Molecular tools for early detection and control of spread of multidrug resistant organisms in the healhcare setting

2016 ◽  
Author(s):  
Icaro Boszczowski
Keyword(s):  
Early Detection ◽  
Multidrug Resistant ◽  
Molecular Tools ◽  
Multidrug Resistant Organisms ◽  
And Control

The management of NDM-β-lactamase-producing carbapenem-resistant Enterobacterales in Tuscany

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Ninci ◽  
M Grazzini ◽  
D Paolini ◽  
F Niccolini ◽  
M T Mechi ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Rectal Swab ◽  
Task Force ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Outbreak Management ◽  
Carbapenem Resistant ◽  
Multidrug Resistant Organisms ◽  
And Control

Abstract Issue An important outbreak of New Delhi metallo-β-beta-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) has been reported from north-western of Tuscany since November 2018. NDM is a metallo-β-lactamase able to hydrolyze most β-lactames (including carbapenems) with limited treatment options. Description of the Problem From November 2018 to May 2019, 7 Tuscan hospitals notified a total of 350 infected or colonized cases. This outbreak was described in a risk assessment edited by the European Centre for Disease Prevention and Control (ECDC) in June 2019. The Ministry of Health and the Tuscany Region promptly adopted infection prevention control measures. Results Since July 2019, a regional task force, composed by experts in infectivology, microbiology and public health, coordinated the following actions: Publication of Regional Resolutions which have established practical guidelines for the outbreak management. These measures included:(I) the introduction of screening test for CRE by rectal swab for hospitalized patients; (II) the implementation of microbiological rapid molecular tests and genotyping of rectal swab; (III) the enhancement of standard and transmission-based precautions; (iv) the strengthening of handover between hospital setting and primary healthcare; (v) the implementation of a regional data-base for outbreak surveillance.Monthly regional meetings with the infection control teams of each hospital.Site visits (n. 44) performed by a group of experts in all healthcare facilities. After the implementation of these measures, a trend for decrease in positive blood cultures of NDM was registered. Lessons The spread of NDM in Tuscany has been the opportunity to standardize and improve the approach to Multidrug-Resistant Organisms (MDROs) prevention and control. Key messages The spread of NDM in Tuscany has been the opportunity to standardize and improve the approach to Multidrug-Resistant Organisms (MDROs) prevention and control. The cooperation among stakeholders and the standardization of precaution measures and healthcare workers’ behavior allows to effectively face the MDROs diffusion.

scholarly journals Occurrence of carbapenem-resistant organisms in gastrointestinal postoperative infections: A therapeutic challenge

2021 ◽  
Vol 8 (4) ◽  
pp. 313-320
Author(s):  
Secunda Rupert ◽  
Pavithra Sankar ◽  
Karthick Govindaraj ◽  
Shanthi Sornamani David Raj ◽  
Jeswanth Sathyanesan ◽  
...  
Keyword(s):  
Early Detection ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Diagnostic Laboratory ◽  
Simple Method ◽  
Carbapenem Resistant ◽  
Operative Care ◽  
Multidrug Resistant Organisms

Dissemination of multidrug resistant organisms including Carbapenem-Resistant Organisms (CRO) in Hospitals is of global concern. Such nosocomial infections are more common during surgical procedures involving prolonged post-operative care and Hospital stay. Treatment options include administration of prophylactic antibiotics, which are broad-spectrum antibiotics. However, long-term administration of these antibiotics leads to an increase in the incidence of multidrug resistant organisms in Hospital sectors. To evaluate early detection of carbapenemase producing organisms from the clinical isolates of postoperative patients by carba NP test. The study was conducted at the diagnostic laboratory in clinical samples obtained from hospitalized patients. A total of 716 clinical samples were tested by employing basic microbiological and biochemical testing methods and the isolates were screened for antimicrobial susceptibility. Carbapenem-resistant isolates were then confirmed by E-test (imipenem, meropenem) and also via carba NP test.In a total of 716 samples, 257 tested positive for various microorganisms, of which 230 gram-negative bacilli were identified. Amongst them, 93 isolates were identified as resistant to carbapenem by disc diffusion method of which 50 isolates were tested for carbapenemase production. Within the 50 isolates, 47 isolates were resistant to E-test meropenem and 40 isolates were resistant to imipenem. Of note, 35 out of the 50 CROs were identified as carbapenemase producers. Our results show that Carba NP test is a simple method that can be employed routinely for early detection of carbapenemase mediated CROs thus reducing the spread of resistant strains in Hospitals.

scholarly journals Recommendations For Metrics For Multidrug-Resistant Organisms In Healthcare Settings: SHEA/HICPAC Position Paper

2008 ◽  
Vol 29 (10) ◽  
pp. 901-913 ◽  
Author(s):  
Adam L. Cohen ◽  
David Calfee ◽  
Scott K. Fridkin ◽  
Susan S. Huang ◽  
John A. Jernigan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Infection Prevention ◽  
Healthcare Setting ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
Healthcare Settings ◽  
Multidrug Resistant Organisms ◽  
Vulnerable Patient ◽  
Trends Over Time ◽  
And Control

Monitoring multidrug-resistant organisms (MDROs) and the infections they cause in a healthcare setting is important to detect newly emerging antimicrobial resistance profiles, to identify vulnerable patient populations, and to assess the need for and effectiveness of interventions; however, it is unclear which metrics are the best, because most of the metrics are not standardized. This document describes useful and practical metrics and surveillance considerations for measuring MDROs and the infections they cause in the practice of infection prevention and control in healthcare settings. These metrics are designed to aid healthcare workers in documenting trends over time within their facility and should not be used for interfacility comparison.

scholarly journals Status Update on Infection Prevention and Control at Deployed Medical Treatment Facilities

2019 ◽  
Vol 185 (3-4) ◽  
pp. 451-460
Author(s):  
Alice E Barsoumian ◽  
Steffanie L Solberg ◽  
Ashley S Hanhurst ◽  
Amanda L Roth ◽  
Tamara S Funari ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
Targeted Interventions ◽  
Multidrug Resistant Organisms ◽  
Treatment Facilities ◽  
Healthcare Associated ◽  
And Control

Abstract Introduction Infections with multidrug resistant organisms that spread through nosocomial transmission complicate the care of combat casualties. Missions conducted to review infection prevention and control (IPC) practices at deployed medical treatment facilities (MTFs) previously showed gaps in best practices and saw success with targeted interventions. An IPC review has not been conducted since 2012. Recently, an IPC review was requested in response to an outbreak of multidrug resistant organisms at a deployed facility. Materials and Methods A Joint Service team conducted onsite IPC reviews of MTFs in the U.S. Central Command area of operations. Self-assessments were completed by MTF personnel in anticipation of the onsite assessment, and feedback was given individually and at monthly IPC working group teleconferences. Goals of the onsite review were to assist MTF teams in conducting assessments, review practices for challenges and successes, provide on the spot education or risk mitigation, and identify common trends requiring system-wide action. Results Nine deployed MTFs participated in the onsite assessments, including four Role 3, three Role 2 capable of surgical support, and two Role 1 facilities. Seventy-eight percent of sites had assigned IPC officers although only 43% underwent required predeployment training. Hand hygiene and healthcare associated infection prevention bundles were monitored at 67% and 29% of MTFs, respectively. Several challenges including variability in practices with turnover of deployed teams were noted. Successes highlighted included individual team improvements in healthcare associated infections and mentorship of untrained personnel. Conclusions Despite successes, ongoing challenges with optimal deployed IPC were noted. Recommendations for improvement include strengthening IPC culture, accountability, predeployment training, and stateside support for deployed IPC assets. Variability in IPC practices may occur from rotation to rotation, and regular reassessment is required to ensure that successes are sustained through times of turnover.

scholarly journals Using Audit and Feedback and the Benchmark to Enhance Infection Prevention and Control of Multidrug Resistant Organisms: a Quasi-experiment Study

2020 ◽  
Author(s):  
Qian Zhou ◽  
Xiaoquan Lai ◽  
Xinping Zhang
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Audit And Feedback ◽  
Infection Prevention And Control ◽  
Mixed Effect ◽  
Multimodal Intervention ◽  
Multidrug Resistant Organisms ◽  
And Control

Abstract BackgroundInfection prevention and control (IPC) is important to prevent the spread of multidrug resistant organisms (MDROs). We aimed to enhance and explore the implementation of preventing and controlling MDROs using audit and feedback and the benchmark. MethodsThis quasi-experimental design was conducted in three hospitals from 1st March 2018 to 30th September 2019. A multimodal intervention treated audit and feedback and benchmark as key components for MDROs IPC was conducted in Wuhan, China. A checklist of 40 implementation indicators based on IPC measures was formed to guide the audit twice a week. Immediate feedback was verbally given after each audit on the spot, and written feedbacks containing benchmark and individual implementation levels were delivered monthly or quarterly in three hospitals. The intervention effect was evaluated by Chi-square and Poisson segmented linear regression. Impacts of implementation of indicators on the incidence were modeled by mixed-effect regressions. ResultsThe incidence of nosocomial MDROs decreased by 19.39%, 20.55%, and 24.03% in A, B, and C hospital, respectively. The lowest implementation compliance of indicators was the use of personal protective equipment of doctors (50.24%). The highest was isolated warning signs of nurses (96.46%). The implementation on hand hygiene of doctors (Coef. = -27.87, p=0.001) and nurses (Coef. = -35.44, p=0.001), clean of surrounding instruments and bed unit (Coef. = -4.84, p=0.030), education to patients and relatives (Coef. = -59.51, p=0.031), and sending of specimen inspection timely (Coef. = -9.95, p<0.001) were negatively associated with the incidence of nosocomial MDROs infection. Conclusions The multimodal intervention by strengthening the implementation of audit and feedback and the benchmark is feasible and effective in China. The checklist is an effective and practical tool to measure the level of implementation. Education to patients and relatives, hand hygiene, clean of surrounding instruments and bed unit, and sending of specimen inspection timely are especially crucial.

scholarly journals Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings

2019 ◽  
Vol 5 (4) ◽  
pp. 111 ◽  
Author(s):  
Diego H. Caceres ◽  
Kaitlin Forsberg ◽  
Rory M. Welsh ◽  
David Joseph Sexton ◽  
Shawn R. Lockhart ◽  
...  
Keyword(s):  
Early Detection ◽  
Infection Control ◽  
High Mortality ◽  
Fungal Pathogen ◽  
Multidrug Resistant ◽  
Candida Auris ◽  
Laboratory Methods ◽  
Healthcare Settings ◽  
The World ◽  
And Control

Candida auris is an emerging multidrug-resistant fungal pathogen. Since first reported in 2009, C. auris has caused healthcare outbreaks around the world, often involving high mortality. Identification of C. auris has been a major challenge as many common conventional laboratory methods cannot accurately detect it. Early detection and implementation of infection control practices can prevent its spread. The aim of this review is to describe recommendations for the detection and control of C. auris in healthcare settings.

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