Microbiological Surveillance of Endoscopes in a Southern Italian Transplantation Hospital: A Retrospective Study from 2016 to 2019

Endoscopes are medical instruments that are used routinely in health structures. Due to their invasive nature and contact with many patients, they may cause hospital-acquired infections if not disinfected correctly. To ensure a high-level disinfection procedure or reprocessing, since the methods currently adopted in our institute are adequate, we evaluated retrospectively the presence of microorganisms in our endoscopes after reprocessing. Microbiological surveillance was performed from January 2016 to December 2019 in the instruments in use in our endoscopic room after reprocessing. In total, 35 endoscopes (3 duodenoscopes, 3 echoendoscopes, 12 bronchoscopes, 5 colonoscopes, and 12 gastroscopes) were evaluated for the presence of microorganisms, including multidrug-resistant pathogens and indicator microorganisms (IMOs). Our procedures were in agreement with an internal protocol based on Italian, international, and the Center for Disease Control and Prevention (CDC) recommendations. Of a total of 811 samples, 799 (98.5%) complied with the regulatory guidelines, while 9 (1.1%) were positive for IMOs, and 3 (0.4%) displayed more than 10 colony-forming units (CFU) of environmental and commensal pathogens. Our results show that the internal reprocessing protocol is very efficient, leading to a very low number of observed contaminations, and it could be easily implemented by other health facilities that face a huge number of hospital-acquired infections due to incorrectly disinfected endoscopes.

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Assessing Knowledge, Attitude, and Practices on Hospital Acquired Infections Control by Anaesthesia Practitioners in the Operating Theatres of the Tamale Teaching Hospital (TTH); Ghana

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i06/891 ◽

2020 ◽

Vol 5 (06) ◽

Author(s):

Martin Mumuni Danaah Malick ◽

Edem Yao Akpa ◽

Peter Paul Bamaalabong

Keyword(s):

Infection Control ◽

Cross Sectional Study ◽

Cross Sectional ◽

Face To Face ◽

Hospital Acquired Infections ◽

Hospital Infection Control ◽

Operating Theatres ◽

Control And Prevention ◽

Healthcare Associated ◽

Hospital Acquired

Background: Hospital Acquired Infections (HAIs) place a significant economic burden on the healthcare system. Infection control practices are important in minimizing healthcare associated infections. However, low compliance with Universal and Standard Precautions has been reported in a number of studies. The Centre for Disease Control and Prevention (CDC) developed baseline definitions for HAIs that were republished in 2004 and has defined HAIs as those that develop during hospitalization but are neither present nor incubating upon the patient’s admission to the hospital; generally, these infections occur between 48 to 72 hours after admission and within 10 days after hospital discharge. this study aimed at unveiling the level of knowledge, attitude and practices on infection prevention control in the operating theatres by anaesthesia practitioners at TTH. Materials and Methods: A cross-sectional study design was employed. A mixed-method approach was used for data collection which includes a structured questionnaire carried out via face to face interview and observation. Results: The study showed that 100% of the respondents have knowledge on hospital acquired infection control in the theatre in one way or the other whereas attitude and practices toward hospital infection control in the operating theatres are undesirable in some specific areas of infection control such as wearing of sterile gowns and goggle. As high as 80.6% and 69.4% do not wear goggle and gowns respectively whilst performing regional anaesthesia. Conclusions: This study demonstrated that anaesthetists at TTH have reported sub-optimal levels of compliance i.e. attitude and practices with selective infection control. The study further demonstrated that discrepancies exist between anaesthetists’ attitudes towards a guideline as well as their actual practice.

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Complete Genome Sequence of Klebsiella pneumoniae Phage Sweeny

Microbiology Resource Announcements ◽

10.1128/mra.01047-19 ◽

2019 ◽

Vol 8 (39) ◽

Cited By ~ 1

Author(s):

Nicholas Martinez ◽

Eric Williams ◽

Heather Newkirk ◽

Mei Liu ◽

Jason J. Gill ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Complete Genome Sequence ◽

Protein Level ◽

Multidrug Resistant ◽

Content Type ◽

Hospital Acquired Infections ◽

Multidrug Resistant Bacterium ◽

Protein Encoding ◽

Hospital Acquired ◽

Encoding Genes

Klebsiella pneumoniae is a multidrug-resistant bacterium causing many severe hospital-acquired infections. Here, we describe siphophage Sweeny that infects K. pneumoniae. Of its 78 predicted protein-encoding genes, a functional assignment was given to 36 of them. Sweeny is most closely related to T1-like phages at the protein level.

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Hospital-acquired infections due to multidrug-resistant organisms in Hungary, 2005-2010

Eurosurveillance ◽

10.2807/ese.18.02.20352-en ◽

2013 ◽

Vol 18 (2) ◽

Author(s):

S Caini ◽

A Hajdu ◽

A Kurcz ◽

K Böröcz

Keyword(s):

Infection Control ◽

Multidrug Resistant ◽

Special Focus ◽

Gram Negative ◽

Hospital Acquired Infections ◽

Health Authorities ◽

Multidrug Resistant Organisms ◽

Public Health Authorities ◽

Gram Negative Organisms ◽

Hospital Acquired

Healthcare-associated infections caused by multidrug-resistant organisms are associated with prolonged medical care, worse outcome and costly therapies. In Hungary, hospital-acquired infections (HAIs) due to epidemiologically important multidrug-resistant organisms are notifiable by law since 2004. Overall, 6,845 case-patients (59.8% men; median age: 65 years) were notified in Hungary from 2005 to 2010. One third of case-patients died in hospital. The overall incidence of infections increased from 5.4 in 2005 to 14.7 per 100,000 patient-days in 2010. Meticillin-resistant Staphylococcus aureus (MRSA) was the most frequently reported pathogen (52.2%), but while its incidence seemed to stabilise after 2007, notifications of multidrug-resistant Gram-negative organisms have significantly increased from 2005 to 2010. Surgical wound and bloodstream were the most frequently reported sites of infection. Although MRSA incidence has seemingly reached a plateau in recent years, actions aiming at reducing the burden of HAIs with special focus on Gram-negative multidrug-resistant organisms are needed in Hungary. Continuing promotion of antimicrobial stewardship, infection control methodologies, reinforced HAI surveillance among healthcare and infection control practitioners, and engagement of stakeholders, hospital managers and public health authorities to facilitate the implementation of existing guidelines and protocols are essential.

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In Vitro Antifungal Combination of Flucytosine with Amphotericin B, Voriconazole, or Micafungin against Candida auris Shows No Antagonism

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01393-19 ◽

2019 ◽

Vol 63 (12) ◽

Cited By ~ 8

Author(s):

A. L. Bidaud ◽

F. Botterel ◽

A. Chowdhary ◽

E. Dannaoui

Keyword(s):

Amphotericin B ◽

Inhibitory Concentration ◽

Geometric Mean ◽

Multidrug Resistant ◽

Candida Auris ◽

Content Type ◽

Hospital Acquired Infections ◽

Resistant Mutants ◽

Hospital Acquired

ABSTRACT Candida auris is an emerging, multidrug-resistant pathogen responsible for invasive hospital-acquired infections. Flucytosine is an effective anti-Candida species drug, but which cannot be used as a monotherapy because of the risk of development of resistant mutants during treatment. It is, therefore, noteworthy to test possible combinations with flucytosine that may have a synergistic interaction. In this study, we determined the in vitro interaction between flucytosine and amphotericin B, micafungin, or voriconazole. These combinations have been tested against 15 C. auris isolates. The MIC ranges (geometric mean [Gmean]) of flucytosine, amphotericin B, micafungin, and voriconazole were 0.125 to 1 μg/ml (0.42 μg/ml), 0.25 to 1 μg/ml (0.66 μg/ml), 0.125 to 0.5 μg/ml (0.3 μg/ml), and 0.03 to 4 μg/ml (1.05 μg/ml), respectively. When tested in combination, indifferent interactions were mostly observed with fractional inhibitory concentration index values from 0.5 to 1, 0.31 to 1.01, and 0.5 to 1.06 for the combinations of flucytosine with amphotericin B, micafungin, and voriconazole, respectively. A synergy was observed for the strain CBS 10913 from Japan. No antagonism was observed for any combination. The combination of flucytosine with amphotericin B or micafungin may be relevant for the treatment of C. auris infections.

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Plasmids and Bacterial Strains Mediating Multidrug-Resistant Hospital-Acquired Infections Are Coresidents of the Hospital Environment

Microbial Drug Resistance ◽

10.1089/mdr.2012.0104 ◽

2013 ◽

Vol 19 (2) ◽

pp. 104-109 ◽

Cited By ~ 16

Author(s):

Thu Betteridge ◽

John Merlino ◽

Jonathon Natoli ◽

Elaine Y.-L. Cheong ◽

Thomas Gottlieb ◽

...

Keyword(s):

Multidrug Resistant ◽

Hospital Environment ◽

Bacterial Strains ◽

Hospital Acquired Infections ◽

Hospital Acquired

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Avoiding ventilator-associated pneumonia: Curcumin-functionalized endotracheal tube and photodynamic action

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2006759117 ◽

2020 ◽

Vol 117 (37) ◽

pp. 22967-22973

Author(s):

Amanda C. Zangirolami ◽

Lucas D. Dias ◽

Kate C. Blanco ◽

Carolina S. Vinagreiro ◽

Natalia M. Inada ◽

...

Keyword(s):

Endotracheal Tube ◽

Bacterial Infections ◽

Bacterial Resistance ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Ventilator Associated Pneumonia ◽

Hospital Acquired Infection ◽

Hospital Acquired Infections ◽

Hospitalization Costs ◽

Hospital Acquired

Hospital-acquired infections are a global health problem that threatens patients’ treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient’s trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT’s functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy’s potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.

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Characterization of the Enterobacter Phage vB_EclM_CIP9

Microbiology Resource Announcements ◽

10.1128/mra.01600-19 ◽

2020 ◽

Vol 9 (13) ◽

Author(s):

Klara Wang ◽

Marielou G. Tamayo ◽

Tiffany V. Penner ◽

Bradley W. M. Cook ◽

Deborah A. Court ◽

...

Keyword(s):

Enterobacter Cloacae ◽

Opportunistic Pathogen ◽

Multidrug Resistant ◽

Open Reading Frames ◽

Resistant Isolate ◽

Content Type ◽

Hospital Acquired Infections ◽

Hospital Acquired ◽

Reading Frames

Enterobacter cloacae is an opportunistic pathogen that causes hospital-acquired infections in immunocompromised patients. Here, we describe vB_EclM_CIP9, a novel Enterobacter phage that infects a multidrug-resistant isolate of E. cloacae. Phage vB_EclM_CIP9 is a myovirus that has a 174,924-bp genome, with 296 predicted open reading frames.

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In Vitro Activity of Pentamidine Alone and in Combination with Antibiotics against Multidrug-Resistant Clinical Pseudomonas aeruginosa Strains

Antibiotics ◽

10.3390/antibiotics9120885 ◽

2020 ◽

Vol 9 (12) ◽

pp. 885

Author(s):

Soraya Herrera-Espejo ◽

Tania Cebrero-Cangueiro ◽

Gema Labrador-Herrera ◽

Jerónimo Pachón ◽

María Eugenia Pachón-Ibáñez ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Public Health Problem ◽

Multidrug Resistant ◽

Vitro Activity ◽

Synergistic Activity ◽

In Vitro Activity ◽

Hospital Acquired Infections ◽

Time Kill ◽

Hospital Acquired

Multidrug-resistant (MDR) Pseudomonas aeruginosa is a public health problem causing both community and hospital-acquired infections, and thus the development of new therapies for these infections is critical. The objective of this study was to analyze in vitro the activity of pentamidine as adjuvant in combinations to antibiotics against seven clinical P. aeruginosa strains. The Minimum Inhibitory Concentration (MIC) was determined following standard protocols, and the results were interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints; however, the gentamicin activity was interpreted according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. The bactericidal in vitro activity was studied at 1×MIC concentrations by time–kill curves, and also performed in three selected strains at 1/2×MIC of pentamidine. All studies were performed in triplicate. The pentamidine MIC range was 400–1600 μg/mL. Four of the strains were MDR, and the other three were resistant to two antibiotic families. The combinations of pentamidine at 1×MIC showed synergistic activity against all the tested strains, except for pentamidine plus colistin. Pentamidine plus imipenem and meropenem were the combinations that showed synergistic activity against the most strains. At 1/2×MIC, pentamidine plus antibiotics were synergistic with all three analyzed strains. In summary, pentamidine in combination with antibiotics showed in vitro synergy against multidrug-resistant P. aeruginosa clinical strains, which suggests its possible use as adjuvant to antibiotics for the therapy of infections from MDR P. aeruginosa.

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Molecular Analysis of VanA Outbreak ofEnterococcus faeciumin Two Warsaw Hospitals: The Importance of Mobile Genetic Elements

BioMed Research International ◽

10.1155/2014/575367 ◽

2014 ◽

Vol 2014 ◽

pp. 1-12 ◽

Cited By ~ 19

Author(s):

Ewa Wardal ◽

Katarzyna Markowska ◽

Dorota Żabicka ◽

Marta Wróblewska ◽

Małgorzata Giemza ◽

...

Keyword(s):

Insertion Sequence ◽

Molecular Data ◽

Multidrug Resistant ◽

Common Source ◽

Hospital Acquired Infections ◽

Vancomycin Resistant ◽

Clonal Variability ◽

Almost All ◽

Hospital Acquired ◽

Vntr Analysis

Vancomycin-resistantEnterococcus faeciumrepresents a growing threat in hospital-acquired infections. Two outbreaks of this pathogen from neighboring Warsaw hospitals have been analyzed in this study. Pulsed-field gel electrophoresis (PFGE) ofSmaI-digested DNA, multilocus VNTR analysis (MLVA), and multilocus sequence typing (MLST) revealed a clonal variability of isolates which belonged to three main lineages (17, 18, and 78) of nosocomialE. faecium. All isolates were multidrug resistant and carried several resistance, virulence, and plasmid-specific genes. Almost all isolates shared the same variant of Tn1546transposon, characterized by the presence of insertion sequence ISEf1and a point mutation in thevanAgene. In the majority of cases, this transposon was located on 50 kb or 100 kb pRUM-related plasmids, which lacked, however, theaxe-txetoxin-antitoxin genes. 100 kb plasmid was easily transferred by conjugation and was found in various clonal backgrounds in both institutions, while 50 kb plasmid was not transferable and occurred solely in MT159/ST78 strains that disseminated clonally in one institution. Although molecular data indicated the spread of VRE between two institutions or a potential common source of this alert pathogen, epidemiological investigations did not reveal the possible route by which outbreak strains disseminated.

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Microbial Environmental Pollution in ICUs: Results, Trends, and Suggestions from a Long-Lasting Surveillance

Atmosphere ◽

10.3390/atmos12091174 ◽

2021 ◽

Vol 12 (9) ◽

pp. 1174

Author(s):

Daniela D’Alessandro ◽

Massimo Fabiani ◽

Letizia Appolloni

Keyword(s):

Underlying Disease ◽

Hospital Acquired Infections ◽

Hospital Environments ◽

Life Threatening ◽

Surgical Icus ◽

Microbial Strains ◽

Opportunistic Pathogenic ◽

Hospital Acquired ◽

Microbiological Surveillance

Intensive care units (ICUs) are special areas in hospitals for patients with severe and life-threatening diseases. ICUs are of several categories, such as neonatal ICUs, cardiac ICUs, neurological ICUs, surgical ICUs, etc. The ICUs’ patients may show a high susceptibility for hospital-acquired infections (HAIs) depending on underlying disease, duration of stay and treatment. ICUs are considered potential reservoirs for (opportunistic) pathogenic microbial strains and the risk of acquiring infection in these hospital environments is higher than in others. Several studies show the role of inanimate surface and equipment contamination in the transmission of pathogens to ICU patients. The aim of this study is to describe the results of 124 sampling campaigns performed during 12 years of microbiological surveillance of five ICUs of different categories, for an overall number of 714 samples (232 from air and 482 from surface), to analyze their trends and to elaborate suggestions to improve ICUs’ environmental quality and patients’ safety.

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