Impact of the ?Zero Resistance? program on acquisition of multidrug-resistant bacteria in patients admitted to Intensive Care Units in Spain. A prospective, intervention, multimodal, multicenter study

Objective: To assess the impact of a multimodal interventional project (Zero Resistance) on the acquisition of multidrug-resistant bacteria (MDR-B) during the patient's ICU stay.Design: Prospective, open-label, interventional, multicenter study. Setting: 103 ICUs.Patients: Critically ill patients admitted to the ICUs over a 27-month period. Interventions: Implementation of a bundle of 10 recommendations to prevent emergence and spread of MDR-B in the ICU. Main variable of interest: Rate of patients acquiring MDR-B during their ICU stay, with differ-entiation between colonization and infection.Results: A total of 139,505 patients were included. In 5409 (3.9%) patients, 6020 MDR-B on ICU admission were identified, and in 3648 (2.6%) patients, 4269 new MDR-B during ICU stay were isolated. The rate of patients with MDR-B detected on admission increased significantly (IRR 1.43, 95% CI 1.31-1.56) (p < 0.001) during the study period, with an increase of 32.2% between the initial and final monthly rates. On the contrary, the rate of patients with MDR-B during ICU stay decreased non-significantly (IRR 0.93, 95% CI 0.83-1.03) (p = 0.174), with a 24.9% decrease between initial and final monthly rates. According to the classification into colonization or infection, there was a highly significant increase of MDR-B colonizations detected on admission (IRR 1.69, 95% CI 1.52-1.83; p < 0.0001) and a very significant decrease of MDR-B-infections during ICU stay (IRR 0.67, 95% CI 0.57-0.80, p < 0.0001).Conclusions: The implementation of ZR project-recommendations was associated with a signi-ficantly reduction an infection produced by MDR-B acquired during the patient's ICU stay.(c) 2022 Published by Elsevier Espan similar to a, S.L.U.

Automated summary

This study assessed the impact of a multimodal interventional project (Zero Resistance) on the acquisition of multidrug-resistant bacteria (MDR-B) during the patient's ICU stay. The results showed a reduction in the rate of patients acquiring MDR-B after the implementation of the intervention.