scholarly journals Successful Disinfection of a New Healthcare Facility Contaminated with Pseudomonas aeruginosa

Hygiene ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 1-13
Author(s):  
Alain Ficheux ◽  
Jérémy Réthoret ◽  
Jonas Laget ◽  
Cristel Baux ◽  
Nathalie Gayrard ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bacterial Contamination ◽  
Bacterial Load ◽  
Healthcare Facility ◽  
Water Systems ◽  
Water Networks ◽  
Healthcare Facilities ◽  
Biofilm Development ◽  
Positive Results

Contamination of water use points in health establishments is a frequent and concerning problem. Maintenance and disinfection of water systems can be inefficient. Sterilizing filters are commonly used at selected taps. We report diagnostic and corrective approaches that have succeeded in making a contaminated health facility sustainably compatible with its activity without restriction in taps use. The zones contaminated with pseudomonas as well as those, along the water networks, at risk of biofilm development were identified. Corrective measures on the network and various types of decontamination were carried out. At the end of this work, the bacterial load in the water significantly decreased and 219 out of 223 controls were negative for P. aeruginosa over 3 years of follow-up. Four positive results were linked to three taps not used for care which were satisfactorily treated locally. Errors at the design and setup phases of health facilities may result in resistant bacterial contamination. P. aeruginosa contamination of newly built healthcare facilities is an underreported problem. Guidelines on design, disinfection, and monitoring procedures of water networks of healthcare facilities should be adapted consequently and would certainly improve the offered care limiting patients’ risk and avoid many unwanted financial situations for the providers.

scholarly journals Evaluation of Multidrug-Resistant P. aeruginosa in Healthcare Facility Water Systems

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1500
Author(s):  
Maria Luisa Cristina ◽  
Marina Sartini ◽  
Elisa Schinca ◽  
Gianluca Ottria ◽  
Beatrice Casini ◽  
...  
Keyword(s):  
Tap Water ◽  
Water System ◽  
Culture Method ◽  
Healthcare Facility ◽  
Water Systems ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Water Safety ◽  
Antibiotic Resistant ◽  
Healthcare Facilities

According to the WHO, P. aeruginosa is one of the antibiotic-resistant bacteria that represent the biggest threat to public health. The aim of the study was to establish the prevalence of antibiotic-resistant P. aeruginosa in the water systems of various healthcare facilities over the course of nine years. A total of 4500 tap water system samples were taken from seventeen healthcare facilities. The culture method was used to detect P. aeruginosa, and the isolates were then tested for antibiotic resistance using the standardised disc diffusion method. Eleven antibiotics from five different classes were tested. P. aeruginosa was found to have contaminated 2.07% (no. 93) of the water samples. The majority of positive samples came from the dental units (30.11%) and the ward kitchens (23.66%). Considering the total isolates, 56.99% (no. 3) were resistant to at least one of the antibiotics tested. A total of 71.43% of P. aeruginosa isolated from water emerging from dental unit handpieces was antibiotic-resistant, with 45% of it resistant to ≥3 classes of antibiotics. Out of the total isolates, 19.35% showed resistance to carbapenems. It would be advisable to systematically screen tap water for opportunistic micro-organisms such as P. aeruginosa, as many countries already do, including this in the Water Safety Plan.

Disinfection and sterilization

2019 ◽  
pp. 95-142
Author(s):  
Nizam Damani
Keyword(s):  
Risk Assessment ◽  
Antimicrobial Activity ◽  
Healthcare Facility ◽  
Healthcare Facilities ◽  
Practical Advice ◽  
Key Points ◽  
Practical Guidance ◽  
Chemical Disinfection

The chapter on decontamination examines various methods of heat sterilization and chemical disinfection. It outlines how to carry out a risk assessment of contaminated items and equipment based on the Spaulding classification and provides practical guidance on how to decontaminate various items in healthcare facilities. It also discusses how to transport items, clean, disinfect, and sterilize various items and equipment in healthcare facility. It outlines various heat sterilization procedures and gives practical advice on how to maintain various types of sterilizer or autoclave and how to safely store sterile items. Detail is also provided on how to use chemical disinfectants in healthcare facilities and summarizes the use and antimicrobial activity of various disinfectants and antiseptics. This chapter also includes advice on decontamination of endoscopes and maintenance of automatic endoscope reprocessors. It also provides practical advice and summarizes the key points on how to investigate and follow up cases after a failure of decontamination process.

scholarly journals Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

2021 ◽  
Vol 10 (6) ◽  
pp. 1309
Author(s):  
Hye Young Han ◽  
Ki Cheol Park ◽  
Eun-Ae Yang ◽  
Kyung-Yil Lee
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Serological Test ◽  
Corticosteroid Treatment ◽  
23S Rrna ◽  
Laboratory Parameters ◽  
The Mean ◽  
Domain V ◽  
Positive Results ◽  
Mycoplasma Pneumoniae Pneumonia

We have found that early corticosteroid therapy was effective for reducing morbidity during five Korea-wide epidemics. We evaluated the clinical and laboratory parameters of 56 children who received early corticosteroid treatment for pneumonia that was caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae) or macrolide-sensitive M. pneumoniae between July 2019 and February 2020. All subjects had dual positive results from a PCR assay and serological test, and received corticosteroids within 24–36 h after admission. Point mutation of residues 2063, 2064, and 2067 was identified in domain V of 23S rRNA. The mean age was 6.8 years and the male:female ratio was 1.2:1 (31:25 patients). Most of the subjects had macrolide-resistant M. pneumoniae (73%), and all mutated strains had the A2063G transition. No significant differences in clinical and laboratory parameters were observed between macrolide-resistant and macrolide-sensitive M. pneumoniae groups that were treated with early dose-adjusted corticosteroids. Higher-dose steroid treatment may be needed for patients who have fever that persists for >48 h or increased biomarkers such as lactate dehydrogenase concentration at follow-up despite a usual dose of steroid therapy.

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

scholarly journals Comparison of Two Novel Methods for Sink Drain Disinfection

2020 ◽  
Vol 41 (S1) ◽  
pp. s180-s180
Author(s):  
Muhammed Fawwaz Haq ◽  
Lucas Jones ◽  
Natalia Pinto Herrera ◽  
Jennifer Cadnum ◽  
Philip Carling ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Contact Time ◽  
Healthcare Facility ◽  
Gram Negative ◽  
Disinfection Methods ◽  
Initial Reduction ◽  
Repeated Measures Analysis ◽  
Potential Reservoir ◽  
Cleaning And Disinfection

Background: Sink drainage systems are a potential reservoir for the dissemination of gram-negative bacilli but are not amenable to standard methods of cleaning and disinfection. Pouring liquid disinfectants down drains has only a limited and transient effect on drain colonization, presumably due to inadequate disinfectant contact time and suboptimal penetration into areas harboring biofilm-associated organisms. Methods: We compared the antimicrobial efficacy of 2 novel sink disinfection methods intended to enhance disinfectant contact time and penetration. Healthcare facility sinks were randomly assigned to disinfection with 300 mL hydrogen peroxide-based disinfectant applied either as a foam (N = 13 sinks) or instilled for 30 minutes behind a temporary obstruction created by an inflated urinary catheter balloon (N = 12 sinks). Swabs were used to collect quantitative cultures from the proximal sink drain to depth of 2.5 cm (1 inch) below the strainer before treatment and at 15 minutes and 1, 2, 3, 5, and 7 days after treatment. Repeated measures analysis of variance was performed to compare the efficacy of the 2 treatments. Results: As shown in Fig. 1, both methods yielded an initial reduction of >3 log10 CFU of gram-negative bacilli. Over the 7-day follow-up period, disinfectant instillation resulted in significantly greater reduction than the foam application (P < .01). Recovery of sink colonization to >2 log per swab occurred at day 3 for both treatments, whereas recovery to >3 log per swab occurred on day 3 for the foam treatment versus day 7 for disinfectant instillation. Conclusions: Two novel disinfection methods were effective in reducing sink drain colonization for several days. The instillation method was more effective than the foam method in maintaining reductions over 7 days.Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

scholarly journals Sodium Salicylate Influences the Pseudomonas aeruginosa Biofilm Structure and Susceptibility Towards Silver

2021 ◽  
Vol 22 (3) ◽  
pp. 1060
Author(s):  
Erik Gerner ◽  
Sofia Almqvist ◽  
Peter Thomsen ◽  
Maria Werthén ◽  
Margarita Trobos
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Biofilm Formation ◽  
Sodium Salicylate ◽  
Treatment Strategies ◽  
Cell Aggregation ◽  
Wound Fluid ◽  
Global Challenge ◽  
3D Collagen ◽  
Biofilm Development ◽  
Biofilm Structure

Hard-to-heal wounds are typically infected with biofilm-producing microorganisms, such as Pseudomonas aeruginosa, which strongly contribute to delayed healing. Due to the global challenge of antimicrobial resistance, alternative treatment strategies are needed. Here, we investigated whether inhibition of quorum sensing (QS) by sodium salicylate in different P. aeruginosa strains (QS-competent, QS-mutant, and chronic wound strains) influences biofilm formation and tolerance to silver. Biofilm formation was evaluated in simulated serum-containing wound fluid in the presence or absence of sodium salicylate (NaSa). Biofilms were established using a 3D collagen-based biofilm model, collagen coated glass, and the Calgary biofilm device. Furthermore, the susceptibility of 48-h-old biofilms formed by laboratory and clinical strains in the presence or absence of NaSa towards silver was evaluated by assessing cell viability. Biofilms formed in the presence of NaSa were more susceptible to silver and contained reduced levels of virulence factors associated with biofilm development than those formed in the absence of NaSa. Biofilm aggregates formed by the wild-type but not the QS mutant strain, were smaller and less heterogenous in size when grown in cultures with NaSa compared to control. These data suggest that NaSa, via a reduction of cell aggregation in biofilms, allows the antiseptic to become more readily available to cells.

scholarly journals In Vitro Anti-Biofilm and Antibacterial Properties of Streptococcus downii sp. nov.

2021 ◽  
Vol 9 (2) ◽  
pp. 450
Author(s):  
Maigualida Cuenca ◽  
María Carmen Sánchez ◽  
Pedro Diz ◽  
Lucía Martínez-Lamas ◽  
Maximiliano Álvarez ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Quantitative Polymerase Chain Reaction ◽  
Bacterial Load ◽  
Antibacterial Properties ◽  
Antibacterial Activities ◽  
Oral Bacteria ◽  
Periodontal Pathogens ◽  
Biofilm Model ◽  
Biofilm Development

The aim of this study was to evaluate the potential anti-biofilm and antibacterial activities of Streptococcus downii sp. nov. To test anti-biofilm properties, Streptococcus mutans, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans were grown in a biofilm model in the presence or not of S. downii sp. nov. for up to 120 h. For the potential antibacterial activity, 24 h-biofilms were exposed to S. downii sp. nov for 24 and 48 h. Biofilms structures and bacterial viability were studied by microscopy, and the effect in bacterial load by quantitative polymerase chain reaction. A generalized linear model was constructed, and results were considered as statistically significant at p < 0.05. The presence of S. downii sp. nov. during biofilm development did not affect the structure of the community, but an anti-biofilm effect against S. mutans was observed (p < 0.001, after 96 and 120 h). For antibacterial activity, after 24 h of exposure to S. downii sp. nov., counts of S. mutans (p = 0.019) and A. actinomycetemcomitans (p = 0.020) were significantly reduced in well-structured biofilms. Although moderate, anti-biofilm and antibacterial activities of S. downii sp. nov. against oral bacteria, including some periodontal pathogens, were demonstrated in an in vitro biofilm model.

scholarly journals Anti-Pseudomonas aeruginosa antibody detection in patients with bronchiectasis without cystic fibrosis

Thorax ◽  
2001 ◽  
Vol 56 (9) ◽  
pp. 669-674
Author(s):  
E Caballero ◽  
M-E Drobnic ◽  
M-T Pérez ◽  
J-M Manresa ◽  
A Ferrer ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Outer Membrane ◽  
Outer Membrane Proteins ◽  
Antibody Detection ◽  
Individual Bands ◽  
Diagnostic Usefulness ◽  
Group A ◽  
Group B

BACKGROUNDPseudomonas aeruginosa is a frequent cause of infection in patients with bronchiectasis. Differentiation between non-infected patients and those with different degrees of P aeruginosainfection could influence the management and prognosis of these patients. The diagnostic usefulness of serum IgG antibodies againstP aeruginosa outer membrane proteins was determined in patients with bronchiectasis without cystic fibrosis.METHODSFifty six patients were classified according to sputum culture into three groups: group A (n=18) with no P aeruginosain any sample; group B (n=18) with P aeruginosa alternating with other microorganisms; and group C (n=20) with P aeruginosa in all sputum samples. Each patient had at least three sputum cultures in the 6 months prior to serum collection. Detection of antibodies was performed by Western blot and their presence against 20 protein bands (10–121 kd) was assessed.RESULTSAntibodies to more than four bands in total or to five individual bands (36, 26, 22, 20 or 18 kd) differentiated group B from group A, while antibodies to a total of more than eight bands or to 10 individual bands (104, 69, 63, 56, 50, 44, 30, 25, 22, 13 kd) differentiated group C from group B. When discordant results between the total number of bands and the frequency of P aeruginosa isolation were obtained, the follow up of patients suggested that the former, in most cases, predicted chronic P aeruginosacolonisation.CONCLUSIONIn patients with bronchiectasis the degree of P aeruginosa infection can be determined by the number and type of outer membrane protein bands indicating which serum antibodies are present.

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