Study design
infection
INFECTION
We conducted a pragmatic, cluster-randomized, nonblinded cross-over study in the included randomized ICUs between June 2019 and June 2020. We included 6 adult ICUs in a tertiary care hospital, Seoul, South Korea: two medical ICUs (23 beds), two surgical ICUs (26 beds), a cardiac ICU (16 beds), and a cardiothoracic surgery ICU (15 beds) in a tertiary care hospital. The study was approved by the physicians and nurse team leaders of each ICU and the institutional review board (IRB no. 2019–0274). The requirements for informed consent were waived. ICUs were randomly assigned to perform active surveillance testing (intervention) or use standard precautions (control) during the initial 6-month study period (period 1), followed by a 1-month washout period, and alternative during the second 6-month period (period 2). Randomization of ICU was performed by SPSS for Windows software, version 21 (SPSS Inc., Chicago, IL, USA). The microbiology laboratory processed surveillance specimens using standard culture-based identification of CRGNB. Patients with histories of CRGNB colonization or infection were placed under contact precautions at the time of admission.