scholarly journals Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes

2021 ◽  
Vol 18 (5) ◽  
pp. 2482
Author(s):  
Beatrice Casini ◽  
Benedetta Tuvo ◽  
Emanuele Marciano ◽  
Giuliana Del Magro ◽  
Giulia Gemignani ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Management Practices ◽  
Safety Management ◽  
University Hospital ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Cdc Guidelines ◽  
Patient Health ◽  
High Concern ◽  
Prevention Of Infections ◽  
Microbiological Surveillance

Background: Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. Method: A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed. Moreover, microbiological surveillance of endoscopes was carried out according to the CDC guidelines. Results: In the first phase of sampling, 10/10 (100%) endoscopes were found to be non-compliant, of which 7 showed results for high-concern organisms (HCOs), such as KPC-K. pneumoniae, P. aeruginosa and E. coli. After implementing corrective actions, 12 out of 17 endoscopes were found to be non-compliant (70.5%), of which 8 showed results for HCOs, such as KPC-K. oxytoca and P. aeruginosa. During the last year of regular microbiological surveillance, only 23% of endoscopes (35/152) were found to be non-compliant, of which 7 showed results for HCOs, such as NDM-K. pneumoniae, P. aeruginosa and A. baumannii. The crucial issues were related to samples collected from the internal channels of duodenoscopes. Conclusion: Managing the risk associated with the reprocessing of digestive endoscopes, through risk assessment at every stage of the process, is important for the prevention of infections associated with the use of these device.

scholarly journals Klebsiella pneumoniae carbapenemase-producing Serratia marcescens outbreak in a university hospital

2017 ◽  
Author(s):  
Felipe Francisco Tuon ◽  
Kassia Cordova ◽  
Thayrine Mayara Dario ◽  
Luciana de Souza Nunes ◽  
Afonso Luís Barth ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Serratia Marcescens ◽  
University Hospital ◽  
Klebsiella Pneumoniae Carbapenemase

scholarly journals Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil

2017 ◽  
Vol 11 (05) ◽  
pp. 379-386 ◽  
Author(s):  
Ana Carolina Polano Vivan ◽  
Juliana Ferraz Rosa ◽  
Camila Fonseca Rizek ◽  
Marsileni Pelisson ◽  
Silvia Figueiredo Costa ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Outer Membrane Proteins ◽  
University Hospital ◽  
Pcr Analysis ◽  
Extended Spectrum Beta Lactamase ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Carbapenem Resistant ◽  
Sds Page ◽  
Control And Prevention ◽  
The University

Introduction: The emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kpn) isolates is attracting significant attention in nosocomial infection settings. K. pneumoniae is the main pathogen that harbours blaKPC genes. Methodology: This study evaluated 54 K. pneumoniae carbapenem-resistant isolates from patients hospitalized at the University Hospital of Londrina, between July 2009 and July 2010. The isolates were phenotypically screened for carbapenemase production and submitted for genotypic confirmation by polymerase chain reaction (PCR) for KPC, metallo-β-lactamases, OXA-48, and extended-spectrum beta-lactamase genes. The absence of outer membrane proteins (OMP) was investigated by SDS-PAGE. The susceptibility profile was determined by broth microdilution, according to Clinical and Laboratory Standards Institute protocol. Results: All isolates were phenotypically positive for class A carbapenemase production, but negative for metallo-β-lactamase activity. PCR analysis demonstrated that all isolates carried blaKPC genes and sequencing showed that all strains belonged to KPC-2 subtype. Four strains did not show porin expression, and all isolates were resistant to ertapenem, meropenem, and imipenem. Susceptibility rates reached 35.2% for gentamicin, 85.2% for polymixyn B, 87% for colistin, and 98.1% for both tigecycline and fosfomycin. Pulsed-field gel electrophoresis showed six clones, and three of them predominated among the isolates. Conclusions: KPC-2-producing K. pneumoniae is becoming predominant among carbapenem-resistant K. pneumoniae isolates at the hospital. The association of the enzyme KPC with other resistance determinants, such as loss of porins, may increase the severity of the situation of nosocomial infections. There is an urgent need to develop strategies for infection control and prevention.

scholarly journals Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Providencia stuartii in a University Hospital in Brazil

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Fabiana Hiromi Takashina ◽  
Talita Cristina Galvão ◽  
Luana Soares De Moraes ◽  
Amanda Cristina Ishioka De Oliveira ◽  
Caroline Martins De Matos ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
University Hospital ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Providencia Stuartii

scholarly journals Nosocomial infections by Klebsiella pneumoniae carbapenemase producing enterobacteria in a teaching hospital

2014 ◽  
Vol 12 (3) ◽  
pp. 282-286 ◽  
Author(s):  
Gabriela Seibert ◽  
Rosmari Hörner ◽  
Bettina Holzschuh Meneghetti ◽  
Roselene Alves Righi ◽  
Nara Lucia Frasson Dal Forno ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Nosocomial Infections ◽  
Descriptive Study ◽  
University Hospital ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
And Control ◽  
Epidemiological Characteristics ◽  
Rapid Laboratory ◽  
Tracheal Aspirates

Objective To analyze the profile of patients with microorganisms resistant to carbapenems, and the prevalence of the enzyme Klebsiella pneumoniae carbapenemase in interobacteriaceae. Methods Retrospective descriptive study. From the isolation in bacteriological tests ordered by clinicians, we described the clinical and epidemiological characteristics of patients with enterobacteria resistants to carbapenems at a university hospital, between March and October 2013. Results We included 47 isolated patients in this study, all exhibiting resistance to carbapenems, including 9 patients who were confirmed as infected/colonized with K. pneumoniae carbapenemase. Isolation in tracheal aspirates (12; 25.5%) predominated. The resistance to ertapenem, meropenem, and imipenem was 91.5%, 83.0% and 80.0%, respectively. Aminoglycosides was the class of antimicrobials that showed the highest sensitivity, 91.5% being sensitive to amikacin and 57.4% to gentamicin. Conclusion The K. pneumoniae carbapenemase was an important agent in graun isotaling in hospital intection. The limited therapeutic options emphasize the need for rapid laboratory detection, as well as the implementation of measures to prevent and control the spread of these pathogens.

scholarly journals Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period

2019 ◽  
Vol 37 (6) ◽  
pp. 387-393
Author(s):  
Cátia Caneiras ◽  
Luís Lito ◽  
Sagrario Mayoralas-Alises ◽  
Salvador Díaz-Lobato ◽  
José Melo-Cristino ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
University Hospital ◽  
Resistance Determinants
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