scholarly journals Emergence and Clonal Spread of KPC-2 Producing Clinical Klebsiella Aerogenes Isolates From a Teaching Hospital in Tucuman, Argentina.

2020 ◽  
Author(s):  
Juan Martín Vargas ◽  
María Paula Moreno Mochi ◽  
Juan Manuel Nuñez ◽  
Silvana Mochi ◽  
Mariel Cáceres ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Antimicrobial Treatment ◽  
Control Measures ◽  
Molecular Characteristics ◽  
Klebsiella Aerogenes ◽  
Adult Intensive Care Unit ◽  
Infection Control Measures ◽  
Potential Risk Factors ◽  
Clonal Spread ◽  
Healthcare Associated

Abstract IntroductionKlebsiella aerogenes is a nosocomial pathogen associated with drug resistance and healthcare-associated infections. We pursued this study to investigate an outbreak of clinical carbapenem-resistant K. aerogenes(CRKA) in an argentinian tertiary hospital which persisted for 4 months despite aggressive infection control measures. The primary goals aimed to evaluate the molecular characteristics and the clonal relationships among the CRKA isolates.MethodsWe characterized CRKA isolates by multiplex PCR and PFGE. The information was integrated with clinical and epidemiologic data.ResultsThe 14 CRKA strains were disseminated in an adult intensive care unit (50%) and five different wards. In patients who received antimicrobial treatment, 8 staggered to directed treatment, mainly with amikacin(6/8) and/or carbapenemes(5/8). The overall mortality was 42.8%, and the attributed mortality to CRKA infection was 21.4%, strains showed high rates of resistance to most of the antimicrobials without resistance to Amikacin and Tigecycline, and carried the blaKPC-2, blaSHV-2 and blaCTXM-15 genes. The PFGE indicated 2 distinct groups; 12/14 CRKA isolatesassociated with the dominant subgroup A and likely to be primarily responsible for the first isolation and subsequent dissemination in the hospital.ConclusionThe outbreak characteristics data showed prolonged hospitalization and previous use of broad-spectrum antibiotics as potential risk factors for the acquisition of CRKA.

scholarly journals Prevalence and mechanisms of carbapenem resistance  among  Klebsiella aerogenes  in a tertiary hospital in China

2020 ◽  
Author(s):  
Luxiang Liu ◽  
Jingjing Quan ◽  
Dongdong Zhao ◽  
Weichao Liao ◽  
Jiaojian Lv ◽  
...  
Keyword(s):  
Intensive Care ◽  
Efflux Pump ◽  
Carbapenem Resistance ◽  
Clonal Diversity ◽  
Tertiary Hospital ◽  
Molecular Characteristics ◽  
Klebsiella Aerogenes ◽  
Carbapenem Resistant ◽  
Efflux Pump Inhibition ◽  
Clonal Spread

Abstract Background: Klebsiella aerogenes has emerged as one of the most important nosocomial pathogens for patients in intensive care units (ICU) in recent years. This study aims to evaluated the prevalence and molecular characteristics of clinical carbapenem-resistant K. aerogenes (CRKA) isolates in a tertiary hospital in China.Results: Twenty CRKA were identified among all the isolates, with the rate of 5.5% (20/364). Six CRKA isolates produced KPC-2 and 1 CRKA isolate produced NDM-1. PFGE and MLST indicated that the 20 CRKA strains were clonal diversity. All the bla KPC-2 gene and bla NDM-1 gene were located on plasmids and all the plasmids with bla KPC-2 and bla NDM-1 genes could successfully transferred to EC600 or J53. Twelve of 13 CRKA strains without any carbapenemase genes were positive for efflux pump inhibition test.Conclusion: Overall, the prevalence of CRKA in the tertiary hospital in Zhejiang Province of China is 5.5%. Only 35% of CRKA produce carbapenemase and efflux pumps might play an important role in the carbapenem resistance of K. aerogenes. It is necessary to strengthen the surveillance of carbapenem resistance in the hospital to prevent the horizontal and clonal spread of CRKA.

scholarly journals Microbiological and molecular characteristics of carbapenemase-producing Klebsiella pneumoniae endemic in a tertiary Greek hospital during 2004-2010

2012 ◽  
Vol 17 (7) ◽  
Author(s):  
A Zagorianou ◽  
E Sianou ◽  
E Iosifidis ◽  
V Dimou ◽  
E Protonotariou ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Antibiotic Use ◽  
The United States ◽  
Tertiary Hospital ◽  
Control Measures ◽  
Molecular Characteristics ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Infection Control Measures

We report 570 carbapenemase-producing Klebsiella pneumoniae (CPKP) clinical isolates in a 1,040-bed Greek tertiary hospital during 2004 to 2010. The first CPKP (VIM-producing) was isolated in September 2004. Despite initial containment, VIM producers have become endemic since 2006. KPC-producing K. pneumoniae was first isolated in August 2007 from a patient who came from Israel, spread rapidly, and outcompeted VIM. Overall, 267 (47%) VIM-producing and 301 (53%) KPC-producing strains were isolated, including 141 (24.7%) from patients with bacteraemia. Two isolates carrying both VIM and KPC were isolated in two consecutive months in 2009, but not since. The prevalence of CPKP increased from 0% in 2003 to 38.3% in 2010 (p<0.0001). All genotyped KPC producers harboured blaKPC-2 and belonged to two clones, among which the hyperepidemic Greek clone, related to those from the United States and Israel, predominated. Most metallo-beta-lactamase (MBL) producers carried the blaVIM-1 gene and belonged to several clones, whereas all but one isolate with blaVIM-12 were clustered within a five-month period, arising from one clone. Resistance to non-beta-lactam antibiotics was also increased among CPKP. They were almost invariably resistant to ciprofloxacin and trimethoprim-sulfamethoxazole. Resistance to colistin increased from 3.5% (4/115) in 2008 to 20.8% (25/120) in 2010, and resistance to tigecycline also increased. Following reinforcement of infection control measures, prevalence of CPKP (mainly KPC) has been reduced since mid-2009 (from 46% in 2009 to 38.3% in 2010). In view of the exhaustion of available therapies, investment in infection control resources and optimal antibiotic use is urgently required.

scholarly journals Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

2021 ◽  
pp. 1-24
Author(s):  
Eliza R. Thompson ◽  
Faith S. Williams ◽  
Pat A. Giacin ◽  
Shay Drummond ◽  
Eric Brown ◽  
...  
Keyword(s):  
Large Scale ◽  
Infection Prevention ◽  
Index Patient ◽  
Field Investigation ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Va Health Care System ◽  
Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

Molecular Characterization ofStenotrophomonas maltophiliaIsolates from Cystic Fibrosis Patients and the Hospital Environment

2009 ◽  
Vol 30 (8) ◽  
pp. 753-758 ◽  
Author(s):  
Carolina Marzuillo ◽  
Maria De Giusti ◽  
Daniela Tufi ◽  
Alessandra Giordano ◽  
Angela Del Cimmuto ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Monitoring Program ◽  
Control Measures ◽  
Hospital Environment ◽  
Molecular Heterogeneity ◽  
Infection Control Measures ◽  
Clonal Spread ◽  
Multiple Strains ◽  
Outpatient Settings ◽  
And Control

Objectives.To ascertain whether cystic fibrosis (CF) patients are colonized or infected with unique or multiple strains ofStenotrophomonas maltophilia; to understand whether some strains colonize or infect more than 1 patient, indicating clonal spread; and to explore the molecular heterogeneity of hospital water isolates and their correlation with clinical isolates.Setting.The regional CF center of Policlinico “Umberto I” of Rome, Italy.Methods.The study was carried out on a random sample ofS. maltophiliaisolates (n= 110) collected from CF patients (n= 50) during the period 2002–2005 and on 24 water isolates obtained during a monitoring program in the first 6 months of 2005. Home environmental samplings were not performed. All isolates, which were recovered from cultures of specimens obtained in both inpatient and outpatient settings, were genotyped with DNA macrorestriction analysis with the restriction enzymeXbaland pulsed-field gel electrophoresis.Results.One-third of the patients with repeated episodes ofS. maltophiliainfection or colonization hosted more than 1 strain. A potential transmission, defined as the isolation of the same strain in 2 or more patients, occurred 5 times, showing a frequency of potential transmission episodes slightly higher than previously reported. Water, taps, and sinks of the different rooms of the CF center tended to be persistently colonized with the same strain ofS. maltophilia, with no correlation between clinical and water-associated isolates.Conclusions.The study does not provide sufficient data to conclude definitively that isolation of colonized or infected CF patients and control of hospital water systems contamination would be beneficial infection control measures. Epidemiologic analytical studies that correlate the presence ofS. maltophiliawith clinical outcomes are strongly needed.

scholarly journals Healthcare Workers Infection Rate in the Era of Coronavirus Disease 2019 - in Tertiary Teaching Hospital

2021 ◽  
Vol 9 (A) ◽  
pp. 651-658
Author(s):  
Mona Mohiedden ◽  
Aml M. Said ◽  
Ahmed M. Ali ◽  
Mohammed M. Abdel Razik ◽  
Maha Ali Gad
Keyword(s):  
Healthcare Workers ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Control Measures ◽  
University Hospitals ◽  
Cross Sectional ◽  
Infection Control Measures ◽  
Increased Risk ◽  
Tertiary Teaching ◽  
Potential Risk Factors

BACKGROUND: Healthcare workers (HCWs) are at the frontline defense against coronavirus disease 2019 (COVID-19) pandemic. AIM: The study aimed to describe the characteristics and appraise potential risk factors of COVID-19 transmission among HCWs who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in one of Cairo University Hospitals. METHOD: Cross-sectional descriptive analysis of confirmed polymerase chain reaction (PCR) positive versus negative cases for COVID-19. RESULTS: Through March–June 2020, (145/846; 17%) suspected HCWs were tested for COVID-19 by PCR; out of them (70/145; 48.3%) were confirmed as positive, these positive cases represented (70/846; 8.3%) of all HCWs of the hospital. About 33% of confirmed COVID-19 positive HCWs acquired the infection from the healthcare while only (13/70; 19%) from community settings, and no clear exposure data were identified in (34/70; 48%) of cases. Most of symptomatic cases showed a positive PCR test for SARS-CoV-2 versus asymptomatic cases, p < 0.001. There was no statistical significance regarding gender, age, presence of comorbidity, workload or the type of acquisition. CONCLUSION: HCWs are at an increased risk of COVID-19 infection at the workplace. Strict implementation of infection control measures is of crucial role in preventing transmission of COVID-19 infection in health-care settings.

Surveillance for Healthcare associated Infections in Indian NICUs: Researchable Issues

2009 ◽  
Vol 23 (4) ◽  
pp. 331-336
Author(s):  
Ashwani Kumar ◽  
Praveen Kumar
Keyword(s):  
Developed Countries ◽  
Control Measures ◽  
Surveillance Systems ◽  
Healthcare Associated Infections ◽  
Infection Control Measures ◽  
Infection Surveillance ◽  
Healthcare Associated ◽  
Symptoms And Signs ◽  
Local Research ◽  
Underlying Risk

Systematic surveillance is the first and integral step of all infection control measures, especially in intensive care settings. Surveillance systems started evolving in developed countries nearly 40 years ago. With experience and wisdom gained, the surveillance methods have improved and become more standardized. It is now clearly recognized that all patients are not at equal risk. For fair comparisons over time within an unit and in between units, the denominator must take the underlying risk into account. Infection surveillance in the NICU presents a number of unique challenges regarding definitions and differing symptoms and signs in the neonate. Although the importance of surveillance is being increasingly recognized in our country and the methods of developed countries are being adopted, there are numerous issues which need local research. This is in view of the limited manpower and financial resources and different profile of organisms and their epidemiology.

scholarly journals Epidemiological analysis of Elizabethkingia meningoseptica infection cluster among mechanically ventilated pediatric intensive care patients

2018 ◽  
Vol 5 (8) ◽  
pp. 3212 ◽  
Author(s):  
Wafaa Seddik Hamza ◽  
Samar Saeed Morsi ◽  
Ebtehal Saleh Al Roomi ◽  
Vincent Olubunmi Rotimi
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Blood Stream Infection ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Control Measures ◽  
Mechanically Ventilated ◽  
Infection Control Measures ◽  
Elizabethkingia Meningoseptica ◽  
Healthcare Associated

Background: Elizabethkingia meningoseptica is frequently found in hospital environments and usually associated with healthcare-associated infections (HAIs), particularly in patients in the intensive care units (ICU). The current study report an outbreak of E. meningoseptica infection/colonization in the pediatric intensive care unit, highlighted the infection control methods used to stem the spread.Methods: During a period of 7 months, May-November 2015, 4 patients were infected/ colonized by E. meningoseptica. Infection control measures were re-emphasized after each case and environmental swabs were cultured to detect possible source. Follow up for 25 months to ensure eradication of the pathogen.Results: Four patients were colonized/ infected with E. meningoseptica, their mean age 22 months. The average time patients spent in ICU between admission and isolation of E. meningoseptica was 27.5±19.2 days. All patients were mechanically ventilated. 25% E. meningoseptica isolated from blood causing healthcare associated Central Line Associated Blood Stream Infection (CLABSI) while it was isolated from endotracheal tube (ETT) secretion in 75% as healthcare associated colonization. The 4 isolates confirmed as identical using pulsed field gel electrophoresis (PFGE).Conclusions: Intensive infection control measures including healthcare workers education, emphasizing hand hygiene, comprehensive cleaning and disinfection of equipment and the environment are important to eradicate the bacterium.

scholarly journals Nurses’ Awareness of Infection Control Measures, and the Role and Effect in Patient and Family Education

2017 ◽  
Vol 13 (27) ◽  
pp. 59
Author(s):  
Sahar Hammoud ◽  
Bassam Ghazi ◽  
Mohamad Nassredine ◽  
Mohamad Abou Haidar
Keyword(s):  
Infection Control ◽  
Healthcare Providers ◽  
Family Members ◽  
Control Measures ◽  
Family Education ◽  
Healthcare Sector ◽  
Infection Control Measures ◽  
High Level ◽  
Healthcare Associated ◽  
Respiratory Hygiene

Background: Healthcare Associated Infections are serious problems in healthcare sector that threatened patient safety since decades till present. The proper adherence to infection control measures is a major factor in reducing these infections. Objectives: The objectives of this study were, to assess the level of nurses’ awareness with infection control measures in Lebanon and to determine its role in implementing patient and family education. Methodology and Results: A quantitative study was done. Questionnaires were distributed over 260 nurses, and 260 patients and family members at four well known hospitals in Lebanon. The study showed a high level of infection control awareness (81.57 %) among Lebanese nurses, and showed that Lebanese hospitals are training their nurses on IC topics (99.1 % of nurses were trained). As for patients and family members’ education, the JCI accredited hospital showed the highest level of education on infection control measures (58.3 %). Conclusion and Recommendations: The study showed that nurses who had a high awareness in infection control educated more their patients and family members on these measures than nurses with low awareness. (64.1 % and 42.1 % when educating on respiratory hygiene, p=0.013, 86.2 % and 57.9 % when educating on usage of PPE, p=0.000, 89.2 % and 68.4 % when educating on the reason for isolation, p=0.001). The major recommendations were to enhance the culture that believes in the partnership between patients, their families and healthcare providers at the hospitals level, and to include a new standard in the Lebanese Accreditation Standards that requires educating patients and family members on infection control measures at the Ministry of Public Health level.

Sign in / Sign up

Export Citation Format

Share Document