Email program reduced drug-resistance in ICUs

HealthDay News – Weekly emails explaining infection-control interventions to hospital leadership and intensive care unit staff correlated with a reduction in the rates of carbapenem-resistant Acinetobacter baumannii, according to researchers.

“Weekly and systematic dissemination of the findings of a bundle of interventions was successful in decreasing the rates of carbapenem-resistant A. baumannii across a large public hospital,” wrote the L. Silvia Monoz-Price, MD, and colleagues in the American Journal of Infection Control.

The researchers retrospectively analyzed monthly rates of new acquisitions of carbapenem-resistant A. baumannii among hospitalized patients at a 1,500 bed public teaching hospital before and after implementation of weekly electronic communications. The emails described, interpreted and packaged findings from the previous week’s active surveillance, environmental and hand cultures, along with environmental disinfections.

New acquisitions were defined as the isolation of the first carbapenem-resistant A baumannii isolate after 48 hours of hospitalization in a patient without previous history of A baumannii. From January 2010 through June 2013, there were 438 new acquisitions of carbapenem-resistant A. baumannii, the researchers determined.

From baseline to post intervention periods, the rate of acquisition decreased hospital wide from 5.13% to 1.93% per 10,000 patient-days (P<0.0001).

Medical intensive care units also saw a drop in rates – from 67.15% to 17.4% (P<0.0001) — as did trauma intensive care units, from 55.9% to 14.7% (P=0.0004).

“These regular highly visible communications allowed us to create a sense of accountability for new cases that unified both the leadership and providers toward the common goal of decreasing new acquisitions of carbapenem-resistant A. baumannii,” wrote the researchers.

Information included in the weekly email communications included:

• The number and location of new carbapenem-resistant A baumannii acquisitions
• Environmental findings including culture results and ultraviolet markers, as indicators of cleaning
• Maps of the units showing the location of carbapenem-resistant A baumannii-positive patients and objects
• Action plans for infection control