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  • Title: Central line-associated bloodstream infection in a trauma intensive care unit: impact of implementation of Society for Healthcare Epidemiology of America/Infectious Diseases Society of America practice guidelines.
    Author: Mazi W, Begum Z, Abdulla D, Hesham A, Maghari S, Assiri A, Senok A.
    Journal: Am J Infect Control; 2014 Aug; 42(8):865-7. PubMed ID: 25087138.
    Abstract:
    BACKGROUND: This study aimed to assess the impact implementation of the basic Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) practice recommendations in reducing central line-associated bloodstream infection (CLABSI) in intensive care units (ICUs). METHODS: The prospective study was conducted from January 2011-December 2012 at the 23-bed trauma ICU in Saudi Arabia. The basic SHEA/IDSA practice recommendations were introduced and implemented during the year 2012. Laboratory-confirmed CLABSIs were identified, and the antimicrobial susceptibility of isolates was determined. Data were collected and analyzed for benchmarking with the National Healthcare Safety Network. RESULTS: There was a 58% decline in the CLABSI incidence rate from 3.87 to 1.5 per 1,000 central line days in 2011 and 2012, respectively (standardized infection ratio, 0.42; P = .043). Three institutional risk factors were identified and resolved: health care personnel education, removal of nonessential catheters, and use of a catheter cart. Three Klebsiella pneumoniae isolates susceptible only to imipenem, 1 pandrug resistant Acinetobacter baumannii, and 2 Enterococcus faecalis, with 1 isolate resistant to vancomycin, were identified in 2012. CONCLUSION: The basic SHEA/ISDA practice recommendation is an effective prevention model for the reduction of CLABSIs in the ICU. Additional measures are needed to control the spread of multidrug-resistant organisms.
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