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DC Field | Value | Language |
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dc.contributor.author | Suarez, Cristina | - |
dc.contributor.author | Peña Miralles, Carmen | - |
dc.contributor.author | Arch, Olga | - |
dc.contributor.author | Domínguez Luzón, Ma. Ángeles (María Ángeles) | - |
dc.contributor.author | Tubau, Fe | - |
dc.contributor.author | Juan, Carlos | - |
dc.contributor.author | Gavaldá, Laura | - |
dc.contributor.author | Sora, Mercedes | - |
dc.contributor.author | Oliver, Antonio | - |
dc.contributor.author | Pujol Rojo, Miquel | - |
dc.contributor.author | Ariza Cardenal, Javier | - |
dc.date.accessioned | 2018-01-25T09:52:49Z | - |
dc.date.available | 2018-01-25T09:52:49Z | - |
dc.date.issued | 2011-10-13 | - |
dc.identifier.issn | 1471-2334 | - |
dc.identifier.uri | http://hdl.handle.net/2445/119284 | - |
dc.description.abstract | Background: Studies of recent hospital outbreaks caused by multiresistant P.aeruginosa (MRPA) have often failed to identify a specific environmental reservoir. We describe an outbreak due to a single clone of multiresistant (MR) Pseudomonas aeruginosa (PA) and evaluate the effectiveness of the surveillance procedures and control measures applied. Methods: Patients with MRPA isolates were prospectively identified (January 2006-May 2008). A combined surveillance procedure (environmental survey, and active surveillance program in intensive care units [ICUs]) and an infection control strategy (closure of ICU and urology wards for decontamination, strict compliance with cross-transmission prevention protocols, and a program restricting the use of carbapenems in the ICUs) was designed and implemented. Results: Three hundred and ninety patients were identified. ICU patients were the most numerous group (22%) followed by urology patients (18%). Environmental surveillance found that 3/19 (16%) non-ICU environmental samples and 4/63 (6%) ICU samples were positive for the MRPA clonal strain. In addition, active surveillance found that 19% of patients were fecal carriers of MRPA. Significant changes in the trends of incidence rates were noted after intervention 1 (reinforcement of cleaning procedures): -1.16 cases/1,000 patient-days (95%CI -1.86 to -0.46; p = 0.003) and intervention 2 (extensive decontamination): -1.36 cases/1,000 patient-days (95%CI -1.88 to -0.84; p < 0.001) in urology wards. In addition, restricted use of carbapenems was initiated in ICUs (January 2007), and their administration decreased from 190-170 DDD/1,000 patient-days (October-December 2006) to 40-60 DDD/1,000 patient-days (January-April 2007), with a reduction from 3.1 cases/1,000 patient-days in December 2006 to 2.0 cases/1,000 patient-days in May 2007. The level of initial carbapenem use rose again during 2008, and the incidence of MRPA increased progressively once more. Conclusions: In the setting of sustained MRPA outbreaks, epidemiological findings suggest that patients may be a reservoir for further environmental contamination and cross-transmission. Although our control program was not successful in ending the outbreak, we think that our experience provides useful guidance for future approaches to this problem. | - |
dc.format.extent | 8 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | BioMed Central | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1186/1471-2334-11-272 | - |
dc.relation.ispartof | Bmc Infectious Diseases, 2011, vol. 11, p. 272 | - |
dc.relation.uri | https://doi.org/10.1186/1471-2334-11-272 | - |
dc.rights | cc-by (c) Suarez, Cristina et al., 2011 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Pseudomonas | - |
dc.subject.classification | Epidemiologia | - |
dc.subject.classification | Infeccions nosocomials | - |
dc.subject.classification | Higiene hospitalària | - |
dc.subject.other | Pseudomonas | - |
dc.subject.other | Epidemiology | - |
dc.subject.other | Nosocomial infections | - |
dc.subject.other | Hospital hygiene | - |
dc.title | A large sustained endemic outbreak of multiresistant Pseudomonas aeruginosa: a new epidemiological scenario for nosocomial acquisition | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 607929 | - |
dc.date.updated | 2018-01-25T09:52:49Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 21995287 | - |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Patologia i Terapèutica Experimental) |
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