title: [Evaluation of the effect of a cleaning/disinfection intervention on the rate of multiresistant microorganism infections in the Intensive Care Unit].
abstract: OBJECTIVE
  Evaluate the effect of an intervention on the rate of nosocomial infections (NI) produced by multiresistant microorganisms in the Intensive Care Units.
  
  
  METHODS
  A study was conducted before and after an intervention in two ICUs to control an outbreak of multiresistant Acinetobacter baumanii (MRAB). During the outbreak (from 22-12-06 to 12-2-07) the wards were closed and both the wards and the equipment of both ICUs were cleaned and disinfected. A microbiological sampling was also made. The nosocomial infection rate density of the multiresistant microorganisms was compared between hospitalized patients: preintervention (1-3-2006 to 15-12-2006) and postintervention (1-3-2007 to 15-12-2007). To certify if there were any statistically significant differences between them, a rate ratio (RT) was calculated with a 95% confidence interval. The level of statistical significance was established at p < 0.05. We stratified per unit, per type of microorganism and location of the infection.
  
  
  RESULTS
  The global NI incidence rate for multiresistant microorganisms significantly declined after the interventions in both units (RT: 1.83, 95% CI: 1.34-2.50), p < 0.005. A significant decrease was also observed on the NI incidence rate for the following microorganisms: P. aeruginosa (RT: 2.36, 95% CI: 1.41-3.96), Enterobacter BLEE (RT: 2.31, 95% CI: 1.11-4.82) and S. maltophilia (RT: 2.77, 95% CI: 1.10-6.99). In regards to the infection location, a significant decrease in respiratory infection rates was observed (RT: 1.96, 95% CI: 1.29-2.99).
  
  
  CONCLUSIONS
  The intervention conducted to control the MRAB outbreak was effective in reducing the NI incidence of multiresistant microorganisms.
authors.affiliation: Hospital Clínico San Carlos, Madrid, España. msimon.hcsc@salud.madrid.org
authors.forename: M J
authors.initials: MJ
authors.lastname: Simón García
authors.forename: J A
authors.initials: JA
authors.lastname: González Sánchez
authors.forename: F
authors.initials: F
authors.lastname: Alcudia Pérez
authors.forename: C
authors.initials: C
authors.lastname: Sánchez Sánchez
authors.forename: B
authors.initials: B
authors.lastname: Gómez Mayoral
authors.forename: M R
authors.initials: MR
authors.lastname: Merino Martínez
mesh_terms: D000151:Acinetobacter Infections / Q000517:prevention & control*; D040981:Acinetobacter baumannii; D003428:Cross Infection / Q000517:prevention & control*; D004203:Disinfection; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007362:Intensive Care Units