scholarly journals ANTIMICROBIAL SUSCEPTIBILITY AND DETECTION METHODS FOR THE EXTENDED‑SPECTRUM β-LACTAMASES PRODUCING ENTEROBACTERIACEAE FROM CLINICAL SAMPLES

2018 ◽  
Vol 11 (5) ◽  
pp. 139
Author(s):  
Kaviyarasan G ◽  
Rajamanikandan Kcp ◽  
Sabarimuthu M ◽  
Ramya S ◽  
Arvind Prasanth D
Keyword(s):  
Infection Control ◽  
Bacterial Infections ◽  
Control Measures ◽  
Detection Methods ◽  
Clinical Samples ◽  
Healthcare Settings ◽  
Infection Control Measures ◽  
Extended Spectrum ◽  
Drug Choice ◽  
Synergy Test

Objectives: Detection of extended-spectrum β-lactamases (ESBLs) is crucial for the infection control and antibiotic choice in healthcare settings. The aim of this study is to develop a standardized, inexpensive, and simple approach that is able to detect ESBL-producing Enterobacteriaceae isolates.Methods: Isolates those were resistant to at least one of the three indicator cephalosporins (cefotaxime, cefpodoxime, and ceftazidime) were tested for ESBL production using the double disc synergy test (DDST), combined disc synergy test (CDST) test and genotypic detection of the responsible gene for the ESBL.Result: From 64 isolates, 28 were resistant to cephalosporins. In 28 isolates, 23 were positive in CDST but in the DDST 18 were showing ESBL positive. 10 were positive in both CDST and DDST.Conclusion: Resistance to cephalosporins, which are the drug choice to treat mixed bacterial infections by the Enterobacteriaceae of which disseminate rapidly being plasmid mediated. Hence, it is necessary that rapid detection of ESBL should be done and immediate infection control measures should be implemented to prevent their dissemination.

Rethinking creative research methods in response to COVID-19: Creating a remote research kit

2021 ◽  
Vol 12 (3) ◽  
pp. 271-288 ◽  
Author(s):  
Rebecka Fleetwood-Smith
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Infection Control ◽  
Public Engagement ◽  
Control Measures ◽  
Arts Organizations ◽  
Healthcare Settings ◽  
Infection Control Measures ◽  
Hospital Environments ◽  
Creative Research

The ‘Sensing Spaces of Healthcare: Rethinking the NHS Hospital’ project involves working with National Health Service (NHS) staff, patients and visitors to explore their experiences of hospital environments. Over the course of the project, creative approaches centred on art-based and design-led practices are employed to research people’s experiences. Such approaches often involve working closely with participants during sessions. As COVID-19 infection control measures have affected in-person research, it has been necessary to develop and adopt alternative low-contact approaches. This article presents the development of a remote creative research kit designed to be used without a researcher/practitioner present. The kit has been developed through work with creative practitioners, hospital arts organizations, patient and public contributors and learning from public engagement events. The remote creative research kit has led to rethinking and reimagining the ways in which such approaches may be of benefit more broadly in healthcare settings.

Carbapenem-ResistantEnterobacteriaceae: A Strategic Roadmap for Infection Control

2017 ◽  
Vol 38 (5) ◽  
pp. 580-594 ◽  
Author(s):  
N. Deborah Friedman ◽  
Yehuda Carmeli ◽  
Aaron Lea Walton ◽  
Mitchell James Schwaber
Keyword(s):  
Infection Control ◽  
Medical Problem ◽  
Control Measures ◽  
Global Public Health ◽  
Regional Variability ◽  
Preparedness Plan ◽  
Healthcare Settings ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Crude Mortality

The incidence of carbapenem-resistantEnterobacteriaceae(CRE) has increased worldwide with great regional variability. Infections caused by these organisms are associated with crude mortality rates of up to 70%. The spread of CRE in healthcare settings is both an important medical problem and a major global public health threat. All countries are at risk of falling victim to the emergence of CRE; therefore, a preparedness plan is required to avoid the catastrophic natural course of this epidemic. Proactive and adequate preventive measures locally, regionally, and nationally are required to contain the spread of these bacteria. The keys to success in preventing the establishment of CRE endemicity in a region are early detection through targeted laboratory protocols and containment of spread through comprehensive infection control measures. This guideline provides a strategic roadmap for infection control measures based on the best available evidence and expert opinion, to enable preparation of a multifaceted preparedness plan to abort epidemics of CRE.Infect Control Hosp Epidemiol2017;38:580–594

scholarly journals Economic Impact of Outbreaks of Norovirus Infection in Hospitals

2011 ◽  
Vol 32 (2) ◽  
pp. 191-193 ◽  
Author(s):  
Bruce Y. Lee ◽  
Sarah M. McGlone ◽  
Rachel R. Bailey ◽  
Zachary S. Wettstein ◽  
Craig A. Umscheid ◽  
...  
Keyword(s):  
Infection Control ◽  
Economic Impact ◽  
Control Measures ◽  
Johns Hopkins Hospital ◽  
Computer Simulation Model ◽  
Hospital Administrators ◽  
Healthcare Settings ◽  
Infection Control Measures ◽  
Hospital Stays ◽  
And Control

Norovirus is highly infectious and can spread rapidly in healthcare settings, consuming resources and resulting in longer hospital stays. Although the economic impact of specific past outbreaks has been reported (eg, a 2007 outbreak of norovirus infection at Johns Hopkins Hospital cost an estimated $650,000), these costs may not be generalizable. We developed an economic computer simulation model to assist policy makers, hospital administrators, infection control professionals, and other healthcare workers in determining how much to invest in norovirus prevention and control interventions above and beyond existing infection control measures.

scholarly journals Gram Negative Extended Spectrum Beta-Lactamase Producing Bacteria Prevalence in Jouf Region Tertiary Care Hospital, Saudi Arabia

2021 ◽  
Author(s):  
Javid Iqbal Rather ◽  
Zahoor Mohi ud din ◽  
Farkhanda N. Syed ◽  
Mir Haris ◽  
Mudasar Nabi ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Control Measures ◽  
Clinical Samples ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Infection Control Measures ◽  
Antimicrobial Sensitivity ◽  
Extended Spectrum

Extended Spectrum beta lactamase producing pathogens are reported in many clinical samples and pose an emerging threat health. To find the prevalence of ESBL producing Enterobactriacea pathogens isolated from inpatients (Medical and Surgical Wards; Hospital stay > 72 h) admitted to Prince, Mutib, Hospital Sakaka, Jouf. A total of 1043 Enterobactriacea were isolated during April 2015 to October 2016 study period. Vitek -2 compact (biomeriux Leon, France) was used for identification and antimicrobial sensitivity (AST) test. A Total of 115/1043 (11.02%) ESBL producing pathogens were isolated from urine 15.07% (n=242), sputum 13.6 % (n=220), wound 10.8% (n=287) and blood 5.4 % (n=294). Klebsiella pneumonia is most dominant followed by E coli and Proteus miribilis. Cephamycins and carbapenems were found most effective (100% sensitivity) against the pathogens isolated. The aminoglycosides, beta lactams and Fluroquinolnes class of antibiotics, microorganisms have gained the resistance of 20%, 22.7%, 40-70% respectively. The infection control measures should be taken seriously and making of effective use of antibiotics is need of hour.

Occurrence of ESBLs in Clinical Isolates of Klebsiella Species and Comparative Analysis of Phenotypic Detection Methods

2020 ◽  
Vol 18 (3) ◽  
pp. 255-260
Author(s):  
Taqdees Malik ◽  
Asma Naim
Keyword(s):  
Detection Methods ◽  
Phenotypic Characterization ◽  
Clinical Samples ◽  
Zone Of Inhibition ◽  
Diagnostic Laboratory ◽  
Klebsiella Species ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Zone ◽  
Synergy Test

Aims: Drug resistance enzymes like beta-lactamases and Extended-Spectrum Beta- Lactamases (ESBLs) are mostly produced in the response of mutation and a few other factors. These enzymes are plasmid-mediated that can confer resistance against several β-lactam agents including cephalosporin and extended-spectrum cephalosporin. This study is conducted to determine the frequency of ESBL producing Klebsiella strains and to compare the phenotypic detection methods among various clinical samples collected from a commercial centralized Microbiology diagnostic laboratory. Materials and Methods: 125 Klebsiella strains were collected for this study. After identification and susceptibility testing, the phenotypic characterization of ESBL producing K. pneumoniae (n=89) and K. oxytoca (n=36) species was performed by using the double disc synergy test and the combination disc test. Results: In our study, 80 (64%) Klebsiella isolates were found to be ESBL positive due to their ability to produce an extended zone of inhibition with combination disc whereas 45 (36%) isolates were ESBL negative with no extended zone of inhibition. The phenotypic findings obtained by using the combination disc method and double disc synergy method were re-confirmed by molecular methods. By comparing the phenotypic finding with the genotypic results, we identified 80 (64%) Klebsiella isolates as ESBL positive and 45 (36%) isolates as ESBL negative. These genotypic findings of the ESBL producing strains were similar to the results obtained from the combination disc method. It also confirmed that the double disc synergy test was unable to detect 47 ESBL producing klebsiella strains. Conclusion: For implementing strict infection control policy and to stop the spread of resistant strains, it is important to detect ESBL producing isolates more rapidly. A suitable antimicrobial therapy can be started timely with the early detection of resistance enzymes either phenotypically or genotypically. It has been proved that the combination disc test can be used more reliably and preferably as compared to the double disc synergy test for the detection of ESBL enzymes produced by Klebsiella strains.

scholarly journals Epidemiology and control measures of an OXA-48-producing Enterobacteriaceae hospital-wide oligoclonal outbreak

2018 ◽  
Vol 146 (5) ◽  
pp. 656-662 ◽  
Author(s):  
V. Pérez-Blanco ◽  
L. Redondo-Bravo ◽  
G. Ruíz-Carrascoso ◽  
J. R. Paño-Pardo ◽  
R. Gómez-Gil ◽  
...  
Keyword(s):  
Infection Control ◽  
Tertiary Hospital ◽  
Control Measures ◽  
Clinical Samples ◽  
Significant Drop ◽  
Contact Precautions ◽  
Infection Control Measures ◽  
Electronic Alerts ◽  
Initial Control ◽  
Incident Cases

AbstractThe main objective of our study was to describe the epidemiological and microbiological features of an oligoclonal hospital-wide outbreak caused by OXA-48-producing Enterobacteriaceae (OXA-48-PE). OXA-48 is a carbapenemase belonging to Ambler class D beta-lactamases, identified frequently in the Mediterranean and Southern European countries, and associated with several Enterobacteriaceae species. An outbreak of OXA-48-PE with a complex epidemic pattern was detected in January 2011. Initial control measures included contact precautions and the reinforcement of infection control practices, but despite all efforts made, the epidemiological situation hardly changed and new measures were implemented during 2013. An observational retrospective study was performed to describe the main features of the outbreak and to analyse the cumulative incidence (CI) trends. Eight hundred and 16 patients colonised or infected by OXA-48-PE were identified during the 2-year period (January 2013–December 2014), female 46%, mean age (s.d.), 71.6 (15.2). The samples isolated in the incident cases were rectal swabs (80%), urine samples (10.7%), blood samples (2.8%) and other clinical samples (6.6%). The most frequent OXA-48-PE was Klebsiella pneumoniae. Eleven different clones were identified, but K. pneumoniae sequence types 11 and 405 were predominant: ST11 (64.2%) and ST405 (29.3%). OXA-48-PE CI trend suffered a statistically significant change in August 2013, which continued the following months. Though we could not eradicate the outbreak, we observed a statistically significant drop in CI after an intervention for OXA-48-PE control, based on patient cohort, active surveillance, electronic alerts and reinforcement of infection control measures in a tertiary hospital.

scholarly journals A recurrent and transesophageal echocardiography–associated outbreak of extended-spectrum β-lactamase–producing Enterobacter cloacae complex in cardiac surgery patients

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Tom Van Maerken ◽  
Els De Brabandere ◽  
Audrey Noël ◽  
Liselotte Coorevits ◽  
Pascal De Waegemaeker ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infection Control ◽  
Transesophageal Echocardiography ◽  
Positive Culture ◽  
Case Definition ◽  
Control Measures ◽  
University Hospital ◽  
Epidemiological Investigation ◽  
Infection Control Measures ◽  
Extended Spectrum

Abstract Background We report a recurrent outbreak of postoperative infections with extended-spectrum β-lactamase (ESBL)–producing E. cloacae complex in cardiac surgery patients, describe the outbreak investigation and highlight the infection control measures. Methods Cases were defined as cardiac surgery patients in Ghent University Hospital who were not known preoperatively to carry ESBL-producing E. cloacae complex and who postoperatively had a positive culture for this multiresistant organism between May 2017 and January 2018. An epidemiological investigation, including a case-control study, and environmental investigation were conducted to identify the source of the outbreak. Clonal relatedness of ESBL-producing E. cloacae complex isolates collected from case patients was assessed using whole-genome sequencing–based studies. Results Three separate outbreak episodes occurred over the course of 9 months. A total of 8, 4 and 6 patients met the case definition, respectively. All but one patients developed a clinical infection with ESBL-producing E. cloacae complex, most typically postoperative pneumonia. Overall mortality was 22% (4/18). Environmental cultures were negative, but epidemiological investigation pointed to transesophageal echocardiography (TEE) as the outbreak source. Of note, four TEE probes showed a similar pattern of damage, which very likely impeded adequate disinfection. The first and second outbreak episode were caused by the same clone, whereas a different strain was responsible for the third episode. Conclusions Health professionals caring for cardiac surgery patients and infection control specialists should be aware of TEE as possible infection source. Caution must be exercised to prevent and detect damage of TEE probes.

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