Impact and cost of infection control measures to reduce nosocomial transmission of extended-spectrum β-lactamase-producing organisms in a non-outbreak setting

2007 ◽  
Vol 65 (4) ◽  
pp. 354-360 ◽  
Author(s):  
L.O. Conterno ◽  
J. Shymanski ◽  
K. Ramotar ◽  
B. Toye ◽  
R. Zvonar ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Infection Control Measures ◽  
Extended Spectrum

scholarly journals ANTIMICROBIAL SUSCEPTIBILITY AND DETECTION METHODS FOR THE EXTENDED‑SPECTRUM β-LACTAMASES PRODUCING ENTEROBACTERIACEAE FROM CLINICAL SAMPLES

2018 ◽  
Vol 11 (5) ◽  
pp. 139
Author(s):  
Kaviyarasan G ◽  
Rajamanikandan Kcp ◽  
Sabarimuthu M ◽  
Ramya S ◽  
Arvind Prasanth D
Keyword(s):  
Infection Control ◽  
Bacterial Infections ◽  
Control Measures ◽  
Detection Methods ◽  
Clinical Samples ◽  
Healthcare Settings ◽  
Infection Control Measures ◽  
Extended Spectrum ◽  
Drug Choice ◽  
Synergy Test

Objectives: Detection of extended-spectrum β-lactamases (ESBLs) is crucial for the infection control and antibiotic choice in healthcare settings. The aim of this study is to develop a standardized, inexpensive, and simple approach that is able to detect ESBL-producing Enterobacteriaceae isolates.Methods: Isolates those were resistant to at least one of the three indicator cephalosporins (cefotaxime, cefpodoxime, and ceftazidime) were tested for ESBL production using the double disc synergy test (DDST), combined disc synergy test (CDST) test and genotypic detection of the responsible gene for the ESBL.Result: From 64 isolates, 28 were resistant to cephalosporins. In 28 isolates, 23 were positive in CDST but in the DDST 18 were showing ESBL positive. 10 were positive in both CDST and DDST.Conclusion: Resistance to cephalosporins, which are the drug choice to treat mixed bacterial infections by the Enterobacteriaceae of which disseminate rapidly being plasmid mediated. Hence, it is necessary that rapid detection of ESBL should be done and immediate infection control measures should be implemented to prevent their dissemination.

scholarly journals Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures

2011 ◽  
Vol 32 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Vincent C. C. Cheng ◽  
Lisa M. W. Wong ◽  
Josepha W. M. Tai ◽  
Jasper F. W. Chan ◽  
Kelvin K. W. To ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Infection Control Team ◽  
Concurrent Control ◽  
Infection Control Measures ◽  
Control Team ◽  
Hospital Networks ◽  
Polymerase Chain ◽  
Hospital Acquired

Background.Nosocomial outbreaks of norovirus infection pose a great challenge to the infection control team.Methods.Between November 1, 2009, and February 28, 2010, strategic infection control measures were implemented in a hospital network. In addition to timely staff education and promotion of directly observed hand hygiene, reverse-transcription polymerase chain reaction for norovirus was performed as an added test by the microbiology laboratory for all fecal specimens irrespective of the request for testing. Laboratory-confirmed cases were followed up by the infection control team for timely intervention. The incidence of hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was compared with the corresponding period in the preceding 12 months, and the incidence in the other 6 hospital networks in Hong Kong was chosen as the concurrent control. Phylogenetic analysis of norovirus isolates was performed.Results.Of the 988 patients who were tested, 242 (25%) were positive for norovirus; 114 (47%) of those 242 patients had norovirus detected by our added test. Compared with the corresponding period in the preceding 12 months, the incidence of hospital-acquired norovirus infection decreased from 131 to 16 cases per 1,000 potentially infectious patient-days (P < .001 ), although the number of hospital-acquired infections was low in both the study period (n = 8) and the historical control periods (n = 11). The incidence of hospital-acquired norovirus infection in our hospital network (0.03 cases per 1,000 patient-days) was significantly lower than that of the concurrent control (0.06 cases per 1,000 patient-days) (P = .015). Forty-three (93%) of 46 norovirus isolates sequenced belonged to the genogroup II.4 variant.Conclusions.Strategic infection control measures with an added test maybe useful in controlling nosocomial transmission of norovirus.

scholarly journals A recurrent and transesophageal echocardiography–associated outbreak of extended-spectrum β-lactamase–producing Enterobacter cloacae complex in cardiac surgery patients

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Tom Van Maerken ◽  
Els De Brabandere ◽  
Audrey Noël ◽  
Liselotte Coorevits ◽  
Pascal De Waegemaeker ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infection Control ◽  
Transesophageal Echocardiography ◽  
Positive Culture ◽  
Case Definition ◽  
Control Measures ◽  
University Hospital ◽  
Epidemiological Investigation ◽  
Infection Control Measures ◽  
Extended Spectrum

Abstract Background We report a recurrent outbreak of postoperative infections with extended-spectrum β-lactamase (ESBL)–producing E. cloacae complex in cardiac surgery patients, describe the outbreak investigation and highlight the infection control measures. Methods Cases were defined as cardiac surgery patients in Ghent University Hospital who were not known preoperatively to carry ESBL-producing E. cloacae complex and who postoperatively had a positive culture for this multiresistant organism between May 2017 and January 2018. An epidemiological investigation, including a case-control study, and environmental investigation were conducted to identify the source of the outbreak. Clonal relatedness of ESBL-producing E. cloacae complex isolates collected from case patients was assessed using whole-genome sequencing–based studies. Results Three separate outbreak episodes occurred over the course of 9 months. A total of 8, 4 and 6 patients met the case definition, respectively. All but one patients developed a clinical infection with ESBL-producing E. cloacae complex, most typically postoperative pneumonia. Overall mortality was 22% (4/18). Environmental cultures were negative, but epidemiological investigation pointed to transesophageal echocardiography (TEE) as the outbreak source. Of note, four TEE probes showed a similar pattern of damage, which very likely impeded adequate disinfection. The first and second outbreak episode were caused by the same clone, whereas a different strain was responsible for the third episode. Conclusions Health professionals caring for cardiac surgery patients and infection control specialists should be aware of TEE as possible infection source. Caution must be exercised to prevent and detect damage of TEE probes.

scholarly journals Proactive infection control measures to prevent nosocomial transmission of vancomycin-resistant enterococci in Hong Kong

2014 ◽  
Vol 113 (10) ◽  
pp. 734-741 ◽  
Author(s):  
Vincent Chi-Chung Cheng ◽  
Josepha Wai-Ming Tai ◽  
Jonathan Hon-Kwan Chen ◽  
Simon Yung-Chun So ◽  
Wing-Chun Ng ◽  
...  
Keyword(s):  
Hong Kong ◽  
Infection Control ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Intensive Care Unit Outbreak of Extended-Spectrum β-Lactamase–Producing Klebsiella Pneumoniae Controlled by Cohorting Patients and Reinforcing Infection Control Measures

2008 ◽  
Vol 29 (6) ◽  
pp. 517-524 ◽  
Author(s):  
C. Laurent ◽  
H. Rodriguez-Villalobos ◽  
F. Rost ◽  
H. Strale ◽  
J.-L. Vincent ◽  
...  
Keyword(s):  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Rate Ratio ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Intensive Care Department ◽  
Contact Precautions ◽  
Care Department ◽  
Infection Control Measures

Objective.To describe an outbreak of extended-spectrum β-lactamase (ESBL)–producing Klebsiella pneumoniae in the intensive care units (ICUs) of a hospital and the impact of routine and reinforced infection control measures on interrupting nosocomial transmission.Design.Outbreak report.Setting.A 31-bed intensive care department (composed of 4 ICUs) in a university hospital in Belgium.Intervention.After routine infection control measures (based on biweekly surveillance cultures and contact precautions) failed to interrupt a 2-month outbreak of ESBL-producing K. pneumoniae, reinforced infection control measures were implemented. The frequency of surveillance cultures was increased to daily sampling. Colonized patients were moved to a dedicated 6-bed ICU, where they received cohorted care with the support of additional nurses. Two beds were closed to new admissions in the intensive care department. Meetings between the ICU and infection control teams were held every day. Postdischarge disinfection of rooms was enforced. Broad-spectrum antibiotic use was discouraged.Results.Compared with a baseline rate of 0.44 cases per 1,000 patient-days for nosocomial transmission, the incidence peaked at 11.57 cases per 1,000 patient-days (October and November 2005; rate ratio for peak vs baseline, 25.46). The outbreak involved 30 patients, of whom 9 developed an infection. Bacterial genotyping disclosed that the outbreak was polyclonal, with 1 predominant genotype. Reinforced infection control measures lasted for 50 days. After the implementation of these measures, the incidence fell to 0.08 cases per 1,000 patient-days (rate ratio for after the outbreak vs during the outbreak, 0.11).Conclusion.These data indicate that, in an intensive care department in which routine screening and contact precautions failed to prevent and interrupt an outbreak of ESBL-producing K. pneumoniae, reinforced infection control measures controlled the outbreak without major disruption of medical care.

scholarly journals Infection prevention measures for patients undergoing hemodialysis during the COVID-19 pandemic in Japan: a nationwide questionnaire survey

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuka Sugawara ◽  
◽  
Masao Iwagami ◽  
Kan Kikuchi ◽  
Yoko Yoshida ◽  
...  
Keyword(s):  
Infection Control ◽  
Questionnaire Survey ◽  
Infection Prevention ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Third Wave ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Before And After ◽  
Dialysis Facilities

Abstract Background Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic affecting a variety of medical treatments, including hemodialysis. This study aims to investigate the implementation of infection control measures, to examine the shortage of personal protective equipment (PPE) and disinfectants, and to quantify the number of nosocomial COVID-19 transmissions in hemodialysis facilities in Japan during the pandemic. Methods We conducted a nationwide questionnaire survey between 20 October and 16 November 2020 (i.e., between the “second wave” and “third wave” in Japan) in the 4198 dialysis facilities of the Japanese Association of Dialysis Physicians and the Japanese Society for Dialysis Therapy. A total of 2227 facilities (53.0%) responded. The questionnaire consisted of (i) characteristics of facilities, (ii) infection prevention measures in routine dialysis practices, (iii) shortage of PPE, (iv) feasibility of various isolation measures, and (v) nosocomial transmission. Results Half of the responding facilities were hospitals with multiple departments, and the other half were clinics specialized in dialysis. Several infection prevention measures such as health checks of staff and patients, donning of masks before and after hemodialysis, and disinfection of frequently contacted areas were implemented during the COVID-19 pandemic. There was a significant improvement in the implementation rate of these measures during the pandemic, compared to before it, which reached over 90%. More than half of the facilities reported a shortage of disposable masks (67.2%) and hand sanitizer alcohol (56.7%). Isolation of COVID-19 patients in private rooms was possible only in 52.7% of the facilities. The majority of facilities (73.3%) could not accept COVID-19 dialysis patients due to lack of space and manpower. Nosocomial transmission of COVID-19 occurred in 4.0% of the facilities. Of those infected, 51.9% were staff. Conclusions This survey revealed that most hemodialysis facilities in Japan had improved implementation of infection control measures and had shortage of PPEs and disinfectants, though some facilities did not implement infection prevention measures adequately, mainly due to the limited space of the facility. It may be recommended that each facility immediately establishes isolation measures to prepare for the pandemic of COVID-19.

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