scholarly journals Results of screening for emergent highly resistant bacteria in Tunisian intensive care units

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Ben Rejeb ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
M Kahloul ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Early Identification ◽  
Infection Prevention ◽  
Screening Program ◽  
Control Measures ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Resistant Bacteria ◽  
Prevention Interventions

Abstract Background The infections caused by emergent highly resistant bacteria (eHBR) that develop in intensive care units (ICUs) may result in significant patient illnesses and deaths, extend the duration of hospital stays and generate added costs. Facing this problem, the screening that emphasizes early identification of colonized patients, reduces the prevalence and incidence of infection, improves patient outcomes and reduces healthcare costs. In this context, we have implemented a screening for eHBR in ICUs of Sahloul university hospital of Sousse (Tunisia), which we report in this study the first six-months outcomes. Methods Rectal swab cultures were collected to detect Vancomycin resistant enterococcus (VRE) and Carbapenemase producing Enterobacteriaceae (CPE) among patients admitted in six ICUs of Sahloul university hospital of Sousse (Tunisia) and more than three times, at least one week apart, between 1 June and 31 December 2018. Results During the study period 174 patients were screened. Of them, 69.5% were male and 73.6% were admitted in surgical ICU. In total, 161 and 152 samples were realized respectively for the detection of CPE and VRE. These samples were positive in 15% and 8.5% respectively for CPE and VRE. Klebsiella pneumoniae OXA 48 was the most isolated CPE (80%). Conclusions Our screening program helped us in infection control by early identification of patients, thereby facilitating an informed decision about infection prevention interventions. Moreover, these results encouraged us to improve and generalize this program throughout the hospital. Key messages eHRB screening becomes an important axis in the prevention of eHRB infections in our facilities. eHRB screening allows the reinforcement of the basic infection prevention and control measures.

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 The emerging extensively drug resistant bacteria in a university hospital in Tunisia in 2019

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Tilouche ◽  
N Haddad ◽  
S Boujaafar ◽  
R Elaissi ◽  
S Kahloun ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Drug Resistant Bacteria ◽  
Rectal Swabs ◽  
Vancomycin Resistant

Abstract Background The discovery of antibiotics revolutionized medicine in the 20th century, however the emergence of extensively drug-resistant bacteria constitute a growing problem in our hospitals in Tunisia and across the world. This study aims to evaluate a screening program for Carbapenemase Producing Enterobacteriaceae (CPE) and vancomycin-resistant enterococci (VRE) undertaken by the Microbiology Laboratory of Sahloul University Hospital. Methods A descrptive and retrospective study was carried out between 01st April 2018 and 31th December 2019 in the university hospital Sahloul, in East Coast of Tunisia. The screening was based on rectal swabs; it concerned Medical Intensive Care Units, the postoperative unit, the paediatric and the nephrology departments. The rectal swabs were seeded on the chromID CARBASMART and chromID VRE agars(biomerieux, France)in search of CPE and VRE respectively. The identification and the antibiotic susceptibilities testing were performed using the Vitek2 System (biomerieux,France) Results In total, 191 patients were screened. Among them, 56% were admitted in Intensive Care Units, 9.95% in postoperative unit, 30.9% in paediatric department and 3.14% in the nephrology department. A total of 38 extensively drug-resistant bacteria were isolated: 20 CPE and 18 VRE. Among isolated CPE, 17 were identified as Klebsiella pneumonia: The ConfirmationKPC/MBLkit (RoscoDiagnostica, Denmark) supplemented with a disc of Temocillin showed that 7 strains produced metallo-carbapenemase and 10 strains produced OXA 48 carbapenemase. The other isoloted CPE were OXA-48 producers. All VRE were identified as Enterococcus faecium, Their Vancomycin and Teicoplanine MICs were greater than 32 mg/L. Conclusions Mastering the spread of extensively drug-resistant bacteria involves a multidisciplinary preventive strategy. It must include strict application of hygiene measures, early detection and isolation of carriers and rationalization of antibiotic use. Key messages the emergence of extensively drug-resistant bacteria constitute a growing problem that`s why Carbapenemase Producing Enterobacteriaceae and vancomycin-resistant enterococci screening is crucial. Anti microbial agents use must be rationalized.

scholarly journals Plasmid curing pattern of nosocomial pathogens of intensive care units (ICU) in Zagazig University Hospital

2017 ◽  
Vol 2 (4) ◽  
pp. 703-711
Author(s):  
Soheir El Salam ◽  
Mohammed Farouk Ghaly ◽  
Ahmed Anwar Shahen ◽  
Mahmoud Mostafa Amer ◽  
Sanaa Atef Abdelkader
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Complete Removal ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Plasmid Curing

Nosocomial infections and antibiotic resistance are serious and growing phenomenon in contemporary medicine and has emerged as one of the public health concerns. A total of seventy isolates of bacteria were collected from patients. The selected isolates include 33 (56.9%) from males and 25 (43.1%) from females. All bacteria were susceptible to imipenem followed by amikacin, ceftazidime, ciprofloxacin and tobramycin, respectively. The multi-drug resistant (MDR) bacterial isolates (33 isolates) divided into four groups named Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus were selected to be identified according to the keys of different identification protocols. Escherichia coli found to be the most frequent pathogen within MDR isolates followed by Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumonia, respectively. The MICs and MBCs of (Imipenem, Amikacin, Ceftazidime and ciprofloxacin) against the most resistant isolates were determined. Generally, P. aeruginosa (Strain No. 55) was found to be the highest resistant bacteria. Plasmid profile of Pseudomonas aeruginosa was carried out, after incubation at 37oc for 24hr recorded no changes in plasmid and compared with incubation at 43oc (plasmid curing) which showed complete removal of plasmid bands and the tested bacteria became more sensitive to antibiotics. This study therefore determined the prevalence, anti-biotic susceptibility and plasmid patterns of P. aeruginosa strains from clinical specimens obtained from the intensive care units of Zagazig University Hospital in Egypt.Asian J. Med. Biol. Res. December 2016, 2(4): 703-711

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 Healthcare-associated infections in Intensive Care Units: epidemiology and infection control in low-to-middle income countries

2015 ◽  
Vol 9 (10) ◽  
pp. 1040-1045 ◽  
Author(s):  
Emine Alp ◽  
Nizam Damani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Middle Income ◽  
Middle Income Countries ◽  
Healthcare Associated ◽  
And Control

Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

scholarly journals Starting parenting in isolation a qualitative user-initiated study of parents’ experiences with hospitalization in Neonatal Intensive Care units during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258358
Author(s):  
Nina M. Kynø ◽  
Drude Fugelseth ◽  
Lina Merete Mæland Knudsen ◽  
Bente Silnes Tandberg
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Negative Impact ◽  
Structured Interview ◽  
Control Measures ◽  
University Hospital ◽  
Neonatal Intensive Care Units ◽  
Post Discharge ◽  
Parental Experiences

Background Worldwide, strict infection control measures including visitation regulations were implemented due to the COVID-19 pandemic at Neonatal Intensive Care Units (NICUs). These regulations gave restricted access for parents to their hospitalized infants. The consequence was limited ability to involve in the care of their infants. At Oslo University Hospital entry to NICU was denied to all except healthy mothers in March 2020. The absolute access ban for fathers lasted for 10 weeks. The aim of this study was to explore parental experiences with an infant hospitalized in the NICU during this absolute visitation ban period. Methods We invited post discharge all parents of surviving infants that had been hospitalized for at least 14 days to participate. They were interviewed during autumn 2020 using an explorative semi-structured interview approach. Data were analyzed via inductive thematic analysis. Results Nine mothers and four fathers participated. The COVID-19 regulations strongly impacted the parent’s experiences of their stay. The fathers’ limited access felt life-impacting. Parents struggled to become a family and raised their voices to be heard. Not being able to experience parenthood together led to emotional loneliness. The fathers struggled to learn how to care for their infant. The regulations might lead to a postponed attachment. On the other hand, of positive aspect the parents got some quietness. Being hospitalized during this first wave was experienced as exceptional and made parents seeking alliances by other parents. Social media was used to keep in contact with the outside world. Conclusions The regulations had strong negative impact on parental experiences during the NICU hospitalization. The restriction to fathers’ access to the NICU acted as a significant obstacle to early infant-father bonding and led to loneliness and isolation by the mothers. Thus, these COVID-19 measures might have had adverse consequences for families.

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