A Comprehensive Program to Reduce CRO Transmission in LTACH Settings

Written by Sarah Sheldon | Sep 23, 2025 6:00:02 PM

Infection prevention is one of the greatest challenges in long-term acute care hospitals. With vulnerable patient populations and the growing threat of multi drug-resistant organisms (MDROs), hospitals need innovative approaches that go beyond standard cleaning protocols. A recent initiative at the Rehabilitation Hospital of Southern New Mexico (RHSNM) demonstrates how combining process improvement with advanced disinfection technology can dramatically reduce transmission of carbapenem-resistant organisms (CROs).

The Challenge

Providing high-quality post-acute services to chronically, critically ill patients in long-term acute care hospitals (LTACHs) is complicated by the persistent threat of hospital-acquired infections (HAIs). Among the most concerning are carbapenem-resistant organisms (CROs), particularly carbapenem-resistant Acinetobacter baumannii (CRAB). These multidrug-resistant organisms (MDROs) often render first-line antibiotic treatments ineffective, creating significant risks for patient outcomes and staff safety.

The Approach

At the Rehabilitation Hospital of Southern New Mexico (RHSNM) and Advanced Care Hospital of Southern New Mexico, a multidisciplinary team implemented a comprehensive process improvement program designed to reduce CRO transmission.

Key components of the program included:

Interdisciplinary antimicrobial stewardship led by pharmacy
Staff education and training
Real-time monitoring and feedback
Compliance audits
Environmental cleaning protocols featuring a novel dry aerosolizing hydrogen peroxide (aHP) disinfection technology (Breezy Blue) for all LTAC patients.

Unlike traditional fogging systems, Breezy Blue can disinfect a 1,000 sq. ft. space in just one minute, with rooms safe to re-enter in 15 minutes. Rooms do not need to be sealed, and the system can be remotely activated with real-time tracking and auditable data records, a major advancement for infection prevention programs.

The Results

Between January 2023 and July 2025, 24 patients known to be colonized or infected with CROs were admitted to RHSNM. During this 24-month period, only two cases were detected after admission. Following epidemiologic investigation, one case was determined to be unrelated to in-facility transmission, leaving only one true transmission event.

Compared to the lowest per-admission reproduction number of 0.40 — which would predict approximately 9.6 in-facility transmissions, this represents a statistically significant reduction in transmission (p<0.004).

The Technology Behind the Success

This improvement program’s success was enabled by Breezy Blue, a novel aHP disinfection technology. Fast, inexpensive, and thorough, Breezy Blue offers hospitals a powerful solution for infection prevention. With real-time data capture and auditable records, it gives infection prevention teams both the effectiveness and accountability they need to protect patients and staff.

Implications for Hospitals

The findings from RHSNM underscore the importance of combining process improvement with advanced disinfection technologies. By integrating Breezy Blue into daily protocols, hospitals can significantly reduce the risk of CRO transmission while improving safety for both patients and staff. Hospitals can also strengthen prevention strategies during seasonal surges, as highlighted in our recent post on reducing flu-related hospitalizations.

These results will be highlighted at the upcoming APIC-SD event, where infection prevention professionals from across the country will gather to share best practices in advancing patient safety.

To learn more about how Breezy Blue works and how to protect your space, contact us at breezymed.com/contact-us to schedule a demo or learn more.

View full post