scholarly journals NovelblaKPC-carrying species identified in the hospital environment

2016 ◽  
Author(s):  
Hang T.T. Phan ◽  
Zoie Aiken ◽  
Oluwafemi Akinremi ◽  
Julie Cawthorne ◽  
Andrew Dodgson ◽  
...  

AbstractblaKPC, encoding one of five dominant global carbapenemase families, is increasingly identified in environmental species difficult to characterize using routine diagnostic methods, with epidemiological and clinical implications. During environmental hospital infection prevention and control investigations (Manchester, UK) we used whole genome sequencing to confirm species identification for isolates infrequently associated withblaKPCand/or difficult to classify by MALDI-ToF. Four previously undescribedblaKPC-carrying species were identified from the hospital environment, including a putative, novelEnterobacterspecies.

2019 ◽  
Vol 69 (10) ◽  
pp. 1649-1656 ◽  
Author(s):  
Sunando Roy ◽  
John Hartley ◽  
Helen Dunn ◽  
Rachel Williams ◽  
Charlotte A Williams ◽  
...  

Abstract Background Influenza A virus causes annual epidemics in humans and is associated with significant morbidity and mortality. Haemagglutinin (HA) and neuraminidase (NA) gene sequencing have traditionally been used to identify the virus genotype, although their utility in detecting outbreak clusters is still unclear. The objective of this study was to determine the utility, if any, of whole-genome sequencing over HA/NA sequencing for infection prevention and control (IPC) in hospitals. Methods We obtained all clinical samples from influenza (H1N1)-positive patients at the Great Ormond Street Hospital between January and March 2016. Samples were sequenced using targeted enrichment on an Illumina MiSeq sequencer. Maximum likelihood trees were computed for both whole genomes and concatenated HA/NA sequences. Epidemiological data was taken from routine IPC team activity during the period. Results Complete genomes were obtained for 65/80 samples from 38 patients. Conventional IPC analysis recognized 1 outbreak, involving 3 children, and identified another potential cluster in the haemato-oncology ward. Whole-genome and HA/NA phylogeny both accurately identified the previously known outbreak cluster. However, HA/NA sequencing additionally identified unrelated strains as part of this outbreak cluster. A whole-genome analysis identified a further cluster of 2 infections that had been previously missed and refuted suspicions of transmission in the haemato-oncology wards. Conclusions Whole-genome sequencing is better at identifying outbreak clusters in a hospital setting than HA/NA sequencing. Whole-genome sequencing could provide a faster and more reliable method for outbreak monitoring and supplement routine IPC team work to allow the prevention of transmission.


2018 ◽  
Vol 45 (6) ◽  
pp. e29-e32 ◽  
Author(s):  
Robert D. Kirkcaldy ◽  
Katy Town ◽  
Kim M. Gernert ◽  
Virginia B. Bowen ◽  
Elizabeth A. Torrone ◽  
...  

Author(s):  
Hilary Humphreys

Multi-drug-resistant Enterobacteriales are an increasing problem and include those mediated by extended-spectrum β‎-lactamases (ESBLs) and carpapenemase production (CPE). Third-generation cephalosporins are inactivated by ESBLs but for CPEs there are much fewer options for treatment. The challenge in detection, management, and treatment is compounded by CPEs occurring amongst such a broad category of Gram-negative bacilli and because the genetic elements are very mobile, often being quickly and widely disseminated through plasmids. Phenotypic tests for identification have their limitations and there is increasing emphasis on PCR with microarrays and whole genome sequencing being available in specialist centres. Colistin is often the drug of first choice for CPE infections but is usually combined with another agent such as an aminoglycoside. Aggressive infection prevention and control precautions are mandatory given the propensity to spread, the reduced options for treatment, and a lack of insight to patterns and duration of carriage.


2018 ◽  
Vol 1 (1) ◽  
pp. 46
Author(s):  
Erna Tsalatsatul Fitriyah ◽  
Meidiana Dwidiyanti ◽  
Luky Dwiantoro

Background: Infectious diseases have become one of the world’s serious problems including in Indonesia. Infectious diseases can originate from the community and hospital environment. Health workers performing inappropriate medical procedures could also be a cause of transmission of infectious diseases. Infection prevention and control nurses (IPCNs) as the pioneers of prevention and infection control in hospitals have not optimally played their roles.   Purpose: This study aimed to explore the roles of IPCNs and their constraints in preparing for emerging infectious diseases. Methods: The present study employed a qualitative design with the hermeneutic phenomenological approach. The samples were seven IPCNs for the primary participants, and two Infection Prevention and Control Officers (IPCOs) and 13 Infection Prevention and Control Link Nurses (IPCLNs) as the triangulation participants. The data were collected using in-depth semi-structured interviews analyzed using a content analysis technique.   Results: The results identified two themes: (1) IPCNs played roles as clinical practitioners, activity coordinators, administrators, and educators, and (2) the roles of IPCNs had not been optimal due to the lack of support from the hospital management, insufficient infrastructure, weak monitoring and evaluation, and the unavailability of appropriate rewards and  punishment.Conclusion: The majority of participants in this study agreed that IPCNs had tried well to play their roles. However, various obstacles were encountered, which hindered the IPCNs in performing their roles.


Author(s):  
Dorota Jaślan ◽  
Jerzy Rosiński ◽  
Małgorzata Siewierska ◽  
Anna Szczypta ◽  
Marta Wałaszek ◽  
...  

Background: The results of several studies in the area of infection control in Poland are disturbing. The situation may be shaped by many factors. However, the key factor for effective infection prevention and control is dedicated personnel, especially infection prevention and control nurses (IPCN). Nevertheless, based on the available published data and the authors’ experience, in many Polish hospitals infection control is not sufficiently appreciated by managers, it is consequently underfunded, and treated by medical staff as a nuisance. This may influence the nurses willingness to work as IPCN. The aim of the study was to assess the nursing students’ perception of the work of IPCN and their interest in employment in this position, as well as the potential reasons for choosing this particular specialization. Materials and methods: The study was conducted using the authors’ anonymous questionnaire conducted among nursing students of three Polish universities. The questionnaire was prepared by a panel of experts working in the field of infection control, including nurses working both as academic teachers and infection control nurses in hospitals. The design of the questionnaire was based on the authors’ own experience, knowledge, and exchanging information with the practitioners in infection control in Poland. The reliability of the questionnaire was confirmed by the Cronbach alpha test. The raw alpha values and 95% CI for two main questions concerning opinion were: 0.76 (0.72–0.81) and 0.69 (0.63–0.75). Results: The study was conducted among 253 students, mostly women (98%) of full-time (31.4%) and extramural (68.6%) studies. The age range of the respondents was 20–58 years, median = 26 years, IQR = 19 years. To the key item in the questionnaire, i.e., “Would you like to work as an IPCN?”, 84.6% (214 respondents; first group) of the respondents answered “no” and 15.4% (39 respondents, second group) answered “yes”. The results revealed no significant differences between the two groups concerning the position responsibilities and appreciation by other medical staff. Additionally, for respondents willing to work as ICPN the most important issues were the influence on patient safety, expected salary, and possibility of professional development; for the respondents from the other group the most important issue was lack of contact with patients. The results concerning the students’ opinion on the perception of IPCN by medical personnel proved to be peculiar. About 80% of the respondents confirmed the IPCNs’ key role in ensuring patient and personnel safety, while only 31.6% declared their high standing in the hospital hierarchy. Conclusions: The obtained results indicate the necessity of thorough studies on the organization and structure of infection control in Polish hospitals, with a particular emphasis on building a positive perception of IPCNs by medical staff, as well as implementing an education campaign on infection control in the hospital environment.


Author(s):  
Janice Cho ◽  
Scott Cunningham ◽  
Meng Pu ◽  
Ryan J Lennon ◽  
Jennifer Dens Higano ◽  
...  

Abstract Background Current approaches in tracking Clostridioides difficile infection (CDI) and individualizing patient management are incompletely defined. Methods We recruited 468 subjects with CDI at Mayo Clinic Rochester between May and December 2016 and performed whole-genome sequencing (WGS) on C. difficile isolates from 397. WGS was also performed on isolates from a subset of the subjects at the time of a recurrence of infection. The sequence data were analyzed by determining core genome multilocus sequence type (cgMLST), with isolates grouped by allelic differences and the predicted ribotype. Results There were no correlations between C. difficile isolates based either on cgMLST or ribotype groupings and CDI outcome. An epidemiologic assessment of hospitalized subjects harboring C. difficile isolates with ≤2 allelic differences, based on standard infection prevention and control assessment, revealed no evidence of person-to-person transmission. Interestingly, community-acquired CDI subjects in 40% of groups with ≤2 allelic differences resided within the same zip code. Among 18 subjects clinically classified as having recurrent CDI, WGS revealed 14 with initial and subsequent isolates differing by ≤2 allelic differences, suggesting a relapse of infection with the same initial strain, and 4 with isolates differing by >50 allelic differences, suggesting reinfection. Among the 5 subjects classified as having a reinfection based on the timing of recurrence, 3 had isolates with ≤2 allelic differences between them, suggesting a relapse, and 2 had isolates differing by >50 allelic differences, suggesting reinfection. Conclusions Our findings point to potential transmission of C. difficile in the community. WGS better differentiates relapse from reinfection than do definitions based on the timing of recurrence.


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