Pseudo-outbreak ofMycobacterium gordonaeFollowing the Opening of a Newly Constructed Hospital at a Chicago Medical Center

2014 ◽  
Vol 36 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Kavitha Prabaker ◽  
Chethra Muthiah ◽  
Mary K. Hayden ◽  
Robert A. Weinstein ◽  
Jyothirmai Cheerala ◽  
...  
Keyword(s):  
Water Samples ◽  
Potable Water ◽  
Medical Center ◽  
University Hospital ◽  
Gastric Aspirate ◽  
Colony Forming Units ◽  
Hospital Patients ◽  
Potable Water Supply ◽  
Ice Water ◽  
Chicago Medical

OBJECTIVETo identify the source of a pseudo-outbreak ofMycobacterium gordonaeDESIGNOutbreak investigation.SETTINGUniversity Hospital in Chicago, Ilinois.PATIENTSHospital patients withM. gordonae-positive clinical cultures.METHODSAn increase in isolation ofM. gordonaefrom clinical cultures was noted immediately following the opening of a newly constructed hospital in January 2012. We reviewed medical records of patients withM. gordonae-positive cultures collected between January and December 2012 and cultured potable water specimens in new and old hospitals quantitatively for mycobacteria.RESULTSOf 30 patients withM. gordonae-positive clinical cultures, 25 (83.3%) were housed in the new hospital; of 35 positive specimens (sputum, bronchoalveolar lavage, gastric aspirate), 32 (91.4%) had potential for water contamination.M. gordonaewas more common in water collected from the new vs. the old hospital [147 of 157 (93.6%) vs. 91 of 113 (80.5%),P=.001]. Median concentration ofM. gordonaewas higher in the samples from the new vs. the old hospital (208 vs. 48 colony-forming units (CFU)/mL;P<.001). Prevalence and concentration ofM. gordonaewere lower in water samples from ice and water dispensers [13 of 28 (46.4%) and 0 CFU/mL] compared with water samples from patient rooms and common areas [225 of 242 (93%) and 146 CFU/mL,P<.001].CONCLUSIONSM. gordonaewas common in potable water. The pseudo-outbreak ofM. gordonaewas likely due to increased concentrations ofM. gordonaein the potable water supply of the new hospital. A silver ion-impregnated 0.5-μm filter may have been responsible for lower concentrations ofM. gordonaeidentified in ice/water dispenser samples. Hospitals should anticipate that construction activities may amplify the presence of waterborne nontuberculous mycobacterial contaminants.Infect Control Hosp Epidemiol 2014;00(0): 1–6

scholarly journals SYNTHESIS OF THE ORGANIZATION OF TREATMENT, RESEARCH AND TEACHING (CASE STUDY AT THE UNIVERSITY HOSPITAL IN AACHEN)

2021 ◽  
pp. 349-358
Author(s):  
Maryna Lienkova ◽  
Irina Bulakh
Keyword(s):  
Medical Center ◽  
Multidisciplinary Treatment ◽  
University Hospital ◽  
Survey Analysis ◽  
University Hospitals ◽  
Medical Institutions ◽  
Hospital Patients ◽  
Student Training ◽  
Treatment Research ◽  
The University

The article considers and analyzes the existing in the world, but new for Ukraine, type of healthcare institutions - a university hospital, which today is an example of one of the largest and best university hospitals in Germany - the Medical Center of the University of Aachen. The planning and functional structure of the university hospital and special design approaches that contributed to its design and development are analyzed. The purpose of the article is to illustrate an innovative approach for our state to the organization of medical institutions and to emphasize the importance of their implementation in the domestic healthcare system. The research methodology is based on the systematization and analysis of data from various information sources, as well as on the method of sociological survey (analysis of reviews). The article considers the features of the structure of the University Hospital Aachen, namely the multidisciplinary treatment, research and student training, which are combined in one institution. According to hospital patients, the only drawback of this structure is the frequent long wait for visitors. This is probably due to the significant daily flow of patients of varying complexity and, consequently, the shortcomings of the managerial approach. However, at the same time, the hospital has many advantages, which were highlighted in the article.  

scholarly journals Nosocomial legionella pneumonia: demonstration of potable water as the source of infection

1988 ◽  
Vol 101 (3) ◽  
pp. 647-654 ◽  
Author(s):  
B. Ruf ◽  
D. Schürmann ◽  
I. Horbrach ◽  
K. Seodel ◽  
H. D. Pohle
Keyword(s):  
Monoclonal Antibodies ◽  
Water Supply ◽  
Legionella Pneumophila ◽  
Water Samples ◽  
Potable Water ◽  
Supply System ◽  
University Hospital ◽  
Environmental Isolates ◽  
Legionella Pneumonia ◽  
Source Of Infection

SUMMARYFrom January 1983 until December 1985, 35 cases of sporadic nosocomial legionella pneumonia, all caused byLegionella pneumophila, were diagnosed in a university hospital.L. pneumophilaserogroup (SG) 1 was cultured from 12 of the 35 cases and compared to correspondingL. pneumophilaSG 1 isolates from water outlets in the patients' immediate environment by subtyping with monoclonal antibodies. The corresponding environmental isolates were identical to 9 out of 12 (75%) of those from the cases. However, even in the remaining three cases identical subtypes were found distributed throughout the hospital water supply. From the hospital water supply four different subtypes ofL. pneumophilaSG 1 were isolated, three of which were implicated in legionella pneumonia. Of 453 water samples taken during the study 298 (65.8%) were positive for legionellae. Species ofLegionellaother thanL. pneumophilahave not been isolated. This may explain the exclusiveness ofL.pneumophilaas the legionella pneumonia-causing agent. Our results suggest that the water supply system was the source of infection.

Prospective 3-Year Surveillance for Nosocomial and EnvironmentalLegionella pneumophila: Implications for Infection Control

2006 ◽  
Vol 27 (5) ◽  
pp. 459-465 ◽  
Author(s):  
S. Boccia ◽  
P. Laurenti ◽  
P. Borella ◽  
U. Moscato ◽  
G. Capalbo ◽  
...  
Keyword(s):  
Infection Control ◽  
Nosocomial Pneumonia ◽  
Legionella Pneumophila ◽  
Water Samples ◽  
Water Distribution ◽  
Monitoring Program ◽  
University Hospital ◽  
Contamination Level ◽  
Surveillance Program ◽  
Colony Forming Units

Objectives.To perform a 3-year, prospective surveillance program for legionnaires disease (LD) in a large university hospital in Rome, and to assess the usefulness of the hospital water monitoring program in predicting the risk of nosocomial LD.Methods.Samples from patients with new cases of nosocomial pneumonia were sent for legionella laboratory investigations. Meanwhile, water samples for bacteriological analysis were collected every 6 months from high- and medium-risk hospital wards (10 in total).Legionella pneumophilaisolates collected were serotyped and analyzed by pulsed-field gel electrophoresis.Results.From June 2001 through May 2004, the pneumonia surveillance identified one case of nosocomial LD among 43 cases of nosocomial pneumonia (2.3%). Environmental investigations detectedL. pneumophilain 12 (18.7%) of the 64 water samples, of which 50% belonged to serogroup 1. TheL. pneumophilacount and the percentage of positive locations never exceeded 102colony-forming units/L and 20%, respectively, except when the LD nosocomial case occurred (positive water samples, 40%; I. pneumophila count, <102colony-forming units/L). Genotyping showed 3 prevalent clones ofL. pneumophilain the water distribution network, of which one persisted over the 3 years. One clone contained 3 differentL. pneumophilaserogroups (2, 4, and 6).Conclusions.The low incidence of nosocomial cases of LD appears to be associated with a low percentage (<20%) of positive water samples per semester and with a low contamination level (<102colony-forming units/L). An infection control system for nosocomial LD should, therefore, be based on both environmental and clinical surveillance, together with the appropriate maintenance of the hospital water distribution system.

Presence and Chromosomal Subtyping ofLegionellaSpecies in Potable Water Systems in 20 Hospitals of Catalonia, Spain

2001 ◽  
Vol 22 (11) ◽  
pp. 673-676
Author(s):  
Miquel Sabrià ◽  
Marian García-Núñez ◽  
Maria L. Pedro-Botet ◽  
Nieves Sopena ◽  
Josep M. Gimeno ◽  
...  
Keyword(s):  
Water Supply ◽  
Legionella Pneumophila ◽  
Potable Water ◽  
Geographic Area ◽  
Chromosomal Dna ◽  
Colony Forming Units ◽  
Clonal Distribution ◽  
Potable Water Supply ◽  
Dna Restriction ◽  
Great Genetic Diversity

AbstractObjective:To investigate the presence and clonal distribution ofLegionellaspecies in the water supply of 20 hospitals in Catalonia, Spain.Setting:20 hospitals in Catalonia, an area of 32,000 km2, located in northeast Spain.Methods:Environmental cultures of 186 points of potable water supply and 10 cooling towers were performed for the presence ofLegionellaspecies. Following filtration and acid treatment, the samples were seeded in selective MWY (modified Wadowsky Yee)-buffered charcoal yeast extract-a agar. All isolates obtained were characterized microbiologically and genotyped bySfilpulsed-field gel electrophoresis (PFGE).Results:73 of 196 water samples, representing 17 of the 20 hospitals included in the study, were positive forLegionella pneumophila(serogroups 1, 2-14, or both). The degree of contamination ranged from 200 to 74,250 colony-forming units/L. Twenty-five chromosomal DNA subtypes were detected by PFGE. A single DNA subtype was identified in 10 hospitals, 2 DNA subtypes were observed in 6 hospitals, and 1 hospital exhibited 3 different DNA subtypes. Each hospital had its ownLegionellaDNA subtype, which was not shared with any other hospitals.Conclusions:Legionellawas present in the water of most of the hospitals studied; each such hospital had a unique, dominant chromosomal DNA subtype. The verification of several genomic DNA restriction profiles in such a small geographic area demonstrates the great genetic diversity ofLegionellain the aquatic environment.

Intestinal parasite survey of Kyungpook National University Hospital patients

1971 ◽  
Vol 9 (2) ◽  
pp. 47 ◽  
Author(s):  
Dong Wik Choi ◽  
Sung Deok Park ◽  
Jae Woun Kim ◽  
Doo Hong Ahn ◽  
Young Myung Kim
Keyword(s):  
Intestinal Parasite ◽  
University Hospital ◽  
Hospital Patients ◽  
National University

Securing Potable Water Supply under Extreme Scarcity

10.1596/30593 ◽  
2018 ◽  
Author(s):  
Philippe Marin ◽  
Bambos Charalambous ◽  
Thierry Davy
Keyword(s):  
Water Supply ◽  
Potable Water ◽  
Potable Water Supply

CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le
Keyword(s):  
Clinical Features ◽  
University Hospital ◽  
Female Ratio ◽  
Tube Obstruction ◽  
Level Ii ◽  
Study Results ◽  
Male Female Ratio ◽  
Hospital Patients ◽  
Level I

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

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