Search and You Will Find: Detecting Extended-Spectrum β-Lactamase–Producing Klebsiella pneumoniae from a Patient's Immediate Environment

2013 ◽  
Vol 34 (5) ◽  
pp. 534-536 ◽  
Author(s):  
Christopher Judge ◽  
Sandra Galvin ◽  
Liam Burke ◽  
Toney Thomas ◽  
Hilary Humphreys ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
High Rate ◽  
Gram Negative Bacteria ◽  
Healthcare Associated Infection ◽  
Vancomycin Resistant Enterococci ◽  
Extended Spectrum ◽  
Skin Colonization ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Contamination of inanimate surfaces contributes to the transmission of healthcare-associated infection, a phenomenon that is well documented for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The high rate of skin colonization with these bacteria among healthcare workers increases the risk of cross contamination via high-touch surfaces. Since gram-negative bacteria are believed to survive poorly on surfaces, their role in the transmission of infection has not been investigated as widely. Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) are widespread and endemic in nosocomial settings. Given the increasing prevalence of infections involving ESBL-PE, the role of the environment in ESBL-PE transmission should be explored. This study reports the evaluation of 2 ESBL-PE recovery methods from typical hospital surface materials and their application for recovery of ESBL-PE adjacent to an ESBL-positive patient.

scholarly journals DEKONTAMINASI DAN PEMBERSIHAN AKHIR (TERMINAL CLEANING) DI LINGKUNGAN ICU (Intensive Care Unit)

Medicinus ◽  
2018 ◽  
Vol 4 (9) ◽  
Author(s):  
Cucunawangsih Cucunawangsih
Keyword(s):  
Intensive Care Unit ◽  
Beta Lactamase ◽  
Healthcare Associated Infection ◽  
Extended Spectrum Beta Lactamase ◽  
Vancomycin Resistant Enterococci ◽  
Acinetobacter Spp ◽  
Vancomycin Resistant ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
Hydrogen Peroxide Vapor

<p>Patogen MDRO, seperti vancomycin-resistant enterococci (VRE), methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), <em>Acinetobacter spp.</em>, <em>extended spectrum beta-lactamase</em> (<em>ESBL</em>)-producing bacteria, dan <em>Clostridium defficile </em>seringkali menyebabkan kolonisasi/<em>healthcare-associated infection</em> (HAI) di lingkungan ICU. Sejumlah penelitian membuktikan bahwa petugas kesehatan menularkan pathogen ini melalui kontak langsung dengan tangan atau sarung tangan setelah menyentuh permukaan yang terkontaminasi atau pasien. Lingkungan berperan penting pada penyebaran <em>hospital-acquired pathogens</em> (HAP) dan terjadinya HAI. Metode pembersihan dan dekontaminasi rutin yang telah diterapkan dan dilakukan di lingkungan rumah sakit seringkali gagal ataupun tidak efektif dalam menggurangi penyebaran patogen MDRO. Kegagalan ini disebabkan tidak seluruh permukaan medis dan rumahtangga yang seringkali tersentuh tidak terdekontaminasi dengan sempurna. Untuk itu diperlukan tindakan lanjutan berupa pembersihan terminal menggunakan metode baru, seperti (1) hydrogen peroxide vapor (HPV) dan (2) sinar UV yang telah terbukti efektif secara mikrobiologi, aman dan mudah digunakan.</p>

The Role Played by Contaminated Surfaces in the Transmission of Nosocomial Pathogens

2011 ◽  
Vol 32 (7) ◽  
pp. 687-699 ◽  
Author(s):  
Jonathan A. Otter ◽  
Saber Yezli ◽  
Gary L. French
Keyword(s):  
Healthcare Workers ◽  
Healthcare Associated Infections ◽  
Infection Rates ◽  
Nosocomial Pathogens ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surface ◽  
Vancomycin Resistant ◽  
Healthcare Associated ◽  
Cleaning And Disinfection ◽  
Endemic Transmission

Studies in the 1970s and 1980s suggested that environmental surface contamination played a negligible role in the endemic transmission of healthcare-associated infections. However, recent studies have demonstrated that several major nosocomial pathogens are shed by patients and contaminate hospital surfaces at concentrations sufficient for transmission, survive for extended periods, persist despite attempts to disinfect or remove them, and can be transferred to the hands of healthcare workers. Evidence is accumulating that contaminated surfaces make an important contribution to the epidemic and endemic transmission ofClostridium difficile,vancomycin-resistant enterococci, methicillin-resistantStaphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa,and norovirus and that improved environmental decontamination contributes to the control of outbreaks. Efforts to improve environmental hygiene should include enhancing the efficacy of cleaning and disinfection and reducing the shedding of pathogens. Further high-quality studies are needed to clarify the role played by surfaces in nosocomial transmission and to determine the effectiveness of different interventions in reducing associated infection rates.

scholarly journals Vancomycin-Resistant Enterococci and Extended-Spectrum β-Lactamase-Producing Bacterial Colonization of the Cervix after Emergency Cerclage: Is It Safe?

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 933
Author(s):  
Won-Kyu Jang ◽  
Jin-Gon Bae
Keyword(s):  
Early Onset ◽  
Neonatal Death ◽  
Medical Center ◽  
Bacterial Colonization ◽  
Control Group ◽  
Vancomycin Resistant Enterococci ◽  
Extended Spectrum ◽  
Early Onset Sepsis ◽  
Cervical Surgery ◽  
Vancomycin Resistant

Antimicrobial resistance is currently becoming a global threat to human health. We performed a retrospective study on patients who underwent emergency cerclage between January 2016 and December 2018 at the Dongsan Medical Center. Cervical culture was first performed before surgery to confirm that there was no infection and was repeated on days 1, 4, and 7 after surgery. A total of 85 pregnant women underwent emergency cerclage. Among them, six patients had vancomycin-resistant enterococci (VRE) colonization in the cervix after cerclage, and 23 patients developed extended-spectrum β-lactamase (ESBL)-producing bacterial colonization in the cervix. The average gestational age at delivery was lower in the VRE group. Neonatal death was also significantly higher in the VRE group. The rate of occurrence of early-onset sepsis was also higher in the VRE group, and both VRE and ESBL-producing bacterial colonization cases in which early-onset sepsis occurred resulted in neonatal death. The prognosis of cervical VRE colonization after cervical surgery was poor, whereas the prognosis of ESBL-producing bacterial colonization in the cervix did not differ significantly from that of the control group. However, careful neonatal treatment is required considering that early-onset sepsis is fatal to the newborn.

Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

2021 ◽  
pp. 1-6
Author(s):  
Sarah N. Redmond ◽  
Basya S. Pearlmutter ◽  
Yilen K. Ng-Wong ◽  
Heba Alhmidi ◽  
Jennifer L. Cadnum ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Veterans Affairs ◽  
Portable Equipment ◽  
Healthcare Facilities ◽  
Clostridioides Difficile ◽  
Bacteriophage Ms2 ◽  
Vancomycin Resistant Enterococci ◽  
Observational Cohort ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Abstract Objective: To investigate the timing and routes of contamination of the rooms of patients newly admitted to the hospital. Design: Observational cohort study and simulations of pathogen transfer. Setting: A Veterans’ Affairs hospital. Participants: Patients newly admitted to the hospital with no known carriage of healthcare-associated pathogens. Methods: Interactions between the participants and personnel or portable equipment were observed, and cultures of high-touch surfaces, floors, bedding, and patients’ socks and skin were collected for up to 4 days. Cultures were processed for Clostridioides difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Simulations were conducted with bacteriophage MS2 to assess plausibility of transfer from contaminated floors to high-touch surfaces and to assess the effectiveness of wearing slippers in reducing transfer. Results: Environmental cultures became positive for at least 1 pathogen in 10 (59%) of the 17 rooms, with cultures positive for MRSA, C. difficile, and VRE in the rooms of 10 (59%), 2 (12%), and 2 (12%) participants, respectively. For all 14 instances of pathogen detection, the initial site of recovery was the floor followed in a subset of patients by detection on sock bottoms, bedding, and high-touch surfaces. In simulations, wearing slippers over hospital socks dramatically reduced transfer of bacteriophage MS2 from the floor to hands and to high-touch surfaces. Conclusions: Floors may be an underappreciated source of pathogen dissemination in healthcare facilities. Simple interventions such as having patients wear slippers could potentially reduce the risk for transfer of pathogens from floors to hands and high-touch surfaces.

scholarly journals Discontinuation of Reflex Testing of Stool Samples for Vancomycin-Resistant Enterococci Resulted in Increased Prevalence

2013 ◽  
Vol 34 (8) ◽  
pp. 838-840 ◽  
Author(s):  
Mandy Bodily ◽  
Kathleen M. McMullen ◽  
Anthony J. Russo ◽  
Nupur D. Kittur ◽  
Joan Hoppe-Bauer ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Hospital Costs ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Vancomycin Resistant Enterococci ◽  
Number Of Patients ◽  
Reflex Testing ◽  
Stool Samples ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Discontinuation of reflex testing of stool submitted forClostridium difficiletesting for vancomycin-resistant enterococci (VRE) led to an increase in the number of patients with healthcare-associated VRE bacteremia and bacteriuria (0.21 vs 0.36 cases per 1,000 patient-days;P< .01). Cost-benefit analysis showed reflex screening and isolation of VRE reduced hospital costs.

scholarly journals A nosocomial cluster of vancomycin resistant enterococci among COVID-19 patients in an intensive care unit

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Stefanie Kampmeier ◽  
Hauke Tönnies ◽  
Carlos L. Correa-Martinez ◽  
Alexander Mellmann ◽  
Vera Schwierzeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Whole Genome Sequence ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Abstract Background Currently, hospitals have been forced to divert substantial resources to cope with the ongoing coronavirus disease 2019 (COVID-19) pandemic. It is unclear if this situation will affect long-standing infection prevention practices and impact on healthcare associated infections. Here, we report a nosocomial cluster of vancomycin-resistant enterococci (VRE) that occurred on a COVID-19 dedicated intensive care unit (ICU) despite intensified contact precautions during the current pandemic. Whole genome sequence-based typing (WGS) was used to investigate genetic relatedness of VRE isolates collected from COVID-19 and non-COVID-19 patients during the outbreak and to compare them to environmental VRE samples. Methods Five VRE isolated from patients (three clinical and two screening samples) as well as 11 VRE and six vancomycin susceptible Enterococcus faecium (E. faecium) samples from environmental sites underwent WGS during the outbreak investigation. Isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). Results WGS revealed two genotypic distinct VRE clusters with genetically closely related patient and environmental isolates. The cluster was terminated by enhanced infection control bundle strategies. Conclusions Our results illustrate the importance of continued adherence to infection prevention and control measures during the COVID-19 pandemic to prevent VRE transmission and healthcare associated infections.

scholarly journals Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay

2020 ◽  
Vol 8 (2) ◽  
pp. 203 ◽  
Author(s):  
Carlos L. Correa-Martinez ◽  
Hauke Tönnies ◽  
Neele J. Froböse ◽  
Alexander Mellmann ◽  
Stefanie Kampmeier
Keyword(s):  
Core Genome ◽  
Hospital Setting ◽  
Hospital Environment ◽  
Environmental Isolates ◽  
Resistance Determinants ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
And Control ◽  
Sequence Types

Vancomycin-resistant enterococci (VRE) are relevant nosocomial pathogens with an increasing incidence in the last decades. Their transmission is optimal in the hospital setting, as it offers two potential, large reservoirs that are closely related: susceptible patients and their environment. Here we investigate the role of the hospital environment in the nosocomial transmission of VRE by establishing concrete links between contaminated surfaces and colonized/infected patients in outbreak and non-outbreak settings. Environmental and patient VRE isolates were collected between 2013 and 2019 and analyzed by whole-genome sequencing (WGS), subsequent multilocus sequence typing (MLST), and core genome (cg) MLST. Pairs of isolates differing in <3 alleles were rated as closely related, making a transmission likely. Fifty-three environmental VRE isolates were analyzed. MLST sequence types (ST) ST203 (50.0%), ST192 (21.3%), ST117 (17.3%), ST721 (8.8%), ST80 (2%), and ST1489 (0.7%) were detected, carrying the resistance determinants vanA (72.7%), vanB (24%), or both (3.3%). Of the 53 environmental isolates, 51 were found to form five clusters with genetically related patient isolates (n = 97 isolates). WGS confirms the role of the environment in the transmission dynamics of VRE in both the outbreak and non-outbreak settings, highlighting the importance of prevention and control of VRE spread.

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