scholarly journals Genotypic Characterisation of Multi Drug Resistant Gram-Negative Bacteria with Special Reference to Carbapenem Resistance in a Teaching Hospital, Hyderabad, Telangana State

2021 ◽  
Vol 10 (14) ◽  
pp. 1039-1041
Author(s):  
Swathi Gurajala ◽  
Sandeep Kumar Tipparthi ◽  
Rajkumar H.R.V.
Keyword(s):  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Resistant Bacteria ◽  
Antimicrobial Drug Resistance ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
Prevention And Control Measures ◽  
And Control

Bacteria develop antimicrobial drug resistance through several mechanisms, the common one being the production of enzymes. As the number of antibiotics discovered is in notable numbers in the past few years, it is important to preserve high-end antibiotics for the treatment of multidrug-resistant organisms (MDROs) infections, by appropriate use of antibiotics. A study was conducted to record prevalence, phenotypic and genotypic characters of MDROs in our hospital, with reference to carbapenem resistance. 200 multidrug-resistant clinical isolates were collected in 6 months. Carbapenem-resistant organisms were detected phenotypically confirmed for the production of carbapenemases by modified Hodge test (MHT) and genotypic detection was done by a multiplex polymerase chain reaction (PCR) assay for the five most predominant carbapenemases (bla NDM-1, bla OXA-48 , bla VIM, bla IMP, bla KPC). The isolates consisted of E. coli (53 %) followed by K. pneumoniae (30 %), P. aeruginosa (13 %), and acinetobacter spp (4 %). Among these, 40 (20 %) isolates were carbapenem-resistant. Of these 40, 27 (67.5 %) showed an increase in zone size by the MHT, suggestive of metallo-beta-lactamase (MBL) mediated carbapenem resistance and about 32 (80 %) isolates were found to contain at least one carbapenemase gene. bla NDM-1 accounted for 37.5 % (12 / 32) of the isolates and was the most predominant one followed by bla OXA-48 [28 % (9 / 32)]. 22 % (7 / 32) of the isolates had one or more carbapenemase genes. Identifying the mechanisms of resistance of pathogens is important to implement strict infection prevention and control measures in the hospital to prevent the transmission of the resistant pathogens. KEY WORDS Multidrug-Resistant Bacteria, Bla NDM-1 Gene, Bla OXA-48 Gene, Carbapenem Resistance, Carbapenem Resistant Organisms.

scholarly journals Knowing More of the Iceberg: How Detecting a Greater Proportion of Carbapenem-Resistant Enterobacteriaceae Carriers Influences Transmission

2019 ◽  
Vol 221 (11) ◽  
pp. 1782-1794 ◽  
Author(s):  
Sarah M Bartsch ◽  
Kim F Wong ◽  
Owen J Stokes-Cawley ◽  
James A McKinnell ◽  
Chenghua Cao ◽  
...  
Keyword(s):  
Control Measures ◽  
Infection Prevention And Control ◽  
Healthcare Facilities ◽  
Contact Precautions ◽  
Carbapenem Resistant ◽  
Adult Inpatient ◽  
Prevention And Control Measures ◽  
And Control ◽  
The Impact ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Clinical testing detects a fraction of carbapenem-resistant Enterobacteriaceae (CRE) carriers. Detecting a greater proportion could lead to increased use of infection prevention and control measures but requires resources. Therefore, it is important to understand the impact of detecting increasing proportions of CRE carriers. Methods We used our Regional Healthcare Ecosystem Analyst–generated agent-based model of adult inpatient healthcare facilities in Orange County, California, to explore the impact that detecting greater proportions of carriers has on the spread of CRE. Results Detecting and placing 1 in 9 carriers on contact precautions increased the prevalence of CRE from 0% to 8.0% countywide over 10 years. Increasing the proportion of detected carriers from 1 in 9 up to 1 in 5 yielded linear reductions in transmission; at proportions >1 in 5, reductions were greater than linear. Transmission reductions did not occur for 1, 4, or 5 years, varying by facility type. With a contact precautions effectiveness of ≤70%, the detection level yielding nonlinear reductions remained unchanged; with an effectiveness of >80%, detecting only 1 in 5 carriers garnered large reductions in the number of new CRE carriers. Trends held when CRE was already present in the region. Conclusion Although detection of all carriers provided the most benefits for preventing new CRE carriers, if this is not feasible, it may be worthwhile to aim for detecting >1 in 5 carriers.

scholarly journals Surveillance and Control Efforts for Carbapenemase-Producing Gram-Negatives at a High Burden Vietnam University Hospital

2020 ◽  
Vol 41 (S1) ◽  
pp. s398-s398
Author(s):  
Tuan Huynh ◽  
Vasquez Amber ◽  
Lan Pham ◽  
Loan Luong ◽  
Tuan Le ◽  
...  
Keyword(s):  
Carbapenem Resistance ◽  
Control Measures ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Second Phase ◽  
Gram Negative ◽  
High Burden ◽  
Carbapenem Resistant ◽  
And Control

Background: Carbapenem-resistant gram-negative bacteria are an urgent threat to healthcare safety around the world. In Vietnam, Although surveillance and control of multidrug-resistant organisms is a national priority, information on the burden of these resistant pathogens is still scarce. At University Medical Center Ho Chi Minh City, Vietnam, we aimed to better understand carbapenem-resistance through 2 phases: (1) assess proportion of carbapenem-resistant gram-negative organisms that are carbapanemase-producing (CP-CRO) and (2) assess transmission burden of carbapenemase-producing carbapenem-resistant Enterobacterieacea (CP-CRE) in the general intensive care unit (ICU). Methods: In the first phase, all gram-negative clinical isolates collected between November 2018 and April 2019 were tested for carbapenem-resistance using the disc-diffusion method and were defined as meropenem resistant using the Clinical and Laboratory Standards Institute 2018 break point (M100-Performance Standards for Antimicrobial Susceptibility Testing, 28th Edition). Carbapenem-resistant bacteria were tested for phenotypic carbapenemase-production using the Becton Dickinson Phoenix CPO Detect assay. In the second phase, we instituted CP-CRE rectal screening using CHROMagar mSuperCARBA media for all ICU patients from July through September 2019. Patients were screened on admission, and negative patients were rescreened every 2 days until discharge, death, or CRE-positive screening or culture. Admission prevalence and incidence of CP-CRE transmission was calculated among CP-CRE infected or colonized patients. Results: From November 2018 through April 2019, 599 gram-negative clinical isolates from 543 patient samples were identified. Of these, 108 were carbapenem-resistant; 107 (99%) of carbapenem-resistant isolates were carbapenemase-producing by phenotypic method. Most CP-CRO were Acinetobacter baumannii (45 of 107, 42%) or Klebsiella pneumoniae (39 of 107, 36%). During ICU CP-CRE colonization screening, the July positivity rate on admission was 40% (32 of 81), the August positivity rate on admission was 30% (21 of 71), and the September positivity rate on admission was 40% (30 of 75). Of those with negative admission screen, the proportion of new CP-CRE colonization in July was 45% (22 of 49), the proportion of new CP-CRE colonization in August was 64% (32 of 50), and the proportion of new CP-CRE colonization in September was 44% (20 of 45). Across all 3 months of screening, the proportions of CP-CRE that were Klebsiella, Citrobacter, or Enterobacter were 68% (118 of 174) and the proportion of CP-CRE that were Eschericia coli was 37% (56 of 174). The average number of days to turn from negative to positive screening result was 4.1. Conclusions: Our analysis demonstrates that nearly all carbapenem-resistant organisms at our hospital are carbapenemase producing. In the ICU, we identified a high burden of CP-CRE, attributable to high presence on admission and new acquisition in the ICU. An intervention package based on CDC-recommended enhanced infection control measures is being implemented to decrease CP-CRE transmission in the ICU.Funding: NoneDisclosures: None

scholarly journals Multidrug-resistant organism infections and mortality: estimates from a large Italian hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Moro ◽  
G P Vigezzi ◽  
E Callari ◽  
A Biancardi ◽  
P Nizzero ◽  
...  
Keyword(s):  
Public Health ◽  
Hospital Mortality ◽  
Significant Risk ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Outcome Variable ◽  
Resistant Bacteria ◽  
Risk Of Death ◽  
Carbapenem Resistant

Abstract Background Multidrug-resistant organisms (MDRO) are one of the most critical public health concerns, particularly in hospital settings. Nearly 8% of hospitalized patients develop healthcare-associated infections (HAI), 20% of which is caused by MDRO. Aim of the study was to estimate nosocomial infection-associated in-hospital mortality, by different MDRO, in a large Italian teaching hospital. Methods We conducted a retrospective cohort study on patients hospitalized at San Raffaele Hospital, Milan, from 2016 to 2018. Two existing datasets were merged: hospital discharge records and MDRO surveillance data. Exposure was defined as any HAI caused by MDRO, and main outcome variable was in-hospital mortality from all causes. Results A total of 78,795 patients were studied (mean age 59.3 y, age range 18-105 y). 1,345 patients with at least one MDRO had mean age of 68 y, mean length of stay (LOS) of 32.8 days and mean DRG weight of 3.8. 77,450 patients without MDRO isolation had mean age of 59 y, mean LOS of 7.2 days and mean DRG weight of 1.6. Risk of in-hospital mortality is 3.4 times higher in patients with at least one MDRO isolation (OR 3.4; 95% CI 2.8-4.2). Enterococci (OR 2.6; 95% CI 1.1-6.3), A. baumannii (OR 3.5; 95% CI 1.4-8.6), P. aeruginosa (OR 1.8; 95% CI 0.8-4.2), MRSA (OR 3.4; 95% CI 2.1-5.4), ESBL-producing (OR 1.9; 95% CI 1.4-2.7) and carbapenem-resistant bacteria (OR 3.8; 95% CI 2.5-5.7), and carbapenem-resistant K. pneumoniae (OR 5.5; 95% CI 3.2-9.2) isolations were risk factors for nosocomial mortality. Conclusions Patients with MDRO isolations were older, more complex and had 5 times longer LOS than ones without MDRO. Deceased patients were 18% among MDRO cohort against only 2% among others. Bacteria included in WHO list of priority pathogens with antibiotic resistance were associated with a significantly higher risk of death. These results prove the urgency of controlling MDROs' spread that threatens global public health and available treatments of infections. Key messages Nosocomial MDRO isolation is a significant risk factor for in-hospital mortality from all causes. Infection prevention and control measures, and antibiotic stewardship are key strategies in order to prevent MDRO transmission and HAI, AR spreading and their burden of related deaths.

scholarly journals Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rapeephan R. Maude ◽  
Monnaphat Jongdeepaisal ◽  
Sumawadee Skuntaniyom ◽  
Thanomvong Muntajit ◽  
Stuart D. Blacksell ◽  
...  
Keyword(s):  
General Public ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
The Public ◽  
Educational Videos ◽  
Prevention And Control Measures ◽  
And Control

Abstract Background Key infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. Results Knowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting. Conclusions Detailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide.

scholarly journals Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Stéphane Marot ◽  
◽  
Isabelle Malet ◽  
Valentin Leducq ◽  
Karen Zafilaza ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Healthcare Workers ◽  
Disease Onset ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Rapid Decline ◽  
Prevention And Control Measures ◽  
Few Data ◽  
Antibody Levels ◽  
And Control

AbstractThere are only few data concerning persistence of neutralizing antibodies (NAbs) among SARS-CoV-2-infected healthcare workers (HCW). These individuals are particularly exposed to SARS-CoV-2 infection and at potential risk of reinfection. We followed 26 HCW with mild COVID-19 three weeks (D21), two months (M2) and three months (M3) after the onset of symptoms. All the HCW had anti-receptor binding domain (RBD) IgA at D21, decreasing to 38.5% at M3 (p < 0.0001). Concomitantly a significant decrease in NAb titers was observed between D21 and M2 (p = 0.03) and between D21 and M3 (p < 0.0001). Here, we report that SARS-CoV-2 can elicit a NAb response correlated with anti-RBD antibody levels. However, this neutralizing activity declines, and may even be lost, in association with a decrease in systemic IgA antibody levels, from two months after disease onset. This short-lasting humoral protection supports strong recommendations to maintain infection prevention and control measures in HCW, and suggests that periodic boosts of SARS-CoV-2 vaccination may be required.

scholarly journals Awareness of COVID-19 Before and After Quarantine Based on Crowdsourced Data From Rabigh City, Saudi Arabia: A Cross-Sectional and Comparative Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Mai Aldhahri ◽  
Rana Alghamdi
Keyword(s):  
Saudi Arabia ◽  
Online Survey ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
Second Stage ◽  
Before And After ◽  
Prevention And Control Measures ◽  
Two Stages ◽  
And Control

Background: Infection prevention and control measures are critical for the prevention of the spread of COVID-19.Aim: In this study, we aimed to measure and evaluate the level of awareness and knowledge of the prevention, symptoms, and transmission control of COVID-19 before and after quarantine among the residents of Rabigh city and adjacent villages in Saudi Arabia.Methods: A cross-sectional online survey was conducted in two stages: the first stage took place before quarantine and the second stage took place after quarantine. The survey was filled out electronically.Results: A total of 448 participants responded and filled out the questionnaires. Females (73.70%) formed the largest number of participants for both stages. The majority of the participants were &lt;30 years old (50.90%) and had a high education level in various sectors and levels (97.1%). It was noticeable that during the first stage, the participants' awareness of COVID-19 symptoms was not very high: 13.62% did not know about the symptoms. However, by the second stage, awareness about symptoms had increased (9.6%).Conclusion: The residents of Rabigh city and the surrounding villages had good levels of knowledge about COVID-19.

Breastfeeding During the Covid-19 Pandemic

2021 ◽  
Vol 35 (3) ◽  
pp. 155-158
Author(s):  
JP Dadhich ◽  
Nupur Bidla
Keyword(s):  
Control Measures ◽  
Infection Prevention And Control ◽  
Evidence Based ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Childhood Morbidity ◽  
Infant And Young Child ◽  
Prevention And Control Measures ◽  
Evidence Based Guidelines ◽  
And Control

The COVID-19 pandemic has posed a serious challenge to the lactating women to practice optimal infant and young child feeding. Although international and national agencies developed appropriate evidence-based guidelines early in the pandemic, availability of this information to the mothers and their caregivers needs to be enhanced. This becomes important in view of apprehension about the risk of a decline in breastfeeding practices during the pandemic due to various factors. Any decrease in the breastfeeding rates may lead to increased childhood morbidity, mortality, and malnutrition. This article provides a glimpse of available evidence-based guidelines on breastfeeding by Covid-19 positive mothers and attempts by the baby food industry to exploit the situation by promoting their products. The article also deals with infection prevention and control measures to be observed by the mother while caring and breastfeeding her baby and other action required to protect breastfeeding from commercial influence.

Mass SARS-CoV-2 Testing in a Dormitory-Style Correctional Facility in Arkansas

2021 ◽  
pp. e1-e10
Author(s):  
Lindsay K. Tompkins ◽  
Jayleen K. L. Gunn ◽  
Blake Cherney ◽  
Jason E. Ham ◽  
Roberta Horth ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Close Contact ◽  
Correctional Facility ◽  
Mitigation Strategies ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Strict Enforcement ◽  
Prevention And Control Measures ◽  
And Control ◽  
Respiratory Specimens

Objectives. To assess SARS-CoV-2 transmission within a correctional facility and recommend mitigation strategies. Methods. From April 29 to May 15, 2020, we established the point prevalence of COVID-19 among incarcerated persons and staff within a correctional facility in Arkansas. Participants provided respiratory specimens for SARS-CoV-2 testing and completed questionnaires on symptoms and factors associated with transmission. Results. Of 1647 incarcerated persons and 128 staff tested, 30.5% of incarcerated persons (range by housing unit = 0.0%–58.2%) and 2.3% of staff tested positive for SARS-CoV-2. Among those who tested positive and responded to symptom questions (431 incarcerated persons, 3 staff), 81.2% and 33.3% were asymptomatic, respectively. Most incarcerated persons (58.0%) reported wearing cloth face coverings 8 hours or less per day, and 63.3% reported close contact with someone other than their bunkmate. Conclusions. If testing remained limited to symptomatic individuals, fewer cases would have been detected or detection would have been delayed, allowing transmission to continue. Rapid implementation of mass testing and strict enforcement of infection prevention and control measures may be needed to mitigate spread of SARS-CoV-2 in this setting. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306117 )

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