scholarly journals KPC-Producing Enterobacter cloacae Transfer Through Pipework Between Hospital Sink Waste Traps in a Laboratory Model System

2020 ◽  
Vol 41 (S1) ◽  
pp. s308-s309
Author(s):  
Paz Aranega Bou ◽  
Nicholas Ellaby ◽  
Matthew Ellington ◽  
Ginny Moore
Keyword(s):  
Clinical Setting ◽  
Drainage System ◽  
Model System ◽  
Laboratory Model ◽  
Bacterial Populations ◽  
Hospital Acquired Infections ◽  
System 2 ◽  
Gram Negative Organisms ◽  
Hospital Acquired

Background: Carbapenemase-producing Enterobacterales (CPE) have become an increasingly common cause of hospital-acquired infections while their reservoirs within the clinical setting remain poorly understood. Outbreaks have been linked to hospital sinks, which have been shown to harbor and, under certain conditions, disperse CPE to surrounding surfaces. Hospital and laboratory studies have proposed that Gram-negative organisms, including CPE, can migrate through plumbing biofilms, leading to widespread contamination of the drainage system. Methods: To assess the prevalence of CPE in hospital sinks, drain swabs and waste trap water samples were taken from 10 sinks in 10 hospitals. Hospitals were in different regions of England; 4 had reported recent cases of CPE infection. To investigate spread and dispersal of CPE, waste traps from a single hospital were installed in a laboratory model sink system. Built to simulate a clinical setting, the model incorporated 12 sinks, 6 of which were connected through a common waste pipe. All 12 taps were automatically flushed. Drainage was automatically controlled. Nutrients were provided daily to maintain the bacterial populations, which were regularly sampled to monitor their composition. At 3 weeks after installation, the waste traps were subjected to a drainage backflow event. Waste trap water populations continued to be monitored, and when transfer between sinks was suspected, isolates were characterized and compared using whole-genome sequencing. Results: Between January and June 2019, 200 samples were taken from 103 sinks. In total, 24 (23%) sinks (in 8 hospitals) harbored CRE; of which 10 (in 5 hospitals) harbored at least 1 CPE. Immediately after a backflow event in the laboratory model system, 2 KPC-producing E. cloacae were recovered from a waste trap in which CPE had not been previously detected. The isolates were identified as ST501 and ST31 and were genetically indistinguishable from those colonizing sinks elsewhere in the system. Following intersink transfer, KPC-producing E. cloacae ST501 successfully integrated into the microbiome of the recipient sink and was detected in the waste trap water at least 6 months after the backflow event. At 2 and 3 months after the backflow, other intersink transfers involving Escherichia coli and KPC-producing E. cloacae were also observed. Conclusions: Sink waste traps and drains are a reservoir for CPE in hospitals. Once established, CPE contamination might not be confined to a single sink and could spread through wastewater plumbing. Hospitals frequently report drainage problems, which could cause or facilitate CPE transfer between sinks and could lead to long-term establishment.Funding: NoneDisclosures: None

scholarly journals Hospital-acquired infections due to multidrug-resistant organisms in Hungary, 2005-2010

2013 ◽  
Vol 18 (2) ◽  
Author(s):  
S Caini ◽  
A Hajdu ◽  
A Kurcz ◽  
K Böröcz
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Special Focus ◽  
Gram Negative ◽  
Hospital Acquired Infections ◽  
Health Authorities ◽  
Multidrug Resistant Organisms ◽  
Public Health Authorities ◽  
Gram Negative Organisms ◽  
Hospital Acquired

Healthcare-associated infections caused by multidrug-resistant organisms are associated with prolonged medical care, worse outcome and costly therapies. In Hungary, hospital-acquired infections (HAIs) due to epidemiologically important multidrug-resistant organisms are notifiable by law since 2004. Overall, 6,845 case-patients (59.8% men; median age: 65 years) were notified in Hungary from 2005 to 2010. One third of case-patients died in hospital. The overall incidence of infections increased from 5.4 in 2005 to 14.7 per 100,000 patient-days in 2010. Meticillin-resistant Staphylococcus aureus (MRSA) was the most frequently reported pathogen (52.2%), but while its incidence seemed to stabilise after 2007, notifications of multidrug-resistant Gram-negative organisms have significantly increased from 2005 to 2010. Surgical wound and bloodstream were the most frequently reported sites of infection. Although MRSA incidence has seemingly reached a plateau in recent years, actions aiming at reducing the burden of HAIs with special focus on Gram-negative multidrug-resistant organisms are needed in Hungary. Continuing promotion of antimicrobial stewardship, infection control methodologies, reinforced HAI surveillance among healthcare and infection control practitioners, and engagement of stakeholders, hospital managers and public health authorities to facilitate the implementation of existing guidelines and protocols are essential.

scholarly journals 687. In vitro Activity of a New Generation Oxopyrazole Antibiotic Against Acinetobacter spp.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S312-S312
Author(s):  
Joel Goldberg ◽  
Christopher Bethel ◽  
Andrea M Hujer ◽  
Kristine Hujer ◽  
Steven Marshall ◽  
...  
Keyword(s):  
In Vitro Activity ◽  
Penicillin Binding Proteins ◽  
Hospital Acquired Infections ◽  
New Class ◽  
Carbapenem Resistant ◽  
Acinetobacter Spp ◽  
Gram Negative Organisms ◽  
New Generation ◽  
Hospital Acquired

Abstract Background Acinetobacter spp. resistant to common antibiotics have become a worrying cause of hospital-acquired infections and represent a critical need for innovative antibacterial development. New oxopyrazole agents targeting penicillin-binding proteins (PBPs) based on a non-β-lactam core and incorporating a siderophore moiety (figure) which facilitates transport to the periplasm are being developed which show promise against Gram-negative organisms including Acinetobacter spp. Methods YU253911, an example of this new class of antibacterials, was characterized in vitro. Minimum inhibitory concentrations (MICs) were determined by broth microdilution against a collection of 200 previously described (whole-genome sequencing) Acinetobacter isolates including 98 carbapenem-resistant A. baumannii strains. YU253911’s antimicrobial activity was also evaluated in combination with complementary PBP agents and β-lactamase inhibitors by MIC and disc diffusion testing. All studies were performed according to current Clinical and Laboratory Standards Institute (CLSI) guidelines using iron-depleted media. Breakpoints for ceftazidime were arbitrarily chosen as reference. Results Using ceftazidime (breakpoint ≤8 μg/mL) as a comparator, 175 of the 200 Acinetobacter isolates were susceptible to YU253911, which possessed an MIC50 of 0.5 μg/mL and an MIC90 of 16 μg/mL. This compared favorably to all previously tested β-lactams including penicillins, cephalosporins, monobactams and carbapenems (MIC50s 2 to >16 μg/mL). Against the subset of carbapenem-resistant A. baumannii isolates, YU253911’s potency was similar with an MIC50 of 1 μg/mL. Genetic analysis showed β-lactamase genes, including OXA-23 and other carbapenemases, were common in both YU253911-resistant and susceptible strains. Conclusion YU253911 demonstrates promising in vitro potency against a collection of Acinetobacter isolates and compares favorably to β-lactam antibiotics. Understanding interactions with PBP agents and β lactamase inhibitors is being explored as well as further studies on the mechanism of resistance. Disclosures All authors: No reported disclosures.

Chlorhexidine Bathing and Microbial Contamination in Patients’ Bath Basins

2012 ◽  
Vol 21 (5) ◽  
pp. 338-342 ◽  
Author(s):  
Jan Powers ◽  
Jennifer Peed ◽  
Lindsey Burns ◽  
Mary Ziemba-Davis
Keyword(s):  
Bacterial Growth ◽  
Microbial Contamination ◽  
Chlorhexidine Gluconate ◽  
Coagulase Negative Staphylococcus ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Hospital Acquired Infections ◽  
Bacterial Contaminants ◽  
Gram Negative Organisms ◽  
Hospital Acquired

Background Research has demonstrated the hazards associated with patients’ bath basins and microbial contamination. In a previous study, soap and water bath basins in 3 acute care hospitals were found to be reservoirs for bacteria and potentially associated with the development of hospital-acquired infections. Bacteria grew in 98% of the basin samples; the most common were enterococci (54%), and 32% were gram-negative organisms. Objective To assess the presence of bacterial contaminants in wash basins when chlorhexidine gluconate solution is used in place of standard soap and water to wash patients. Methods Bathing with chlorhexidine gluconate is the standard of practice for all patients in intensive care units at St Vincent Hospital. Specimens from 90 bath basins used for 5 days or more were cultured for bacterial growth to assess contamination of basins when chlorhexidine gluconate is used. Results Of the 90 basins cultured, only 4 came back positive for microbial growth; all 4 showed growth of gram-positive organisms. Three of the 4 organisms were identified as coagulase-negative staphylococcus, which is frequently found on the skin. This translates into a 95.5% reduction in bacterial growth when chlorhexidine gluconate is used as compared with soap and water in the previous study (Fisher exact test, P < .001). The only factor that was related to positive cultures of samples from basins was the sex of the patient. Discussion Compared with the previous study examining microbial contamination of basins when soap and water was used to bathe patients, bacterial growth in patients’ bath basins decreased significantly with the use of chlorhexidine gluconate, drastically reducing the risk for hospital-acquired infections. Such reduced risk is especially important for critically ill patients at high risk for bacterial infection.

Patients’ Bath Basins as Potential Sources of Infection: A Multicenter Sampling Study

2009 ◽  
Vol 18 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Debra Johnson ◽  
Lauri Lineweaver ◽  
Lenora M. Maze
Keyword(s):  
Bacterial Colonization ◽  
Gram Negative ◽  
Sterile Culture ◽  
Hospital Acquired Infections ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Gram Negative Organisms ◽  
A Prospective Study ◽  
Hospital Acquired ◽  
Rates Of Growth

Background Nosocomial infections are a marked burden on the US health care system and are linked to a high number of patient deaths. Objective To identify and quantify bacteria in patients’ bath basins and evaluate the basins as a possible reservoir for bacterial colonization and a risk factor for subsequent hospital-acquired infection. Methods In a prospective study at 3 acute care hospitals, 92 bath basins, including basins from 3 intensive care units, were evaluated. Sterile culture sponges were used to obtain samples from the basins. The culture sponges were sent to an outside laboratory, and qualitative and quantitative microbial tests were conducted and the results reported. Results Some form of bacteria grew in 98% of the samples (90 sponges), either by plating or on enrichment (95% confidence interval, 92%–99.7%). The organisms with the highest positive rates of growth on enrichment were enterococci (54%), gram-negative organisms (32%), Staphylococcus aureus (23%), vancomycin-resistant enterococci (13%), methicillin-resistant S aureus (8%), Pseudomonas aeruginosa (5%), Candida albicans (3%), and Escherichia coli (2%). Mean plate counts, in colony-forming units, were 10 187 for gram-negative organisms, 99 for E coli, 30 for P aeruginosa, 86 for S aureus, 207 for enterococci, and 31 for vancomycin-resistant enterococci. Conclusions Bath basins are a reservoir for bacteria and may be a source of transmission of hospital-acquired infections. Increased awareness of bath basins as a possible source of transmission of hospital-acquired infections is needed, particularly for high-risk patients.

scholarly journals Case report of a successfully treated gentamicin and ciprofloxacin resistant Serratia marcescens prosthetic joint infection

2014 ◽  
Vol 96 (8) ◽  
pp. e23-e25 ◽  
Author(s):  
TA Cannon ◽  
DG Partridge ◽  
RA Boden ◽  
R Townsend ◽  
I Stockley
Keyword(s):  
Serratia Marcescens ◽  
Joint Infection ◽  
Complex Case ◽  
Hospital Acquired Infections ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Gram Negative Organisms ◽  
Multiresistant Strains ◽  
Hospital Acquired

We report the case of an eradicated multiresistant Serratia marcescens prosthetic hip joint infection. It is estimated that enteric Gram-negative organisms account for approximately 8% of prosthetic joint infections. However, the evolving multiresistant strains of organisms being encountered in hospital acquired infections is making eradication increasingly difficult. We describe n our surgical and microbiological approach to this in a complex case.

scholarly journals Broad spectrum antimicrobial PDMS-based biomaterial for catheter fabrication

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Arunmozhiarasi Armugam ◽  
Siew Ping Teong ◽  
Diane S. W. Lim ◽  
Shook Pui Chan ◽  
Guangshun Yi ◽  
...  
Keyword(s):  
Room Temperature ◽  
Microbial Colonization ◽  
Organic Polymer ◽  
Antimicrobial Compound ◽  
Infection Rates ◽  
Hospital Acquired Infections ◽  
Healthcare Settings ◽  
High Infection ◽  
Hospital Acquired

Abstract Background In addition to the widespread use of antibiotics in healthcare settings, the current COVID-19 pandemic has escalated the emergence of antibiotic resistance. Nosocomial infections among hospitalized patients is a leading site for such resistant microbial colonization due to prolonged use of invasive devices and antibiotics in therapies. Invasive medical devices, especially catheters, are prone to infections that could accelerate the development of resistant microbes. Often, catheters - particularly urinary catheters - are prone to high infection rates. Antibiotic-coated catheters can reduce infection rates and although commercially available, are limited in efficacy and choices. Methods Herein, a novel and facile method to fabricate PMDS-based biomaterial for the development of antimicrobial eluting catheters is presented. Silicone based organic polymer polydimethylsiloxane (PDMS) was used to prepare a biomaterial containing novel polymeric imidazolium antimicrobial compound. Results It was found that the PDMS-based biomaterials could eradicate microbial colonization even after 60 days in culture with continuous microbial challenge, be recycled over multiple uses, stored at room temperature for long-term usage and importantly is biocompatible. Conclusion The PDMS-based biomaterial displayed biocidal functionality on microbes of clinical origin, which form major threats in hospital acquired infections. Graphical Abstract

scholarly journals The increasing isolation ofSerratiaspecies from clinical specimens

1979 ◽  
Vol 82 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Heather J. L. Brooks ◽  
T. J. Chambers ◽  
Soad Tabaqchali
Keyword(s):  
Antibiotic Resistance ◽  
Cross Infection ◽  
Multiple Antibiotic Resistance ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Hospital Acquired Infections ◽  
Gram Negative Organisms ◽  
Hospital Acquired ◽  
Simple Screening

SUMMARYA 14-month survey was undertaken in a diagnostic bacteriology laboratory to determine the incidence ofSerratiaspp. in routine clinical specimens. Gram-negative organisms with enterobacteria-like colonies were tested by a simple screening procedure. Fifty-eight strains ofS. marcescensand two strains ofS. liquefacienswere isolated from 59 patients. The strains were usually nonpigmented and exhibited multiple antibiotic resistance. Serotyping and determination of bacteriocine sensitivity patterns revealed that the majority of infections were sporadic, although episodes of cross-infection did occur.S. marcescenswas considered to contribute significantly to morbidity and mortality in 53% of patients and appears to be of increasing importance in hospital-acquired infections.

Reduction of hospital-acquired infections in the neonatal intensive care unit: A long-term commitment

2019 ◽  
Vol 47 (8) ◽  
pp. 1002-1005
Author(s):  
Orna Flidel-Rimon ◽  
Alex Guri ◽  
Dina Levi ◽  
Pnina Ciobotaro ◽  
Maly Oved ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Hospital Acquired Infections ◽  
Hospital Acquired
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