Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms
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Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomesin intensive care units (ICUs). Contact precautions are necessary to reduce the transmission ofMDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates andpatient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectivelyanalyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibioticsused, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after therelocation, were included. Of them, 234 were admitted to the ICU before the relocation and229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, didnot differ between the two groups. After the relocation, the incidence rate of MDR respiratorypathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that differencewas statistically insignificant. The use of colistin was significantly reduced from 53.5days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantlydifferent before and after ICU relocation. However, ICU relocation could be helpful in reducingthe use of antibiotics against MDR pathogens and improving patient outcomes.
Abstract
Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomesin intensive care units (ICUs). Contact precautions are necessary to reduce the transmission ofMDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates andpatient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectivelyanalyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibioticsused, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after therelocation, were included. Of them, 234 were admitted to the ICU before the relocation and229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, didnot differ between the two groups. After the relocation, the incidence rate of MDR respiratorypathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that differencewas statistically insignificant. The use of colistin was significantly reduced from 53.5days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantlydifferent before and after ICU relocation. However, ICU relocation could be helpful in reducingthe use of antibiotics against MDR pathogens and improving patient outcomes.
참고문헌 (26)
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