Guidance on Frequency and Location of Environmental Sampling for Acinetobacter baumannii

Comparative analysis of dermal and inhalation exposures to antineoplastic drugs among workers in the workplaces: a systematic review

OBJECTIVE

Occupational exposure to antineoplastic drugs presents significant health risks to workers, necessitating a comprehensive understanding of both dermal and inhalation exposures. This systematic review examines the relative significance of cutaneous versus inhalation exposure among professionals handling these potent medications.

STUDY DESIGN

Systematic review.

METHODS

A systematic search using the PECO framework was conducted in PubMed, Scopus, and Web of Science, adhering to PRISMA guidelines. Data from surface and air sampling studies were collected and analyzed.

RESULTS

Ten studies met the inclusion criteria, assessing various antineoplastic drugs across different occupational settings. Surface contamination levels varied widely, with concentrations ranging from very low to high, whereas airborne monitoring consistently reported "Not Detectable" levels. Exposure levels were influenced by workplace practices, handling procedures, and the sensitivity of detection methods.

CONCLUSIONS

This systematic review of ten studies on dermal and inhalation exposure to antineoplastic drugs in various occupational settings reveals significant variability in contamination levels. Tailored safety measures, including stringent protocols, decontamination procedures, and respiratory protection, are essential for workplace safety. The review highlights the importance of standardized safety protocols, considering the impact of workplace practices and detection method sensitivity. Additionally, it underscores the health risks associated with even low-level exposure, emphasizing the need for biological monitoring. Despite some limitations, this study offers valuable insights for enhancing the safety of staffs handling these potent drugs, guiding future research and policy development.

The use of UV-C radiation for terminal disinfection of pathogenic Gram-negative rods: a pilot study

In this controlled study, we found that exposure to ultraviolet-C (UV-C) radiation was able to arrest the growth of selected pathogenic enteric and nonfermenting Gram-negative rods. Further studies are needed to confirm the clinical efficacy and determine optimal implementation strategies for utilizing UV-C terminal disinfection.

Molecular and epidemiological investigation of a colistin-resistant OXA-23-/NDM-1-producing Acinetobacter baumannii outbreak in the Southwest Indian Ocean Area

Dual resistance to colistin and carbapenems is a milestone reached by certain extensively-drug resistant (XDR) Gram-negative bacteria. This study describes the first outbreak of XDR colistin- and carbapenem-resistant OXA-23-/NDM-1-producing Acinetobacter baumannii (CCRAB) in the European overseas territory of Reunion Island (France, Indian Ocean). Between April 2019 and June 2020, 13 patients admitted to the University Hospital of Reunion Island were involved in the outbreak, of whom eight were infected and six died. The first case was traced to a medical evacuation from Mayotte Island (Comoros archipelago). An epidemiological link could be established for 11 patients. All of the collected CCRAB isolates showed the same resistance profile and co-produced intrinsic β-lactamases OXA-69 and ADC-191, together with acquired carbapenem-hydrolysing β-lactamases OXA-23 and NDM-1. A mutation likely involved in colistin resistance was detected in the two-component system PmrAB (D82N in PmrA). All of the isolates were found to belong to ST^Pas1/ST^Ox231 clonal complex and were phylogenetically indistinguishable. Their further characterization by whole-genome sequence analyses (whole-genome multi-locus sequence typing, single nucleotide polymorphisms) provided hints about the transmission pathways. This study pleads for strict application of control and prevention measures in institutions where the risk of imported XDR bacteria is high.

The role of hospital environment in transmissions of multidrug-resistant gram-negative organisms

Infections by multidrug-resistant (MDR) Gram-negative organisms (GN) are associated with a high mortality rate and present an increasing challenge to the healthcare system worldwide. In recent years, increasing evidence supports the association between the healthcare environment and transmission of MDRGN to patients and healthcare workers. To better understand the role of the environment in transmission and acquisition of MDRGN, we conducted a utilitarian review based on literature published from 2014 until 2019.

Comparison of nylon-flocked swab and cellulose sponge methods for carbapenem-resistant Enterobacteriaceae and gram-negative organism recovery from high-touch surfaces in patient rooms

The ideal sampling method and benefit of qualitative versus quantitative culture for carbapenem-resistant Enterobacteriaceae (CRE) recovery in hospitalized patient rooms and bathrooms is unknown. Although the use of nylon-flocked swabs improved overall gram-negative organism recovery compared with cellulose sponges, they were similar for CRE recovery. Quantitative culture was inferior and unrevealing beyond the qualitative results.