scholarly journals SARS-CoV-2 aerosol generation during respiratory equipment reprocessing

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Camila Quartim de Moraes Bruna ◽  
Caroline Lopes Ciofi-Silva ◽  
Anderson Vicente de Paula ◽  
Lucy Santos Villas Boas ◽  
Noely Evangelista Ferreira ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Medical Devices ◽  
Aerosol Generation ◽  
Surface Samples ◽  
Tertiary Hospitals ◽  
Air Sample ◽  
Sterile Processing

AbstractAerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices. Air and surface samples were collected from the sterile processing department of two teaching tertiary hospitals during the reprocessing of respiratory equipment used in patients diagnosed with coronavirus disease 2019 and from intensive care units during treatment of these patients. SARS-CoV-2 was detected only in 1 air sample before the beginning of decontamination process. Viable severe acute respiratory syndrome coronavirus 2 RNA was not detected in any sample collected from around symptomatic patients or in sterile processing department samples. The cleaning of respiratory equipment does not cause aerosolization of SARS-CoV-2. We believe that the use of medical masks is sufficient while reprocessing medical devices during the coronavirus disease 2019 pandemic.

scholarly journals Otolaryngology activity in two hospitals in northern and central Italy differently affected by COVID-19 pandemic

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042199848
Author(s):  
Antonio Minni ◽  
Francesco Pilolli ◽  
Massimo Ralli ◽  
Niccolò Mevio ◽  
Luca Roncoroni ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Healthcare System ◽  
Central Italy ◽  
Northern Italy ◽  
Public Hospitals ◽  
Geographical Differences ◽  
Italian Regions

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic had a significant impact on the Italian healthcare system, although geographical differences were present; regions in northern Italy have been the most severely affected while regions in the south of the country were relatively spared. Otolaryngologists were actively involved in the management of the pandemic. In this work, we analyzed and compared the otolaryngology surgical activity performed during the pandemic in two large public hospitals located in different Italian regions. In northern Italy, otolaryngologists were mainly involved in performing surgical tracheotomies in COVID-19 positive patients and contributed to the management of these patients in intensive care units. In central Italy, where the burden of the infection was significantly lower, otolaryngologists focused on diagnosis and treatment of emergency and oncology patients. This analysis confirms the important role of the otolaryngology specialists during the pandemic, but also highlights specific differences between two large hospitals in different Italian regions.

scholarly journals A multicentered pharmacoepidemiological approach to evaluate clinically significant potential drug–drug interactions in medical intensive care settings in Pakistan

2018 ◽  
Vol 25 (4) ◽  
pp. 190-195 ◽  
Author(s):  
Faisal Shakeel ◽  
Jamshaid Ali Khan ◽  
Muhammad Aamir ◽  
Syed Muhammad Asim ◽  
Irfan Ullah
Keyword(s):  
Intensive Care ◽  
Drug Interactions ◽  
Intensive Care Units ◽  
Potential Drug ◽  
Significant Potential ◽  
Significant Difference ◽  
Tertiary Hospitals ◽  
Medical Intensive Care ◽  
Clinically Significant ◽  
Multiple Drugs

Background: Iatrogenic injuries due to drug–drug interactions are particularly significant in critical care units because of the severely compromised state of the patient. The risk further increases with the use of multiple drugs, increasing age, and stay of the patient. Objective: The aim was to assess potential drug–drug interactions, evaluate clinically significant potential drug–drug interactions and their predictors in medical intensive care units of tertiary hospitals in Pakistan. Methods: Analysis of patient data collected from medical intensive care units of tertiary hospitals in Pakistan were carried out using Micromedex DrugReax. Various statistical tools were applied to identify the significance of associated predictors. Results: In a total of 830 patients, prevalence of potential drug–drug interactions was found to be 39%. These attributed to 190 drug combinations, of which 15.4% were clinically significant. A significant association of potential drug–drug interactions was present with number of prescribed drugs, age, and gender. In terms of clinically significant potential drug–drug interactions, the association was significant with increasing age. Moreover, one-way analysis of variance revealed a significant difference in the means of potential drug–drug interactions among the four hospitals. Conclusion: A prevalence of 39% potential drug–drug interactions was observed in patients of medical intensive care unit, with 22.8% being clinically significant. These attributed to nine drug pairs and could easily be avoided to reduce the risk of adverse effects from potential drug–drug interactions.

scholarly journals Assessment of Respiratory Bacterial Coinfections Among Severe Acute Respiratory Syndrome Coronavirus 2-Positive Patients Hospitalized in Intensive Care Units Using Conventional Culture and BioFire, FilmArray Pneumonia Panel Plus Assay

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Camille Kolenda ◽  
Anne-Gaëlle Ranc ◽  
Sandrine Boisset ◽  
Yvan Caspar ◽  
Anne Carricajo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Bacterial Infections ◽  
Early Stage ◽  
Bacterial Load ◽  
Empiric Antibiotic Therapy ◽  
Molecular Diagnostic ◽  
Oral Flora ◽  
Conventional Culture

Abstract Background Approximately 15% of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present with severe forms of the disease and require hospitalization in intensive care units, which has been associated with high mortality rates. The prevalence of bacterial infections in these patients is not well established, and more data are needed to guide empiric antibiotic therapy and improve patient outcomes. Methods In this prospective multicenter study, we assessed bacterial coinfections identified in culture from 99 French patients infected by SARS-Cov-2 and hospitalized in intensive care units. We concomitantly evaluated an innovative molecular diagnostic technology technique, the BioFire, FilmArray Pneumonia Panel plus (FA-pneumo) assay, to identify these coinfections at an early stage, and its concordance with conventional culture. Results We showed that a bacterial coinfection was detected in 15% of patients based on conventional culture. Staphylococcus aureus and Haemophilus influenzae were the most prevalent pathogens. The sensitivity of FA-pneumo compared with culture was 100%. In contrast, the specificity varied between 88.4% and 100% according to the pathogen, and our results highlighted that 60.5% of bacterial targets reported using this assay were not recovered by culture; 76.9% of discordant results corresponded to bacteria belonging to commensal oral flora and/or reported with ≤105 copies/mL bacterial nucleic acids. Conclusions Based on its excellent sensitivity, the FA-pneumo assay is useful to rule out bacterial coinfections in the context of severe SARS-CoV-2 infection and avoid the inappropriate prescription of antibiotics. However, positive tests should be interpreted carefully, taking into consideration deoxyribonucleic acid bacterial load and all clinical and biological signs.

scholarly journals Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Daniel A. Hofmaenner ◽  
◽  
Pedro David Wendel Garcia ◽  
Branko Duvnjak ◽  
Bhavya Chakrakodi ◽  
...  
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Ribonucleic Acid ◽  
Bacterial Contamination ◽  
Tertiary Care ◽  
Invasive Ventilation ◽  
Gram Negative ◽  
Skin Flora

Abstract Background In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission. Methods Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients. Results A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards. Conclusions After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.

scholarly journals Microbiological surveillance of operation theatre’s and intensive care units in a tertiary care hospital in NCR region, New Delhi

2020 ◽  
Vol 9 (1) ◽  
pp. 204
Author(s):  
Soumya Singh ◽  
Rohit Kumar ◽  
Mrinmoy Sarma
Keyword(s):  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Infection Prevention And Control ◽  
Care Hospital ◽  
Air Samples ◽  
Pseudomonas Spp ◽  
Surface Samples ◽  
Acinetobacter Spp ◽  
And Control

Background: Harbouring of potential pathogens in operation theatres (OTs) and intensive care units (ICUs) of hospital is a major cause of patient’s morbidity and mortality. Environmental monitoring by the microbiological testing of surfaces and equipments is useful to detect changing trends of types and counts of microbial flora. High level of microbial contamination indicates the needs for periodic surveillance aimed at early detection of bacterial contamination levels and prevention of hospital acquired infections.Methods: During a period of 6 months from January 2019 to June 2019, Air sampling from Operation theaters and Intensive care units were done by settle plate method. Swabs were taken from different sites and equipments and bacterial species were isolated and identified from them.Results: A total of 1410 samples were collected from various sites of Operation theaters and Intensive care units over a period of 6 months in which 960 were surface samples and 450 were air samples. Out of 960 surface samples, 95(9.89%) and out of 450 air samples, 90 (20%) were bacterial positive. Isolated organism was divided into normal flora (CONS, Micrococci), contaminant (bacillus species) and pathogenic organism e.g. Staphylococcus aureus, Acinetobacter spp., Pseudomonas spp etc. Out of those 30 (16.20%) CONS, 50 (27.02%) Micrococci, 75 (40.50%) Bacillus spp, 16 (8.6%) Staphylococcus aureus, 1(0.54%) Acinetobacter spp, 2 (1.08%) Pseudomonas spp, 4 (2.16%) Klebsiella, 7 (3.78%) Escherichia coli were isolated.Conclusions: Strengthening surveillance and laboratory capacity will surely enhance infection prevention and control. Routine sampling is strongly recommended for increasing awareness to identify and control all possible sources and types of infections.

scholarly journals Influence of different test gases in a non-destructive 100% quality control system for medical devices

2016 ◽  
Vol 2 (1) ◽  
pp. 587-591
Author(s):  
Thomas Pollack ◽  
Hermann Seitz
Keyword(s):  
Risk Management ◽  
Quality Control ◽  
Intensive Care ◽  
Control System ◽  
Intensive Care Units ◽  
Medical Devices ◽  
Quality Control System ◽  
Critical Ill Patients ◽  
Non Destructive ◽  
Critical Ill

AbstractThe purpose of this research is to evaluate the detectability of defect membranes in intravenous (IV) infusion filter systems. The device under test (DUT) protects critical ill patients and has a high priority for the risk management of intensive care units. The developed quality control system stands out from other filter integrity methods because no method located on this topic represents such a simple, reliable, fast and non-destructive technique, examined without liquid. The invented method works as a pressure driven test and uses gas to identify defects. Previous studies have demonstrated the capability of detecting various types of errors. In this paper the influence of different test gases on the detectability of smallest defects is presented.

scholarly journals Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients

2020 ◽  
Author(s):  
Daniel A Hofmänner ◽  
Pedro D Wendel Garcia ◽  
Branko Duvnjak ◽  
Bhavya Chakrakodi ◽  
Julian D Maier ◽  
...  
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Ribonucleic Acid ◽  
Bacterial Contamination ◽  
Tertiary Care ◽  
Invasive Ventilation ◽  
Gram Negative ◽  
Skin Flora

Abstract Background: In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission.Methods: Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients.Results: A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards.Conclusions: After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.

scholarly journals Immunocompromised patients with SARS-CoV-2 infection in intensive care units, outcome and mortality

2021 ◽  
Vol 6 (1) ◽  
pp. 021-025
Author(s):  
DENIS Cynthia ◽  
MERDJI Hamid ◽  
BALDACINI Mathieu ◽  
SCHENCK Maleka ◽  
ARTZNER Thierry ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Immunocompromised Patients ◽  
Icu Patients ◽  
Lymphoid Malignancies ◽  
Radiological Features ◽  
Northeastern France

Background: The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak severely hit Northeastern France from March to May 2020. The massive arrival of SARS-CoV-2 positive patients in the intensive care units (ICU) raised the question of how immunocompromised patients would be affected. Therefore, we analyzed the clinical, biological and radiological features of 24 immunocompromised ICU patients with severe SAR-CoV-2 infection. Results: The mortality rate was significantly higher for immunocompromised patients compared with other patients (41.7% versus 27.3%, respectively, p = 0.021). Mortality occurred in the first 2 weeks of intensive care, highlighting the possible interest in prolonged full-code managnement of these patients. Finally, patients with lymphoid malignancies appeared to be particularly affected, mostly with monoclonal gamma-pathology. Conclusion: Mortality rate of SARS-CoV-2 acute respiratory syndrome in immuno-compromised patient is high. No treatment was associated with survival improvement. Prolonged full-code management is required for these patients.

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