Evidence map›Paper›PMID 41965858›Full record

ArticleAntimicrobial resistance and infection control2026

Multiphase terminal environmental disinfection targeting Acinetobacter baumannii sustains reduction in multidrug-resistant organism healthcare-associated infections in an ICU.

Sangsang Qiu, Qinfen Xu, Yun Mao, Yuqing Gong, Qinhong Huang, Haixiang Wang, Mengjing Chen, Fangying Ni, Hongyang Xu, Jianming Wang

Abstract read
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In one paragraph

Article in Antimicrobial resistance and infection control, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Sangsang Qiu *Department of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Qinfen Xu *Department of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Yun MaoDepartment of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Yuqing GongDepartment of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Qinhong HuangDepartment of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Haixiang WangDepartment of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Rd., Wuxi, 214023, People's Republic of China.
Mengjing ChenDepartment of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Fangying NiDepartment of Infection Control, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People's Republic of China.
Hongyang XuDepartment of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Rd., Wuxi, 214023, People's Republic of China. xhy1912@aliyun.com.
Jianming WangDepartment of Epidemiology, Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Ave., Nanjing, 211166, People's Republic of China. jmwang@njmu.edu.cn.

Funding

Changzhou Medical Center Grant CMCM202211the National Natural Science Foundation of China 82473693
6 · The paper itself

Abstract

backgroundAcinetobacter baumannii (AB) exhibits prolonged persistence on intensive care unit (ICU) surfaces and plays a pivotal role in healthcare-associated transmission. However, evidence linking terminal environmental disinfection programs specifically targeting AB to clinical infection outcomes remains scarce. This study aims to evaluate a multi-phase terminal disinfection program and the risk of multidrug-resistant organism healthcare-associated infection (MDRO-HAI).

methodsA prospective four-phase study was conducted in a single ICU from September 2024 to September 2025. Patients with negative AB screening within 48 h of ICU admission were recruited and followed up for a maximum of 40 days. Phase 1 maintained routine infection control practices; phase 2 implemented a standardized terminal disinfection protocol encompassing cleaner training, microbiological monitoring with feedback and correction, and adjunct aerosolized hydrogen peroxide disinfection in isolation rooms; phase 3 retained the standardized protocol but discontinued enhanced supervision and feedback; phase 4 maintained the protocol while strengthening healthcare-worker hand hygiene. Environmental surfaces and the hands of patients and staff were monitored for AB colonization. Infection-free survival was analyzed using the Kaplan-Meier method and the log-rank test. Cox proportional hazards models were employed to assess the association between study phase and MDRO-HAI, adjusting for age, sex, diabetes, and hypertension.

resultsAmong 560 enrolled patients, baseline characteristics were broadly comparable across phases. AB positivity rates on environmental surfaces and hands showed a progressive, significant decline (trend tests, both P < 0.001). A total of 46 MDRO-HAI events occurred, with an overall incidence of 8.21%. Infection-free survival differed significantly across phases (log-rank P < 0.001). Compared with phase 1, the adjusted hazard ratios (HRs) for MDRO-HAI were 0.48 (95% CI: 0.23-0.99) in phase 2, 0.26 (95% CI: 0.12-0.59) in phase 3, and 0.14 (95% CI: 0.05-0.40) in phase 4, with a significant downward trend across successive phases.

conclusionsA standardized multi-phase terminal environmental disinfection program targeting AB was independently associated with a sustained reduction in ICU MDRO-HAI risk. Notably, strengthened hand hygiene effectively supported the maintenance of infection control gains after the withdrawal of intensive daily supervision for cleaning staff. These findings provide optimization of long-term MDRO prevention strategies in high-risk healthcare settings.

Indexed as

Acinetobacter baumanniiAcinetobacter InfectionsCross InfectionDisinfectionDrug Resistance, Multiple, BacterialInfection ControlIntensive Care UnitsFemaleHumansHydrogen PeroxideMaleProspective StudiesHydrogen PeroxideAcinetobacter baumanniiEnvironmental hygieneHand contaminationHealthcare-associated infectionIntensive care unitMultidrug-resistant organismTerminal disinfection

Identifiers

PMID41965858
PMCPMC13185230

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.