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Meda M, Weinbren M. The healthcare built environment - an under-recognized and preventable source of transmission of organisms and antimicrobial resistance to patients. J Hosp Infect 2024; 144:150. [PMID: 37952607 DOI: 10.1016/j.jhin.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Affiliation(s)
- M Meda
- Frimley Health NHS Foundation Trust, Frimley, UK
| | - M Weinbren
- New Hospital Programme, NHS England, London, UK.
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2
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Inkster T, Weinbren M. Xenophilus aerolatus: what's in a name? J Hosp Infect 2023; 139:238-239. [PMID: 37487792 DOI: 10.1016/j.jhin.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 07/26/2023]
Affiliation(s)
- T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK.
| | - M Weinbren
- Department of Microbiology, Kingsmill Hospital, Sutton-in-Ashfield, UK
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3
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Inkster T, Walker J, Weinbren M. Waterborne infections in haemato-oncology units - a narrative review. J Hosp Infect 2023:S0195-6701(23)00165-2. [PMID: 37290689 DOI: 10.1016/j.jhin.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
Bone marrow transplant and haemato-oncology patients are at risk of healthcare associated infections due to waterborne pathogens. We undertook a narrative review of waterborne outbreaks in haemato-oncology patients from 2000-2022. Databases searched included Pubmed, DARE and CDSR and were undertaken by two authors. We analysed the organisms implicated, sources identified and infection prevention and control strategies implemented. The most commonly implicated pathogens were Pseudomonas aeruginosa, non-tuberculous mycobacteria and Legionella pneumophila. Bloodstream infection was the most common clinical presentation. The majority of incidents employed multimodal strategies to achieve control, addressing both the water source and routes of transmission. This review highlights the risk to haemato-oncology patients from waterborne pathogens and discusses future preventative strategies and the requirement for new UK guidance for haemato-oncology units.
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Affiliation(s)
- T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK.
| | - J Walker
- Walker on Water, 23 Anderson Road, Bishopdown, Salisbury, UK
| | - M Weinbren
- Department of Microbiology, Kings Mill Hospital, Sutton-in -Ashfield, UK
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4
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Inkster T, Wilson G, Black J, Mallon J, Connor M, Weinbren M. Cupriavidus spp and other waterborne organisms in healthcare water systems across the United Kingdom. J Hosp Infect 2022; 123:80-86. [PMID: 35181399 DOI: 10.1016/j.jhin.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cupriavidus pauculus is a rare clinical pathogen with cases having been linked to contaminated hospital water systems. An outbreak of three cases of C. pauculus and other waterborne organisms was reported in a Glasgow hospital in 2018. AIMS The aim of this study was to determine whether Cupriavidus spp are present in hospital water systems elsewhere in Scotland and the UK and to ascertain the optimal laboratory methodology for detection. We also sought to establish where in the water system these organisms are detected and whether a selective media could be developed for isolation. In addition, we tested water samples for the presence of other Gram negative waterborne organisms. METHODS Water samples were received from ten UK NHS hospitals and from various parts of the water system. Isolates were plated on to TSA and Pseudomonas Isolation Agar and further identified using MALDI-TOF and 16S PCR FINDINGS: Cupriavidus spp. were detected in four of ten hospitals tested and all five isolates were from the periphery of the water system. All hospitals had evidence of other OPPPs. Cupriavidus spp. were identified using TSA, with some isolates growing on Pseudomonas isolation agar; as such they may be inadvertently be detected when testing water specifically for Pseudomonas aeruginosa. CONCLUSION This study demonstrates that isolation of Cupriavidus spp. was not unique to the Glasgow incident, these bacteria being present in hospital water systems elsewhere in the UK. We therefore recommend water testing in response to clinical cases. Consideration should also be given to water testing following bacteraemias due to other rare and unusual water borne pathogens.
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Affiliation(s)
- T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK; NHS Assure, National Services Scotland, Edinburgh, UK.
| | - G Wilson
- Department of Microbiology, Glasgow Royal Infirmary, Glasgow, UK
| | - J Black
- Department of Microbiology, Glasgow Royal Infirmary, Glasgow, UK
| | - J Mallon
- Department of Microbiology, Glasgow Royal Infirmary, Glasgow, UK
| | - M Connor
- Department of Microbiology, Dumfries and Galloway Hospital, UK
| | - M Weinbren
- NHS Assure, National Services Scotland, Edinburgh, UK
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Weinbren M, Inkster T, Lafferty F. Drains and the periphery of the water system - what do you do when the guidance is outdated? Infect Prev Pract 2022; 3:100179. [PMID: 34988421 PMCID: PMC8696270 DOI: 10.1016/j.infpip.2021.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/11/2021] [Indexed: 11/21/2022] Open
Abstract
The periphery of the water system (defined as the last 2 m of pipework from an outlet and ensuing devices including drainage), is the juncture of multiple inherent risks: the necessity to use materials with higher risk of biofilm formation, difficulty in maintaining safe water temperatures, a human interface with drainage systems, poor design, poor layout and use by staff. Add to this risk a large new healthcare facility capital build programme in England, outdated guidance and bacteria emanating from drainage systems containing highly mobile genetic elements (threatening the end of the antibiotic era), and the scene is set for the perfect storm. There is an urgent need for the re-evaluation of the periphery of the water system and drainage systems. Consequently, in this article we examine the requirement and placement of hand wash stations (HWSs), design of showers, kitchens and the dirty utility with respect to water services. Lastly, we discuss the provision of safe water to high-risk patient groups. The purpose of this article is to stimulate debate and provide infection control and design teams with support in deviating from the outdated existing guidance and to challenge conventional thinking until new advice is forthcoming.
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Affiliation(s)
- M Weinbren
- Department of Microbiology, King's Mill Hospital, Sutton-in-Ashfield, UK
| | - T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
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Weinbren M, Inkster T. Role of the kitchen environment. Infect Prev Pract 2021; 3:100155. [PMID: 34647009 PMCID: PMC8498711 DOI: 10.1016/j.infpip.2021.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- M Weinbren
- Department of Microbiology, King's Mill Hospital, Sutton-in-Ashfield, UK
| | - T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
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Bak A, Mugglestone MA, Ratnaraja NV, Wilson JA, Rivett L, Stoneham SM, Bostock J, Moses SE, Price JR, Weinbren M, Loveday HP, Islam J, Wilson APR. SARS-CoV-2 routes of transmission and recommendations for preventing acquisition: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance. J Hosp Infect 2021; 114:79-103. [PMID: 33940093 PMCID: PMC8087584 DOI: 10.1016/j.jhin.2021.04.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Affiliation(s)
- A Bak
- Healthcare Infection Society, UK.
| | | | - N V Ratnaraja
- British Infection Association, UK; University Hospitals Coventry & Warwickshire NHS Trust, UK
| | - J A Wilson
- Infection Prevention Society, UK; Richard Wells Research Centre, University of West London, UK
| | - L Rivett
- Healthcare Infection Society, UK; Cambridge University NHS Hospitals Foundation Trust, UK
| | - S M Stoneham
- Healthcare Infection Society, UK; Brighton and Sussex University Hospitals NHS Trust, UK
| | | | - S E Moses
- British Infection Association, UK; Royal College of Pathologists, UK; East Kent Hospitals University NHS Foundation Trust, UK
| | - J R Price
- Healthcare Infection Society, UK; Imperial College Healthcare NHS Trust, UK
| | - M Weinbren
- Healthcare Infection Society, UK; Sherwood Forest Hospitals NHS Foundation Trust, UK
| | - H P Loveday
- Infection Prevention Society, UK; Richard Wells Research Centre, University of West London, UK
| | - J Islam
- Healthcare Infection Society, UK; Brighton and Sussex University Hospitals NHS Trust, UK
| | - A P R Wilson
- Healthcare Infection Society, UK; University College London Hospitals NHS Foundation Trust, UK
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Abstract
Immunosuppressed patients are at increased risk of developing hospital-acquired fungal infections. The risk of fungal infection from construction is well established, but water ingress also presents a risk if it is not dealt with promptly. This article describes four such scenarios and the learning points from each. Water ingress may go under-reported and, as such, may be an underestimated source of fungal healthcare-associated infections.
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Affiliation(s)
- T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK.
| | - M Weinbren
- Department of Microbiology, King's Mill Hospital, Sutton-in-Ashfield, UK
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9
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Affiliation(s)
- M Weinbren
- Department of Microbiology, King's Mill Hospital, Sutton-in-Ashfield, UK.
| | - T Inkster
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
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Weinbren M, Weston V, Woods S, Collins M, Coultas A, O'Connell N, Dunne C. Oxygenating the argument for consistent performance of anaerobic blood cultures and blood volumes collected. J Hosp Infect 2019; 102:351-352. [DOI: 10.1016/j.jhin.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/04/2019] [Indexed: 11/16/2022]
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11
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Agwuh K, Weinbren M. Pseudomonas water testing and ISO standards in UK and Germany. J Hosp Infect 2018; 100:e155-e156. [PMID: 30121321 DOI: 10.1016/j.jhin.2018.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 11/27/2022]
Affiliation(s)
- K Agwuh
- Department of Microbiology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - M Weinbren
- Department of Microbiology, King's Mill Hospital NHS Foundation Trust, Sutton-in-Ashfield, UK.
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Abstract
BACKGROUND Handwashing is viewed as the most important barrier to cross-infection. Incorrect use of clinical handwash basins may lead to cross-infection either from contaminated water or due to failure to decontaminate hands. Elbow-operated taps used correctly prevent recontamination of hands during operation. Many elbow-operated taps are installed incorrectly, with the handle flush with the back panel, making it difficult to open using the elbow. AIM To determine the effect of altering the angle of the handle of elbow-operated taps on handwashing technique. METHODS An observational study was conducted using two rooms; in one the handles of the elbow-operated taps were flush with the inspection panel behind, and in the other they were set at 35°. FINDINGS Thirty-five staff members washed their hands in both rooms. Hands were used to turn on the taps in 97% of instances. In 57% of washes hands were recontaminated when used to turn the tap off. Only six individuals consistently used their elbows to turn outlets off. Surprisingly, more individuals used their elbows to operate taps whose handles were flush with the inspection panel behind. CONCLUSION Greater emphasis needs to be placed on correct use of elbow-operated outlets. The decision to use elbow- or sensor-operated outlets is not clear-cut, as each has pros and cons. There is much room for improvement in design and standardization of handwash basins. Given the importance of handwashing it is surprising that these gaps exist.
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Affiliation(s)
- M Weinbren
- Department of Microbiology, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK.
| | - L Bree
- Department of Infection Control, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK
| | - S Sleigh
- Department of Infection Control, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK
| | - M Griffiths
- Department of Estates/Engineering, Chesterfield Royal Hospital Foundation Trust, Calow, Derbyshire, UK
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Weinbren M, Bree L, Cain-Arens D. Novel use of fluorescent gel to ensure that cleaning does not take place. J Hosp Infect 2015; 92:296. [PMID: 26616411 DOI: 10.1016/j.jhin.2015.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 11/29/2022]
Affiliation(s)
- M Weinbren
- Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK.
| | - L Bree
- Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK
| | - D Cain-Arens
- Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK
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Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, Ladhani S, Watson C, Ramsay M, Kaczmarksi E, Borrow R, Gray S, Hadlington D, Weinbren M, Bhattacharjee D, Inglis N. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.44.20308-en] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report an outbreak of Neisseria meningitidis serogroup W135, associated with a transient transmission event between asymptomatic individuals in a healthcare setting. Two elderly persons subsequently developed invasive meningococcal disease. The duration and type of close contact for those directly involved in the probable transmission incident would not have warranted chemoprophylaxis according to current guidelines. Meningococcal infection in older persons usually presents with pneumonia rather than meningitis or septicaemia with purpura.
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Affiliation(s)
- R Puleston
- Health Protection Agency, Nottingham, United Kingdom
| | - C Beck
- Health Protection Agency, Nottingham, United Kingdom
| | - M Tahir
- Health Protection Agency, Birmingham, United Kingdom
| | - M Bardhan
- Health Protection Agency, Birmingham, United Kingdom
| | - P Charlemagne
- Health Protection Agency, Birmingham, United Kingdom
| | - C Alves
- Health Protection Agency, Birmingham, United Kingdom
| | - S Ladhani
- Health Protection Agency, London, United Kingdom
| | - C Watson
- Health Protection Agency, London, United Kingdom
| | - M Ramsay
- Health Protection Agency, London, United Kingdom
| | - E Kaczmarksi
- Meningococcal Reference Unit, Health Protection Agency, Public Health Laboratory, Manchester, United Kingdom
| | - R Borrow
- Meningococcal Reference Unit, Health Protection Agency, Public Health Laboratory, Manchester, United Kingdom
| | - S Gray
- Meningococcal Reference Unit, Health Protection Agency, Public Health Laboratory, Manchester, United Kingdom
| | - D Hadlington
- West Midlands Ambulance Service, West Midlands, United Kingdom
| | - M Weinbren
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - D Bhattacharjee
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - N Inglis
- NHS Coventry and Warwickshire, Coventry, United Kingdom
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Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, Ladhani S, Watson C, Ramsay M, Kaczmarksi E, Borrow R, Gray S, Hadlington D, Weinbren M, Bhattacharjee D, Inglis N. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill 2012; 17:20308. [PMID: 23137486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- R Puleston
- Health Protection Agency, Nottingham, United Kingdom.
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Hope R, Mushtaq S, James D, Pllana T, Warner M, Livermore DM, Brown D, Rooney P, Palmer R, Croal J, Weinbren M, Hogue S, Gould K, Cumberland N, Logan M, Pillay DG, Thomas C, Want S, Oppenheim B, Kent R, Manjula, Rizkalla, Wade J, Wilcox M, Swann A, Leonard A, Galloway, Al-Wali W, Hudson SJ, Rogers J, Winstanley T, Riley UBG, Johnstone DJ, El-Bouri K, Jones G, MacGowan A, Jepson A, Unsworth, James E, Shetty N, Shemko M, Hastings M, Lafong C, Richards S, Nash J, Waghorn D, Cullen M, Todd N, Anderson AN, D'Arcy S, Goodburn C, Bignardi G. Tigecycline activity: low resistance rates but problematic disc breakpoints revealed by a multicentre sentinel survey in the UK. J Antimicrob Chemother 2010; 65:2602-9. [DOI: 10.1093/jac/dkq370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Weinbren M. Herschell Kenneth Weinbren. West J Med 2010. [DOI: 10.1136/bmj.c5020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lewis T, Griffith C, Gallo M, Weinbren M. A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces. J Hosp Infect 2008; 69:156-63. [PMID: 18468725 DOI: 10.1016/j.jhin.2008.03.013] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Accepted: 03/20/2008] [Indexed: 11/25/2022]
Abstract
Hospital cleaning continues to attract patient, media and political attention. In the UK it is still primarily assessed via visual inspection, which can be misleading. Calls have therefore been made for a more objective approach to assessing surface cleanliness. To improve the management of hospital cleaning the use of adenosine triphosphate (ATP) in combination with microbiological analysis has been proposed, with a general ATP benchmark value of 500 relative light units (RLU) for one combination of test and equipment. In this study, the same test combination was used to assess cleaning effectiveness in a 1300-bed teaching hospital after routine and modified cleaning protocols. Based upon the ATP results a revised stricter pass/fail benchmark of 250 RLU is proposed for the range of surfaces used in this study. This was routinely achieved using modified best practice cleaning procedures which also gave reduced surface counts with, for example, aerobic colony counts reduced from >100 to <2.5 cfu/cm(2), and counts of Staphylococcus aureus reduced from up to 2.5 to <1 cfu/cm(2) (95% of the time). Benchmarking is linked to incremental quality improvements and both the original suggestion of 500 RLU and the revised figure of 250 RLU can be used by hospitals as part of this process. They can also be used in the assessment of novel cleaning methods, such as steam cleaning and microfibre cloths, which have potential use in the National Health Service.
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Affiliation(s)
- T Lewis
- University Hospitals Coventry and Warwickshire NHS Trust Hospital, Walsgrave, Coventry, UK
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Kaye M, Skidmore S, Osman H, Weinbren M, Warren R. Surveillance of respiratory virus infections in adult hospital admissions using rapid methods. Epidemiol Infect 2006; 134:792-8. [PMID: 16388686 PMCID: PMC2870437 DOI: 10.1017/s0950268805005364] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2005] [Indexed: 11/07/2022] Open
Abstract
Both influenza and respiratory syncytial virus (RSV) cause epidemics of respiratory illness of variable severity during the winter season. Influenza in particular has been blamed for hospital winter bed pressures, although it is thought that RSV may also play a role. Human metapneumovirus (hMPV) is a new respiratory virus reported to be important in children; only a limited number of studies are available for adult populations. We aimed to determine initially the burden of virologically confirmed infections, i.e. influenza, RSV and hMPV using polymerase chain reaction (PCR) technology and, in addition, to assess the feasibility of this approach as a surveillance tool for these respiratory viruses. Adult patients admitted to hospital in the previous 24 hours with onset of acute respiratory symptoms in the last 14 days were asked to participate. Informed written consent was obtained and nose and throat swabs taken. Multiplex PCR for influenza A (H1N1 and H3N2), influenza B and RSV A and B were carried out together with a separate PCR for hMPV. A total of 219 patients in 2001-2002 and 216 in 2002-2003 were tested and the combined results for both seasons were: 8 positive for influenza A/H1N1, 14 for influenza A/H3N2, 2 for influenza B, 14 for RSV A and 6 for RSV B. Most patients (261/435) were >65 years and most positives (30/44) were found within this age group. A number of patients aged >65 years who were positive for influenza (12/15) reported having had vaccine. In total, 373 samples were tested for hMPV and 20 were found positive across all age groups except the 45-54 years age group. As influenza activity was low during the study period the impact of infection on admissions could not be assessed. Nevertheless the viruses studied accounted for 15% of hospital admissions for respiratory infection. Most patients were aged >65 years, as expected. In the two years studied RSV and hMPV were each responsible for as many hospitalized cases of respiratory infection as influenza. Influenza infection must be considered even in those who give a history of vaccination. The molecular methods used in this study showed that surveillance of these respiratory viruses can be conducted and may help in the management of patients.
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Affiliation(s)
- M Kaye
- Microbiology Department, The Shrewsbury and Telford Hospital NHS Trust, Telford, Shropshire, UK.
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Jain S, Weinbren M, Rowley J, Bradley A. Arterial blood gas syringe safety device: does it present a greater hazard? J Hosp Infect 2004; 57:264-5. [PMID: 15236858 DOI: 10.1016/j.jhin.2004.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2004] [Indexed: 10/26/2022]
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Weinbren M. Interpretive laboratory reporting. Commun Dis Public Health 2002; 5:260-1. [PMID: 12434702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Reis DJ, Weinbren M, Corvelli A. A circadian rhythm of norepinephrine regionally in cat brain: its relationship to environmental lighting and to regional diurnal variations in brain serotonin. J Pharmacol Exp Ther 1968; 164:135-45. [PMID: 5303399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Abstract
The concentration of noradrenaline, but not serotonin, in the brainstem of cats is reduced 3 hours after the production of a defense reaction by supracollicular decerebration, even when movements and changes in blood pressure are abolished by transection of the spinal cord. After midcollicular decerebration, which does not elicit a defense reaction, noradrenaline concentrations do not change. The decrease in its concentration accompanying the defense reaction produtced by brain lesions probably reflects activity, in this behavior, of neturons containinig noradrenaline.
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Weinbren M. The Value of Tomography in the Examination of Fractured Vertebrae. Acta Radiol 1954. [DOI: 10.1177/0284185154042s11625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Broughton-Alcock W, Weinbren M. Generalized Infection of Muscles with Cysticercus cellulosæ; measurements of cysts and comparison with those of Trichinella spiralis. Proc R Soc Med 1930; 24:222-4. [PMID: 19987884 PMCID: PMC2182087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Broughton-Alcock W, Weinbren M. Generalized Infection of Muscles with Cysticercus Cellulosæ; Measurements of Cysts and Comparison with Those of Trichinella Spiralis. Proc R Soc Med 1930. [DOI: 10.1177/003591573002400255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Broughton-Alcock W, Weinbren M. Generalized Infection of Muscles with Cysticercus cellulosæ; measurements of cysts and comparison with those of Trichinella spiralis. Proc R Soc Med 1930; 24:222-224. [PMID: 20912281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Weinbren M. DIAGNOSIS AND TREATMENT OF PULMONARY TUBERCULOSIS. West J Med 1930. [DOI: 10.1136/bmj.1.3610.516-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Weinbren M. Ultra-Violet Radiation in the Treatment of Skin Ulcers. Br J Radiol 1929. [DOI: 10.1259/0007-1285-2-22-477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Weinbren M. Surgical and Pulmonary Tuberculosis. Proc R Soc Med 1928; 21:748-752. [PMID: 19986373 PMCID: PMC2103113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Weinbren M. Ultra-Violet Radiation and Varicose Ulcers. West J Med 1927. [DOI: 10.1136/bmj.2.3488.900-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Weinbren M. Ultra-Violet Radiation and Varicose Ulcers. West J Med 1927. [DOI: 10.1136/bmj.2.3479.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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