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Antimicrobial Resistance & Infection Control

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Open Access 01-12-2018 | Research

Implementing an infection control and prevention program decreases the incidence of healthcare-associated infections and antibiotic resistance in a Russian neuro-ICU

Authors: Ksenia Ershova, Ivan Savin, Nataliya Kurdyumova, Darren Wong, Gleb Danilov, Michael Shifrin, Irina Alexandrova, Ekaterina Sokolova, Nadezhda Fursova, Vladimir Zelman, Olga Ershova

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2018

Abstract

Background

The impact of infection prevention and control (IPC) programs in limited resource countries such as Russia are largely unknown due to a lack of reliable data. The aim of this study is to evaluate the effect of an IPC program with respect to healthcare associated infection (HAI) prevention and to define the incidence of HAIs in a Russian ICU.

Methods

A pioneering IPC program was implemented in a neuro-ICU at Burdenko Neurosurgery Institute in 2010 and included hand hygiene, surveillance, contact precautions, patient isolation, and environmental cleaning measures. This prospective observational cohort study lasted from 2011 to 2016, included high-risk ICU patients, and evaluated the dynamics of incidence, etiological spectrum, and resistance profile of four types of HAIs, including subgroup analysis of device-associated infections. Survival analysis compared patients with and without HAIs.

Results

We included 2038 high-risk patients. By 2016, HAI cumulative incidence decreased significantly for respiratory HAIs (36.1% vs. 24.5%, p-value = 0.0003), urinary-tract HAIs (29.1% vs. 21.3%, p-value = 0.0006), and healthcare-associated ventriculitis and meningitis (HAVM) (16% vs. 7.8%, p-value = 0.004). The incidence rate of EVD-related HAVM dropped from 22.2 to 13.5 cases per 1000 EVD-days. The proportion of invasive isolates of Klebsiella pneumoniae and Acinetobacter baumannii resistant to carbapenems decreased 1.7 and 2 fold, respectively. HAVM significantly impaired survival and independently increasing the probability of death by 1.43.

Conclusions

The implementation of an evidence-based IPC program in a middle-income country (Russia) was highly effective in HAI prevention with meaningful reductions in antibiotic resistance.

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Title: Implementing an infection control and prevention program decreases the incidence of healthcare-associated infections and antibiotic resistance in a Russian neuro-ICU
Authors: Ksenia Ershova
Ivan Savin
Nataliya Kurdyumova
Darren Wong
Gleb Danilov
Michael Shifrin
Irina Alexandrova
Ekaterina Sokolova
Nadezhda Fursova
Vladimir Zelman
Olga Ershova
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Antimicrobial Resistance & Infection Control / Issue 1/2018
Electronic ISSN: 2047-2994
DOI: https://doi.org/10.1186/s13756-018-0383-4

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