scholarly journals Epidemiological profile of healthcare-associated infections caused by Carbapenemase-producing Enterobacteriaceae

2019 ◽  
Vol 53 ◽  
Author(s):  
André Luiz Silva Alvim ◽  
Bráulio Roberto Gonçalves Marinho Couto ◽  
Andrea Gazzinelli
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Hospital Environment ◽  
Automated System ◽  
Healthcare Associated Infections ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Hospital Infection Control ◽  
Carbapenemase Gene ◽  
Epidemiological Profile ◽  
Healthcare Associated

ABSTRACT Objective: To study the epidemiological profile of Healthcare-associated Infections caused by Enterobacteria which carry the Klebsiella pneumoniae Carbapenemase gene (blaKPC) in the hospital environment. Method: A descriptive study was conducted in a private hospital in Belo Horizonte, MG, Brazil, which included all patients with infections caused by Enterobacteriaceae which carry the Klebsiella pneumoniae Carbapenemase gene. The data were collected by the Automated System of Hospital Infection Control and analyzed by descriptive statistics by the Epi Info 7 program. Results: Eighty-two (82) patients participated in the study. Klebsiella pneumoniae was the most frequent species (68%) isolated in blood (30%), bronchoalveolar lavage (22%) and urine (18%), while catheter-associated bloodstream infection (30%) predominated regarding topography. A case fatality rate of 62% is highlighted in evaluating the outcome. Conclusion: The resistance genes spread rapidly, limiting the antimicrobial options for treating infectious diseases. The epidemiological profile of Healthcare-Associated Infections found in this study can be prevented by prevention and infection control programs.

Persisting intrahospital transmission of multidrug-resistant Klebsiella pneumoniae and challenges for infection control

2019 ◽  
Vol 40 (8) ◽  
pp. 904-909 ◽  
Author(s):  
Isabelle Vock ◽  
Sarah Tschudin-Sutter
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Global Scale ◽  
Resistance Mechanisms ◽  
Healthcare Associated Infections ◽  
The Past ◽  
Healthcare Settings ◽  
Healthcare Associated ◽  
Antibiotic Agents

AbstractIn the past several decades, the incidence of Klebsiella pneumoniae harboring resistance mechanisms against multiple antibiotic agents has increased on a global scale. We discuss reasons for ongoing transmission of multidrug-resistant K. pneumoniae in healthcare settings, which has resulted in the successful spread and establishment of this pathogen. It is now one of the most important causes of healthcare-associated infections worldwide.

scholarly journals Using Whole Genome Sequencing to Investigate a Mock-Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in Real-Time

2021 ◽  
Vol 34 (13) ◽  
Author(s):  
Alexandra Sofia Simões ◽  
Tiago Touret ◽  
Nuno Alexandre Faria ◽  
Susana Peres Ladeiro ◽  
João Costa ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Environmental Samples ◽  
Clinical Isolates ◽  
Whole Genome ◽  
Healthcare Associated Infections ◽  
Carbapenem Resistant ◽  
Healthcare Associated

Introduction: Healthcare associated infections due to carbapenem-resistant Klebsiella pneumoniae (CRKP) are a major concern in Portuguese hospitals. Whole genome sequencing (WGS) can improve infection control, but this practice is not routinely used by hospital clinical laboratories in Portugal. We simulated the investigation of a CRKP outbreak based on WGS, with the aim of determining, in the minimum possible time, genetic relatedness between CRKP clinical and environmental isolates.Material and Methods: Ten CRKP clinical isolates routinely obtained in the hospital laboratory were used. Forty environmental samples - from sinks and sink drains of ward rooms - were collected. Environmental samples were plated on selective media and presumptive CRKP colonies were isolated. Total DNA was extracted from all putative CRKP isolates and sequenced. Clonal relatedness was determined by multi-locus sequence typing and core genome single nucleotide polymorphism analysis; the presence of carbapenemase genes was evaluated.Results: Clinical isolates were characterized in 48 hours: eight strains were confirmed as CRKP, of which six were of ST13 and carried blaKPC-3. Environmental samples results were obtained in six days: eight CRKP were isolated from which five were of ST13 and carried blaKPC-3. Clinical and environmental ST13 isolates were highly related: ten (of 11) isolates differed from each other in < 0.001% of 2 172 367 core nucleotides.Discussion: WGS can be used as a high-resolution effective tool to investigate healthcare associated infections and track routes of dissemination in real-time.Conclusion: In Portugal, routine use of WGS to improve infection control could thrive through collaborative initiatives between hospitals and research institutes.

scholarly journals A Potential Way to Decrease the Know-Do Gap in Hospital Infection Control in Vietnam: “Providing Specific Figures on Healthcare-Associated Infections to the Hospital Staff Can ‘Wake Them Up’ to Change Their Behaviour”

2018 ◽  
Vol 15 (7) ◽  
pp. 1549 ◽  
Author(s):  
La Lien ◽  
Eva Johansson ◽  
Pham Lan ◽  
Nguyen Chuc ◽  
Nguyen Thoa ◽  
...  
Keyword(s):  
Infection Control ◽  
Health Workers ◽  
Hospital Staff ◽  
Infection Control Practice ◽  
Hospital Infection ◽  
Main Theme ◽  
Healthcare Associated Infections ◽  
Urban Hospital ◽  
Hospital Infection Control ◽  
Healthcare Associated

Adequate infection control plays a key role in preventing healthcare-associated infections (HAIs). This study aimed to explore staff perceptions of hospital infection control in a rural and an urban hospital in Vietnam. Individual interviews were conducted with hospital managers, and focus group discussions were conducted with doctors, nurses and cleaning workers separately. Content analysis was applied. An interview guide including discussion points on HAIs, hand hygiene and healthcare waste management was used. Generally, the staff were knowledgeable of hospital infection control, but they were not aware of the situation in their own hospital, and infection control practices in the hospitals remained poor. Reported difficulties in infection control included lack of resources, poor awareness and patient overload. A main theme emerged: ‘Making data on HAIs available for health workers can improve their awareness and motivate them to put their existing knowledge into practice, thus decreasing the know-do gap in infection control’. This could be a feasible intervention to improve infection control practice in the hospitals with limited resources, high workload and patient overload.

scholarly journals Reorganization of nurse scheduling reduces the risk of healthcare associated infections

2019 ◽  
Author(s):  
Eugenio Valdano ◽  
Chiara Poletto ◽  
Pierre-Yves Boëlle ◽  
Vittoria Colizza
Keyword(s):  
Infection Control ◽  
Wearable Sensors ◽  
Healthcare Services ◽  
University Hospital ◽  
Transmission Model ◽  
Healthcare Associated Infections ◽  
Nurse Scheduling ◽  
Hospital Infection Control ◽  
Healthcare Associated ◽  
The Impact

ABSTRACTBackgroundEfficient prevention and control of healthcare associated infections (HAIs) is still an open problem.ObjectiveTo design efficient hospital infection control strategies by reorganizing nurse scheduling.Design, setting, and participantsProof-of-concept modeling study based on high-resolution contact data from wearable sensors between patients, nurses, doctors, and administrative staff at a short-stay geriatric ward of a University hospital.MethodsWe considered isolation and contact removal to identify the most important class of individuals for HAI dissemination. We introduced a novel intervention based on the reorganization of nurse scheduling. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. We evaluated the impact of interventions through a Susceptible-Colonized-Susceptible transmission model on the empirical and reorganized contacts.ResultsIsolation and contact removal produced the largest risk reduction when acting on nurses. Reorganizing their schedules reduced HAI risk by 27% (95% confidence interval [24,29]%) while preserving the timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. No overall change in the number of nurses per patient resulted from the intervention.ConclusionsReorganization of nurse scheduling offers an alternative change of practice that substantially limits HAI risk in the ward while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for better infection control in hospitals.

scholarly journals Retrospective Study of Genetic Diversity of Acinetobacter Baumannii-Resistant Strains Isolated from Patients in Rīga East University Hospital in Latvia

2021 ◽  
Vol 75 (2) ◽  
pp. 142-148
Author(s):  
Māris Liepiņš ◽  
Angelika Krūmiņa ◽  
Irēna Meistere ◽  
Diāna Kosjkina ◽  
Juris Ķibilds ◽  
...  
Keyword(s):  
Infection Control ◽  
Acinetobacter Baumannii ◽  
Pathogenic Bacteria ◽  
Control Measures ◽  
University Hospital ◽  
Hospital Environment ◽  
Molecular Testing ◽  
Healthcare Associated Infections ◽  
In Vitro Susceptibility ◽  
Healthcare Associated

Abstract Acinetobacter baumannii is an aerobic gram-negative opportunistic bacterial pathogen, an emerging cause of healthcare-associated infections, associated with increased morbidity, mortality and healthcare costs. It has been widely found in the hospital environment, exhibiting high resistance to antimicrobials, affecting the spread of healthcare-associated infections and preventing effective infection control. The role of virulence factors in the pathogenesis of A. baumannii related human infections remains unclear. Therefore, molecular testing of pathogenic bacteria is an important tool for improving infection control measures against A. baumannii with combined resistance. The aim of this study was to analyse A. baumannii infection cases, antimicrobial resistance profiles and to characterise the genetic heterogeneity of isolates. In general, outbreaks occurring in hospitals are presumed to be clonal, with patient-to-patient transmission of essentially identical strains. Treatment decisions are based on a combination of in vitro susceptibility assays and empirical results based on patient outcomes.

scholarly journals Percepção da equipe de enfermagem quanto ao controle de infecção em um hospital de ensino

2019 ◽  
Vol 19 (77) ◽  
Author(s):  
Josni Tauffer ◽  
Bruna Tais Zack ◽  
Manoela Cristina Berticelli ◽  
Maria Julia Navarro Kássim ◽  
Sabrina Kássia Menegusso Carmello ◽  
...  
Keyword(s):  
Infection Control ◽  
Financial Incentives ◽  
Healthcare Associated Infections ◽  
Effective Prevention ◽  
Professional Performance ◽  
Hospital Infection Control ◽  
Nursing Team ◽  
Individual Protection ◽  
Healthcare Associated ◽  
And Control

Introdução: A prevenção e controle de infecções através de medidas que envolvam a qualificação da assistência hospitalar é primordial quando focado no conhecimento e na importância dos assuntos relacionados a essa temática. Frente a isto, o conhecimento e a concepção da equipe de enfermagem sobre o trabalho do controle de infecção auxiliam na aprimoração da qualidade e obtenção dos resultados esperados. Objetivo: Analisar a percepção dos profissionais da equipe de enfermagem quanto ao serviço de controle de infecção em um hospital escola. Métodos: A coleta de dados seguiu a proposta de estudo quantitativo e qualitativo, formadas por questões abertas e fechadas que foram transcritas de forma analítica e elencadas conforme eixos temáticos as quais sofreram análise de Bardin. Os resultados das questões fechadas foram descritos por meio do programa Excel com apresentações dos resultados em frequência e porcentagem. Resultados: 17 (85%) dos profissionais entrevistados eram do sexo feminino; 18 (90%) responderam que a falta de adesão à higienização das mãos é responsável por maior parte das infecções relacionadas à assistência à saúde na instituição; 14 (70%) dos profissionais evidenciaram que a grande circulação de profissionais propicia o surgimento de infecções relacionadas à assistência à saúde; 12 (60%) dos profissionais afirmaram ter conhecimento sobre os índices de infecções relacionadas à assistência à saúde em seu setor; 17 (85%) afirmam a disponibilização de ferramentas para o controle de infecções relacionadas à assistência à saúde; 16 (80%) afirmam ter participado em algum momento de treinamentos relacionados ao controle de infecção; 18 (90%) higienização das mãos e 11 (55%) observação nos critérios de isolamento, os demais variam entre 8 a 9% considerando respectivamente importante a esterilização de materiais e utilização de equipamento de proteção individual; 18 (90%) afirmam conhecer o trabalho do enfermeiro em controle de infecção. Conclusão: A atuação do profissional enfermeiro faz-se necessária, na vigilância da incidência das infecções relacionadas à assistência à saúde e na prestação de cuidados. O conjunto multifatorial e multiprofissional, que engloba desde incentivos financeiros quanto a prevenção continuada e eficaz ao paciente, com a implementação de linguagem horizontal definida por aplicação de práticas e protocolos assistenciais sem desvios de informações contribui significativamente na redução das infecções relacionadas à assistência à saúde.Palavras-chave: Infecções relacionadas à assistência à saúde; Controle de Infecção; Vigilância em Saúde; Enfermagem. ABSTRACTThe prevention and control of infections through measures involving the qualification of hospital care is paramount when focused on the knowledge and importance of issues related to this thematic. Faced with this, the knowledge and conception of the nursing team about the work of infection control helps to improve the quality and obtain the expected results. Objective: To analyze the perception of nursing team regarding hospital infection control service in a school hospital. Methods: The data collection followed the proposal of a quantitative and qualitative study, formed by open and closed questions which was transcribed analytically and listed according to thematic axes which were analyzed by Bardin. The results of the closed questions were described through the Excel program with presentations of results in frequency and percentage. Results: 17 (85%) of the professionals interviewed were female. 18 (90%) answered that lack of adherence to hand hygiene is responsible for most of the healthcare-associated infections in the institution; 14 (70%) of the professionals showed the large circulation of professionals facilitates the emergence of healthcare-associated infections; 12 (60%) of the professionals stated that they had knowledge about the healthcare-associated infections indices in their sector; 17 (85%) affirm the availability of tools for the control of healthcare-associated infections; 16 (80%) reported having participated in some training related to infection control; 18 (90%) hands hygiene and 11 (55%) Note in the isolation criteria, the others vary from 8 to 9% considering, respectively, material sterilization and use of individual protection equipment; 18 (90%) stated that they knew the nurse's job in infection control. Conclusion: Nursing professional performance is necessary, in the surveillance of the incidence of healthcare-associated infections and in the provision of care. The multifactorial and multiprofessional set, from financial incentives to continuous and effective prevention to the patient, with the implementation of horizontal language defined by the application of practices and protocols assists without deviations of information contributes significantly to the reduction of healthcare-associated infections.Keywords: Health-care-related infections; Infection Control; Health Surveillance; Nursing.

scholarly journals Clinical and microbiological characteristics of nosocomial, healthcare-associated, and community-acquired Klebsiella pneumoniae infections in Guangzhou, China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Tingting Le ◽  
Ling Wang ◽  
Chaoying Zeng ◽  
Leiwen Fu ◽  
Zhihua Liu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Resistance ◽  
Empirical Therapy ◽  
Clonal Diversity ◽  
Extended Spectrum Beta Lactamase ◽  
Microbiological Characteristics ◽  
Carbapenemase Gene ◽  
Cross Transmission ◽  
Healthcare Associated

Abstract Background Klebsiella pneumoniae (K. pneumoniae) is a common pathogen associated with hospital and community-onset infections. This study aimed to compare the clinical and microbiological characteristics of nosocomial, healthcare-associated (HCA), and community-acquired (CA) K. pneumoniae infections. Methods Clinical data were extracted from electronic medical records and analyzed retrospectively. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) production were determined for all identified strains. Carbapenemase and ESBL genes were amplified by PCR. Genotyping of carbapenem-resistant K. pneumoniae (CRKP) and ESBL-producing strains was performed by pulsed-field gel electrophoresis (PFGE). Results Of 379 K. pneumoniae infections, 98 (25.9%) were nosocomial, 195 (51.5%) were healthcare-associated, and 86 (22.6%) were community-acquired. Hematological malignancy (OR = 4.467), and hypertension (OR = 2.08) and cerebral vascular disease (OR = 2.486) were associated with nosocomial and HCA infections respectively, when compared to CA infections. Overall, the incidence of antimicrobial resistance for the majority of agents tested was similar between nosocomial and HCA infections (P > 0.05) and both groups had a higher incidence than CA infections (P < 0.05). Moreover, 95.1% (78/82) of CRKP strains were isolated from the nosocomial and HCA groups. The blaKPC was the most prevalent carbapenemase gene among CRKP strains (80.5%, 66/82). ESBL-producing strains were prevalent among nosocomial (40.8%), HCA (35.9%) and CA groups (24.4%). The blaCTX-M-9-group and blaCTX-M-1-group genes were predominant in nosocomial (65.0%) and CA strains (66.7%), respectively. PFGE results showed ESBL-producing and CRKP strains were genetically diverse. Identical PFGE profiles were observed among HCA and nosocomial strains. Conclusions Nosocomial and HCA K. pneumoniae infections presented similar clinical features and antimicrobial resistance, and both two types of infections were different to CA infections. CRKP and ESBL-producing strains were disseminated mainly in HCA and nosocomial groups, and showed a clonal diversity. The cross transmission of CRKP was existed among HCA and nosocomial patients. This finding suggests that similar empirical therapy should be considered for patients with nosocomial and HCA K. pneumoniae infections and bacterial resistance surveillance of these infections is necessary.

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