Category: HAI: Disinfection/Sterilization & Environmental Infection Prevention

Poster Session: HAI: Disinfection/Sterilization & Environmental Infection Prevention

813 - The Reduction of the acquisition rate of carbapenem resistant Acinetobacter baumannii after room privatization in the intensive care unit.

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Presenting Author(s)

Jongtak Jung

Assistant Professor
Soonchunhyang University Seoul Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

PC

Pyoeng Gyun Choe

Assistant professor
Seoul National University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CK

Chang Kyung Kang

Professor
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KS

Kyung Ho Song

Professor
Seoul National University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
WP

Wan Beom Park

Professor
Seoul National University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JB

Ji-Hwan Bang

Dr
Seoul Metropolitan Boramae Hospital
Dongjak-gu, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EK

Eu Suk Kim

Dr
Seoul National University Bundang Hospital
Bundang-gu, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SP

Sang Won Park

Professor
Seoul National University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HK

Hong Bin Kim

Professor, Division of Infectious Diseases
Seoul National University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NK

Nam-Joong Kim

Professor
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MO

Myoung-don Oh

Professor
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Acinetobacter baumannii is one of the major pathogens of hospital-acquired infection recently and hospital outbreaks have been reported worldwide. On September 2017, New intensive care unit(ICU) with only single rooms, remodeling from old ICU with multibed bay rooms, was opened in an acute-care tertiary hospital in Seoul, Korea. We investigated the effect of room privatization in the ICU on the acquisition of carbapenem-resistant Acinetobacter baumannii(CRAB).

Methods: We retrospectively reviewed medical records of patients who admitted to the medical ICU in a tertiary care university-affiliated 1,800-bed hospital from 1 January 2015 to 1 January 2019. Patients admitted to the medical ICU before the remodeling of the ICU were designated as the control group, and those who admitted to the medical ICU after the remodeling were designated as the intervention group. Then we compared the acquisition rate of CRAB between the control and intervention groups. Patients colonized with CRAB or patients with CRAB identified in screening tests were excluded from the study population. The multivariable Cox regression model was performed using variables with p-values of less than 0.1 in the univariate analysis.

Results: A total of 1,105 cases admitted to the ICU during the study period were analyzed. CRAB was isolated from 110 cases in the control group(n=687), and 16 cases in the intervention group(n=418). In univariate analysis, room privatization, prior exposure to antibiotics (carbapenem, vancomycin, fluoroquinolone), mechanical ventilation, central venous catheter, tracheostomy, the presence of feeding tube(Levin tube or percutaneous gastrostomy) and the length of ICU stay were significant risk factors for the acquisition of CRAB (p< 0.05). In the multivariable Cox regression model, the presence of feeding tube(Hazard ratio(HR) 4.815, 95% Confidence interval(CI) 1.94-11.96, p=0.001) and room privatization(HR 0.024, 95% CI 0.127-0.396, p=0.000) were independent risk factors.Table 1. Univariate analysis of Carbapenem-resistant Acinetobacter baumannii

Table 2. Multivariable Cox regression model of the acquisition of Carbapenem-resistant Acinetobacter baumannii

Conclusion: In the present study, room privatization of the ICU was correlated with the reduction of CRAB acquisition independently. Remodeling of the ICU to the single room would be an efficient strategy for preventing the spreading of multidrug-resistant organisms and hospital-acquired infection.