Carbapenem Resistant Acinetobacter baumannii management

[Kirrily Whitehead]

Hi all,

We currently have a patient in our ICU with CRAB, was intubated ventilated, now ventilated with a trachy, inter hospital transfer from Thailand.

Our Infectious Disease doctor has asked the question around ventilator cleaning and environmental screening specifically for Carbapenem Resistant Acinetobacter baumannii.

We’ve scoured all the relevant guidelines including the Australian Commission on Safety and Quality in Health Care, NHMRC, CDC and WHO Guidelines for prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities etc…plus interstate and our own management guidelines.

Cannot find anything different other than contact precautions (PPE, glove use, hand hygiene), single room with ensuite facilities, dedicated non critical equipment, minimal amounts of equipment and supplies are taken into the room, increased cleaning frequency (2x day in ICU) with chlorine based product (diluted to 1,000ppm available chlorine), particular attention to all high tough surfaces, ensure all cleaning equipment and solutions are changed before moving to next patient/room, etc,

Have discussed with our respiratory technician in ICU, circuits changed every 14 days, expiratory filter being changed every shift. Once patient discharge ventilator cleaning would include a 2 step clean, detergent then disinfect wipes (Clinell), the only internal mechanism of the ventilator to be reprocessed is the expiratory valve and cover.

Is anyone aware of anything else pertaining to ventilator cleaning and environmental screening practice?

Thanks so much

Kind Regards

Kirrily

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Kirrily Whitehead – Infection Prevention and Control CNS
Infection Prevention and Control Unit | Central Australia Health Service

Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517736
e … kirrily.whitehead@nt.gov.au http://www.nt.gov.au/health

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