Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Prevention of colonization and infection by Klebsiella pneumoniae carbapenemase-producing enterobacteriaceae in long-term acute-care hospitals.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
104 citing papers in PubMed, 4 syntheses or guidelines pooled it, 184 citations in OpenAlex.
- Infection prevention, control and antimicrobial stewardship measures in intensive in-patient rehabilitation setting: a systematic review.Antimicrobial resistance and infection control · 2026Pooled it
- The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.BMC infectious diseases · 2019Pooled it
- Control of Carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa in Healthcare Facilities: A Systematic Review and Reanalysis of Quasi-experimental Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- A Systematic Review and Meta-analyses of the Clinical Epidemiology of Carbapenem-Resistant Enterobacteriaceae.Antimicrobial agents and chemotherapy · 2018Pooled it
- Cluster-Randomized Controlled Trial of Enhanced Carbapenem-Resistant Enterobacterales Prevention Program in General Medicine Wards, Siriraj Hospital.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Trial
- Fecal microbiota transplantation promotes reduction of antimicrobial resistance by strain replacement.Science translational medicine · 2023Trial
- Trial
- Effectiveness of a Multicomponent Intervention to Reduce Multidrug-Resistant Organisms in Nursing Homes: A Cluster Randomized Clinical Trial.JAMA network open · 2021Trial
- Safety and immunogenicity of an adjuvantedHuman vaccines & immunotherapeutics · 2021Trial
- Decolonization to Reduce Postdischarge Infection Risk among MRSA Carriers.The New England journal of medicine · 2019Trial
- Chlorhexidine gluconate bathing of adult patients in intensive care units in São Paulo, Brazil: Impact on the incidence of healthcare-associated infection.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesTrial
- Carbapenemase-producing Enterobacterales infections: a real-world cohort study from a secondary hospital in Shanghai, China.BMC infectious diseases · 2026Article
- Impact of targeted infection prevention and control interventions on bloodstream infections and colonization with carbapenem-resistant organisms among hospitalized neonates, Bangladesh, 2023-2024.Antimicrobial resistance and infection control · 2026Article
- Genomic inference of sites of transmission during regional spread of blaNature communications · 2026Article
- Regression-based modeling of pairwise genomic linkage data identifies risk factors for healthcare-associated pathogen transmission: application to carbapenem-resistantMicrobiology spectrum · 2026Article
- Development and validation of a psychometric tool for assessing the readiness and feasibility of CRE screening in LMICs: A cross-sectional instrument validation study.SAGE open medicine · 2026Article
- Incidence and outcomes for colonization of multidrug-resistance organisms (MDROs) among patients undergoing elective orthopedic surgery.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Evaluation of colonization with multidrug-resistant microorganisms and the incidence of attributable infections in patients undergoing hematopoietic stem cell transplantation.Turkish journal of medical sciences · 2026Article
- Transmission thresholds for the spread of infections in healthcare facilities.PLoS computational biology · 2025Article
- A network analysis of carbapenem-resistant Klebsiella pneumoniae among healthcare facilities.Scientific reports · 2025Observational
44 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundKlebsiella pneumoniae carbapenemase-producing Enterobacteriaceae (hereafter "KPC") are an increasing threat to healthcare institutions. Long-term acute-care hospitals (LTACHs) have especially high prevalence of KPC.
methodsUsing a stepped-wedge design, we tested whether a bundled intervention (screening patients for KPC rectal colonization upon admission and every other week; contact isolation and geographic separation of KPC-positive patients in ward cohorts or single rooms; bathing all patients daily with chlorhexidine gluconate; and healthcare-worker education and adherence monitoring) would reduce colonization and infection due to KPC in 4 LTACHs with high endemic KPC prevalence. The study was conducted between 1 February 2010 and 30 June 2013; 3894 patients were enrolled during the preintervention period (lasting from 16 to 29 months), and 2951 patients were enrolled during the intervention period (lasting from 12 to 19 months).
resultsKPC colonization prevalence was stable during preintervention (average, 45.8%; 95% confidence interval [CI], 42.1%-49.5%), declined early during intervention, then reached a plateau (34.3%; 95% CI, 32.4%-36.2%; P<.001 for exponential decline). During intervention, KPC admission prevalence remained high (average, 20.6%, 95% CI, 19.1%-22.3%). The incidence rate of KPC colonization fell during intervention, from 4 to 2 acquisitions per 100 patient-weeks (P=.004 for linear decline). Compared to preintervention, average rates of clinical outcomes declined during intervention: KPC in any clinical culture (3.7 to 2.5/1000 patient-days; P=.001), KPC bacteremia (0.9 to 0.4/1000 patient-days; P=.008), all-cause bacteremia (11.2 to 7.6/1000 patient-days; P=.006) and blood culture contamination (4.9 to 2.3/1000 patient-days; P=.03).
conclusionsA bundled intervention was associated with clinically important and statistically significant reductions in KPC colonization, KPC infection, all-cause bacteremia, and blood culture contamination in a high-risk LTACH population.
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