The impact of discontinuing single-room isolation of patients with vancomycin-resistant enterococci : a quasi-experimental single-centre study in South Korea
Copyright © 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved..
OBJECTIVES: There is limited data on the effects of discontinuing single-room isolation while maintaining contact precautions, such as the use of gowns and gloves. In April 2021, our hospital ceased single-room isolation for patients with vancomycin-resistant enterococci (VRE) because of single-room unavailability. This study assessed the impact of this policy by examining the incidence of hospital-acquired VRE bloodstream infections (HA-VRE BSI).
METHODS: This retrospective quasi-experimental study was conducted at a tertiary-care hospital in Seoul, South Korea. Time-series analysis was used to evaluate HA-VRE BSI incidence at the hospital level and in the haematology unit before (phase 1) and after (phase 2) the policy change.
RESULTS: At the hospital level, HA-VRE BSI incidence level (VRE BSI per 1000 patient-days per month) and trend did not change significantly between phase 1 and phase 2 (coefficient -0.015, 95% confidence interval (CI): -0.053 to 0.023, P=0.45 and 0.000, 95% CI: -0.002 to 0.002, P=0.84, respectively). Similarly, HA-VRE BSI incidence level and trend in the haematology unit (-0.285, 95% CI: -0.618 to 0.048, P=0.09 and -0.018, 95% CI: -0.036 to 0.000, P = 0.054, respectively) did not change significantly across the two phases.
CONCLUSIONS: Discontinuing single-room isolation of VRE-colonized or infected patients was not associated with an increase in the incidence of VRE BSI at the hospital level or among high-risk patients in the haematology unit. Horizontal intervention for multi-drug-resistant organisms, including measures such as enhanced hand hygiene and environmental cleaning, may be more effective at preventing VRE transmission.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:147 |
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| Enthalten in: |
The Journal of hospital infection - 147(2024) vom: 15. März, Seite 77-82 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Park, S [VerfasserIn] |
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| Links: |
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| Themen: |
Bloodstream infection |
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| Anmerkungen: |
Date Revised 03.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.jhin.2024.02.025 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Park, S |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of discontinuing single-room isolation of patients with vancomycin-resistant enterococci |b a quasi-experimental single-centre study in South Korea |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a OBJECTIVES: There is limited data on the effects of discontinuing single-room isolation while maintaining contact precautions, such as the use of gowns and gloves. In April 2021, our hospital ceased single-room isolation for patients with vancomycin-resistant enterococci (VRE) because of single-room unavailability. This study assessed the impact of this policy by examining the incidence of hospital-acquired VRE bloodstream infections (HA-VRE BSI) | ||
| 520 | |a METHODS: This retrospective quasi-experimental study was conducted at a tertiary-care hospital in Seoul, South Korea. Time-series analysis was used to evaluate HA-VRE BSI incidence at the hospital level and in the haematology unit before (phase 1) and after (phase 2) the policy change | ||
| 520 | |a RESULTS: At the hospital level, HA-VRE BSI incidence level (VRE BSI per 1000 patient-days per month) and trend did not change significantly between phase 1 and phase 2 (coefficient -0.015, 95% confidence interval (CI): -0.053 to 0.023, P=0.45 and 0.000, 95% CI: -0.002 to 0.002, P=0.84, respectively). Similarly, HA-VRE BSI incidence level and trend in the haematology unit (-0.285, 95% CI: -0.618 to 0.048, P=0.09 and -0.018, 95% CI: -0.036 to 0.000, P = 0.054, respectively) did not change significantly across the two phases | ||
| 520 | |a CONCLUSIONS: Discontinuing single-room isolation of VRE-colonized or infected patients was not associated with an increase in the incidence of VRE BSI at the hospital level or among high-risk patients in the haematology unit. Horizontal intervention for multi-drug-resistant organisms, including measures such as enhanced hand hygiene and environmental cleaning, may be more effective at preventing VRE transmission | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bloodstream infection | |
| 650 | 4 | |a Contact precaution | |
| 650 | 4 | |a Isolation | |
| 650 | 4 | |a VRE | |
| 700 | 1 | |a Bae, S |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, E O |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, E |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, M J |e verfasserin |4 aut | |
| 700 | 1 | |a Chong, Y P |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, S-H |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, S-O |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Y S |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, J |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, S-H |e verfasserin |4 aut | |
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