Epidemiological surveillance of multidrug-resistant gram-negative bacteria in a solid organ transplantation department
Anastasia Geladari
Solid Organ Transplantation Department, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorTheodoros Karampatakis
Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorCharalampos Antachopoulos
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorElias Iosifidis
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorOlga Tsiatsiou
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorLida Politi
Microbiology Department, National and Kapodistrian University School of Medicine, Athens, Greece
Search for more papers by this authorAggeliki Karyoti
Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorVasilios Papanikolaou
Solid Organ Transplantation Department, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorAthanassios Tsakris
Microbiology Department, National and Kapodistrian University School of Medicine, Athens, Greece
Search for more papers by this authorCorresponding Author
Emmanuel Roilides
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Correspondence
Emmanuel Roilides, MD, PhD, Third Department of Pediatrics, Hippokration General Hospital, Thessaloniki, Greece.
Email: [email protected]
Search for more papers by this authorAnastasia Geladari
Solid Organ Transplantation Department, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorTheodoros Karampatakis
Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorCharalampos Antachopoulos
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorElias Iosifidis
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorOlga Tsiatsiou
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorLida Politi
Microbiology Department, National and Kapodistrian University School of Medicine, Athens, Greece
Search for more papers by this authorAggeliki Karyoti
Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorVasilios Papanikolaou
Solid Organ Transplantation Department, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Search for more papers by this authorAthanassios Tsakris
Microbiology Department, National and Kapodistrian University School of Medicine, Athens, Greece
Search for more papers by this authorCorresponding Author
Emmanuel Roilides
Third Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
Infection Control Committee, Hippokration General Hospital, Thessaloniki, Greece
Correspondence
Emmanuel Roilides, MD, PhD, Third Department of Pediatrics, Hippokration General Hospital, Thessaloniki, Greece.
Email: [email protected]
Search for more papers by this authorAbstract
Background
We assessed the impact of intensified infection control measures (ICM) on colonization and infection caused by carbapenem-resistant (CR) Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii in a solid organ transplantation (SOT) department.
Methods
A quasi-experimental methodology was followed. The study was divided into three periods: pre-intervention, intervention with implementation of an ICM bundle including active surveillance program (ASP) and gradually enhanced measures, and post-ASP without ASP. The bundle included active surveillance cultures, contact precautions, hand hygiene, education of health care workers (HCWs), monitoring of compliance, and environmental cleaning. Incidence of colonization and infection caused by CR gram-negative bacteria was recorded. Molecular analysis of CR bacteria was performed for a certain period.
Results
During the intervention, incidence of colonization reduced from 19% to 9% (P<.001). The compliance of HCWs with contact precautions and hand hygiene also improved. Monthly incidence of infections caused by these CR bacteria increased from 2.8 to 6.9/1000 bed-days (P<.001). However, this increase did not have such a strong trend after the intervention. Most K. pneumoniae isolates, the commonest pathogen, carried the blaKPC gene. Colonization and infection rates by CR K. pneumoniae, P. aeruginosa, and A. baumannii were high among SOT recipients.
Conclusion
In settings where CR gram-negative bacteria are endemic, colonization and infection rates by these bacteria are high among SOT recipients. Implementation of enhanced ICM in all related units of a hospital, although challenging, reduces colonization rates by CR gram-negative bacteria.
Supporting Information
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