Infection control in the intensive care unit: the Pavia experience
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Department of Public Health, Università degli Studi di Pavia, Pavia, Italy
Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A103
Health care activities could contribute to the spread of infections when standard precautions are not respected, as the Covid-19 pandemic showed. Every year in Italy 7% of patients contracts a healthcare-associated infection (HAI). HAIs are responsible for more than 10,000 deaths per year, and wards with fragile patients are the most affected. This study Aims to highlight the key role of prevention and control of HAIs, especially in critical units. In April 2022, an outbreak of Acinetobacter baumannii and Carbapenem-resistant Klebsiella pneumoniae occurred within the intensive care unit of IRCCS Fondazione Policlinico San Matteo, Pavia (Italy), affecting 9 patients. To address the issue, Medical Direction (MD) developed a strategy based on the specific biological characteristics of survival of the micro-organisms. The initiative resulted in daily monitoring of cases, observation of adherence to good hand hygiene practices by health professionals (HPs) and performance of rectal screening swabs to all patients, both at the admission and on a bi-weekly basis. Furthermore, recurring microbiological sampling on bronchoscopes were implemented, with an operating instruction being formulated, to deal with the highly operator-dependent nature of their reprocessing. Regarding environmental hygiene, MD provided for the use of Gioalcool 70% disinfectant and disposable cleaning material, while the entirety of the area involved was sanitized. Hospital Infection Committee also organized an audit to raise HPs’ awareness and train them to comply with good care practices. Thanks to the swift response provided by MD, the outbreak ended on May 29th. Actions to control infection spread were punctually and effectively implemented. Covid-19 pandemic represented an opportunity to increase preparedness to critical events, as the Pavia experience demonstrated. Therefore, it is crucial not to underestimate standard precautions, and to keep operating instructions and training programs updated, to provide high-quality care in an increasingly resilient health system, strengthened by the pandemic experience.