{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:09:28Z","timestamp":1786640968566,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"St Thomas\u2019 National Health Service (NHS) Foundation Trust"},{"DOI":"10.13039\/100009360","name":"King\u2019s College London","doi-asserted-by":"publisher","award":["RJ112\/N027"],"award-info":[{"award-number":["RJ112\/N027"]}],"id":[{"id":"10.13039\/100009360","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile infections declined across the UK National Health Service in the decade that followed implementation of an infection control campaign. The national impact on intensive care unit (ICU)-acquired infections has not been documented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on MRSA, C. difficile, vancomycin-resistant Enterococcus (VRE), and ICU\u2013acquired bloodstream infections (UABSIs) for 1 189 142 patients from 2007 to 2016 were analyzed. Initial coverage was 139 ICUs increasing to 276 ICUs, representing 100% of general adult UK ICUs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>ICU MRSA and C. difficile acquisitions per 1000 patients decreased between 2007 and 2016 (MRSA acquisitions, 25.4 to 4.1; and C. difficile acquisitions, 11.1 to 3.5), whereas VRE acquisitions increased from 1.5 to 5.9. There were 13 114 UABSIs in 1.8% of patients who stayed longer than 48 hours on ICU. UABSIs fell from 7.3 (95% confidence interval [CI], 6.9\u20137.6) to 1.6 (95% CI, 1.5\u20131.7)\/1000 bed days. Adjusting for patient factors, the incidence rate ratio was 0.21 (95% CI, 0.19\u20130.23, P &amp;lt; .001) from 2007 to 2016. The greatest reduction, comparing rates in 2007\/08 and 2015\/16, was for MRSA (97%), followed by P. aeruginosa (81%), S. aureus (79%) and Candida spp (72%), with lower reductions for the coliforms (E. coli 57% and Klebsiella 49%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Large decreases in ICU-acquired infections occurred across the UK ICU network linked with the first few years of a national infection control campaign, but rates have since been static. Further reductions will likely require a new intervention framework.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz720","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T19:09:51Z","timestamp":1564513791000},"page":"2530-2540","source":"Crossref","is-referenced-by-count":20,"title":["Reductions in Methicillin-resistant Staphylococcus aureus, Clostridium difficile Infection and Intensive Care Unit\u2013Acquired Bloodstream Infection Across the United Kingdom Following Implementation of a National Infection Control Campaign"],"prefix":"10.1093","volume":"70","author":[{"given":"Jonathan D","family":"Edgeworth","sequence":"first","affiliation":[{"name":"Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, King\u2019s College London and Guy\u2019s and St Thomas\u2019 National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Batra","sequence":"first","affiliation":[{"name":"Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, King\u2019s College London and Guy\u2019s and St Thomas\u2019 National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Wulff","sequence":"first","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Harrison","sequence":"first","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"key":"2020061010551348100_CIT0001","article-title":"Epidemiology and control of health care acquired infections in limited resource settings.","volume-title":"Bennett and Brachman\u2019s hospital infection","author":"Rosenthal","year":"2013","edition":"6th"},{"key":"2020061010551348100_CIT0002","volume-title":"Oxford textbook of infectious disease control: a geographical analysis from medieval quarantine to global eradication","author":"Smallman-Raynor","year":"2013"},{"key":"2020061010551348100_CIT0003"},{"key":"2020061010551348100_CIT0004","author":"Department"},{"key":"2020061010551348100_CIT0005","first-page":"58","article-title":"Control of health-care-associated infections, 1961-2011","volume":"60","author":"Dixon","year":"2011","journal-title":"MMWR Suppl"},{"key":"2020061010551348100_CIT0006","doi-asserted-by":"crossref","first-page":"757","DOI":"10.2471\/BLT.11.088179","article-title":"Health-care-associated infection in Africa: a systematic review","volume":"89","author":"Bagheri Nejad","year":"2011","journal-title":"Bull World Health Organ"},{"key":"2020061010551348100_CIT0007","volume-title":"The Burden of Healthcare-Associated Infections in Southeast Asia: A Systematic Literature Review and Meta-analysis. 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