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Acquisition of antibiotic-resistant Gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) Cluster Randomized Trial
Clinical Infectious Diseases ( IF 9.055 ) Pub Date : 2020-01-23 , DOI: 10.1093/cid/ciaa071
Harris A, Morgan D, Pineles L, et al.

BackgroundThe Benefits of Universal Gloves and Gowns cluster randomized trial found varying effects on MRSA and VRE and no increase in adverse events. The aim of this study was to assess whether the intervention decreases the acquisition of antibiotic-resistant Gram-negative bacteria. MethodsSecondary analysis of 20 hospital intensive care unit, randomized trial. The intervention consisted of healthcare workers wearing gloves and gowns when entering any patient room compared to standard care. The primary composite outcome was acquisition of any antibiotic-resistant Gram-negative bacteria based on surveillance cultures. FindingsA total of 40,492 admission and discharge perianal swabs from 20,246 individual patient admissions were included in the primary outcome. For the primary outcome of acquisition of any antibiotic-resistant Gram-negative bacteria, the intervention had a RR of 0.90 (95% CI 0.71 to 1.12, p= 0.34). Effects on the secondary outcomes of individual bacteria acquisition were as follows: carbapenem-resistant Enterobacteriaceae [RR 0.86 (95% CI, 0.60 to 1.24), p=0.43], carbapenem-resistant Acinetobacter [RR 0.81 (95% CI, 0.52 to 1.27) p=0.36], carbapenem-resistant Pseudomonas [RR 0.88 (95% CI, 0.55 to 1.42) p=0.62], ESBL producing bacteria [RR 0.94, (95% CI, 0.71 to 1.24) p=0.67]. InterpretationUniversal glove and gown use in the ICU was associated with a non-statistically significant decrease in acquisition of antibiotic-resistant Gram-negative bacteria. Individual hospitals should consider the intervention based on the importance of these organisms at their hospital, effect sizes, confidence intervals, and cost of instituting the intervention. Trial registrationClinicaltrials.gov identifier NCT01318213
更新日期:2020-01-24

 

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