scholarly journals An outbreak of norovirus infection in a long-term care facility in Brazil

2010 ◽  
Vol 8 (4) ◽  
pp. 410-413 ◽  
Author(s):  
Fernando Gatti de Menezes ◽  
Vanessa Maria da Silva de Poli Correa ◽  
Fábio Gazelato de Mello Franco ◽  
Miriam Ikeda Ribeiro ◽  
Maria Fátima dos Santos Cardoso ◽  
...  
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Control Strategies ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Infection Control Measures

ABSTRACT Objective: To describe a norovirus outbreak in a Brazilian long-term care facility from July 8 to 29, 2005. Methods: In the first 48 to 72 hours after onset of symptoms in inpatients and employees, the main infection control strategies were staff education, emphasis on hand washing, implementing contact precautions up to 48-72 hours after resolution of symptoms, complete cleaning of the rooms and exclusion of symptomatic employees from work until 48-72 hours after resolution of their symptoms. Epidemiological and clinical characteristics of the norovirus infections were described based on chart review. Results: The incidence among inpatients and employees was 41.3% and 16.25%, respectively. The main symptom was diarrhea, affecting 100% of inpatients and employees. Forty-four percent of specimens were positive by RIDASCREEN® Norovirus analyses, and identified as norovirus genogroup GII. Seventy percent of inpatients were women and their age range was 51-98 years. Inpatients had in average two comorbid conditions – 87.3% with cardiovascular or chronic pulmonary condition and 47.6% with dementia. There was not relapse or death. Conclusions: The early infection-control measures associated to surveillance are required to keep long-term care facilities free of noroviruses and to protect those who are most vulnerable.

Tightly Clustered Outbreak of Group A Streptococcal Disease at a Long-Term Care Facility

2006 ◽  
Vol 27 (12) ◽  
pp. 1377-1384 ◽  
Author(s):  
Kathryn E. Arnold ◽  
Jody L. Schweitzer ◽  
Barbara Wallace ◽  
Monique Salter ◽  
Ruth Neeman ◽  
...  
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Infection Control Measures ◽  
Group A

Objective.To describe investigation of a tightly clustered outbreak of invasive group A streptococcal (GAS) disease associated with a high mortality rate in a long-term care facility (LTCF).Design.Cross-sectional carriage survey and epidemiologic investigation of LTCF resident and employee cohorts.Setting.A 104-bed community LTCF between March 1 and April 7, 2004.Patients.A cohort of LTCF residents with assigned beds at the time of the outbreak.Interventions.Reinforcement of standard infection control measures and receipt of chemoprophylaxis by GAS carriers.Results.Four confirmed and 2 probable GAS cases occurred between March 16 and April 1, 2004. Four case patients died. The final case occurred during the investigation, before the patient was determined to be a GAS carrier. No case occurred during the 6 months after the intervention. Disease was caused by typeemm3GAS; 16.5% of residents and 2.4% of employees carried the outbreak strain. Disease was clustered in 1 quadrant of the LTCF and associated with nonintact skin. GAS disease or carriage was associated with having frequent personal visitors.Conclusions.Widespread carriage of a virulent GAS strain likely resulted from inadequate infection control measures. Enhanced infection control and targeted prophylaxis for GAS carriers appeared to end the outbreak. In addition to employees, regular visitors to LTCFs should be trained in hand hygiene and infection control because of the potential for extended relationships over time, leading to interaction with multiple residents, and disease transmission in such residential settings. Specific attention to prevention of skin breaks and proper wound care may prevent disease. The occurrence of a sixth case during the investigation suggests urgency in addressing severe, large, or tightly clustered outbreaks of GAS infection in LTCFs.

Persistence of Fluoroquinolone-Resistant, Multidrug-ResistantStreptococcus pneumoniaein a Long-Term–Care Facility Efforts to Reduce Intrafacility Transmission

2005 ◽  
Vol 26 (3) ◽  
pp. 239-247 ◽  
Author(s):  
Alicia M. Fry ◽  
Chi Chi N. Udeagu ◽  
Montse Soriano-Gabarro ◽  
Scott Fridkin ◽  
Diana Musinski ◽  
...  
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Nasopharyngeal Carriage ◽  
Outbreak Strain ◽  
Term Care ◽  
Long Term Care Facility ◽  
Infection Control Measures

AbstractObjective:We describe an effort to reduce transmission of a multidrug-resistantStreptococcus pneumoniae(MDRSP) in a long-term-care facility (LTCF).Design:Longitudinal cross-sectional study.Setting:An LTCF in New York City with ongoing disease due to an MDRSP strain among residents with AIDS since a 1995 outbreak. The MDRSP outbreak strain was susceptible to vancomycin but not to other antimicrobials tested, including fluoroquinolones.Participants:Residents and staff members of the LTCF during 1999 through 2001.Intervention:Implementing standard infection control measures, and developing and implementing "enhanced standard" infection control measures, modified respiratory droplet prevention measures to reduce inter-resident transmission.Results:Before the intervention, nasopharyngeal carriage of the MDRSP outbreak strain was detected in residents with AIDS and residents with tracheostomies who were not dependent on mechanical ventilation. The prevalence of nasopharyngeal carriage of the MDRSP outbreak strain was 7.8% among residents who had AIDS and 14.6% among residents with tracheostomies. After training sessions on standard and enhanced standard infection control measures, the staff appeared to have good knowledge and practice of the infection control measures. After the intervention, new transmission among residents with tracheostomies was prevented; however, these residents were prone to persistent tracheal carriage and needed ongoing enhanced standard infection control measures. Ongoing transmission among residents with AIDS, a socially active group, was documented, although fewer cases of disease due to the outbreak strain occurred.Conclusions:Infection control contributed to less transmission of MDRSP in the LTCF. Additional strategies are needed to reduce transmission and carriage among certain resident populations.

An Outbreak of Acute Gastroenteritis in a Geriatric Long-Term–Care Facility: Combined Application of Epidemiological and Molecular Diagnostic Methods

1999 ◽  
Vol 20 (05) ◽  
pp. 306-311 ◽  
Author(s):  
Arthur Marx ◽  
David K. Shay ◽  
Jacqueline S. Noel ◽  
Carol Brage ◽  
Joseph S. Bresee ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Infection Control Measures ◽  
Geriatric Long Term Care

AbstractObjective:To assess possible transmission modes of, and risk factors for, gastroenteritis associated with Norwalk-like viruses (NLVs) in a geriatric long-term-care facility.Methods:During a prolonged outbreak of acute gastroenteritis, epidemiological data on illness among residents and employees were collected in conjunction with stool, vomitus, and environmental specimens for viral testing. NLVs were identified by electron microscopy in stool and vomitus specimens, and further characterized by reverse-transcriptase polymerase chain reaction and nucleotide sequencing. Potential risk factors were examined through medical-record review, personal interview, and a self-administered questionnaire sent to all employees.Results:During the outbreak period, 52 (57%) of 91 residents and 34 (35%) of 90 employees developed acute gastroenteritis. Four case-residents were hospitalized; three residents died at the facility shortly after onset of illness. A point source was not identified; no association between food or water consumption and gastroenteritis was identified. A single NLV strain genetically related to Toronto virus was the only pathogen identified. Residents were at significantly higher risk of gastroenteritis if they were physically debilitated (relative risk [RR], 3.5; 95% confidence interval [CI95], 1.0-12.9), as were employees exposed to residents with acute gastroenteritis (RR, 2.6; CI95, 1.1-6.5) or ill household members (RR, 2.3; CI95, 1.4-3.6). Adherence to infection control measures among the nursing staff may have reduced the risk of gastroenteritis, but the reduction did not reach statistical significance.Conclusions:In the absence of evidence for food-borne or waterborne transmission, NLVs likely spread among residents and employees of a long-term-care facility through person-to-person or airborne droplet transmission. Rapid notification of local health officials, collection of clinical specimens, and institution of infection control measures are necessary if viral gastroenteritis transmission is to be limited in institutional settings

scholarly journals COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitch van Hensbergen ◽  
Casper D. J. den Heijer ◽  
Petra Wolffs ◽  
Volker Hackert ◽  
Henriëtte L. G. ter Waarbeek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Border Region ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Cross Border

Abstract Background The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically. Methods Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections. Results Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Conclusions Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

scholarly journals Investigation of a Prolonged Group A Streptococcus Outbreak Among Residents and Outpatients Receiving Wound Care at a Long-Term Care Facility (LTCF)

2020 ◽  
Vol 41 (S1) ◽  
pp. s305-s306
Author(s):  
Alana Cilwick ◽  
April Burdorf ◽  
Wendy Bamberg ◽  
Christopher Czaja ◽  
Alexis Burakoff ◽  
...  
Keyword(s):  
Infection Control ◽  
Staff Member ◽  
Long Term Care ◽  
Wound Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Group A

Background: In February 2019, the Colorado Department of Public Health and Environment (CDPHE) identified a cluster of 3 invasive group A Streptococcus (GAS) infections in residents receiving wound care in a long-term care facility (LTCF). An investigation revealed a larger outbreak that extended to nonresidents receiving outpatient wound care at the LTCF. Methods: A case was defined as a positive culture for GAS emm type 82 from an individual with exposure to the LTCF between January and June 2019. Cases were categorized as clinical (symptoms of GAS disease or GAS isolated from a wound or sterile site) or carriage (no symptoms). Carriers were identified via samples collected from throat and skin lesions. Screening occurred in 2 rounds and included residents of affected units followed by screening of all wound-care staff and residents facility-wide. Available isolates were sent for emm type testing and whole-genome sequencing (WGS) at the CDC. CDPHE staff performed infection control observations. Results: We identified 14 cases: 8 clinical and 6 carriage (from 5 residents and 1 staff member). Two patients with invasive GAS died. Of 8 patients with clinical GAS, 6 resided in the facility on or 1 day prior to symptom onset; 2 were not residents but received outpatient therapy at the LTCF. All 8 patients with clinical GAS (100%) and 3 carriers had received wound care. The staff member with emm 82 carriage had provided wound care and occupational therapy to the affected residents and the 2 outpatients. Two additional cases were detected with onset dates following staff member decolonization. Moreover, 13 of the 14 emm 82 isolates were found to be identical by WGS. Infection control observations identified lapses in staff wound care and hand hygiene practices in the residential and outpatient settings of the facility. Conclusions: This investigation details a large GAS outbreak in an LTCF associated with asymptomatic carriage in residents and staff that included patients who had only received care in the outpatient portion of the facility. The outbreak was halted following decolonization of a staff member and improvements in infection control, including in the outpatient setting. Outpatient services, particularly wound care, provided by LTCFs should be considered when investigating LTCF-related GAS cases and outbreaks.Funding: NoneDisclosures: None

Failure to Control an Outbreak of Multidrug-ResistantStreptococcus pneumoniaein a Long-Term–Care Facility Emergence and Ongoing Transmission of a Fluoroquinolone-Resistant Strain

2005 ◽  
Vol 26 (3) ◽  
pp. 248-255 ◽  
Author(s):  
Rosalind J. Carter ◽  
Genevieve Sorenson ◽  
Richard Heffernan ◽  
Julia A. Kiehlbauch ◽  
John S. Kornblum ◽  
...  
Keyword(s):  
Long Term Care ◽  
Antimicrobial Prophylaxis ◽  
Care Facility ◽  
Control Measures ◽  
Fluoroquinolone Resistance ◽  
Outbreak Strain ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

AbstractObjectives:To characterize risk factors associated with pneumococcal disease and asymptomatic colonization during an outbreak of multidrug-resistantStreptococcus pneumoniae(MDRSP) among AIDS patients in a long-term–care facility (LTCF), evaluate the efficacy of antimicrobial prophylaxis in eliminating MDRSP colonization, and describe the emergence of fluoroquinolone resistance in the MDRSP outbreak strain.Design:Epidemiologic investigation based on chart review and characterization of SP strains by antimicrobial susceptibility testing and PFGE and prospective MDRSP surveillance.Setting:An 80-bed AIDS-care unit in an LTCF.Participants:Staff and residents on the unit.Results:From April 1995 through January 1996, 7 cases of MDRSP occurred. A nasopharyngeal (NP) swab survey of all residents (n = 65) and staff (n = 70) detected asymptomatic colonization among 6 residents (9%), but no staff. Isolates were sensitive only to rifampin, ofloxacin, and vancomycin. A 7-day course of rifampin and ofloxacin was given to eliminate colonization among residents: NP swab surveys at 1, 4, and 10 weeks after prophylaxis identified 1 or more colonized residents at each follow-up with isolates showing resistance to one or both treatment drugs. Between 1996 and 1999, an additional 6 patients were diagnosed with fluoroquinolone-resistant (FQ-R) MDRSP infection, with PFGE results demonstrating that the outbreak strain had persisted 3 years after the initial outbreak was recognized.Conclusions:Chemoprophylaxis likely contributed to the development of a FQ-R outbreak strain that continued to be transmitted in the facility through 1999. Long-term control of future MDRSP outbreaks should rely primarily on vaccination and strict infection control measures.

scholarly journals Investigation of a COVID-19 Outbreak and Its Successful Containment in a Long Term Care Facility in Qatar

2021 ◽  
Vol 9 ◽  
Author(s):  
Hanadi Al Hamad ◽  
Manal Mustafa Mohd. Malkawi ◽  
Jameela Ali A. A. Al Ajmi ◽  
Mariam Nooh J. H. Al-Mutawa ◽  
Sanjay Harish Doiphode ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Infection Control ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Artery Disease

Introduction: The objective of this study is to investigate the COVID-19 outbreak and its successful containment in a long-term care facility, Qatar.Materials and Methods: It was a retrospective case series of 24 COVID-19 positive patients inclusive of elderly, patient attenders, and front-liners from 06th to 18th June 2020. Laboratory, radiological, and treatment findings were assessed from electronic records.Results: The outbreak management team concluded that despite all the pre-existing preventive measures implemented at the start of the pandemic, there was still evidence of lapses in infection control practices such as breach of infection control protocols like improper use of personal protective equipment. The infection prevention and control team promptly reassessed and implemented more stringent infection control methods and practices that successfully contained the outbreak on July 1, 2020. Among the seven elderly patients, the average age was 76.28 years ± SD25.5 and all were females. 57% of the patients were symptomatic. The most common comorbidities were Dementia (57%), Diabetes mellitus (43%), Coronary Artery Disease (43%), and Seizures (43%). Ground glass appearances in the lungs were found in 29% of the patients. Among the three deceased patients, Dementia and Coronary Artery Disease were the common comorbidities. Persistent elevation in blood glucose levels was observed among all patients during this period of infection.Conclusion: Elderlies in long-term care facilities are with certain pre-existing comorbidities which makes them more prone to develop COVID-19 complications. Thus, intensive infection control measures like ongoing education and awareness, staff compliance monitoring, quick contact tracing, visitor policy revision, ongoing patient and caregivers monitoring are inevitable recommendations for effective outbreak prevention and management.

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