[Evaluation of the effect of a cleaning/disinfection intervention on the rate of multiresistant microorganism infections in the Intensive Care Unit].
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.
Simón García
M J
MJ
Hospital Clínico San Carlos, Madrid, España. msimon.hcsc@salud.madrid.org
González Sánchez
J A
JA
Alcudia Pérez
F
F
Sánchez Sánchez
C
C
Gómez Mayoral
B
B
Merino Martínez
M R
MR
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