BRMO Module 1b Evidence-tabel

Arena (2013)

Type of study:

Cohort study

Setting and country:

Italy, hospital

Funding and conflicts of interest:

No conflicts of interest reported

Study is supported by grants from FP7 projects

TEMPOTEST-QC (grant HEALTH-2009-241742) and EvoTAR (grant

HEALTH-F3-2011-2011-282004)

Inclusion criteria:

Patients positive for ESCRKP from a nonsterile site (e.g., from a nasopharyngeal or rectal swab )or normally sterile site (e.g., from a central venous catheter [CVC], blood, or cerebrospinal fluid).

Exclusion criteria:

Not fulfilling inclusion criteria

N total at baseline:

N=127 patients
N=28 infected
N=99 colonized

Groups comparable at baseline?

Not applicable

Describe intervention (treatment/procedure/test):

Additional infection control measures

Describe control (treatment/procedure/test):

Standard infection prevention measures

Length of follow-up:

Not applicable

Loss-to-follow-up:

Not applicable

Incomplete outcome data:

No incomplete outcome data.

Outcome measures and effect size (include 95% CI and p-value if available):

Outbreak

Infection control measures

The authors conclude that that AmpC type enzyme-producing strains can cause large outbreaks with significant morbidity and mortality effects. Control of the outbreak was related to reinforcement of infection control measures based on increased awareness of the problem, hand hygiene reliance, and encouragement of alcohol-based hand rub use by health care workers.

Diestra (2011)

Type of study:

Cohort study

Setting and country:

Spain, Hospital

Funding and conflicts of interest:

No conflicts of interest reported

Study is supported by Ministerio de Ciencia e Innovacio´ n, Instituto de Salud Carlos III – FEDER, Spanish

Network for the Research in Infectious Diseases

Inclusion criteria:

Patients admitted to Granollers Hospital between June 2007 and January 2008, who tested positive for K. pneumoniae

Exclusion criteria:

Not fulfilling inclusion criteria

N total at baseline:

N=2459 patients tested
N=26 positive for K. pneumoniae

Groups comparable at baseline?

Not applicable

Describe intervention (treatment/procedure/test):

Additional infection control measures

Describe control (treatment/procedure/test):

Standard infection prevention measures

Length of follow-up:

Not applicable

Loss-to-follow-up:

Not applicable

Incomplete outcome data:

No incomplete outcome data.

Outcome measures and effect size (include 95%CI and p-value if available):

Outbreak

Infection control measures

The authors conclude that community clones entered the hospital and spread by cross-infection. The small number of patients per cluster was probably attributable to the infection control programme in place in the centre.

Ohana (2006)

Type of study:

Cohort study

Setting and country:

France, physical medicine and rehabilitation unit

Funding and conflicts of interest:

The study does not include a statement on funding or conflicts of interest

Inclusion criteria:

Patients who had stayed in the PMRU and gave at least one clinical sample and/or rectal swab positive for ACC-1-Kp. Healthcare-associated infections were classified according to the criteria of the Centers for Disease Control and Prevention.

Exclusion criteria:

Not fulfilling inclusion criteria

N total at baseline:

n=40 cases

Groups comparable at baseline?

Not applicable

Describe intervention (treatment/procedure/test):

Additional infection control measures

Describe control (treatment/procedure/test):

Standard infection prevention measures

Length of follow-up:

Not applicable

Loss-to-follow-up:

Not applicable

Incomplete outcome data:

No incomplete outcome data.

Outcome measures and effect size (include 95%CI and p-value if available):

Outbreak

Infection control measures

The authors conclude that the outbreak was only controlled after the introduction of rigorous patient placement (i.e. single rooms or cohorting in the same room), while allowing the patients to have free access to the various technical services (e.g. physiotherapy and occupational therapy) and living spaces necessary for re-education.