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 ◽  
...  

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.

2000 ◽  
Vol 21 (11) ◽  
pp. 730-732 ◽  
Author(s):  
David M. Weinstock ◽  
Janet Eagan ◽  
Sharp Abdel Malak ◽  
Maureen Rogers ◽  
Holly Wallace ◽  
...  

AbstractIn January 1998, an outbreak of influenza A occurred on our adult bone marrow transplant unit. Aggressive infection control measures were instituted to halt further nosocomial spread. A new, more rigorous approach was implemented for the 1998/99 influenza season and was extremely effective in preventing nosocomial influenza at our institution.


Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 619
Author(s):  
María Milagro Montero ◽  
Carlota Hidalgo López ◽  
Inmaculada López Montesinos ◽  
Luisa Sorli ◽  
Cristina Barrufet Gonzalez ◽  
...  

Introduction: The aim of this study was to analyze a nosocomial coronavirus disease 2019 (COVID-19) outbreak that occurred on a polyvalent non-COVID-19 ward at a tertiary care university hospital in Spain during the first wave of the pandemic and to describe the containment measures taken. The outbreak affected healthcare workers (HCWs) and kidney disease patients including transplant patients and those requiring maintenance hemodialysis. Methods: The outbreak investigation and report were conducted in accordance with the Orion statement guidelines. Results: In this study, 15 cases of COVID-19 affecting 10 patients and 5 HCWs were identified on a ward with 31 beds and 43 HCWs. The patients had tested negative for severe acute respiratory syndrome coronavirus 2 infection on admission. One of the HCWs was identified as the probable index case. Five patients died (mortality rate, 50%). They were all elderly and had significant comorbidities. The infection control measures taken included the transfer of infected patients to COVID-19 isolation wards, implementation of universal preventive measures, weekly PCR testing of patients and HCWs linked to the ward, training of HCWs on infection control and prevention measures, and enhancement of cleaning and disinfection. The outbreak was contained in 2 weeks, and no new cases occurred. Conclusion: Nosocomial COVID-19 outbreaks can have high attack rates involving both patients and HCWs and carry a high risk of patient mortality. Hospitals need to implement effective infection prevention and control strategies to prevent nosocomial COVID-19 spread.


2021 ◽  
Author(s):  
Yanjie Xia ◽  
Huarui Xiao ◽  
Jin Yang ◽  
Qiaoling Tian ◽  
Fanfan Xing ◽  
...  

Abstract Background: Respiratory Syncytial Virus (RSV)is recognized as one of the most common causes of acute respiratory infections in adults which is associated with significant morbidity and mortality in the elderly and immunocompromised adults. Moreover RSV can spread rapidly through close contact through respiratory droplets leading to clusters of cases or outbreaks in health care facilities. Herein we demonstrate the successful control and the risk factors of the RSV outbreak involving 39 patients in a Hematology and Bone Marrow Transplant(BMT) Unit. Methods: We performed an epidemiological investigation,analyzed the risk factors and implemented the infection control measures for this nosocomial RSV outbreak in the Hematology and BMT Unit. Furthermore we implemented the RSV screening for all the inpatients and medical staff of Hematology and BMT Unit and the infection control bundles to stop the outbreak.Results: 24 patients were tested positive for RSV, 2 of which were confirmed to be hospital acquired respiratory infection according to Chinese hospital infection diagnostic criteria,the other cases were hospital acquired. Our multimodal infection control bundle was able to rapidly control this outbreak,newly diagnosed patients with RSV infection were distributed in the first three weeks of this outbreak.All cases were discharged after recovery or remission. Conclusion: The successful infection control management of RSV outbreak should include interruption of all potential transmission routes.In Hematology and BMT Unit, restriction of social activities is useful to stop RSV transmission despite some temporal negative impact on the emotional needs of the patients.Universal RSV screening and vigorous enforcement of infection control measures was effective in the containment of this outbreak.


1999 ◽  
Vol 20 (11) ◽  
pp. 756-758 ◽  
Author(s):  
Jeffrey D. Klausner ◽  
Carol Zukerman ◽  
Ajit P. Limaye ◽  
Lawrence Corey

AbstractUsing molecular typing methods, we confirmed an outbreak ofStenotrophomonas maltophiliaamong bone marrow transplant patients. The likely source was a healthcare worker who may have washed with moisturizer instead of soap between patients. Hospital epidemiologists need to go beyond antibiograms when evaluating outbreaks and be vigilant about all aspects of hand washing.


Author(s):  
María Florencia Angueyra ◽  
Débora Natalia Marcone ◽  
Florencia Escarrá ◽  
Noelia Soledad Reyes ◽  
Yamile Rubies ◽  
...  

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.


Blood ◽  
1990 ◽  
Vol 76 (12) ◽  
pp. 2462-2465 ◽  
Author(s):  
HJ Kolb ◽  
J Mittermuller ◽  
C Clemm ◽  
E Holler ◽  
G Ledderose ◽  
...  

Abstract Three patients with hematologic relapse after bone marrow transplantation for chronic myelogenous leukemia were treated with interferon alpha and transfusion of viable donor buffy coat. All had complete hematologic and cytogenetic remission, which persisted 32 to 91 weeks after treatment. In two patients graft-versus-host disease developed and was treated by immunosuppression. These results are an example of adoptive immunotherapy without cytoreductive chemotherapy or radiotherapy in human chimeras.


Author(s):  
Majid M. Alshamrani ◽  
Aiman El-Saed ◽  
Azzam Mohammed ◽  
Majed F. Alghoribi ◽  
Sameera M. Al Johani ◽  
...  

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.


2006 ◽  
Vol 27 (9) ◽  
pp. 991-993 ◽  
Author(s):  
Maciej Piotr Chlebicki ◽  
Moi Lin Ling ◽  
Tse Hsien Koh ◽  
Li Yang Hsu ◽  
Ban Hock Tan ◽  
...  

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.


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