Effect of open and closed endotracheal suctioning on cross-transmission with Gram-negative bacteria: A prospective crossover study

Critical Care Medicine

Volumn 39, Issue 6, 2011, Pages 1313-1321

  Jongerden, Irene P ^a   Buiting, Anton G ^b   Leverstein Van Hall, Maurine A ^a   Speelberg, Ben ^b   Zeidler, Shimriet ^a   Kesecioglu, Jozef ^a   Bonten, Marc J ^a  

^a UNIVERSITY MEDICAL CENTER UTRECHT   (Netherlands)

^b CPRLab   (Netherlands)

Author keywords

antibiotic resistance; cross infection; crosstransmission; infection control; intensive care; mechanical ventilation; suction

Indexed keywords

ACINETOBACTER; ADULT; AGED; ARTICLE; ARTIFICIAL VENTILATION; BACTERIAL TRANSMISSION; CLOSED ENDOTRACHEAL SUCTIONING; CROSS INFECTION; DISEASE SURVEILLANCE; ENTEROBACTER; FEMALE; GENOTYPE; GRAM NEGATIVE BACTERIUM; HUMAN; INFECTION RISK; INTENSIVE CARE UNIT; INTERMETHOD COMPARISON; MAJOR CLINICAL STUDY; MALE; OPEN ENDOTRACHEAL SUCTIONING; PRIORITY JOURNAL; PROSPECTIVE STUDY; PSEUDOMONAS AERUGINOSA; STENOTROPHOMONAS MALTOPHILIA; SURGICAL TECHNIQUE; TEACHING HOSPITAL; TRACHEOBRONCHIAL TOILET; UNIVERSITY HOSPITAL;

EID: 79957630142     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3182120815     Document Type: Article

References (58)

1. Roberts RR, Hota B, Ahmad I, et al: Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: Implications for antibiotic stewardship. Clin Infect Dis 2009; 49:1175-1184.
2. Magnason S, Kristinsson KG, Stefansson T, et al: Risk factors and outcome in ICUacquired infections. Acta Anaesthesiol Scand 2008; 52:1238-1245.
3. Cardenosa Cendrero JA, Sole-Violan J, Bordes BA, et al: Role of different routes of tracheal colonization in the development of pneumonia in patients receiving mechanical ventilation. Chest 1999; 116:462-470. (Pubitemid 29382133)
4. van Saene HK, Damjanovic V, Murray AE, et al: How to classify infections in intensive care units-The carrier state, a criterion whose time has come? J Hosp Infect 1996; 33:1-12. (Pubitemid 26178978)
5. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004; 32: 470-485.
6. Silvestri L, Bragadin CM, Milanese M, et al: Are most ICU infections really nosocomial? A prospective observational cohort study in mechanically ventilated patients. J Hosp Infect 1999; 42:125-133. (Pubitemid 29273819)
7. Cefai C, Richards J, Gould FK, et al: An outbreak of Acinetobacter respiratory tract infection resulting from incomplete disinfection of ventilatory equipment. J Hosp Infect 1990; 15:177-182. (Pubitemid 20139991)
8. Barchitta M, Cipresso R, Giaquinta L, et al: Acquisition and spread of Acinetobacter baumannii and Stenotrophomonas maltophilia in intensive care patients. Int J Hyg Environ Health 2009; 212:330-337.
9. Johnson KL, Kearney PA, Johnson SB, et al: Closed versus open endotracheal suctioning: Costs and physiologic consequences. Crit Care Med 1994; 22:658-666. (Pubitemid 24121568)
10. Zeitoun SS, Botura Leite de Barros AB, Diccini S: A prospective, randomized study of ventilator-associated pneumonia in patients using a closed vs open suction system. J Clin Nurs 2003; 12:484-489. (Pubitemid 37260199)
11. Carlon GC, Fox SJ, Ackerman NJ: Evaluation of a closed-tracheal suction system. Crit Care Med 1987; 15:522-525. (Pubitemid 17080310)
12. Jongerden IP, Rovers MM, Grypdonck MH, et al: Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: A meta-analysis. Crit Care Med 2007; 35:260-270. (Pubitemid 46035704)
13. Maggiore SM, Iacobone E, Zito G, et al: Closed versus open suctioning techniques. Minerva Anestesiol 2002; 68:360-364. (Pubitemid 41787569)
14. Cobley M, Atkins M, Jones PL: Environmental contamination during tracheal suction. A comparison of disposable conventional catheters with a multiple-use closed system device. Anaesthesia 1991; 46:957-961.
15. Lorente L, Lecuona M, Martin MM, et al: Ventilator-associated pneumonia using a closed versus an open tracheal suction system. Crit Care Med 2005; 33:115-119. (Pubitemid 40116545)
16. Moher D, Schulz KF, Altman DG: The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 2001; 357:1191-1194. (Pubitemid 32378696)
17. Schulz KF, Altman DG, Moher D: CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Ann Intern Med 2010; 152:726-732.
18. Campbell MK, Elbourne DR, Altman DG: CONSORT statement: Extension to cluster randomised trials. BMJ 2004; 328:702-708. (Pubitemid 38393415)
19. Nijssen S, Florijn A, Top J, et al: Unnoticed spread of integrin-carrying Enterobacteriaceae in intensive care units. Clin Infect Dis 2005; 41:1-9. (Pubitemid 40863736)
20. Vu-Thien H, Corbineau G, Hormigos K, et al: Multiple-locus variable-number tandemrepeat analysis for longitudinal survey of sources of Pseudomonas aeruginosa infection in cystic fibrosis patients. J Clin Microbiol 2007; 45:3175-3183. (Pubitemid 47585637)
21. Fontana C, Favaro M, Minelli S, et al: Acinetobacter baumannii in intensive care unit: A novel system to study clonal relationship among the isolates. BMC Infect Dis 2008; 8:79.
22. Infection Prevention Workingparty: Indications for isolation. Leiden, The Netherlands, November 2006. Available at: http://www.wip. nl/UK/free-content/ Richtlijnen/Indications% 20for%20isolation.pdf. Accessed February 24, 2011.
23. Infection Prevention Working Group: Measures to Prevent Transmission of Highly Resistant Microorganisms (HRMO). Leiden, Werkgroep Infectie Preventie, 2005. Report No. 39.
24. Robert R, Grollier G, Frat JP, et al: Colonization of lower respiratory tract with anaerobic bacteria in mechanically ventilated patients. Intensive Care Med 2003; 29: 1062-1068. (Pubitemid 36918546)
25. Ewig S, Torres A, El-Ebiary M, et al: Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury. Incidence, risk factors, and association with ventilator-associated pneumonia. Am J Respir Crit Care Med 1999; 159: 188-198. (Pubitemid 29036523)
26. Feldman C, Kassel M, Cantrell J, et al: The presence and sequence of endotracheal tube colonization in patients undergoing mechanical ventilation. Eur Respir J 1999; 13: 546-551. (Pubitemid 29180163)
27. Bergmans DC, Bonten MJ, Stobberingh EE, et al: Colonization with Pseudomonas aeruginosa in patients developing ventilatorassociated pneumonia. Infect Control Hosp Epidemiol 1998; 19:853-855. (Pubitemid 128472209)
28. Durairaj L, Mohamad Z, Launspach JL, et al: Patterns and density of early tracheal colonization in intensive care unit patients. J Crit Care 2009; 24:114-121.
29. Horianopoulou M, Legakis NJ, Kanellopoulou M, et al: Frequency and predictors of colonization of the respiratory tract by VIM- 2-producing Pseudomonas aeruginosa in patients of a newly established intensive care unit. J Med Microbiol 2006; 55:1435-1439. (Pubitemid 44651672)
30. Azim A, Dwivedi M, Rao PB, et al: Epidemiology of bacterial colonization at intensive care unit admission with emphasis on extended- spectrum beta-lactamase- and metallo- beta-lactamase-producing Gram-negative bacteria-An Indian experience. J Med Microbiol 2010; 59:955-960.
31. Sterne JA, White IR, Carlin JB, et al: Multiple imputation for missing data in epidemiological and clinical research: Potential and pitfalls. BMJ 2009; 338:b2393.
32. Little RJA, Rubin DB: Statistical Analysis With Missing Data. Second Edition. Wiley, New York, 2002.
33. Grundmann H, Barwolff S, Tami A, et al: How many infections are caused by patientto- patient transmission in intensive care units? Crit Care Med 2005; 33:946-951. (Pubitemid 40638162)
34. Deppe SA, Kelly JW, Thoi LL, et al: Incidence of colonization, nosocomial pneumonia, and mortality in critically ill patients using a Trach Care closed-suction system versus an open-suction system: Prospective, randomized study. Crit Care Med 1990; 18: 1389-1393.
35. Topeli A, Harmanci A, Cetinkaya Y, et al: Comparison of the effect of closed versus open endotracheal suction systems on the development of ventilator-associated pneumonia. J Hosp Infect 2004; 58:14-19. (Pubitemid 39207106)
36. Adams DH, Hughes M, Elliott TS: Microbial colonization of closed-system suction catheters used in liver transplant patients. Intensive Crit Care Nurs 1997; 13:72-76. (Pubitemid 127683435)
37. Bonten MJM, Bergmans DCJJ, Speijer H, et al: Characteristics of polyclonal endemicity of Pseudomonas aeruginosa colonization in intensive care units-Implications for infection control. Am J Respir Crit Care Med 1999; 160:1212-1219. (Pubitemid 29487461)
38. Olson B, Weinstein RA, Nathan C, et al: Epidemiology of endemic Pseudomonas aeruginosaaeruginosa: Why infection control efforts have failed. J Infect Dis 1984; 150:808-816. (Pubitemid 15182133)
39. Bergmans DC, Bonten MJ, van Tiel FH, et al: Cross-colonisation with Pseudomonas aeruginosa of patients in an intensive care unit. Thorax 1998; 53:1053-1058. (Pubitemid 28567007)
40. Bertrand X, Thouverez M, Talon D, et al: Endemicity, molecular diversity and colonisation routes of Pseudomonas aeruginosa in intensive care units. Intensive Care Med 2001; 27:1263-1268. (Pubitemid 32758922)
41. Agodi A, Barchitta M, Cipresso R, et al: Pseudomonas aeruginosa carriage, colonization, and infection in ICU patients. Intensive Care Med 2007; 33:1155-1161. (Pubitemid 47036900)
42. Ortega B, Groeneveld AB, Schultsz C: Endemic multidrug-resistant Pseudomonas aeruginosa in critically ill patients. Infect Control Hosp Epidemiol 2004; 25:825-831. (Pubitemid 40036757)
43. Johnson JK, Smith G, Lee MS, et al: The role of patient-to-patient transmission in the acquisition of imipenem-resistant Pseudomonas aeruginosa colonization in the intensive care unit. J Infect Dis 2009; 200:900-905.
44. Vincent JL, Rello J, Marshall J, et al: International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009; 302:2323-2329 2.
45. de Smet AM, Kluytmans JA, Cooper BS, et al: Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 2009; 360:20-31.
46. Nijssen S, Fluit A, van de Vijver D, et al: Effects of reducing beta-lactam antibiotic pressure on intestinal colonization of antibiotic- resistant Gram-negative bacteria. Intensive Care Med 2010; 36:512-519.
47. Meyer E, Schwab F, Gastmeier P, et al: Surveillance of antimicrobial use and antimicrobial resistance in German intensive care units (SARI): A summary of the data from 2001 through 2004. Infection 2006; 34: 303-309. (Pubitemid 46001355)
48. Hanberger H, Arman D, Gill H, et al: Surveillance of microbial resistance in European intensive care units: A first report from the Care-ICU programme for improved infection control. Intensive Care Med 2009; 35:91-100.
49. Hidron AI, Edwards JR, Patel J, et al: NHSN annual update: Antimicrobial-resistant pathogens associated with healthcare-associated infections: Annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008; 29:996-1011.
50. Rosenthal VD, Maki DG, Jamulitrat S, et al: International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009. Am J Infect Control 2010; 38:95-104.
51. DePew CL, Moseley MJ, Clark EG, et al: Open vs closed-system endotracheal suctioning: A cost comparison. Crit Care Nurse 1994; 14: 94-100.
52. Rabitsch W, Kostler WJ, Fiebiger W, et al: Closed suctioning system reduces cross- contamination between bronchial system and gastric juices. Anesth Analg 2004; 99: 886-892. (Pubitemid 39100384)
53. Zielmann S, Grote R, Sydow M, et al: Endotracheal suctioning using a 24-hours continuous system. Can costs and waste products be reduced? [in German] Anaesthesist 1992; 41:494-498.
54. Subirana M, Sola I, Benito S: Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev 2007; 4:CD004581.
55. Wertheim HF, Vos MC, Boelens HA, et al: Low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission in The Netherlands: The value of search and destroy and restrictive antibiotic use. J Hosp Infect 2004; 56:321-325. (Pubitemid 38444086)
56. Kollef MH, Prentice D, Shapiro SD, et al: Mechanical ventilation with or without daily changes of in-line suction catheters. Am J Respir Crit Care Med 1997; 156: 466-472. (Pubitemid 27351980)
57. Stoller JK, Orens DK, Fatica C, et al: Weekly versus daily changes of in-line suction catheters: Impact on rates of ventilator-associated pneumonia and associated costs. Respir Care 2003; 48:494-499. (Pubitemid 47372026)
58. Lorente L, Lecuona M, Jimenez A, et al: Tracheal suction by closed system without daily change versus open system. Intensive Care Med 2006; 32:538-544