Should We Vigorously Try to Contain and Control Methicillin-ResistantStaphylococcus aureus?

1991 ◽  
Vol 12 (01) ◽  
pp. 46-54 ◽  
Author(s):  
John M. Boyce
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Questionnaire Survey ◽  
Control Measures ◽  
Controlled Trials ◽  
Survey Questionnaire ◽  
Hospital Epidemiology ◽  
High Incidence ◽  
And Control

AbstractObjective:To review practices currently used to control transmission of methicillin-resistantStaphylococcusaureus (MRSA) in hospitals, determine the frequency of their use, and discuss the indications for implementing such measures.Design:A questionnaire survey to determine how commonly selected control practices are used, and a literature review of the efficacy of control practices.Participants:Two hundred fifty-six of 360 hospital-based members fo the Society for Hospital Epidemiology of America, Inc. (SHEA) completed the survey questionnaire.Result:Many different combinations of surveillance and control measures are used by hospitals with MRSA. Nine percent of hospitals stated that no special measures were used to control MRSA. The efficacy of commonly used control measures has not been established by controlled trials.Conclusions:Implementing control measures is warranted when MRSA causes a high incidence of serious nosocomial infections, and is desirable when MRSA has been newly introduced into a hospital or into an intensive care unit, or when MRSA accounts for more than 10% of nosocomial staphylococcal isolates. While the value of some practices is well established, measures such as routinely attempting to eradicate carriage of MRSA by colonized patients and personnel require further evaluation.

Varicella exposure in a neonatal intensive care unit: Case report and control measures

1988 ◽  
Vol 16 (4) ◽  
pp. 167-172 ◽  
Author(s):  
Beth Hewitt Stover ◽  
Karen M. Cost ◽  
Charles Hamm ◽  
Garrett Adams ◽  
Larry N. Cook
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Measures ◽  
And Control

A Decrease in the Number of Cases of Necrotizing Enterocolitis Associated with the Enhancement of Infection Prevention and Control Measures during aStaphylococcus aureusOutbreak in a Neonatal Intensive Care Unit

2012 ◽  
Vol 33 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Brigitte Lemyre ◽  
Wenlong Xiu ◽  
Nicole Rouvinez Bouali ◽  
Janet Brintnell ◽  
Jo-Anne Janigan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Prevention And Control Measures ◽  
And Control

Objective.Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitiveStaphylococcus aureus(MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC.Design.Retrospective chart review.Setting.A 24-bed, university-affiliated, inborn level 3 NICU.Participants.Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed.Interventions.Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased.Results.Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P< .002).Conclusion.Although this observational study cannot establish a causal relationship, there was a significant decrease in the incidence of NEC following implementation of enhanced infection prevention and control measures to manage an MSSA outbreak.Infect Control Hosp Epidemiol2012;33(1):29-33

scholarly journals Genomic Investigation of Carbapenem-Resistant Klebsiella pneumonia Colonization in an Intensive Care Unit in South Africa

Genes ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 951
Author(s):  
Osama Madni ◽  
Daniel G. Amoako ◽  
Akebe Luther King Abia ◽  
Joan Rout ◽  
Sabiha Yusuf Essack
Keyword(s):  
South Africa ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Control Measures ◽  
Automated System ◽  
Infection Prevention And Control ◽  
Klebsiella Pneumonia ◽  
Class I Integrons ◽  
Prevention And Control Measures ◽  
And Control

The study investigated carbapenemase-producing Klebsiella pneumoniae (CPKP) isolates of patients in an intensive care unit (ICU) in a public hospital in the KwaZulu-Natal province, South Africa using whole-genome sequencing (WGS). Ninety-seven rectal swabs, collected from all consenting adult patients (n = 31) on days 1, 3, and 7 and then weekly, were screened for carbapenemase-production using Chrome-ID selective media. Antibiotic susceptibility was determined for the fourteen positive CPKP isolates obtained using the VITEK 2 automated system. All isolates (100%) were resistant to ertapenem and meropenem, and 71.4% (n = 10) were resistant to imipenem. All CPKP isolates were subjected to ERIC/PCR, and a sub-sample of isolates was selected for WGS based on their antibiograms and clonality. All sequenced isolates harbored the blaOXA-181 carbapenemase (100%) and co-carried other β-lactamase genes such as blaOXA-1, blaCTX-M-15, blaTEM-1B, and blaSHV-1. IncF, IncX3, and Col plasmid replicons groups and class I integrons (ln191 and ln27) were detected. All isolates belonged to the same sequence type ST307 and capsular serotypes (K102, O2v2). All the isolates carried the same virulence repertoire, reflecting the epidemiological relationship between isolates. blaOXA-181 was located on a multi-replicon plasmid similar to that of E. coli p010_B-OXA181, and isolates were aligned with several South African and international clades, demonstrating horizontal and vertical transboundary distribution. The findings suggest that blaOXA-181 producing K. pneumoniae is endemic in this ICU, colonizing the patients. CRE screening and enhanced infection prevention and control measures are urgently required.

scholarly journals Incidence of thrombotic complications in COVID-19

2021 ◽  
Author(s):  
William J. Jenner ◽  
Diana A. Gorog
Keyword(s):  
Intensive Care Unit ◽  
Observational Studies ◽  
Severity Of Illness ◽  
Controlled Trials ◽  
Thrombotic Risk ◽  
Randomized Controlled ◽  
Hospitalised Patients ◽  
High Incidence ◽  
Thrombotic Complications ◽  
Asymptomatic Individuals

AbstractA high incidence of thrombosis in hospitalised patients with COVID-19 was identified early during the pandemic. Accurately quantifying thrombotic risk may assist prognosis and guide appropriate thromboprophylaxis. Observational studies have estimated the rate of thrombosis in both hospitalised and non-hospitalised patients with COVID-19, and how this corresponds to the severity of illness. In this review, we provide an overview of the incidence and prevalence of arterial and venous thrombotic events in patients with COVID-19 and highlight the limitations in the studies to date. Asymptomatic individuals with COVID-19 and those with mild symptoms are at very low risk of thrombotic complications. However, rates of thrombosis are substantially increased in hospitalised patients, and are strikingly high in those patients who are critically-ill requiring treatment on the intensive care unit and especially those requiring extracorporeal membrane oxygenation. Clinicians managing such patients need to be aware of these risks and take appropriate steps with respect to thromboprophylaxis and heightened clinical vigilance. Large prospective observational studies will more accurately quantify thrombotic rate, and randomized controlled trials are currently investigating optimal thromboprophylactic strategies.

Management and control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit

2014 ◽  
Vol 44 (5) ◽  
pp. 229-231 ◽  
Author(s):  
S. Alfandari ◽  
J. Gois ◽  
P.-Y. Delannoy ◽  
H. Georges ◽  
N. Boussekey ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Carbapenem Resistant ◽  
And Control

Family-centred care in the Neonatal Intensive Care Unit: A concept analysis and literature review

2021 ◽  
Author(s):  
Catherine Larocque ◽  
Wendy E. Peterson ◽  
Janet E. Squires ◽  
Martha Mason-Ward ◽  
Kelli Mayhew ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Concept Analysis
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