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논문 기본 정보

자료유형
학술저널
저자정보
Byun Joung-Hee (Department of Pediatrics Pusan National University Children's Hospital Yangsan Korea.Research Insti) Park Su Eun (Department of Pediatrics Pusan National University Children's Hospital Yangsan Korea.Infection Prev) Seo Minhae (Department of Pediatrics Pusan National University Children's Hospital Yangsan Korea.) Jang Jeungmi (Department of Nursing Pusan National University Yangsan Hospital Yangsan Korea.) Hwang Mi Sun (Department of Nursing Pusan National University Yangsan Hospital Yangsan Korea.) Song Ju Yeoun (Infection Prevention and Control Department Pusan National University Yangsan Hospital Yangsan Kore) Chang Chulhun L. (Department of Laboratory Medicine Pusan National University Yangsan Hospital Yangsan Korea.) Kim Young A (Department of Pediatrics Pusan National University Children's Hospital Yangsan Korea.Research Insti)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.46
발행연도
2021.11
수록면
1 - 12 (12page)
DOI
10.3346/jkms.2021.36.e307

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Background: Multidrug-resistant Acinetobacter baumannii (MDRAB) is widespread among intensive care units worldwide, posing a threat to patients and the health system. We describe the successful management of a MDRAB outbreak by implementing an infection-control strategy in a pediatric intensive care unit (PICU). Methods: This retrospective study investigated the patients admitted to the PICU in periods 1 (8 months) and 2 (7 months), from the index MDRAB case to intervention implementation, and from intervention implementation to cessation of MDRAB spread. An infection-control strategy was designed following six concepts: 1) cohort isolation of colonized patients, 2) enforcement of hand hygiene, 3) universal contact precautions, 4) environmental management, 5) periodic surveillance culture study, and 6) monitoring and feedback. Results: Of the 427 patients, 29 were confirmed to have MDRAB colonization, of which 18 had MDRAB infections. Overall incidence per 1,000 patient days decreased from 7.8 (period 1) to 5.8 (period 2). The MDRAB outbreak was declared terminated after the 6-month followup following period 2. MDRAB was detected on the computer keyboard and in condensed water inside the ventilator circuits. The rate of hand hygiene performance was the lowest in the three months before and after index case admission and increased from 84% (period 1) to 95% (period 2). Patients with higher severity, indicated by a higher Pediatric Risk of Mortality III score, were more likely to develop colonization (P = 0.030), because they had invasive devices and required more contact with healthcare workers. MDRAB colonization contributed to an increase in the duration of mechanical ventilation and PICU stay (P < 0.001), but did not affect mortality (P = 0.273). Conclusion: The MDRAB outbreak was successfully terminated by the implementation of a comprehensive infection-control strategy focused on the promotion of hand hygiene, universal contact precautions, and environmental management through multidisciplinary teamwork.
#Acinetobacter baumannii #Outbreak #Intensive Care Unit #Pediatric #Infection-control

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참고문헌 (30)

참고문헌 신청
Weber DJ / 2010 / Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species / Am J Infect Control 38(5 Suppl 1):S25~S33 google schola 최인선 / 2019 / 국내 Acinetobacter 임상분리주 내 adeG, adeB, adeE, adeY, abeM 및 adeJ 유출 펌프 유전자의 분포 / Laboratory Medicine Online 9(4):201~209 dbpia Wendt C / 1997 / Survival of Acinetobacter baumannii on dry surfaces / J Clin Microbiol 35(6):1394~1397 google schola Hong KB / 2012 / Investigation and control of an outbreak of imipenem-resistant Acinetobacter baumannii Infection in a pediatric intensive care unit / Pediatr Infect Dis J 31(7):685~690 google schola 이호진 / 2016 / Clinical and Economic Evaluation of Multidrug-Resistant Acinetobacter baumannii Colonization in the Intensive Care Unit / Infection and Chemotherapy 48(3):174~180 google schola

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