Impact of intensive infection control team activities on the acquisition of methicillin-resistant Staphylococcus aureus , drug-resistant Pseudomonas aeruginosa and the incidence of Clostridium difficile -associated disease

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 19; no. 6; pp. 1047 - 1052
• Main Authors: Suzuki, Hiromichi, Senda, Junko, Kotaki, Noriko, Yamashita, Keita, Tokuda, Yasuharu, Kanesaka, Yohko, Ishikawa, Hiroichi
• Format: Journal Article
• Language: English
• Published: Tokyo Elsevier Ltd 2013; Springer Japan
• Subjects: Anti-Bacterial Agents - pharmacology; Antimicrobial stewardship program; Clostridium difficile - drug effects; Clostridium difficile - isolation & purification; Clostridium Infections - epidemiology; Clostridium Infections - microbiology; Clostridium Infections - prevention & control; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Drug Resistance, Bacterial; Electronic medical record; Hematology, Oncology and Palliative Medicine; Humans; Infection control; Infection Control - methods; Infection Control - statistics & numerical data; Infectious Diseases; Japan - epidemiology; Medical Microbiology; Medicine; Medicine & Public Health; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Multidrug-resistant organism; Original Article; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - epidemiology; Pseudomonas Infections - microbiology; Pseudomonas Infections - prevention & control; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Virology; Japan; Multidrug-resistant organism; Antimicrobial stewardship program; Infection control; Electronic medical record
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1007/s10156-013-0621-x

Abstract The transmission of multidrug-resistant organisms (MDROs) is an emerging problem in acute healthcare facilities. To reduce this transmission, we introduced intensive infection control team (ICT) activities and investigated the impact of their introduction. This study was conducted at a single teaching hospital from 1 April 2010 to 31 March 2012. During the intervention period, all carbapenem use was monitored by the ICT, and doctors using carbapenems inappropriately were individually instructed. Information related to patients with newly identified MDROs was provided daily to the ICT and instructions on the appropriate infection control measures for MDROs were given immediately with continuous monitoring. The medical records of newly hospitalized patients were reviewed daily to check previous microbiological results and infection control intervention by the ICT was also performed for patients with a previous history of MDROs. Compared with the pre-intervention period, the antimicrobial usage density of carbapenems decreased significantly (28.5 vs 17.8 defined daily doses/1000 inpatient days; p < 0.001) and the frequency of use of sanitary items, especially the use of aprons, increased significantly (710 vs 1854 pieces/1000 inpatient days; p < 0.001). The number of cases with hospital-acquired MRSA (0.66 vs 0.29 cases/1000 inpatient days; p < 0.001), hospital-acquired drug-resistant Pseudomonas aeruginosa (0.23 vs 0.06 cases/1000 inpatient days; p = 0.006) and nosocomial Clostridium difficile -associated disease (0.47 vs 0.11 cases/1000 inpatient days; p < 0.001) decreased significantly during the intervention period. Our study showed that proactive and continuous ICT interventions were effective for reduction of MDRO transmission.