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Decreased transmission of Enterobacteriaceae with extended-spectrum beta-lactamases in an intensive care unit by nursing reorganization.
J Hosp Infect. 1995 Oct; 31(2):89-97.JH

Abstract

In our gastrointestinal surgical intensive care unit (SICU), the large number of patients with multiple enterostomies enhances the risk of nosocomial transmission of gut extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLE) by health care workers. A control study performed in our SICU from June-August 1992 showed an ESBLE gut colonization rate of 70%. To reduce this rate, nursing procedures were intensified or modified, particularly handwashing, single-use equipment and waste control. To test the efficiency of these procedures, 64 patients hospitalized for more than two days from September 1992-March 1993 were screened for gut acquisition of ESBLE. Rectal samples were taken within 48 h after admission and then weekly. After nursing reorganization, the ESBLE colonization rate dropped significantly to 40% (P < 0.001). Twenty patients (31.7%) acquired a gut ESBLE, after a mean of 24.3 +/- 13.7 days. Each patient was colonized with one, two or three ESBLE (Klebsiella pneumoniae, Escherichia coli and Enterobacter aerogenes). Baseline characteristics of the 20 colonized and 39 non-colonized patients showed no significant difference (Student's t-test, P > 0.05). The nursing workload, estimated as a omega index, was greater in the colonized group (P < 0.001). These findings show that strict observance of nursing procedures can significantly reduce ESBLE acquisition in a high-risk surgical unit.

Authors+Show Affiliations

Department of Anesthesiology and Intensive care, Saint-Antoine Hospital, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

8551026

Citation

Soulier, A, et al. "Decreased Transmission of Enterobacteriaceae With Extended-spectrum Beta-lactamases in an Intensive Care Unit By Nursing Reorganization." The Journal of Hospital Infection, vol. 31, no. 2, 1995, pp. 89-97.
Soulier A, Barbut F, Ollivier JM, et al. Decreased transmission of Enterobacteriaceae with extended-spectrum beta-lactamases in an intensive care unit by nursing reorganization. J Hosp Infect. 1995;31(2):89-97.
Soulier, A., Barbut, F., Ollivier, J. M., Petit, J. C., & Lienhart, A. (1995). Decreased transmission of Enterobacteriaceae with extended-spectrum beta-lactamases in an intensive care unit by nursing reorganization. The Journal of Hospital Infection, 31(2), 89-97.
Soulier A, et al. Decreased Transmission of Enterobacteriaceae With Extended-spectrum Beta-lactamases in an Intensive Care Unit By Nursing Reorganization. J Hosp Infect. 1995;31(2):89-97. PubMed PMID: 8551026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decreased transmission of Enterobacteriaceae with extended-spectrum beta-lactamases in an intensive care unit by nursing reorganization. AU - Soulier,A, AU - Barbut,F, AU - Ollivier,J M, AU - Petit,J C, AU - Lienhart,A, PY - 1995/10/1/pubmed PY - 1995/10/1/medline PY - 1995/10/1/entrez SP - 89 EP - 97 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 31 IS - 2 N2 - In our gastrointestinal surgical intensive care unit (SICU), the large number of patients with multiple enterostomies enhances the risk of nosocomial transmission of gut extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLE) by health care workers. A control study performed in our SICU from June-August 1992 showed an ESBLE gut colonization rate of 70%. To reduce this rate, nursing procedures were intensified or modified, particularly handwashing, single-use equipment and waste control. To test the efficiency of these procedures, 64 patients hospitalized for more than two days from September 1992-March 1993 were screened for gut acquisition of ESBLE. Rectal samples were taken within 48 h after admission and then weekly. After nursing reorganization, the ESBLE colonization rate dropped significantly to 40% (P < 0.001). Twenty patients (31.7%) acquired a gut ESBLE, after a mean of 24.3 +/- 13.7 days. Each patient was colonized with one, two or three ESBLE (Klebsiella pneumoniae, Escherichia coli and Enterobacter aerogenes). Baseline characteristics of the 20 colonized and 39 non-colonized patients showed no significant difference (Student's t-test, P > 0.05). The nursing workload, estimated as a omega index, was greater in the colonized group (P < 0.001). These findings show that strict observance of nursing procedures can significantly reduce ESBLE acquisition in a high-risk surgical unit. SN - 0195-6701 UR - https://www.unboundmedicine.com/medline/citation/8551026/Decreased_transmission_of_Enterobacteriaceae_with_extended_spectrum_beta_lactamases_in_an_intensive_care_unit_by_nursing_reorganization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0195-6701(95)90163-9 DB - PRIME DP - Unbound Medicine ER -