TY - JOUR T1 - 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 JO - Medicina Intensiva (English Edition) T2 - AU - Álvarez-Lerma,Francisco AU - Catalán-González,Mercedes AU - Álvarez,Joaquín AU - Sánchez-García,Miguel AU - Palomar-Martínez,Mercedes AU - Fernández-Moreno,Inmaculada AU - Garnacho-Montero,José AU - Barcenilla-Gaite,Fernando AU - García,Rosa AU - Aranaz-Andrés,Jesús AU - Lozano-García,Francisco J. AU - Ramírez-Galleymore,Paula AU - Martínez-Alonso,Montserrat SN - 21735727 M3 - 10.1016/j.medine.2022.12.002 DO - 10.1016/j.medine.2022.12.002 UR - https://medintensiva.org/en-impact-zero-resistance-program-on-articulo-S2173572722003496 AB - ObjectiveTo 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. DesignProspective, open-label, interventional, multicenter study. Setting103 ICUs. PatientsCritically ill patients admitted to the ICUs over a 27-month period. InterventionsImplementation of a bundle of 10 recommendations to prevent emergence and spread of MDR-B in the ICU. Main variable of interestRate of patients acquiring MDR-B during their ICU stay, with differentiation between colonization and infection. ResultsA 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). ConclusionsThe implementation of ZR project-recommendations was associated with a significantly reduction an infection produced by MDR-B acquired during the patient’s ICU stay. ER -