Table 6.
General characteristics of the reported clusters and outbreaks in ICU
| Timeline | Characteristics | Identified source | Control measures | Recurrence | ||
|---|---|---|---|---|---|---|
| 1995–2007 | Scattered clusters affecting 1–2 patients/month | • Endogenous • Common source |
• Hand hygiene compliance • Patient placement on contact isolation |
Intermittent | ||
| 2007–08 | Outbreaks occurring in ICU on periodic basis Incidence rate 5–25/1000 patient-days | Case-control study • Endogenous - Malignancy - Recent surgery • Common source - Water contamination with MDR-Ab |
• Targeted intervention - Infection control practices - Enforcing adherence to hand hygiene - Proper use of personal protective equipment - Controlled visitation to patients - Targeted education and guidance • Intensified presence of ICPP team |
Frequent | ||
| 2009–11 | Major outbreaks occurring in ICU on monthly basis Incidence rate 4–30/1000 patient-days |
• Endogenous - Underlying diseases - Invasive procedures • Common source - Contaminated ventilators Lack of compliance with IC measures |
Key measures • Strict compliance hand hygiene policy • Patient placement on contact precautions until cleared by negative results of screening cultures • Judicious use of antibiotics • H2O2 decontamination |
Ongoing | ||
| 2012–14 | Alternating endemic clusters and outbreaks occurring on monthly basis Colonization pressure: | Significant findings for point and propagated sources | Implementation of Drastic measures were implemented - Key revisions of policies and procedures - Key change in cleaning and disinfection methods |
Ongoing | ||
| 2012 | 2013 | 2014 | ||||
| 284.0 | 263.0 | 322.0 | ||||