• Regev Cohen, Zvi Shimoni, Riad Ghara, Ron Ram, and Ronen Ben-Ami.
• Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel; Technion Israel Institute of Technology, Haifa, Israel. Electronic address: regevc@laniado.org.il.
• Am J Infect Control. 2014 Sep 1; 42 (9): 996-1001.

BackgroundAcinetobacter 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.MethodsWe 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.ResultsBetween 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).ConclusionsImplementing 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.Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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