scholarly journals Genomic epidemiologic assessment implicates prolonged silent carriage, virulence factors and transmission between staff and patients in a NICU outbreak of MRSA.

2021 ◽  
Author(s):  
sharline madera ◽  
Nicole McNeil ◽  
Paula Hayakawa Serpa ◽  
Jack Kamm ◽  
Christy Pak ◽  
...  
Keyword(s):  
Virulence Factors ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Control Strategies ◽  
Genomic Analysis ◽  
Severe Infection ◽  
Healthcare Personnel ◽  
Outbreak Strain ◽  
Early Implementation ◽  
Prevention Interventions

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in neonatal intensive care units (NICU) that carries significant morbidity and mortality. Improving our understanding of MRSA transmission dynamics, especially among high risk patients, is an infection prevention priority. Methods: We investigated a cluster of clinical MRSA cases in the NICU using a combination of epidemiologic review and whole genome sequencing (WGS) of isolates from clinical and surveillance cultures obtained from patients and healthcare personnel (HCP). Results: Phylogenetic analysis identified two genetically distinct phylogenetic clades and revealed multiple silent transmission events between HCP and infants. The predominant outbreak strain harbored multiple virulence factors. Epidemiologic investigation and genomic analysis identified a HCP colonized with the dominant MRSA outbreak strain who cared for the majority of NICU patients who were infected or colonized with the same strain, including one NICU patient with severe infection seven months before the described outbreak. These results guided implementation of infection prevention interventions that prevented further transmission events. Conclusion: Silent transmission of MRSA between HCP and NICU patients likely contributed to a NICU outbreak involving a virulent MRSA strain. WGS enabled data-driven decision making to inform implementation of infection control policies that mitigated the outbreak. Prospective WGS coupled with epidemiologic analysis can be used to detect transmission events and prompt early implementation of control strategies.

scholarly journals COVID-19 Pandemic – Implications, Planning, and Recommendations related to Dental Care Services and Dental Education

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 92-98
Author(s):  
Fazal Ghani
Keyword(s):  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Clinical Symptoms ◽  
Dental Education ◽  
Control Strategies ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
Dental Services ◽  
And Control

During the past few months, our understanding of the transmission, epidemiology, clinical symptoms, and management of Covid-19 has considerably improved. This had made the dental healthcare personnel confident enough and ready to provide safely by implementing efficient prevention and cross-infection control strategies in the dental clinical setting. , At the same time, it is necessary that we must be constantly aware of the continuation of such infectious threats challenging our infection control regimen and preparedness to provide dental treatments and teaching and education. Good infection prevention and control strategies need to be evidence-based and in line with the recommendations of the local and international public health agencies. The disruption in dental services and dental education all over the world resulted in this pandemic has emphasized and resulted in new, innovative and improved infection prevention and control strategies and adoption of alternative teaching, learning and assessment strategies for students. It further reinforces the need for continued research exploring ways for responding better to future contagious disease threats.  

scholarly journals Low SARS-CoV-2 Seroprevalence and No Active Infections among Dogs and Cats in Animal Shelters with Laboratory-Confirmed COVID-19 Human Cases among Employees

Biology ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 898
Author(s):  
Caitlin M. Cossaboom ◽  
Alexandra M. Medley ◽  
Jessica R. Spengler ◽  
Esther A. Kukielka ◽  
Grace W. Goryoka ◽  
...  
Keyword(s):  
United States ◽  
Neutralizing Antibodies ◽  
Infection Prevention ◽  
The United States ◽  
Viral Rna ◽  
Animal Shelters ◽  
Early Implementation ◽  
Prevention Interventions ◽  
Low Probability

Human-to-animal and animal-to-animal transmission of SARS-CoV-2 has been documented; however, investigations into SARS-CoV-2 transmission in congregate animal settings are lacking. We investigated four animal shelters in the United States that had identified animals with exposure to shelter employees with laboratory-confirmed COVID-19. Of the 96 cats and dogs with specimens collected, only one dog had detectable SARS-CoV-2 neutralizing antibodies; no animal specimens had detectable viral RNA. These data indicate a low probability of human-to-animal transmission events in cats and dogs in shelter settings with early implementation of infection prevention interventions.

Effective infection prevention and control strategies in a large accredited psychiatric facility in Singapore

2020 ◽  
Author(s):  
Daniel Poremski ◽  
Sandra Henrietta Subner ◽  
Grace Lam Fong Kin ◽  
Raveen Dev Ram Dev ◽  
Mok Yee Ming ◽  
...  
Keyword(s):  
Mental Health ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Control Strategies ◽  
Infection Prevention And Control ◽  
Psychiatric Facility ◽  
Essential Services ◽  
Community Transmission ◽  
And Control

The Institute of Mental Health in Singapore continues to attempt to prevent the introduction of COVID-19, despite community transmission. Essential services are maintained and quarantine measures are currently unnecessary. To help similar organizations, strategies are listed along three themes: sustaining essential services, preventing infection, and managing human and consumable resources.

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 The Science Behind Safe School Re-Opening: Leveraging the Pillars of Infection Control to Support Safe Elementary and Secondary Education During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Elissa M Schechter-Perkins ◽  
Polly van den Berg ◽  
Westyn Branch-Elliman
Keyword(s):  
Infection Control ◽  
Infection Prevention ◽  
Diagnostic Testing ◽  
Current Evidence ◽  
Implementation Barriers ◽  
Safe School ◽  
Elementary And Secondary Education ◽  
School Settings ◽  
Environmental Controls ◽  
Prevention Interventions

Abstract There are limited tools for adapting COVID-19 infection control plans to school settings. We present an infection prevention model for optimizing safe re-opening for elementary and secondary schools during the global COVID-19 pandemic and review the current evidence behind various infection prevention interventions in school settings. The model is adapted from the Centers for Disease Control and Prevention fundamental pillars for infection prevention, and includes four categories of intervention: epidemiologic controls (town prevalence metrics, diagnostic testing, quarantine strategies), administrative controls (state vaccination policies, alternative school models, symptom screens, quarantine breaks), engineering/environmental controls (distancing, outdoor space, ventilation), and personal protective equipment (PPE)/Hand hygiene (face coverings, hand sanitizing). The adapted infection control pillars model utilizes implementation-science informed considerations to maximize pragmatism and adherence by leveraging evidence-based strategies. It highlights the necessity of redundant infection prevention interventions, acknowledges the importance of community buy-in to achieve real-world effectiveness, and addresses tactics to overcome implementation barriers. Recommendations are grounded in the Dynamic Sustainability Framework and include suggestions to maintain infection prevention effectiveness over time to ensure ongoing safety.

scholarly journals Legal Requirements for Infection Prevention and Control Training Among Healthcare Personnel

2020 ◽  
Vol 41 (S1) ◽  
pp. s70-s70
Author(s):  
Lauren Weil ◽  
Alexa Limeres ◽  
Astha KC ◽  
Carissa Holmes ◽  
Tara Holiday ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
Content Areas ◽  
Training Requirements ◽  
Training Content ◽  
And Control ◽  
Dental Professionals

Background: When healthcare providers lack infection prevention and control (IPC) knowledge and skills, patient safety and quality of care can suffer. For this reason, state laws sometimes dictate IPC training; these requirements can be expressed as applying to various categories of healthcare personnel (HCP). We performed a preliminary assessment of the laws requiring IPC training across the United States. Methods: During February–July 2018, we searched WestlawNext, a legal database, for IPC training laws in 51 jurisdictions (50 states and Washington, DC). We used standard legal epidemiology methods, including an iterative search strategy to minimize results that were outside the scope of the coding criteria by reviewing results and refining search terms. A law was defined as a regulation or statute. Laws that include IPC training for healthcare personnel were collected for coding. Laws were coded to reflect applicable HCP categories and specific IPC training content areas. Results: A total of 278 laws requiring IPC training for HCP were identified (range, 1–19 per jurisdiction); 157 (56%) did not specify IPC training content areas. Among the 121 (44%) laws that did specify IPC content, 39 (32%) included training requirements that focused solely on worker protections (eg, sharps injury prevention and bloodborne pathogen protections for the healthcare provider). Among the 51 jurisdictions, dental professionals were the predominant targets: dental hygienists (n = 22; 43%), dentists (n = 20; 39%), and dental assistants (n = 18; 35%). The number of jurisdictions with laws requiring training for other HCP categories included the following: nursing assistants (n = 25; 49%), massage therapists (n = 11; 22%), registered nurses (n = 10; 20%), licensed practical nurses (n = 10; 20%), emergency medical technicians and paramedics (n = 9; 18%), dialysis technicians (n = 8; 18%), home health aides (n = 8;16%), nurse midwives (n = 7; 14%), pharmacy technicians (n = 7; 14%), pharmacists (n = 6; 12%), physician assistants (n = 4; 8%), podiatrists (n = 3; 6%), and physicians (n = 2; 4%). Conclusions: Although all jurisdictions had at least 1 healthcare personnel IPC training requirement, many of the laws lack specificity and some focus only on worker protections, rather than patient safety or quality of care. In addition, the categories of healthcare personnel regulated among jurisdictions varied widely, with dental professionals having the most training requirements. Additional IPC training requirements exist at the facility level, but this information was not analyzed as a part of this project. Further analysis is needed to inform our assessment and identify opportunities for improving IPC training requirements, such as requiring IPC training that more fully addresses patient protections.Funding: NoneDisclosures: None

scholarly journals 506. Variation in Occupational Activities and Infection Prevention Practices in Healthcare Personnel Based on Exposure to COVID-19 Units

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S319-S319
Author(s):  
Jessica Howard-Anderson ◽  
Carly Adams ◽  
Amy C Sherman ◽  
William C Dube ◽  
Teresa C Smith ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Panel Member ◽  
Healthcare Personnel ◽  
Similar Proportion ◽  
Review Panel ◽  
High Exposure ◽  
Material Support ◽  
Social Distancing ◽  
Occupational Activities ◽  
Low Exposure

Abstract Background Healthcare personnel (HCP) may be at increased risk for COVID-19, but differences in risk by work activities are poorly defined. Centers for Disease Control and Prevention recommends cohorting hospitalized patients with COVID-19 to reduce in-hospital transmission of SARS-CoV-2, but it is unknown if occupational and non-occupational behaviors differ based on exposure to COVID-19 units. Methods We analyzed a subset of HCP from an ongoing CDC-funded SARS-CoV-2 serosurveillance study. HCP were recruited from four Atlanta hospitals of different sizes and patient populations. All HCP completed a baseline REDCap survey. We used logistic regression to compare occupational activities and infection prevention practices among HCP stratified by exposure to COVID-19 units: low (0% of shifts), medium (1–49% of shifts) or high (≥50% of shifts). Results Of 211 HCP enrolled (36% emergency department [ED] providers, 35% inpatient RNs, 17% inpatient MDs/APPs, 7% radiology technicians and 6% respiratory therapists [RTs]), the majority (79%) were female and the median age was 35 years. Nearly half of the inpatient MD/APPs (46%) and RNs (47%) and over two-thirds of the RTs (67%) worked primarily in the ICU. Aerosol generating procedures were common among RNs, MD/APPs, and RTs (26–58% performed ≥1), but rare among ED providers (0–13% performed ≥1). Compared to HCP with low exposure to COVID-19 units, those with medium or high exposure spent a similar proportion of shifts directly at the bedside and were about as likely to practice universal masking. Being able to consistently social distance from co-workers was rare (33%); HCP with high exposure to COVID-19 units were less likely to report social distancing in the workplace compared to those with low exposure; however, this was not significantly different (OR 0.6; 95% CI: 0.3, 1.1). Concerns about personal protective equipment in COVID-19 units were similar across levels of exposure (Table 1). Table 1: Occupational activities and infection prevention behaviors of healthcare personnel stratified by level of exposure to COVID-19 units Conclusion The proportion of time spent in dedicated COVID-19 units did not appear to influence time HCP spend directly at the bedside or infection prevention practices (social distancing and universal masking) in the workplace. Risk for SARS-CoV-2 infection in HCP may depend more on factors acting at the individual level rather than those related to location of work. Disclosures Jessica Howard-Anderson, MD, Antibacterial Resistance Leadership Group (ARLG) (Other Financial or Material Support, The ARLG fellowship provides salary support for ID fellowship and mentored research training) Ben Lopman, PhD, MSc, Takeda Pharmaceuticals (Advisor or Review Panel member, Research Grant or Support, Other Financial or Material Support, Personal fees)World Health Organization (Advisor or Review Panel member, Other Financial or Material Support, Personal fees for technical advice and analysis)

scholarly journals Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhijie Zhang ◽  
Yu Cao ◽  
Yanjian Li ◽  
Xufang Chen ◽  
Chen Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Biofilm Formation ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Anti Fungal ◽  
Hospital Acquired ◽  
And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

scholarly journals Sustained Infection Reduction in Outpatient Hemodialysis Centers Participating in a Collaborative Bloodstream Infection Prevention Effort

2016 ◽  
Vol 37 (7) ◽  
pp. 863-866 ◽  
Author(s):  
Sarah H. Yi ◽  
Alexander J. Kallen ◽  
Sally Hess ◽  
Virginia R. Bren ◽  
Mary E. Lincoln ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Bloodstream Infection ◽  
Infection Prevention ◽  
Infect Control Hosp ◽  
Current Analysis ◽  
Prevention Effort ◽  
Prevention Interventions ◽  
Infection Reduction ◽  
Dialysis Facilities

Among dialysis facilities participating in a bloodstream infection (BSI) prevention collaborative, access-related BSI incidence rate improvements observed immediately following implementation of a bundle of BSI prevention interventions were sustained for up to 4 years. Overall, BSI incidence remained unchanged from baseline in the current analysis.Infect Control Hosp Epidemiol 2016;37:863–866

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