scholarly journals Infection control measures in times of antimicrobial resistance: a matter of solidarity

2020 ◽  
Vol 38 (S1) ◽  
pp. 47-55 ◽  
Author(s):  
Babette Rump ◽  
Aura Timen ◽  
Marlies Hulscher ◽  
Marcel Verweij
Keyword(s):  
Well Being ◽  
Multidrug Resistant ◽  
Additional Benefit ◽  
Control Measures ◽  
Individual Autonomy ◽  
Compensation Policy ◽  
Public Interests ◽  
Infection Control Measures ◽  
Baseline Levels ◽  
The One

AbstractControl measures directed at carriers of multidrug-resistant organisms are traditionally approached as a trade-off between public interests on the one hand and individual autonomy on the other. We propose to reframe the ethical issue and consider control measures directed at carriers an issue of solidarity. Rather than asking “whether it is justified to impose strict measures”, we propose asking “how to best care for a person’s carriership and well-being in ways that do not imply an unacceptable risk for others?”. A solidarity approach could include elevating baseline levels of precaution measures and accepting certain risks in cases where there is exceptionally much at stake. A generous national compensation policy that also covers for costs related to dedicated care is essential in a solidarity approach. An additional benefit of reframing the questions is that it helps to better acknowledge that being subjected to control measures is a highly personal matter.

scholarly journals Can Copper Products and Surfaces Reduce the Spread of Infectious Microorganisms and Hospital-Acquired Infections?

Materials ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3444
Author(s):  
Joji Abraham ◽  
Kim Dowling ◽  
Singarayer Florentine
Keyword(s):  
Infection Control ◽  
Hospital Admissions ◽  
Copper Alloys ◽  
Well Being ◽  
Mortality Rates ◽  
Pathogen Transmission ◽  
Control Measures ◽  
Traditional Use ◽  
Healthcare Facilities ◽  
Infection Control Measures

Pathogen transfer and infection in the built environment are globally significant events, leading to the spread of disease and an increase in subsequent morbidity and mortality rates. There are numerous strategies followed in healthcare facilities to minimize pathogen transfer, but complete infection control has not, as yet, been achieved. However, based on traditional use in many cultures, the introduction of copper products and surfaces to significantly and positively retard pathogen transmission invites further investigation. For example, many microbes are rendered unviable upon contact exposure to copper or copper alloys, either immediately or within a short time. In addition, many disease-causing bacteria such as E. coli O157:H7, hospital superbugs, and several viruses (including SARS-CoV-2) are also susceptible to exposure to copper surfaces. It is thus suggested that replacing common touch surfaces in healthcare facilities, food industries, and public places (including public transport) with copper or alloys of copper may substantially contribute to limiting transmission. Subsequent hospital admissions and mortality rates will consequently be lowered, with a concomitant saving of lives and considerable levels of resources. This consideration is very significant in times of the COVID-19 pandemic and the upcoming epidemics, as it is becoming clear that all forms of possible infection control measures should be practiced in order to protect community well-being and promote healthy outcomes.

Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

2021 ◽  
pp. 1-7
Author(s):  
Katharina R. Rynkiewich ◽  
Jinal Makhija ◽  
Mary Carl M. Froilan ◽  
Ellen C. Benson ◽  
Alice Han ◽  
...  
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Skilled Nursing ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Resident Care ◽  
Semistructured Interviews ◽  
Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

scholarly journals Conceptualizing the Impact of MDRO Control Measures Directed at Carriers: A Capability Approach

2020 ◽  
pp. 203-224
Author(s):  
Morten Fibieger Byskov ◽  
Babette Olga Rump ◽  
Marcel Verweij
Keyword(s):  
Capability Approach ◽  
Ethical Dilemmas ◽  
Well Being ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Human Capabilities ◽  
Multidrug Resistant Organisms ◽  
The Impact ◽  
Specific Control

Abstract Many countries have implemented specific control measures directed at carriers of multidrug-resistant organisms (MDRO) in order to prevent further introduction and transmission of resistant organisms into hospitals and other healthcare related settings. These control measures may in many ways affect the lives and well-being of carriers of MDRO, resulting in complex ethical dilemmas that often remain largely implicit in practice. In this chapter, we propose to conceptualize the impact of MDRO control measures on the well-being of individual carriers in terms of capabilities and functionings. A capabilitarian framework for the ethical treatment of MDRO carriers commits us to conceptualize the harm done to carriers in terms of the impact that MDRO control measures have on what they are able to do or be. Adopting and adapting Nussbaum’s list of ten central human capabilities, we present a taxonomy of capabilities and functionings that are normatively relevant for the design and evaluation of MDRO control measures.

A Bundle of Measures to Control an Outbreak of Pseudomonas aeruginosa Associated With P-Trap Contamination

2018 ◽  
Vol 39 (2) ◽  
pp. 164-169 ◽  
Author(s):  
Houssein Gbaguidi-Haore ◽  
Amélie Varin ◽  
Pascal Cholley ◽  
Michelle Thouverez ◽  
Didier Hocquet ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
High Risk ◽  
Bacterial Load ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Pipe System ◽  
Infection Control Measures ◽  
Cross Transmission ◽  
Proactive Measures

OBJECTIVETo describe an outbreak of multidrug-resistant Pseudomonas aeruginosa in which the hospital waste-pipe system was the likely source of contamination and to report the bundle of measures that facilitated the long-term control of the outbreak.DESIGNOutbreak investigation.SETTINGThe hematology unit of a tertiary-care referral center.PATIENTSPatients who were colonized or infected with P. aeruginosa belonging to the clonal outbreak.METHODSPatients admitted to our 15-bed stem-cell transplantation hematology unit were screened for P. aeruginosa carriage. Pseudomonas aeruginosa isolates were also obtained from diagnostic samples. We assessed the microbiological contamination of P-traps, water and toilets for 42 months. Extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) were screened and identified by polymerase chain reaction (PCR) and sequencing. Molecular typing of ESBL- or MBL-producing isolates was carried out using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).RESULTSFrom 2009 to 2013, a biclonal outbreak of IMP-19–producing ST235 (11 cases) and IMP-29–producing ST111 (10 cases) of P. aeruginosa occurred. The environmental investigation strongly suggested that P-traps were the reservoirs for the outbreak strains. A bundle of infection control measures, including engineering interventions on water outlets and disinfection of P-traps, controlled the outbreak.CONCLUSIONSWe report a prolonged outbreak of IMP-producing high-risk clones of P. aeruginosa, for which P-traps seems to play a major role in cross-transmission. It appears essential to implement proactive measures to limit the bacterial load in water fittings of high-risk units.Infect Control Hosp Epidemiol 2018;39:164–169

scholarly journals Endemicity ofAcinetobacter calcoaceticus-baumanniiComplex in an Intensive Care Unit in Malaysia

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Amreeta Dhanoa ◽  
Ganeswrie Rajasekaram ◽  
Soo Sum Lean ◽  
Yuet Meng Cheong ◽  
Kwai Lin Thong
Keyword(s):  
Intensive Care ◽  
Genetic Relatedness ◽  
Acinetobacter Calcoaceticus ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Effective Control ◽  
Icu Patients ◽  
Infection Control Measures ◽  
High Degree

Introduction.Acinetobacter calcoaceticus-baumanniicomplex (ACB complex) is a leading opportunistic pathogen in intensive care units (ICUs). Effective control of spread requires understanding of its epidemiological relatedness. This study aims to determine the genetic relatedness and antibiotic susceptibilities of ACB complex in an ICU in Malaysia.Methodology. Pulsed field gel electrophoresis (PFGE), E-test, and disk diffusion were used for isolates characterization.Results. During the study period (December 2011 to June 2012), 1023 patients were admitted to the ICU and 44 ACB complex (blood,n=21, and blind bronchial aspirates,n=23) were recovered from 38 ICU patients. Six isolates were from non-ICU patients. Of the 44 ICU isolates, 88.6% exhibited multidrug-resistant (MDR) patterns. There was high degree of resistance, with minimum inhibitory concentration90(MIC90) of >32μg/mL for carbapenems and ≥256μg/mL for amikacin, ampicillin/sulbactam, and cefoperazone/sulbactam. Isolates from the main PFGE cluster were highly resistant. There was evidence of dissemination in non-ICU wards.Conclusion. High number of clonally related MDR ACB complex was found. While the ICU is a likely reservoir facilitating transmission, importation from other wards may be important contributor. Early identification of strain relatedness and implementation of infection control measures are necessary to prevent further spread.

scholarly journals The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Jamile Marchi ◽  
Nina Johansson ◽  
Anna Sarkadi ◽  
Georgina Warner
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Infection Control ◽  
Children And Adolescents ◽  
Scoping Review ◽  
Well Being ◽  
Control Measures ◽  
Parenting Support ◽  
Infection Control Measures ◽  
The Impact

Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health.Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0–18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions.Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors.Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.

scholarly journals TB management in the European Union/European Economic Area: a multi‐centre survey

2021 ◽  
Vol 25 (2) ◽  
pp. 126-133
Author(s):  
G. Sotgiu ◽  
S. Rosales-Klintz ◽  
R. Centis ◽  
L. D'Ambrosio ◽  
R. Verduin ◽  
...  
Keyword(s):  
European Union ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Infection Control Measures ◽  
Treatment And Prevention ◽  
Economic Area

BACKGROUND: Essential TB care in the European Union/European Economic Area (EU/EEA) comprises 21 standards for the diagnosis, treatment and prevention of TB that constitute the European Union Standards for Tuberculosis Care (ESTC).METHODS: In 2017, we conducted an audit on TB management and infection control measures against the ESTC standards. TB reference centres in five EU/EEA countries were purposely selected to represent the heterogeneous European TB burden and examine geographic variability.RESULTS: Data from 122 patients, diagnosed between 2012 and 2015 with multidrug-resistant TB (n = 49), extensively drug‐resistant TB (XDR‐TB) (n = 11), pre‐XDR‐TB (n = 29) and drug‐susceptible TB (n = 33), showed that TB diagnosis and treatment practices were in general in agreement with the ESTC.CONCLUSION: Overall, TB management and infection control practices were in agreement with the ESTC in the selected EU/EEA reference centres. Areas for improvement include strengthening of integrated care services and further implementation of patient‐centred approaches.

Transmission of Pathogenic Bacterial Organisms in the Anesthesia Work Area

2008 ◽  
Vol 109 (3) ◽  
pp. 399-407 ◽  
Author(s):  
Randy W. Loftus ◽  
Matthew D. Koff ◽  
Corey C. Burchman ◽  
Joseph D. Schwartzman ◽  
Valerie Thorum ◽  
...  
Keyword(s):  
Surface Area ◽  
Odds Ratio ◽  
Bacterial Resistance ◽  
Positive Culture ◽  
Anesthesia Machine ◽  
Multidrug Resistant ◽  
Infectious Complications ◽  
Control Measures ◽  
Infection Control Measures ◽  
Work Area

Background The current prevalence of hospital-acquired infections and evolving amplification of bacterial resistance are major public health concerns. A heightened awareness of intraoperative transmission of potentially pathogenic bacterial organisms may lead to implementation of effective preventative measures. Methods Sixty-one operative suites were randomly selected for analysis. Sterile intravenous stopcock sets and two sites on the anesthesia machine were decontaminated and cultured aseptically at baseline and at case completion. The primary outcome was the presence of a positive culture on the previously sterile patient stopcock set. Secondary outcomes were the number of colonies per surface area sampled on the anesthesia machine, species identification, and antibiotic susceptibility of isolated organisms. Results Bacterial contamination of the anesthesia work area increased significantly at the case conclusion, with a mean difference of 115 colonies per surface area sampled (95% confidence interval [CI], 62-169; P < 0.001). Transmission of bacterial organisms, including vancomycin-resistant enterococcus, to intravenous stopcock sets occurred in 32% (95% CI, 20.6-44.9%) of cases. Highly contaminated work areas increased the odds of stopcock contamination by 4.7 (95% CI, 1.42-15.42; P = 0.011). Contaminated intravenous tubing was associated with a trend toward increased nosocomial infection rates (odds ratio, 3.08; 95% CI, 0.56-17.5; P = 0.11) and with an increase in mortality (95% CI odds ratio, 1.11-infinity; P = 0.0395). Conclusion Potentially pathogenic, multidrug-resistant bacterial organisms are transmitted during the practice of general anesthesia to both the anesthesia work area and intravenous stopcock sets. Implementation of infection control measures in this area may help to reduce both the evolving problem of increasing bacterial resistance and the development of life-threatening infectious complications.

scholarly journals Drug Resistance Pattern of Bacterial Pathogens of Enterobacteriaceae Family

2018 ◽  
Vol 4 ◽  
pp. 15-22
Author(s):  
Bhola Shankar Sah ◽  
Manita Aryal ◽  
Dipak Bhargava ◽  
Amrullah Siddique
Keyword(s):  
Drug Resistance ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Resistance Pattern ◽  
Esbl Producer ◽  
Culture Techniques ◽  
Infection Control Measures ◽  
Conventional Culture ◽  
Drug Resistance Pattern ◽  
Esbl Producers

Objectives: This study was done to determine the drug resistance pattern and Extended Spectrum β-Lactamase (ESBL) in bacterial isolates of Enterobacteriaceae family from different clinical specimens.Methods: The isolates were identified by conventional culture techniques and subjected to antimicrobial susceptibility testing by modified Kirby Bauer disk diffusion methods and ESBL detection by combined disk method.Results: Of the total 1602 sample processed 200 (12.5%) bacteria of Enterobacteriaceae family were isolated and 85.5% of them were multidrug resistant. Of the total Enterobacteriaceae isolates 27% were ESBL producers. Single isolate of stool was MDR and ESBL producer. Higher prevalence of MDR isolates (100%) and ESBL producer (41.2%) was observed in sputum specimen. Higher multidrug resistance (92.1%) and ESBL production (35%) was detected in Klebsiella pneumoniae.Conclusion: The most effective antibiotics towards the isolates of Enterobacteriaceae were imipenem, amikacin, chloramphenicol and tetracycline. Emergence of MDR and ESBL producing Enterobacteriaceae requires proper infection control measures and routine and reliable detection of ESBL with rationale use of antibiotics.  

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