The Importance of Transferring Accountability for Infection Control Practices to the Direct Care Providers: Lessons Learned from a Neonatal Intensive Care Unit Outbreak of Pseudomonas aeruginosa

OBJECTIVETo use whole genome sequencing to describe the likely origin of an outbreak of Pseudomonas aeruginosa in a neonatal unit.DESIGNOutbreak investigation.SETTINGThe neonatal intensive care unit service of a major obstetric tertiary referral center.PATIENTSInfants admitted to the neonatal unit who developed P. aeruginosa colonization or infection.METHODSWe undertook whole genome sequencing of P. aeruginosa strains isolated from colonized infants and from the neonatal unit environment.RESULTSEighteen infants were colonized with P. aeruginosa. Isolates from 12 infants and 7 environmental samples were sequenced. All but one of the clinical isolates clustered in ST253 and no differences were detected between unmapped reads. The environmental isolates revealed a variety of sequence types, indicating a large diverse bioburden within the unit, which was subsequently confirmed via enterobacterial repetitive intergenic consensus–polymerase chain reaction typing of post-outbreak isolates. One environmental isolate, obtained from a sink in the unit, clustered within ST253 and differed from the outbreak strain by 9 single-nucleotide polymorphisms only. This information allowed us to focus infection control activities on this sink.CONCLUSIONSWhole genome sequencing can provide detailed information in a clinically relevant time frame to aid management of outbreaks in critical patient management areas. The superior discriminatory power of this method makes it a powerful tool in infection control.Infect. Control Hosp. Epidemiol. 2015;36(9):1058–1064

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Surveillance of Pseudomonas aeruginosa-isolates in a neonatal intensive care unit over a one year-period

International Journal of Hygiene and Environmental Health ◽

10.1078/1438-4639-00288 ◽

2004 ◽

Vol 207 (3) ◽

pp. 259-266 ◽

Cited By ~ 7

Author(s):

Lutz Thomas Zabel ◽

Peter Heeg ◽

Rangmar Goelz

Keyword(s):

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

One Year

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Beginning to See the Light: Lessons Learned From the Development of the Circadian System for Optimizing Light Conditions in the Neonatal Intensive Care Unit

Frontiers in Neuroscience ◽

10.3389/fnins.2021.634034 ◽

2021 ◽

Vol 15 ◽

Author(s):

Esther M. Hazelhoff ◽

Jeroen Dudink ◽

Johanna H. Meijer ◽

Laura Kervezee

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Clinical Outcomes ◽

Neonatal Intensive Care ◽

Circadian System ◽

Lessons Learned ◽

Preterm Neonates ◽

Negative Effects ◽

Beneficial Effects

The circadian timing system optimizes health by temporally coordinating behavior and physiology. During mammalian gestation, fetal circadian rhythms are synchronized by the daily fluctuations in maternal body temperature, hormones and nutrients. Circadian disruption during pregnancy is associated with negative effects on developmental outcomes in the offspring, highlighting the importance of regular and robust 24-h rhythms over gestation. In the case of preterm birth (before 37 weeks of gestation), maternal cues no longer synchronize the neonate’s circadian system, which may adversely affect the neonate. There is increasing evidence that introducing robust light-dark cycles in the Neonatal Intensive Care Unit has beneficial effects on clinical outcomes in preterm infants, such as weight gain and hospitalization time, compared to infants exposed to constant light or constant near-darkness. However, the biological basis for these effects and the relationship with the functional and anatomical development of the circadian system is not fully understood. In this review, we provide a concise overview of the effects of light-dark cycles on clinical outcomes of preterm neonates in the NICU and its alignment with the development of the circadian system.

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