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Do contact precautions reduce the incidence of ICU-acquired Pseudomonas aeruginosa infections? The DPCPYO cluster-randomized crossover trial

dc.rights.licenseopenen_US
dc.contributor.authorSLEKOVEC, C.
dc.contributor.authorROBERT, J.
dc.contributor.authorBERTHELOT, P.
dc.contributor.authorVAN DER MEE-MARQUET, N.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorROGUES, Anne-Marie
dc.contributor.authorDEROUIN, V.
dc.contributor.authorCHOLLEY, P.
dc.contributor.authorBERTRAND, X.
dc.contributor.authorGBAGUIDI-HAORE, H.
dc.date.accessioned2021-03-15T15:33:32Z
dc.date.available2021-03-15T15:33:32Z
dc.date.issued2020-11-02
dc.identifier.issn1058-4838en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/26666
dc.description.abstractEnBACKGROUND: Issue of contact precautions as contributory factors for reducing P. 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 the 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, patient- and ICU-level covariates. The Simpson diversity index (SDI) and the transmission index (TI) of Pa isolates were derived from pulsed-field gel electrophoresis typing. RESULTS: Within recruited ICUs, the cumulative incidence and the incidence rate of ICU-acquired Pa infections were 3.38% (55/1625) vs 3.44% (57/1658) and 3.31 vs 3.52 per 1 000 patient-days at risk during CP and IP, respectively. Multivariable models indicated that the intervention did not significantly change the cumulative incidence (subdistribution hazard ratio 0.91, 95% confidence interval [CI] 0.49-1.67, p=0.76) and the rate (cause-specific hazard ratio 1.36, 95%CI 0.71-2.63, p=0.36) 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.
dc.language.isoENen_US
dc.title.enDo contact precautions reduce the incidence of ICU-acquired Pseudomonas aeruginosa infections? The DPCPYO cluster-randomized crossover trial
dc.title.alternativeClin Infect Disen_US
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.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamPharmacoEpi-Drugsen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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