scholarly journals 2455. Outbreak of carbapenemase-producing Enterobacteriaceae in cardiology units associated with contaminated water dispenser and sink drain in Korea

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S849-S850
Author(s):  
Jiwon Jung ◽  
Hye-Suk Choi ◽  
Jeong-Young Lee ◽  
Min Jee Hong ◽  
Sun Hee Kwak ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tertiary Care ◽  
Water Environment ◽  
Water System ◽  
Contact Tracing ◽  
Contact Precaution ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Patient Room ◽  
Large Outbreak

Abstract Background There is a growing concern about the importance of hospital water environment for the transmission of carbapenemase-producing Enterobacteriaceae (CPE). Herein, we report a large outbreak in cardiology units involving intensive care units (ICU) and wards at a tertiary care hospital. Methods During a CPE outbreak between July and December 2018, contact tracing and environmental sampling were performed. For outbreak control, we performed education to healthcare workers, hand hygiene enforcement, active surveillance test, preemptive isolation, chlorhexidine bathing for CPE positive patients, and deep terminal cleaning including UV and hydrogen peroxide non-touch disinfection. Patients with CPE were isolated at a single room with dedicated staffs, contact precaution was implemented, and when case patients were located in multi-patient room, we performed surveillance culture for exposed patients in the room. Results A total of 87 patients with CPE infection or colonization were identified at two cardiology ICUs and three cardiology wards. CPE from the first two index patients were identified from sputum culture suspecting pneumonia, and the remaining 85 patients were identified to harbor CPE through surveillance culture (exposed patients n = 22, active surveillance test n = 63). Diverse organisms were identified; organisms with blakpc (n = 13), blaNDM-1 (n = 55), blaVIM or blaIMP (n = 12), blaOXA-48 (n = 3), and co-producing organisms (n = 4). We performed environmental culture; KPC-producing Escherichia coli was isolated from water dispenser in ICU and NDM-1 producing Citrobacter freundii and Enterobacter cloacae were isolated from sinks in the patient room. Outbreak ended after the removal of water dispenser and the replacement of sink drain with pouring bleach to the sink drain. Conclusion Water dispenser and sink drain were suspected for the possible reservoirs of CPE in this outbreak. Replacement of plumbing system and use of bleach for pouring to sink as well as the removal of water dispenser was needed to control outbreak. Investigation of water system is warranted for finding the source of CPE. Disclosures All authors: No reported disclosures.

Nosocomial Transmission of Methicillin-Resistant Staphylococcus aureus: A Blinded Study to Establish Baseline Acquisition Rates

2003 ◽  
Vol 24 (6) ◽  
pp. 415-421 ◽  
Author(s):  
Joel T. Fishbain ◽  
Joseph C. Lee ◽  
Honghung D. Nguyen ◽  
Jeffery A. Mikita ◽  
Cecilia P. Mikita ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Transmission Rate ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Nosocomial Transmission ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Average Hospital ◽  
Methicillin Resistant ◽  
History Of

AbstractObjective:To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.Design:A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.Setting:Tertiary-care military medical facility.Participants:All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.Results:Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.Conclusions:Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.

scholarly journals 817. Appropriate Sites for the Active Surveillance of Carbapenemase-producing Enterobacteriaceae

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S501-S502
Author(s):  
Joung Ha Park ◽  
Hye-Suk Choi ◽  
Hyejin Yang ◽  
Hyun-Ju Lee ◽  
Sun Hee Kwak ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Study Cohort ◽  
Care Hospital ◽  
Negative Group ◽  
Limited Data ◽  
Surgical Intensive Care ◽  
Transmission Rates

Abstract Background Active surveillance tests for carbapenemase-producing Enterobacteriaceae (CPE) are recommended in patients showing risk factors for colonization by these bacteria. There are limited data however on whether surveillance tests for anatomic sites other than the stool would be useful to detect CPE colonization, and we investigated this in our present study. Methods Retrospective analysis was performed on cases at our tertiary care hospital during a 5-year period. The study patients with CPE colonization had been admitted to our surgical intensive care unit (SICU) or sub-ICU for liver transplantation in this period and undergone surveillance tests for both the stool and other sites. Patients were grouped as stool CPE negative (but which included CPE positive cases from initial sputum and other site tests) or positive. Results Among the total study cohort of 158 patients, 138 (87.3%) were included in the stool CPE positive group and the remaining 20 (12.7%) in the stool CPE negative group. While the sensitivity of CPE surveillance testing of the stool was 87.3% (95% CI 81.1-92.1), the sensitivity when combining stool and sputum samples was 93.7% (88.7-96.9). The transmission rates were similar for patients showing CPE positivity in the stool, sputum and other sites, at 4.8% (27/557), 4.7% (3/64), and 6.7% (1/15), respectively (p = 0.95). Conclusion The sensitivity of CPE detection in a stool sample is suboptimal for ruling out CPE colonization and the transmission rates are similar between stool-positive or -negative cases. Combining surveillance of the stool with other sites may be needed for detecting CPE. Disclosures All Authors: No reported disclosures

scholarly journals Microbiological profile of patients attending sexually transmitted infection/reproductive tract infection clinic in a tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3649
Author(s):  
Sonal Prakash Chavan ◽  
Sharmila Sanjay Raut ◽  
Pragati Sharma ◽  
Ravindra Kashinath Khadse
Keyword(s):  
Reproductive Tract ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Contact Tracing ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Reproductive Tract Infection ◽  
Tract Infections

Background: Sexually transmitted infections (STIs)/reproductive tract infections (RTIs) are an important public health problem worldwide. Growing spread of RTIs/STIs are an augmenting factor for HIV transmission. Due to lack of adequate laboratory infrastructure, there is limited data. Hence information regarding STIs lies essentially on syndromic basis.Methods: This was an observational, cross-sectional study carried from June 2016 to September 2016 with sample size of 300 patients attending STI/RTI clinic. Various samples were collected like scrapings, exudates and swabs from ulcerative lesions for microscopy. Urethral, vaginal and cervical swabs for wet mount, gram stain and culture. Blood sample were collected for RPR, TPHA, ELISA HSV II, HIV, HBsAg. Processing and identification of organism as per NACO guidelines.Results: Out of total 300 cases, 255 (85%) are females and 45 (15%) are males. Maximum cases are from 25-44 years age group. Genital discharge syndrome is more common in females while genital ulcerative syndrome more in males. Coinfection with HIV is found in 17% cases. Herpes genitals (20%) is the most common causative agent for ulcerative STIs in males. VDS is the most common syndrome in Females. Candida (27.8%), G. vaginalis (12.2%) and T. vaginalis (3.5%).Conclusions: Viral and fungal STIs are more common than bacterial STIs. Targeted intervention and contact tracing as done for HIV should be effectively emphasised for STI/RTI also. Syndromic approach should be supplemented by Laboratory diagnosis for more effective outcome.

scholarly journals Appropriate sites for the active surveillance of carbapenemase-producing Enterobacteriaceae

2021 ◽  
Author(s):  
Joung Ha Park ◽  
Hye-Suk Choi ◽  
Hyejin Yang ◽  
Hyun-Ju Lee ◽  
Sun Hee Kwak ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Study Cohort ◽  
Care Hospital ◽  
Negative Group ◽  
Limited Data ◽  
Surgical Intensive Care ◽  
Transmission Rates

Abstract Background: Active surveillance tests for carbapenemase-producing Enterobacteriaceae (CPE) are recommended in patients showing risk factors for colonization by these bacteria. There are limited data however on whether surveillance tests for anatomic sites other than the stool would be useful to detect CPE colonization, and we investigated this in our present study.Methods: Retrospective analysis was performed on cases at our tertiary care hospital during a 5-year period. Patients with CPE colonization had been admitted to our surgical intensive care unit (SICU) or sub-ICU for liver transplantation in this period and undergone surveillance tests for both the stool and other sites. Patients were grouped as stool CPE negative (but which included CPE positive cases from initial sputum and other site tests) or positive. Results: Among the total study cohort of 158 patients, 138 (87.3%) were included in the stool CPE positive group and the remaining 20 (12.7%) in the stool CPE negative group. While the sensitivity of CPE surveillance testing of the stool was 87.3% (95% CI 81.1-92.1), the sensitivity when combining stool and sputum samples was 93.7% (88.7-96.9). The transmission rates were similar for patients showing CPE positivity in the stool, sputum and other sites, at 4.8% (27/557), 4.7% (3/64), and 6.7% (1/15), respectively (p = 0.95).Conclusions: The sensitivity of CPE detection in a stool sample is suboptimal for ruling out CPE colonization and the transmission rates are similar between stool-positive or -negative cases. Thus, combining surveillance of the stool with other sites may be needed for detecting CPE.

Pseudo-Outbreak of “Mycobacterium paraffinicum” Infection and/or Colonization in a Tertiary Care Medical Center

2009 ◽  
Vol 30 (9) ◽  
pp. 848-853 ◽  
Author(s):  
Shu-Hua Wang ◽  
Preeti Pancholi ◽  
Kurt Stevenson ◽  
Mitchell A. Yakrus ◽  
W. Ray Butler ◽  
...  
Keyword(s):  
Patient Care ◽  
Medical Center ◽  
Tertiary Care ◽  
Water System ◽  
Care Hospital ◽  
Molecular Tools ◽  
Environmental Isolates ◽  
Environmental Investigation ◽  
Tertiary Care Medical Center ◽  
Slow Growing

Objective.To investigate a pseudo-outbreak of “Mycobacterium paraffinicum” (unofficial taxon) infection and/or colonization, using isolates recovered from clinical and environmental specimens.Design.Outbreak investigation.Setting.University-affiliated, tertiary-care hospital.Methods.M. paraffinicum, a slow-growing, nontuberculous species of mycobacteria, was recovered from 21 patients and an ice machine on a single patient care unit over a 2.5-year period. The clinical, epidemiological, and environmental investigation of this pseudo-outbreak is described.Results.Twenty-one patients with pulmonary symptoms and possible risk factors for tuberculosis were admitted to inpatient rooms that provided airborne isolation conditions in 2 adjacent hospital buildings. In addition, 1 outpatient had induced sputum cultured for mycobacteria in the pulmonary function laboratory. Of the samples obtained from these 21 patients, 26 isolates from respiratory samples and 1 isolate from a stool sample were identified asM. paraffinicum. Environmental isolates obtained from an ice machine in the patient care unit where the majority of the patients were admitted were also identified asM. paraffinicum.Conclusions.An epidemiological investigation that used molecular tools confirmed the suspicion of a pseudo-outbreak ofM. paraffinicuminfection and/or colonization. The hospital water system was identified as the source of contamination.

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