Silver-embedded screens in the intensive care unit. A new tool to control multi-drug resistant bacterial cross-transmission
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The purpose of this study was to assess the effectiveness of silver-embedded surfaces (BactiBlock®) to prevent surface colonization by multi-resistant bacteria (MRB) and to reduce the incidence of MRB colonization and infection in patients admitted to an intensive care unit (ICU). A 6-month prospective observational study in a 24-bed mixed ICU divided into two identical subunits (12 beds each) was designed. Seven solid mobile screens were placed in one of the subunits while in the other cloth screens remained. Solid screens were constructed with high-density polyethylene embedded in Bactiblock®. To evaluate the effectiveness of screens coated with Bactiblock®, number of MRB isolates on screens were compared for 6 months. Likewise, numbers of new patients and ICU-stays with MRB colonization in the two subunits were compared. One hundred forty screen samples were collected in 10-point prevalent days. MRB were detected on 28 (20.0%) samples. Over the 70 samples taken on cloth folding screens, MRB were detected in 25 (35.7%), while only 3 (4.3%) of the 70 samples taken on Bactiblock® screens were positive for MRB (p < 0.001). The unit with Bactiblock® screens presented fewer number of ICU stays with MRB colonization (27.8% vs 47.1%; p < 0.001). No significant differences were found in the global incidence of MRB nosocomial infection. The presence of Bactiblock® embedded in solid folding screens avoided MRB surface colonization and reduced MRB transmission to patients admitted to critical care units, proving to be an useful tool in the control of MRB.
KeywordsIntensive Care Unit Nosocomial Infection Intensive Care Unit Stay Acinetobacter Baumannii Critical Care Unit
Compliance with ethical standards
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Conflict of interest
The authors declare that they have no conflict of interest.
The Hospital La Fe Bioethical Committee approved this study.
- 2.Antimicrobial resistance interactive database (EARS-Net). Available at: http://www.ecdc.europa.eu/en/healthtopics/antimicrobial_resistance/ database/Pages/database.aspx. Accessed 12 December 2015
- 3.National Antimicrobial Resistance Monitoring System for Enteric Bacteria Report. CDC. Available at: http://www.cdc.gov/narms/reports/index.html. Accessed 10 December 2015
- 4.The bacterial challenge: time to react. ECDC/EMEA Technical report. 2009. Available at: http://www.ecdc.europa.eu/en/publications/Publications. Accessed 10 December 2015
- 7.Wilson APR, Smyth D, Moore G, Singleton J, Jackson R, Gant V, Jeanes A, Shaw S, James E, Cooper B, Kafatos G, Cookson B, Singer M, Bellingan G (2011) The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: a randomized crossover study in critical care units in two hospitals. Crit Care Med 39:651–658CrossRefPubMedGoogle Scholar
- 8.Tokmaji G, Vermeulen H, Müller MC, Kwakman PH, Schultz MJ, Zaat SA (2015) Silver-coated endotracheal tubes for prevention of ventilator-associated pneumonia in critically ill patients. Cochrane Database Syst Rev 8:CD009201Google Scholar
- 11.WHO (2009) WHO Guidelines on hand hygiene in health care. 2009. WHO, Geneva. Available at: http://www.who.int/gpsc/5may/tools/en/. Accessed 15 December 2015
- 12.Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice LB, Stelling J, Struelens MJ, Vatopoulos A, Weber JT, Monnet DL (2012) Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18:268–281CrossRefPubMedGoogle Scholar
- 16.Ucgun I, Dagli CE, Kiremitci A, Yildirim H, Ak G, Aslan S (2013) Effects of isolation rooms on the prevalence of hospital acquired pneumonia in a respiratory ICU. Eur Rev Med Pharmacol Sci 17:S2–S8Google Scholar
- 19.Yu F, Ying Q, Chen C, Ding B, Liu Y, Lu Y, Qin Z, Parsons C, Salgado C, Qu D, Pan J, Wang L (2012) Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring blaIMP-4 and blaDHA-1 in a neonatal intensive care unit in China. J Med Microbiol 61:984–989CrossRefPubMedGoogle Scholar
- 20.Lister DM, Kotsanas D, Ballard SA, Howden BP, Carse E, Tan K, Scott C, Gillespie EE, Mahony AA, Doherty R, Korman TM, Johnson PD, Stuart RL (2015) Outbreak of vanB vancomycin-resistant Enterococcus faecium colonization in a neonatal service. Am J Infect Control 43:1061–1065CrossRefPubMedGoogle Scholar