Study | Setting (beds); country | Definition of ward closure (length) | Other measures | Inpatient outcomes (includes index case(s))a | Controlled (Y, N, NA) | Due tob |
---|---|---|---|---|---|---|
Acinetobacter baumannii | ||||||
Alfandari et al. [97] | ICU (16) and infectious diseases unit at a general hospital (400); France | Second outbreak: no new admissions | Stage 1: 8 Stage 2: 2 | 20 in total: 15 infected (75Â %), 6 died (30Â %) | Y | Multiple, particularly equipment disinfection |
Ayraud-Thévenot et al. [69] | Surgical (15), medical (12), and intermediate care units (6) at a teaching hospital (1500); France | First outbreak: undefined partial and complete closure (1 m) Second outbreak: no new admissions | First outbreak: 7 Second outbreak: 3 | First outbreak: 20 in total: 16 (80 %) asymptomatic, 4 (20 %) infected, 1 (5 %) died Second outbreak: 7 in total: 3 (43 %) asymptomatic, 4 (57 %) infected | Y | Closure |
Enoch et al. [102] | Neurosciences critical care unit (21) and general ICU (14) at a teaching hospital (1100); UK | Phase 2: limited transfers (16d) | Phase 1: 5 | 19 in total (16, 3): 8 (42Â %) died; 9 (47Â %) positive; 10 (53Â %) infected | Y | All |
Phase 2: 6 | ||||||
Phase 3: 5 | ||||||
Koeleman et al. [76] | Surgical ward at a teaching hospital; The Netherlands | Stage 3: no new admissions (12d) | Stage 1: 2 | 13 in total: 8 (62Â %) infected, 5 (38Â %) colonized | Y | Closure for disinfection |
Stage 2: 3 | ||||||
Stage 3: 2 | ||||||
Landelle et al. [77] | 5 ICUs: 4 surgical and 1 medical (95 total) at a teaching hospital (860); France | No new admissions | Phase 1: 5 | 86 in total | Y | Multiple excluding closure |
Phase 2: 2 | ||||||
Phase 3: 3 | ||||||
Phase 4: 1 | ||||||
Phase 5: 4 | ||||||
Simor et al. [92] | Burn unit (14) at a teaching hospital; Canada | No new admissions (1w) | 8 | 31/247 in total: 18 (58Â %) infected; 7 (23Â %) died | Y | Multiple |
Wagenvoort et al. [100] | ICU in a specialty hospital; The Netherlands | Limited admissions | 3 | 66 in total | Y | All |
Coxsackie virus | ||||||
Konjajev et al. [110] | Neonatal unit, Yugoslavia | Unspecified closure | 2 | 6 in total | Y | Closure |
Enterobacter aerogenes | ||||||
Piagnerelli et al. [109] | Geriatric acute unit (30); Belgium | Unspecified (20d) | 4 | 12 in total | Y | Closure |
Enterococcus faecium | ||||||
Bartley et al. [70] | Renal unit (30), infectious diseases unit at a teaching hospital (800); Australia | No new admissions (pre- and during outbreak) | Prior to outbreak: 5 | 47 in total | Y | Multiple |
Outbreak: 11 | ||||||
Ergaz et al. [73] | NICU (16); Israel | No new admissions (1m) | 6 | 11/18 in total: 3 (27Â %) infections; 8 (73Â %) positive | Y | Multiple |
Liu et al. [80] | Surgical (15) and emergency (10) ICUs at a teaching hospital (1500); China | No new admission area (2w) | 5 | 8 in total | Y | All |
Moretti et al. [83] | Gastroenterology clinic and several units at a teaching hospital; Brazil | No new admissions (15d) | Phase 1: 5 | 321 in total: 16 (5 %) infected | N: significant (p < 0.001) reduction in cases | Multiple |
Phase 2: 3 | ||||||
Sample et al. [95] | Hematology–oncology unit (32) at a teaching hospital (1100); Canada | Stage 1: limited admissions | 5 | 16 in total: 3 (23 %) died | Y | All |
Stage 2: no new admissions | ||||||
Enterobacter cloacae | ||||||
Donkers et al. [72] | NICU at a teaching hospital; Holland | No new admissions (<1m) | 5 | 26 in total: 2 (8Â %) died | Y | Dedicated and disposable equipment |
Modi et al. [81] | NICU at a maternity hospital; England | No new admissions | 3 | 12 in total: 6 (50Â %) positive; 6 (50Â %); 2 (17Â %) died | Y | All |
van den Berg et al. [94] | NICU(15) at a tertiary hospital (950); The Netherlands | No new admissions | Stage 1: 5 | 32 in total: 2 (6Â %) infected | Y | Mainly equipment disinfection |
Stage 2: 5 | ||||||
Escherichia coli | ||||||
Moissenet et al. [82] | Neonatal ward (30) at a children’s teaching hospital; France | Phase 2: no new admissions (1w ≥ 2w) Phase 3: no new admissions (1w ≥ 2w) | Phase 1: 5 | 26/59 in total | Y | Ward closure |
Phase 2: 3 | ||||||
Phase 4: 4 | ||||||
Quinet et al. [85] | Neonatal unit (30); France | Limiting admissions to infants born at the hospital; no new admissions (6w) | 6 | 27/59 neonatal patients affected | Y | Closure |
Klebsiella pneumoniae | ||||||
Carbonne et al. [101] | Seven hospitals; France | All 7 hospitals: limited transfers | 7 | 13 in total: 4 (31Â %) infected; 9 (69Â %) positive | Y | All |
Grogan et al. [103] | Pediatric intensive care; Ireland | No new admissions; limited discharges (1w) | 10 | 3 in total | Y | Multiple |
Kassis-Chikhani et al. [104] | Abdominal surgery care center (81) in a teaching hospital (716); France | Limited new admissions; limited transfers | First 7m: 5 | 8 in total (6, 2); 4 (50Â %) died | Y | Multiple |
Next 4.5m: 6 | ||||||
Laurent et al. [105] | 4 ICUs (6, 6, 8, 1) at a teaching hospital (858); Belgium | Limited transfers, no new admissions | 11 | 30 in total: 9 (30Â %) infected; 3 (10Â %) died | Y | All |
Macrae et al. [106] | Intensive care section (8) and special care section (15) at a neonatal unit; UK | Stage 1: limited transfers (10d) Stage 2: no new admissions (39d) | Stage 1: 5 Stage 2: 11 | 22 in total: 15 (68Â %) positive; 1 (14Â %) died | Y | Temporary ward opened so infected ward could be closed for disinfection |
McKee Jr. et al. [75] | Intensive care nursery (30) at a teaching children’s hospital; USA | No new admissions (2w) | 6 | 26/232 in total: 21 (81 %) positive; 5 (19 %) infected; 1 (4 %) died | Y | All |
Reish et al. [89] | NICU at a tertiary care center; Israel | No new admissions | 3 | 8 in total: 5 (63Â %) infected; 3 (37Â %) positive; 3 (37Â %) died | Y | All |
Ritter et al. [90] | Surgical ward in a specialty hospital; The Netherlands | No new admission | 4 | 11 (10Â %) infected; 4 (36Â %) died | Y | Disinfection during closure |
Parvovirus | ||||||
Pillay et al. [99] | General pediatric ward; England | Limited admissions | 5 | 9 in total: 2 (22Â %) patients infected | Y | All |
Seng et al. [91] | Adult surgical unit (28); England | No new admissions | 3 | 3/6 in total: 3 (50Â %) positive; 3 (50Â %) infected | Y | Author does not know |
Salmonella | Â | |||||
Newman [98] | NICU (18) at a teaching hospital; Ghana | Limited admissions | 3 | 21/72 in total | Y | Aseptic measures and closure |
Serratia marcescens | ||||||
Assadian et al. [68] | NICU (8) at a teaching hospital (2168); Austria | No new admissions (10d) | First outbreak: 4 | 8 in total: 5 (63Â %) infected; 3 (37Â %) positive | N: 2 of different isolates after 41d | NA |
Second outbreak: 2 | ||||||
Lewis et al. [78] | Neonatal; England | No new admissions (7w) | 9 | 13/24 in total: 2 (15Â %) died | Y | Closure |
Maragakis et al. [79] | NICU (36) at a tertiary care hospital (926); USA | No new admissions | 9 | 18 in total | Y | Closing beds to enable cohorting |
Staphylococcus aureus | ||||||
Boyce et al. [107] | Burn unit (4) at a teaching hospital (580); USA | Stage 1: restricted admissions (3 occasions) | 5 | 245 in total: 151 infections; 40 (26Â %) deaths | N: new cases until permanent closure | Permanent closure |
Stage 2: permanently closed | ||||||
Danchivijitr et al. [96] | Burn unit; Thailand | Phase 1: No new admission (2m) | Phase 1: 3 | 19/29 in total: 14 (74Â %) infected; 5 (26Â %) positive; 5 (26Â %) died | N | NA |
Phase 2: 2 | ||||||
Hill and Ferguson [74] | Special baby care unit (24) at a university hospital; UK | Stage 1: no new admissions (2 occasions: 10d, 2w) | 9 | 35/315 in total: 2 (6Â %) infected; 1 (3Â %) died | N | NA |
Kluytmans et al. [108] | Hematology unit and surgical unit at a teaching hospital; The Netherlands | Undefined closure | Outbreak 1: 5 | 27 in total: 24 (89Â %) infected; 5 (19Â %) died | Y | Mainly external cohort isolation |
Outbreak 2: 4 | ||||||
Price et al. [84] | Neonatal medical and surgical unit; England | No new admissions | 13 | 11 in total: 2 (18Â %) infected; 1 (9Â %) died | Y | All |
Rampling et al. [87] | Male surgical (37) and female surgical (32) wards; UK | Closure of one bay at a time; no new admissions | Phase 1: 7 | 69 in total (66, 3) | Y | Closure and environmental disinfection |
Phase 2: 5 | ||||||
Rashid et al. [88] | Burn unit (12) at a regional hospital; Ireland | No new admissions (2w) | 7 | 18/ 176 in total: 3 (17Â %) infected | Y | All |
Teare et al. [93] | Burn unit (20) and plastics unit (84); England | No new admission | Stage 1: 1 | 19 in total | Y | Treatment for HCW |
Stage 2: 2 | ||||||
Stage 3: 3 | ||||||
Stage 4: 5 | ||||||
Streptococcus | ||||||
Deutscher et al. [71] | Long-term acute care hospital; USA | No new admissions (26d) | 9 | 19 in total: 8 (42Â %) positive; 3 (16Â %) assumed; 8 (42Â %) asymptomatic; 2 (15Â %) died | Y | All |
Ramage et al. [86] | Medical unit (24) at a community hospital (235); Canada | No new admissions | 6 | 3/25 in total: 3 (100Â %) died | Y | HCW treatment and infected inpatient deaths |