Reducing the spread of Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus on a burns unit
Frédéric Barbut1, Saber Yezli, Maurice Mimoun
1Saint-Antoine Hospital, Paris, France. frederic.barbut@sat.aphp.fr
Abstract:
Methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii are major nosocomial pathogens in burns units. We investigated the impact of an infection control bundle on the incidence of nosocomial MRSA and A. baumannii in our burns unit, comparing a pre-intervention period (December 2006-August 2008) with an intervention period (September 2008-December 2009). The bundle comprised regular hydrogen peroxide vapour (HPV) disinfection of the rooms following discharge of patients colonized or infected by multidrug-resistant bacteria, pre-emptive cohort isolation of newly admitted patients before being proven culture negative, cohorting of colonized or infected patients, installation of two air disinfection systems in the corridors of the unit and improvement of material storage. We also investigated the microbiological efficacy of HPV disinfection by sampling the environment before and after HPV treatments. HPV disinfection eliminated pathogens from the environment and significantly reduced total bacterial surface counts, and total fungal air and surface counts, on both a unit and room scale. The incidence of nosocomial MRSA infection or colonization fell by 89.3% from 7.22 to 0.77 cases/1000 patient days (p<0.0001) and A. baumannii fell by 88.8% from 6.92 to 0.77 cases/1000 patient days (p=0.002) in the intervention period with no further outbreaks of these organisms occurring in this period. The infection control bundle resulted in a significant reduction in the incidence of nosocomial MRSA and A. baumannii in our burns unit and prevented further outbreaks of these organisms.
Insights
An infection control bundle significantly reduced hospital-acquired Methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii in a burns unit. Hydrogen peroxide vapor disinfection proved effective against environmental pathogens, preventing further outbreaks.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii are significant causes of hospital-acquired infections in burns units.
- Controlling the spread of multidrug-resistant organisms in high-risk environments like burns units is critical.
Purpose of the Study:
- To evaluate the effectiveness of an infection control bundle in reducing nosocomial MRSA and A. baumannii incidence in a burns unit.
- To assess the microbiological efficacy of hydrogen peroxide vapor (HPV) disinfection in eliminating pathogens from the environment.
Main Methods:
- A pre-intervention and intervention period study design was used, comparing infection rates before and after bundle implementation.
- The infection control bundle included regular HPV room disinfection, pre-emptive cohort isolation, patient cohorting, air disinfection systems, and improved material storage.
- Environmental sampling was performed to evaluate HPV disinfection efficacy against bacterial and fungal counts.
Main Results:
- Nosocomial MRSA incidence decreased by 89.3% (7.22 to 0.77 cases/1000 patient days) and A. baumannii by 88.8% (6.92 to 0.77 cases/1000 patient days).
- HPV disinfection effectively eliminated pathogens and reduced overall bacterial and fungal counts in the environment.
- No further outbreaks of MRSA or A. baumannii occurred during the intervention period.
Conclusions:
- The implemented infection control bundle significantly reduced the incidence of nosocomial MRSA and A. baumannii in the burns unit.
- The bundle successfully prevented further outbreaks of these multidrug-resistant organisms.
- HPV disinfection is a valuable tool for environmental decontamination in healthcare settings.
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