scholarly journals A Survey of Antibiotic-Resistant Microorganisms in Hospital Sink Drains

2020 ◽  
Vol 41 (S1) ◽  
pp. s108-s108
Author(s):  
Lauren Franco ◽  
Christine Ganim ◽  
Windy Tanner
Keyword(s):  
Selective Pressure ◽  
Tap Water ◽  
Patient Room ◽  
Antibiotic Resistant ◽  
Tail Pipe ◽  
Healthcare Settings ◽  
Significant Difference ◽  
Healthcare Environments ◽  
Control And Prevention ◽  
Patient Use

Background: Handwashing sinks in healthcare environments are reservoirs for healthcare pathogens and antibiotic-resistant microorganisms (ARO). We investigated the distribution of HCP and ARO within and among handwashing sinks in healthcare settings. To do this, we determined the differences in the number of ARO between samples within a sink (biofilm vs planktonic samples), between sink types (healthcare worker [HCW] vs patient room sinks), and between hospitals in the same city. Methods: Tap water, sink surface, drain cover, tail pipe, p-trap water and p-trap samples were collected from 2 patient room sinks and 2 HCW sinks over 11 months in 2 acute-care hospitals. Suspected pathogens were isolated from selective media (Pseudosel, Chromagar KPC, and MacConkey with 2 mg/L cefotaxime) and identified via MALDI-ToF. Isolates confirmed to be healthcare pathogens were characterized via disk diffusion to determine their antibiotic susceptibility according to CLSI guidelines. Isolates not susceptible to carbapenems (meropenem or ertapenem) were tested further via the modified carbapenem inactivation method to detect carbapenemase production. Results:Pseudomonas aeruginosa and Enterobacteriaceae (Enterobacter spp, Klebsiella spp, and Citrobacter spp) were the most frequently isolated pathogens. Among these isolates (195 P. aeruginosa and 42 Enterobacteriaceae isolates), 28.5% of P. aeruginosa and 85.7% of Enterobacteriaceae were nonsusceptible to 1 or more of the antibiotics tested. Of the isolates that were nonsusceptible to a carbapenem (46 of 237; 19%), none displayed phenotypic carbapenemase production. Other mechanisms of resistance have not been confirmed. There was no significant difference in the percentage of nonsusceptible HCP isolated from biofilm samples (from p-trap and tail pipe) compared to planktonic (p-trap water) samples (P > .05 for P. aeruginosa and Enterobacteriaceae). A greater percentage of resistant or intermediate isolates was recovered from patient room sinks than from HCW sinks (P < .05) for both P. aeruginosa and Enterobacteriaceae isolates (76.4 vs 32.9% for Enterobacteriaceae, 25.6 vs 0.3% for P. aeruginosa). We detected no significant difference in percentage of nonsusceptible isolates between the 2 hospitals sampled (P > .05). Conclusions: This survey of healthcare sinks supports previous work citing that they are reservoirs for HCP and ARO. This work further examines the distribution of HCP and ARO within and among sinks in these environments. Our findings thus far in the 2 hospitals studied reveal a higher percentage of ARO in patient sinks than in HCW sinks. This finding may suggest a higher input of ARO from patient use or greater selective pressure in patient room sinks.Disclosures: NoneFunding: Lauren Franco, Centers for Disease Control and Prevention

scholarly journals Colistin resistance of non-pathogenic strains of Escherichia coli occurring as natural intestinal flora in broiler chickens treated and not treated with colistin sulphate

2020 ◽  
Vol 64 (3) ◽  
pp. 399-405
Author(s):  
Michał Majewski ◽  
Anna Łukomska ◽  
Jarosław Wilczyński ◽  
Danuta Wystalska ◽  
Przemysław Racewicz ◽  
...  
Keyword(s):  
Broiler Chickens ◽  
Selective Pressure ◽  
Intestinal Flora ◽  
Antibiotic Use ◽  
Colistin Resistance ◽  
Gene Encoding ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Significant Difference ◽  
Resistant Strains

AbstractIntroductionA significant threat to public health is presented by antibiotic-resistant strains of bacteria, selective pressure on which results from antibiotic use. Colistin is an antibiotic commonly used in veterinary medicine, but also one of last resort in human medicine. Since the 2015 discovery in China of the mcr-1 gene encoding colistin resistance in Enterobacteriaceae, other countries have noted its presence. This study was to find the mcr-1 gene prevalence in E. coli isolated from poultry slaughtered in Poland.Material and MethodsCloacal swabs were taken from December 2017 to October 2018 from broiler chickens in three regions. The samples (n = 158) were grouped as flocks treated with colistin sulphate (n = 87) and those not treated (n = 71). Resistance to antimicrobials commonly used in poultry was evaluated by minimum inhibitory concentration. The presence of the mcr-1 gene was confirmed by PCR.ResultsIsolates containing the mcr-1 gene were yielded by 11.27% of the samples from not treated flocks and 19.54% of those from treated flocks, but no statistically significant difference in the prevalence of the gene was seen between the groups.ConclusionThe results clearly preclude intensification of selective pressure for colistin resistance due to colistin sulphate treatment because they show that the avian gastrointestinal tract was already inhabited by colistin-resistant E. coli by the time the chickens came to the poultry house.

Blood contamination of the pharmaceutical staff by irinotecan and its two major metabolites inside and outside a compounding unit

2021 ◽  
pp. 107815522110120
Author(s):  
Victoire Béchet ◽  
Hubert Benoist ◽  
Frédéric Beau ◽  
Fabienne Divanon ◽  
Stéphanie Lagadu ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Antineoplastic Drug ◽  
Blood Contamination ◽  
Staff Members ◽  
Adverse Health Effects ◽  
Healthcare Settings ◽  
Significant Difference ◽  
Drug Contamination ◽  
Contamination Levels

Background Caregivers in healthcare settings are exposed to a risk of antineoplastic drug contamination which can lead to adverse health effects. Biological monitoring is necessary to estimate the actual level of exposure of these workers. This study was conducted with the aim of assessing blood contamination levels by irinotecan and its metabolites of pharmaceutical staff operating inside and outside a compounding unit. Methods The study took place within the pharmaceutical unit of a French comprehensive cancer centre. Blood samples were collected from the pharmacy workers operating inside and outside the compounding unit, and analysed by UHPLC-MS/MS. Plasma and red blood cell irinotecan and its metabolites (SN-38; APC) were determined with a validated analytical method detection test. Results A total of 17/78 (21.8%) plasma and red blood cell-based assays were found to be contaminated among staff. Overall, the total number of positive assays was significantly higher for staff members working outside the compounding unit than for workers working inside it ( P = 0.022), with respectively 5/42 (11.9%) and 12/36 (33.3%) positive assays. For plasma dosages, the “outside” group had a significantly higher number of positive assays ( P = 0.014). For red blood cell-based assays, no significant difference was found ( P = 0.309). Conclusions This study reveals that pharmaceutical staff serving in health care settings are exposed to a risk of antineoplastic drug contamination, not only inside the compounding room but also in adjacent rooms. The results would help to raise awareness and potentially establish protective measures for caregivers working in areas close to the compounding room as well.

scholarly journals Compliance with Standard Precautions and Its Relationship with Views on Infection Control and Prevention Policy among Healthcare Workers during COVID-19 Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3420
Author(s):  
Eliza Lai-Yi Wong ◽  
Kin-Fai Ho ◽  
Dong Dong ◽  
Annie Wai-Ling Cheung ◽  
Peter Sen-Yung Yau ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
High Risk Group ◽  
Infection Prevention And Control ◽  
Prevention Policy ◽  
Standard Precautions ◽  
Healthcare Settings ◽  
Control And Prevention ◽  
And Control ◽  
Infection Control And Prevention

Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.

scholarly journals Comparison of Antibiotic Resistance Profile of Escherichia coli between Pristine and Human-Impacted Sites in a River

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 575
Author(s):  
Emi Nishimura ◽  
Masateru Nishiyama ◽  
Kei Nukazawa ◽  
Yoshihiro Suzuki
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Resistant Bacteria ◽  
Downstream Site ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Upstream Site ◽  
Resistance Profile ◽  
Antibiotic Resistance Profile ◽  
Significant Difference

Information on the actual existence of antibiotic-resistant bacteria in rivers where sewage, urban wastewater, and livestock wastewater do not load is essential to prevent the spread of antibiotic-resistant bacteria in water environments. This study compared the antibiotic resistance profile of Escherichia coli upstream and downstream of human habitation. The survey was conducted in the summer, winter, and spring seasons. Resistance to one or more antibiotics at upstream and downstream sites was on average 18% and 20%, respectively, and no significant difference was observed between the survey sites. The resistance rates at the upstream site (total of 98 isolated strains) to each antibiotic were cefazolin 17%, tetracycline 12%, and ampicillin 8%, in descending order. Conversely, for the downstream site (total of 89 isolated strains), the rates were ampicillin 16%, cefazolin 16%, and tetracycline 1% in descending order. The resistance rate of tetracycline in the downstream site was significantly lower than that of the upstream site. Furthermore, phylogenetic analysis revealed that many strains showed different resistance profiles even in the same cluster of the Pulsed-Field Gel Electrophoresis (PFGE) pattern. Moreover, the resistance profiles differed in the same cluster of the upstream and the downstream sites. In flowing from the upstream to the downstream site, it is plausible that E. coli transmitted or lacked the antibiotic resistance gene.

scholarly journals On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 684
Author(s):  
Sofia Svebrant ◽  
Robert Spörndly ◽  
Richard H. Lindberg ◽  
Therese Olsen Sköldstam ◽  
Jim Larsson ◽  
...  
Keyword(s):  
Municipal Wastewater ◽  
Wastewater Treatment Plants ◽  
High Flow ◽  
Resistant Bacteria ◽  
Municipal Wastewater Treatment ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Untreated Wastewater ◽  
Significant Difference ◽  
Hospital Sewage

Hospital sewage constitutes an important point source for antibiotics and antibiotic-resistant bacteria due to the high antibiotic use. Antibiotic resistance can develop and cause problems in sewage systems within hospitals and municipal wastewater treatment plants, thus, interventions to treat hospital sewage on-site are important. Ozonation has proven effective in treating relatively clean wastewater, but the effect on untreated wastewater is unclear. Therefore, we piloted implementation of ozonation to treat wastewater in a tertiary hospital in Uppsala, Sweden. We measured active pharmaceutical ingredients (APIs) using liquid chromatography-mass spectrometry and antibiotic-resistant Enterobacteriaceae using selective culturing pre- and post-ozonation. Comparing low (1 m3/h) and high (2 m3/h) flow, we obtained a ‘dose-dependent’ effect of API reduction (significant reduction of 12/29 APIs using low and 2/29 APIs using high flow, and a mean reduction of antibiotics of 41% using low vs. 6% using high flow, 25% vs. 6% for all APIs). There was no significant difference in the amount of antibiotic-resistant Enterobacteiaceae pre- and post-ozonation. Our results demonstrate that ozonation of untreated wastewater can reduce API content. However, due to the moderate API decrease and numerous practical challenges in the on-site setting, this specific ozonation system is not suitable to implement at full scale in our hospital.

scholarly journals Determination of essential and non-essential element contents of drinking water and baby water for infant’s nutrition

2021 ◽  
Vol 44 (1) ◽  
pp. 194-202
Author(s):  
Funda Demir ◽  
Meral Yildirim Ozen ◽  
Emek Moroydor Derun
Keyword(s):  
Water Samples ◽  
Infant Nutrition ◽  
Tap Water ◽  
Essential Element ◽  
Essential Elements ◽  
Local Market ◽  
Drinking Waters ◽  
Significant Difference ◽  
Element Contents

Abstract In this study, essential (Ca, Cr, Cu, Fe, K, Mg, Na, P, Zn), and non-essential (Al, Ni, Pb) element contents of the drinking and baby water samples which are sold in the local market and tap water samples in Istanbul were examined. It was determined that elements of Cr, Cu, Fe, P, Zn, Al, and Ni were below detection limits in all water samples. Among the non-essential elements analyzed in water samples, Pb was the only detected element. At the same time, the percentages that meet the daily element requirements of infants were also calculated. As a result of the evaluations made, there is no significant difference in infant nutrition between baby waters and other drinking waters in terms of the element content.

The Preparedness of Primary Health Care Network in terms of Emergency Risk Communication: A Study in Iran

2021 ◽  
pp. 1-10
Author(s):  
Zeinab Bagheri ◽  
Tahereh Dehdari ◽  
Masoud Lotfizadeh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Risk Communication ◽  
Health Care Facilities ◽  
Effective Response ◽  
Care Network ◽  
Primary Health ◽  
Significant Difference ◽  
Health Care Network ◽  
Control And Prevention

Abstract Objective: Emergency Risk Communication (ERC) is known as 1 of the important components of an effective response to public health emergencies. In this study, we aimed to investigate the preparedness of the Primary Health Care Network (PHCN) of Iran in terms of the ERC. Methods: This study was conducted in 136 Primary Health Care Facilities (PHCFs) affilated to Shahrekord University of Medical Sciences, Chaharmahal and Bakhtiari Province, Iran. Data in terms of ERC were collected using a checklist developed by the Center of Disease Control and Prevention (CDC). Results: The findings of the study revealed that 65.9% of the PHCFs had low preparedness in terms of the ERC, 33.3% had a moderate level and 0.8% had high preparedness in this regard. There was a significant difference between the level of ERC and the history of crisis in the past year, PHCF type, and the education level of the responsible employees in the crisis unit in the PHCF. Conclusions: The results showed that the PHCFs studied need to increase their capacity and capability in the field of ERC. Further efforts to provide ERC components may increase the preparedness of PHCN in Iran in terms of the ERC.

scholarly journals Impact of cleaning regimes on dental water unit contamination

2011 ◽  
Vol 9 (4) ◽  
pp. 647-652 ◽  
Author(s):  
Soad A. Abdallah ◽  
Ahmed I. Khalil
Keyword(s):  
High Speed ◽  
Tap Water ◽  
Daily Basis ◽  
Dental Chair ◽  
Dental Clinics ◽  
Significant Difference ◽  
Before And After ◽  
Hand Piece ◽  
Viable Bacteria ◽  
Dental Unit Waterlines

Microorganisms that have been identified in dental unit waterlines (DUWLs) are of concern because they can cause infections, especially in immunocompromised patients. This study aimed to assess the incidence of microbial contamination in DUWLs before and after intervention to reduce contamination, and to investigate the presence of coliforms, Escherichia coli and Pseudomonas aeruginosa. Water samples were collected aseptically from the waterlines. The high-speed hand-piece and dental chair units were served by one distillation apparatus, which was fed by the potable tap water of four dental clinics. Different interventions were used: chlorination, flushing before clinics and between patients, draining at the end of the day, and freshly distilled water on a daily basis. There was a significant difference between the level of contamination in the high-speed hand-piece (1.5–2.7 log CFU/ml) and dental chair unit water (2.0–3.5 log CFU/ml). Coliforms (0.9%) E. coli (0.9%) and Pseudomonas (1.8%) were detected during 2008. This study indicates the need to monitor water quality regularly and prevent stagnation in DUWLs to reduce the number of viable bacteria to &lt;100 CFU/ml. We recommend flushing the DUWL for 2 min before the first patient and for 10–20 s between patients, flushing the dental unit at the end of the day and draining it overnight to reduce the development of biofilms, and chlorination of the DUWLs.

Antibiotic selective pressure for the maintenance of antibiotic resistant genes in coliform bacteria isolated from the aquatic environment

2003 ◽  
Vol 47 (3) ◽  
pp. 249-253 ◽  
Author(s):  
J.C. Park ◽  
J.C. Lee ◽  
J.Y. Oh ◽  
Y.W. Jeong ◽  
J.W. Cho ◽  
...  
Keyword(s):  
Aquatic Environment ◽  
Selective Pressure ◽  
Functional Class ◽  
Coliform Bacteria ◽  
Antibiotic Resistant ◽  
Gene Cassettes ◽  
Class 1 Integrons ◽  
Selective Pressures ◽  
Class 1 ◽  
Inti1 Gene

Coliform bacteria isolated from the aquatic environment were investigated for antibiotic susceptibility and detailed structures of class 1 integrons. A high proportion of isolates were found to be resistant to sulfamethoxazole, aminoglycosides, and β-lactams. The 750 (53.6%) isolates were resistant to one or more of the antibiotics tested out of 1,400 coliform bacteria. Based on the MIC of antibiotics and antibiogram, 150 isolates were selected and further studied for class 1 integrons. The intI1 gene was found in 36 (24.0%) of the 150 isolates. Twelve isolates carried the gene cassettes responsible for antibiotic resistance, while no gene cassettes were found in 24 isolates. Seven different genes, dfrA5, dfrA7, dfrA12, dfrA17, aaA2, aaA5, and aad(3’), were detected in gene cassettes. The dfrA and aad genes located on class 1 integrons were responsible for resistance to trimethoprim and aminoglycosides. The remaining 24 coliform bacteria had the incomplete or non-functional class 1 integrons. These results indicated that antibiotic selective pressures may play an important role to maintain gene cassettes of class 1 integrons and in the absence of sustained antibiotic pressures, such as the aquatic environment, coliform bacteria may carry empty or non-functional class 1 integrons.

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