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. 2023 Sep 26;3(1):e162.
doi: 10.1017/ash.2023.439. eCollection 2023.

Synergy between infection control and antimicrobial stewardship programs to control carbapenem-resistant Enterobacterales

Wanda Cornistein  1 , Daniela Santonato  1 , Paula Andrea Novau  1 , Leonardo Guillermo Fabbro  1 , Melisa Fernanda Jorge  1 , Maria Agustina Malvicini  2 , Viviana Vilches  3 , Fernando Martin Iudica  4
Affiliations

Synergy between infection control and antimicrobial stewardship programs to control carbapenem-resistant Enterobacterales

Wanda Cornistein et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: Argentina is the third country in the world with the higher levels of CRE. The primary objective is to achieve an optimal result in the CRE infection rate after the implementation of an IPC program and antimicrobial stewardship programs (ASP) in a large teaching hospital in Argentina.

Methods: Retrospective, observational study from January 2018 to December 2021, in a 220-bed tertiary care teaching hospital in Buenos Aires province. Actions aimed at CRE control and prevention included CRE and healthcare-associated infection (HAI) surveillance; compliance with hand hygiene, hospital hygiene, contact isolation precautions, and care bundles for the prevention of device-associated infections; optimization of antimicrobial treatments, antimicrobial consumption, education, and feedback.

Results: Synergy between an ICP and ASP achieved controlled rate of CRE infections reaching the lowest levels during 2020 (0.08 episodes/1000 patient days). Colonization rate remained stable throughout the study period. Ventilator-associated pneumonia (VAP) rate showed a trend toward lower rates. Compliance with care bundles showed rates >85%. Antimicrobial consumption increased slightly during the study period (15%). Among high-impact antimicrobials, only colistin consumption increased.

Conclusion: Our study demonstrates the sustained and beneficial impact of an IPC Program and an ASP to control CRE infection.

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Conflict of interest statement

Wanda Cornistein received speaker honoraria from MSD, PFIZER, ROCHE, and BD in the last year. The other authors declared no potential conflicts of interest with respect to research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Incidence density of carbapenem-resistant Enterobacterales infection.
Figure 2.
Figure 2.
Hand hygiene compliance rate. Note: Adherence to hand hygiene moments and technique. The blue star marks the point in time when observations via cameras was added to direct observation.
See this image and copyright information in PMC

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