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Long-Term Impact of Universal Contact Precautions on Rates of Multidrug-Resistant Organisms in ICUs: A Comparative

E Yoko Furuya1, Bevin Cohen2, Haomiao Jia2

  • 11Division of Infectious Diseases,Columbia University Medical Center,New York,New York.

Infection Control and Hospital Epidemiology
|March 23, 2018
PubMed

Insights

Universal contact precautions (UCP) did not significantly reduce multidrug-resistant organism (MDRO) rates in intensive care units (ICUs). Hospital-wide infection prevention efforts were likely responsible for observed MDRO decreases over nine years.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Public Health

Background:

  • Multidrug-resistant organisms (MDROs) pose a significant threat in healthcare settings, particularly in intensive care units (ICUs).
  • Universal contact precautions (UCP) are infection control measures aimed at reducing the transmission of MDROs.
  • Evaluating the long-term impact of UCP on MDRO rates is crucial for optimizing infection prevention strategies.

Purpose of the Study:

  • To assess the effect of implementing universal contact precautions (UCP) on the incidence of multidrug-resistant organisms (MDROs) in intensive care units (ICUs).
  • To compare MDRO rates in ICUs with UCP to those without UCP over a 9-year period.

Main Methods:

  • A retrospective, nonrandomized observational study was conducted over nine years (2006-2014) at an 800-bed academic medical center.
  • Longitudinal MDRO incidence density rates were analyzed using time series analyses based on generalized linear models.
  • Monthly MDRO rates were compared between a baseline period and the UCP implementation period, and between UCP and non-UCP ICUs.

Main Results:

  • Overall MDRO rates decreased during the study period, but no significant trend change was observed after UCP implementation in the intervention units.
  • There was no significant difference in the annual decrease of MDRO rates between ICUs with UCP (6.6% decrease) and those without UCP (6.0% decrease).
  • The study found no detectable additional impact of UCP on MDRO rates beyond general hospital-wide infection prevention improvements.

Conclusions:

  • The implementation of universal contact precautions (UCP) did not demonstrate a significant additional impact on reducing multidrug-resistant organism (MDRO) rates in ICUs.
  • Observed decreases in MDROs were likely attributable to broader hospital-wide infection prevention initiatives during the study period.
  • Further research may be needed to identify specific interventions that provide a greater impact on MDRO reduction in critical care settings.

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