Evaluation of a modified cleaning procedure in the prevention of carbapenem-resistant Acinetobacter baumannii clonal spread in a burn intensive care unit using a high-sensitivity luminometer

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• 作者：B. Casini^a ; ^{beatrice.casini@med.unipi.it} ; C. Selvi^a ; M.L. Cristina^b ; M. Totaro^a ; A.L. Costa^a ; P. Valentini^a ; S. Barnini^c ; A. Baggiani^a ; E. Tagliaferri^d ; G. Privitera^a
• 关键词：Carbapenem-resistant Acinetobacter baumannii ; Burn intensive care unit ; Cleaning schedule ; Surfaces ; ATP assay ; Pulsed-field gel electrophoresis
• 刊名：Journal of Hospital Infection
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：95
• 期：1
• 页码：46-52
• 全文大小：467 K
• 卷排序：95

文摘

Enhanced environmental cleaning practices are among the most accepted measures for controlling the spread of carbapenem-resistant Acinetobacter baumannii (CR-Ab).AimTo evaluate the impact of heightened cleaning on an ongoing CR-Ab outbreak in a burn intensive care unit (BICU) of an Italian teaching hospital, where chlorhexidine–60% isopropyl alcohol was applied as a complementary disinfectant on high-touch surfaces.MethodsCompliance with the microbial limit proposed for the BICU by AFNOR-NF-S90-351 (20 colony-forming units/100cm2) was assessed by plate count, and compared with the results obtained with intracellular adenosine triphosphate (ATP) detection. Genotyping was performed using pulsed-field gel electrophoresis.FindingsDuring the standard cleaning regimen, three out of 23 samples (13%) gave results over the AFNOR limit and five (21.7%) showed unacceptable ATP levels with 100 relative light units/100 cm2 as the benchmark limit (sensibility 86.4%, specificity 92.2%). Following improvement of the cleaning procedure, only two samples out of 50 (4%) did not satisfy the microbiological criteria and seven (14%) exceeded the ATP limit. In a successive phase, eight of 30 samples collected showed unacceptable results (27%).ConclusionsAdding chlorhexidine–60% isopropyl alcohol as complementary disinfectant proved to be effective for reducing environmental microbial contamination, ATP levels and CR-Ab infection/colonization in patients admitted to the BICU. Real-time monitoring by ATP assay was useful for managing the cleaning schedule and reducing hospital infections, although the calculated values must be interpreted as cleanliness indicators rather than risk indicators.