scholarly journals Transmission Dynamics of Carbapenemase-Producing Klebsiella Pneumoniae and Anticipated Impact of Infection Control Strategies in a Surgical Unit

PLoS ONE ◽  
2012 ◽  
Vol 7 (7) ◽  
pp. e41068 ◽  
Author(s):  
Vana Sypsa ◽  
Mina Psichogiou ◽  
Georgia-Aikaterina Bouzala ◽  
Linos Hadjihannas ◽  
Angelos Hatzakis ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Control Strategies ◽  
Transmission Dynamics ◽  
Surgical Unit

scholarly journals 1627. Outbreaks of Klebsiella pneumoniae in Special Care Nurseries (SCN) in Jamaica: Role of Whole-Genome Sequencing

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S593-S593
Author(s):  
Maliha Aziz ◽  
Alison M Nicholson ◽  
Maya Nadimpalli ◽  
Sanjeev Sariya ◽  
Lance Price ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Control Strategies ◽  
Special Care ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Whole Genome ◽  
Single Source

Abstract Background Klebsiella pneumoniae is a frequent cause of neonatal sepsis and carries a high mortality rate in lower and middle-income countries (LMICs). From March-November 2015, two Jamaican hospitals experienced K. pneumoniae outbreaks in their Special Care Nurseries (SCNs). New admissions to both SCNs were temporarily halted while additional infection control strategies were implemented. 31 babies were infected, of which 15 died. International collaboration was requested to help investigate if the sepsis cases were nosocomial transmission, repeated introductions from the community, or both using whole-genome sequencing Methods We sequenced DNA from 19 outbreak isolates (n = 13 from Hospital A, n = 6 from Hospital B) on an Illumina HiSeq2500 instrument and assembled short-reads using SPAdes. We used ResFinder v3.1.0 to screen resistance genes and assigned MLSTs using in-house scripts. To compare the outbreak isolates, we selected a reference genome from among the assembled isolates, aligned raw reads using the Burrows–Wheeler Aligner (BWA), identified SNPs using GATK UnifiedGenotyper, and removed the recombined regions using Gubbins v2.3.4. We further contextualized the 19 outbreak isolates against a global collection of more than 300 K. pneumoniae genomes. Results All 13 isolates from Hospital A appeared to be from a single source. All were ST45 and encoded blaCTX-M-15, which confers extended-spectrum β-lactam (ESBL) resistance. Five of 6 isolates from Hospital B appeared to be from a separate, single source. These 5 isolates were ST268 and susceptible to most antibiotics. 1 isolate from Hospital B was ST628, encoded blaCTX-M-15, and grouped separately from other Hospital B outbreak isolates. Hospital A and B outbreak isolates formed independent, unique clades within a global K. pneumoniae collection. Conclusion Our findings indicate nosocomial transmission was responsible for both neonatal K. pneumoniae outbreaks, rather than repeat introductions from the community. The main sequence types we detected (ST45 and ST268) are not known pandemic clones and may circulate regionally. Multifaceted infection control measures were implemented for effectively halting outbreaks. Disclosures All authors: No reported disclosures.

Modeling of the transmission dynamics of carbapenem resistant Klebsiella pneumoniae in hospitals and design of control strategies

2021 ◽  
Author(s):  
Suttikiat Changruenngam ◽  
Charin Modchang ◽  
Dominique J. Bicout
Keyword(s):  
Klebsiella Pneumoniae ◽  
Antibiotic Treatment ◽  
Control Strategies ◽  
Transmission Dynamics ◽  
Global Public Health ◽  
Factors Affecting ◽  
Carbapenem Resistant ◽  
Number Of Treatment ◽  
Epidemiological Characteristics ◽  
The Impact

Abstract Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as a major threat to global public health. Epidemiological and infection controls associated with CRKP are very challenging owing to several potential elements involved in a complicated cycle of transmission. Here, we proposed a comprehensive mathematical model to investigate the transmission dynamics of CRKP, determine factors affecting the prevalence, and evaluate the impact of interventions on the transmission. The model includes the essential compartments, which are uncolonized, asymptomatic colonized, symptomatic colonized, and relapsed patients. Moreover, the symptomatic colonized and relapsed patients are further classified into subpopulations according to their number of treatment failures or relapses. We found that the admission of colonized patients and the use of antibiotics have a significant influence on the endemic transmission. The proposed treatment efficacy, which is defined as a combination of the treatment duration and the probability of successful treatment, could also describe the effects of antibiotic treatment on the transmission. A high efficacy of the antibiotic treatment could significantly reduce the likelihood of readmission of a patient in the health care unit. In addition, our findings demonstrate that the CRKP transmission with different epidemiological characteristics needs to be controlled with distinct interventions.

scholarly journals Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

2020 ◽  
pp. 1-4
Author(s):  
Carla Benea ◽  
Laura Rendon ◽  
Jesse Papenburg ◽  
Charles Frenette ◽  
Ahmed Imacoudene ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Control Strategy ◽  
Healthcare Workers ◽  
Control Strategies ◽  
Risk Exposure ◽  
Nasopharyngeal Swab ◽  
Home Based ◽  
Respiratory Coronavirus ◽  
Second Wave

Abstract Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

scholarly journals Sex-specific deaths in Norway and Sweden during the COVID-19 pandemic: Did mandates make a difference?

2021 ◽  
pp. 140349482110100
Author(s):  
Ralph Catalano
Keyword(s):  
Sex Ratio ◽  
Infection Control ◽  
Temporal Variation ◽  
Risky Behavior ◽  
Control Strategies ◽  
Sex Ratios ◽  
Female Mortality ◽  
All Cause Mortality ◽  
Societal Expectations ◽  
Male To Female

Aims: To determine whether differences between Norway’s and Sweden’s attempts to contain SARS-CoV-2 infection coincided with detectably different changes in their all-cause mortality sex ratios. Measuring temporal variation in the all-cause mortality sex ratio before and during the pandemic in populations exposed to different constraints on risky behavior would allow us to better anticipate changes in the ratio and to better understand its association with infection control strategies. Methods: I apply time Box–Jenkins modeling to 262 months of pre-pandemic mortality sex ratios to arrive at counterfactual values of 10 intra-pandemic ratios. I compare counterfactual to observed values to determine if intra-pandemic ratios differed detectably from those expected as well as whether the Norwegian and Swedish differences varied from each other. Results: The male to female mortality sex ratio in both Norway and Sweden increased during the pandemic. I, however, find no evidence that the increase differed between the two countries despite their different COVID-19 containment strategies. Conclusion: Societal expectations of who will die during the COVID-19 pandemic will likely be wrong if they assume pre-pandemic mortality sex ratios because the intra-pandemic ratios appear, at least in Norway and Sweden, detectably higher. The contribution of differences in policies to reduce risky behavior to those higher ratios appears, however, small.

scholarly journals Implementation of an Antimicrobial Stewardship Program in Five Colombian Hospitals in 2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s273-s273
Author(s):  
Christian Pallares ◽  
María Virginia Villegas Botero
Keyword(s):  
Infection Control ◽  
Antimicrobial Stewardship ◽  
Control Strategies ◽  
Education And Training ◽  
Public Hospitals ◽  
International Standards ◽  
International Consensus ◽  
Stewardship Program ◽  
And Training

Background: More than 50% of antibiotics used in hospitals are unnecessary or inappropriate. The antimicrobial stewardship programs (ASPs) are coordinated efforts to promote the rational and effective use of antibiotics including appropriate selection, dosage, administration, and duration of therapy. When an ASP integrates infection control strategies, it is possible to decrease the transmission of multidrug-resistant pathogens. Methods: In 2018, 5 Colombian hospitals were selected to implement an ASP. Private and public hospitals from different cities were included in the study, ranging from 200 to 700 beds. Our team, consisting of an infectious disease and hospital epidemiologist, visited each hospital to establish the baseline of their ASP program, to define the ASP outcomes according to each hospital’s needs, and to set goals for ASP outcomes in the following 6–12 months. Follow-up was scheduled every 2 months through Skype video conference. The baseline diagnosis or preintervention evaluation was done using a tool adapted from previous reports (ie, international consensus and The Joint Commission international standards). Documentation related to ASPs, such as microbiological profiles, antimicrobial guidelines (AMG) and indicators for the adherence to them as well as antimicrobial resistance (AMR) prevention through protocols, were written and/or updated. Prevention and infection control requirements and protocols were also updated, and cleaning and antiseptic policies were created. Training in rational use of antibiotic, infection control and prevention, and cleaning and disinfection were carried out with the healthcare workers in each institution. Results: Before the intervention, the development of the ASP according to the tool was 27% (range, 5%–47%). The lowest institutional scores were the item related to ASP feedback and reports (11% on average), followed by education and training (14%), defined ASP responsibilities (23%), ASP function according to priorities (26%), and AMR surveillance (27%). After the intervention, the ASP development increased to 57% (range, 39%–81%) in the hospitals. The highest scores achieved were for education and training (90%), surveillance (75%), and the activities of the infection control committee (70%). The items that made the greatest contribution to ASP development were the individual antibiogram, including the bacteria resistance profile, and the development of the AMG based on the local epidemiology in each hospital. Conclusions: The implementation of an ASP should include training and education as well as defining outcomes according to the hospital’s needs. Once the strategy is implemented, follow-up is key to achieving the goals.Funding: NoneDisclosures: None

Emergence and Recovery of Ceftazidime-avibactam Resistance in blaKPC-33-Harboring Klebsiella pneumoniae Sequence Type 11 Isolates in China

2020 ◽  
Vol 71 (Supplement_4) ◽  
pp. S436-S439
Author(s):  
Qingyu Shi ◽  
Dandan Yin ◽  
Renru Han ◽  
Yan Guo ◽  
Yonggui Zheng ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Polymyxin B ◽  
Sequence Type ◽  
First Report ◽  
Clinical Strains

Abstract This is the first report of ceftazidime–avibactam resistance caused by the blaKPC-33 mutation through the D179Y variant during the treatment of blaKPC-2-positive Klebsiella pneumoniae-related infections in China. The blaKPC-33-containing K. pneumoniae was susceptible to meropenem–vaborbactam, cefepime–zidebactam, tigecycline, and polymyxin B. The blaKPC-33 gene was located on a 77 551-bp transformable plasmid harboring qnrS1 and blaLAP-2. Detecting blaKPC-33-positive K. pneumoniae clinical strains is important for infection control.

scholarly journals Modeling the spread of porcine reproductive and respiratory syndrome virus (PRRSV) in a swine population: transmission dynamics, immunity information, and optimal control strategies

2019 ◽  
Vol 2019 (1) ◽  
Author(s):  
Phithakdet Phoo-ngurn ◽  
Chanakarn Kiataramkul ◽  
Farida Chamchod
Keyword(s):  
Mathematical Model ◽  
Vaccination Coverage ◽  
Control Strategies ◽  
Vaccination Rate ◽  
Transmission Dynamics ◽  
Respiratory Syndrome Virus ◽  
Respiratory Problems ◽  
Prrs Virus ◽  
Swine Population ◽  
Swine Disease

Abstract Porcine reproductive and respiratory syndrome (PRRS) is an important swine disease that affects many swine industries worldwide. The disease can cause reproductive failure and respiratory problems in a swine population. As vaccination is an important tool to control the spread of PRRS virus (PRRSV), we employ a mathematical model to investigate the transmission dynamics of PRRSV and the effects of immunity information, as well as vaccination control strategies. We also explore optimal vaccination coverage and vaccination rate to minimize the number of infected swines and vaccination efforts. Our results suggest that: (i) higher vaccination coverage and vaccination rate together with prior knowledge about immunity may help reduce the prevalence of PRRSV, and (ii) longer maximum vaccination efforts are required when swines stay longer in a population and it takes them longer time to recover from PRRS infections.

scholarly journals TRANSMISSION DYNAMICS OF DENGUE IN COSTA RICA: THE ROLE OF HOSPITALIZATIONS

2019 ◽  
Vol 27 (1) ◽  
pp. 241-266
Author(s):  
FABIO SANCHEZ ◽  
JORGE ARROYO-ESQUIVEL ◽  
PAOLA VÁSQUEZ
Keyword(s):  
Costa Rica ◽  
Compartmental Model ◽  
Control Strategies ◽  
Transmission Dynamics ◽  
Basic Reproductive Number ◽  
Reproductive Number ◽  
Specific Parameter ◽  
Public Health Officials ◽  
Disease Free

For decades, dengue virus has caused major problems for public health officials in tropical and subtropical countries around the world. We construct a compartmental model that includes the role of hospitalized individuals in the transmission dynamics of dengue in Costa Rica. The basic reproductive number, R0, is computed, as well as a sensitivity analysis on R0 parameters. The global stability of the disease-free equilibrium is established. Numerical simulations under specific parameter scenarios are performed to determine optimal prevention/control strategies.

scholarly journals Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting

2016 ◽  
Vol 54 (10) ◽  
pp. 2436-2447 ◽  
Author(s):  
Matthew L. Faron ◽  
Nathan A. Ledeboer ◽  
Blake W. Buchan
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Control Strategies ◽  
Resistance Mechanisms ◽  
Clinical Microbiology Laboratory ◽  
Laboratory Methods ◽  
Content Type ◽  
Important Health ◽  
Vancomycin Resistant ◽  
Hospital Acquired

Infections attributable to vancomycin-resistantEnterococcus(VRE) strains have become increasingly prevalent over the past decade. Prompt identification of colonized patients combined with effective multifaceted infection control practices can reduce the transmission of VRE and aid in the prevention of hospital-acquired infections (HAIs). Increasingly, the clinical microbiology laboratory is being asked to support infection control efforts through the early identification of potential patient or environmental reservoirs. This review discusses the factors that contribute to the rise of VRE as an important health care-associated pathogen, the utility of laboratory screening and various infection control strategies, and the available laboratory methods to identify VRE in clinical specimens.

Sign in / Sign up

Export Citation Format

Share Document