Epidemiology and Control of Pertussis Outbreaks in a Tertiary Care Center and the Resource Consumption Associated With These Outbreaks

2009 ◽  
Vol 30 (5) ◽  
pp. 467-473 ◽  
Author(s):  
Surbhi Leekha ◽  
Rodney L. Thompson ◽  
Priya Sampathkumar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Syndrome ◽  
Resource Consumption ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
Tertiary Care Center ◽  
Healthcare Facilities ◽  
And Control

Objective.To describe the epidemiology and control of 2 separate outbreaks of pertussis at a large tertiary care center and the resource consumption associated with these outbreaks.Design.Descriptive study.Setting.The Mayo Clinic in Rochester, Minnesota, a tertiary care center catering to both referral patients and patients from the community.Methods.We reviewed routine and enhanced surveillance data collected by infection prevention and control practitioners during the outbreaks. Pertussis was diagnosed either on the basis of a nasopharyngeal specimen positive for Bordetella pertussis by use of polymerase chain reaction (PCR) or on the basis of a compatible clinical syndrome along with an epidemiologic link to PCR-confirmed cases.Results.Two pertussis outbreaks, the first community based and the second hospital based (ie, due to transmission among healthcare personnel), occurred during the period from October 2004 through October 2005. In the first outbreak from November 2004 through March 2005, there were 109 cases diagnosed; 105 (96%) of these cases were diagnosed on the basis of a nasopharyngeal specimen positive for B. pertussis by use of PCR. Adolescents 10-19 years of age were most affected (77 cases [71%]). Only 13 cases (12%) occurred among healthcare personnel; however, many healthcare personnel required postexposure prophylaxis. A second outbreak of 122 cases occurred during the period from July through October 2005; of these 122 cases, 96 (79%) were diagnosed on the basis of a nasopharyngeal specimen positive for B. pertussis by use of PCR, and 64 (52%) involved healthcare personnel. There were many instances of transmission among healthcare personnel and from patients to healthcare personnel, but no documented transmission from healthcare personnel to Patients. The outbreaks were controlled by aggressive case finding, treatment of those infected, prophylaxis of all healthcare personnel and patients who had contact with both probable and confirmed cases, implementation of educational efforts, and compliance with respiratory etiquette. Vaccination of healthcare personnel against pertussis began in October 2005.Conclusion.Pertussis remains a public health problem. Outbreaks in healthcare facilities consume the resources of those facilities in terms of personnel, testing, treatment of cases, and prophylaxis of those individuals who were in contact with those cases. Adult vaccination may reduce the disease burden.

scholarly journals Promoting COVID-19 vaccination among healthcare personnel: a multifaceted intervention at a tertiary care center in Japan

2021 ◽  
pp. 1-26
Author(s):  
Akane Takamatsu ◽  
Hitoshi Honda ◽  
Tomoya Kojima ◽  
Kengo Murata ◽  
Hilary Babcock
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Vaccination Rate ◽  
Multifaceted Intervention ◽  
Vaccine Hesitancy ◽  
Healthcare Personnel ◽  
Tertiary Care Center ◽  
Post Intervention ◽  
Post Vaccination

Abstract Objective The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). Design Before-after trial Participants and setting Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan. Interventions A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed. Results Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine’s safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered “unwilling” or “unsure” eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037). Conclusions The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.

scholarly journals First Candida auris Outbreak during a COVID-19 Pandemic in a Tertiary-Care Center in Lebanon

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 157
Author(s):  
Fatima Allaw ◽  
Nada Kara Zahreddine ◽  
Ahmad Ibrahim ◽  
Joseph Tannous ◽  
Hussein Taleb ◽  
...  
Keyword(s):  
Infection Control ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Arab Countries ◽  
Infection Prevention And Control ◽  
Tertiary Care Center ◽  
Candida Auris ◽  
American University ◽  
American University Of Beirut

Candida auris is an emerging fungal pathogen considered as a global health threat. Recently there has been growing concern regarding drug resistance, difficulty in identification, as well as problems with eradication. Although outbreaks have been reported throughout the globe including from several Arab countries, there were no previous reports from Lebanon. We herein report the first cases of C. auris infection from the American University of Beirut Medical Center, a tertiary care center in Lebanon describing the clinical features of the affected patients in addition to the infection control investigation and applied interventions to control the outbreak. Fourteen patients with C. auris infection/colonization identified using MALDI-TOF and VITEK 2- Compact system were reported over a period of 13 weeks. Patients were admitted to four separate critical care units. All of them came through the emergency room and had comorbid conditions. Half of the patients were infected with COVID-19 prior to isolation of the C. auris. C. auris was isolated from blood (two isolates), urine (three isolates), respiratory tract (10 isolates) and skin (one isolate). All the patients had received broad spectrum antibiotics prior to isolation of C. auris. Six patients received antifungal treatment, while the remaining eight patients were considered colonized. Environmental cultures were taken from all four units and failed to isolate the organism from any cultured surfaces. A series of interventions were initiated by the Infection Prevention and Control team to contain the outbreak. Rapid detection and reporting of cases are essential to prevent further hospital transmission. A national standardized infection control registry needs to be established to identify widespread colonization.

scholarly journals 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S384-S384
Author(s):  
Jeannette L Comeau ◽  
Allana M Ivany ◽  
Terry Romeo ◽  
Bridget S Maxwell ◽  
Natalie Nymark ◽  
...  
Keyword(s):  
Care Center ◽  
Health Centre ◽  
Tertiary Care ◽  
Turnaround Time ◽  
Rapid Identification ◽  
Acute Onset ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Clinical Microbiology Laboratory ◽  
And Control

Abstract Background Norovirus is one of the most common viral pathogens implicated in gastroenteritis outbreaks in community and healthcare settings. The virus’ short incubation period and high attack rate allow its rapid spread through inpatient wards to patients (Patients), staff and visitors. Early identification and appropriate implementation of infection prevention and control measures is essential to interrupt transmission. Methods The IWK Health Centre is a 250-bed tertiary care Pediatric and Women’s hospital serving the Maritime Provinces, Canada. We describe a norovirus outbreak in our Pediatric Medical Unit, a 24-bed, single room ward with individual bathrooms for patients and families. Hospital-acquired norovirus definition: Patients admitted ≥48 hours with lab-confirmed norovirus AND ≥ 1 of: (1) acute onset diarrhea (no noninfectious cause) or (2) ≥2 of: nausea, vomiting, abdominal pain, fever, or headache. In 2017 the FilmArray Gastrointestinal (GI) Panel was introduced in the Clinical Microbiology Laboratory as part of a prospective post-implementation study. Since then, stool samples sent for viral, bacterial, or parasitic testing are evaluated by PCR. The panel tests for 22 GI analytes, including five viruses, with a 2-hour turnaround time. Previously, in-house stool viral testing was limited to adeno- and rotavirus antigen. Patient characteristics were collected and analyzed for this study. Results Patients 1, 2, and 3 had new onset diarrhea and emesis; Pt 1 on day 0, and Patients 2 and 3 on day 1. Patient 3’s parents (likely source) had had diarrhea and emesis on days 3 and 2, and used the ward kitchen. Two care-givers of Patient 2, and 1 medical resident developed diarrhea and emesis over days 0 to 2. The outbreak was declared over on day 7. Patients 1, 2, and 3 all tested positive for norovirus in stool on day 1. On days 2–3, six other patients with diarrhea tested norovirus negative. All symptomatic patients were immediately placed on contact precautions, room/ward cleaning frequency increased and proper hand hygiene was reinforced. Common areas (playroom/kitchen) were closed until the outbreak was over. All patients with loose stool were tested during the outbreak. Conclusion FilmArrayGI panel enabled same-day identification of norovirus in this single-ward outbreak and permitted real-time identification of the termination of the outbreak. Disclosures All authors: No reported disclosures.

scholarly journals Hydatid disease: a 2 years retrospective study in a tertiary care center in South India

2018 ◽  
Vol 5 (2) ◽  
pp. 602 ◽  
Author(s):  
Haren Reddy Illuri ◽  
Caren D. Souza ◽  
Erel A. I. Dias ◽  
Prashanth Philip Das
Keyword(s):  
Soft Tissue ◽  
Hydatid Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Farm Animals ◽  
Tertiary Care Center ◽  
Hepatic Hydatid Disease ◽  
Patient Profile ◽  
History Of

Background: Hydatid disease (HD) is a common parasitic zoonosis and its mortality, morbidity, and socioeconomic burden makes it a significant public health problem. Though a primary disease of liver (55-70%) followed by the lung (18-35%) it is now found to affect various other organs like spleen, kidney, peritoneal cavity, skin and muscles (2%) heart, brain, vertebral column, ovaries, pancreas, gallbladder, thyroid gland, breast, and bones (1%). This study is done to describe the spectrum of presentation of hydatid disease in India. Author also discuss the rare cases of soft tissue and bone hydatid disease and peritoneal hydatid disease in this study.Methods: It was a retrospective observational study done in a tertiary care center in India. Data was collected from patients admitted with diagnosis of hydatid disease from the patient data files and included patient profile, area of residence, occupation, history of exposure to farm animals or dogs, investigation findings and management given. Special emphasis was given to cases of extrahepatic hydatid disease and their management. The collected data was tabulated.Results: Author found 17 cases of documented hydatid disease in the two years period. This included 11 case of hepatic hydatid disease and 6 cases of extrahepatic disease with unusual locations of bone and soft tissue, lung and parietal peritoneum. The majority of patients were in the age group of 30-50 yrs with history of exposure to sheep and farm animals. All patients received 4-6 weeks of 15mg/kg/day albendazole preoperatively. Five patients showed regression in size of the cyst and were hence continued on medical management.Conclusions: The remaining patients underwent surgical drainage procedure. Albendazole was continued post operatively for next 6 months.

scholarly journals Trends of Multidrug-Resistant Pathogens, Difficult to Treat Bloodstream Infections, and Antimicrobial Consumption at a Tertiary Care Center in Lebanon from 2015–2020: COVID-19 Aftermath

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1016
Author(s):  
Amanda Chamieh ◽  
Rita Zgheib ◽  
Sabah El-Sawalhi ◽  
Laure Yammine ◽  
Gerard El-Hajj ◽  
...  
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
P Value ◽  
Tertiary Care Center ◽  
Antimicrobial Consumption ◽  
Dynamic Collaboration

Introduction: We studied the trend of antimicrobial resistance and consumption at Saint George Hospital University Medical Center (SGHUMC), a tertiary care center in Beirut, Lebanon, with a focus on the SARS-CoV-2 pandemic. Materials and Methods: We calculated the isolation density/1000 patient-days (PD) of the most isolated organisms from 1 January 2015–31 December 2020 that included: E. coli (Eco), K. pneumoniae (Kp), P. aeruginosa (Pae), A. baumannii (Ab), S. aureus (Sau), and E. faecium (Efm). We considered March–December 2020 a surrogate of COVID-19. We considered one culture/patient for each antimicrobial susceptibility and excluded Staphylococcus epidermidis, Staphylococcus coagulase-negative, and Corynebacterium species. We analyzed the trends of the overall isolates, the antimicrobial susceptibilities of blood isolates (BSI), difficult-to-treat (DTR) BSI, carbapenem-resistant Enterobacteriaceae (CRE) BSI, and restricted antimicrobial consumption as daily-defined-dose/1000 PD. DTR implies resistance to carbapenems, beta-lactams, fluoroquinolones, and additional antimicrobials where applicable. Results and Discussion: After applying exclusion criteria, we analyzed 1614 blood cultures out of 8314 cultures. We isolated 85 species, most commonly Eco, at 52%. The isolation density of total BSI in 2020 decreased by 16%: 82 patients were spared from bacteremia, with 13 being DTR. The isolation density of CRE BSI/1000 PD decreased by 64% from 2019 to 2020, while VREfm BSI decreased by 34%. There was a significant decrease of 80% in Ab isolates (p-value < 0.0001). During COVID-19, restricted antimicrobial consumption decreased to 175 DDD/1000 PD (p-value < 0.0001). Total carbapenem consumption persistently decreased by 71.2% from 108DDD/1000 PD in 2015–2019 to 31 DDD/1000 PD in 2020. At SGHUMC, existing epidemics were not worsened by the pandemic. We attribute this to our unique and dynamic collaboration of antimicrobial stewardship, infection prevention and control, and infectious disease consultation.

scholarly journals Assessment of Infection Prevention and Control Implementation in Primary and Secondary Health Care Facilities in Rivers State

2021 ◽  
Vol 33 (2) ◽  
pp. 100-114
Author(s):  
A. Dan-Jumbo ◽  
C.T. Briggs-Nduye ◽  
T.C. Uzosike
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Health Care Facilities ◽  
World Health ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Rivers State ◽  
And Control

Background: Controlling infections in healthcare facilities is necessary for reducing infection transmission. There is limited data on the status of Infection Prevention and Control (IPC) programme in healthcare facilities in Rivers State. An assessment of IPC implementation in health facilities in Rivers State was therefore conducted.Methods: In this cross-sectional study, stratified sampling technique was applied to select 99 healthcare facilities. Health personnel in-charge of selected facilities were interviewed using the validated Infection Prevention and Control Assessment Framework (IPCAF) tool. It was modified to focus on four out of eight core components areas and graded using the World Health Organization IPCAF guidelines.Results: Twenty (20.2%) facilities had IPC programmes with clearly defined objectives and activity plans. A copy of the IPC guidelines was available in 56 (56.6%) facilities, however, only 13 (13.1%) monitored implementation of the guidelines. Forty (40.4%) facilities had healthcare workers that were trained based on updated IPC guidelines. Supply of personal protective equipment was adequate in 29 (29.3%) facilities and a mixed method of healthcare waste disposal was practiced in 46 (46.4%) facilities. Overall, 56 (56.6%) of the facilities had scores within the basic IPC level of practice while 43 (43.4%) had scores within the intermediate level of IPC practice.Conclusion: Findings from this study indicate that IPC committees should be set up in all healthcare facilities with the obligation of updating IPC guidelines, training healthcare personnel, and implementing IPC activities in respective healthcare facilities.

scholarly journals Bat Intrusions at a Tertiary Care Center, Iowa 2018–2020

2021 ◽  
Vol 1 (S1) ◽  
pp. s16-s16
Author(s):  
Mohammed Alsuhaibani ◽  
Takaaki Kobayashi ◽  
Lorinda Sheeler ◽  
Alexandra Trannel ◽  
Stephanie Holley ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Medical Center ◽  
Care Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Potential Exposure ◽  
And Control

Background: Bats are recognized as important vectors in disease transmission. Frequently, bats intrude into homes and buildings, increasing the risk to human health. We describe bat intrusions and exposure incidents in our hospital over a 3-year period. Methods: The University of Iowa Hospitals and Clinics (UIHC) is an 811-bed academic medical center in Iowa City, Iowa. Established in 1928, UIHC currently covers 209,031.84 m2 (~2,250,000 ft2) and contains 6 pavilions built between 1928 and 2017. We retrospectively obtained bat intrusion calls from the infection prevention and control program call database at UIHC during 2018–2020. We have also described the event management for intrusions potentially associated with patient exposures. Results: In total, 67 bat intrusions occurred during 2018–2020. The most frequent locations were hallways or lounges 28 (42%), nonclinical office spaces 19 (14%), and stairwells 8 (12%). Most bat intrusions (65%) occurred during the summer and fall (June–November). The number of events were 15 in 2018, 28 in 2019, and 24 in 2020. We observed that the number of intrusions increased with the age of each pavilion (Figure 1). Of 67 intrusions, 2 incidents (3%) were associated with potential exposure to patients. In the first incident, reported in 2019, the bat was captured in a patient care area and released before an investigation of exposures was completed and no rabies testing was available. Also, 10 patients were identified as having had potential exposure to the bat. Among them, 9 patients (90%) received rabies postexposure prophylaxis. In response to this serious event, we provided facility-wide education on our bat control policy, which includes the capture and safe handling of the bat, assessment of potential exposures, and potential need for rabies testing. We also implemented a bat exclusion project focused on the exterior of the oldest hospital buildings. The second event, 1 patient was identified to have potential exposure to the bat. The bat was captured, tested negative for rabies, no further action was needed. Conclusions: Bat intrusions can be an infection prevention and control challenge in facilities with older buildings. Hospitals may need animal intrusion surveillance systems, management protocols, and remediation efforts.Funding: NoDisclosures: None

scholarly journals Trends of leptospirosis cases in a tertiary care center in Northern Kerala during January 2013 to October 2019

2020 ◽  
Vol 7 (9) ◽  
pp. 3397
Author(s):  
Rameela Sanya ◽  
Jayasree Anandabhavan Kumaran
Keyword(s):  
At Risk ◽  
Rainy Season ◽  
Care Center ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Older Individuals ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
And Control

Background: Leptospirosis is a zoonosis endemic in tropical climates. Though overall incidence of leptospirosis has decreased during recent years, it continues to be a major public health problem, highly underreported in India. Various trends such as seasonal, geographical, mortality have to be studied in detail for proper planning of prevention and control programs. The objective of this study was to assess geographical, seasonal, mortality trends of leptospirosis cases attending a tertiary care centre in Northern Kerala, from January 2013 to October 2019.Methods: A record-based retrospective study was conducted where leptospirosis cases attending tertiary care centre were included. Data was entered into Microsoft Excel 2007, analysed using Epi Info 7. Results were expressed as frequencies, percentages.Results: Among 647 leptospirosis cases, 141 were confirmed and 506 were probable. Maximum number of cases were reported in 2014 and maximum deaths were reported in 2019. Majority belonged to 51-60 years age category; males outnumbered females. Maximum cases were reported during September, August. Major hotspots for leptospirosis were Kannur and Taliparamba Municipalities and Koothuparamba.Conclusions: During rainy season, probably younger individuals are at risk as they indulge in leisure like swimming, playing while post rainy season older individuals are at risk due to occupational exposure. The number of deaths showed a declining trend from 2013 to 2018, but increased in 2019. Few of the previous hotspots reported decline in cases probably due to improved surveillance and control activities.

Sign in / Sign up

Export Citation Format

Share Document