Application of control measures for infections caused by multi-resistant gram-negative bacteria in intensive care unit patients.
Multi-resistant gram-negative rods are important pathogens in intensive care units (ICU), cause high rates of mortality, and need infection control measures to avoid spread to another patients. This study was undertaken prospectively with all of the patients hospitalized at ICU, Anesthesiology of the Hospital São Paulo, using the ICU component of the National Nosocomial Infection Surveillance System (NNIS) methodology, between March 1, 1997 and June 30, 1998. Hospital infections occurring during the first three months after the establishment of prevention and control measures (3/1/97 to 5/31/97) were compared to those of the last three months (3/1/98 to 5/31/98). In this period, 933 NNIS patients were studied, with 139 during the first period and 211 in the second period. The overall rates of infection by multi-resistant microorganisms in the first and second periods were, respectively, urinary tract infection: 3.28/1000 patients/day; 2.5/1000 patients/day; pneumonia: 2.10/1000 patients/day; 5.0/1000 patients/day; bloodstream infection: 1.09/1000 patients/day; 2.5/1000 patients/day. A comparison between overall infection rates of both periods (Wilcoxon test) showed no statistical significance (p = 0.067). The use of intervention measures effectively decreased the hospital bloodstream infection rate (p < 0.001), which shows that control measures in ICU can contribute to preventing hospital infections.
Comissão de Epidemiologia Hospitalar, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, 04024-002, Brasil.
Sinaida Teixeira
ST
Martins
Marina
M
Moreira
Guilherme Henrique Campos
GH
Furtado
Cristiane Grande Jimenez
CG
Marino
Flávia Ribeiro
FR
Machado
Sergio Barsanti
SB
Wey
Eduardo Alexandrino Servolo
EA
Medeiros
D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D006784:Hospitals, Teaching; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units