Impact of transition from open bay to single room design neonatal intensive care unit on multidrug-resistant organism colonization rates.


Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Feb 2022
Historique:
received: 01 10 2021
revised: 04 12 2021
accepted: 05 12 2021
pubmed: 14 12 2021
medline: 16 2 2022
entrez: 13 12 2021
Statut: ppublish

Résumé

The influence of the neonatal intensive care unit (NICU) design on the acquisition of multidrug-resistant organisms (MDROs) has not been well-documented. To examine the effect of single room unit (SRU) versus open bay unit (OBU) design on the incidence of colonization with MDROs and third-generation cephalosporin-resistant bacteria (3G-CRB) in infants admitted to the NICU. Retrospective cohort study, including all infants admitted to the NICU of a tertiary care academic hospital two years prior to and two years following the transition from OBU to SRU in May 2017. Weekly cultures of throat and rectum were collected to screen for MDRO carriership. Incidence of colonization (percentage of all infants and incidence density per 1000 patient-days) with MDROs and 3G-CRB were compared between OBU and SRU periods. Incidence analysis of 1293 NICU infants, identified 3.2% MDRO carriers (2.5% OBU, 4.0% SRU, not significant), including 2.3% extended-spectrum β-lactamase-producing Enterobacterales carriers, and 18.6% 3G-CRB carriers (17% OBU, 20% SRU, not significant). No differences were found in MDRO incidence density per 1000 patient-days between infants admitted to OBU (1.56) compared to SRU infants (2.63). Transition in NICU design from open bay to SRUs was not associated with a reduction in colonization rates with MDROs or 3G-CRB in our hospital. Further research on preventing the acquisition and spread of resistant bacteria at high-risk departments such as the NICU, as well as optimal ward design, are needed.

Sections du résumé

BACKGROUND BACKGROUND
The influence of the neonatal intensive care unit (NICU) design on the acquisition of multidrug-resistant organisms (MDROs) has not been well-documented.
AIM OBJECTIVE
To examine the effect of single room unit (SRU) versus open bay unit (OBU) design on the incidence of colonization with MDROs and third-generation cephalosporin-resistant bacteria (3G-CRB) in infants admitted to the NICU.
METHODS METHODS
Retrospective cohort study, including all infants admitted to the NICU of a tertiary care academic hospital two years prior to and two years following the transition from OBU to SRU in May 2017. Weekly cultures of throat and rectum were collected to screen for MDRO carriership. Incidence of colonization (percentage of all infants and incidence density per 1000 patient-days) with MDROs and 3G-CRB were compared between OBU and SRU periods.
FINDINGS RESULTS
Incidence analysis of 1293 NICU infants, identified 3.2% MDRO carriers (2.5% OBU, 4.0% SRU, not significant), including 2.3% extended-spectrum β-lactamase-producing Enterobacterales carriers, and 18.6% 3G-CRB carriers (17% OBU, 20% SRU, not significant). No differences were found in MDRO incidence density per 1000 patient-days between infants admitted to OBU (1.56) compared to SRU infants (2.63).
CONCLUSION CONCLUSIONS
Transition in NICU design from open bay to SRUs was not associated with a reduction in colonization rates with MDROs or 3G-CRB in our hospital. Further research on preventing the acquisition and spread of resistant bacteria at high-risk departments such as the NICU, as well as optimal ward design, are needed.

Identifiants

pubmed: 34902498
pii: S0195-6701(21)00436-9
doi: 10.1016/j.jhin.2021.12.006
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

90-97

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

A van der Hoeven (A)

Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: a.van_der_hoeven@lumc.nl.

V Bekker (V)

Division of Neonatology, Department of Pediatrics, Willem Alexander Children's Hospital - Leiden University Medical Center (LUMC), Leiden, the Netherlands.

S J Jansen (SJ)

Division of Neonatology, Department of Pediatrics, Willem Alexander Children's Hospital - Leiden University Medical Center (LUMC), Leiden, the Netherlands.

B Saccoccia (B)

Division of Neonatology, Department of Pediatrics, Willem Alexander Children's Hospital - Leiden University Medical Center (LUMC), Leiden, the Netherlands.

R J M Berkhout (RJM)

Division of Neonatology, Department of Pediatrics, Willem Alexander Children's Hospital - Leiden University Medical Center (LUMC), Leiden, the Netherlands.

E Lopriore (E)

Division of Neonatology, Department of Pediatrics, Willem Alexander Children's Hospital - Leiden University Medical Center (LUMC), Leiden, the Netherlands.

K E Veldkamp (KE)

Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands.

M T van der Beek (MT)

Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands.

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