Direct costs and clinical impact of adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit

2020 ◽  
pp. 1-7
Author(s):  
María Florencia Angueyra ◽  
Débora Natalia Marcone ◽  
Florencia Escarrá ◽  
Noelia Soledad Reyes ◽  
Yamile Rubies ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Median Duration ◽  
Tertiary Care ◽  
Productivity Loss ◽  
High Risk Pregnancy ◽  
Control Measures ◽  
Viral Spread ◽  
Infection Control Measures ◽  
Risk Pregnancy

Abstract Objective: To report a conjunctivitis outbreak in a neonatology intensive care unit (NICU) and determine the associated economic impact. Design: Prospective observational study. Setting: Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, a private, tertiary-care healthcare institution in Buenos Aires, Argentina. Participants: The study included 52 NICU neonates and 59 NICU-related healthcare workers (HCWs) from CEMIC hospital. Methods: Neonates and HCWs were swabbed for real-time polymerase chain reaction (PCR) testing, viral culture, and typing by sequencing. Infection control measures, structural and logistic changes were implemented. Billing records were analyzed to determine costs. Results: From January 30 to April 28, 2018, 52 neonates were hospitalized in the NICU. Among them, 14 of 52 (21%) had bilateral conjunctivitis with pseudomembranes. Symptomatic neonates and HCWs were HAdV-D8 positive. Ophthalmological symptoms had a median duration of 18 days (IQR, 13–24.5). PCR positivity and infectious range had a median duration of 18.5 days. As part of containment measures, the NICU and the high-risk pregnancy unit were closed to new patients. The NICU was divided into 2 areas for symptomatic and asymptomatic patients; a new room was assigned for the general nursery, and all deliveries from the high-risk pregnancy unit were redirected to other hospitals. The outbreak cost the hospital US$205,000: implementation of a new nursery room and extra salaries cost US$30,350 and estimated productivity loss during 1 month cost US$175,000. Conclusions: Laboratory diagnosis confirmed the cause of this outbreak as HAdV-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial viral spread. This outbreak represented a serious institutional problem, causing morbidity, significant economic loss, and absenteeism.

scholarly journals The interplay of SARS-CoV-2 and Clostridioides difficile infection

2021 ◽  
Vol 16 (6) ◽  
pp. 439-443
Author(s):  
Sahil Khanna ◽  
Colleen S Kraft
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
Antibiotic Exposure ◽  
Hospital Acquired Infections ◽  
Infection Control Measures ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Hospital Acquired

The COVID-19 pandemic has changed the way we practice medicine and lead our lives. In addition to pulmonary symptoms; COVID-19 as a syndrome has multisystemic involvement including frequent gastrointestinal symptoms such as diarrhea. Due to microbiome alterations with COVID-19 and frequent antibiotic exposure, COVID-19 can be complicated by Clostridioides difficile infection. Co-infection with these two can be associated with a high risk of complications. Infection control measures in hospitals is enhanced due to the COVID-19 pandemic which in turn appears to reduce the incidence of hospital-acquired infections such as C. difficile infection. Another implication of COVID-19 and its potential transmissibility by stool is microbiome-based therapies. Potential stool donors should be screened COVID-19 symptoms and be tested for COVID-19.

Management of Candida auris outbreak in a tertiary-care setting in Saudi Arabia

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Majid M. Alshamrani ◽  
Aiman El-Saed ◽  
Azzam Mohammed ◽  
Majed F. Alghoribi ◽  
Sameera M. Al Johani ◽  
...  
Keyword(s):  
Infection Control ◽  
Care Setting ◽  
Tertiary Care ◽  
Sharp Decrease ◽  
Control Measures ◽  
Candida Auris ◽  
Environmental Cleaning ◽  
Infection Control Measures ◽  
Local Experience ◽  
Tertiary Care Setting

Abstract Objective: To describe local experience in managing an outbreak of Candida auris in a tertiary-care setting. Methods: In response to emerging Candida auris, an outbreak investigation was conducted at our hospital between March 2018 and June 2019. Once a patient was confirmed to have Candida auris, screening of exposed patients and healthcare workers (HCWs) was conducted. Postexposure screening included those who had had direct contact with or shared the same unit or ward with a laboratory-confirmed case. In response to the increasing number of cases, new infection control measures were implemented. Results: In total, 23 primary patients were detected over 15 months. Postexposure screening identified 11 more cases, and all were patients. Furthermore, ~28.6% of patients probably caught infection in another hospital or in the community. Infection control measures were strictly implemented including hand hygiene, personal protective equipment, patient hygiene, environmental cleaning, cohorting of patients and HCWs, and avoiding the sharing of equipment. The wave reached a peak in April 2019, followed by a sharp decrease in May 2019 and complete clearance in June 2019. The case patients were equally distributed between intensive care units (51.4%) and wards (48.6%). More infections (62.9%) occurred than colonizations (37.1%). Urinary tract infection (42.9%) and candidemia (17.1%) were the main infections. In total, 7 patients (20.0%) died during hospitalization; among them, 6 (17.1%) died within 30 days of diagnosis. Conclusions: Active screening of exposed patients followed by strict infection control measures, including environmental cleaning, was successful in ending the outbreak. Preventing future outbreaks is challenging due to outside sources of infection and environmental resistance.

First Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a Tertiary Care Hospital in Singapore

2006 ◽  
Vol 27 (9) ◽  
pp. 991-993 ◽  
Author(s):  
Maciej Piotr Chlebicki ◽  
Moi Lin Ling ◽  
Tse Hsien Koh ◽  
Li Yang Hsu ◽  
Ban Hock Tan ◽  
...  
Keyword(s):  
Infection Control ◽  
Enterococcus Faecium ◽  
Public Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Vancomycin Resistant

We report the first outbreak of vancomycin-resistantEnterococcus faeciumcolonization and infection among inpatients in the hematology ward of an acute tertiary care public hospital in Singapore. Two cases of bacteremia and 4 cases of gastrointestinal carriage were uncovered before implementation of strict infection control measures resulted in control of the outbreak.

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

Exogenous Sources ofPseudomonas aeruginosain Intensive Care Unit Patients Implementation of Infection Control Measures and Follow-Up With Molecular Typing

2006 ◽  
Vol 27 (9) ◽  
pp. 953-957 ◽  
Author(s):  
Christiane Petignat ◽  
Patrick Francioli ◽  
Immaculée Nahimana ◽  
Aline Wenger ◽  
Jacques Bille ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Pfge Pattern ◽  
Control Measures ◽  
Icu Patients ◽  
Infection Control Measures ◽  
Exogenous Origin

Background.In 1998, a study in the intensive care unit (ICU) of our institution suggested possible transmission of Pseudomonas aeruginosa from faucet to patient and from patient to patient. Infection-control measures were implemented to reduce the degree ofP. aeruginosacolonization in faucets, to reduce the use of faucet water in certain patient care procedures, and to reduce the rate of transmission from patient to patient.Objective.To evaluate the effect of the control measures instituted in 1999 to preventP. aeruginosainfection and colonization in ICU patients.Design.Prospective, molecular, epidemiological investigation.Setting.A 870-bed, university-affiliated, tertiary care teaching hospital.Methods.The investigation was performed in a manner identical to the 1998 investigation. ICU patients with a clinical specimen positive forP. aeruginosawere identified prospectively. Swab specimens from the inner part of the ICU faucets were obtained for the culture on 9 occasions between September 1997 and December 2000. All patients and environmental isolates were typed by pulsed-field gel electrophoresis (PFGE).Results.Compared with the 1998 study, in 2000 we found that the annual incidence of ICU patients colonized or infected withP. aeruginosahad decreased by half (26.6 patients per 1,000 admissions in 2000 vs 59.0 patients per 1,000 admissions in 1998), although the populations of patients were comparable. This decrease was the result of the decreased incidence of cases in which an isolate had a PFGE pattern identical to that of an isolate from a faucet (7.0 cases per 1,000 admissions in 2000, vs 23.6 per 1,000 admissions in 1998) or from another patient (6.5 cases per 1,000 admissions in 2000 vs 16.5 cases per 1,000 admissions in 1998), whereas the incidence of cases in which the isolate had a unique PFGE pattern remained nearly unchanged (13.1 cases per 1,000 admissions in 2000 vs 15.6 cases per 1,000 admissions in 1998).Conclusions.These results suggest that infection control measures were effective in decreasing the rate ofP. aeruginosacolonization and infection in ICU patients, confirming thatP. aeruginosastrains were of exogenous origin in a substantial proportion of patients during the preintervention period.

Transmission and control in an institutional pandemic influenza A(H1N1) 2009 outbreak

2011 ◽  
Vol 140 (6) ◽  
pp. 1102-1110 ◽  
Author(s):  
N. ARINAMINPATHY ◽  
N. RAPHAELY ◽  
L. SALDANA ◽  
C. HODGEKISS ◽  
J. DANDRIDGE ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Pandemic Influenza ◽  
Summer School ◽  
Influenza A ◽  
Control Measures ◽  
Infection Control Measures ◽  
Influenza A H1n1 ◽  
Hygiene Measures ◽  
The Impact

SUMMARYA pandemic influenza A(H1N1) 2009 outbreak in a summer school affected 117/276 (42%) students. Residential social contact was associated with risk of infection, and there was no evidence for transmission associated with the classroom setting. Although the summer school had new admissions each week, which provided susceptible students the outbreak was controlled using routine infection control measures (isolation of cases, basic hygiene measures and avoidance of particularly high-risk social events) and prompt treatment of cases. This was in the absence of chemoprophylaxis or vaccination and without altering the basic educational activities of the school. Modelling of the outbreak allowed estimation of the impact of interventions on transmission. These models and follow-up surveillance supported the effectiveness of routine infection control measures to stop the spread of influenza even in this high-risk setting for transmission.

Control of Nosocomial Clostridium difficile Transmission in Bone Marrow Transplant Patients

2000 ◽  
Vol 21 (3) ◽  
pp. 226-228 ◽  
Author(s):  
Hend Hanna ◽  
Issam Raad ◽  
Virginia Gonzalez ◽  
Jan Umphrey ◽  
Jeffrey Tarrand ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Clostridium Difficile ◽  
Infection Control ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Marrow Transplant ◽  
Control Measures ◽  
Transplant Patients ◽  
Infection Control Measures

AbstractThis is a report of six cases of Clostridium difficile-associated diarrhea (CDAD) that occurred among cancer patients undergoing bone marrow transplantation in a tertiary-care cancer hospital. Specific infection control measures that were taken to minimize the nosocomial spread of CDAD also are discussed.

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