Background Acinetobacter baumannii is a leading cause of ventilator-associated pneumonia, often as a result of ventilator equipment contamination. Evidence-based guidance on optimal care of ventilator equipment to prevent infection is lacking. Here, we report on a significant and persistent reduction in A baumannii infection rates achieved by introducing a strict policy on ventilator care. Methods We implemented an institution-wide ventilator care policy that included routine exchange of breathing circuits and external bacterial filters (every 7-14 days) and replacement followed by routine sterilization of internal bacterial filters (every 4-8 weeks). We analyzed sputum cultures and patient outcomes among ventilated patients before and after the intervention. Results Between January 2012 and March 2013, 321 patients ventilated for more than 3 days comprised the study cohort. Health care-associated A baumannii acquisition was significantly reduced during the postintervention period (33% vs 16%; odds ratio, 0.39; 95% confidence interval, 0.23-0.67; P =.0008). Additionally, the median time to A baumannii acquisition was significantly longer postintervention (59 vs 21 days; P <.0001). A baumannii ventilator-associated pneumonia risk was also reduced postintervention (odds ratio, 0.39; P =.005). Conclusions Implementing a stricter standard of ventilator care than that currently defined in published guidelines can significantly decrease health care-associated A baumannii acquisition and related adverse outcomes among ventilated patients.
- Bacterial filter
- Respirator equipment care
- Ventilator-associated pneumonia