Impact of removing sinks from an intensive care unit on isolations by gram-negative non-fermenting bacilli in patients with invasive mechanical ventilation

Abstract

Introduction and objective: Contamination of sinks, even due to their underuse, is associated with the transmission of non-fermenting gram-negative bacilli (NFGNB) to patients in Augmented Care Units. After previous monitoring with environmental and patient samples, we now explore the impact of removing sinks from ICU cubicles on incidental isolations related to health care in bronchoaspirate samples of patients with invasive mechanical ventilation (IMV).

Material and methods: Quasi-experimental study, before-and-after, pre-intervention annuities April 2014-2016 and post-intervention April 2016-2017. Incidence densities per 1,000 days of IMV were studied, comparing by the exact method based on the binomial distribution and estimating the incidence density ratio.

Results: The incidence densities per 1,000 days of IMV of isolations by NFGNB in bronchoaspirate samples of the pre and post-intervention periods were 11.28 and 1.9, respectively. This implies a post-intervention incidence density 5.90 times lower than before (95% CI: 1.49-51.05, P=.003).

Conclusions: Despite of the limitations of the design, the removal of sinks showed a reduction of the isolations.

Keywords: Bacilo gramnegativo no fermentador; Bronchoaspirate sample; Broncoaspirado; Control de la infección; Infection control; Intensive care unit; Lavabo; Monitoring; Non-fermenting gram-negative bacilli; Sink; Unidad de cuidados intensivos; Vigilancia.