Infection prevention, control and antimicrobial stewardship measures in intensive in-patient rehabilitation setting: a systematic review

Introduction The necessity for targeted strategies to prevent and manage multidrug-resistant organism infections in intensive rehabilitation settings is driven by the heightened vulnerability of patients, exacerbated by the unique organizational and technical aspects of these environments. This study aimed to establish an interpretative framework of internationally validated interventions to enhance infection prevention in intensive rehabilitation facilities. Materials and methods A systematic review, conducted following PRISMA guidelines, categorized interventions into three key domains: Antimicrobial Stewardship, Behavioural Prevention, and Sanitation and Environmental Cleaning. Results The 17 articles selected for review provide a comprehensive overview of interventions within the three domains. Antimicrobial Stewardship interventions demonstrated potential in reducing Clostridioides difficile colonization through decreased antimicrobial use. Behavioural Prevention interventions were associated with reduced multidrug-resistant organism colonization and infections. Sanitation and Environmental Cleaning interventions, including hand hygiene, correlated with a decreased incidence of Clostridioides difficile cases. Discussion and conclusions This systematic review underscores the importance of implementing multi-component interventions, encompassing both pharmacological and non-pharmacological approaches, across this critical setting.