scholarly journals Differential Effects of Chlorhexidine Skin Cleansing Methods on Residual Chlorhexidine Skin Concentrations and Bacterial Recovery

2018 ◽  
Vol 39 (4) ◽  
pp. 405-411 ◽  
Author(s):  
Yoona Rhee ◽  
Louisa J. Palmer ◽  
Koh Okamoto ◽  
Sean Gemunden ◽  
Khaled Hammouda ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Teaching Hospitals ◽  
Resistant Organism ◽  
Sterile Water ◽  
Polyester Cloth ◽  
Surgical Icus ◽  
Healthcare Associated ◽  
Skin Cleansing

BACKGROUNDBathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)–impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results.OBJECTIVETo determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin.DESIGNProspective, randomized 2-center study with blinded assessment.PARTICIPANTS AND SETTINGHealthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016.INTERVENTIONCleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non–antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C).RESULTSIn total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001).CONCLUSIONIn healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined.Infect Control Hosp Epidemiol 2018;39:405–411

scholarly journals Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

2019 ◽  
Vol 69 (11) ◽  
pp. 1837-1844 ◽  
Author(s):  
Lona Mody ◽  
Laraine L Washer ◽  
Keith S Kaye ◽  
Kristen Gibson ◽  
Sanjay Saint ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Resistant Organism ◽  
Dominant Hand ◽  
Paired Samples ◽  
Environmental Surfaces ◽  
Healthcare Associated ◽  
The Impact ◽  
Panton Valentine Leukocidin

AbstractBackgroundThe impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further.MethodsPatients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients’ hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing.ResultsA total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces.ConclusionsOur data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

MedPharmRes ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 17-21
Author(s):  
Lam Nguyen-Ho ◽  
Duong Hoang-Thai ◽  
Vu Le-Thuong ◽  
Ngoc Tran-Van
Keyword(s):  
Risk Factor ◽  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
Community Acquired Pneumonia ◽  
Resistant Organism ◽  
Healthcare Associated Infection ◽  
Female Ratio ◽  
High Prevalence ◽  
Need To Evaluate ◽  
Healthcare Associated

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR. Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included. Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia. Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

scholarly journals Modeling Regional Transmission and Containment of a Healthcare-associated Multidrug-resistant Organism

2019 ◽  
Author(s):  
Prabasaj Paul ◽  
Rachel B Slayton ◽  
Alexander J Kallen ◽  
Maroya S Walters ◽  
John A Jernigan
Keyword(s):  
Multidrug Resistant ◽  
Resistant Organism ◽  
Healthcare Associated

No-Touch Disinfection Methods to Decrease Multidrug-Resistant Organism Infections: A Systematic Review and Meta-analysis

2017 ◽  
Vol 39 (1) ◽  
pp. 20-31 ◽  
Author(s):  
Alexandre R. Marra ◽  
Marin L. Schweizer ◽  
Michael B. Edmond
Keyword(s):  
Ultraviolet Light ◽  
Meta Analysis ◽  
Random Effect ◽  
Multidrug Resistant ◽  
Resistant Organism ◽  
Infection Rates ◽  
Disinfection Methods ◽  
Healthcare Associated ◽  
The Impact ◽  
No Touch Disinfection

BACKGROUNDRecent studies have shown that using no-touch disinfection technologies (ie, ultraviolet light [UVL] or hydrogen peroxide vapor [HPV] systems) can limit the transmission of nosocomial pathogens and prevent healthcare-associated infections (HAIs). To investigate these findings further, we performed a systematic literature review and meta-analysis on the impact of no-touch disinfection methods to decrease HAIs.METHODSWe searched PubMed, CINAHL, CDSR, DARE and EMBASE through April 2017 for studies evaluating no-touch disinfection technology and the nosocomial infection rates for Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and other multidrug-resistant organisms (MDROs). We employed random-effect models to obtain pooled risk ratio (pRR) estimates. Heterogeneity was evaluated with I2 estimation and the Cochran Q statistic. Pooled risk ratios for C. difficile, MRSA, VRE, and MDRO were assessed separately.RESULTSIn total, 20 studies were included in the final review: 13 studies using UVL systems and 7 studies using HPV systems. When the results of the UVL studies were pooled, statistically significant reduction ins C. difficile infection (CDI) (pRR, 0.64; 95% confidence interval [CI], 0.49–0.84) and VRE infection rates (pRR, 0.42; 95% CI, 0.28–0.65) were observed. No differences were found in rates of MRSA or gram-negative multidrug-resistant pathogens.CONCLUSIONSUltraviolet light no-touch disinfection technology may be effective in preventing CDI and VRE infection.Infect Control Hosp Epidemiol 2018;39:20–31

scholarly journals Hospital Policies Related to Transmission of Methicillin-Resistant Staphylococcus aureus (MRSA)

2020 ◽  
Vol 41 (S1) ◽  
pp. s252-s253
Author(s):  
Lindsey Lesher Erickson ◽  
Toben Nelson ◽  
J. Michael Oakes
Keyword(s):  
Hand Hygiene ◽  
Influenza Vaccination ◽  
Traffic Safety ◽  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Resistant Organism ◽  
Training And Education ◽  
Hospital Policies ◽  
Corrective Actions ◽  
Organizational Rules

Background: MRSA continues to spread in hospitals, despite modest recent success. Gaps exist regarding how hospital policies impact MRSA transmission in hospitals. Characterization of the policy environment has been useful in approaching other public health issues including control of alcohol, firearms, tobacco, and traffic safety. Objective: Our goal was to describe measurable and modifiable policy components designed to prevent MRSA in hospital settings. Methods: We examined 4 types of hospital policies from 5 metropolitan hospitals in Minnesota: hand hygiene, multidrug-resistant organism (MDRO) and isolation, healthcare personnel influenza vaccination, and whistleblower (corporate compliance). We developed a tool to systematically evaluate policies for each topic that included 19–23 instructional and implementation elements guided by regulatory and clinical practice guidelines: purpose, expectations, education and training, monitoring, enforcement, corrective actions, responsibilities, and corrective actions. Each policy element was evaluated for its presence (yes or no) and thoroughness (nonexistent = 0, cursory = 1, thorough = 2). Results: All hospitals had hand hygiene and MDRO and isolation policies; 3 of 5 had influenza and whistleblower policies. The policies varied in comprehensiveness and thoroughness across hospitals and topics. Most policies included purpose and policy statements with a statement of organizational rules (14 of 16 and 16 of 16, respectively) with mean thoroughness scores of 1.04 and 1.20, respectively. Most policies lacked consequences for noncompliance (6 of 16), accountability (6 of 16), and monitoring and enforcement of policy expectations (5 of 16). When included, the policy components scored low for thoroughness, and 50% of policies (8 of 16; range, 20% for hand hygiene and 100% for influenza vaccination) specified expectations for educating staff about the policy topic, with a mean thoroughness score of 0.75. Responsibilities for policy expectations were lacking: responsibilities for product needs and availability (3 of 13), training and education (1 of 16); and monitoring compliance with skills and techniques (4 of 16). Of the 4 policy types, influenza vaccination was the most complete. All influenza policies had 50% of categories completed versus hand hygiene (26%), MDRO (17%), and whistleblower (26%). The hand hygiene policies scored highest for thoroughness; 48% of policy elements scored >1.0 versus MDRO (22%), influenza (25%), and whistleblower (11%). Conclusions: We developed a systematic method to quantitatively evaluate hospital policies. Our review of hospital policies most commonly contained thorough instructional elements such as organizational requirements and protocols and procedures. Policies often lacked implementation elements such as expectations for monitoring, enforcement, responsibilities, accountabilities, and staff training and education. As we begin to characterize policy, endogenous in nature, as a potential exposure, it is important that we develop rigorous measurement. We have provided a first step in developing such an approach.Funding: NoneDisclosures: None

scholarly journals Healthcare Associated Infections: An Interoperable Infrastructure for Multidrug Resistant Organism Surveillance

2020 ◽  
Vol 17 (2) ◽  
pp. 465 ◽  
Author(s):  
Roberta Gazzarata ◽  
Maria Eugenia Monteverde ◽  
Carmelina Ruggiero ◽  
Norbert Maggi ◽  
Dalia Palmieri ◽  
...  
Keyword(s):  
Service Oriented Architecture ◽  
Health Care Systems ◽  
Multidrug Resistant ◽  
Resistant Organism ◽  
Local Health Authority ◽  
Local Health ◽  
Healthcare Associated Infections ◽  
Clinical Document ◽  
Care Systems ◽  
Healthcare Associated

Prevention and surveillance of healthcare associated infections caused by multidrug resistant organisms (MDROs) has been given increasing attention in recent years and is nowadays a major priority for health care systems. The creation of automated regional, national and international surveillance networks plays a key role in this respect. A surveillance system has been designed for the Abruzzo region in Italy, focusing on the monitoring of the MDROs prevalence in patients, on the appropriateness of antibiotic prescription in hospitalized patients and on foreseeable interactions with other networks at national and international level. The system has been designed according to the Service Oriented Architecture (SOA) principles, and Healthcare Service Specification (HSSP) standards and Clinical Document Architecture Release 2 (CDAR2) have been adopted. A description is given with special reference to implementation state, specific design and implementation choices and next foreseeable steps. The first release will be delivered at the Complex Operating Unit of Infectious Diseases of the Local Health Authority of Pescara (Italy).

Pulsed-xenon ultraviolet light disinfection in a burn unit: Impact on environmental bioburden, multidrug-resistant organism acquisition and healthcare associated infections

Burns ◽  
2017 ◽  
Vol 43 (2) ◽  
pp. 388-396 ◽  
Author(s):  
Caroline Green ◽  
Jeremy C. Pamplin ◽  
Kristine N. Chafin ◽  
Clinton K. Murray ◽  
Heather C. Yun
Keyword(s):  
Ultraviolet Light ◽  
Multidrug Resistant ◽  
Resistant Organism ◽  
Healthcare Associated Infections ◽  
Burn Unit ◽  
Healthcare Associated

scholarly journals Assessment of antibiotic-resistant organism transmission among rooms of hospitalized patients, healthcare personnel, and the hospital environment utilizing surrogate markers and selective bacterial cultures

2020 ◽  
Vol 41 (5) ◽  
pp. 539-546
Author(s):  
Jennie H. Kwon ◽  
Kimberly Reske ◽  
Caroline A. O’Neil ◽  
Candice Cass ◽  
Sondra Seiler ◽  
...  
Keyword(s):  
Academic Medical Center ◽  
Tertiary Care ◽  
Hospital Environment ◽  
Healthcare Personnel ◽  
Resistant Organism ◽  
Surrogate Markers ◽  
Antibiotic Resistant ◽  
Contact Precautions ◽  
Bacterial Cultures ◽  
Fluorescent Powder

AbstractObjective:To assess potential transmission of antibiotic-resistant organisms (AROs) using surrogate markers and bacterial cultures.Design:Pilot study.Setting:A 1,260-bed tertiary-care academic medical center.Participants:The study included 25 patients (17 of whom were on contact precautions for AROs) and 77 healthcare personnel (HCP).Methods:Fluorescent powder (FP) and MS2 bacteriophage were applied in patient rooms. HCP visits to each room were observed for 2–4 hours; hand hygiene (HH) compliance was recorded. Surfaces inside and outside the room and HCP skin and clothing were assessed for fluorescence, and swabs were collected for MS2 detection by polymerase chain reaction (PCR) and selective bacterial cultures.Results:Transfer of FP was observed for 20 rooms (80%) and 26 HCP (34%). Transfer of MS2 was detected for 10 rooms (40%) and 15 HCP (19%). Bacterial cultures were positive for 1 room and 8 HCP (10%). Interactions with patients on contact precautions resulted in fewer FP detections than interactions with patients not on precautions (P < .001); MS2 detections did not differ by patient isolation status. Fluorescent powder detections did not differ by HCP type, but MS2 was recovered more frequently from physicians than from nurses (P = .03). Overall, HH compliance was better among HCP caring for patients on contact precautions than among HCP caring for patients not on precautions (P = .003), among nurses than among other nonphysician HCP at room entry (P = .002), and among nurses than among physicians at room exit (P = .03). Moreover, HCP who performed HH prior to assessment had fewer fluorescence detections (P = .008).Conclusions:Contact precautions were associated with greater HCP HH compliance and reduced detection of FP and MS2.

scholarly journals 931A Prospective, Controlled Study of Multidrug-Resistant Organism Colonization among Healthcare Personnel

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S269-S270
Author(s):  
Brooke K. Decker ◽  
Anna F. Lau ◽  
Christine D. Spalding ◽  
Sara J. Blosser ◽  
John P. Dekker ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Controlled Study ◽  
Resistant Organism ◽  
Prospective Controlled Study
Sign in / Sign up

Export Citation Format

Share Document