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Wassef M, Mukhtar A, Nabil A, et al. Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt. Infect Drug Resist. 2020;13:229-236doi: 10.2147/IDR.S236814.
Wassef, M., Mukhtar, A., Nabil, A., Ezzelarab, M., & Ghaith, D. (2020). Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt. Infection and drug resistance, 13229-236. https://doi.org/10.2147/IDR.S236814
Wassef, Mona, et al. "Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt." Infection and drug resistance vol. 13 (2020): 229-236. doi: https://doi.org/10.2147/IDR.S236814
Wassef M, Mukhtar A, Nabil A, Ezzelarab M, Ghaith D. Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt. Infect Drug Resist. 2020 Jan 28;13:229-236. doi: 10.2147/IDR.S236814. eCollection 2020. PMID: 32095080; PMCID: PMC6995287.
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Infect Drug Resist. 2020 Jan 28;13:229-236. doi: 10.2147/IDR.S236814. eCollection 2020.

Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt.

Infection and drug resistance

Mona Wassef, Ahmed Mukhtar, Ahmed Nabil, Moushira Ezzelarab, Doaa Ghaith

Affiliations

  1. Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
  2. Department of Anesthesia and Critical Care, Faculty of Medicine, Cairo University, Cairo, Egypt.
  3. Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

PMID: 32095080 PMCID: PMC6995287 DOI: 10.2147/IDR.S236814

Abstract

INTRODUCTION: Surgical site infections (SSIs) are one of the most frequently reported hospital acquired infections associated with significant spread of antibiotic resistance.

PURPOSE: We aimed to evaluate a bundle-based approach in reducing SSI at acute surgical intensive care unit of the Emergency Hospital of Cairo University.

PATIENTS AND METHODS: Our prospective study ran from March 2018 to February 2019 and used risk assessment. The study was divided into three phases. Phase I: (pre-bundle phase) for 5 months; data collection, active surveillance of the SSIs, screening for OXA-48 producing

RESULTS: Phase I encompassed 177 patients, while Phase III included 93 patients. A significant reduction of colonization from 24% to 15% (p<0.001) was observed. Similarly, a decrease of SSI from 27% to 15% (p=0.02) was noticed. A logistic regression was performed to adjust for confounding in the implementation of the bundle and we found a 70% reduction of SSI odd's ratio (OR's ratio = 0.3) confidence interval (95% CI 0.14-0.6) with significant Apache II (p=0.04), type of wound; type II (p=0.002), type III (p=0.001) and duration of surgery (p=0.04) as independent risk factors for SSI.

CONCLUSION: Our study demonstrated that the implementation of a multidisciplinary bundle containing evidence-based interventions was associated with a significant reduction of colonization and SSIs and was met with staff approval and acceptable compliance.

© 2020 Wassef et al.

Keywords: ICU; MDR- Acinetobacter; OXA 48; colonization

Conflict of interest statement

The authors report no conflicts of interest in this work.

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