Stenotrophomonas maltophilia causing blood stream infection in neonates and infants: a cause for concern

2017 ◽  
Vol 48 (3) ◽  
pp. 227-229 ◽  
Author(s):  
Rinku Sah ◽  
Shraddha Siwakoti ◽  
Ratna Baral ◽  
Rupa S Rajbhandari ◽  
Basuda Khanal
Keyword(s):  
Infection Control ◽  
Stenotrophomonas Maltophilia ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Infection Control Team ◽  
Infection Control Measures ◽  
Hospital Infection Control ◽  
Neonates And Infants

Stenotrophomonas maltophilia ( S. maltophilia) is an important Gram-negative, non-fermentative, multidrug resistant (MDR) nosocomial organism. We evaluated the isolation of S. maltophilia from the seven blood culture specimens received from the Paediatric Emergency Department (PED) of BP Koirala Institute of Health Sciences (BPKIHS) over the duration of two weeks. The suspicion of a possible outbreak was raised and the hospital infection control team investigated the source and found the hand of one healthcare provider harbouring a similar organism. All six steps of hand hygiene were subsequently strictly enforced after which the same bacteria were no longer isolated. Infection control measures should be rigorously adopted for the control of such nosocomial bacteria.

scholarly journals Epidemiological analysis of Elizabethkingia meningoseptica infection cluster among mechanically ventilated pediatric intensive care patients

2018 ◽  
Vol 5 (8) ◽  
pp. 3212 ◽  
Author(s):  
Wafaa Seddik Hamza ◽  
Samar Saeed Morsi ◽  
Ebtehal Saleh Al Roomi ◽  
Vincent Olubunmi Rotimi
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Blood Stream Infection ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Control Measures ◽  
Mechanically Ventilated ◽  
Infection Control Measures ◽  
Elizabethkingia Meningoseptica ◽  
Healthcare Associated

Background: Elizabethkingia meningoseptica is frequently found in hospital environments and usually associated with healthcare-associated infections (HAIs), particularly in patients in the intensive care units (ICU). The current study report an outbreak of E. meningoseptica infection/colonization in the pediatric intensive care unit, highlighted the infection control methods used to stem the spread.Methods: During a period of 7 months, May-November 2015, 4 patients were infected/ colonized by E. meningoseptica. Infection control measures were re-emphasized after each case and environmental swabs were cultured to detect possible source. Follow up for 25 months to ensure eradication of the pathogen.Results: Four patients were colonized/ infected with E. meningoseptica, their mean age 22 months. The average time patients spent in ICU between admission and isolation of E. meningoseptica was 27.5±19.2 days. All patients were mechanically ventilated. 25% E. meningoseptica isolated from blood causing healthcare associated Central Line Associated Blood Stream Infection (CLABSI) while it was isolated from endotracheal tube (ETT) secretion in 75% as healthcare associated colonization. The 4 isolates confirmed as identical using pulsed field gel electrophoresis (PFGE).Conclusions: Intensive infection control measures including healthcare workers education, emphasizing hand hygiene, comprehensive cleaning and disinfection of equipment and the environment are important to eradicate the bacterium.

Early Cessation of a Vancomycin-Resistant Enterococci (VRE) Outbreak in a Hematology-Oncology Department after Implementation of an Enhanced Infection Control Intervention. A Single Center Experience.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2209-2209
Author(s):  
Andrew J. Ullmann ◽  
Thomas Fischer ◽  
Bernd Jansen ◽  
Christoph Huber
Keyword(s):  
Infection Control ◽  
Outpatient Clinic ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Control Measures ◽  
Single Patient ◽  
Contact Precautions ◽  
Single Center Experience ◽  
Infection Control Measures ◽  
Admission Policies

Abstract Introduction: Worldwide, the incidence of nosocomial outbreaks of VRE has increased especially in high-risk patients such as hematology-oncology patients. Outbreaks reported so far, required a minimum of three months to be controlled. Such outbreaks have a serious impact on daily care and treatment of the patients and hospital economics. Patients and Methods: We describe the outcome of a VRE-outbreak in a department with 48 beds (fourteen 2-patient rooms, and 20 single-patient rooms) including allogeneic BMT. Epidemiological evaluation was initiated after two patients in the department for the first time had a blood stream infection (BSI) with VRE within one week. Two goals had to be achieved immediately: 1) Assessment of the outbreak and 2) Implementation of enhanced infection control measures. Screening of all inpatients on a weekly basis became mandatory (stool sample or rectal swab). All patients, regardless of their status, received a single-patient room and had their own assigned restroom. Therefore an additional ward had to be opened. The patients and staff were re-trained in hygiene rules and contact precautions. Positive VRE-tested patients were cohorted in one ward. In addition, spot screening was performed in the outpatient clinic. Due to a low number of restroom facilities and patient rooms, the outpatient clinic was closed for new admissions and reopened within 6 weeks at a new site with improved facilities and more patient rooms. Antibiotic usage was reviewed. Utilization of glycopeptides and cephalosporins was decreased. Pulsed-field gel electrophoresis (PFGE) was performed on all isolates. The outbreak was actively discussed in the local newspapers and television to inform the public of the situation. Results: This is the largest VRE-outbreak in a hematology-oncology department reported to date. Four-hundred-seventy-five patients were evaluated and 1246 tests were performed, resulting in a mean test frequency of 2.6 tests per patient. In this patient population, 34 VRE-colonized patients were identified, 18 within the first 4 weeks of screening. From January through April 2004, a total of 31 VRE-colonized patients were detected. Two additional VRE-BSI occurred. All patients with VRE-BSI were treated successfully with linezolid. PFGE demonstrated a dominant clone indicating a nosocomial transmission mode. After the opening of the new outpatient clinic and normalization of admission policies on the inpatient wards [the extra ward was closed and ID control measures stayed in effect] only 3 additional VRE-colonized patients were detected but PFGE demonstrated different clones. Cutting down on new admissions and actively discussing the outbreak in public was rewarded with back-to-baseline admissions after cessation of the outbreak. Conclusion: Though VRE-infections nowadays can easily be treated with linezolid, its detection indicates an infection control problem. Awareness of the development of resistant microbes especially in the immunocompromised setting requires pragmatic and stringent ID control measures to prevent or to cease early an outbreak of this magnitude.

Optimizing Hospital Infection Control: The Role of Mathematical Modeling

2014 ◽  
Vol 35 (12) ◽  
pp. 1521-1530 ◽  
Author(s):  
Tan N. Doan ◽  
David C. M. Kong ◽  
Carl M. J. Kirkpatrick ◽  
Emma S. McBryde
Keyword(s):  
Mathematical Modeling ◽  
Infection Control ◽  
Nosocomial Infections ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Infection Control Measures ◽  
Hospital Infection Control ◽  
Considerable Morbidity

Multidrug-resistant bacteria are major causes of nosocomial infections and are associated with considerable morbidity, mortality, and healthcare costs. Preventive strategies have therefore become increasingly important. Mathematical modeling has been widely used to understand the transmission dynamics of nosocomial infections and the quantitative effects of infection control measures. This review will explore the principles of mathematical modeling used in nosocomial infections and discuss the effectiveness of infection control measures investigated using mathematical modeling.Infect Control Hosp Epidemiol 2014;35(12):1521–1530

Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

2021 ◽  
pp. 1-7
Author(s):  
Katharina R. Rynkiewich ◽  
Jinal Makhija ◽  
Mary Carl M. Froilan ◽  
Ellen C. Benson ◽  
Alice Han ◽  
...  
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Skilled Nursing ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Resident Care ◽  
Semistructured Interviews ◽  
Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

scholarly journals TB management in the European Union/European Economic Area: a multi‐centre survey

2021 ◽  
Vol 25 (2) ◽  
pp. 126-133
Author(s):  
G. Sotgiu ◽  
S. Rosales-Klintz ◽  
R. Centis ◽  
L. D'Ambrosio ◽  
R. Verduin ◽  
...  
Keyword(s):  
European Union ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Infection Control Measures ◽  
Treatment And Prevention ◽  
Economic Area

BACKGROUND: Essential TB care in the European Union/European Economic Area (EU/EEA) comprises 21 standards for the diagnosis, treatment and prevention of TB that constitute the European Union Standards for Tuberculosis Care (ESTC).METHODS: In 2017, we conducted an audit on TB management and infection control measures against the ESTC standards. TB reference centres in five EU/EEA countries were purposely selected to represent the heterogeneous European TB burden and examine geographic variability.RESULTS: Data from 122 patients, diagnosed between 2012 and 2015 with multidrug-resistant TB (n = 49), extensively drug‐resistant TB (XDR‐TB) (n = 11), pre‐XDR‐TB (n = 29) and drug‐susceptible TB (n = 33), showed that TB diagnosis and treatment practices were in general in agreement with the ESTC.CONCLUSION: Overall, TB management and infection control practices were in agreement with the ESTC in the selected EU/EEA reference centres. Areas for improvement include strengthening of integrated care services and further implementation of patient‐centred approaches.

scholarly journals Management of a Hospital-Wide COVID-19 Outbreak Affecting Patients and Healthcare Workers

2020 ◽  
Vol 2 (12) ◽  
pp. 2540-2545
Author(s):  
Steffen Höring ◽  
René Fussen ◽  
Johannes Neusser ◽  
Michael Kleines ◽  
Thea Laurentius ◽  
...  
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Spatial Separation ◽  
Control Measures ◽  
Medical Conditions ◽  
Hospital Workers ◽  
Infection Control Team ◽  
Healthcare Facilities ◽  
Infection Control Measures ◽  
Control Team

AbstractTo the best of our knowledge, here, we describe the first hospital-wide outbreak of SARS-CoV-2 that occurred in Germany in April 2020. We aim to share our experience in order to facilitate the management of nosocomial COVID-19 outbreaks in healthcare facilities. All patients and hospital workers were screened for SARS-CoV-2 repeatedly. An infection control team on the side was installed. Strict spatial separation of patients and intensified hygiene training of healthcare workers (HCW) were initiated. By the time of reporting, 26 patients and 21 hospital workers were infected with a cluster of cases in the geriatric department. Fourteen patients developed COVID-19 consistent symptoms and five patients with severe pre-existing medical conditions died. The outbreak was successfully contained after intensified infection control measures were implemented and no further cases among patients were detected over a period of 14 days. Strict application of standard infection control measures proved to be successful in the management of nosocomial SARS-CoV-2 outbreaks.

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