scholarly journals 868. Investigations of Healthcare-Associated Elizabethkingia Infections – United States, 2013-2019

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S472-S472
Author(s):  
Matthew B Crist ◽  
John R McQuiston ◽  
Maroya Spalding Walters ◽  
Elizabeth Soda ◽  
Heather Moulton-Meissner ◽  
...  
Keyword(s):  
Water Management ◽  
Infection Control ◽  
Acute Care ◽  
Local Health ◽  
Care Hospital ◽  
Patient Exposure ◽  
Management Plans ◽  
Water Management Plans ◽  
Healthcare Associated ◽  
Ventilated Patients

Abstract Background Elizabethkingia (EK) are non-motile gram-negative rods found in soil and water and are an emerging cause of healthcare-associated infections (HAIs). We describe Centers for Disease Control and Prevention (CDC) consultations for healthcare-associated EK infections and outbreaks. Methods CDC maintains records of consultations with state or local health departments related to HAI outbreaks and infection control breaches. We reviewed consultations involving EK species as the primary pathogen of concern January 1, 2013 to December 31, 2019 and summarized data on healthcare settings, infection types, laboratory analysis, and control measures. Results We identified 9 consultations among 8 states involving 73 patient infections. Long-term acute-care hospitals (LTACHs) accounted for 4 consultations and 32 (43%) infections, and skilled nursing facilities with ventilated patients (VSNFs) accounted for 2 consultations and 31 (42%) infections. Other settings included an acute care hospital, an assisted living facility, and an outpatient ear, nose, and throat clinic. Culture sites included the respiratory tract (n=7 consultations), blood (n=4), and sinus tract (n=1), and E. anophelis was the most commonly identified species. Six consultations utilized whole genome sequencing (WGS); 4 identified closely related isolates from different patients and 2 also identified closely related environmental and patient isolates. Mitigation measures included efforts to reduce EK in facility water systems, such as the development of water management plans, consulting water management specialists, flushing water outlets, and monitoring water quality, as well as efforts to minimize patient exposure such as cleaning of shower facilities and equipment, storage of respiratory therapy supplies away from water sources, and use of splash guards on sinks. Conclusion EK is an important emerging pathogen that causes HAI outbreaks, particularly among chronically ventilated patients. LTACHs and VSNFs accounted for the majority of EK consultations and patient infections. Robust water management plans and infection control practices to minimize patient exposure to contaminated water in these settings are important measures to reduce infection risk among vulnerable patients. Disclosures All Authors: No reported disclosures

Systematic approaches in water management: Aquatic outlook and decision support systems combining monitoring, research, policy analysis and information technology

1996 ◽  
Vol 34 (12) ◽  
pp. 9-16 ◽  
Author(s):  
J. de Jong ◽  
J. T. van Buuren ◽  
J. P. A. Luiten
Keyword(s):  
Water Management ◽  
Policy Analysis ◽  
Research Policy ◽  
Human Life ◽  
Management Policy ◽  
Ecological Aspects ◽  
Management Plans ◽  
Water Management Plans ◽  
Life On Earth

Sustained developments is the target of almost every modern water management policy. Sustainability is focused on human life and on the ecological quality of our environment. Both aspects are essential for life on earth. Within a river catchment area this means that well balanced relations have to be laid between human activities and ecological aspects in the involved areas. Policy analysis is especially looking for the most efficient way to analyse and to overcome bottlenecks. In The Netherlands project “The Aquatic Outlook” all these elements are worked out in a nationwide scale, providing the scientific base and policy analysis from which future water management plans can be derived.

scholarly journals Comparing Complexity in Watershed Governance: The Case of California

Water ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 766 ◽  
Author(s):  
Nicola Ulibarri ◽  
Nataly Escobedo Garcia
Keyword(s):  
Water Management ◽  
Environmental Governance ◽  
Watershed Scale ◽  
Institutional Reforms ◽  
Institutional Fit ◽  
Geographic Context ◽  
Management Plans ◽  
Water Management Plans ◽  
Watershed Governance ◽  
Different Levels

Environmental governance scholars argue that optimal environmental performance can be achieved by matching the scale of governance to the scale of the resource being managed. In the case of water, this means managing at the scale of the watershed. However, many watersheds lack a single watershed-scale organization with authority over all water resources and instead rely on cross-jurisdiction coordination or collaboration among diverse organizations. To understand what “watershed governance” looks like fully, this paper maps organizations with rights to use, regulate, or manage water in four subwatersheds in California (the American, Cosumnes, and Kings Rivers in the Sacramento-San Joaquin watershed and the Shasta River in the Klamath watershed). We assemble datasets of water organizations, water rights holders, and water management plans and use content analysis and social network analysis to explore what water management looks like in the absence of a single basin authority. We describe the institutional complexity that exists in each watershed, compare the physical and institutional interconnections between actors in the watersheds, and then ask to what extent these connections map onto watershed boundaries. We find that the ways in which water management is complex takes very different forms across the four watersheds, despite their being located in a similar political, social, and geographic context. Each watershed has drastically different numbers of actors and uses a very different mix of water sources. We also see very different levels of coordination between actors in each watershed. Given these differences, we then discuss how the institutional reforms needed to create watershed-scale management are unique for each watershed. By building a stronger comparative understanding of what watershed governance actually entails, this work aims to build more thoughtful recommendations for building institutional fit.

scholarly journals Monitoring Hydrometeorological Droughts Using a Simplified Precipitation Index

Climate ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 19 ◽  
Author(s):  
Abdullah A. Alsumaiei
Keyword(s):  
Water Management ◽  
Precipitation Index ◽  
Drought Severity ◽  
Data Normalization ◽  
Precipitation Data ◽  
Hydrological Data ◽  
Groundwater Drought ◽  
Management Plans ◽  
Water Management Plans ◽  
The Impact

Efficient water management plans should rely on quantitative metrics for assessing water resource shortage scenarios. This study develops a simplified precipitation index (PI) requiring precipitation data only in order to assess hydrometeorological droughts affecting various hydrological systems. The PI index is inspired by the famous Standardized Precipitation Index (SPI), and it aims to provide the same indication for drought severity and duration while overcoming the disadvantage of needing hydrological data normalization. Avoiding hydrological data normalization overcomes the non-satisfactory results of this procedure that were reported in previous studies. Analysis of groundwater drought drivers in the arid region of Kuwait is presented to test the index applicability at timescales 12 and 24 months using available historical precipitation data from 1958 to 2017. A bivariate joint probability analysis was conducted by Clayton copula to assess the occurrence of certain drought severities and durations. The results showed that PI is comparable to the original SPI and provides drought severity linearly propagating with respect to time. This index constitutes a simple means to help water managers assess and describe the impact of droughts in precipitation-controlled systems and establish appropriate water management plans.

scholarly journals Are Many Patients Diagnosed With Healthcare-associated Clostridioides difficile Infections Colonized With the Infecting Strain on Admission?

2019 ◽  
Vol 69 (10) ◽  
pp. 1801-1804 ◽  
Author(s):  
Melany Gonzalez-Orta ◽  
Carlos Saldana ◽  
Yilen Ng-Wong ◽  
Jennifer Cadnum ◽  
Annette Jencson ◽  
...  
Keyword(s):  
Whole Genome Sequencing ◽  
Acute Care ◽  
Genome Sequencing ◽  
Acute Care Hospital ◽  
Whole Genome ◽  
Care Hospital ◽  
Clostridioides Difficile ◽  
Healthcare Associated

Abstract In a cohort of 480 patients admitted to an acute care hospital, 68 (14%) had positive perirectal cultures for toxigenic Clostridioides difficile on admission. Of the 11 patients (2%) diagnosed with healthcare-associated C. difficile infections, 3 (27%) had genetically related admission and infection isolates, based on whole-genome sequencing.

DISPOSABLE GROUNDWATER RESOURCES OF RIVER BASINS IN POLAND IN THE LIGHT OF SUSTAINABLE MANAGEMENT

2016 ◽  
pp. 0-0
Author(s):  
Andrzej SADURSKI ◽  
Elzbieta Przytuła
Keyword(s):  
Water Management ◽  
Sustainable Management ◽  
Groundwater Resources ◽  
Groundwater Exploitation ◽  
Ore Bodies ◽  
Catchment Areas ◽  
Management Plans ◽  
Water Management Plans ◽  
Modelling Techniques ◽  
Analytical Approaches

The term groundwater resources was introduced to hydrogeology from economic geology similarly to the resources of ore bodies almost a hundred years ago. It has been used for the need of physical planning, investment in new water intakes, and water management. Discussion on the groundwater resources started in the past after implementation of new methods of their evaluation, e.g. analytical approaches, and physical and then numerical modelling techniques. The ecological aspects of water demand, indicated in the Water Framework Directive, oblige the EU countries to introduce a new idea for the estimation of groundwater resources. This idea is also presented in the water management plans for river catchment areas. Distribution of available groundwater resources in the country and comparison with the groundwater exploitation is the background of proper, sustainable management of its resources. Available groundwater resources of the country, understood as a total amount of disposable and prospective groundwater resources, is 36.4 million m3/day (as of December 31, 2015), including 21.4 million m3/day of disposable resources, and 15 million m3/day of estimated prospective resources.

Fuzzy AHP Assessment of Water Management Plans

2007 ◽  
Vol 22 (7) ◽  
pp. 877-894 ◽  
Author(s):  
Bojan Srdjevic ◽  
Yvonilde Dantas Pinto Medeiros
Keyword(s):  
Water Management ◽  
Fuzzy Ahp ◽  
Management Plans ◽  
Water Management Plans

Acute Emergence of Elizabethkingia meningoseptica Infection among Mechanically Ventilated Patients in a Long-Term Acute Care Facility

2010 ◽  
Vol 31 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Kingsley N. Weaver ◽  
Roderick C. Jones ◽  
Rosemary Albright ◽  
Yolanda Thomas ◽  
Carlos H. Zambrano ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Facility ◽  
Acute Care Hospitals ◽  
Care Hospital ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Elizabethkingia Meningoseptica ◽  
Ventilated Patients

Objective.To describe an outbreak of infection associated with an infrequently implicated pathogen, Elizabethkingia meningoseptica, in an increasingly prominent setting for health care of severely ill patients, the long-term acute care hospital.Design.Outbreak investigation.Setting.Long-term acute care hospital with 55 patients, most of whom were mechanically ventilated.Methods.We defined a case as E. meningoseptica isolated from any patient specimen source from December 2007 through April 2008, conducted an investigation of case patients, obtained environmental specimens, and performed microbiologic testing.Results.Nineteen patients had E. meningoseptica infection, and 8 died. All case patients had been admitted with respiratory failure that required mechanical ventilation. Among the 8 individuals who died, the time from collection of the first specimen positive for E. meningoseptica to death ranged from 6 to 43 days (median, 16 days). Environmental sampling was performed on 106 surfaces; E. meningoseptica was isolated from only one swab. Three related pulsed-field gel electrophoresis patterns were identified in patient isolates; the environmental isolate yielded a fourth, unrelated pattern.Conclusion.Long-term acute care hospitals with mechanically ventilated patients could serve as an important transmission setting for E. meningoseptica. This multidrug-resistant bacterium could pose additional risk when patients are transferred between long-term acute care hospitals and acute care hospitals.

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