scholarly journals Disinfection of Male Luer Style Connectors for Prevention of Catheter Related Bloodstream Infections Using an Isopropyl Alcohol Dispensing Cap

2010 ◽  
Vol 4 (2) ◽  
Author(s):  
James P. Kennedy ◽  
Richard A. Lasher ◽  
Donald Solomon ◽  
Robert W. Hitchcock
Keyword(s):  
Isopropyl Alcohol ◽  
Bacterial Colonization ◽  
Reaction Force ◽  
Bloodstream Infections ◽  
Bacterial Count ◽  
Positive Control ◽  
Test Apparatus ◽  
Two Phase ◽  
E Coli ◽  
Log Reduction

Bacterial colonization of needleless injection sites (NISs) frequently results in catheter related bloodstream infections (CRBSIs). Hospitals have instituted protocols aimed at disinfecting NIS prior to access. Furthermore, several manufactures have developed devices that facilitate disinfection of NIS. Despite these steps, the incidence of CRBSI is still alarmingly high. Currently, there is no protocol or device intended to disinfect male luer connectors such as those found on IV tubing that are commonly coupled and decoupled from the NISs. Since these IV tubing connectors directly contact the NIS (which have been repeatedly shown to have varying levels of bacterial colonization), it is highly likely that they, too, will have varying levels of contamination. In order for disinfection of the NIS to be effective, the IV tubing connector must also be disinfected. Our design goal was to develop a device that could be used to disinfect a male luer style connector without allowing antiseptic into the inner lumen of the male luer. We designed a three component system that utilizes a silicone sealing cone to seal the male luer, a reservoir foam that holds 70% isopropyl alcohol (IPA), and a reaction force foam that increases the seal pressure of the sealing cone while the reservoir foam is compressed delivering the IPA to the outside surface of the male luer post. Sealing cone geometry was optimized using a custom built seal pressure test apparatus. Reservoir and reaction force foam functional parameters were assessed using an Instron test apparatus. A two phase compression stroke was designed into the device to allow for sealing and dispensing of IPA. An IPA transfer test was used to assess the transfer of disinfectant from the reservoir foam to a liquid filled male luer connector (modeling an IV tubing connector). No disinfectant was found to be transferred from the device to the inner lumen of the IV tubing connector model (n=30). To test the efficacy of the device on reducing bacterial count on the male luer, a disinfection study was performed using the optimized device. Male luers were immersed in bacterial suspensions of S. aureus, S. epidermis, P. aerginosa, and E. coli. A 4 log reduction compared with a positive control was found in each sample treated with our disinfection cap (n=120). In conclusion, we developed a device that effectively delivers an antiseptic to a male luer style connector without leaking any antiseptic to the inner lumen of the luer post

An antimicrobial polycationic sand filter for water disinfection

2011 ◽  
Vol 63 (9) ◽  
pp. 1997-2003 ◽  
Author(s):  
Annalisa Onnis-Hayden ◽  
Bryan B. Hsu ◽  
Alexander M. Klibanov ◽  
April Z. Gu
Keyword(s):  
Treatment Plant ◽  
Antimicrobial Properties ◽  
Bacterial Count ◽  
Water Disinfection ◽  
Aqueous Sample ◽  
Secondary Effluent ◽  
E Coli ◽  
Log Reduction ◽  
Disinfection Process ◽  
Aqueous Effluent

A new sand filtration water disinfection technology is developed which relies on the antimicrobial properties of hydrophobic polycations (N-hexylated polyethylenimine) covalently attached to the sand's surface. The efficacy of the filter disinfection process was evaluated both with water spiked with E. coli and with real aqueous effluent from a wastewater treatment plant. For the former, over 7-log reduction in bacterial count was achieved. With real environmental wastewater secondary effluent samples, the E. coli concentration reduction declined to under 2 logs. This reduced inactivation efficiency compared to the model aqueous sample is likely due to the particulate or colloidal matter present that diminishes the contact between the immobilized polycation and the suspended bacteria. Preliminary sand washing methods were tested to assess potential ‘regeneration’ approaches. Potential advantages of the proposed approach over conventional disinfection in terms of eliminating harmful by-products and reducing energy consumption are discussed.

scholarly journals S100A12 and hBD2 Correlate with the Composition of the Fecal Microflora in ELBW Infants and Expansion ofE. coliIs Associated with NEC

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
A. C. Jenke ◽  
J. Postberg ◽  
B. Mariel ◽  
K. Hensel ◽  
D. Foell ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Bacterial Colonization ◽  
Bacterial Count ◽  
Antibiotic Use ◽  
Intestinal Microbiome ◽  
Extremely Low Birth Weight ◽  
Total Bacterial Count ◽  
Microbiota Composition ◽  
E Coli ◽  
Fecal Microflora

Objective. To describe the development of the gut microbiota in extremely low birth weight (ELBW) infants with and without necrotizing enterocolitis (NEC) between April 2008 and December 2009, fecal microflora was prospectively analyzed in fecal samples of all ELBW infants using real-time PCR assays. In addition, fecal inflammatory were measured.Results. Fecal microflora established early in ELBW infants and microbiota composition remained stable over the first 28 days of life except for the prevalence ofC. difficilewhich decreased with decreasing antibiotic use. Infants who subsequently developed NEC had an increase of total bacterial count (9.8-fold) 24 h prior to clinical symptoms mainly due to the expansion ofE. colispecies (21.6-fold), whereas microbiota composition did not differ from healthy ELBW infants five days before onset of NEC. Importantly, S100A12 and hBD2 positively correlated with the total andE. colibacterial CFU/g feces (r20.4 and 0.64, resp.).Conclusions. In summary, we found evidence for a disturbed homeostasis between the intestinal microbiome and host immunity in ELBW infants with NEC. Moreover, S100A12 and hBD2 correlate with the fecal microbiota thus linking the intestinal innate immune response to the bacterial colonization thus possibly providing a diagnostic tool in the future.

Effect of UV Light on Disinfection of Peritoneal Dialysis Catheter Connections

2017 ◽  
Vol 37 (1) ◽  
pp. 109-111 ◽  
Author(s):  
John Ashley ◽  
Julia A. Rasooly ◽  
Ian Tran ◽  
Lawrence E. Yost ◽  
Glenn M. Chertow
Keyword(s):  
Peritoneal Dialysis ◽  
Uv Light ◽  
Positive Control ◽  
Solution Set ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
E Coli ◽  
Log Reduction ◽  
Transfer Catheter ◽  
Positive Controls

We evaluated the microbiological performance of an ultraviolet (UV) light-based peritoneal dialysis catheter connection system. The system includes a UV light-generating device combined with a UV transmissive window incorporated into the transfer set. Each UV transparent transfer set was inoculated with 10 μL of cultured inoculum consisting of either S. aureus, E. coli, or C. albicans. After being inoculated, we attached a solution set connector to the transfer catheter, and exposed that connection to a UV light dose of approximately 340 mJoules/cm2. After exposure to UV light, we broke the seal of the solution set and opened the plunger valve on the UV transmissive transfer catheter. We then flushed 10 mL of dialysate through the connection. The flushed solution was collected, diluted, plated on agar medium, and incubated for 24 hours. Results were compared to positive controls collected in an identical manner without exposure to UV light. Thirty test samples and 3 positive controls were collected for each organism. All test samples exposed to UV light had complete kill of bacteria except 1 colony on a single plate in the S. aureus group. Mean log reduction was 4.03 for C. albicans, 4.73 for S. aureus, and 5.29 for E. coli. All positive control samples had significant bacterial growth. Our results demonstrate that the application of UV light within a UV transmissive transfer catheter window produces a germicidal effect upon microorganisms known to be associated with peritonitis.

Bloodstream Infections in Hematological Cancer Patients Colonized By Multiresistant Bacteria: Results of a Multicentric Prospective Observational Seifem Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1023-1023
Author(s):  
Chiara Cattaneo ◽  
Roberta Di Blasi ◽  
Crisitina Skert ◽  
Anna Candoni ◽  
Marco Picardi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Cancer Patients ◽  
Antibiotic Treatment ◽  
Bacterial Colonization ◽  
Bloodstream Infections ◽  
Considerable Proportion ◽  
Hematological Cancer ◽  
E Coli ◽  
Multiresistant Bacteria

Abstract Introduction. Incidence and mortality due to multiresistant (MR) bloodstream infections (BSI) are increasing in the last years among hematological patients (pts). Also rate of MR colonization seems to be relevant, but few data are available on the actual incidence of MR colonization and the probability of developing a BSI in hematological pts. In order to evaluate the incidence of MR bacterial colonization and the probability of developing MR BSI in hematological pts, we carried out a multicentric prospective observational study within the SEIFEM group. Patients and Methods. Since March 1st 2015, all cancer patients were screened at least for rectal swab at admission in 11 Hematology Centres participating to SEIFEM; culture of other sites were performed if clinically indicated. Patients showing MR bacterial colonization were recorded in a database where the occurrence of any BSI was correlated with age, gender, type and phase of haematological disease, stem cell transplantation (SCT), presence of invasive devices, type of colonizing bacteria. Results. During a 3-month period (March 1st -May 31st 2015), 75 pts with MR colonization were observed. Incidence was 9.8% among all admitted pts (75/764). Median age was 61y (range 20-81) and M/F ratio 46/29. Thirty-three pts were affected by acute leukemia (AL), 30 by lymphoma (Ly), 10 by myeloma (MM), 1 by myelofibrosis and 1 by aplastic anemia. Nineteen pts underwent SCT during the period of observation (11 autologous and 8 allogeneic, respectively). Vancomycin resistant enterococci (VRE) were responsible for colonization in 6 (8%) pts, extended spectrum β-lactamases producing (ESBL) enterobacteria in 29 (38.8%) and carbapenemase producing (CP) Gram-Negative Rods (GNR) in 49 (65.3%). Seven pts showed multiple colonizations. In 8 cases colonizing enterobacteria (6 E. coli, 1 E. cloacae, 1 P. mirabilis) were both ESBL and carbapenemase producers. Rectum was the most frequent site of colonization (70.7%). No risk factor for type of colonizing bacteria emerged except for previous intensive care unit stay for CP GNR colonization (p=0.02, chi-square test). Overall, 15 (20%) pts colonized with MR bacteria developed BSI by the same pathogen (MR related BSI) (1 VRE, 5 ESBL producing E. coli, 5 CP K. pneumoniae, 2 CP P. aeruginosa and 2 CP Acinetobacter spp). Therefore, rate of related BSI according to type of antibiotic resistance was 16.7% for VRE colonization, 17.2% for ESBL producing enterobacteria and 18.4% for CP GNR, respectively. Among CP enterobacteria, K. pneumoniae, but not other enterobacteria, was predictive of related BSI (25%). All but 2 related BSI occurred during neutropenia. At multivariate analysis, previous cephalosporin treatment was associated to related BSI (OR 0.25 [CI 0.07-0.91], p=0.03). Unrelated BSI were also observed in 15 pts (20%), including 3 MR BSI (2 CP P. aeruginosa and 1 CP K. pneumoniae). After a median follow-up of 61 days (range 30-116), 9 pts died (12%). Death was attributable to CP GNR related BSI in 3 pts. Multivariate analysis showed that CP GNR related BSI (OR 6.1, CI 1-36.2, p=0.04), together with a relapsed/refractory hematological disease (OR 10, CI 1.5-66.4, p=0.02) and presence of urinary catheter (OR 9.1, CI 1.3-62.1, p=0.02), was an independent predictor variable for death. Conclusions. Incidence of MR colonizing bacteria, particularly CP GNR, is quite high among hematological cancer pts and is associated with related BSI in a considerable proportion of them. Unrelated MR BSI may also occur. Previous antibiotic treatment with cephalosporins is a risk factor for MR related BSI and CP related BSI are predictive of death. Empiric antibiotic treatment should be planned taking into account these results. Disclosures No relevant conflicts of interest to declare.

scholarly journals Soluble Expression and Efficient Purification of Recombinant Class I Hydrophobin DewA

2021 ◽  
Vol 22 (15) ◽  
pp. 7843
Author(s):  
Sang-Oh Ahn ◽  
Ho-Dong Lim ◽  
Sung-Hwan You ◽  
Dae-Eun Cheong ◽  
Geun-Joong Kim
Keyword(s):  
Tertiary Structure ◽  
Signal Sequence ◽  
Soluble Expression ◽  
Class I ◽  
Soluble Form ◽  
Two Phase ◽  
E Coli ◽  
Small Proteins ◽  
Industrial Use ◽  
Shed Light

Hydrophobins are small proteins (<20 kDa) with an amphipathic tertiary structure that are secreted by various filamentous fungi. Their amphipathic properties provide surfactant-like activity, leading to the formation of robust amphipathic layers at hydrophilic–hydrophobic interfaces, which make them useful for a wide variety of industrial fields spanning protein immobilization to surface functionalization. However, the industrial use of recombinant hydrophobins has been hampered due to low yield from inclusion bodies owing to the complicated process, including an auxiliary refolding step. Herein, we report the soluble expression of a recombinant class I hydrophobin DewA originating from Aspergillus nidulans, and its efficient purification from recombinant Escherichia coli. Soluble expression of the recombinant hydrophobin DewA was achieved by a tagging strategy using a systematically designed expression tag (ramp tag) that was fused to the N-terminus of DewA lacking the innate signal sequence. Highly expressed recombinant hydrophobin DewA in a soluble form was efficiently purified by a modified aqueous two-phase separation technique using isopropyl alcohol. Our approach for expression and purification of the recombinant hydrophobin DewA in E. coli shed light on the industrial production of hydrophobins from prokaryotic hosts.

scholarly journals A Decade in Trying to Increase Hand Hygiene—Finally Success

2020 ◽  
Vol 41 (S1) ◽  
pp. s93-s94
Author(s):  
Linda Huddleston ◽  
Sheila Bennett ◽  
Christopher Hermann
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Second Phase ◽  
Two Phase ◽  
Hygiene Compliance ◽  
Tract Infections ◽  
The Voice

Background: Over the past 10 years, a rural health system has tried 10 different interventions to reduce hospital-associated infections (HAIs), and only 1 intervention has led to a reduction in HAIs. Reducing HAIs is a goal of nearly all hospitals, and improper hand hygiene is widely accepted as the main cause of HAIs. Even so, improving hand hygiene compliance is a challenge. Methods: Our facility implemented a two-phase longitudinal study to utilize an electronic hand hygiene reminder system to reduce HAIs. In the first phase, we implemented an intervention in 2 high-risk clinical units. The second phase of the study consisted of expanding the system to 3 additional clinical areas that had a lower incidence of HAIs. The hand hygiene baseline was established at 45% for these units prior to the voice reminder being turned on. Results: The system gathered baseline data prior to being turned on, and our average hand hygiene compliance rate was 49%. Once the voice reminder was turned on, hand hygiene improved nearly 35% within 6 months. During the first phase, there was a statistically significant 62% reduction in the average number of HAIs (catheter associated urinary tract infections (CAUTI), central-line–acquired bloodstream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant organisms (MDROs), and Clostridiodes difficile experienced in the preliminary units, comparing 12 months prior to 12 months after turning on the voice reminder. In the second phase, hand hygiene compliance increased to >65% in the following 6 months. During the second phase, all HAIs fell by a statistically significant 60%. This was determined by comparing the HAI rates 6 months prior to the voice reminder being turned on to 6 months after the voice reminder was turned on. Conclusions: The HAI data from both phases were aggregated, and there was a statistically significant reduction in MDROs by 90%, CAUTIs by 60%, and C. difficile by 64%. This resulted in annual savings >$1 million in direct costs of nonreimbursed HAIs.Funding: NoneDisclosures: None

scholarly journals POS0384 A NOVEL MECHANISM LINKING MUCOSAL BACTERIA WITH AUTOANTIBODY RESPONSES IN RA: ACETYLATED BACTERIAL LYSATE AS A MODEL ANTIGEN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 422.1-422
Author(s):  
M. Volkov ◽  
A. S. B. Kampstra ◽  
K. van Schie ◽  
J. Kwekkeboom ◽  
T. Huizinga ◽  
...  
Keyword(s):  
B Cells ◽  
Cell Activation ◽  
Positive Control ◽  
Negative Control ◽  
B Cell Activation ◽  
Human Fibrinogen ◽  
Post Translational Modifications ◽  
E Coli ◽  
Bacterial Proteins ◽  
Citrullinated Proteins

Background:Rheumatoid arthritis (RA) is characterized by autoantibodies against post-translationally modified proteins (AMPA) such as citrullinated, carbamylated and acetylated proteins. Importantly, these antibodies are highly multireactive, as they often recognize more than one of these post-translational modifications. Despite extensive research, the antigens inducing the breach of tolerance remain unknown, although microbial antigens are often suspected. Various bacteria are known to be capable of acetylation, therefore, it is intriguing to know what mechanisms can underlie the breach of tolerance towards acetylated proteins and development of anti-acetylated protein antibodies (AAPA).Objectives:To investigate whether acetylated proteins of bacterial origin (1) are recognized by human derived AMPA and AMPA expressing B cells; and (2) can induce AMPA development when used to immunize mice.Methods:Acetylated E. coli proteins were acquired with two separate methods (Figure 1A): by culturing E. coli in a condition promoting auto-acetylation (intrinsically acetylated bacterial proteins, IABP), or by directly acetylating lysate-derived proteins via a chemical reaction (extrinsically acetylated BP, EABP). Acetylated ovalbumin (AcOVA) served as positive control for AAPA induction in mice, non-acetylated BP (NABP) and phosphate buffer saline (PBS) served as negative control. Mice were immunized with these proteins and the resulting antibody response was studied by ELISA. Furthermore, EABP/IABP/NABP were investigated for recognition by human-derived AAPA with ELISA and AAPA-expressing B cells with spleen tyrosine kinase (Syk) phosphorylation assay; acetylated human fibrinogen and native fibrinogen served as positive and negative control.Results:Repetitive immunization of mice with EABP resulted in an AMPA response recognizing acetylated, carbamylated and citrullinated proteins. AMPA titers in these mice exceeded the titers in the positive control mice immunized with AcOVA and were substantially higher than in the NABP-immunized mice (Figure 1B). Human-derived monoclonal AAPA recognized EABP and IABP (not shown). B cell activation (measured by Syk phosphorylation) assay indicated that AAPA expressing B cells recognized EABP and (to a lesser extent) IABP, but not NABP (Figure 1C).Conclusion:Acetylated bacterial proteins are potent antigens that can induce cross-reactive AMPA responses in mice and they are recognized by human AAPA. This suggests that acetylated bacterial proteins could possibly be involved in the breach of tolerance in RA.Acknowledgements:We thank Dr. Can Araman and Prof. Chunaram Choudhary for their advice regarding optimization of bacterial auto-acetylation.Disclosure of Interests:None declared

scholarly journals 1576. Re-Evaluation of cefepime or piperacillin-tazobactam to Decrease Use of Carbapenems in ESBL-Producing Enterobacterales BloodStream Infections (REDUCE-BSI)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S786-S787
Author(s):  
Catherine H Vu ◽  
Veena Venugopalan ◽  
Barbara A Santevecchi ◽  
Stacy A Voils ◽  
Kartikeya Cherabuddi ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Bloodstream Infections ◽  
Causative Organism ◽  
E Coli ◽  
Development Of Resistance ◽  
Baseline Characteristics ◽  
Secondary Outcomes ◽  
Klebsiella Spp ◽  
Decrease Use ◽  
Infection Recurrence

Abstract Background The ideal therapy for treatment of bloodstream infections (BSI) due to ESBL-producing organisms is widely debated. Although prior studies have demonstrated efficacy of non-carbapenems (CBPNs) for ESBL infections, results from the MERINO study group found increased mortality associated with piperacillin/tazobactam (PT) when compared with meropenem for treatment of ESBL BSI. The goal of this study was to investigate patient outcomes associated with the use of CBPN-sparing therapies (PT and cefepime (CEF)) for ESBL BSI. The primary outcome was in-hospital mortality between non-CBPN (PT and CEF) and CBPN groups. Secondary outcomes included clinical cure, microbiologic cure, infection recurrence, and development of resistance. Methods This was a retrospective observational study of patients admitted to the hospital from May 2016 - May 2019 with a positive blood culture for an ESBL-producing organism. Patients receiving meropenem, ertapenem, PT, or CEF were included. Patients were excluded if &lt; 18 years old, receiving antibiotics for &lt; 24 hours, treated for a polymicrobial BSI, or receiving concomitant antibiotic therapy for another gram-negative (non-ESBL) infection. Results One hundred and fourteen patients were analyzed; 74 (65%) patients received CBPN therapy compared with 40 (35%) patients that received a non-CBPN (CEF N=30, PT N=10). There were no statistically significant differences in baseline characteristics between groups. The overall in-hospital mortality rate was 6% (N=7). Eight percent of patients (N=6) in the CBPN arm died compared to 3% (N=1) of patients in the non-CBPN arm, P = 0.42. No difference in mortality was detected between groups when evaluating subgroups with Pitt bacteremia score ≥4 (N=25), requiring ICU admission (N=50), non-genitourinary source (N=50), or by causative organism (N=76 E. coli; N=38 Klebsiella spp.). There was no difference between groups for secondary outcomes. Conclusion CEF and PT are reasonable options for the treatment of ESBL BSI and did not result in increased mortality or decreased clinical efficacy when compared to CBPNs in this cohort. Disclosures All Authors: No reported disclosures

PCR for the Specific Detection of an Escherichia coli O157:H7 Laboratory Control Strain

2015 ◽  
Vol 78 (9) ◽  
pp. 1738-1744 ◽  
Author(s):  
MICHAEL KNOWLES ◽  
DOMINIC LAMBERT ◽  
GEORGE HUSZCZYNSKI ◽  
MARTINE GAUTHIER ◽  
BURTON W. BLAIS
Keyword(s):  
Escherichia Coli ◽  
Pathogenic Bacteria ◽  
Control Measure ◽  
Positive Control ◽  
Food Microbiology ◽  
Escherichia Coli O157 ◽  
Control Strain ◽  
E Coli ◽  
Signature Sequences ◽  
Materials Used

Control strains of bacterial pathogens such as Escherichia coli O157:H7 are commonly processed in parallel with test samples in food microbiology laboratories as a quality control measure to assure the satisfactory performance of materials used in the analytical procedure. Before positive findings can be reported for risk management purposes, analysts must have a means of verifying that pathogenic bacteria (e.g., E. coli O157:H7) recovered from test samples are not due to inadvertent contamination with the control strain routinely handled in the laboratory environment. Here, we report on the application of an in-house bioinformatic pipeline for the identification of unique genomic signature sequences in the development of specific oligonucleotide primers enabling the identification of a common positive control strain, E. coli O157:H7 (ATCC 35150), using a simple PCR procedure.

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