Hiding in Plain Sight: Contaminated Ice Machines Are a Potential Source for Dissemination of Gram-Negative Bacteria and Candida Species in Healthcare Facilities

2018 ◽  
Vol 39 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Anubhav Kanwar ◽  
Jennifer L. Cadnum ◽  
Dongyan Xu ◽  
Annette L. Jencson ◽  
Curtis J. Donskey
Keyword(s):  
Nursing Homes ◽  
Contaminated Water ◽  
Gram Negative Bacteria ◽  
Potential Mechanism ◽  
Fluorescent Tracer ◽  
Gram Negative ◽  
Healthcare Facilities ◽  
Potential Source ◽  
Effective Interventions ◽  
Inner Surface

BACKGROUNDContaminated ice machines have been linked to transmission of pathogens in healthcare facilities.OBJECTIVETo determine the frequency and sites of contamination of ice machines in multiple healthcare facilities and to investigate potential mechanisms of microorganism dispersal from contaminated ice machines to patients.DESIGNMulticenter culture survey and simulation study.SETTINGThe study took place in 5 hospitals and 2 nursing homes in northeastern Ohio.METHODSWe cultured multiple sites on ice machines from patient care areas. To investigate potential mechanisms of microbial dispersal from contaminated ice machines, we observed the use of ice machines and conducted simulations using a fluorescent tracer and cultures.RESULTSSamples from 64 ice machines in the 5 hospitals and 2 nursing homes (range, 3–16 per facility) were cultured. Gram-negative bacilli and/or Candida spp were recovered from 100% of drain pans, 52% of ice and/or water chutes, and 72% of drain-pan grilles. During the operation of ice machines, ice often fell through the grille, resulting in splattering, with dispersal of contaminated water from the drain pan to the drain-pan grille, cups, and the hands of those using the ice machine. Contamination of the inner surface of the ice chute resulted in contamination of ice cubes exiting the chute.CONCLUSIONSOur findings demonstrate that ice machines in healthcare facilities are often contaminated with gram-negative bacilli and Candida species, and provide a potential mechanism by which these organisms may be dispersed. Effective interventions are needed to reduce the risk of dissemination of pathogenic organisms from ice machines.Infect Control Hosp Epidemiol 2018;39:253–258

scholarly journals Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?

2021 ◽  
Author(s):  
Kristina Bertl ◽  
Chiarra Geissberger ◽  
David Zinndorf ◽  
Pia Edlund Johansson ◽  
Hatem Al-Shammari ◽  
...  
Keyword(s):  
Chlorhexidine Gluconate ◽  
Water Jet ◽  
Contamination Rate ◽  
Contaminated Water ◽  
Gram Negative Bacteria ◽  
Cross Contamination ◽  
Periodontal Pathogens ◽  
Bacterial Colonisation ◽  
Gram Negative ◽  
Time Point

Abstract Objective To assess whether bacterial colonisation in a power-driven water flosser can be prevented. Materials and methods Twenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp. Results Contamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19–56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans. Conclusion Neither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU. Clinical relevance Bacterial colonisation in a power-driven water flosser seems impossible to prevent; to restrict the risk of cross-contamination within a household, one device per person should be recommended.

scholarly journals Multidrug-Resistant Gram-Negative Bacteria: Inter- and Intradissemination Among Nursing Homes of Residents With Advanced Dementia

2015 ◽  
Vol 36 (8) ◽  
pp. 930-935 ◽  
Author(s):  
Erika M. C. D’Agata ◽  
Daniel Habtemariam ◽  
Susan Mitchell
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Risk Group ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
High Risk Group ◽  
Pulsed Field Gel Electrophoresis ◽  
Gram Negative Bacteria ◽  
Advanced Dementia ◽  
Gram Negative

OBJECTIVETo quantify the extent of inter– and intra–nursing home transmission of multidrug-resistant gram-negative bacteria (MDRGN) among residents with advanced dementia and characterize MDRGN colonization among these residents.DESIGNProspective cohort study.SETTINGTwenty-two nursing homes in the greater Boston, Massachusetts, area.PATIENTSResidents with advanced dementia.METHODSSerial rectal surveillance cultures for MDRGN and resident characteristics were obtained every 3 months for 12 months or until death. Molecular typing of MDRGN isolates was performed by pulsed-field gel electrophoresis.RESULTSA total of 190 MDRGN isolates from 152 residents with advanced dementia were included in the analyses. Both intra– and inter–nursing home transmission were identified. Genetically related MDRGN strains, recovered from different residents, were detected in 18 (82%) of the 22 nursing homes. The percent of clonally related strains in these nursing homes ranged from 0% to 86% (average, 35%). More than 50% of strains were clonally related in 3 nursing homes. Co-colonization with more than 1 different MDRGN species occurred among 28 residents (18.4%). A total of 168 (88.4%), 20 (10.5%), and 2 (1.0%) of MDRGN isolates were resistant to 3, 4, and 5 different antimicrobials or antimicrobial classes, respectively.CONCLUSIONSMDRGN are spread both within and between nursing homes among residents with advanced dementia. Infection control interventions should begin to target this high-risk group of nursing home residents.Infect Control Hosp Epidemiol2015;36(8):930–935

scholarly journals ESβL, AmpC and carbapenemase co-production in multi-drug resistant Gram-negative bacteria from HIV-infected patients in southwestern Nigeria

2021 ◽  
Vol 22 (1) ◽  
pp. 38-51
Author(s):  
F.M. Adeyemi ◽  
S.B. Akinde
Keyword(s):  
Control Measures ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Multi Drug Resistance ◽  
Gram Negative Bacteria ◽  
Southwestern Nigeria ◽  
Gram Negative ◽  
Healthcare Facilities ◽  
Infection Control Measures ◽  
Tertiary Healthcare

Background: The rising global emergence of Gram-negative bacteria (GNB) producing β-lactam hydrolysing enzymes in clinical infections constitutes a growing public health threat. This study investigated the occurrence of co-production of extended spectrum β-lactamase (ESβL), AmpC β-lactamases, and carbapenemases among GNB isolated from HIVinfected patients in two tertiary healthcare facilities in southwest Nigeria.Methodology: A total of 115 GNB isolates previously recovered from HIV-infected patients at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, and the State Specialist Hospital, Akure, were investigated. The isolates were characterized to species level with the Microbact 24E kit and screened for ESβL production using the double-disc test (DDT) and combination disc methods, AmpC using modified Hodge test (MHT) and AmpC EDTA disc, and carbapenemase production using the MHT and EDTA disc test. Antibiotic susceptibility testing (AST) was performed by the Kirby-Bauer disc diffusion method.Results: A total of 15 species of GNB were characterized. The AST profile of the isolates revealed high resistance rates to ampicillin (94.5%), tetracycline (74.5%), sulphamethoxazole-trimethoprim (66.3%), and lowest resistance to imipenem (10.9%). Multi-drug resistance (MDR) was observed in 93.6% while 98.8% of ESβL, AmpC, and carbapenemase-producing isolates had multiple antibiotic resistance (MAR) indices ≥ 0.2. ESβL production was detected in 53.9%, AmpC in 20.9% and carbapenemase in 25.2% of the isolates. ESβL, AmpC or carbapenemase or co-production of two or all three enzymes was detected in 80 (69.6%) isolates, while only 10.0% produced all three enzymes.Conclusion: The isolation of MDR bacteria and isolates co-producing β-lactam hydrolysing enzymes in immunocompromised individuals portend grave consequences. Routine screening for these enzymes in MDR bacteria will be highly essential to guide the institution of appropriate antibiotic therapy and infection control measures. Keywords: ESβL, AmpC, carbapenemase, HIV, MDR, clinical isolates, MHT, DDST   French Title: Coproduction d'ESβL, AmpC et carbapénémase dans des bactéries Gram-négatives multirésistantes de patients infectés par le VIH dans le sud-ouest du Nigéria Contexte: L'émergence mondiale croissante de bactéries à Gram négatif (GNB) produisant des enzymes d'hydrolyse de β-lactame dans les infections cliniques constitue une menace croissante pour la santé publique. Cette étude a examiné l'occurrence de la coproduction de β-lactamases à spectre étendu (ESβL), de  β-lactamases AmpC et de carbapénémases parmi les GNB isolés de patients infectés par le VIH dans deux établissements de santé tertiaires du sud-ouest du Nigéria. Méthodologie: Un total de 115 isolats de GNB précédemment récupérés de patients infectés par le VIH au complexe hospitalier universitaire Obafemi Awolowo, Ile-Ife, et au State Specialist Hospital, Akure, ont été  étudiés. Les isolats ont été caractérisés au niveau des espèces avec le kit Microbact 24E et criblés pour la  production d'ESβL en utilisant le test à double disque (DDT) et les méthodes de disques combinés, AmpC en utilisant le test Hodge modifié (MHT) et le disque AmpC EDTA, et la production de carbapénémase en utilisant le MHT et test de disque EDTA. Le test de sensibilité aux antibiotiques (AST) a été effectué par la méthode de diffusion de disque de Kirby-Bauer Résultats: Un total de 15 espèces de GNB ont été caractérisées. Le profil AST des isolats a révélé des taux derésistance élevés à l'ampicilline (94,5%), à la tétracycline (74,5%), au sulfaméthoxazole-triméthoprime (66,3%) età la plus faible résistance à l'imipénème (10,9%). Une résistance à plusieurs médicaments (MDR) a été observéedans 93,6% tandis que 98,8% des isolats producteurs d'ESβL, AmpC et carbapénémase avaient de multiples indices de résistance aux antibiotiques (MAR) ≥ 0,2. La production d'ESβL a été détectée dans 53,9%, AmpC dans 20,9% et carbapénémase dans 25,2% des isolats. ESβL, AmpC ou carbapénémase ou la coproduction de deux ou des trois enzymes a été détectée dans 80 isolats (69,6%), tandis que seulement 10,0% ont produit les trois enzymes. Conclusion: L'isolement des bactéries MDR et des isolats co-producteurs d'enzymes d'hydrolyse des β-lactamines chez les individus immunodéprimés laisse présager de graves conséquences. Le dépistage systématique de ces enzymes dans les bactéries MDR sera très essentiel pour guider la mise en place d'une antibiothérapie appropriée et de mesures de contrôle des infections. Mots-clés: ESβL, AmpC, carbapénémase, VIH, MDR, isolats cliniques, MHT, DDST

scholarly journals Mahuang-Fuzi-Xixin Decoction Reverses Depression-Like Behavior in LPS-Induced Mice by Regulating NLRP3 Inflammasome and Neurogenesis

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Wen Jing ◽  
Shanshan Song ◽  
Hong Sun ◽  
Ying Chen ◽  
Quan Zhao ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Nlrp3 Inflammasome ◽  
Neurotrophic Factor ◽  
Gram Negative Bacteria ◽  
Potential Mechanism ◽  
Major Depressive ◽  
Interacting Protein ◽  
Antidepressive Effect ◽  
Gram Negative

Evidence suggests that inflammation and neurogenesis play an important role in major depressive disorder (MDD). Mahuang-Fuzi-Xixin decoction (MFX), as the traditional Chinese prescription, has been widely applied for asthma, migraine, and MDD in clinics. However, the effects of MFX on the potential mechanism in MDD are still unclear. Hence, the present study is aimed at exploring whether the antidepressive effect of MFX is connected to the anti-inflammatory and promoting neurogenesis. Besides, lipopolysaccharide (LPS) of Gram-negative bacteria can induce depressive-like behaviors. We demonstrated that administration of MFX corrected the depressive-like behaviors in LPS-induced mice and significantly decreased the expression of IL-1β in the hippocampus. LPS injection induced a significant increase in the levels of NLRP3, cleaved caspase-1 p20, and ASC in the hippocampus, as well as Trx-interacting protein (TXNIP), and MFX could reverse this change. What is more, treatment of MFX increased the level of doublecortin (DCX), brain-derived neurotrophic factor (BDNF), and tropomyosin-related kinase receptor B (TrkB) in the hippocampus which means that MFX could promote the neurogenesis. In conclusion, the study indicates that MFX relieves a depressive-like state in LPS-induced mice through the inhibition of the NLRP3 inflammasome and the enhancement of the neurogenesis pathway.

Bacterial-Mucosal Cell Junctional Complexes

1974 ◽  
Vol 32 ◽  
pp. 144-145
Author(s):  
Roger C. Wagner
Keyword(s):  
Intestinal Wall ◽  
Rat Colon ◽  
Mucosal Cell ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Mucosal Cells ◽  
Mucosal Lining ◽  
Degenerative Alterations ◽  
Junctional Complexes ◽  
Intestinal Mucosal Cells

Bacteria exhibit the ability to adhere to the apical surfaces of intestinal mucosal cells. These attachments either precede invasion of the intestinal wall by the bacteria with accompanying inflammation and degeneration of the mucosa or represent permanent anchoring sites where the bacteria never totally penetrate the mucosal cells.Endemic gram negative bacteria were found attached to the surface of mucosal cells lining the walls of crypts in the rat colon. The bacteria did not intrude deeper than 0.5 urn into the mucosal cells and no degenerative alterations were detectable in the mucosal lining.

Rapid demonstration of septic or infectious arthritis due to Gram-negative bacteria

1992 ◽  
Vol 50 (1) ◽  
pp. 686-687
Author(s):  
Jacob S. Hanker ◽  
Paul R. Gross ◽  
Beverly L. Giammara
Keyword(s):  
Chronic Arthritis ◽  
Blood Cultures ◽  
Gram Negative Bacteria ◽  
Infectious Arthritis ◽  
Bacterial Arthritis ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Blood cultures are positive in approximately only 50 per cent of the patients with nongonococcal bacterial infectious arthritis and about 20 per cent of those with gonococcal arthritis. But the concept that gram-negative bacteria could be involved even in chronic arthritis is well-supported. Gram stains are more definitive in staphylococcal arthritis caused by gram-positive bacteria than in bacterial arthritis due to gram-negative bacteria. In the latter situation where gram-negative bacilli are the problem, Gram stains are helpful for 50% of the patients; they are only helpful for 25% of the patients, however, where gram-negative gonococci are the problem. In arthritis due to gram-positive Staphylococci. Gramstained smears are positive for 75% of the patients.

Ultrastructure of periplasmic bodies in gram-negative bacteria

1990 ◽  
Vol 48 (3) ◽  
pp. 640-641
Author(s):  
Xie Nianming ◽  
Ding Shaoqing ◽  
Wang Luping ◽  
Yuan Zenglin ◽  
Zhan Guolai ◽  
...  
Keyword(s):  
Electron Microscope ◽  
Campylobacter Jejuni ◽  
Proteus Mirabilis ◽  
Shigella Flexneri ◽  
Morphological Description ◽  
Gram Negative Bacteria ◽  
Periplasmic Space ◽  
Clostridium Tetani ◽  
Gram Negative ◽  
Brucella Canis

Perhaps the data about periplasmic enzymes are obtained through biochemical methods but lack of morphological description. We have proved the existence of periplasmic bodies by electron microscope and described their ultrastructures. We hope this report may draw the attention of biochemists and mrophologists to collaborate on researches in periplasmic enzymes or periplasmic bodies with each other.One or more independent bodies may be seen in the periplasmic space between outer and inner membranes of Gram-negative bacteria, which we called periplasmic bodies. The periplasmic bodies have been found in seven species of bacteria at least, including the Pseudomonas aeroginosa. Shigella flexneri, Echerichia coli. Yersinia pestis, Campylobacter jejuni, Proteus mirabilis, Clostridium tetani. Vibrio cholerae and Brucella canis.

Dual stain kit for the microscopic gram classification of ocular infection bacteria

1993 ◽  
Vol 51 ◽  
pp. 248-249
Author(s):  
Jacob S. Hanker ◽  
Dale N. Holdren ◽  
Kenneth L. Cohen ◽  
Beverly L. Giammara
Keyword(s):  
Contact Lenses ◽  
Ocular Infection ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Gram Staining ◽  
Ocular Infections ◽  
Different Types ◽  
Culture Positive ◽  
Increased Susceptibility

Keratitis and conjunctivitis (infections of the cornea or conjunctiva) are ocular infections caused by various bacteria, fungi, viruses or parasites; bacteria, however, are usually prominent. Systemic conditions such as alcoholism, diabetes, debilitating disease, AIDS and immunosuppressive therapy can lead to increased susceptibility but trauma and contact lens use are very important factors. Gram-negative bacteria are most frequently cultured in these situations and Pseudomonas aeruginosa is most usually isolated from culture-positive ulcers of patients using contact lenses. Smears for staining can be obtained with a special swab or spatula and Gram staining frequently guides choice of a therapeutic rinse prior to the report of the culture results upon which specific antibiotic therapy is based. In some cases staining of the direct smear may be diagnostic in situations where the culture will not grow. In these cases different types of stains occasionally assist in guiding therapy.

Neutrophil pseudoplatelets in subgingival plaque and crevicular fluid samples from periodontal diseased sites

1989 ◽  
Vol 47 ◽  
pp. 862-863 ◽  
Author(s):  
J Hanker ◽  
E.J. Burkes ◽  
G. Greco ◽  
R. Scruggs ◽  
B. Giammara
Keyword(s):  
Electron Microscopy ◽  
Bone Marrow ◽  
Peripheral Blood ◽  
Gingival Crevicular Fluid ◽  
Light And Electron Microscopy ◽  
Subgingival Plaque ◽  
Staining Reaction ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Crevicular Fluid

The mature neutrophil with a segmented nucleus (usually having 3 or 4 lobes) is generally considered to be the end-stage cell of the neutrophil series. It is usually found as such in the bone marrow and peripheral blood where it normally is the most abundant leukocyte. Neutrophils, however, must frequently leave the peripheral blood and migrate into areas of infection to combat microorganisms. It is in such areas that neutrophils were first observed to fragment to form platelet-size particles some of which have a nuclear lobe. These neutrophil pseudoplatelets (NPP) can readily be distinguished from true platelets because they stain for neutrophil myeloperoxidase. True platelets are not positive in this staining reaction because their peroxidase Is inhibited by glutaraldehyde. Neutrophil pseudoplatelets, as well as neutrophils budding to form NPP, could frequently be observed in peripheral blood or bone marrow samples of leukemia patients. They are much more prominent, however, in smears of inflammatory exudates that contain gram-negative bacteria and in gingival crevicular fluid samples from periodontal disease sites. In some of these samples macrophages ingesting, or which contained, pseudoplatelets could be observed. The myeloperoxidase in the ingested pseudoplatelets was frequently active. Despite these earlier observations we did not expect to find many NPP in subgingival plaque smears from diseased sites. They were first seen by light microscopy (Figs. 1, 3-5) in smears on coverslips stained with the PATS reaction, a variation of the PAS reaction which deposits silver for light and electron microscopy. After drying replicate PATS-stained coverslips with hexamethyldisilazane, they were sputter coated with gold and then examined by the SEI and BEI modes of scanning electron microscopy (Fig. 2). Unstained replicate coverslips were fixed, and stained for the demonstration of myeloperoxidase in budding neutrophils and NPP. Neutrophils, activated macrophages and spirochetes as well as other gram-negative bacteria were also prominent in the PATS stained samples. In replicate subgingival plaque smears stained with our procedure for granulocyte peroxidases only neutrophils, budding neutrophils or NPP were readily observed (Fig. 6).

Antimicrobial and cytotoxic activity of Macrophomina phaseolina isolated from gummosis infected citrus reticulata

2013 ◽  
pp. 125-133
Author(s):  
Rubal C Das ◽  
Rajib Banik ◽  
Robiul Hasan Bhuiyan ◽  
Md Golam Kabir
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Brine Shrimp ◽  
Inhibitory Concentration ◽  
Lethal Dose ◽  
Macrophomina Phaseolina ◽  
Chloroform Extract ◽  
Citrus Reticulata ◽  
Gram Negative Bacteria ◽  
Gram Negative

Macrophomina phaseolina is one of the pathogenic organisms of gummosis disease of orange tree (Citrus reticulata). The pathogen was identified from the observation of their colony size, shape, colour, mycelium, conidiophore, conidia, hyaline, spore, and appressoria in the PDA culture. The crude chloroform extracts from the organism showed antibacterial activity against a number of Gram positive and Gram-negative bacteria. The crude chloroform extract also showed promising antifungal activity against three species of the genus Aspergillus. The minimum inhibitory concentration (MIC) of the crude chloroform extract from M. phaseolina against Bacillus subtilis, Staphylococcus aureus, Escherichia coli, and Shigella sonnie were 128 ?gm, 256 ?gm, 128 ?gm and 64 ?gm/ml respectively. The LD50 (lethal dose) values of the cytotoxicity assay over brine shrimp of the crude chloroform extract from M. phaseolina was found to be 51.79 ?gm/ml. DOI: http://dx.doi.org/10.3329/cujbs.v5i1.13378 The Chittagong Univ. J. B. Sci.,Vol. 5(1 &2):125-133, 2010

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