title: Control of endemic extensively drug-resistant Acinetobacter baumannii with a cohorting policy and cleaning procedures based on the 1 room, 1 wipe approach.
abstract: Our institution experienced an endemic situation with extensively drug-resistant (XDR) Acinetobacter baumannii in the intensive care units (ICUs). Here, we describe the long-term results of the implementation of a screening and cohorting policy and new cleaning techniques based on a procedure that we call the 1 room, 1 wipe approach.
  
  
  
  We conducted a 4-year quasi-experimental study in the ICUs of an 800-bed teaching hospital. The main actions implemented were active surveillance of XDR A baumannii and cohorting of carriers and introducing new cleaning techniques intended to avoid sharing wipes between rooms.
  
  
  
  XDR A baumannii significantly decreased from 132 cases in 2011 to 8 cases in 2014 and from 10.78 cases per 1,000 patient days in 2011 to 0.69 cases per 1,000 patient days in 2014. Segmented regression analysis showed that after implementing the measures, the monthly rates presented a sustained negative slope, with a significant change of -0.623 (P = .002).
  
  
  
  The prompt identification and isolation of patients and adequate environmental cleaning are effective measures for reducing XDR A baumannii in ICUs. The 1 wipe, 1 room approach should be considered a standard measure for cleaning hospital facilities to avoid cross-transmission as a result of reusable cleaning wipes.
authors.affiliation: Preventive Medicine Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: lgavalda@bellvitgehospital.cat.
authors.forename: Laura
authors.initials: L
authors.lastname: Gavaldà
authors.affiliation: Preventive Medicine Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Soriano
authors.affiliation: Microbiology Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Cámara
authors.affiliation: Intensive Care Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Gasull
authors.affiliation: Infectious Diseases Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Arch
authors.affiliation: Intensive Care Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ferrer
authors.affiliation: Infectious Diseases Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Shaw
authors.affiliation: Intensive Care Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Granada
authors.affiliation: Microbiology Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Dominguez
authors.affiliation: Infectious Diseases Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Pujol
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D019353:Endemic Diseases; D006291:Health Policy; D006784:Hospitals, Teaching; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D065228:Non-Randomized Controlled Trials as Topic; D016134:Organizational Policy; D013030:Spain / Q000453:epidemiology
keywords: Acinetobacter baumannii; disinfection; infection control; screening