Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19925
Title: Control of Carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa in Healthcare Facilities: A Systematic Review and Reanalysis of Quasi-experimental Studies.
Authors: Tomczyk, Sara;Zanichelli, Veronica;Grayson, M Lindsay;Twyman, Anthony;Abbas, Mohamed;Pires, Daniela;Allegranzi, Benedetta;Harbarth, Stephan
Affiliation: Department of Infectious Diseases, Centro Hospitalar Lisboa Norte and Faculdade de Medicina da Universidade de Lisboa, Portugal
Institute of Global Health, University of Geneva, Switzerland
Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Switzerland
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
Department of Medicine, University of Melbourne, Victoria, Australia
Infection Prevention and Control Global Unit, Service Delivery and Safety Department, World Health Organization, Switzerland
Issue Date: 23-Nov-2018
EDate: 2018-11-23
Citation: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2018; online first: 23 November
Abstract: 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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19925
DOI: 10.1093/cid/ciy752
PubMed URL: 30475989
Type: Journal Article
Appears in Collections:Journal articles

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