Challenges facing psychiatric intensive care during COVID-19: mitigating the risk of transmission on a PICU

2020 ◽  
Vol 16 (2) ◽  
pp. 89-94
Author(s):  
Ria Pugh ◽  
Luke Skelton ◽  
Lucy Blake ◽  
Margaret Butler ◽  
Bethan Harries ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Care Services ◽  
Control Protocols ◽  
And Control

This is the second of five brief reports which document the experience of a London psychiatric intensive care unit (PICU) which faced an outbreak of COVID-19 infection relatively early in the pandemic. The aim is to share what was learnt and examine the challenges which lie ahead for psychiatric intensive care services. This article will present how the PICU adapted to the changing landscape with consideration of the COVID-19 infectious window, infection prevention and control protocols and the unique challenges faced by PICU services.

Evolution of the environmental microbiota of a new neonatal intensive care unit (NICU) and implications for infection prevention and control

2020 ◽  
pp. 1-6
Author(s):  
Philip Zachariah ◽  
Felix D. Rozenberg ◽  
Stephania Stump ◽  
Dagmara I. Moscoso ◽  
Ganga Krishnamurthy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Patient Transfer ◽  
Infection Prevention And Control ◽  
Differential Abundance ◽  
And Control

Abstract Objective: To describe changes in the environmental microbiota of a new neonatal intensive care unit (NICU) and potential implications for infection prevention and control (IPC) efforts. Design: Prospective observational study. Setting: A newly constructed level IV neonatal cardiac intensive care unit (NCICU) before and after patient introduction and the original NICU prior to patient transfer. Methods: Environmental samples were obtained from the original NICU prior to patient transfer to a new NCICU. Serial sampling of patient rooms and provider areas of the new NICU was conducted immediately prior to patient introduction and over an 11-month study period. Microbiota at each sampling point were characterized using Illumina sequencing of the V3/V4 region of the 16S rRNA gene. Microbiota characteristics (α and β diversity and differential abundance) were compared based on time, location, and clinical factors (room-level antibiotic use and patient turnover). Results: An immediate increase in the environmental differential abundance of gut anaerobes were seen after patient introduction. There was an increase in the relative abundance of Staphylococcus spp, Klebsiella spp, Pseudomonas spp, and Streptococcus spp over time. The new NCICU consistently showed more diverse microbiota and remained distinct from the original NICU. The microbiota of the provider areas of the NCICU eventually formed a cluster separate from the patient rooms. Patient turnover increased room-level microbiota diversity. Conclusion: Microbiota characteristics of the new NICU were distinct from the original ICU despite housing similar patients. Patient and provider areas developed distinct microbiota profiles. Non–culture-based methods may be a useful adjunct to current IPC practice.

A Decrease in the Number of Cases of Necrotizing Enterocolitis Associated with the Enhancement of Infection Prevention and Control Measures during aStaphylococcus aureusOutbreak in a Neonatal Intensive Care Unit

2012 ◽  
Vol 33 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Brigitte Lemyre ◽  
Wenlong Xiu ◽  
Nicole Rouvinez Bouali ◽  
Janet Brintnell ◽  
Jo-Anne Janigan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Prevention And Control Measures ◽  
And Control

Objective.Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitiveStaphylococcus aureus(MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC.Design.Retrospective chart review.Setting.A 24-bed, university-affiliated, inborn level 3 NICU.Participants.Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed.Interventions.Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased.Results.Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P< .002).Conclusion.Although this observational study cannot establish a causal relationship, there was a significant decrease in the incidence of NEC following implementation of enhanced infection prevention and control measures to manage an MSSA outbreak.Infect Control Hosp Epidemiol2012;33(1):29-33

scholarly journals Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhijie Zhang ◽  
Yu Cao ◽  
Yanjian Li ◽  
Xufang Chen ◽  
Chen Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Biofilm Formation ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Anti Fungal ◽  
Hospital Acquired ◽  
And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

scholarly journals Compliance to infection prevention and control practices for prevention of SARS-CoV-2 transmission at tertiary care hospital in North Mumbai

2021 ◽  
Vol 8 (10) ◽  
pp. 4837
Author(s):  
Kinjal Patel ◽  
Suraj Purusottaman ◽  
Trupti Carval ◽  
Lekhan Narvekar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Care Hospital ◽  
And Control

Background: Infection control practices played a major role in prevention of SARS-CoV-2 in healthcare settings. Aim of the study was to know the compliance to infection control and prevention practices by healthcare workers in COVID-19 pandemic and the measures taken for prevention of SARS-CoV-2 spread in the hospital.Methods: An observational study was conducted at tertiary care hospital for a period of one month. All healthcare workers involved in patient care of COVID-19 and non COVID-19 was observed for their infection control practices. Areas were divided in two category, intensive care unit and indoor wards for audit. Environmental samples of various surfaces from intensive care unit and wards were taken and analyzed for the presence of SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction.Results: Overall compliance to infection prevention practices were improved during pandemic. Hand hygiene compliance in intensive care unit and indoor wards of COVID-19 unit were 78.66% and 74.36% whilst in non COVID-19 units was 72.47% and 62.31% respectively. Compliance to revised biomedical waste (BMW) policy at COVID-19 unit were 85.20% and 71.49% in intensive care unit and ward respectively. However, at non COVID-19 unit, it was 65.22% and 57.60%. Nursing station and doffing area of ICU at non-COVID-19 unit showed presence of SARS-CoV-2 virus. While all samples collected from COVID-19 unit were negative.Conclusions: Infection prevention and control practices play a key role to curtail transmission of infection. Awareness among healthcare workers, hospital environment, and usage of personal protective equipment should be optimized even at non COVID-19 facility.

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