Stopping Hospital Infections With Environmental Services (SHINE): A Cluster-randomized Trial of Intensive Monitoring Methods for Terminal Room Cleaning on Rates of Multidrug-resistant Organisms in the Intensive Care Unit
| العنوان: | Stopping Hospital Infections With Environmental Services (SHINE): A Cluster-randomized Trial of Intensive Monitoring Methods for Terminal Room Cleaning on Rates of Multidrug-resistant Organisms in the Intensive Care Unit |
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| المؤلفون: | Matthew J, Ziegler, Hilary H, Babcock, Sharon F, Welbel, David K, Warren, William E, Trick, Pam, Tolomeo, Jacqueline, Omorogbe, Diana, Garcia, Tracy, Habrock-Bach, Onofre, Donceras, Steven, Gaynes, Leigh, Cressman, Jason P, Burnham, Warren, Bilker, Sujan C, Reddy, David, Pegues, Ebbing, Lautenbach, Brendan J, Kelly, Barry, Fuchs, Niels D, Martin, Jennifer H, Han |
| المصدر: | Clin Infect Dis |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Methicillin-Resistant Staphylococcus aureus, Microbiology (medical), Cross Infection, Intensive Care Units, Adenosine Triphosphate, Infectious Diseases, Vancomycin, Drug Resistance, Multiple, Bacterial, Gram-Negative Bacteria, Major Article, Humans, Vancomycin-Resistant Enterococci |
| الوصف: | Background Multidrug-resistant organisms (MDROs) frequently contaminate hospital environments. We performed a multicenter, cluster-randomized, crossover trial of 2 methods for monitoring of terminal cleaning effectiveness. Methods Six intensive care units (ICUs) at 3 medical centers received both interventions sequentially, in randomized order. Ten surfaces were surveyed each in 5 rooms weekly, after terminal cleaning, with adenosine triphosphate (ATP) monitoring or an ultraviolet fluorescent marker (UV/F). Results were delivered to environmental services staff in real time with failing surfaces recleaned. We measured monthly rates of MDRO infection or colonization, including methicillin-resistant Staphylococcus aureus, Clostridioides difficile, vancomycin-resistant Enterococcus, and MDR gram-negative bacilli (MDR-GNB) during a 12-month baseline period and sequential 6-month intervention periods, separated by a 2-month washout. Primary analysis compared only the randomized intervention periods, whereas secondary analysis included the baseline. Results The ATP method was associated with a reduction in incidence rate of MDRO infection or colonization compared with the UV/F period (incidence rate ratio [IRR] 0.876; 95% confidence interval [CI], 0.807–0.951; P = .002). Including the baseline period, the ATP method was associated with reduced infection with MDROs (IRR 0.924; 95% CI, 0.855–0.998; P = .04), and MDR-GNB infection or colonization (IRR 0.856; 95% CI, 0.825–0.887; P Conclusions Intensive monitoring of ICU terminal room cleaning with an ATP modality is associated with a reduction of MDRO infection and colonization. |
| تدمد: | 1537-6591 1058-4838 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3e2c51b7254c9a7f6065263deecf1002 https://doi.org/10.1093/cid/ciac070 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3e2c51b7254c9a7f6065263deecf1002 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
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