1
|
Yoginath Bhambure S, E Costa LIC, Gatty AM, Manjunatha KG, Vittal R, Sannejal AD. Unveiling the traits of antibiotic resistance and virulence in Escherichia coli obtained from poultry waste. Braz J Microbiol 2024; 55:2997-3007. [PMID: 38809497 PMCID: PMC11405593 DOI: 10.1007/s42770-024-01367-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/12/2024] [Indexed: 05/30/2024] Open
Abstract
Antibiotic resistance and virulence factors in avian pathogenic Escherichia coli (APEC) have become significant concerns, contributing to adverse environmental effects. The extensive use of antibiotics in poultry farming has resulted in the emergence of antibiotic-resistant APEC strains. This study prioritizes the molecular screening of APEC to uncover their antibiotic resistance and virulence attributes, with specific attention to their environmental impact. To address the imperative of understanding APEC pathogenesis, our study analyzed 50 poultry waste samples including 10 poultry litter, 15 fecal matter, 15 wastewater, and 10 anatomical waste samples. For the presence of virulence genes, 35 Escherichia coli isolates were subjected to molecular characterization. Amongst these, 27 were APEC strains demonstrating the presence of at least four virulence genes each. Notably, virulence genes such as fimH, ompA, ybjX, waaL, cvaC, hlyF, iss, ompT, and iroN were observed among all the E. coli isolates. Furthermore, eleven of the APEC strains exhibited resistance to tetracycline, ampicillin, sulphonamides, and fluoroquinolones.These findings highlight the role of APEC as a potential source of environmental pollution serving as a reservoir for virulence and resistance genes. Understanding the dynamics of antibiotic resistance and virulence in APEC is essential due to its potential threat to broiler chickens and the broader population through the food chain, intensifying concerns related to environmental pollution. Recognizing the ecological impact of APEC is essential for developing effective strategies to mitigate environmental pollution and safeguard the health of ecosystems and human populations.
Collapse
Affiliation(s)
- Sahil Yoginath Bhambure
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Paneer campus, Deralakatte, Mangalore, 575018, India
| | - Lakiesha Inacia Coelho E Costa
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Paneer campus, Deralakatte, Mangalore, 575018, India
| | - Ashwitha M Gatty
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Paneer campus, Deralakatte, Mangalore, 575018, India
| | - Kavitha Guladahalli Manjunatha
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Paneer campus, Deralakatte, Mangalore, 575018, India
| | - Rajeshwari Vittal
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Paneer campus, Deralakatte, Mangalore, 575018, India
| | - Akhila Dharnappa Sannejal
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Paneer campus, Deralakatte, Mangalore, 575018, India.
| |
Collapse
|
2
|
Timofte D, Jepson RE. PRO: Environmental microbiological surveillance does support infection control in veterinary hospitals. JAC Antimicrob Resist 2024; 6:dlae113. [PMID: 39091688 PMCID: PMC11293430 DOI: 10.1093/jacamr/dlae113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Affiliation(s)
- Dorina Timofte
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of
Infection, Veterinary and Ecological Sciences, Leahurst Campus, University of
Liverpool, Chester High Road, Neston CH64 7TE,
UK
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary
College, Hawkshead Lane, North Mymms, Hertfordshire AL9
7TA, UK
| |
Collapse
|
3
|
Assefa A, Woldemariam M, Aklilu A, Alelign D, Zakir A, Manilal A, Mohammed T, M. Alahmadi R, Raman G, Idhayadhulla A. Typical pneumonia among human immunodeficiency virus-infected patients in public hospitals in southern Ethiopia. PLoS One 2024; 19:e0307780. [PMID: 39078837 PMCID: PMC11288459 DOI: 10.1371/journal.pone.0307780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/10/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. OBJECTIVE To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. METHODS A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum β-lactamase (ESβL) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. RESULTS Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation4 (CD4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load ≥ 150 were found statistically significant. CONCLUSION The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.
Collapse
Affiliation(s)
- Ayele Assefa
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Melat Woldemariam
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Addis Aklilu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dagninet Alelign
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abdurezak Zakir
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aseer Manilal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Mohammed
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Reham M. Alahmadi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Gurusamy Raman
- Department of Life Sciences, Yeungnam University, Gyeongsan, Gyeongbuk-Do, South Korea
| | - Akbar Idhayadhulla
- Research Department of Chemistry, Nehru Memorial College (Affiliated to Bharathidasan University), Puthanampatti, Tiruchirappalli District, Tamil Nadu
| |
Collapse
|
4
|
D'Accolti M, Soffritti I, Bini F, Mazziga E, Caselli E. Tackling transmission of infectious diseases: A probiotic-based system as a remedy for the spread of pathogenic and resistant microbes. Microb Biotechnol 2024; 17:e14529. [PMID: 39045894 PMCID: PMC11267305 DOI: 10.1111/1751-7915.14529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/04/2024] [Indexed: 07/25/2024] Open
Abstract
Built environments (BEs) currently represent the areas in which human beings spend most of their life. Consistently, microbes populating BEs mostly derive from human occupants and can be easily transferred from BE to occupants. The hospital microbiome is a paradigmatic example, representing a reservoir for harmful pathogens that can be transmitted to susceptible patients, causing the healthcare-associated infections (HAIs). Environmental cleaning is a crucial pillar in controlling BE pathogens and preventing related infections, and chemical disinfectants have been largely used so far towards this aim. However, despite their immediate effect, chemical-based disinfection is unable to prevent recontamination, has a high environmental impact, and can select/increase antimicrobial resistance (AMR) in treated microbes. To overcome these limitations, probiotic-based sanitation (PBS) strategies were recently proposed, built on the use of detergents added with selected probiotics able to displace surrounding pathogens by competitive exclusion. PBS was reported as an effective and low-impact alternative to chemical disinfection, providing stable rebalance of the BE microbiome and significantly reducing pathogens and HAIs compared to disinfectants, without exacerbating AMR and pollution concerns. This minireview summarizes the most significant results obtained by applying PBS in sanitary and non-sanitary settings, which overall suggest that PBS may effectively tackle the infectious risk meanwhile preventing the further spread of pathogenic and resistant microbes.
Collapse
Affiliation(s)
- Maria D'Accolti
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTAUniversity of FerraraFerraraItaly
- CIAS Research CenterUniversity of FerraraFerraraItaly
| | - Irene Soffritti
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTAUniversity of FerraraFerraraItaly
- CIAS Research CenterUniversity of FerraraFerraraItaly
| | - Francesca Bini
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTAUniversity of FerraraFerraraItaly
- CIAS Research CenterUniversity of FerraraFerraraItaly
| | - Eleonora Mazziga
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTAUniversity of FerraraFerraraItaly
- CIAS Research CenterUniversity of FerraraFerraraItaly
| | - Elisabetta Caselli
- Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTAUniversity of FerraraFerraraItaly
- CIAS Research CenterUniversity of FerraraFerraraItaly
| |
Collapse
|
5
|
Basak SS, Adak A. Physicochemical methods for disinfection of contaminated surfaces - a way to control infectious diseases. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2024; 22:53-64. [PMID: 38887763 PMCID: PMC11180059 DOI: 10.1007/s40201-024-00893-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/21/2024] [Indexed: 06/20/2024]
Abstract
This paper represents the reviews of recent advancements in different physicochemical methods for disinfecting contaminated surfaces, which are considered to be responsible for transmitting different bacterial, viral, and fungal infectious diseases. Surface disinfection can be achieved by applying chemicals, UV-based processes, ionization radiation (gamma-ray, X-ray and electron beam), application of self-disinfecting surfaces, no-touch room disinfection methods, and robotic disinfection methods for built-in settings. Application of different chemicals, such as alcohols, hydrogen peroxide, peracetic acid, quaternary ammonium salts, phenol, and iodine solution, are common and economical. However, the process is time-consuming and less efficient. The use of UVC light (wavelength: 200-280 nm, generated by low vapor mercury lamps or pulse xenon light) has gained much attention for disinfecting fomites worldwide. In recent times, the combination of UV and H2O2, based on the principle of the advanced oxidation process, has been applied for disinfecting inanimate surfaces. The process is very efficient and faster than chemical and UV processes. Heavy metals like copper, silver, zinc, and other metals can inactivate microbes and are used for surface modification to produce self-disinfecting surfaces and used in healthcare facilities. In combination with UVB (280-315 nm) and UVA (315-400 nm), titanium oxide has been utilized for disinfecting contaminated surfaces. Ionization radiation, one of the advanced methods, can be used in disinfecting medical devices and drugs. Post-COVID-19 pandemic, the no-touch and robotic disinfection methods utilizing chemicals or UVC lights have received much importance in built-in settings. Among these methods, surface disinfection by applying chemicals by fogging/vaporization and UV radiation methods has been widely reported in the literature compared to other methods. Supplementary Information The online version contains supplementary material available at 10.1007/s40201-024-00893-2.
Collapse
Affiliation(s)
- Shib Sankar Basak
- Department of Civil Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103 India
| | - Asok Adak
- Department of Civil Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103 India
| |
Collapse
|
6
|
Lompo P, Heroes AS, Ouédraogo K, Okitale P, Wakpo A, Kalema J, Lunguya O, Tinto H, Affolabi D, Sangaré L, Jacobs J. Knowledge, awareness, and risk practices related to bacterial contamination of antiseptics, disinfectants, and hand hygiene products among healthcare workers in sub-saharan Africa: a cross-sectional survey in three tertiary care hospitals (Benin, Burkina Faso, and DR Congo). Antimicrob Resist Infect Control 2024; 13:44. [PMID: 38627805 PMCID: PMC11020199 DOI: 10.1186/s13756-024-01396-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Antiseptics, disinfectants, and hand hygiene products can be contaminated with bacteria and cause healthcare-associated infections, which are underreported from low- and middle-income countries. To better understand the user-related risk factors, we conducted a knowledge, awareness, and practice survey among hospital staff in sub-Saharan Africa. METHODS Self-administered questionnaire distributed among healthcare workers in three tertiary care hospitals (Burkina Faso, Benin, Democratic Republic of the Congo). RESULTS 617 healthcare workers (85.3% (para)medical and 14.7% auxiliary staff) participated. Less than half (45.5%) had been trained in Infection Prevention & Control (IPC), and only 15.7% were trained < 1 year ago. Near two-thirds (64.2%) preferred liquid soap for hand hygiene, versus 33.1% for alcohol-based hand rub (ABHR). Most (58.3%) expressed confidence in the locally available products. Knowledge of product categories, storage conditions and shelf-life was inadequate: eosin was considered as an antiseptic (47.5% of (para)medical staff), the shelf life and storage conditions (non-transparent container) of freshly prepared chlorine 0.5% were known by only 42.6% and 34.8% of participants, respectively. Approximately one-third of participants approved using tap water for preparation of chlorine 0.5% and liquid soap. Most participants (> 80%) disapproved recycling soft-drink bottles as liquid soap containers. Nearly two-thirds (65.0%) declared that bacteria may be resistant to and survive in ABHR, versus 51.0% and 37.4% for povidone iodine and chlorine 0.5%, respectively. Depicted risk practices (n = 4) were ignored by 30 to 40% of participants: they included touching the rim or content of stock containers with compresses or small containers, storing of cotton balls soaked in an antiseptic, and hand-touching the spout of pump dispenser. Filling containers by topping-up was considered good practice by 18.3% of participants. Half (52.1%) of participants acknowledged indefinite reuse of containers. Besides small differences, the findings were similar across the study sites and professional groups. Among IPC-trained staff, proportions recognizing all 4 risk practices were higher compared to non-trained staff (35.9% versus 23.8%, p < 0.0001). CONCLUSIONS The present findings can guide tailored training and IPC implementation at the healthcare facility and national levels, and sensitize stakeholders' and funders' interest.
Collapse
Affiliation(s)
- Palpouguini Lompo
- Clinical Research Unit of Nanoro, Institut de Recherche en Science de la Santé, Ouagadougou, 11 BP 218, Burkina Faso.
- Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, 2000, Belgium.
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Naamsestraat 22, Box 5401, Leuven, 3000, Belgium.
| | - Anne-Sophie Heroes
- Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, 2000, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Naamsestraat 22, Box 5401, Leuven, 3000, Belgium
| | - Kadija Ouédraogo
- Clinical Research Unit of Nanoro, Institut de Recherche en Science de la Santé, Ouagadougou, 11 BP 218, Burkina Faso
| | - Patient Okitale
- Département de Microbiologie, Cliniques Universitaires de Kinshasa, BP 127, Kinshasa, Congo
| | - Abel Wakpo
- Centre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou, 01 BP 386, Benin
| | - Jocelyne Kalema
- Département de Microbiologie, Cliniques Universitaires de Kinshasa, BP 127, Kinshasa, Congo
- Département de Microbiologie, National Institute of Biomedical Research, Av. De la Démocratie N°5345, Kinshasa, Congo
| | - Octavie Lunguya
- Département de Microbiologie, Cliniques Universitaires de Kinshasa, BP 127, Kinshasa, Congo
- Département de Microbiologie, National Institute of Biomedical Research, Av. De la Démocratie N°5345, Kinshasa, Congo
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Science de la Santé, Ouagadougou, 11 BP 218, Burkina Faso
| | - Dissou Affolabi
- Centre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou, 01 BP 386, Benin
| | - Lassana Sangaré
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, 03 BP 7022, Burkina Faso
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, 2000, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Naamsestraat 22, Box 5401, Leuven, 3000, Belgium
| |
Collapse
|
7
|
Nieto-Rosado M, Sands K, Portal EAR, Thomson KM, Carvalho MJ, Mathias J, Milton R, Dyer C, Akpulu C, Boostrom I, Hogan P, Saif H, Sanches Ferreira AD, Hender T, Portal B, Andrews R, Watkins WJ, Zahra R, Shirazi H, Muhammad A, Ullah SN, Jan MH, Akif S, Iregbu KC, Modibbo F, Uwaezuoke S, Audu L, Edwin CP, Yusuf AH, Adeleye A, Mukkadas AS, Mazarati JB, Rucogoza A, Gaju L, Mehtar S, Bulabula ANH, Whitelaw A, Roberts L, Chan G, Bekele D, Solomon S, Abayneh M, Metaferia G, Walsh TR. Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria. Nat Commun 2024; 15:2758. [PMID: 38553439 PMCID: PMC10980694 DOI: 10.1038/s41467-024-46684-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/06/2024] [Indexed: 04/02/2024] Open
Abstract
Hospital surfaces can harbour bacterial pathogens, which may disseminate and cause nosocomial infections, contributing towards mortality in low- and middle-income countries (LMICs). During the BARNARDS study, hospital surfaces from neonatal wards were sampled to assess the degree of environmental surface and patient care equipment colonisation by Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs). Here, we perform PCR screening for extended-spectrum β-lactamases (blaCTX-M-15) and carbapenemases (blaNDM, blaOXA-48-like and blaKPC), MALDI-TOF MS identification of GNB carrying ARGs, and further analysis by whole genome sequencing of bacterial isolates. We determine presence of consistently dominant clones and their relatedness to strains causing neonatal sepsis. Higher prevalence of carbapenemases is observed in Pakistan, Bangladesh, and Ethiopia, compared to other countries, and are mostly found in surfaces near the sink drain. Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens and Leclercia adecarboxylata are dominant; ST15 K. pneumoniae is identified from the same ward on multiple occasions suggesting clonal persistence within the same environment, and is found to be identical to isolates causing neonatal sepsis in Pakistan over similar time periods. Our data suggests persistence of dominant clones across multiple time points, highlighting the need for assessment of Infection Prevention and Control guidelines.
Collapse
Affiliation(s)
- Maria Nieto-Rosado
- Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK.
- Division of Infection and Immunity, Cardiff University, Cardiff, UK.
| | - Kirsty Sands
- Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Edward A R Portal
- Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Kathryn M Thomson
- Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Maria J Carvalho
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Department of Medical Sciences, Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Jordan Mathias
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Rebecca Milton
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Calie Dyer
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Chinenye Akpulu
- Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Ian Boostrom
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Patrick Hogan
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Habiba Saif
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Ana D Sanches Ferreira
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
- Parasites and Microbes Programme, Wellcome Sanger Institute Hinxton, Hinxton, UK
| | - Thomas Hender
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Barbra Portal
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Robert Andrews
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - W John Watkins
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Rabaab Zahra
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Haider Shirazi
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Adil Muhammad
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Syed Najeeb Ullah
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Hilal Jan
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Shermeen Akif
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | | | | | | | | | - Chinago P Edwin
- Department of Microbiology, Medway Maritime Hospital NHS Foundation Trust, Gillingham, Kent, UK
- Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Adeola Adeleye
- Murtala Muhammad Specialist Hospital, Kano City, Nigeria
| | | | | | - Aniceth Rucogoza
- The National Reference Laboratory, Rwanda Biomedical Centre, Kigali, Rwanda
| | - Lucie Gaju
- The National Reference Laboratory, Rwanda Biomedical Centre, Kigali, Rwanda
| | - Shaheen Mehtar
- Unit of IPC, Stellenbosch University, Cape Town, South Africa
- Infection Control Africa Network, Cape Town, South Africa
| | - Andrew N H Bulabula
- Infection Control Africa Network, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Andrew Whitelaw
- Division of Medical Microbiology, Stellenbosch University, Cape Town, South Africa
- National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Lauren Roberts
- Division of Medical Microbiology, Stellenbosch University, Cape Town, South Africa
| | - Grace Chan
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics and Child Health, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Delayehu Bekele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
- Department of Obstetrics and Gynecology, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Semaria Solomon
- Department of Microbiology, Immunology and Parasitology, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mahlet Abayneh
- Department of Pediatrics and Child Health, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Gesit Metaferia
- Department of Microbiology, Immunology and Parasitology, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Timothy R Walsh
- Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| |
Collapse
|
8
|
Chelaru EC, Muntean AA, Hogea MO, Muntean MM, Popa MI, Popa GL. The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden. Antibiotics (Basel) 2024; 13:295. [PMID: 38666971 PMCID: PMC11047529 DOI: 10.3390/antibiotics13040295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/29/2024] Open
Abstract
Antimicrobial resistance (AMR) is a worldwide healthcare problem. Multidrug-resistant organisms (MDROs) can spread quickly owing to their resistance mechanisms. Although colonized individuals are crucial for MDRO dissemination, colonizing microbes can lead to symptomatic infections in carriers. Carbapenemase-producing Enterobacterales (CPE) are among the most important MDROs involved in colonizations and infections with severe outcomes. This review aimed to track down the first reports of CPE in Africa, describe their dissemination throughout African countries and summarize the current status of CRE and CPE data, highlighting current knowledge and limitations of reported data. Two database queries were undertaken using Medical Subject Headings (MeSH), employing relevant keywords to identify articles that had as their topics beta-lactamases, carbapenemases and carbapenem resistance pertaining to Africa or African regions and countries. The first information on CPE could be traced back to the mid-2000s, but data for many African countries were established after 2015-2018. Information is presented chronologically for each country. Although no clear conclusions could be drawn for some countries, it was observed that CPE infections and colonizations are present in most African countries and that carbapenem-resistance levels are rising. The most common CPE involved are Klebsiella pneumoniae and Escherichia coli, and the most prevalent carbapenemases are NDM-type and OXA-48-type enzymes. Prophylactic measures, such as screening, are required to combat this phenomenon.
Collapse
Affiliation(s)
- Edgar-Costin Chelaru
- Department of Microbiology II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.-C.C.); (A.-A.M.); (M.-O.H.); (M.-M.M.)
| | - Andrei-Alexandru Muntean
- Department of Microbiology II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.-C.C.); (A.-A.M.); (M.-O.H.); (M.-M.M.)
- Department of Microbiology, Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Mihai-Octav Hogea
- Department of Microbiology II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.-C.C.); (A.-A.M.); (M.-O.H.); (M.-M.M.)
| | - Mădălina-Maria Muntean
- Department of Microbiology II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.-C.C.); (A.-A.M.); (M.-O.H.); (M.-M.M.)
| | - Mircea-Ioan Popa
- Department of Microbiology II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.-C.C.); (A.-A.M.); (M.-O.H.); (M.-M.M.)
- Department of Microbiology, Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Gabriela-Loredana Popa
- Department of Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Parasitic Disease Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
| |
Collapse
|
9
|
Keneh NK, Kenmoe S, Bowo-Ngandji A, Tatah Kihla Akoachere JF, Gonsu Kamga H, Ndip RN, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Tendongfor N, Ndip LM, Esemu SN. A mapping review of methicillin-resistant Staphylococcus aureus proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon. PLoS One 2023; 18:e0296267. [PMID: 38134014 PMCID: PMC10745167 DOI: 10.1371/journal.pone.0296267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has increased and poses a significant threat to human and animal health in Cameroon and the world at large. MRSA strains have infiltrated various settings, including hospitals, communities, and livestock, contributing to increased morbidity, treatment costs, and mortality. This evidence synthesis aims to understand MRSA prevalence, resistance patterns, and genetic characterization in Cameroon. METHODS The methodology was consistent with the PRISMA 2020 guidelines. Studies of any design containing scientific data on MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon were eligible for inclusion, with no restrictions on language or publication date. The search involved a comprehensive search strategy in several databases including Medline, Embase, Global Health, Web of Science, African Index Medicus, and African Journal Online. The risk of bias in the included studies was assessed using the Hoy et al tool, and the results were synthesized and presented in narrative synthesis and/or tables and graphs. RESULTS The systematic review analyzed 24 studies, mostly conducted after 2010, in various settings in Cameroon. The studies, characterized by moderate to low bias, revealed a wide prevalence of MRSA ranging from 1.9% to 46.8%, with considerable variation based on demographic and environmental factors. Animal (0.2%), food (3.2% to 15.4%), and environmental samples (0.0% to 34.6%) also showed a varied prevalence of MRSA. The genetic diversity of MRSA was heterogeneous, with different virulence gene profiles and clonal lineages identified in various populations and sample types. Antimicrobial resistance rates showed great variability in the different regions of Cameroon, with notable antibiotic resistance recorded for the beta-lactam, fluoroquinolone, glycopeptide, lincosamide, and macrolide families. CONCLUSION This study highlights the significant variability in MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon, and emphasizes the pressing need for comprehensive antimicrobial stewardship strategies in the country.
Collapse
Affiliation(s)
- Nene Kaah Keneh
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | - Hortense Gonsu Kamga
- Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaoundé, Cameroon
| | - Roland Ndip Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | - Lucy Mande Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| |
Collapse
|
10
|
Fresno M, Pavez L, Poblete Y, Cortez A, Del Pozo T. Unveiling antimicrobial resistance in Chilean fertilized soils: a One Health perspective on environmental AMR surveillance. Front Microbiol 2023; 14:1239761. [PMID: 38107869 PMCID: PMC10722175 DOI: 10.3389/fmicb.2023.1239761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023] Open
Abstract
Antimicrobial resistance (AMR) poses a significant threat to humans and animals as well as the environment. Within agricultural settings, the utilization of antimicrobial agents in animal husbandry can lead to the emergence of antimicrobial resistance. In Chile, the widespread use of animal-derived organic amendments, including manure and compost, requires an examination of the potential emergence of AMR resulting from their application. The aim of this research was to identify and compare AMR genes found in fertilized soils and manure in Los Andes city, Chile. Soil samples were collected from an agricultural field, comprising unamended soils, amended soils, and manure used for crop fertilization. The selected genes (n = 28) included genes associated with resistance to beta-lactams, tetracyclines, sulfonamides, polymyxins, macrolides, quinolones, aminoglycosides, as well as mobile genetic elements and multidrug resistance genes. Twenty genes were successfully identified in the samples. Tetracycline resistance genes displayed the highest prevalence, followed by MGE and sulfonamides, while quinolone resistance genes were comparatively less abundant. Notably, blaOXA, sulA, tetO, tetW, tetM, aac (6) ib., and intI1, exhibited higher frequencies in unamended soils, indicating their potential persistence within the soil microbiome and contribution to the perpetuation of AMR over time. Given the complex nature of AMR, it is crucial to adopt an integrated surveillance framework that embraces the One Health approach, involving multiple sectors, to effectively address this challenge. This study represents the first investigation of antimicrobial resistance genes in agricultural soils in Chile, shedding light on the presence and dynamics of AMR in this context.
Collapse
Affiliation(s)
- Marcela Fresno
- Núcleo de Investigaciones Aplicadas en Ciencias Veterinarias y Agronómicas, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Providencia, Santiago, Chile
- Red CYTED-USCC. CYTED 412RT0117: Una Salud en Iberoamérica y El Caribe frente al cambio climático y la pérdida de biodiversidad, Santiago, Chile
| | - Leonardo Pavez
- Núcleo de Investigación en Ciencias Biológicas (NICB), Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Providencia, Santiago, Chile
- Departamento de Ciencias Humanas, Universidad Bernardo O’Higgins, Santiago, Chile
| | - Yanina Poblete
- Núcleo de Investigaciones Aplicadas en Ciencias Veterinarias y Agronómicas, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Providencia, Santiago, Chile
| | - Alexandra Cortez
- Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Santiago, Chile
| | - Talía Del Pozo
- Núcleo de Investigaciones Aplicadas en Ciencias Veterinarias y Agronómicas, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Providencia, Santiago, Chile
| |
Collapse
|
11
|
Fayed B, Lazreg IK, AlHumaidi RB, Qasem MAAA, Alajmy BMGN, Bojbarah FMAM, Senok A, Husseiny MI, Soliman SSM. Intra-clade Heterogeneity in Candida auris: Risk of Management. Curr Microbiol 2023; 80:295. [PMID: 37486431 DOI: 10.1007/s00284-023-03416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
Candida auris has emerged as a significant nosocomial fungal pathogen with a high risk of pathogenicity. Since the initial detection of C. auris in 2009, it gained lots of attention with a recent alert by the Centers for Disease Control and Prevention (CDC) due to its high infectivity and drug resistance. Several studies showed the capability of C. auris to secrete lytic enzymes, germinate, and form a biofilm that eventually results in interactions with the host cells, leading to serious infections. Other studies demonstrated a decrease in susceptibility of C. auris strains to available antifungals, which may be caused by mutations within the target genes, or the drug efflux pumps. However, the contribution of C. auris heterogeneity in pathogenicity and drug resistance is not well studied. Here, we shed light on the factors contributing to the development of heterogeneity in C. auris. These include phenotypic changes, biofilm formation, mechanisms of drug resistance, host invasion, mode of transmission, and expression of virulence factors. C. auris exhibits different phenotypes, particularly aggregative, and non-aggregative forms that play an important role in fungal heterogeneity, which significantly affects drug resistance and pathogenicity. Collectively, heterogeneity in C. auris significantly contributes to ineffective treatment, which in turn affects the fungal pathogenicity and drug resistance. Therefore, understanding the underlying reasons for C. auris heterogeneity and applying effective antifungal stewardship could play a major role in controlling this pathogen.
Collapse
Affiliation(s)
- Bahgat Fayed
- Research Institute for Medical and Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, UAE
- Chemistry of Natural and Microbial Products, National Research Centre, Cairo, Egypt
| | - Imene K Lazreg
- Research Institute for Medical and Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Razan B AlHumaidi
- Research Institute for Medical and Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, UAE
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Maryam A A A Qasem
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Bashayir M Gh N Alajmy
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Fatemh M A M Bojbarah
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14 Dubai Healthcare City, P.O.Box 505055, Dubai, UAE
| | - Mohamed I Husseiny
- Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
- Department of Translational Research & Cellular Therapeutics, Arthur Riggs Diabetes & Metabolism Research Institute, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Sameh S M Soliman
- Research Institute for Medical and Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, UAE.
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, UAE.
| |
Collapse
|
12
|
Joachim A, Manyahi J, Issa H, Lwoga J, Msafiri F, Majigo M. Predominance of Multidrug-Resistant Gram-Negative Bacteria on Contaminated Surfaces at a Tertiary Hospital in Tanzania: A Call to Strengthening Environmental Infection Prevention and Control Measures. Curr Microbiol 2023; 80:148. [PMID: 36964831 DOI: 10.1007/s00284-023-03254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023]
Abstract
The spreading of multidrug resistance (MDR) strains in the hospital settings via contaminated surfaces have been increasingly reported where Gram-negative bacteria have been implicated in causing most nosocomial infections. This study aimed to determine the rate of contamination with multi-resistant gram-negative bacteria in the hospital environment. A cross-sectional study was conducted at Muhimbili National Hospital paediatric department, between July and August 2020. Non-repetitive surface swab samples were collected from predefined surfaces and medical device surfaces, and cultured on MacConkey agar with and without antibiotics. Isolates were identified using biochemical test and tested for antibiotic susceptibility using the Kirby-Bauer disk diffusion method. The rate of hospital contamination with Gram-negative bacteria across the Pediatrics units was 30%, with a high rate observed in oncology units (34.8%) and the malnutrition/diarrhoea ward (32.1%). Sink/washing basin had the highest frequency of bacterial contamination (74.2%). We observed a high rate of ESBL (32.5%), with Acinetobacter baumannii, Klebsiella pneumoniae, and E. coli being the predominant ESBL-producing Gram-negative bacteria, while carbapenemase-producing Gram-negative bacteria was detected at 22.8%. Highest resistance rates (63-100%) were observed against ceftriaxone and trimethoprim-sulfamethoxazole. Up to 51% of the Gram-negative bacteria showed resistant to meropenem. MDR strains were detected in 61.4% of Gram-negative bacteria isolated. In conclusion, we observed a high rate of MDR bacteria contaminating hospital surfaces. The higher rate of MDR calls for a need to strengthen infectious prevention control measures, including cleaning practices in the hospital environment, to reduce the risk of transmission of resistant strains to patients and healthcare workers.
Collapse
Affiliation(s)
- Agricola Joachim
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania.
| | - Joel Manyahi
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Habiba Issa
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Jackline Lwoga
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Frank Msafiri
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Mtebe Majigo
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| |
Collapse
|
13
|
Deusdará TT, Felix MKC, Brito HS, Ribeiro DR, Cangussu EWS, Albuquerque B, Santos GR, Chaves JR, Carvalho WCR, Astolfi-Filho S, Assunção EN, Mariúba LAM, Nogueira PA, Viana KF, Brandi IV, Cangussu ASR. Resistance determinants of emerging pathogens isolated from an intensive care unit as a parameter of population health conditions of the Legal Amazon microregion. BRAZ J BIOL 2023; 83:e269778. [PMID: 37018840 DOI: 10.1590/1519-6984.269778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/23/2023] [Indexed: 04/05/2023] Open
Abstract
Abstract Bacteria responsible for causing infections are common in hospital environments, water, soil, and food products. The infection risk is intensified by the absence of public sanitation, poor quality of life, and food scarcity. These external factors promote the dissemination of pathogens by direct contamination or biofilm formation. In this work, we identified bacterial isolates obtained from intensive care units in the southern region of Tocantins, Brazil. We compared matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) techniques and 16S ribosomal ribonucleic acid (rRNA) molecular analysis; we also performed phenotypic characterization. Fifty-six isolates characterized using morphotinctorial tests were classified as gram-positive (80.4%; n = 45) and gram-negative (19.6%; n = 11) and were resistant to several antibiotic classes; notably, we identified the blaOXA-23 resistance gene in the ILH10 isolate. Microbial identification using MALDI-TOF MS resulted in the identification of Sphingomonas paucimobilis and Bacillus circulans. 16S rRNA sequencing revealed four isolates belonging to the genera Bacillus and Acinetobacter. The similarity was superior to 99% for Acinetobacter schindleri in the Basic Local Alignment Search Tool (BLAST), grouped in the clade superior to 90%. Several strains isolated from intensive care units (ICU) were resistant to various antibiotic classes. These techniques allowed for the identification of several microorganisms of importance in public health, enabling improvements in human infection control and proving the quality of inputs, food, and water.
Collapse
Affiliation(s)
| | | | | | | | | | | | - G. R. Santos
- Universidade Federal do Tocantins, Brasil; Universidade Federal do Tocantins, Brasil
| | | | | | | | | | | | | | - K. F. Viana
- Universidade Federal da Integração Latino-Americana, Brasil
| | | | - A. S. R. Cangussu
- Universidade Federal do Tocantins, Brasil; Universidade Federal do Tocantins, Brasil; Universidade Federal do Tocantins, Brasil
| |
Collapse
|
14
|
Bosserman RE, Kwon JH. Know your Microbe Foes: The Role of Surveillance in Combatting Antimicrobial Resistance. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:517-523. [PMID: 36568832 PMCID: PMC9765335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Antibiotic-resistant organisms (AROs) are difficult and costly to treat, associated with high mortality rates, and are on the rise. In the United States, there is limited tracking of AROs, which can contribute to transmission and inhibit infection prevention interventions. Surveillance is limited by a lack of standardized methods for colonization screening and limited communication regarding patient ARO-status between healthcare settings. Some regional surveillance and reporting efforts are in place for extensively-resistant AROs such as carbapenem-resistant Enterobacterales (CRE), but need to be further expanded nationwide and to include other AROs such as extended-spectrum β-lactamase (ESBL) producing organisms. Increased surveillance of ARO infections and colonization will inform future targeted intervention and infection prevention strategies.
Collapse
Affiliation(s)
| | - Jennie H. Kwon
- To whom all correspondence should be addressed:
Jennie H. Kwon, DO, MSCI, Washington University School of Medicine, Division of
Infectious Diseases, St. Louis, MO 63110;
| |
Collapse
|
15
|
El Haddad L, Angelidakis G, Clark JR, Mendoza JF, Terwilliger AL, Chaftari CP, Duna M, Yusuf ST, Harb CP, Stibich M, Maresso A, Chemaly RF. Genomic and Functional Characterization of Vancomycin-Resistant Enterococci-Specific Bacteriophages in the Galleria mellonella Wax Moth Larvae Model. Pharmaceutics 2022; 14:1591. [PMID: 36015218 PMCID: PMC9414631 DOI: 10.3390/pharmaceutics14081591] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Phages are naturally occurring viruses that selectively kill bacterial species without disturbing the individual's normal flora, averting the collateral damage of antimicrobial usage. The safety and the effectiveness of phages have been mainly confirmed in the food industry as well as in animal models. In this study, we report on the successful isolation of phages specific to Vancomycin-resistant Enterococci, including Enterococcus faecium (VREfm) and Enterococcus faecalis from sewage samples, and demonstrate their efficacy and safety for VREfm infection in the greater wax moth Galleria mellonella model. No virulence-associated genes, antibiotic resistance genes or integrases were detected in the phages' genomes, rendering them safe to be used in an in vivo model. Phages may be considered as potential agents for therapy for bacterial infections secondary to multidrug-resistant organisms such as VREfm.
Collapse
Affiliation(s)
- Lynn El Haddad
- Department of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.E.H.); (J.F.M.)
| | - Georgios Angelidakis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
| | - Justin R. Clark
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA; (J.R.C.); (A.L.T.); (A.M.)
| | - Jesus F. Mendoza
- Department of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.E.H.); (J.F.M.)
| | - Austen L. Terwilliger
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA; (J.R.C.); (A.L.T.); (A.M.)
| | - Christopher P. Chaftari
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
| | - Mark Duna
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
| | - Serena T. Yusuf
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
| | - Cynthia P. Harb
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
| | - Mark Stibich
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
- Xenex Disinfection Services, San Antonio, TX 78216, USA
| | - Anthony Maresso
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA; (J.R.C.); (A.L.T.); (A.M.)
| | - Roy F. Chemaly
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.A.); (C.P.C.); (M.D.); (S.T.Y.); (C.P.H.); (M.S.)
| |
Collapse
|
16
|
Synergistic Antibacterial Activity of Green Synthesized Silver Nanomaterials with Colistin Antibiotic against Multidrug-Resistant Bacterial Pathogens. CRYSTALS 2022. [DOI: 10.3390/cryst12081057] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The high frequency of nosocomial bacterial infections caused by multidrug-resistant pathogens contributes to significant morbidity and mortality worldwide. As a result, finding effective antibacterial agents is of critical importance. Hence, the aim of the present study was to greenly synthesize silver nanoparticles (AgNPs) utilizing Salvia officinalis aqueous leaf extract. The biogenic AgNPs were characterized utilizing different physicochemical techniques such as energy-dispersive X-ray spectroscopy (EDX), ultraviolet-visible spectrophotometry (UV-Vis), X-ray diffraction analysis (XRD), transmission electron microscopy (TEM), and Fourier transform infrared spectroscopy (FT-IR) analysis. Additionally, the synergistic antimicrobial effectiveness of the biosynthesized AgNPs with colistin antibiotic against multidrug-resistant bacterial strains was evaluated utilizing the standard disk diffusion assay. The bioformulated AgNPs revealed significant physicochemical features, such as a small particle size of 17.615 ± 1.24 nm and net zeta potential value of −16.2 mV. The elemental mapping of AgNPs revealed that silver was the main element, recording a relative mass percent of 83.16%, followed by carbon (9.51%), oxygen (5.80%), silicon (0.87%), and chloride (0.67%). The disc diffusion assay revealed that AgNPs showed antibacterial potency against different tested bacterial pathogens, recording the highest efficiency against the Escherichia coli strain with an inhibitory zone diameter of 37.86 ± 0.21 mm at an AgNPs concentration of 100 µg/disk. In addition, the antibacterial activity of AgNPs was significantly higher than that of colistin (p ≤ 0.05) against the multidrug resistant bacterial strain namely, Acinetobacter baumannii. The biosynthesized AgNPs revealed synergistic antibacterial activity with colistin antibiotic, demonstrating the highest synergistic percent against the A. baumannii strain (85.57%) followed by Enterobacter cloacae (53.63%), E. coli (35.76%), Klebsiella pneumoniae (35.19%), Salmonella typhimurium (33.06%), and Pseudomonas aeruginosa (13.75%). In conclusion, the biogenic AgNPs revealed unique physicochemical characteristics and significant antibacterial activities against different multidrug-resistant bacterial pathogens. Consequently, the potent synergistic effect of the AgNPs–colistin combination highlights the potential of utilizing this combination for fabrication of highly effective antibacterial coatings in intensive care units for successful control of the spread of nosocomial bacterial infections.
Collapse
|
17
|
Kayta G, Manilal A, Tadesse D, Siraj M. Indoor air microbial load, antibiotic susceptibility profiles of bacteria, and associated factors in different wards of Arba Minch General Hospital, southern Ethiopia. PLoS One 2022; 17:e0271022. [PMID: 35797393 PMCID: PMC9262214 DOI: 10.1371/journal.pone.0271022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022] Open
Abstract
The levels of indoor air microbial load in hospitals are very crucial to the health of patients and health care workers and are to be regularly monitored and maintained at an acceptable level. However, this problem remains overlooked, particularly in developing countries including Ethiopia. A hospital-based cross-sectional study is designed to determine the indoor air microbial load (settle plate technique), microbial isolates (standard microbiological techniques), bacterial susceptibility profiles (Kirby-Bauer disk diffusion technique), and associated factors, in different wards of the title Hospital, southern Ethiopia. An observational checklist was used to collect relevant information related to the associated factors; descriptive and inferential statistics were applied using Statistical Package for Social Sciences (SPSS); p-values ≤ 0.05 in the multivariable analysis were considered statistically significant. The total average bacterial and fungal load of the selected wards was 1914±1081.4 Colony Forming Units (CFU)/m3 (95% CI: 1718.5–2109.48 CFU/m3) and 1533.7±858.8 CFU/m3 (95% CI: 1378.5-1688CFU/m3) respectively. The highest mean bacterial (1914±1081.4 CFU/m3) and fungal (1533.7±858.8 CFU/m3) loads were found in the male surgical and female medical wards respectively. A total of 229 bacterial and 139 fungal isolates were obtained; Gram-positive bacteria were the predominant type, 130 (56.7%), particularly the isolates of Staphylococcus aureus, 46 (20.1%). The predominant fungal isolates were Aspergillus sp., 53(38%). Percentages of multidrug-resistant (MDR), extended-spectrum beta-lactamase (ESBL), and carbapenemase producers respectively were 48.5, 26.5, and 25%. High room crowd index [p = 0.003; Adjusted Odds Ratio (AOR) 12.5 (Confidence Interval (CI) 95%: 2.42–65)], presence of damp/wet materials [p = 0.025; AOR 7 (CI 95%: 1.3–37.4)], intense room traffic [p = 0.004; AOR 9.6 (CI 95%: 1.2–79.3)], inappropriate storage of food and drugs [p = 0.008; AOR 7.5 (CI 95%: 1.7–32)], and unclean environment [p = 0.03; AOR 5.8 (CI 95%: 1.2–28)] showed statistical significance concerning the indoor air microbial loads; most of the wards in Arba Minch General Hospital (AMGH) stand high and not in an acceptable level as per the WHO and the European Commission standards on indoor air microbial load. Periodic air surveillance and infection prevention control programs are required to reduce the transmission of these microbes to inpatients, visitors, and health care workers.
Collapse
Affiliation(s)
- Gebre Kayta
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aseer Manilal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dagimawie Tadesse
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail:
| | - Munira Siraj
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
18
|
Žagar D, Zore A, Torkar KG. The occurrence of antibiotic-resistant bacteria on the clothes of nursery teachers in daycare centres. J Appl Microbiol 2022; 132:4517-4530. [PMID: 35267237 PMCID: PMC9314099 DOI: 10.1111/jam.15520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/28/2022]
Abstract
AIMS Childcare facilities act as microenvironments that facilitate and promote the selection, spread, and transmission of antibiotic-resistant microorganisms in the community. We focused on the study of antimicrobial resistance and genetic predispositions for β-lactamase production in bacterial isolates from nursery teachers' clothing. METHODS AND RESULTS Antimicrobial resistance of bacterial strains belonging to Enterobacteriaceae, Enterococcus, Staphylococcus spp., Pseudomonas spp. and Bacillus spp. isolated from 80 samples of nursery teachers' clothing was determined. The selected ESβL genes were found in 30 (44.1%) of 68 strains examined. The CTX-M type ESβL determinants were detected in 15.4%, 71.5%, and 42.5% of the Enterobacteriaceae, Pseudomonas, and Bacillus isolates, respectively. The OXA-type coding genes were detected only in strains of the genera Pseudomonas (57.1%) and Bacillus (48.6%). Thus, most B. cereus strains were sensitive to the recommended antibiotics used to treat infections caused by these bacteria. Methicillin resistance was phenotypically confirmed in 27 (14.6%) of 185 staphylococcal isolates. Four isolates (2.2%) were identified as MRSA. Vancomycin resistance was not observed in any of the staphylococcal and enterococci strains. CONCLUSIONS This study has shown that potential pathogens have been isolated from the clothing of nursery teachers, posing a risk of transmission to children. These clothes should be maintained and properly laundered to avoid cross-contamination and the spread of multidrug-resistant (MDR) bacteria in childcare centres. SIGNIFICANCE AND IMPACT OF THE STUDY This study provides insight into the route of transmission of MDR microorganisms through the clothing of nursery teachers, to which greater importance should be given in the future. Proper procedures for the cleaning and use of clothing in daycare centres should be clarified and standardised.
Collapse
Affiliation(s)
- Dominika Žagar
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| | - Anamarija Zore
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| | - Karmen Godič Torkar
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| |
Collapse
|
19
|
Esmaeilnia M, Saffari M, Rashki S, Marzhoseyni Z, Khaledi A, Moosavi GA, Atoof F, Alani B. Molecular typing of clinical and environmental isolates of Klebsiella pneumoniae producing ESBLs by PFGE. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2022; 25:208-213. [PMID: 35655602 PMCID: PMC9124538 DOI: 10.22038/ijbms.2022.58445.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Klebsiella pneumoniae is the common cause of pneumonia in hospitalized patients, particularly in intensive care units (ICU). The infection can transfer by medical equipment such as mechanical ventilators. This study aimed to investigate the molecular typing of the extended-spectrum beta-lactamase-producing K. pneumoniae isolates recovered from Beheshti Hospital, Kashan, Iran. MATERIALS AND METHODS K. pneumoniae isolates producing ESBLs have been collected from the samples obtained from Shahid Beheshti hospital, Kashan, Iran. Antimicrobial susceptibility was determined using the Kirby Bauer disk diffusion method. The presence of ESBLs was evaluated using CLSI for ESBL screening by the double-disk diffusion method. Molecular typing was conducted by pulsed-field gel electrophoresis (PFGE). In total, 89 K. pneumoniae isolates were recovered, of which 47.1% were ESBL producers. RESULTS Results showed that all of the clinical and environmental isolates were resistant to ceftriaxone, meropenem, cefazolin, cefotaxime, cephalothin, and piperacillin-tazobactam. All isolates were grouped under four clusters (A-D). The major cluster was related to the C cluster with 22 isolates (19 clinical and 3 environmental). Seventy-two percent of isolates were from the ICU ward. There was no correlation between antibiotic resistance patterns and PFGE clusters (P=0.2). CONCLUSION We observed a common molecular signature among both clinical and environmental K. pneumoniae isolates, indicating a similar genotype and likely a common origin for ESBL producer isolates found in different hospital wards. Therefore, hospitals need to implement an effective infection control system to decrease the spreading of ESBL strains within the hospitals and subsequently the transmission of the infection to patients.
Collapse
Affiliation(s)
- Mohammad Esmaeilnia
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran, Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran
| | - Mahmood Saffari
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran, Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran
| | - Somaye Rashki
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran, Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran
| | - Zeynab Marzhoseyni
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran, Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran
| | - Azad Khaledi
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran, Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran,Corresponding author: Azad Khaledi. Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. Tel: +98-31-55443022;
| | - Gholam Abbas Moosavi
- Department of Vital Statistics and Epidemiology, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Atoof
- Department of Biostatistics, Health Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | - Behrang Alani
- Department of Applied Cell Sciences, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
20
|
Antibacterial and Anti-Biofilm Activities of Essential Oil Compounds against New Delhi Metallo-β-Lactamase-1-Producing Uropathogenic Klebsiella pneumoniae Strains. Antibiotics (Basel) 2022; 11:antibiotics11020147. [PMID: 35203751 PMCID: PMC8868355 DOI: 10.3390/antibiotics11020147] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/20/2022] Open
Abstract
The World Health Organization points out that the opportunistic pathogen Klebsiella pneumoniae that causes various infections among others, urinary tract infections (UTIs), is one of the high-priority species due to a global problem of antimicrobial resistance. The aim of this study was to investigate antibacterial and anti-biofilm activities of chosen constituents of essential oils against NDM-1-producing, uropathogenic K. pneumoniae strains. The genes encoding lipopolysaccharide (uge, wabG), adhesin gene fimH (type I fimbriae) and gene encoding carbapenemase (blaNDM-1) for all tested strains were detected by PCR amplification. The K. pneumoniae ATCC BAA-2473 reference strain was uge- and blaNDM-1-positive. The effectiveness of fifteen essential oil compounds (EOCs) (linalool, β-citronellol, linalyl acetate, menthone, (−)-menthol, (+)-menthol, geraniol, eugenol, thymol, trans-anethole, farnesol, β-caryophyllene, (R)-(+)-limonene, 1,8-cineole, and carvacrol) was assessed by determining the MIC, MBC, MBC/MIC ratio against K. pneumoniae strains by the microdilution method. Anti-biofilm properties of these compounds were also investigated. Thymol, carvacrol and geraniol exhibited the best antibacterial and anti-biofilm activities against uropathogenic NDM-1-producing K. pneumoniae isolates. Results of our investigations provide a basis for more detailed studies of these phytochemicals on their application against uropathogenic K. pneumoniae.
Collapse
|
21
|
Firesbhat A, Tigabu A, Tegene B, Gelaw B. Bacterial profile of high-touch surfaces, leftover drugs and antiseptics together with their antimicrobial susceptibility patterns at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. BMC Microbiol 2021; 21:309. [PMID: 34749674 PMCID: PMC8573887 DOI: 10.1186/s12866-021-02378-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background The hospital environment serves as a source of nosocomial infections, which pose a major therapeutic challenge. Although many bacteria species are common in hospital environments, their distribution, frequency, and antimicrobial susceptibility pattern from high-touch surfaces, leftover drugs, and antiseptics in different wards remain largely unknown. Hence, the aim of this study was to assess the magnitude and frequency of bacterial contaminants and their antimicrobial susceptibility patterns. Methods A total of 384 samples were collected from five selected wards and processed according to standard bacteriological procedures. Samples were collected from high-touch surface using swabs and inoculated on Blood agar, MacConkey agar, Chocolate agar and Mannitol salt agar plates, and incubated at 37 °C for 24 h. On the other hand, the leftover drugs and 80% ethanol samples were collected using sterile cotton swab immersed in sterile tryptone soy broth then inoculated on culture medias and incubated at 37 °C for 24 h. Identification of bacteria species was done using the morphological characteristics, Gram stain, and biochemical tests while antimicrobial susceptibility tests were done using modified Kirby-Bauer disk diffusion technique following the Clinical Laboratory Standards Institute 2021guidelines. Results Among the 384 samples processed, 102 (26.6%) were culture positive and a total of 114 bacterial isolates were identified. Gram-positive bacterial isolates were predominant, 64.9%, while Gram-negatives were 35.1%. The most frequently isolated bacteria were coagulase negative Staphylococci (38.6%) followed by S. aureus (13.2%) and P. aeruginosa (11.4%). On the other hand, the proportion of bacteria isolated from surgical ward, post-natal ward, orthopedic ward, trauma ward, and neonatal intensive care unit ward were 24.6, 21, 20.2, 18.4,15.8%, respectively. Sinks were mainly contaminated with Klebsiella species (81.8%) and A. baumannii (55.6%), while A. baumannii (22.2%) was the most contaminant for 80% ethanol. Gram-positive bacteria had significantly high resistance levels to penicillin (67.6%), cotrimoxazole (67.8%), and cefepime (80%). On the other hand, Gram-negative bacteria revealed the highest resistance levels to tetracycline (82.4%), amoxicillin-clavulanic acid (76.5%), cefepime (66.7%), ceftazidime (67.5%), and piperacillin (92.3%). Moreover, the proportion of multidrug resistant bacteria isolates was 44.7%. Conclusions Data of the present study showed that coagulase negative Staphylococci was the dominant bacterial isolates followed by S. aureus and P. aeruginosa. The proportion of multi-drug resistant bacteria isolates was relatively high. Therefore, appropriate infection prevention and control measures should be implemented.
Collapse
Affiliation(s)
- Atsedewoyn Firesbhat
- Unit of Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P O. box: 196, Gondar, Ethiopia
| | - Abiye Tigabu
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P O. box: 196, Gondar, Ethiopia.
| | - Birhanemeskel Tegene
- Department of Medical Microbiology, St. Paul's Hospital Millennium Medical College, P. O. box 1271, Addis Abeba, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P O. box: 196, Gondar, Ethiopia
| |
Collapse
|
22
|
Teh CSJ, Lee YQ, Kong ZX, Woon JJ, Niek WK, Lau MY, Idris N, Ponnampalavanar SSLS, Ho PF, Yee Por L. Development of a web-based multidrug-resistant organisms (MDRO) monitoring and transmission tracking system on the basis of microbiology and molecular characteristics. JOURNAL OF TAIBAH UNIVERSITY FOR SCIENCE 2021. [DOI: 10.1080/16583655.2021.1978807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yee Qing Lee
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zhi Xian Kong
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jia Jie Woon
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wen Kiong Niek
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Min Yi Lau
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nuryana Idris
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Peng Foong Ho
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Lip Yee Por
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
23
|
Valizadeh S, Yousefi B, Abdolshahi A, Emadi A, Eslami M. Determination of genetic relationship between environmental Escherichia coli with PFGE and investigation of IS element in bla CTX-M gene of these isolates. Microb Pathog 2021; 159:105154. [PMID: 34419612 DOI: 10.1016/j.micpath.2021.105154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/11/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION ESBL producing Escherichia coli (E. coli) have spread in the hospital settings. The aims of this study determination of genetic relationship between Environmental E. coli with PFGE typing and investigation of IS element in blaCTX-M gene of these isolates. MATERIALS AND METHODS A total of 50 E. coli isolates were collected from hospital environmental. The blaCTX-M producing E. coli and IS element of this gene with phylogenetic typing were detected by PCR. The PFGE was performed to detect genetic relationships between this strains. RESULTS Most of the isolates were from urology wards, other samples were isolated from ICU, surgery and orthopedic ward. The majority of isolates were resistant to cefotaxime and ceftazidime antibiotics and also phosphomycin antibiotic resistant were detected in 10% of isolates. CTX-M gene was detected in 72% of isolates. Moreover, ISEcp1, IS26a, and IS26b were detected upstream of CTX-M in 24%, 8% and 16 of isolates. A phylogroup was the most frequent and PFGE analysis exhibited a diverse distribution of E. coli isolates. CONCLUSIONS The results demonstrated the existence of CTX-M-producing E. coli in a hospital environment which is a source for drug-resistant strains. In the most of strains, ISEcp1 was located in the upstream of CTX-M gene and Orf477 was found in the downstream. However, in some strains, IS26 was inserted within the ISEcp1element. Our results show that despite the fact that antibiotics of phosphomycin are not used in this hospital, resistance to phosphomycin was observed in the environmental E. coli.
Collapse
Affiliation(s)
- Saeid Valizadeh
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran
| | - Bahman Yousefi
- Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Anna Abdolshahi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Alireza Emadi
- Deputy of Research and Technology, Semnan University of Medical Sciences, Semnan, Iran
| | - Majid Eslami
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran.
| |
Collapse
|
24
|
Cassone M, Linder M, Shin CJ, Mantey J, Gibson K, Lansing B, Mody L. Not too close! impact of roommate status on MRSA and VRE colonization and contamination in Nursing Homes. Antimicrob Resist Infect Control 2021; 10:104. [PMID: 34225783 PMCID: PMC8258944 DOI: 10.1186/s13756-021-00972-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
Multiple room occupancy is common in Nursing Homes (NHs), and its role in transmission of antibiotic-resistant pathogens is unclear. We investigated prevalence of patient colonization and environmental contamination with vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) in NH roommates, compared it with expected prevalence, and determined specific body and environmental sites that may act as sources of roommate colonization. Roommate contamination was associated with index patient's colonization (relative risk (RR): 2.57 (95% CI 1.04-6.37)) for MRSA, and index patient's immediate environment contamination for VRE (RR: 3.60 (95% CI 1.59-8.12)). When specific index patient sites associated with roommate colonization were investigated, the side table (Fisher's p = 0.029 and 0.047 for VRE and MRSA, respectively) and the nurse call button (p = 0.001 and 0.052) stood out, together with patient hands in the case of VRE (p = 0.026). Future studies should be carried out to establish whether these sites should be a specific target of infection prevention campaigns in NHs with multiple occupancy rooms.
Collapse
Affiliation(s)
- Marco Cassone
- Division of Geriatric and Palliative Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, 3023 BSRB, 109 Zina Pitcher Place48109, USA.
| | - Meghan Linder
- School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Oregon Health Authority, Portland, OR, USA
| | - Cheon Jee Shin
- Division of Geriatric and Palliative Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, 3023 BSRB, 109 Zina Pitcher Place48109, USA.,University of Louisville, Louisville, KY, USA
| | - Julia Mantey
- Division of Geriatric and Palliative Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, 3023 BSRB, 109 Zina Pitcher Place48109, USA
| | - Kristen Gibson
- Division of Geriatric and Palliative Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, 3023 BSRB, 109 Zina Pitcher Place48109, USA
| | - Bonnie Lansing
- Division of Geriatric and Palliative Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, 3023 BSRB, 109 Zina Pitcher Place48109, USA
| | - Lona Mody
- Division of Geriatric and Palliative Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, 3023 BSRB, 109 Zina Pitcher Place48109, USA.,Geriatric Research and Education Clinical Center, VA Ann Arbor, Ann Arbor, MI, USA
| |
Collapse
|
25
|
Seme B, Günther K, Winkler N, Wipprich W. Blue light‐emitting diodes for disinfection. PHOTONICSVIEWS 2021. [PMCID: PMC8250674 DOI: 10.1002/phvs.202100034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Disinfection processes are currently of particular interest due to growing concerns over illnesses caused by human pathogenic germs. Blue light‐emitting diodes (LEDs) can reduce the microbial load on surfaces, in liquids and in air. The high wall‐plug efficiency of the diodes, their additive‐free antimicrobial effect and the good tolerability of the light enable affordable and safe disinfection systems.
Collapse
Affiliation(s)
- Bernd Seme
- Gesellschaft zur Förderung von Medizin‐, Bio‐ und Umwelttechnologien e. V. Felsbachstraße 7 07745 Jena Germany
| | | | | | | |
Collapse
|
26
|
Kasatpibal N, Chittawatanarat K, Nunngam N, Kampeerapanya D, Duangsoy N, Rachakom C, Soison U, Apisarnthanarak A. Impact of multimodal strategies to reduce multidrug-resistant organisms in surgical intensive care units: Knowledge, practices and transmission: A quasi-experimental study. Nurs Open 2021; 8:1937-1946. [PMID: 33760380 PMCID: PMC8186694 DOI: 10.1002/nop2.864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022] Open
Abstract
Aim This study examined the effects of multimodal strategies on knowledge and practices in preventing multidrug‐resistant organism (MDRO) transmission among healthcare personnel (HCP), and to investigate MDRO transmission in two surgical intensive care units (SICUs). Design A quasi‐experimental study with a one‐group pretest–posttest design. Methods We recruited 62 HCP. Data were collected during 2017–2019. Multimodal strategies, including training, educational and reminder posters, an educational YouTube channel, champions and feedback, were used to enhance knowledge and practices. Data were analysed using Wilcoxon signed‐rank test and chi‐square test. Results After the intervention, median knowledge scores increased from 16.0 to 17.0 (p = .001), and overall correct MDRO prevention practices increased from 76.6% to 94.0% (p < .001). The MDRO transmission rate decreased from 25% to 0% (p < .001). Conclusion The findings indicate that multimodal strategies could enhance knowledge and practices for preventing MDRO transmission among HCP and could reduce the MDRO transmission rate in SICUs.
Collapse
Affiliation(s)
- Nongyao Kasatpibal
- Division of Nursing Science, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.,Epidemiology Research Center of Infectious Disease (ERCID), Chiang Mai University, Chiang Mai, Thailand
| | | | - Nantana Nunngam
- Infection Control Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
| | - Daranee Kampeerapanya
- Surgical Critical Care Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
| | - Nongnut Duangsoy
- Surgical Intensive Care Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
| | - Chanban Rachakom
- Surgical Critical Care Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
| | - Ubonrat Soison
- Surgical Critical Care Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
| | | |
Collapse
|
27
|
Chhajed PN, Nene A, Abhyankar N, Akkaraju J, Agarwal R, Arora S, Bhat R, Chawla R, Christopher DJ, Chowdhary SR, Dhar R, Dhooria S, Goyal R, Gupta R, James P, Koul PA, Khader AKA, Madan K, Marwah V, Mehta R, Mohan A, Nangia V, Patel D, Pattabhiraman VR, Sehgal IS, Singh S, Srinivasan A, Swarnakar R, Tampi S. Conventional flexible bronchoscopy during the COVID pandemic: A consensus statement from the Indian Association for Bronchology. Lung India 2021; 38:S105-S115. [PMID: 33686993 PMCID: PMC8104343 DOI: 10.4103/lungindia.lungindia_953_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
During the times of the ongoing COVID pandemic, aerosol-generating procedures such as bronchoscopy have the potential of transmission of severe acute respiratory syndrome coronavirus 2 to the healthcare workers. The decision to perform bronchoscopy during the COVID pandemic should be taken judiciously. Over the years, the indications for bronchoscopy in the clinical practice have expanded. Experts at the Indian Association for Bronchology perceived the need to develop a concise statement that would assist a bronchoscopist in performing bronchoscopy during the COVID pandemic safely. The current Indian Association for Bronchology Consensus Statement provides specific guidelines including triaging, indications, bronchoscopy area, use of personal protective equipment, patient preparation, sedation and anesthesia, patient monitoring, bronchoscopy technique, sample collection and handling, bronchoscope disinfection, and environmental disinfection concerning the coronavirus disease-2019 situation. The suggestions provided herewith should be adopted in addition to the national bronchoscopy guidelines that were published recently. This statement summarizes the essential aspects to be considered for the performance of bronchoscopy in COVID pandemic, to ensure safety for both for patients and healthcare personnel.
Collapse
Affiliation(s)
- Prashant Nemichand Chhajed
- Lung Care and Sleep Centre; Institute of Pulmonology, Medical Research and Development, Mumbai, Maharashtra, India
| | - Amita Nene
- Department of Respiratory Medicine, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Nitin Abhyankar
- Department of Respiratory Medicine, Poona Hospital, Pune, Maharashtra, India
| | - Jayachandra Akkaraju
- Department of Respiratory Medicine, Virinchi Hospital, Hyderabad, Telangana, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Rakesh Chawla
- Department of Respiratory Medicine, Jaipur Golden Hospital, New Delhi, India
| | - D J Christopher
- Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sushmita Roy Chowdhary
- Department of Respiratory Medicne, Apollo Gleaneagles Hospital, Kolkata, West Bengal, India
| | - Raja Dhar
- Department of Pulmonary Medicine, Fortis Hospital, Kolkata, West Bengal, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajiv Goyal
- Department of Respiratory Medicine, Jaipur Golden Hospital and Rajiv Gandhi Cancer Hospital, New Delhi, India
| | - Richa Gupta
- Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prince James
- Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Parvaiz A Koul
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - A K Abdul Khader
- Department of Pulmonary Medicine, KMCT Medical College, Kozhikode, Kerala, India
| | - Karan Madan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Marwah
- Department of Pulmonary, Critical Care and Sleep Medicine, Army Institute of Cardiothoracic Sciences (AICTS), Pune, Maharashtra, India
| | - Ravindra Mehta
- Department of Respiratory Medicine, Apollo Hospitals, Bengaluru, Karnataka, India
| | - Anant Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Nangia
- Institute of Respiratory, Critical Care and Sleep Medicine, Max Hospital, Saket Complex, New Delhi, India
| | - Dharmesh Patel
- City Clinic and Bhailal Amin General Hospital, Vadodara, Gujarat, India
| | - V R Pattabhiraman
- Department of Respiratory Medicine, Royal Care Hospital, Coimbatore, Tamil Nadu, India
| | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetu Singh
- Department of Chest and Tuberculosis, Institute of Respiratory Disease, Jaipur, Rajasthan, India
| | - Arjun Srinivasan
- Department of Respiratory Medicine, Royal Care Hospital, Coimbatore, Tamil Nadu, India
| | - Rajesh Swarnakar
- Department of Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, Maharashtra, India
| | - Shyamsunder Tampi
- Department of Respiratory Medicine, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| |
Collapse
|
28
|
Sebre S, Abegaz WE, Seman A, Awoke T, Desalegn Z, Mihret W, Mihret A, Abebe T. Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates from Inanimate Hospital Environments at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Infect Drug Resist 2020; 13:4439-4448. [PMID: 33364791 PMCID: PMC7751703 DOI: 10.2147/idr.s286293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction Microbial contamination of the hospital environment plays an important role in the spread of healthcare-associated infections (HCAIs). This study was conducted to determine bacterial contamination, bacterial profiles, and antimicrobial susceptibility pattern of bacterial isolates from environmental surfaces and medical equipment. Methods A cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) from June to September 2018. A total of 164 inanimate surfaces located at intensive care units (ICUs) and operation theaters (OTs) were swabbed. All isolates were identified by using routine bacterial culture, Gram staining, and a panel of biochemical tests. For each identified bacteria, antibiogram profiles were determined by the Kirby–Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Results Out of the 164 swabbed samples, 141 (86%) were positive for bacterial growth. The predominant bacteria identified from OTs and ICUs were Staphylococci aureus (23% vs 11.5%), Acinetobacter baumannii (3.8% vs 17.5%) and coagulase-negative Staphylococcus (CoNS) (12.6% vs 2.7%) respectively. Linens were the most contaminated materials among items studied at the hospital (14.8%). Gram-positive bacteria (GPB) had significantly high resistance levels to penicillin (92.8%), cefoxitin (83.5%), and erythromycin (53.6%). On the other hand, Gram-negative bacteria (GNB) revealed the highest resistance levels to ampicillin (97.5%), ceftazidime (91.3%), ceftriaxone (91.3%), and aztreonam (90%). However, a low resistance level was recorded for amikacin (25%) followed by Ciprofloxacin (37.5%). Of the 63 S. aureus isolates, 54 (85.7%) were methicillin-resistant S. aureus (MRSA). Conclusion The inanimate surfaces and commonly touched medical equipment within OTs and ICUs are reservoirs of potentially pathogenic bacteria that could predispose critically ill patients to acquire HCAIs. The proportions of the antimicrobial resistance profile of the isolates are much higher from studied clean inanimate environments.
Collapse
Affiliation(s)
- Shemse Sebre
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Woldaregay Erku Abegaz
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aminu Seman
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tewachew Awoke
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zelalem Desalegn
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wude Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Adane Mihret
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
29
|
Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa FM, Islam S, Jahan D, Nusrat T, Chowdhury TS, Coccolini F, Iskandar K, Catena F, Charan J. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Manag Healthc Policy 2020; 13:1765-1780. [PMID: 33061710 PMCID: PMC7532064 DOI: 10.2147/rmhp.s269315] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Healthcare-associated infections (HCAIs) are a major source of morbidity and mortality and are the second most prevalent cause of death. Furthermore, it has been reported that for every one-hundred patients admitted to hospital, seven patients in high-income economies and ten in emerging and low-income economies acquire at least one type of HCAI. Currently, almost all pathogenic microorganisms have developed antimicrobial resistance, and few new antimicrobials are being developed and brought to market. The literature search for this narrative review was performed by searching bibliographic databases (including Google Scholar and PubMed) using the search terms: "Strategies," "Prevention," and "Healthcare-Associated Infections," followed by snowballing references cited by critical articles. We found that although hand hygiene is a centuries-old concept, it is still the primary strategy used around the world to prevent HCAIs. It forms one of a bundle of approaches used to clean and maintain a safe hospital environment and to stop the transmission of contagious and infectious microorganisms, including multidrug-resistant microbes. Finally, antibiotic stewardship also has a crucial role in reducing the impact of HCAIs through conserving currently available antimicrobials.
Collapse
Affiliation(s)
- Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur57000, Malaysia
| | - Judy McKimm
- Medical Education, Swansea University School of Medicine, Grove Building, Swansea University, Swansea, WalesSA2 8PP, UK
| | - Massimo Sartelli
- Department of General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Sameer Dhingra
- School of Pharmacy, The University of the West Indies, St. Augustine Campus, Faculty of Medical Sciences, Eric Williams Medical Sciences Complex, Uriah Butler Highway, Trinidad & Tobago, West Indies
| | | | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka1342, Bangladesh
| | - Dilshad Jahan
- Department of Hematology, Asgar Ali Hospital, Dhaka1204, Bangladesh
| | - Tanzina Nusrat
- Department of Microbiology, Chittagong Medical College, Chattogram4203, Bangladesh
| | | | - Federico Coccolini
- Department of General Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Katia Iskandar
- School of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
30
|
Alkekhia D, Safford H, Shukla S, Hopson R, Shukla A. β-Lactamase triggered visual detection of bacteria using cephalosporin functionalized biomaterials. Chem Commun (Camb) 2020; 56:11098-11101. [PMID: 32812953 PMCID: PMC7739975 DOI: 10.1039/d0cc04088f] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We report the conjugation of a chromogenic cephalosporin β-lactamase (βL) substrate to polymers and integration into biomaterials for facile, visual βL detection. Identification of these bacterial enzymes, which are a leading cause of antibiotic resistance, is critical in the treatment of infectious diseases. The βL substrate polymer conjugate undergoes a clear to deep yellow color change upon incubation with common pathogenic Gram-positive and Gram-negative bacteria species. We have demonstrated the feasibility of formulating hydrogels with the βL substrate covalently tethered to a poly(ethylene glycol) (PEG) polymer matrix, exhibiting a visible color change in the presence of βLs. This approach has the potential to be used in diagnostic biomaterials for point-of-care detection of βL-producing bacteria, helping combat the spread of drug resistant microbes.
Collapse
Affiliation(s)
- Dahlia Alkekhia
- School of Engineering, Center for Biomedical Engineering, Institute for Molecular and Nanoscale Innovation, Brown University, Providence, RI 02912, USA.
| | | | | | | | | |
Collapse
|
31
|
Recommendations for detection and rapid management of carbapenemase-producing Enterobacterales outbreaks. Infect Prev Pract 2020; 2:100086. [PMID: 34368719 DOI: 10.1016/j.infpip.2020.100086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/19/2020] [Indexed: 12/29/2022] Open
Abstract
There is large heterogeneity in approaches to tackling nosocomial outbreaks caused by carbapenemase-producing Enterobacterales (CPE), however there is limited guidance on how to approach their management. Rapid and robust infection prevention and control interventions can be effective in preventing and reducing the impact of outbreaks in healthcare environments. We present a stepwise approach to aspects of CPE outbreak management, including the development of an action plan, engagement and communication with key stakeholders, developing a dynamic risk assessment, and staff education. These can provide a blueprint for organisations to create templates and checklists to inform their own outbreak response.
Collapse
|
32
|
Soler M, Scholtz A, Zeto R, Armani AM. Engineering photonics solutions for COVID-19. APL PHOTONICS 2020; 5:090901. [PMID: 33015361 PMCID: PMC7523711 DOI: 10.1063/5.0021270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/17/2020] [Indexed: 05/04/2023]
Abstract
As the impact of COVID-19 on society became apparent, the engineering and scientific community recognized the need for innovative solutions. Two potential roadmaps emerged: developing short-term solutions to address the immediate needs of the healthcare communities and developing mid/long-term solutions to eliminate the over-arching threat. However, in a truly global effort, researchers from all backgrounds came together in tackling this challenge. Short-term efforts have focused on re-purposing existing technologies and leveraging additive manufacturing techniques to address shortages in personal protective equipment and disinfection. More basic research efforts with mid-term and long-term impact have emphasized developing novel diagnostics and accelerating vaccines. As a foundational technology, photonics has contributed directly and indirectly to all efforts. This perspective will provide an overview of the critical role that the photonics field has played in efforts to combat the immediate COVID-19 pandemic as well as how the photonics community could anticipate contributing to future pandemics of this nature.
Collapse
Affiliation(s)
- Maria Soler
- Nanobiosensors and Bioanalytical Applications
Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, BIST
and CIBER-BBN, Barcelona, Spain
| | - Alexis Scholtz
- Department of Biomedical Engineering, University
of Southern California, Los Angeles, California 90089,
USA
| | - Rene Zeto
- Mork Family Department of Chemical Engineering and
Materials Science, University of Southern California, Los Angeles,
California 90089, USA
| | | |
Collapse
|
33
|
Voorn MG, Goss SE, Nkemngong CA, Li X, Teska PJ, Oliver HF. Cross-contamination by disinfectant towelettes varies by product chemistry and strain. Antimicrob Resist Infect Control 2020; 9:141. [PMID: 32831143 PMCID: PMC7446058 DOI: 10.1186/s13756-020-00797-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/05/2020] [Indexed: 12/02/2022] Open
Abstract
Background Disinfectant products are used frequently on environmental surfaces (e.g. medical equipment, countertops, patient beds) and patient care equipment within healthcare facilities. The purpose of this study was to assess the risk of cross-contamination of Staphylococcus aureus and Pseudomonas aeruginosa during and after disinfection of predetermined surface areas with ready-to-use (RTU) pre-wetted disinfectant towelettes. Methods This study tested six disinfectant towelette products against S. aureus ATCC CRM-6538 and P. aeruginosa strain ATCC-15442 on Formica surfaces. Each disinfectant was evaluated on a hard nonporous surface and efficacy was measured every 0.5 m2 using a modified version of EPA MLB SOP-MB-33 to study the risk of cross-contamination. Results We found that all of the wipes used in this study transferred S. aureus and P. aeruginosa from an inoculated surface to previously uncontaminated surfaces. Disinfectant towelettes with certain chemistries also retained a high level of viable bacteria after disinfection of the surface area. The cross-contamination risk also varied by product chemistry and bacterial strain. Conclusion Disinfectant wipes can cross-contaminate hard nonporous surfaces and retain viable bacterial cells post-disinfection, especially over larger surface areas. This highlights a need to further investigate the risk disinfectant wipes pose during and post-disinfection and guidance on maximum surface areas treated with a single towelette.
Collapse
Affiliation(s)
- Maxwell G Voorn
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN, 47907, USA
| | - Summer E Goss
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN, 47907, USA
| | - Carine A Nkemngong
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN, 47907, USA
| | - Xiaobao Li
- Diversey Inc., Charlotte, NC, 28273, USA
| | | | - Haley F Oliver
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN, 47907, USA.
| |
Collapse
|
34
|
Rzewuska M, Duncan EM, Francis JJ, Morris AM, Suh KN, Davey PG, Grimshaw JM, Ramsay CR. Barriers and Facilitators to Implementation of Antibiotic Stewardship Programmes in Hospitals in Developed Countries: Insights From Transnational Studies. FRONTIERS IN SOCIOLOGY 2020; 5:41. [PMID: 33869448 PMCID: PMC8022532 DOI: 10.3389/fsoc.2020.00041] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 05/12/2020] [Indexed: 06/12/2023]
Abstract
Objectives: To identify perceived influences on implementation of antibiotic stewardship programmes (ASPs) in hospitals, across healthcare systems, and to exemplify the use of a behavioral framework to conceptualize those influences. Methods: EMBASE and MEDLINE databases were searched from 01/2001 to 07/2017 and reference lists were screened for transnational studies that reported barriers and/or facilitators to implementing actual or hypothetical ASPs or ASP-supporting strategies. Extracted data were synthesized using content analysis with the Theoretical Domains Framework as an organizing framework. Commonly reported influences were quantified. Results: From 3,196 abstracts 75 full-text articles were screened for inclusion. Eight studies met the eligibility criteria. The number of countries involved in each study ranged from 2 to 36. These studies included a total of 1849 participants. North America, Europe and Australasia had the strongest representation. Participants were members of special interest groups, designated hospital representatives or clinical experts. Ten of the 14 theoretical domains in the framework were present in the results reported in the included studies. The most commonly reported (≥4 out of 8 studies) influences on ASP implementation were coded in the domain "environmental context and resources" (e.g., problems with data and information systems; lack of key personnel; inadequate financial resources) and "goals" (other higher priorities). Conclusions: Despite an extensive transnational research effort, there is evidence from international studies of substantial barriers to implementing ASPs in hospitals, even in developed countries. Large-scale efforts to implement hospital antibiotic stewardship in those countries will need to overcome issues around inadequacy of information systems, unavailability of key personnel and funding, and the competition from other priority initiatives. We have enhanced the evidence base to inform guidance by taking a behavioral approach to identify influences on ASP uptake. Systematic review registration: PROSPERO registration number CRD42017076425.
Collapse
Affiliation(s)
- Magdalena Rzewuska
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Eilidh M. Duncan
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Jill J. Francis
- School of Health Sciences, City University of London, London, United Kingdom
| | - Andrew M. Morris
- Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kathryn N. Suh
- Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Peter G. Davey
- Division of Population Health & Genomics, Medical School, University of Dundee, Dundee, United Kingdom
| | - Jeremy M. Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Craig R. Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| |
Collapse
|
35
|
McKinnell JA, Miller LG, Singh RD, Gussin G, Kleinman K, Mendez J, Laurner B, Catuna TD, Heim L, Saavedra R, Felix J, Torres C, Chang J, Estevez M, Mendez J, Tchakalian G, Bloomfield L, Ceja S, Franco R, Miner A, Hurtado A, Hean R, Varasteh A, Robinson PA, Park S, Tam S, Tjoa T, He J, Agrawal S, Yamaguchi S, Custodio H, Nguyen J, Bittencourt CE, Evans KD, Mor V, McConeghy K, Weinstein RA, Hayden MK, Stone ND, Steinberg K, Beecham N, Montgomery J, DeAnn W, Peterson EM, Huang SS. High Prevalence of Multidrug-Resistant Organism Colonization in 28 Nursing Homes: An "Iceberg Effect". J Am Med Dir Assoc 2020; 21:1937-1943.e2. [PMID: 32553489 DOI: 10.1016/j.jamda.2020.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum beta-lactamase producing organisms (ESBLs), and carbapenem-resistant Enterobacteriaceae (CRE) among residents and in the environment of nursing homes (NHs). DESIGN Point prevalence sampling of residents and environmental sampling of high-touch objects in resident rooms and common areas. SETTING Twenty-eight NHs in Southern California from 2016 to 2017. PARTICIPANTS NH participants in Project PROTECT, a cluster-randomized trial of enhanced bathing and decolonization vs routine care. METHODS Fifty residents were randomly sampled per NH. Twenty objects were sampled, including 5 common room objects plus 5 objects in each of 3 rooms (ambulatory, total care, and dementia care residents). RESULTS A total of 2797 swabs were obtained from 1400 residents in 28 NHs. Median prevalence of multidrug-resistant organism (MDRO) carriage per NH was 50% (range: 24%-70%). Median prevalence of specific MDROs were as follows: MRSA, 36% (range: 20%-54%); ESBL, 16% (range: 2%-34%); VRE, 5% (range: 0%-30%); and CRE, 0% (range: 0%-8%). A median of 45% of residents (range: 24%-67%) harbored an MDRO without a known MDRO history. Environmental MDRO contamination was found in 74% of resident rooms and 93% of common areas. CONCLUSIONS AND IMPLICATIONS In more than half of the NHs, more than 50% of residents were colonized with MDROs of clinical and public health significance, most commonly MRSA and ESBL. Additionally, the vast majority of resident rooms and common areas were MDRO contaminated. The unknown submerged portion of the iceberg of MDRO carriers in NHs may warrant changes to infection prevention and control practices, particularly high-fidelity adoption of universal strategies such as hand hygiene, environmental cleaning, and decolonization.
Collapse
Affiliation(s)
- James A McKinnell
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA; Los Angeles County Department of Public Health, Healthcare Outreach Unit, Los Angeles, CA, USA; Expert Stewardship, Newport, CA, USA.
| | - Loren G Miller
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Raveena D Singh
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Gabrielle Gussin
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Ken Kleinman
- University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
| | - Job Mendez
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Bryn Laurner
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tabitha D Catuna
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Lauren Heim
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Raheeb Saavedra
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - James Felix
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Crystal Torres
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Justin Chang
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Marlene Estevez
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Joanna Mendez
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Gregory Tchakalian
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Leah Bloomfield
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Sandra Ceja
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ryan Franco
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Aaron Miner
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Aura Hurtado
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ratharo Hean
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Alex Varasteh
- Department of Medicine, Infectious Disease Clinical Outcomes Research (ID-CORE), LA Biomed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Philip A Robinson
- Expert Stewardship, Newport, CA, USA; Hoag Hospital, Newport, CA, USA
| | - Steven Park
- Department of Pathology and Laboratory Medicine, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Steven Tam
- Division of Geriatrics, Department of Medicine, University of California Irvine, Orange, CA, USA
| | - Thomas Tjoa
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Jiayi He
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Shalini Agrawal
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Stacey Yamaguchi
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Harold Custodio
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Jenny Nguyen
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Cassiana E Bittencourt
- Department of Pathology and Laboratory Medicine, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Kaye D Evans
- Department of Pathology and Laboratory Medicine, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Vincent Mor
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Veterans Affairs Medical Center, Providence VA Medical Center, Providence, RI, USA; Center for Long-Term Care Quality and Innovation, Brown University School of Public Health, Providence, RI, USA
| | - Kevin McConeghy
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Veterans Affairs Medical Center, Providence VA Medical Center, Providence, RI, USA; Center for Long-Term Care Quality and Innovation, Brown University School of Public Health, Providence, RI, USA
| | - Robert A Weinstein
- Cook County Health and Hospitals System, Chicago, IL, USA; Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Mary K Hayden
- Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Nimalie D Stone
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karl Steinberg
- California Association of Long Term Care Medicine, Santa Clarita, CA, USA
| | - Nancy Beecham
- The National Association of Directors of Nursing Administration in Long Term Care, Springdale, OH, USA
| | | | - Walters DeAnn
- California Association of Health Facilities, Sacramento, CA, USA
| | - Ellena M Peterson
- Department of Pathology and Laboratory Medicine, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Susan S Huang
- Division of Infectious Diseases, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA; Department of Medicine, Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA, USA
| |
Collapse
|
36
|
Reduction of Health Care-Associated Infections (HAIs) with Antimicrobial Inorganic Nanoparticles Incorporated in Medical Textiles: An Economic Assessment. NANOMATERIALS 2020; 10:nano10050999. [PMID: 32456213 PMCID: PMC7279532 DOI: 10.3390/nano10050999] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/08/2020] [Accepted: 05/21/2020] [Indexed: 01/27/2023]
Abstract
Health care-associated infections (HAIs) affect millions of patients annually with up to 80,000 affected in Europe on any given day. This represents a significant societal and economic burden. Staff training, hand hygiene, patient identification and isolation and controlled antibiotic use are some of the standard ways to reduce HAI incidence but this is time consuming and subject and subject to rigorous implementation. In addition, the lack of antimicrobial activity of some disinfectants against healthcare-associated pathogens may also affect the efficacy of disinfection practices. Textiles are an attractive substrate for pathogens because of contact with the human body with the attendant warmth and moisture. Textiles and surfaces coated with engineered nanomaterials (ENMs) have shown considerable promise in reducing the microbial burden on those surfaces. Studies have also shown that this antimicrobial affect can reduce the incidence of HAIs. For all of the promising research, there has been an absence of study on the economic effectiveness of ENM coated materials in a healthcare setting. This article examines the relative economic efficacy of ENM coated materials against an antiseptic approach. The goal is to establish the economic efficacy of the widespread usage of ENM coated materials in a healthcare setting. In the absence of detailed and segregated costs, benefits and control variables over at least cross sectional data or time series, an aggregated approach is warranted. This approach, while relying on some supposition allows for a comparison with similar data regarding standard treatment to reduce HAIs and provides a reasonable economic comparison. We find that while, relative to antiseptics, ENM coated textiles represent a significant clinical advantage, they can also offer considerable cost savings.
Collapse
|
37
|
Increased financial burdens and lengths of stay in patients with healthcare-associated infections due to multidrug-resistant bacteria in intensive care units: A propensity-matched case-control study. PLoS One 2020; 15:e0233265. [PMID: 32421700 PMCID: PMC7233534 DOI: 10.1371/journal.pone.0233265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/03/2020] [Indexed: 12/22/2022] Open
Abstract
Background and objectives Incidence rates of healthcare-associated infections (HAIs) depend upon infection control policy and practices, and the effectiveness of the implementation of antibiotic stewardship. Amongst intensive care unit (ICU) patients with HAIs, a substantial number of pathogens were reported to be multidrug-resistant bacteria (MDRB). However, impacts of ICU HAIs due to MDRB (MDRB-HAIs) remain understudied. Our study aimed to evaluate the negative impacts of MRDB-HAIs versus HAIs due to non-MDRB (non-MRDB-HAIs). Methods Among 60,317 adult patients admitted at ICUs of a 2680-bed medical centre in Taiwan between January 2010 and December 2017, 279 pairs of propensity-score matched MRDB-HAI and non-MRDB-HAI were analyzed. Principal findings Between the MDRB-HAI group and the non-MDRB-HAI group, significant differences were found in overall hospital costs, costs of medical and nursing services, medication, and rooms/beds, and in ICU length-of-stay (LOS). As compared with the non-MDRB-HAI group, the mean of the overall hospital costs of patients in the MDRB-HAI group was increased by 26%; for categorized expenditures, the mean of costs of medical and nursing services of patients in the MDRB-HAI group was increased by 8%, of medication by 26.9%, of rooms/beds by 10.3%. The mean ICU LOS in the MDRB-HAI group was increased by 13%. Mortality rates in both groups did not significantly differ. Conclusions These data clearly demonstrate more negative impacts of MDRB-HAIs in ICUs. The quantified financial burdens will be helpful for hospital/government policymakers in allocating resources to mitigate MDRB-HAIs in ICUs; in case of need for clarification/verification of the medico-economic burdens of MDRB-HAIs in different healthcare systems, this study provides a model to facilitate the evaluations.
Collapse
|
38
|
Tamez-Torres KM, Ponce-de-Leon A, Torres-Gonzalez P, Perez-Garcia E, Torres-Veintimilla E, Valle MBD, Sifuentes-Osornio J. High prevalence of MDR gram-negative bacteria in feces of healthy blood donors in Mexico. Eur J Clin Microbiol Infect Dis 2020; 39:1439-1444. [PMID: 32170542 DOI: 10.1007/s10096-020-03858-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/03/2020] [Indexed: 11/26/2022]
Abstract
During the initial stage of a study to recruit universal intestinal microbiota donors in Mexico City, we found multiple "healthy" subjects that colonized with MDRO (Multidrug-resistant organisms). We aimed to describe clinical and demographic characteristics of these individuals. This was a prospective observational study. Participants were consecutively recruited among blood donors. A fecal sample was collected from each subject and analyzed at the same day in search of MDRO through chromographic culture media and, if growth observed, later confirmed by MALDI-TOF and susceptibility testing in Vitek 2 system. From July 2018 to March 2019, 85 individuals were screened for fecal colonization. Median age was 35 years (IQR 27-46 years), and 48/85 (56.4%) were males. Seventy-two (84.7%) subjects harbored at least one MDRO. ESBL-producing microorganisms were found in 72/85 (84.3%) subjects, and E. coli was the most frequent (63/85, 74.1%). Four samples (2 E. coli, 2 P. aeruginosa, 2.4% each) harbored carbapenem-resistant Enterobacteriaceae (CRE), together with an ESBL-producing microorganism. Antibiotic use (p = 0.06) and PPIs or H2-blockers intake (p = 0.03) were more common in the colonized subjects during the previous 6-month period. We report a high incidence of enteric colonization of healthy subjects with MDRO, a condition that may be related to antibiotics or PPIs/H2-blockers consumption. This surprisingly high MDRO colonization rate in potential FMT donors emphasizes the need for careful screening of donors to avoid possible transmission to FMT recipients.
Collapse
Affiliation(s)
- Karla M Tamez-Torres
- Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alfredo Ponce-de-Leon
- Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pedro Torres-Gonzalez
- Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Esteban Perez-Garcia
- Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Estefania Torres-Veintimilla
- Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Miriam Bobadilla-Del Valle
- Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jose Sifuentes-Osornio
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Av. Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Tlalpan, Zip Code 14080, Mexico City, Mexico.
| |
Collapse
|
39
|
Horve PF, Lloyd S, Mhuireach GA, Dietz L, Fretz M, MacCrone G, Van Den Wymelenberg K, Ishaq SL. Building upon current knowledge and techniques of indoor microbiology to construct the next era of theory into microorganisms, health, and the built environment. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:219-235. [PMID: 31308484 PMCID: PMC7100162 DOI: 10.1038/s41370-019-0157-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/23/2019] [Accepted: 06/30/2019] [Indexed: 05/06/2023]
Abstract
In the constructed habitat in which we spend up to 90% of our time, architectural design influences occupants' behavioral patterns, interactions with objects, surfaces, rituals, the outside environment, and each other. Within this built environment, human behavior and building design contribute to the accrual and dispersal of microorganisms; it is a collection of fomites that transfer microorganisms; reservoirs that collect biomass; structures that induce human or air movement patterns; and space types that encourage proximity or isolation between humans whose personal microbial clouds disperse cells into buildings. There have been recent calls to incorporate building microbiology into occupant health and exposure research and standards, yet the built environment is largely viewed as a repository for microorganisms which are to be eliminated, instead of a habitat which is inexorably linked to the microbial influences of building inhabitants. Health sectors have re-evaluated the role of microorganisms in health, incorporating microorganisms into prevention and treatment protocols, yet no paradigm shift has occurred with respect to microbiology of the built environment, despite calls to do so. Technological and logistical constraints often preclude our ability to link health outcomes to indoor microbiology, yet sufficient study exists to inform the theory and implementation of the next era of research and intervention in the built environment. This review presents built environment characteristics in relation to human health and disease, explores some of the current experimental strategies and interventions which explore health in the built environment, and discusses an emerging model for fostering indoor microbiology rather than fearing it.
Collapse
Affiliation(s)
- Patrick F Horve
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Savanna Lloyd
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Gwynne A Mhuireach
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Leslie Dietz
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Mark Fretz
- Institute for Health and the Built Environment, University of Oregon, Portland, OR, 97209, USA
| | - Georgia MacCrone
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Kevin Van Den Wymelenberg
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
- Institute for Health and the Built Environment, University of Oregon, Portland, OR, 97209, USA
| | - Suzanne L Ishaq
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA.
| |
Collapse
|
40
|
Chaoui L, Mhand R, Mellouki F, Rhallabi N. Contamination of the Surfaces of a Health Care Environment by Multidrug-Resistant (MDR) Bacteria. Int J Microbiol 2019; 2019:3236526. [PMID: 31871459 PMCID: PMC6906863 DOI: 10.1155/2019/3236526] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/20/2019] [Accepted: 10/31/2019] [Indexed: 11/18/2022] Open
Abstract
Nosocomial infections (NIs) are known worldwide and remain a major problem despite scientific and technical advances in the field of health. The severity of the infection depends on the characteristics of the microorganisms involved and the high frequency of resistant pathogens in the hospital environment. The aim of this study is to determine the distribution of pathogenic bacteria (and their resistance to antibiotics) that spread on hospital surfaces, more specifically, on those of various departments in the Provincial Hospital Center (PHC) of Mohammedia, Morocco. A cross-sectional study was conducted from March 2017 to April 2018. Samples were collected by swabbing the hospital surfaces, and the isolated bacteria were checked for their susceptibility to antibiotics by the Kirby-Bauer disk diffusion method following the standards of the Clinical and Laboratory Standards Institute (CLSI). Among 200 swab samples, 176 (88%) showed bacterial growth. Gram-negative isolates were predominant at 51.5% (101/196), while the Gram-positives were at 48.5% (95/196). The main isolates are Enterobacteria weighted at 31.6% (62/196), Staphylococcus aureus reaching 24% (47/196), Pseudomonas aeruginosa at 9.2% (18/196), and Acinetobacter spp. with 3.3% (6/196). Moreover, the antimicrobial susceptibility profile of the isolates showed that about 31.7% (32/101) of the Gram-negative isolates were found to be MDR. This resistance is also high among isolates of S. aureus of which 44.7% (20/47) were methicillin-resistant Staphylococcus aureus (MRSA). Contamination of hospital surfaces by MDR bacteria is a real danger to public health. The concept of environmental bacterial reservoir is a reality that requires strict compliance with current guidelines and recommendations for hand hygiene, cleaning, and disinfection of surfaces in hospitals.
Collapse
Affiliation(s)
- Laila Chaoui
- Provincial Diagnostic Laboratory Epidemiological and Environmental Health, Provincial Health Delegation, Mohammedia, Morocco
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| | - RajaaAit Mhand
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| | - Fouad Mellouki
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| | - Naima Rhallabi
- Research Unit Microbiology Hygiene Bioactives Molecules Laboratory Virology Microbiology Quality and Biotechnology/Ecotoxicology Biodiversity, University Hassan II Casablanca, FSTM, Mohammedia, Morocco
| |
Collapse
|
41
|
Croke L. Appropriate environmental cleaning helps address threats from multidrug‐resistant organisms. AORN J 2019; 110:P5. [DOI: 10.1002/aorn.12901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
42
|
Correa-Martinez CL, Stollenwerk VB, Kossow A, Schaumburg F, Mellmann A, Kampmeier S. Risk Factors for Long-Term Vancomycin-Resistant Enterococci Persistence-A Prospective Longitudinal Study. Microorganisms 2019; 7:E400. [PMID: 31561632 PMCID: PMC6843193 DOI: 10.3390/microorganisms7100400] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 01/05/2023] Open
Abstract
Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens that require effective infection control measures, representing a challenge for healthcare systems. This study aimed at identifying risk factors associated with prolonged VRE carriage and determining the rate of clearance that allows the discontinuation of contact precautions. During a 2-year study, screening was performed in patients with a history of VRE or at risk of becoming colonized. After bacterial identification and antibiotic susceptibility testing, glycopeptide resistance was confirmed by PCR. Isolates were compared via whole genome sequence-based typing. Risk factors were recorded, and follow-up screening was performed upon readmission, defining patients as long-term carriers if still colonized ≥10 weeks after first detection. Of 1059 patients positive for VRE, carriage status was assessed upon readmission in 463 patients. VRE was cleared in 56.4% of the cases. Risk factors associated with long-term persistence were hospital stays (frequency, length), hemato-oncological disease, systemic treatment with steroids, and use of antibiotics. No specific genotypic clustering was observed in patients with VRE clearance or persistence. VRE clearance is possibly underestimated. The identification of risk factors favoring long-term carriage may contribute to a targeted implementation of infection control measures upon readmission of patients with history of VRE.
Collapse
Affiliation(s)
- Carlos L Correa-Martinez
- Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany.
| | - Verena B Stollenwerk
- Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany.
| | - Annelene Kossow
- Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany.
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Domagkstraße 10, 48149 Münster, Germany.
| | - Alexander Mellmann
- Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany.
| | - Stefanie Kampmeier
- Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany.
| |
Collapse
|
43
|
Tsai HC, Huang TY, Chen JS, Chen WJ, Lin CY, Hsu BM. Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus in long-term care facilities in eastern Taiwan. Tzu Chi Med J 2019; 31:222-231. [PMID: 31867250 PMCID: PMC6905247 DOI: 10.4103/tcmj.tcmj_136_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/20/2018] [Accepted: 12/11/2018] [Indexed: 12/19/2022] Open
Abstract
Objective: The prevention of infections is crucial in long-term care programs. Investigations of the occurrence and sources of pathogens in long-term care facilities (LTCFs) are still lacking, especially in eastern Taiwan. In this study, we conducted a surveillance of two common pathogens, Acinetobacter baumannii (AB) and methicillin-resistant Staphylococcus aureus (MRSA), in LTCFs in Hualien. Materials and Methods: Pathogenic assays including isolation, identification, and antimicrobial susceptibility tests were conducted for AB and MRSA at LTCFs in Eastern Taiwan. Staphylococcal cassette chromosome mec typing assays were done to understand the relatedness of clonal strains of MRSA. Results: All AB-positive samples in the LTCFs were mainly from water-rich samples and were drug susceptible. Our data indicated that the AB strains from LTCFs were similar to those from Puzi River watersheds in Taiwan, which were not drug resistant to commonly used antibiotics. On the other hand, the drug resistance analysis of MRSA indicated that the genotypes from the LTCFs were similar to those from nearby hospitals. Eight strains of MRSA were isolated from four LTCFs, of which five were identified as hospital-acquired strains according to SSCmed typing assays. Conclusion: These findings suggest that MRSA in LTCFs might propagate from hospitals and could be transmitted between hospitals and LTCFs. Health authorities should be aware of this risk. The long-term follow-up of MRSA is recommended in local medical institutions as well as in LTCFs for correlative analysis.
Collapse
Affiliation(s)
- Hsin-Chi Tsai
- Department of Psychiatry, School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Psychiatry, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Tung-Yi Huang
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Jung-Sheng Chen
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Wen-Jen Chen
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Chong-Yen Lin
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Bing-Mu Hsu
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan.,Center for Innovative on Aging Society (CIRAS), National Chung Cheng University, Chiayi, Taiwan
| |
Collapse
|
44
|
La Fauci V, Costa GB, Genovese C, Palamara MAR, Alessi V, Squeri R. Drug-resistant bacteria on hands of healthcare workers and in the patient area: an environmental survey in Southern Italy's hospital. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2019; 32:303-310. [PMID: 31257821 PMCID: PMC6719646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/18/2019] [Accepted: 05/08/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Drug-resistant bacteria on hands of healthcare workers and in the patient area: an environmental survey in Southern Italy's hospital. METHODS The study was conducted from June 2017 to May 2018 using contact slides for surfaces and active sampling for air. We used automated biochemical methods to identify microorganisms; antibiograms were performed in compliance with the EUCAST expert rules. RESULTS We analyzed 3,760 samples, 16.17% were found positive and 34 % of these were antimicrobial-resistant. On analyzing the isolated Staphylococci, 39% were multidrug-resistant and 5% extensively drug-resistant. A 30% of the Enterococcus faecalis isolates were resistant to gentamycin and vancomycin. We found Klebsiella pneumoniae isolates resistant to ceftriaxone, cefoxitin, mecillinam and imipenem. A 7% and 8% of the Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively, were resistant to gentamicin, imipenem, and ceftazidime. CONCLUSIONS These findings are in line with the international literature, confirming that antimicrobial resistance is also steadily growing in Italy with rates varied for the different pathogens.
Collapse
Affiliation(s)
- V La Fauci
- Vincenza La Fauci, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, A.O.U. Policlinico "G. Martino", Biological tour 1° Floor, via Consolare Valeria, 98125 Messina, Italy.
| | | | | | | | | | | |
Collapse
|
45
|
Yamamoto N, Hamaguchi S, Akeda Y, Santanirand P, Chaihongsa N, Sirichot S, Chiaranaicharoen S, Hagiya H, Yamamoto K, Kerdsin A, Okada K, Yoshida H, Hamada S, Oishi K, Malathum K, Tomono K. Rapid screening and early precautions for carbapenem-resistant Acinetobacter baumannii carriers decreased nosocomial transmission in hospital settings: a quasi-experimental study. Antimicrob Resist Infect Control 2019; 8:110. [PMID: 31297191 PMCID: PMC6598269 DOI: 10.1186/s13756-019-0564-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/18/2019] [Indexed: 12/17/2022] Open
Abstract
Background Active surveillance has the potential to prevent nosocomial transmission of carbapenem-resistant Acinetobacter baumannii (CRAB). We assessed whether rapid diagnosis using clinical specimen-direct loop-mediated isothermal amplification (LAMP), a rapid molecular diagnostic assay, and subsequent intervention, could reduce CRAB nosocomial transmission in intensive care units (ICUs). Methods A before and after (quasi-experimental) study was conducted in two ICUs at the Mahidol University Faculty of Medicine Ramathibodi Hospital with 3 months of observational period followed by 9 months of interventional period. All patients were screened for CRAB using both the culture and LAMP method from rectal swab and/or bronchial aspirates (intubated patients only) upon admission, weekly thereafter, and upon discharge. During the pre-intervention period, we performed contact precautions based on culture results. In contrast, during the intervention period, we initiated contact precautions within a few hours after sample collection on the basis of LAMP results. Results A total of 1335 patients were admitted to the ICUs, of which 866 patients (pre-intervention period: 187; intervention period: 679) were eligible for this study. Incidence rate of CRAB infection decreased to 20.9 per 1000 patient-days in the intervention period from 35.2 in the pre-intervention period (P < 0.02). The calculated hazard ratio of CRAB transmission was 0.65 (95% confidence interval [CI], 0.44–0.97). Risk factors for CRAB acquisition included exposure to carbapenem (hazard ratio, 2.54 [95% CI: 1.61–5.57]). Conclusions LAMP screening for CRAB upon ICU admission proved feasible for routine clinical practice. Rapid screening using LAMP followed by early intervention may reduce CRAB transmission rates in ICUs when compared to conventional intervention. Electronic supplementary material The online version of this article (10.1186/s13756-019-0564-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Norihisa Yamamoto
- 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan.,2Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Shigeto Hamaguchi
- 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan.,2Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Yukihiro Akeda
- 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan.,2Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Pitak Santanirand
- 3Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Narong Chaihongsa
- 3Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suntariya Sirichot
- 3Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Hideharu Hagiya
- 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan.,2Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Kouji Yamamoto
- 4Department of Medical Statistics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Anusak Kerdsin
- 5Faculty of Public Health, Kasetsart University, Sakon Nakhon, Thailand
| | - Kazuhisa Okada
- 2Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Hisao Yoshida
- 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan
| | - Shigeyuki Hamada
- 2Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Kazunori Oishi
- 6Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kumthorn Malathum
- 3Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kazunori Tomono
- 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan
| |
Collapse
|
46
|
Hegarty J, Howson V, Wills T, Creedon SA, Mc Cluskey P, Lane A, Connolly A, Walshe N, Noonan B, Guidera F, Gallagher AG, Murphy S. Acute surgical wound-dressing procedure: Description of the steps involved in the development and validation of an observational metric. Int Wound J 2019; 16:641-648. [PMID: 30932342 PMCID: PMC6850176 DOI: 10.1111/iwj.13072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to develop an observational metric that could be used to assess the performance of a practitioner in completing an acute surgical wound-dressing procedure using aseptic non-touch technique (ANTT). A team of clinicians, academics, and researchers came together to develop an observational metric using an iterative six-stage process, culminating in a Delphi panel meeting. A scoping review of the literature provided a background empirical perspective relating to wound-dressing procedure performance. Video recordings of acute surgical wound-dressing procedures performed by nurses in clinical (n = 11) and simulated (n = 3) settings were viewed repeatedly and were iteratively deconstructed by the metric development group. This facilitated the identification of the discrete component steps, potential errors, and sentinel (serious) errors, which characterise a wound dressing procedure and formed part of the observational metric. The ANTT wound-dressing observational metric was stress tested for clarity, the ability to be scored, and interrater reliability, calculated during a further phase of video analysis. The metric was then subjected to a process of cyclical evaluation by a Delphi panel (n = 21) to obtain face and content validity of the metric. The Delphi panel deliberation verified the face and content validity of the metric. The final metric has three phases, 31 individual steps, 18 errors, and 27 sentinel errors. The metric is a tool that identifies the standard to be attained in the performance of acute surgical wound dressings. It can be used as both an adjunct to an educational programme and as a tool to assess a practitioner's performance of a wound-dressing procedure in both simulated and clinical practice contexts.
Collapse
Affiliation(s)
- Josephine Hegarty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | - Victoria Howson
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | - Teresa Wills
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | - Sile A. Creedon
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | | | - Aoife Lane
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | - Aine Connolly
- Nursing Division, Cork University Hospital GroupIreland
| | - Nuala Walshe
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | - Brendan Noonan
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| | - Fiona Guidera
- Nursing Division, Mercy University HospitalCorkIreland
| | - Anthony G Gallagher
- Application of Science to Simulation based Education and Research on Training Centre, College of Medicine and Health, University College Cork, Cork, Ireland & Faculty of Life and Health SciencesUlster University, Magee Campus, Northland Rd, Londonderry BT48 7JLUnited Kingdom
| | - Siobhan Murphy
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkIreland
| |
Collapse
|
47
|
Pachori P, Gothalwal R, Gandhi P. Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit; a critical review. Genes Dis 2019; 6:109-119. [PMID: 31194018 PMCID: PMC6545445 DOI: 10.1016/j.gendis.2019.04.001] [Citation(s) in RCA: 266] [Impact Index Per Article: 53.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/09/2019] [Indexed: 12/29/2022] Open
Abstract
The emergence of antibiotic resistant bacteria in the healthcare is a serious concern. In the Healthcare premises precisely intensive care unit are major sources of microbial diversity. Recent findings have demonstrated not only microbial diversity but also drug resistant microbes largely habitat in ICU. Pseudomonas aeruginosa found as a part of normal intestinal flora and a significant pathogen responsible for wide range of ICU acquired infection in critically ill patients. Nosocomial infection associated with this organism including gastrointestinal infection, urinary tract infections and blood stream infection. Infection caused by this organism are difficult to treat because of the presence of its innate resistance to many antibiotics (β-lactam and penem group of antibiotics), and its ability to acquire further resistance mechanism to multiple class of antibiotics, including Beta-lactams, aminoglycosides and fluoroquinolones. In the molecular evolution microbes adopted several mechanism to maintain genomic plasticity. The tool microbe use for its survival is mainly biofilm formation, quorum sensing, and horizontal gene transfer and enzyme promiscuity. Such genomic plasticity provide an ideal habitat to grow and survive in hearse environment mainly antibiotics pressure. This review focus on infection caused by Pseudomonas aeruginosa, its mechanisms of resistance and available treatment options. The present study provides a systemic review on major source of Pseudomonas aeruginosa in ICU. Further, study also emphasizes virulence gene/s associated with Pseudomonas aeruginosa genome for extended drug resistance. Study gives detailed overview of antibiotic drug resistance mechanism.
Collapse
Affiliation(s)
- Preeti Pachori
- Department of Biotechnology, Barkatullah University, Bhopal 462026, Madhya Pradesh, India
| | - Ragini Gothalwal
- Department of Biotechnology, Barkatullah University, Bhopal 462026, Madhya Pradesh, India
| | - Puneet Gandhi
- Department of Research, Bhopal Memorial Hospital and Research Centre (BMHRC), Bhopal 462037, Madhya Pradesh, India
| |
Collapse
|
48
|
Abstract
BACKGROUND This is the first study to determine whether nonskid slipper socks in contact with the hospital floor and worn into bed contaminate bed linen. PURPOSE The main purpose of the study was to determine whether contamination of hospital linen occurred with bacteria transferred from the soles of nonskid slipper socks that have touched the floor. METHODS This study mimicked real patients walking on a hospital floor wearing slipper socks and getting back into bed with the slipper socks on. Swab samples were collected from the surfaces of the hospital floor, nonskid slipper sock bottoms, and bed linen in 2 Midwestern hospitals. From the samples, bacterial isolates were identified and tested for antibiotic resistance. RESULTS Isolates obtained from the samples were identified on all 3 surfaces at both hospitals, indicating spread of the bacteria from floor to the bed linen via the nonskid slipper socks. Antibiotic sensitivity test revealed that a significant number of isolates collected were resistant to at least 2 antibiotics tested. CONCLUSION This study demonstrates cross-contamination of bed linen with potentially pathogenic bacteria present on the hospital floor via contact with patient-worn nonskid slipper socks. A simple practice change regarding the wearing of slipper socks could play an important role in preventing pathogen transfer to the bed linen. Awareness of the likelihood of hand contamination after touching the sock bottoms that have come in contact with the hospital floor should also be considered.
Collapse
|
49
|
Wilson AM, Reynolds KA, Sexton JD, Canales RA. Modeling Surface Disinfection Needs To Meet Microbial Risk Reduction Targets. Appl Environ Microbiol 2018; 84:e00709-18. [PMID: 29980557 PMCID: PMC6121971 DOI: 10.1128/aem.00709-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/29/2018] [Indexed: 11/29/2022] Open
Abstract
Nosocomial viral infections are an important cause of health care-acquired infections where fomites have a role in transmission. Using stochastic modeling to quantify the effects of surface disinfection practices on nosocomial pathogen exposures and infection risk can inform cleaning practices. The purpose of this study was to predict the effect of surface disinfection on viral infection risks and to determine needed viral reductions to achieve risk targets. Rotavirus, rhinovirus, and influenza A virus infection risks for two cases were modeled. Case 1 utilized a single fomite contact approach, while case 2 assumed 6 h of contact activities. A 94.1% viral reduction on surfaces and hands was measured following a single cleaning round using an Environmental Protection Agency (EPA)-registered disinfectant in an urgent care facility. This value was used to model the effect of a surface disinfection intervention on infection risk. Risk reductions for other surface-cleaning efficacies were also simulated. Surface reductions required to achieve risk probability targets were estimated. Under case 1 conditions, a 94.1% reduction in virus surface concentration reduced infection risks by 94.1%. Under case 2 conditions, a 94.1% reduction on surfaces resulted in median viral infection risks being reduced by 92.96 to 94.1% and an influenza A virus infection risk below one in a million. Surface concentration in the equations was highly correlated with dose and infection risk outputs. For rotavirus and rhinovirus, a >99.99% viral surface reduction would be needed to achieve a one-in-a-million risk target. This study quantifies reductions of infection risk relative to surface disinfectant use and demonstrates that risk targets for low-infectious-dose organisms may be more challenging to achieve.IMPORTANCE It is known that the use of EPA-registered surface disinfectant sprays can reduce infection risk if used according to the manufacturer's instructions. However, there are currently no standards for health care environments related to contamination levels on surfaces. The significance of this research is in quantifying needed reductions to meet various risk targets using realistic viral concentrations on surfaces for health care environments. This research informs the design of cleaning protocols by demonstrating that multiple applications may be needed to reduce risk and by highlighting a need for more models exploring the relationship among microbial contamination of surfaces, patient and health care worker behaviors, and infection risks.
Collapse
Affiliation(s)
- Amanda M Wilson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Kelly A Reynolds
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jonathan D Sexton
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Robert A Canales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
50
|
Ariza‐Heredia EJ, Chemaly RF. Update on infection control practices in cancer hospitals. CA Cancer J Clin 2018; 68:340-355. [PMID: 29985544 PMCID: PMC7162018 DOI: 10.3322/caac.21462] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/12/2018] [Accepted: 05/09/2018] [Indexed: 12/21/2022] Open
Abstract
Therapies in oncology have evolved rapidly over the last years. At the same pace, supportive care for patients receiving cancer therapy has also evolved, allowing patients to safely receive the newest advances in treatment in both an inpatient and outpatient basis. The recognition of the role of infection control and prevention (ICP) in the outcomes of patients living with cancer has been such that it is now a requirement for hospitals and involves multidisciplinary groups. Some unique aspects of ICP for patients with cancer that have gained momentum over the past few decades include catheter-related infections, multidrug-resistant organisms, community-acquired viral infections, and the impact of the health care environment on the horizontal transmission of organisms. Furthermore, as the potential for infections to cross international borders has increased, alertness for outbreaks or new infections that occur outside the area have become constant. As the future approaches, ICP in immunocompromised hosts will continue to integrate emerging disciplines, such as antibiotic stewardship and the microbiome, and new techniques for environmental cleaning and for controlling the spread of infections, such as whole-genome sequencing. CA Cancer J Clin 2018;000:000-000. © 2018 American Cancer Society.
Collapse
Affiliation(s)
- Ella J. Ariza‐Heredia
- Associate Professor, Department of Infectious Diseases, Infection Control, and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTX
| | - Roy F. Chemaly
- Professor, Department of Infectious Diseases, Infection Control, and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTX
| |
Collapse
|