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Control of Carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa in Healthcare Facilities: A Systematic Review and Reanalysis of Quasi-experimental Studies.

  • Tomczyk S Infection Prevention and Control Global Unit, Service Delivery and Safety Department, World Health Organization, Switzerland.
  • Zanichelli V Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Switzerland.
  • Grayson ML Infectious Diseases Department, Austin Health, Victoria, Australia.
  • Twyman A Infection Prevention and Control Global Unit, Service Delivery and Safety Department, World Health Organization, Switzerland.
  • Abbas M Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Switzerland.
  • Pires D Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Switzerland.
  • Allegranzi B Infection Prevention and Control Global Unit, Service Delivery and Safety Department, World Health Organization, Switzerland.
  • Harbarth S Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Switzerland.
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  • 2018-11-27
Published in:
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - 2019
Acinetobacter
Pseudomonas
Enterobacteriaceae
carbapenem resistance
prevention and control
Acinetobacter baumannii
Anti-Bacterial Agents
Carbapenems
Drug Resistance, Multiple, Bacterial
Enterobacteriaceae
Health Facilities
Humans
Pseudomonas aeruginosa
English Carbapenem-resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPsA) are a serious cause of healthcare-associated infections, although the evidence for their control remains uncertain. We conducted a systematic review and reanalysis to assess infection prevention and control (IPC) interventions on CRE-CRAB-CRPsA in inpatient healthcare facilities to inform World Health Organization guidelines. Six major databases and conference abstracts were searched. Before-and-after studies were reanalyzed as interrupted time series if possible. Effective practice and organization of care (EPOC) quality criteria were used. Seventy-six studies were identified, of which 17 (22%) were EPOC-compatible and interrupted time series analyses, assessing CRE (n = 11; 65%), CRAB (n = 5; 29%) and CRPsA (n = 3; 18%). IPC measures were often implemented using a multimodal approach (CRE: 10/11; CRAB: 4/5; CRPsA: 3/3). Among all CRE-CRAB-CRPsA EPOC studies, the most frequent intervention components included contact precautions (90%), active surveillance cultures (80%), monitoring, audit and feedback of measures (80%), patient isolation or cohorting (70%), hand hygiene (50%), and environmental cleaning (40%); nearly all studies with these interventions reported a significant reduction in slope and/or level. The quality of EPOC studies was very low to low.
Language
  • English
Open access status
hybrid
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Persistent URL
https://folia.unifr.ch/global/documents/171361
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