 18 个月（2015 年 9 月至 2017 年 2 月）和装修后（2017 年 9 月至 2019 年 2 月）入住 ICU 的患者中 CRAB 的获得情况。使用 Cox 比例风险模型进行调整，以调整人口统计学和合并症。
在 901 名患者中，他们共贡献了 8276 个患者日，有 95 名（10.5%）在 ICU 期间获得了 CRAB。装修前（1.87 例/100 患者日）的 CRAB 获得率明显高于装修后（0.39 例/100 患者日）（P<0.001）。在多变量 Cox 回归模型中，CRAB 获得与存在喂养管（调整后的危险比（aHR），6.08；95%置信区间（CI），2.46-15.06；P<0.001）、持续肾脏替代治疗（aHR，1.66；95%CI，1.09-2.53；P=0.019）和 ICU 单人病房装修后入住（aHR，0.23；95%CI，0.12-0.41；P<0.001）显著相关。
将 ICU 病房改造为单人病房是预防多药耐药菌和医院获得性感染传播的有效策略。
