Risk of hospital-acquired Legionellosis from microbial contamination of potable water at a Bone Marrow Transplant Unit in a Czech University Hospital

AbstractObjectiveTo determine the effectiveness of ultraviolet (UV) environmental disinfection system on rates of hospital-acquired vancomycin-resistant enterococcus (VRE) and Clostridium difficile.DesignUsing active surveillance and an interrupted time-series design, hospital-acquired acquisition of VRE and C. difficile on a bone marrow transplant (BMT) unit were examined before and after implementation of terminal disinfection with UV on all rooms regardless of isolation status of patients. The main outcomes were hospital-based acquisition measured through (1) active surveillance: admission, weekly, and discharge screening for VRE and toxigenic C. difficile (TCD) and (2) clinical surveillance: incidence of VRE and CDI on the unit.SettingBone marrow transplant unit at a tertiary-care cancer center.ParticipantsStem cell transplant (SCT) recipients.InterventionTerminal disinfection of all rooms with UV regardless of isolation status of patients.ResultsDuring the 20-month study period, 579 patients had 704 admissions to the BMT unit, and 2,160 surveillance tests were performed. No change in level or trend in the incidence of VRE (trend incidence rate ratio [IRR], 0.96; 95% confidence interval [CI], 0.81–1.14; level IRR, 1.34; 95% CI, 0.37–1.18) or C. difficile (trend IRR, 1.08; 95% CI, 0.89–1.31; level IRR, 0.51; 95% CI, 0.13–2.11) was observed after the intervention.ConclusionsUtilization of UV disinfection to supplement routine terminal cleaning of rooms was not effective in reducing hospital-acquired VRE and C. difficile among SCT recipients.

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Successful Management of Respiratory Syncytial Virus Outbreak in a Hematology and Bone Marrow Transplant Unit

10.21203/rs.3.rs-684795/v1 ◽

2021 ◽

Author(s):

Yanjie Xia ◽

Huarui Xiao ◽

Jin Yang ◽

Qiaoling Tian ◽

Fanfan Xing ◽

...

Keyword(s):

Risk Factors ◽

Bone Marrow ◽

Respiratory Syncytial Virus ◽

Infection Control ◽

Bone Marrow Transplant ◽

Marrow Transplant ◽

Control Measures ◽

Infection Control Measures ◽

Syncytial Virus ◽

Hospital Acquired

Abstract Background: Respiratory Syncytial Virus (RSV)is recognized as one of the most common causes of acute respiratory infections in adults which is associated with significant morbidity and mortality in the elderly and immunocompromised adults. Moreover RSV can spread rapidly through close contact through respiratory droplets leading to clusters of cases or outbreaks in health care facilities. Herein we demonstrate the successful control and the risk factors of the RSV outbreak involving 39 patients in a Hematology and Bone Marrow Transplant(BMT) Unit. Methods: We performed an epidemiological investigation,analyzed the risk factors and implemented the infection control measures for this nosocomial RSV outbreak in the Hematology and BMT Unit. Furthermore we implemented the RSV screening for all the inpatients and medical staff of Hematology and BMT Unit and the infection control bundles to stop the outbreak.Results: 24 patients were tested positive for RSV, 2 of which were confirmed to be hospital acquired respiratory infection according to Chinese hospital infection diagnostic criteria,the other cases were hospital acquired. Our multimodal infection control bundle was able to rapidly control this outbreak,newly diagnosed patients with RSV infection were distributed in the first three weeks of this outbreak.All cases were discharged after recovery or remission. Conclusion: The successful infection control management of RSV outbreak should include interruption of all potential transmission routes.In Hematology and BMT Unit, restriction of social activities is useful to stop RSV transmission despite some temporal negative impact on the emotional needs of the patients.Universal RSV screening and vigorous enforcement of infection control measures was effective in the containment of this outbreak.

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