The Role of Colonization in the Pathogenesis of Nosocomial Infections

1996 ◽  
Vol 17 (3) ◽  
pp. 193-200
Author(s):  
Marc J.M. Bonten ◽  
Robert A. Weinstein
Keyword(s):  
Patient Outcome ◽  
Nosocomial Infections ◽  
Infection Prevention ◽  
Control Measures ◽  
Related Factors ◽  
Topical Antibiotics ◽  
Infection Control Measures ◽  
Close Relationship ◽  
Underlying Illness

AbstractThe close relationship between colonization and the development of nosocomial infections has been demonstrated. Patient-related factors, such as underlying illness for all major sites of infection and advanced age, and pathogen-related factors, such as the ability of bacteria to adhere to epithelial cells, play the major roles in the pathogenesis of colonization. However, exact mechanisms of colonization have not been elucidated, and modulation of bacterial adherence as a method of infection prevention remains experimental. Current methods of infection prevention, therefore, focus either on preventing growth of colonizing microorganisms or on preventing patient-pathogen contact. Topical antibiotics have been used as a method of colonization prevention. However, their effectiveness may be limited by increases in antibiotic resistance; moreover, the effects on patient outcome are controversial. Maintenance of the physiologic mucosal environment using nonantimicrobial agents seems a promising approach, but only a few studies demonstrating efficacy have been published. Prevention of colonization still must rely heavily on basic infection control measures to prevent contact between patient and pathogen.

Optimizing Hospital Infection Control: The Role of Mathematical Modeling

2014 ◽  
Vol 35 (12) ◽  
pp. 1521-1530 ◽  
Author(s):  
Tan N. Doan ◽  
David C. M. Kong ◽  
Carl M. J. Kirkpatrick ◽  
Emma S. McBryde
Keyword(s):  
Mathematical Modeling ◽  
Infection Control ◽  
Nosocomial Infections ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Infection Control Measures ◽  
Hospital Infection Control ◽  
Considerable Morbidity

Multidrug-resistant bacteria are major causes of nosocomial infections and are associated with considerable morbidity, mortality, and healthcare costs. Preventive strategies have therefore become increasingly important. Mathematical modeling has been widely used to understand the transmission dynamics of nosocomial infections and the quantitative effects of infection control measures. This review will explore the principles of mathematical modeling used in nosocomial infections and discuss the effectiveness of infection control measures investigated using mathematical modeling.Infect Control Hosp Epidemiol 2014;35(12):1521–1530

scholarly journals Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

2021 ◽  
pp. 1-24
Author(s):  
Eliza R. Thompson ◽  
Faith S. Williams ◽  
Pat A. Giacin ◽  
Shay Drummond ◽  
Eric Brown ◽  
...  
Keyword(s):  
Large Scale ◽  
Infection Prevention ◽  
Index Patient ◽  
Field Investigation ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Va Health Care System ◽  
Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

The Analysis of the Impact of a Mild, Low-iodine, Lotion Soap on the Reduction of Nosocomial Methicillin-Resistant Staphylococcus aureus: A New Opportunity for Surveillance by Objectives

1987 ◽  
Vol 8 (7) ◽  
pp. 284-288 ◽  
Author(s):  
Kim M. Onesko ◽  
Eugene C. Wienke
Keyword(s):  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Control Measures ◽  
Methicillin Resistant ◽  
Care Community ◽  
Infection Control Measures ◽  
Medical Division ◽  
Tract Infections ◽  
The Impact ◽  
Community Teaching

AbstractA significant unremitting increase in the incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA—the intensive care unit, and a medical division.Over a two-year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two-year period. From year to year, the nosocomial MRSA rate decreased 80% (t test, P=0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitive Staphylococcus aureus (MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine hand-soap permanently at all sinks within the hospital.

scholarly journals Molecular and Epidemiological Characterization of IMP-Type Metallo-β-Lactamase-Producing Enterobacter cloacae in a Large Tertiary Care Hospital in Japan

2014 ◽  
Vol 58 (6) ◽  
pp. 3441-3450 ◽  
Author(s):  
Kayoko Hayakawa ◽  
Tohru Miyoshi-Akiyama ◽  
Teruo Kirikae ◽  
Maki Nagamatsu ◽  
Kayo Shimada ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Tertiary Care ◽  
Enterobacter Cloacae ◽  
Control Measures ◽  
Care Hospital ◽  
Invasive Procedures ◽  
Content Type ◽  
Infection Control Measures ◽  
Large Tertiary Care ◽  
Close Relationship

ABSTRACTIMP-type metallo-β-lactamase enzymes have been reported in different geographical areas and in various Gram-negative bacteria. However, the risk factors and epidemiology pertaining to IMP-type metallo-β-lactamase-producingEnterobacter cloacae(IMP-producingE. cloacae) have not been systematically evaluated. We conducted a retrospective, matched case-control study of patients from whom IMP-producingE. cloacaeisolates were obtained, in addition to performing thorough molecular analyses of the clinically obtained IMP-producingE. cloacaeisolates. Unique cases with IMP-producingE. cloacaeisolation were included. Patients with IMP-producingE. cloacaewere matched to uninfected controls at a ratio of 1 to 3. Fifteen IMP-producingE. cloacaecases were identified, with five of the isolates being obtained from blood, and they were matched to 45 uninfected controls. All (100%) patients from whom IMP-producingE. cloacaeisolates were obtained had indwelling devices at the time of isolation, compared with one (2.2%) uninfected control. Independent predictors for isolation of IMP-producingE. cloacaewere identified as cephalosporin exposure and invasive procedures within 3 months. Although in-hospital mortality rates were similar between cases and controls (14.3% versus 13.3%), the in-hospital mortality of patients with IMP-producingE. cloacae-caused bacteremia was significantly higher (40%) than the rate in controls. IMP-producingE. cloacaeisolates were frequently positive for other resistance determinants. The MICs of meropenem and imipenem were not elevated; 10 (67%) and 12 (80%) of the 15 IMP-producingE. cloacaeisolates had a MIC of ≤1 μg/ml. A phylogenetic tree showed a close relationship among the IMP-producingE. cloacaesamples. Indwelling devices, exposure to cephalosporin, and a history of invasive procedures were associated with isolation of IMP-producingE. cloacae. Screening for carbapenemase production is important in order to apply appropriate clinical management and infection control measures.

scholarly journals Nurses’ Self-report on the Infection Control Unit Activities and their Experience in the Hospital toward Nosocomial Infections in the Sulaimani Hospitals

2020 ◽  
Vol 3 (2) ◽  
pp. 166-177
Author(s):  
Ramand Haji ◽  
◽  
Dana Abdilkarim ◽  
Salar Ali ◽  
Srwa Mohammad ◽  
...  
Keyword(s):  
Infection Control ◽  
Nosocomial Infections ◽  
Control Unit ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Self Report ◽  
Health Staff ◽  
Cross Sectional ◽  
Infection Control Measures ◽  
Spss Software

Background and objectives: Nurses can prevent the occurrence and transmission of noso-comial infections by following infection control measures such as wearing gloves and masks, using appropriate disinfection of skin and preventing accidental needle-stick inju-ries. This research aimed to evaluate the availability of hospital uniforms, personal protec-tive equipment, and infection control activities at hospitals in Sulaimani in the Kurdistan Region of Iraq, and to examine nurses’ experience of nosocomial infections. Methods and materials: A cross-sectional study was performed at 10 governmental hospi-tals during the period from 20th February to 28th September 2018. 525 nurses were se-lected as participants by a convenience sampling method. A self-administrated question-naire was used to collect data, which were analysed using SPSS software. Results: The results showed that 268 nurses (51%) reported that their hospitals provided sufficient uniforms to all the medical staff and the majority of nurses, 444 respondents (84.6%) stated that they were responsible for cleaning their working uniforms. 441 nurses reported that they did not acquire a nosocomial infection, and 479 (91.2%) did not have an accident during their work in the hospital. 79.9% of the nurses (404) reported recapping syringe needles after the usage, and 98 (18.7%) gave a low rating to the infection control unit activity in their hospitals. Finally, more than half of nurses (330) representing 62.9% of the sample were vaccinated against nosocomial infections. Conclusions: Most of Sulaimani governmental hospitals are providing sufficient uniforms for the health staff, the majority of nurses were vaccinated against one or more nosocomi-al infections, and the majority of nurses do needle syringe recapping.

Principles of wound care

2018 ◽  
pp. 105-114
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Wound Care ◽  
Healing Process ◽  
Cost Effective ◽  
Control Measures ◽  
Foot Care ◽  
Nice Guidelines ◽  
Infection Control Measures ◽  
Speed Up ◽  
Careful Assessment

It’s important to be aware of healing process, associated comorbidities, and the role of nutrition in wound care management. Assessment of the amount and type of wound exudate plays an important role in deciding the type of dressing used. Infection or underlying osteomyelitis needs careful assessment, further investigation, and administration of systemic/oral anti-microbial therapy. Early use of non-surgical or surgical debridement is necessary to speed up the healing process. Diagnostic criteria of surgical site infection are increasingly used in postoperative wounds in hospitals for audit of infection control measures. No one type of dressing appears superior over other. Dressings should be cost effective, acceptable to the patients, and easy to use. In addition, in recent decades newer non-surgical debriding method, e.g. larvae therapy and negative pressure wound therapy, are increasingly being used and supported by recent NICE guidelines, especially in diabetic foot care.

scholarly journals The role of genomics in understanding COVID-19 outbreaks in long term care facilities

2020 ◽  
Author(s):  
Dinesh Aggarwal ◽  
Richard Myers ◽  
William L. Hamilton ◽  
Tehmina Bharucha ◽  
Niamh Tumelty ◽  
...  
Keyword(s):  
Long Term Care ◽  
Control Measures ◽  
Sequencing Data ◽  
Term Care ◽  
Genomic Epidemiology ◽  
Infection Control Measures ◽  
Care Facilities ◽  
Epidemiology Studies

A review was undertaken of all genomic epidemiology studies on COVID-19 in long term care facilities (LTCF) that have been published to date. It was found that staff and residents were usually infected with identical, or near identical, SARS-CoV-2 genomes. Outbreaks usually involved one predominant lineage, and the same lineages persisted in LTCFs despite infection control measures. Outbreaks were most commonly due to single or few introductions followed by spread rather than a series of seeding events from the community into LTCFs. Sequencing of samples taken consecutively from the same cases showed persistence of the same genome sequence indicating that the sequencing technique was robust over time. When combined with local epidemiology, genomics facilitated likely transmission sources to be better characterised. Transmission between LTCFs was detected in multiple studies. The mortality rate amongst residents was high in all cases, regardless of the lineage. Bioinformatics methods were inadequate in one third of the studies reviewed, and reproducing the analyses was difficult as sequencing data were not available in many cases.

scholarly journals Virulence genes and antibiotic resistance of Pseudomonas aeruginosa isolated from patients in the Northwestern of Morocco

2019 ◽  
Vol 13 (10) ◽  
pp. 892-898
Author(s):  
Chaimae Elmouaden ◽  
Amin Laglaoui ◽  
Latifa Ennanei ◽  
Mohammed Bakkali ◽  
Mohammed Abid
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Virulence Genes ◽  
Health Workers ◽  
Control Measures ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Infection Control Measures ◽  
Antibiotic Susceptibility Patterns ◽  
High Level

Introduction: Pseudomonas aeruginosa is an ubiquitous bacterium causes various community-acquired and nosocomial infections. In this investigation, we aimed to screen the antibiotic susceptibility patterns and the prevalence of virulence factor genes in a set of Pseudomonas aeruginosa isolated from nosocomial and community-acquired infections in the Northwestern of Morocco. Methodology: A total of 155 of Pseudomonas aeruginosa strains were collected (January 2015 - December 2016) from nosocomial and community-acquired infections at hospital centers and clinical laboratories in the Northwestern of Morocco. Antimicrobial susceptibility test was performed by the standard disk diffusion method. In addition, PCR assays were used for screening five virulence encoding genes (lasB, algD, plcH, exoA, and exoS). Results: Our results revealed that high level of antimicrobial resistance was detected towards aztreonam (27.1%) followed by meropenem (14.2%). The resistance to imipenem was significantly higher in strains isolated from nosocomial infections (12.7%) than strains isolated from community-acquired infections (1.5%). The results highlighted that lasB (98.7%) and exoS (98.7%) were the most frequent virulence genes. Conclusions: This survey provides data about phenotypic and genotypic properties of Pseudomonas aeruginosa emerged in the Northwestern of Morocco. It could be helpful for the health workers to improve infection control measures and to establish a surveillance system.

scholarly journals Implementation of an infection prevention bundle and increased physician awareness improves surgical outcomes and reduces costs associated with spine surgery

2018 ◽  
Vol 29 (1) ◽  
pp. 108-114 ◽  
Author(s):  
Nitin Agarwal ◽  
Prateek Agarwal ◽  
Ashley Querry ◽  
Anna Mazurkiewicz ◽  
Zachary J. Tempel ◽  
...  
Keyword(s):  
Infection Control ◽  
Infection Rate ◽  
Spine Surgery ◽  
Infection Prevention ◽  
Cost Savings ◽  
Control Measures ◽  
Control Group ◽  
Infection Rates ◽  
Infection Control Measures ◽  
Physician Awareness

OBJECTIVEPrevious studies have demonstrated the efficacy of infection prevention protocols in reducing infection rates. This study investigated the effects of the development and implementation of an infection prevention protocol that was augmented by increased physician awareness of spinal fusion surgical site infection (SSI) rates and resultant cost savings.METHODSA cohort clinical investigation over a 10-year period was performed at a single tertiary spine care academic institution. Preoperative infection control measures (chlorohexidine gluconate bathing, Staphylococcus aureus nasal screening and decolonization) followed by postoperative infection control measures (surgical dressing care) were implemented. After the implementation of these infection control measures, an awareness intervention was instituted in which all attending and resident neurosurgeons were informed of their individual, independently adjudicated spinal fusion surgery infection rates and rankings among their peers. During the course of these interventions, the overall infection rate was tracked as well as the rates for those neurosurgeons who complied with the preoperative and postoperative infection control measures (protocol group) and those who did not (control group).RESULTSWith the implementation of postoperative surgical dressing infection control measures and physician awareness, the postoperative spine surgery infection rate decreased by 45% from 3.8% to 2.1% (risk ratio 0.55; 95% CI 0.32–0.93; p = 0.03) for those in the protocol cohort, resulting in an estimated annual cost savings of $291,000. This reduction in infection rate was not observed for neurosurgeons in the control group, although the overall infection rate among all neurosurgeons decreased by 54% from 3.3% to 1.5% (risk ratio 0.46; 95% CI 0.28–0.73; p = 0.0013).CONCLUSIONSA novel paradigm for spine surgery infection control combined with physician awareness methods resulted in significantly decreased SSI rates and an associated cost reduction. Thus, information sharing and physician engagement as a supplement to formal infection control measures result in improvements in surgical outcomes and costs.

Sign in / Sign up

Export Citation Format

Share Document