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Do Contact Precautions Reduce the Incidence of Intensive Care Unit-Acquired Pseudomonas aeruginosa Infections? The DPCPYO (Detection and Contact Precautions for Patients With P. aeruginosa) Cluster-Randomized Crossover Trial

dc.rights.licenseopenen_US
dc.contributor.authorSLEKOVEC, Celine
dc.contributor.authorROBERT, Jerome
dc.contributor.authorBERTHELOT, Philippe
dc.contributor.authorVAN DER MEE-MARQUET, Nathalie
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorROGUES, Anne-Marie
dc.contributor.authorDEROUIN, Veronique
dc.contributor.authorCHOLLEY, Pascal
dc.contributor.authorBERTRAND, Xavier
dc.contributor.authorGBAGUIDI-HAORE, Houssein
dc.contributor.authorGROUP, Dpcpyo Trial
dc.date.accessioned2022-01-17T10:57:12Z
dc.date.available2022-01-17T10:57:12Z
dc.date.issued2021-11-02
dc.identifier.issn1537-6591 (Electronic) 1058-4838 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/124406
dc.description.abstractEnBACKGROUND: The issue of contact precautions as contributory factors for reducing Pseudomonas aeruginosa (Pa) infections in intensive care units (ICUs) remains questioned. We evaluated the impact of the addition of contact precautions to standard precautions for Pa-positive patients on incidence of ICU-acquired Pa infections. METHODS: In this multicenter, cluster-randomized crossover trial, 10 French ICUs were randomly assigned (1:1) to sequence 0-1 (6-month control period [CP]/3-month washout period/6-month intervention period [IP]) or sequence 1-0 (6-month IP/3-month washout period/6-month CP). A surveillance screening program for Pa was implemented. Competing-risks regression models were built with death and discharge without the occurrence of ICU-acquired Pa infection (the primary outcome) as competing events. Models were adjusted for within-ICU correlation and patient- and ICU-level covariates. The Simpson diversity index (SDI) and transmission index (TI) of Pa isolates were derived from pulsed-field gel electrophoresis typing. RESULTS: Within recruited ICUs, the cumulative incidence and incidence rate of ICU-acquired Pa infections were 3.38% (55/1625) versus 3.44% (57/1658) and 3.31 versus 3.52 per 1000 patient-days at risk during the CP and IP, respectively. Multivariable models indicated that the intervention did not significantly change the cumulative incidence (subdistribution hazard ratio, .91; 95% confidence interval [CI], .49-1.67; P = .76) or rate (cause-specific hazard ratio, 1.36; 95% CI, .71-2.63; P = .36) of the primary outcome. SDI and TI did not significantly differ between CP and IP. CONCLUSIONS: The addition of contact precautions to standard precautions for Pa-positive patients with a surveillance screening program does not significantly reduce ICU-acquired Pa infections in non-outbreak situations. Clinical Trials Registration. ISRCTN92710225.
dc.language.isoENen_US
dc.subject.enContact precautions
dc.subject.enPseudomonas aeruginosa
dc.subject.enICU
dc.subject.enPatient-to-patient transmission
dc.subject.enPFGE
dc.title.enDo Contact Precautions Reduce the Incidence of Intensive Care Unit-Acquired Pseudomonas aeruginosa Infections? The DPCPYO (Detection and Contact Precautions for Patients With P. aeruginosa) Cluster-Randomized Crossover Trial
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/cid/ciaa1663en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed33137174en_US
bordeaux.journalClinical Infectious Diseasesen_US
bordeaux.pagee2781-e2788en_US
bordeaux.volume73en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue9en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamPharmacoEpi-Drugsen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Clinical%20Infectious%20Diseases&rft.date=2021-11-02&rft.volume=73&rft.issue=9&rft.spage=e2781-e2788&rft.epage=e2781-e2788&rft.eissn=1537-6591%20(Electronic)%201058-4838%20(Linking)&rft.issn=1537-6591%20(Electronic)%201058-4838%20(Linking)&rft.au=SLEKOVEC,%20Celine&ROBERT,%20Jerome&BERTHELOT,%20Philippe&VAN%20DER%20MEE-MARQUET,%20Nathalie&ROGUES,%20Anne-Marie&rft.genre=article


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