scholarly journals Diagnostic Accuracy of BD Phoenix CPO Detect for Carbapenemase Production in 190 Enterobacteriaceae Isolates

2018 ◽  
Vol 56 (12) ◽  
Author(s):  
Chiou Horng Ong ◽  
Lasantha Ratnayake ◽  
Michelle L. T. Ang ◽  
Raymond Tzer Pin Lin ◽  
Douglas Su Gin Chan
Keyword(s):  
Confidence Interval ◽  
Infection Control ◽  
Diagnostic Accuracy ◽  
Positive Result ◽  
Sensitivity And Specificity ◽  
Patient Management ◽  
Susceptibility Testing ◽  
Control Measures ◽  
Content Type ◽  
Infection Control Measures

ABSTRACT The rapid and accurate detection of carbapenemase-producing Enterobacteriaceae (CPE) is necessary for patient management and infection control measures. We compared the performance of the BD Phoenix CPO Detect with that of a homemade Carba NP assay and a modified carbapenem inactivation method (mCIM) by challenging all 3 assays with 190 isolates of Enterobacteriaceae with meropenem MICs of >0.125 mg/liter. A total of 160 isolates produced KPC-, IMI-1-, NDM-, IMP-, and OXA-type carbapenemases, while 30 isolates were negative for carbapenemase production. The sensitivity and specificity were 90.6% (95% confidence interval [CI], 85.0% to 94.7%) and 100.0% (95% CI, 88.4% to 100.0%), respectively, for the Carba NP; 100.0% (95% CI, 97.7% to 100.0%) and 96.7% (95% CI, 82.7% to 99.9%), respectively, for the mCIM; and 89.4% (95% CI, 83.5% to 93.7%) and 66.7% (95% CI, 47.2% to 82.7%), respectively, for the BD Phoenix CPO Detect. In particular, the BD CPO Detect failed to detect a significant number of CPE with IMI-1. While the BD Phoenix CPO Detect is able to classify carbapenemases and is built into routine susceptibility testing with the potential to reduce the time to CPE detection, its low specificity means that a positive result will need confirmatory testing by another method.

scholarly journals Evaluation of the Liat Cdiff Assay for Direct Detection of Clostridioides difficile Toxin Genes within 20 Minutes

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
David J. Hetem ◽  
Ingrid Bos-Sanders ◽  
Roel H. T. Nijhuis ◽  
Sven Tamminga ◽  
Livia Berlinger ◽  
...  
Keyword(s):  
Infection Control ◽  
Direct Detection ◽  
Point Of Care ◽  
Reference Method ◽  
Turnaround Time ◽  
Control Measures ◽  
Content Type ◽  
Infection Control Measures ◽  
Clostridioides Difficile ◽  
The Difference

ABSTRACT Clostridioides difficile is the main causative agent of antibiotic-associated diarrhea. Prompt diagnosis is required for initiation of timely infection control measures and appropriate adjustment of antibiotic treatment. The cobas Cdiff assay for use on the cobas Liat system enables a diagnostic result in 20 minutes. A total of 252 prospective (n = 150) and retrospective (n = 102) stool specimens from The Netherlands, France, and Switzerland were tested on the cobas Cdiff assay using the Xpert C. difficile assay as a reference method. The overall positive and negative percent agreement (PPA and NPA, respectively) of the cobas Cdiff assay compared with the Xpert C. difficile assay was 98.0% (100/102; 95% confidence interval [CI], 93.1% to 99.5%) and 94.0% (141/150; 95% CI, 89.0% to 96.8%), respectively. When comparing the PPAs of cobas Cdiff and Xpert C. difficile with culture, the results were 91.7% (55/60; 95% CI, 81.9% to 96.4%) and 85.0% (51/60; 95% CI, 73.9% to 91.9%), respectively. The difference was not statistically significant. The cobas Cdiff assay offers a very rapid alternative for diagnosing C. difficile infection. The 20-minute turnaround time provides the potential for point-of-care testing so that adequate infection control measures can be initiated promptly.

scholarly journals Transmissible Spongiform Encephalopathies: An Underrecognized Infection Control Issue

2020 ◽  
Vol 41 (S1) ◽  
pp. s82-s82
Author(s):  
Christina Kaul ◽  
Aradhana Khameraj ◽  
Prashant Malhotra ◽  
Bruce Farber
Keyword(s):  
Infection Control ◽  
Positive Result ◽  
Lumbar Puncture ◽  
Control Measures ◽  
Transmissible Spongiform Encephalopathies ◽  
Progressive Dementia ◽  
Spongiform Encephalopathies ◽  
Abnormal Protein ◽  
Infection Control Measures ◽  
Jakob Disease

Background: Transmissible spongiform encephalopathies comprise a class of rapidly progressive and inevitably fatal degenerative brain disorders. The pathogenesis of these diseases is thought to be due to a change in the structure of the normal prion protein to an abnormal structure, leading to propagation of the abnormal protein. This abnormal protein is highly transmissible; thus, appropriate infection control measures should be put in place if the diagnosis is suspected. However, the diagnosis is often not considered at all, and many hospitals do not have protocols in place. Our hospital missed a case of familial fatal insomnia in a 45-year-old male. He was diagnosed with fatal familial insomnia by autopsy. The autopsy was performed without appropriate infection control measures, leading to costly contamination of medical instruments and exposure of multiple staff. This occurrence led our institution to re-evaluate hospital protocols and guidelines regarding workup and management of transmissible spongiform encephalopathies (TSEs). Methods: We reviewed cases of TSEs or Creutzfeldt-Jakob Disease (CJD)-like illness presenting to our hospital over a 30-month period. Patients were considered for inclusion based on clinical suspicion. CDC diagnostic criteria were used. Infection control measures were employed, including an alert in the EMR. MRI was then performed. If clinical or diagnostic suspicion was high, the patient underwent lumbar puncture. CSF results were reviewed based on criteria Creutzfeldt-Jakob Disease Foundation criteria. Infection control measures were maintained throughout hospitalization. Results: In total, 34 patients met the inclusion criteria: 8 patients had confirmed CJD and 25 were negative. Medical records were not available for 1 patient, who was excluded. Lumbar puncture was performed on all suspected cases. Of those confirmed cases, the 7 patients who underwent lumber puncture had a positive result for 14-3-3 protein. Also, 5 patients underwent RT-QuIC testing and were found to have a positive result. No further cases of contamination occurred using our protocol. Additionally, 1 patient with suspected CJD underwent a brain biopsy with appropriate precautions after an inconclusive lumbar puncture. Although biospy was negative, the case exemplifies how the initiation of a protocol can optimize the workflow and prevent potentially dangerous exposure. Conclusion: Diagnosis of TSEs remains difficult and is often missed. In our case, lack of suspicion for TSE led to a waste of resources and unnecessary exposure of staff member. It is of utmost importance to consider TSEs in rapidly progressive dementia and to employ appropriate sterile guidelines to prevent contamination of equipment and potential subsequent transmission. Healthcare providers should consider a similar protocol in cases suspicious for TSEs.Funding: NoneDisclosures: None

scholarly journals Whole-Genome Sequencing Elucidates Epidemiology of Nosocomial Clusters of Acinetobacter baumannii

2016 ◽  
Vol 54 (9) ◽  
pp. 2391-2394 ◽  
Author(s):  
Stefanie Willems ◽  
Stefanie Kampmeier ◽  
Stefan Bletz ◽  
Annelene Kossow ◽  
Robin Köck ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Acinetobacter Baumannii ◽  
Genome Sequencing ◽  
Core Genome ◽  
Control Measures ◽  
Whole Genome ◽  
Content Type ◽  
Infection Control Measures ◽  
Clonal Spread

We characterized two epidemiologically similarAcinetobacter baumanniiclusters from two separate intensive care units (ICU) using core genome multilocus sequence typing. Clonal spread was confirmed in ICU-1 (12 of 14 isolates shared genotypes); in ICU-2, all genotypes (13 isolates) were diverse, thus excluding transmissions and enabling adequate infection control measures.

Development of Mupirocin Resistance Among Methicillin-ResistantStaphylococcus aureusAfter Widespread Use of Nasal Mupirocin Ointment

1996 ◽  
Vol 17 (12) ◽  
pp. 811-813 ◽  
Author(s):  
Mark A. Miller ◽  
Andre Dascal ◽  
Joseph Portnoy ◽  
Jack Mendelson
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Teaching Hospital ◽  
Susceptibility Testing ◽  
Control Measures ◽  
Infection Control Measures ◽  
Nasal Mupirocin ◽  
Mupirocin Resistance ◽  
Mupirocin Ointment ◽  
Mrsa Strains

AbstractAll methicillin-resistantStaphylococcus aureus(MRSA) strains isolated from colonized or infected patients in a 625-bed public teaching hospital during an epidemic, and for 3 years thereafter, underwent susceptibility testing to mupirocin. Mupirocin resistance among MRSA increased markedly over this period (1990, 2.7%; 1991, 8.0%; 1992, 61.5%; 1993, 65%) in association with increased use of mupirocin ointment as an adjunct to infection control measures.

scholarly journals Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals

2020 ◽  
Author(s):  
Jonathan Remppis ◽  
Tina Ganzenmueller ◽  
Malte Kohns Vasconcelos ◽  
Oliver Heinzel ◽  
Rupert Handgretinger ◽  
...  
Keyword(s):  
Infection Control ◽  
Patient Management ◽  
Tertiary Care ◽  
Control Measures ◽  
Severe Illness ◽  
Mild Disease ◽  
Infection Control Measures ◽  
Paediatric Patients ◽  
Risk Patients ◽  
Healthcare Associated

Abstract PURPOSE: To describe infection control measures and patient management at a tertiary children’s hospital in southern Germany during the COVID-19 pandemic.METHODS: Prospective, observational study of infection control measures, patient management, clinical and virologic data of paediatric patients treated at our hospital during the COVID-19 pandemic from February to May 2020. Infection control measures were documented beginning with preparation for the pandemic. All paediatric patients with suspected SARS-CoV-2 infection were prospectively included in the study.RESULTS: With local triage, restraint of patient admission and testing strategies implemented, healthcare capacity remained adequate and no healthcare-associated infections occurred. Workload in the paediatric emergency department significantly decreased following the lockdown of schools and kindergartens. 7 of 174 (4%) children with and 2 of 208 (1%) children without typical symptoms, respectively, were diagnosed with COVID-19 by PCR. Six out of nine inpatients treated for COVID-19 had underlying comorbidities, two were admitted to the intensive care unit. One patient died shortly after discharge.CONCLUSIONS: While COVID-19 generally causes mild disease in children, severe illness and fatal cases may occur, particularly among children with underlying diseases. Tertiary children’s hospitals may face challenges with treating potential high-risk patients during the pandemic. Thus, timely establishment of effective testing and triage strategies is crucial.

scholarly journals Hospital transmission of borderline oxacillin-resistant Staphylococcus aureus evaluated by whole-genome sequencing

2021 ◽  
Vol 70 (7) ◽  
Author(s):  
Maria M. Konstantinovski ◽  
Karin Ellen Veldkamp ◽  
Adriana P. M. Lavrijsen ◽  
Thijs Bosch ◽  
Margriet E. M. Kraakman ◽  
...  
Keyword(s):  
Infection Control ◽  
Type Species ◽  
Clinical Manifestations ◽  
Control Measures ◽  
Whole Genome ◽  
Skin Infections ◽  
Content Type ◽  
Link Type ◽  
Infection Control Measures ◽  
Risk Patients

Introduction. Staphylococcus aureus is a major cause of hospital infections worldwide. Awareness towards methicillin-resistant S. aureus (MRSA) infections is high but attention towards borderline oxacillin-resistant S. aureus (BORSA) is limited, possibly due to an underestimated clinical relevance, presumption of low incidence and diagnostic limitations. Gap statement. BORSA surveillance has not been routinely implemented, and thus consensus with regard to a definition and infection control measures is lacking. Aim. Our goals were to investigate the occurrence, molecular characteristics and clinical manifestations of BORSA infections in the hospital setting. Methodology. Following an increased incidence in 2016, BORSA cases in 2014/2016 (in our institution) were more specifically evaluated. Medical records were reviewed to investigate epidemiological links, clinical characteristics and outcomes. Resistance and virulence markers were assessed by whole genome sequencing (WGS). Conventional methods: amplified fragment length polymorphism (AFLP) ; multilocus sequence typing (MLST) and multiple locus variable-number tandem repeat analysis (MLVA) were compared with core genome MLST (cgMLST) and whole-genome single nucleotide polymorphism (wgSNP) analysis to confirm genetic clusters. Results. From 2009 to 2013, BORSA comprised 0.1 % of all clinical S. aureus strains. In 2016, the incidence was six-fold higher in comparison to the baseline. Whole-genome SNP and cgMLST confirmed two BORSA clusters among patients with dermatological conditions. Patients with BORSA presented with skin infections, and one case developed a severe invasive infection with a fatal outcome. Infection control measures successfully prevented further transmission in both clusters. WGS findings showed that BORSA strains carried multiple resistance and virulence genes with increased pathogenic potential. Conclusion. WGS and cgMLST effectively characterized and confirmed BORSA clusters among at-risk patients with clinical manifestations ranging from mild skin infections to life-threatening bacteraemia. Clinical awareness and active monitoring are therefore warranted for the timely implementation of infection control measures to prevent BORSA transmission in high-risk patients.

Eye in COVID-19: A Brief Review

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Mohsin Ali ◽  
Qudsia Anwar Dar ◽  
Zahid Kamal ◽  
Alishba Khan
Keyword(s):  
Infection Control ◽  
Respiratory Symptoms ◽  
Literature Search ◽  
Control Measures ◽  
Transmission Route ◽  
Ocular Manifestation ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Ocular Manifestations ◽  
Infection Control Measures

This is a brief review covering the currently available literature on ocular manifestations of COVID-19, andprevention strategies for ophthalmologists. A literature search was carried out of Pubmed, Google Scholar andWHO database of publications on COVID. Keywords used in the search were eye, ocular manifestations,ophthalmology, COVID-19, nCoV-2019, and coronavirus disease. All available articles were reviewed and thosepertinent to the study topic were included. Considering the dearth of information available, ophthalmology journals were also searched separately for relevant articles. Major ocular manifestation of COVID reported in literature is red eye, which usually presents before the onset of respiratory symptoms. Since the eye can be a possible transmission route for SARS-CoV-2, infection control measures should be undertaken by ophthalmologists, including use of personal protection equipment and eye/face covering. A framework for structuring ophthalmological services during the COVID pandemic is also presented in this review.

scholarly journals Estimating the consequences of a COVID-19 super spreader: A stochastic model of a night on the town

2021 ◽  
pp. 140349482110314
Author(s):  
Nils Henrik Kolnes ◽  
Snorre Nilsen Eikeland ◽  
Tor Albert Ersdal ◽  
Geir Sverre Braut
Keyword(s):  
Infection Control ◽  
Stochastic Model ◽  
Control Measures ◽  
Social Distancing ◽  
Infection Control Measures ◽  
Local Municipality ◽  
The Town

A stochastic model estimated the consequences of a COVID-19 super spreader event occurring in the local municipality of Stavanger, Norway as a result of a night on the town. The model imposed different infection control regulations and compared these different scenarios. For Stavanger’s 161 locations of service, secondary transmissions from a super spreader event was estimated to infect a median of 37, requiring the quarantining of 200 guests given no infection control regulations, 23 and 167 when imposing social distancing regulations and other hygienic infection control measures, 7 infected and 63 quarantined guests with restrictions placed on the guest capacity, and 4 infected and 57 quarantined guests with both forms of restriction in use.

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