Korean J Nosocomial Infect Control.  2007 Jun;12(1):58-64.

Influence of an Improved Method of Endotracheal Suction on Nosocomial Pneumonia and Tracheal Colonization by Pseudomonas aeruginosa and Acinetobacter baumannii in Intensive Care Units

• Koo HS
• Eom JS
• Kim JS

Abstract

BACKGROUND: The aim of this study was to evaluate the influence of an improved method of endotracheal suction on nosocomial pneumonia (NP) and tracheal colonization by Pseudomonas aeruginosa and Acinetobacter baumannii in intensive care units (ICUs).
METHODS
The study was carried out in both the medical and surgical ICUs of a tertiary-care university hospital; 2,347 patients were admitted in the ICUs from January 2003 to December 2004. The method of endotracheal suction to remove secretions was improved by using a sterile, individually packed catheter and sterile fluid filled in a small container for a single use instead of sterile catheters and fluid packed or filled in large containers for a multiple use. Then, we compared the incidence of NP, the colonization rates of P. aeruginosa and A. baumanni in the respiratory tract, and their carbapenem resistance before and after the intervention.
RESULTS
The incidence of NP (1,000 patient-day rate) was decreased from 4.08 to 2.46 in the SICU and from 1.4 to 0.8 in the MICU after the intervention, but the differences were not significant. The colonization rate by A. baumannii was decreased significantly from 35.7% to 4.6% in the SICU (P<0.001) and from 12.7% to 7.6% in the MICU (P<0.001). The colonization rate by P. aeruginosa was decreased significantly from 17.7% to 7.4% in the SICU (P<0.001), but not in the MICU. There was also a marked decrease in carbapenem resistance, 21% to 8% in P. aeruginosa and 70% to 16% in A. baumannii.
CONCLUSION
Endotracheal suction with a sterile catheter and sterile fluid is important in preventing respiratory infections and colonization by P. aeruginosa and A. baumannii in the ICU.

Keyword

Acinetobacter baumannii; Colonization; Endotracheal suction; Nosocomial pneumonia; Pseudomonas aeruginosa

MeSH Terms

Acinetobacter baumannii*
Acinetobacter*
Catheters
Colon*
Drug Resistance, Bacterial
Humans
Incidence
Intensive Care Units*
Critical Care*
Pneumonia*
Pseudomonas aeruginosa*
Pseudomonas*
Respiratory System
Respiratory Tract Infections
Suction*