Development of a Surveillance System for Methicillin-ResistantStaphylococcus aureusin German Hospitals

2007 ◽  
Vol 28 (4) ◽  
pp. 446-452 ◽  
Author(s):  
Iris F. Chaberny ◽  
Dorit Sohr ◽  
Henning Rüden ◽  
Petra Gastmeier
Keyword(s):  
Infection Control ◽  
Surveillance System ◽  
Control Measures ◽  
Positive Case ◽  
Incidence Density ◽  
Infection Control Measures ◽  
Large Numbers ◽  
Routine Surveillance ◽  
Number Of Patients ◽  
Mrsa Infection

Objective.To determine the appropriate method to calculate the rate of methicillin-resistantStaphylococcus aureus(MRSA) infection and colonization (hereafter, MRSA rates) for interhospital comparisons, such that the large number of patients who are already MRSA positive on admission is taken into account.Design.A prospective, multicenter, hospital-based surveillance of MRSA-positive case patients from January through December 2004.Setting.Data from 31 hospitals participating in the German national nosocomial infections surveillance system (KISS) were recorded during routine surveillance by the infection control team at each hospital.Results.Data for 4,215 MRSA-positive case patients were evaluated. From this data, the following values were calculated. The median incidence density was 0.71 MRSA-positive case patients per 1,000 patient-days, and the median nosocomial incidence density was 0.27 patients with nosocomial MRSA infection or colonization per 1,000 patient-days (95% CI, 0.18-0.34). The median average daily MRSA burden was 1.13 MRSA patient-days per 100 patient-days (95% CI, 0.86-1.51), with the average daily MRSA burden defined as the total number of MRSA patient-days divided by the total number of patient-days times 100. The median MRSA-days–associated nosocomial MRSA infection and colonization rate, which describes the MRSA infection risk for other patients in hospitals housing large numbers of MRSA-positive patients and/or many patients who were MRSA positive on admission, was 23.1 cases of nosocomial MRSA infection and colonization per 1,000 MRSA patient-days (95% CI, 17.4-28.6). The values were also calculated for various MRSA screening levels.Conclusions.The MRSA-days–associated nosocomial MRSA rate allows investigators to assess the extent of MRSA colonization and infection at each hospital, taking into account cases that have been imported from other hospitals, as well as from the community. This information provides an appropriate incentive for hospitals to introduce further infection control measures.

scholarly journals 510. Exposure Investigation Following a Confirmed Case of Candida auris and Multiple Carbapenemase-Producing Carbapenem-Resistant Organisms

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S247-S247
Author(s):  
Frances Nicholson ◽  
Melanie Curless ◽  
Maggie Schiffhauer ◽  
Sean Zhang ◽  
Patricia Simner ◽  
...  
Keyword(s):  
Infection Control ◽  
Index Patient ◽  
The United States ◽  
Point Prevalence ◽  
Control Measures ◽  
Candida Auris ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Surveillance Cultures ◽  
Routine Surveillance

Abstract Background Co-infections of Candida auris and carbapenemase-producing carbapenem-resistant Gram-negative organisms (CP-CRO) are an increasing global concern and rarely seen in the United States. We report the case of a 59-year-old male, with recent hospitalization in India, admitted to our facility with C. auris isolated from urine and axilla/groin specimens and CP-CRO from five body sites. Methods Travel screening in the emergency department identified a patient at high risk for colonization/infection with multidrug-resistant organisms (MDRO). Contact precautions were initiated. Eight CP-CRO isolates were subsequently identified from clinical and routine surveillance cultures from five separate sites. Of the isolates, seven contained one or more carbapenemase-producing genes detected by Xpert Carba-R assay (Cepheid, Sunnyvale, CA) (Table 1). The microbiology laboratory alerted the infection control department of a presumptive positive C. auris from a clinical urine culture from the same patient. Enhanced mitigation strategies were initiated in regards to cleaning and disinfection. An exposure investigation was also conducted using a point prevalence approach. Surveillance cultures were obtained from inpatients currently admitted to the same unit as the index patient. Axilla/groin specimens were collected for C. auris testing, and rectal specimens were collected for CP-CRO gene testing (CRE Real-Time PCR). Results Eighteen patients in addition to the index patient were hospitalized on the acute medicine unit. One patient refused testing for CP-CRO; therefore, 17 patients were tested for CP-CRO, and 18 patients were tested for C. auris. Neither CP-CRO nor C. auris were recovered from any patient. Conclusion A patient co-infected with C. auris and multiple CP-CRO was identified by clinical and routine surveillance cultures at Johns Hopkins Hospital. Travel screening allowed proactive isolation upon presentation. Enhanced infection control measures were implemented and a point prevalence surveillance study was conducted on the general acute care medicine inpatient unit. No transmission of either C. auris or CP-CRO was detected, likely due in part to rapid identification and strict infection control measures. Disclosures All authors: No reported disclosures.

scholarly journals Evaluation of the Therapeutic Outcomes of Antibiotic Regimen Against Carbapenemase-Producing Klebsiella pneumoniae: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Clement Yaw Effah ◽  
Emmanuel Kwateng Drokow ◽  
Clement Agboyibor ◽  
Shaohua Liu ◽  
Emmanuel Nuamah ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Meta Analysis ◽  
Control Measures ◽  
Cochrane Library ◽  
Antibiotic Regimen ◽  
Success Rates ◽  
Infection Control Measures ◽  
Number Of Patients

Background: Carbapenemase-producing Klebsiella pneumoniae (CpKP) has been implicated as an increasing threat to public health. CpKP is a ubiquitous, opportunistic pathogen that causes both hospital and community acquired infections. This organism hydrolyzes carbapenems and other β-lactams and thus, leading to multiple resistance to these antibiotics. Despite the difficult to treat nature of infections caused by CpKP, little has been discussed on the mortality, clinical response and microbiological success rates associated with various antibiotic regimen against CpKP. This meta-analysis was designed to fill the paucity of information on the clinical impact of various antibiotic therapeutic regimens among patients infected with CpKP.Materials and Methods: Literature in most English databases such as Medline through PubMed, Google Scholar, Web of Science, Cochrane Library and EMBASE, were searched for most studies published between the years 2015–2020. Data were analyzed using the R studio 2.15.2 statistical software program (metaphor and meta Package, Version 2) by random-effects (DerSimonian and Laird) model.Results: Twenty-one (21) studies including 2841 patients who had been infected with CpKP were analysed. The overall mortality rate was 32.2% (95%CI = 26.23–38.87; I2 = 89%; p-value ≤ 0.01, Number of patients = 2716). Pooled clinical and microbiological success rates were 67.6% (95%CI = 58.35–75.64, I2 = 22%, p-value = 0.25, Number of patients = 171) and 74.9% (95%CI = 59.02–86.09, I2 = 53%, p-value = 0.05, Number of patients = 121), respectively. CpKP infected patients treated with combination therapy are less likely to die as compared to those treated with monotherapy (OR = 0.55, 95%CI = 0.35–0.87, p-value = 0.01, Number of patients = 1,475). No significant difference existed between the mortality rate among 60years and above patients vs below 60years (OR = 0.84, 95%CI = 0.28–2.57, p-value = 0.76, 6 studies, Number of patients = 1,688), and among patients treated with triple therapy vs. double therapy (OR = 0.50, 95%CI = 0.21–1.22, p-value = 0.13, 2 studies, Number of patients = 102). When compared with aminoglycoside-sparing therapies, aminoglycoside-containing therapies had positive significant outcomes on both mortality and microbiological success rates.Conclusion: New effective therapies are urgently needed to help fight infections caused by this organism. The effective use of various therapeutic options and the strict implementation of infection control measures are of utmost importance in order to prevent infections caused by CpKP. Strict national or international implementation of infection control measures and treatment guidelines will help improve healthcare, and equip governments and communities to respond to and prevent the spread of infectious diseases caused by CpKP.

Relationship between the Prevalence of Methicillin-ResistantStaphylococcus aureusInfection and Indicators of Nosocomial Infection Control Measures A Population-Based Study in French Hospitals

2009 ◽  
Vol 30 (9) ◽  
pp. 861-869 ◽  
Author(s):  
Leslie Grammatico-Guillon ◽  
Jean-Michel Thiolet ◽  
Pascale Bernillon ◽  
Bruno Coignard ◽  
Babak Khoshnood ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Population Based ◽  
Mean Value ◽  
Control Measures ◽  
Prevalence Survey ◽  
Infection Control Measures ◽  
Mrsa Infection ◽  
The Mean ◽  
National Prevalence

Objective.To assess whether infection control indicators are associated with the prevalence of methicillin-resistantStaphylococcus aureus(MRSA) infection in French hospitals.Methods.We linked the database for the 2006 national prevalence survey of nosocomial infection with the database of infection control indicators (comprised of ICALIN, an indicator of infection control organization, resources, and action, and ICSHA, an indicator of alcohol-based handrub consumption) recorded from hospitals by the Ministry of Health. Data on MRSA infection were obtained from the national prevalence survey database and included the site and origin of infection, the microorganism responsible, and its drug resistance profile. Because the prevalence of MRSA infection was low and often nil, especially in small hospitals, we restricted our analysis to hospitals with at least 300 Patients. We used a multilevel logistic regression model to assess the joint effects of patient-level variables (eg, age, sex, or infection) and hospital-level variables (infection control indicators).Results.Two hundred two hospitals had at least 300 patients, for a total of 128,631 Patients. The overall prevalence of MRSA infection was 0.34% (95% confidence interval [CI], 0.29%-0.39%). The mean value for ICSHA was 7.8 L per 1,000 patient-days (median, 6.1 L per 1,000 patient-days; range, 0-33 L per 1,000 patient-days). The mean value for ICALIN was 92 of a possible 100 points (median, 94.5;range, 67-100). Multilevel analyses showed that ICALIN scores were associated with the prevalence of MRSA infection (odds ratio for a score change of 1 standard deviation, 0.80;95% CI, 0.69-0.93). We found no association between prevalence of MRSA infection and ICSHA. Other variables significantly associated with the prevalence of MRSA infection were sex, vascular or urinary catheter, previous surgery, and the McCabe score.Conclusions.We found a significant association between the prevalence of MRSA infection and ICALIN that suggested that a higher ICALIN score may be predictive of a lower prevalence of MRSA infection.

scholarly journals The Prevalence, Risk, and Management of Methicillin-Resistant Staphylococcus aureus Infection in Diverse Populations across Canada: A Systematic Review

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 393 ◽  
Author(s):  
Elena Mitevska ◽  
Britney Wong ◽  
Bas G. J. Surewaard ◽  
Craig N. Jenne
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Control Measures ◽  
Diverse Populations ◽  
Methicillin Resistant ◽  
Infection Control Measures ◽  
Mrsa Infection

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged after methicillin was introduced to combat penicillin resistance, and its prevalence in Canada has increased since the first MRSA outbreak in the early 1980s. We reviewed the existing literature on MRSA prevalence in Canada over time and in diverse populations across the country. MRSA prevalence increased steadily in the 1990s and 2000s and remains a public health concern in Canada, especially among vulnerable populations, such as rural, remote, and Indigenous communities. Antibiotic resistance patterns and risk factors for MRSA infection were also reported. All studies reported high susceptibility (>85%) to trimethoprim-sulfamethoxazole, with no significant resistance reported for vancomycin, linezolid, or rifampin. While MRSA continues to have susceptibility to several antibiotics, the high and sometimes variable resistance rates to other drugs underscores the importance of antimicrobial stewardship. Risk factors for high MRSA infection rates related to infection control measures, low socioeconomic status, and personal demographic characteristics were also reported. Additional surveillance, infection control measures, enhanced anti-microbial stewardship, and community education programs are necessary to decrease MRSA prevalence and minimize the public health risk posed by this pathogen.

scholarly journals Infection Control Measures in Dental Clinics during Coronavirus Disease-19 Pandemic in Kingdom of Saudi Arabia: A Pilot Study

2021 ◽  
Vol 9 (D) ◽  
pp. 61-67
Author(s):  
Rawa Kamal Abdelrahim ◽  
Husham Abu Elgasim Abdoun ◽  
Pradeep Koppolu ◽  
Lingam Amara Swapna
Keyword(s):  
Saudi Arabia ◽  
Infection Control ◽  
Control Measures ◽  
Categorical Variables ◽  
Prevention Measures ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Infection Control Measures ◽  
Dental Clinics ◽  
Number Of Patients

BACKGROUND: Coronavirus disease (COVID)-19 is an infectious respiratory disease causing different symptoms ranging from mild to more complicated cases. In dental clinics, there is a potential risk of cross-infection between dental health worker and patients. Therefore, new infection prevention measures have been recommended to minimize spread of COVID-19 in dental clinics. AIM: The aim of this study is to get an insight into the infection control measures followed by dentists and modification done in personal protective equipment (PPE) to combat spread of infection during COVID-19 in Kingdom of Saudi Arabia. METHODS: A cross-sectional data using online Google survey. The sample included dentists working in either private or government from different regions in Kingdom of Saudi Arabia. Chi-square test was used to investigate the association between categorical variables (p < 0.05) RESULTS: Seventy dentists included in the study of which 40% are working in Riyadh. Dental clinics are undertaken respiratory triage and reduce number of patients in waiting area (91% and 98%, respectively). Increased usage of PPE (head cap, face shield, and N95 mask) during the pandemic was observed in the study sample (p = 0.001). Working hours and number of patients were reduced during COVID-19. CONCLUSION: Evidence shows that majority of dentists working in KSA are following recommended measures to minimize the spread of COVID-19. Some dentists modified their PPE during the pandemic. However, further research is required to investigate adherence to infection control measures by dentists.

scholarly journals Infection Control Measures in Pakistani Dental Practices During COVID-19 Outbreak

2021 ◽  
Vol 30 (03) ◽  
pp. 152-156
Author(s):  
Yashfika Abdul Bari ◽  
◽  
Syeda Maliha Waqar ◽  
Saqif Nasir ◽  
Kamil Zafar ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Cross Sectional ◽  
Web Based ◽  
Infection Control Measures ◽  
Number Of Patients ◽  
Dental Practitioners ◽  
Dental Practices ◽  
Single Use ◽  
Study Participants

OBJECTIVE: The objective of this study is to assess infection control measures in dental practices during COVID-19 outbreak in Pakistan. METHODOLOGY: It was a cross-sectional web based survey conducted during COVID-19 outbreak from the period of June 2020 to August 2020. The study participants were the dental surgeons who were either working in hospital setup or running their own private practice or working in private dental setup. The survey consisted of sets of questions to assess whether dental practitioners have implemented strategies to combat novel corona virus infection in their practice. It also consists of questions that assess aerosol generating procedures are commencing with or without out any COVID-19 symptoms. RESULTS: About 39.1% participants reported that 75% of the number of patients in their clinic had been reduced and 52.2% of the participants reported that >50% of the patients came for endodontic procedures with pain. Eighty one percent of the participants were maintaining hand hygiene before touching all patients, 71.7% before any cleaning, 78.3% before any aseptic procedure, 81% after exposure to patient’s fluid and 80.4% after touching. There was low compliance regarding the use of personal protective equipment and almost 62.6% were using eye wear for all patients, 58.7% were disinfecting whole clinical room before new patient and 43.9% were using single use (disposable) examination set during COVID-19 outbreak. CONCLUSION: Majority of dentist in Pakistan were following the recommendations and guidelines of infection control practices related to COVID-19 pandemic. KEYWORDS: COVID-19, coronavirus, infection control measures, practices, dentistry

The emergence of multidrug-resistantKlebsiella pneumoniaeof international clones ST13, ST16, ST35, ST48 and ST101 in a teaching hospital in the Paris region

2012 ◽  
Vol 141 (8) ◽  
pp. 1705-1712 ◽  
Author(s):  
G. MARCADE ◽  
S. BRISSE ◽  
S. BIALEK ◽  
E. MARCON ◽  
V. LEFLON-GUIBOUT ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Teaching Hospital ◽  
Sequence Type ◽  
Control Measures ◽  
Incidence Density ◽  
Spatial Relationships ◽  
Cross Contamination ◽  
Infection Control Measures ◽  
Paris Region

SUMMARYDespite infection control measures, an important increase in the extended-spectrum β-lactamase (ESBL)-producingKlebsiella pneumoniaeincidence density occurred in our hospital from 2006 onwards. This study, focusing on the 2005–2007 period, was performed in an attempt to explain this increase. ESBLs were characterized, isolates were typed by ERIC2-PCR, and sequence type (ST) of clustered isolates was determined. Temporal-spatial relationships of patients were analysed to assess possible cross-contamination. Of the 74 ESBL-producing isolates, 30 (40%) were detected at admission, 53 (71·5%) produced CTX-M enzymes, 40 displayed unique ERIC2-PCR profiles and 34 were assigned into six clusters: ST16 (n = 21), ST101, ST48, ST35, ST13, and ST436. Relationships were identified in 22 of the 34 patients harbouring clustered isolates. This study highlights the complex epidemiology of ESBL-producingK. pneumoniaein the mid-2000s with potential cross-contamination for only 30% of the 74 patients in our hospital, and the emergence of clones that are currently spreading worldwide.

Success of an Infection Control Program to Reduce the Spread of Carbapenem-Resistant Klebsiella pneumoniae

2009 ◽  
Vol 30 (5) ◽  
pp. 447-452 ◽  
Author(s):  
Sandeep Kochar ◽  
Timothy Sheard ◽  
Roopali Sharma ◽  
Alan Hui ◽  
Elaine Tolentino ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Infection Control ◽  
Control Program ◽  
Control Measures ◽  
Infection Control Program ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
The Mean ◽  
Vancomycin Resistant

Objective.To assess the effect of enhanced infection control measures with screening for gastrointestinal colonization on limiting the spread of carbapenem-resistant Klebsiella pneumoniae in a New York City hospital endemic for this pathogen.Design.Retrospective observational study with pre- and postinterventional phases.Methods.Beginning in 2006, a comprehensive infection control program was instituted in a 10-bed medical and surgical intensive care unit at a university-based medical center. In addition to being placed in contact isolation, all patients colonized or infected with carbapenem-resistant gram-negative bacilli, vancomycin-resistant Enterococcus, or methicillin-resistant Staphylococcus aureus were cohorted to one end of the unit. Improved decontamination of hands and environmental surfaces was encouraged. In addition, routine rectal surveillance cultures were screened for the presence of carbapenem-resistant pathogens. The number of patients per quarter with clinical cultures positive for carbapenem-resistant K. pneumoniae was compared during the approximately 2-year periods before and after the intervention.Results.The mean number ( ± SD) of new patients per 1,000 patient-days per quarter with cultures yielding carbapenem-resistant K. pneumoniae decreased from 9.7 ± 2.2 before the intervention to 3.7 ± 1.6 after the intervention (P< .001 ). There was no change in the mean number of patient-days or the mean number of patients per quarter with cultures yielding methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, or carbapenem-resistant Acinetobacter baumannii or Pseudomonas aeruginosa after the intervention. There was no association between antibiotic usage patterns and carbapenem-resistant K. pneumoniae.Conclusions.The comprehensive intervention that combined intensified infection control measures with routine rectal surveillance cultures was helpful in reducing the incidence of carbapenem-resistant K. pneumoniae in an intensive care unit where strains producing the carbapenemase KPC were endemic.

scholarly journals Born in Wuhan: lessons from COVID-19 epidemic in China

2020 ◽  
Vol 10 (2) ◽  
pp. 210-220 ◽  
Author(s):  
A. V. Semenov ◽  
N. Yu. Pshenichnaya
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Tracking System ◽  
Control Measures ◽  
Vulnerable Groups ◽  
Epidemic Curve ◽  
Infection Control Measures ◽  
Number Of Patients ◽  
The Government ◽  
Socially Vulnerable Groups

The COVID-19 epidemic curve in China can be divided into several stages. Despite transparency in informing the world public about clusters of undiagnosed viral pneumonia, the country’s health care at the first stage of the epidemic was not ready to provide adequate and rapid response for a fast increase in the number of patients with COVID-19, infection control measures were not fully implemented, which also led to a large number of nosocomial cases of infection among medical workers and patients. Socially vulnerable groups of the population did not refer for medical assistance in a timely manner due to the lack of the disease danger understanding and also in connection with the high cost for them of medical aid. At the second stage, simultaneously with the restrictive measures introduced by the government, the entire health care system was rebooted: free medical care for patients with COVID-19 was provided and the strictest infection control measures were implemented, multi-level contact tracking system using IT technologies was organized, and the capacity of hospitals was increased many times. Through the joint efforts of ministries, mass media, social networks and volunteer movements, an unprecedented social mobilization of the population was achieved. Strict implementation of the entire set of measures aimed at fighting the epidemic allowed to take it under strict control at the third stage and practically eliminate the epidemic after 2,5 months. China’s response to the COVID-19 epidemic can be useful to other countries, in fighting the current pandemic and in preparing for a response to biological threats in the future.

Sign in / Sign up

Export Citation Format

Share Document