Becker's Clinical Quality & Infection Control

53 ANTIBIOTIC RESISTANCE & STEWARDSHIP Researchers create tool to measure infection control quality, antimicrobial use By Anuja Vaidya A study published in Antimicrobial Resistance & Infection Control exam- ined the efficacy of a tool called the Infection Risk Scan, which mea- sures the quality of infection control and antimicrobial use. The Infection Risk Scan, or IRIS, includes a set of objective reproducible mea- surements, such as: • Hand hygiene compliance • Environmental contamination using adenosine triphosphate measurements • Prevalence of resistant microorganisms by active screening • Availability of infection control preconditions • Personal hygiene of healthcare workers • Appropriate use of indwelling medical devices • Appropriate use of antimicrobials The researchers used the tool and visualized the results in a spider plot using traffic light colors. The study shows IRIS provided ward-specific insights, which could be used to create targeted quality improvement programs. The programs grew hand hygiene compliance from 43 percent to 66 percent. Additionally, adenosine triphosphate levels reduced significantly. "The bundle approach and visualization of the IRIS makes it a useful infec- tion prevention tool providing standardization and transparency," study authors concluded. "Targeted interventions can be started based on the results of the improvement plot and repeated IRIS can show the effect of interventions." n 98% of A. baumannii patients had overnight hospital stay in year prior to infection By Anuja Vaidya A study published in Emerging Infectious Diseases investigated the incidence of carbapenem-nonsusceptible Acinetobacter baumannii in the U. S. from 2012 through 2015. Researchers conducted laboratory-and population-based surveillance in certain areas in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon and Tennessee. They collected carbapenem-nonsusceptible A. baumannii cultured from urine or normally sterile sites. They identified 621 cases in 537 patients. The crude annual incidence was 1.2 cases per 100,000 persons. Among the 598 cases for which complete data were available, 98.7 percent occurred among patients who had overnight hospital stays in the previous year. Around 84.6 percent of infections occurred in patients who had an indwelling device. "Although incidence was lower than for other healthcare-associated patho- gens, cases were associated with substantial rates of illness and death," study authors concluded. n Universal contact precautions do not affect drug-resistant infection rates By Anuja Vaidya A study published in Infection Control & Hospital Epidemiology examined the impact of universal contact precautions on multidrug-resistant organism rates in intensive care units. Researchers used a comparative effec- tiveness approach to study the affect of universal contact precautions on multi- drug-resistant organism incidence density rates, including: • Methicillin-resistant Staphylococcus aureus • Vancomycin-resistant enterococci • Carbapenem-resistant Klebsiella pneumoniae ey examined data from a clinical re- search database collected between 2006 and 2014, comparing MDRO rates between the baseline period and the universal contact precautions period, as well as MDRO rates in three ICUs with universal contact precautions to three ICUs without the precautions. While MDRO rates decreased over time, there was no significant decrease in the trend during the universal contact pre- cautions period compared to the baseline period. Additionally, the three ICUs with univer- sal contact precautions experienced a 6.6 percent decrease in MDRO rates per year versus a 6 percent decrease in non-univer- sal contact precaution ICU units. "e results of this nine-year study suggest decreases in MDROs, including multi- drug-resistant gram-negative bacilli, were more likely due to hospital-wide improve- ments in infection prevention during this period, and [universal contact precautions] had no detectable additional impact," study authors concluded. n

• Cover