Persistence of Skin Contamination and Environmental Shedding ofClostridium difficileduring and after Treatment of C.difficileInfection

2010 ◽  
Vol 31 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Ajay K. Sethi ◽  
Wafa N. Al-Nassir ◽  
Michelle M. Nerandzic ◽  
Greg S. Bobulsky ◽  
Curtis J. Donskey
Keyword(s):  
Control Measures ◽  
Limited Information ◽  
Environmental Isolates ◽  
Contact Precautions ◽  
Infection Control Measures ◽  
End Of Treatment ◽  
Skin Contamination ◽  
Stool Samples ◽  
Polymerase Chain ◽  
Current Guidelines

Background.Current guidelines for control ofClostridium difficileinfection (CDI) suggest that contact precautions be discontinued after diarrhea resolves. However, limited information is available regarding the frequency of skin contamination and environmental shedding ofC. difficileduring and after treatment.Design.We conducted a 9-month prospective, observational study involving 52 patients receiving therapy for CDI. Stool samples, skin (chest and abdomen) samples, and samples from environmental sites were cultured forC. difficilebefore, during, and after treatment. Polymerase chain reaction ribotyping was performed to determine the relatedness of stool, skin, and environmental isolates.Results.Fifty-two patients with CDI were studied.C. difficilewas suppressed to undetectable levels in stool samples from most patients during treatment; however, 1-4 weeks after treatment, 56% of patients who had samples tested were asymptomatic carriers ofC. difficile.The frequencies of skin contamination and environmental shedding remained high at the time of resolution of diarrhea (60% and 37%, respectively), were lower at the end of treatment (32% and 14%, respectively), and again increased 1-4 weeks after treatment (58% and 50%, respectively). Skin and environmental contamination after treatment was associated with use of antibiotics for non-CDI indications. Ninety-four percent of skin isolates and 82% of environmental isolates were genetically identical to concurrent stool isolates.Conclusions.Skin contamination and environmental shedding ofC. difficileoften persist at the time of resolution of diarrhea, and recurrent shedding is common 1-4 weeks after therapy. These results provide support for the recommendation that contact precautions be continued until hospital discharge if rates of CDI remain high despite implementation of standard infection-control measures.

scholarly journals Fecal carriage of extended-spectrum β-lactamase- and AmpC- producing Escherichia coli among healthcare workers

2015 ◽  
Vol 9 (03) ◽  
pp. 304-308 ◽  
Author(s):  
Rasha H. Bassyouni ◽  
Sylvana Nady Gaber ◽  
Ahmed Ashraf Wegdan
Keyword(s):  
Healthcare Workers ◽  
Control Measures ◽  
Carriage Rate ◽  
E Coli ◽  
Infection Control Measures ◽  
Fecal Carriage ◽  
Extended Spectrum ◽  
Stool Samples ◽  
Polymerase Chain ◽  
Concentration Methods

Introduction: Commensal E. coli can be considered a reservoir of genes coding for antibiotic resistance that may be transmitted in hospitals by healthcare workers (HCWs). This study aimed to determine the fecal carriage rate of extended-spectrum β-lactamase (ESBL)-producing E. coli among HCWs. Methodology: Stool samples were collected from 200 HCWs. Phenotypic screening for ESBL and AmpC β-lactamases was performed using disk diffusion and minimum inhibitory concentration methods followed by the combined disks test and double synergy differential test for confirmation. Multiplex polymerase chain reaction (PCR) was used to detect blaSHV, blaTEM, blaCTX-M, and CIT groups for AmpC genes. Results: Of 200 E. coli isolates, 100% were susceptible to imipenem, and 59 (29.5%) were resistant to one or more third-generation cephalosporins. By molecular analysis, 21% (42/200) were colonized by ESBL-producing E. coli, and 3% (6/200) were colonized by AmpC-producing E. coli. The blaSHV gene was the predominant ESBL gene, detected in 81.8% of the resistant E. coli isolates. Conclusions: These findings highlight the increase in fecal carriage of E. coli carrying ESBL and AmpC genes among HCWs, which may be one of the causes of the spread of ESBL-producing bacteria in hospitals and requires sound infection control measures. This is the first study of the fecal carriage rate of E. coli carrying AmpC genes in HCWs.

scholarly journals Seroprevalence of SARS-CoV-2 Antibodies Among Health Care Personnel at a Health Care System in Pakistan

2021 ◽  
pp. 101053952110110
Author(s):  
Salma Abbas ◽  
Aun Raza ◽  
Ayesha Iftikhar ◽  
Aamir Khan ◽  
Shahzaib Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Control Measures ◽  
Health Care Personnel ◽  
Test Results ◽  
Antibody Testing ◽  
Chain Reaction ◽  
Past Infection ◽  
Infection Control Measures ◽  
History Of ◽  
Polymerase Chain

Health care personnel (HCP) are at high risk for coronavirus disease-2019 acquisition. Serum antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicate past infection. Our institution offered SARS-CoV-2 antibody testing to HCP. We surveyed HCP with positive test results to explore past exposure to SARS-CoV-2, details of symptoms during the preceding 6 months, and a history of SARS-CoV-2 polymerase chain reaction testing. A total of 2162 HCP underwent antibody testing. Eight hundred fifty-seven (39.6%) employees tested positive and, of these, 820 (95.7%) participated in the survey. When adjusted for age, males had higher odds of testing positive for SARS-CoV-2 antibodies compared with females (OR = 1.68; 95% CI = 1.37-2.05; P = .00) and clinical staff had higher odds of SARS-CoV-2 seropositivity compared with nonclinical staff (OR = 1.273; 95% CI = 1.06-1.53; P = .01). Implementation of effective infection control measures is essential to protect HCP from coronavirus disease-2019.

scholarly journals Multiplex lateral flow immunochromatographic assay is an effective method to detect carbapenemases without risk of OXA-48-like cross reactivity

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hadas Kon ◽  
Shirin Abramov ◽  
Sammy Frenk ◽  
David Schwartz ◽  
Ohad Shalom ◽  
...  
Keyword(s):  
Gold Standard ◽  
Clinical Microbiology ◽  
Cross Reactivity ◽  
Control Measures ◽  
Chain Reaction ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Highly Sensitive ◽  
Polymerase Chain ◽  
The Cross

Abstract Background It is essential to detect carriers of carbapenemase-producing Enterobacterales in order to implement infection control measures. The objectives of this study was to evaluate the NG-Test® CARBA 5 (CARBA 5) assay for detection of five carbapenemases and to assess the cross reactivity of other OXA-type carbapenemases with the OXA-48-like specific antibodies. Methods A total of 197 Enterobacterales isolates were tested. To evaluate the cross reactivity, 73 carbapenem-resistant A. baumannii, harboring OXA-type variants, were tested. Polymerase chain reaction (PCR) served as gold standard for carbapenemase identification. Results Excellent agreement was found between PCR and CARBA 5, for all but one isolate. The single false positive result (a blaSME positive S. marcescens isolate) was incorrectly positive for blaOXA-48 by CARBA 5. No cross reactivity was observed. The sensitivity and specificity were 100.0% and 98.0%, respectively. Conclusions The CARBA 5 assay is highly sensitive and specific and is recommended as a tool for the detection of the main carbapenemases of interest in clinical microbiology laboratories.

scholarly journals Molecular Identification of Fusarium Species Recovered from Hospital Environment in Jos, Nigeria

2020 ◽  
pp. 303-308
Author(s):  
GE Kim ◽  
MO Okolo ◽  
UC Essien ◽  
UE Umeh ◽  
CC Iheukwumere
Keyword(s):  
Fusarium Species ◽  
Health Care Facilities ◽  
Control Measures ◽  
Hospital Environment ◽  
Chain Reaction ◽  
Opportunistic Fungi ◽  
Infection Control Measures ◽  
Hospital Environments ◽  
Care Facilities ◽  
Polymerase Chain

Fusariums pecies are opportunistic fungi that play an important role in nosocomial infection. The reservoir of Fusarium species in the hospital is not well understood in our environment. Therefore, the present study sought to identify the reservoir of Fusarium species in hospital environment. Three hundred and sixty (360) samples were collected from the environment of two tertiary health care facilities A and B. The sample consists of water (120), soil (120) and plants (120) which were sourced from hospital environments. Cultures of these samples were performed and polymerase chain reaction was used to confirm Fusarium species. The most predominant specie was Fusarium oxysporum Hospital A:(57.3%) and Hospital B:(64.4%). Most of the Fusarium isolates (76.7%) were recovered from soil samples, followed by water (45.0%) and the least were from plants (30.8%). In conclusion the present study has demonstrated that hospital environment is a reservoir for Fusarium species. However, identification of such reservoir would further enhance effective infection control measures.

Investigation of a Nosocomial Outbreak Due toSerratia marcescensin a Maternity Hospital

1999 ◽  
Vol 20 (4) ◽  
pp. 233-236 ◽  
Author(s):  
Philippe Berthelot ◽  
Florence Grattard ◽  
Colette Amerger ◽  
Marie-Claude Frery ◽  
Frédéric Lucht ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
Maternity Hospital ◽  
Neonatal Unit ◽  
Control Measures ◽  
Feed Additive ◽  
Chain Reaction ◽  
Infection Control Measures ◽  
Polymerase Chain ◽  
Delivery Rooms

AbstractObjectives:To investigate an outbreak ofSerratia marcescensin a maternity hospital (November 1994 to May 1995).Design:Retrospective analysis of epidemiological data and prospective study of systematic bacteriological samples from patients and environment, with genotyping of strains by arbitrarily primed polymerase chain reaction.Setting:A private maternity hospital, Saint-Etienne, France.Results:In the neonatal unit, 1 newborn developed a bacteremia, and 36 were colonized in stools with Smarcescens.As the colonization of some newborns was shown to occur only a few hours after delivery, the inquiry was extended to other maternity wards, where 8 babies and 4 mothers were found to be colonized. Environmental sampling led to the isolation of Smarcescensfrom a bottle of enteral feed additive in the neonatal unit and from the transducers of two internal tocographs in the delivery rooms. The genotyping of 27 strains showed two different profiles: a major epidemic profile shared by 22 strains (18 from babies of the neonatal unit, 2 from babies of other units, and 2 from breast milk) and another profile shared by 5 strains (2 from transducers of internal tocographs, 2 from babies, and 1 from a mother). The strain isolated from lipid enteral feeding was not available for typing. Although this source of contamination was removed soon from the neonatal unit, the outbreak stopped only when infection control measures were reinforced in the delivery rooms, including the nonreuse of internal tocographs.Conclusions:In delivery rooms, the quality of hygiene needs to be as high as in surgery rooms to prevent nosocomial colonization or infection of neonates at birth.

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 Controle de infecções a pacientes em precaução de contato

2019 ◽  
Vol 13 (4) ◽  
pp. 1081
Author(s):  
Fabiane Estevão Barros ◽  
Enedina Soares ◽  
Maria Luiza Oliveira Teixeira ◽  
Elen Martins da Silva Castelo Branco
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Contact Precaution ◽  
Care Hospital ◽  
Contact Precautions ◽  
Infection Control Measures ◽  
The Face ◽  
Qualitative Descriptive ◽  
Precautionary Measures ◽  
Definition Of

RESUMO Objetivo: descrever o conhecimento do enfermeiro sobre as medidas de precaução de contato. Método: trata-se de um estudo qualitativo, descritivo realizado com 15 enfermeiros que atuam em uma unidade de internação de um instituto hematológico público. Empregaram-se um questionário e um roteiro semiestruturado, Análise de Conteúdo e construção de eixos temáticos. Resultados: emergiram-se dois eixos temáticos: Definição das medidas de precaução de contato e suas indicações e Medidas de controle de Infecções Relacionadas a Assistência à Saúde diante da precaução de contato. Conclusão: evidenciaram-se lacunas no conhecimento dos participantes acerca da implementação das medidas de controle de infecções diante da precaução de contato, principalmente quanto ao uso da paramentação e higienização das mãos. Verificaram-se equívocos quanto aos momentos em que se deve adotar as medidas de precaução de contato. Descritores: Controle de Infecções; Cuidados de Enfermagem; Infecção Hospitalar; Unidades de Internação; Precaução; Enfermagem.ABSTRACTObjective: to describe nurses' knowledge about contact precaution measures. Method: this is a qualitative, descriptive study carried out with 15 nurses who work in an inpatient unit of a public haematological institute. A questionnaire and a semi-structured script, Content Analysis and construction of thematic axes were used. Results: two thematic axes emerged: Definition of contact precautionary measures and their indications and Measures of control of Health Care Related Infections in the face of contact precaution. Conclusion: there were gaps in participants' knowledge about the implementation of infection control measures in face of contact precautions, mainly regarding the use of hand hygiene and hygiene. There were misconceptions as to the moments in which the precautionary measures of contact should be adopted. Descriptors: Infection Control; Nursing care; Hospital Infection; Inpatient Units; Precaution; Nursing.RESUMEN Objetivo: describir el conocimiento del enfermero sobre las medidas de precaución de contacto. Método: se trata de un estudio cualitativo, descriptivo realizado con 15 enfermeros que actúan en una unidad de internación de un instituto hematológico público. Se emplearon un cuestionario y un itinerario semiestructurado, Análisis de Contenido y construcción de ejes temáticos. Resultados: surgieron dos ejes temáticos: Definición de las medidas de precaución de contacto y sus indicaciones y Medidas de control de Infecciones Relacionadas a Asistencia a la Salud ante la precaución de contacto. Conclusión: se evidenció lagunas en el conocimiento de los participantes acerca de la implementación de las medidas de control de infecciones ante la precaución de contacto, principalmente en cuanto al uso de la paramentación e higienización de las manos. Se verificaron equívocos en cuanto a los momentos en que se deben adoptar las medidas de precaución de contacto. Descriptores: Control de Infecciones; Atención de Enfermería; Infección Hospitalaria; Unidades de Internación; Precaución; Enfermería.

scholarly journals Prevalence of qnr Genes among Multidrug Resistance Staphylococcus aureus from Clinical Isolates

2019 ◽  
pp. 1-10
Author(s):  
Abdulrasheed B. Abdu ◽  
Tattfeng Y. Mirabeau
Keyword(s):  
Staphylococcus Aureus ◽  
Low Frequency ◽  
Control Measures ◽  
Clinical Isolates ◽  
Resistance Pattern ◽  
Infection Control Measures ◽  
Study Results ◽  
Polymerase Chain ◽  
High Level ◽  
Human Infections

Objectives: Staphylococcus aureus (S. aureus) is regarded as an important aetiological agent of various human infections. Fluoroquinolones are routinely used in the chemotherapeutic management of these infections; nonetheless, in recent years, a growing rate of resistance to these drugs has been reported worldwide. The aims of this study were to isolate and discover the prevalence of plasmid-mediated (qnrA, qnrB, and qnrS) genes among the quinolone-resistant clinical S. aureus isolates in Bayelsa State, Nigeria. Methods: A total of 25 (31.25%) clinical isolates of S. aureus were collected from hospitalized patients. The bacterial isolates were identified through standard laboratory protocols and further confirmed using the API Staph system (bioMérieux, France) test strips. The antimicrobial susceptibility and minimum inhibitory concentration (MIC) were determined by the standard disk diffusion and serial dilutions methods respectively. Polymerase chain reaction (PCR) was used for detecting qnrA, qnrB, and qnrS genes. Results: Of the 25 S. aureus isolates, 19(76.00%) were resistant to ampicillin-cloxacillin, while 14 (56.00%) each were resistant to norfloxacin and Amoxicillin, 13 (52.00%) each to gentamicin and erythromycin, 11 (44.00%) were resistant to streptomycin, rifampicin and ciprofloxacin, respectively. The resistance pattern among the isolates to chloramphenicol and levofloxacin were 10 (40.00%) and 7 (28.00%) respectively. All the eleven ciprofloxacin resistant were high-level (1000 µg/mL) resistance isolates and only one (9.00%) of these isolates was positive for the qnrB gene. Conclusion: The study results were indicative of the presence of low frequency of qnr genes among the clinical isolates of S. aureus in Yenagoa, indicating that other mechanisms are employed in resisting to these fluoroquinolones. This, however, emphasizes the need for establishing discreet policies associated with infection-control measures in hospital settings.

scholarly journals Co-Occurrence of Plasmid-Mediated AmpC β-Lactamase Activity Among Klebsiella pneumoniae and Escherichia Coli

2017 ◽  
Vol 11 (1) ◽  
pp. 195-202 ◽  
Author(s):  
Abdulaziz Zorgani ◽  
Hiyam Daw ◽  
Najib Sufya ◽  
Abdullah Bashein ◽  
Omar Elahmer ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Gene Encoding ◽  
E Coli ◽  
Infection Control Measures ◽  
Genes Encoding ◽  
Polymerase Chain ◽  
Variant Enzyme

Introduction: Extended-spectrum β-lactamases (ESBLs), including the AmpC type, are important mechanisms of resistance among Klebsiella pneumoniae and Escherichia coli isolates. Objective: The aim of the study was to investigate the occurrence of AmpC-type β-lactamase producers isolated from two hospitals in Tripoli, Libya. Methods: All clinical isolates (76 K. pneumoniae and 75 E. coli) collected over two years (2013-2014) were evaluated for susceptibility to a panel of antimicrobials and were analyzed phenotypically for the ESBL and AmpC phenotype using E-test and ESBL and AmpC screen disc test. Both ESBL and AmpC-positive isolates were then screened for the presence of genes encoding plasmid-mediated AmpC β-lactamases by polymerase chain reaction (PCR). Results: Of the K. pneumoniae and E. coli tested, 75% and 16% were resistant to gentamicin, 74% and 1.3% to imipenem, 71% and 12% to cefoxitin, 80% and 12% to cefepime, 69% and 22.6% to ciprofloxacin, respectively. None of the E. coli isolates were multidrug resistant compared with K. pneumoniae (65.8%). K. pneumoniae ESBL producers were significantly higher (85.5%) compared with (17.3%) E. coli isolates (P <0.0001, OR=4.93). Plasmid-mediated AmpC genes were detected in 7.9% of K. pneumoniae, and 4% E. coli isolates. There was low agreement between phenotypic and genotypic methods, phenotypic testing underestimated detection of AmpC enzyme and did not correlate well with molecular results. The gene encoding CMY enzyme was the most prevalent (66.6%) of AmpC positive isolates followed by MOX, DHA and EBC. Only one AmpC gene was detected in 5/9 isolates, i.e, blaCMY (n=3), bla MOX (n=1), blaDHA (n=1). However, co-occurrence of AmpC genes were evident in 3/9 isolates with the following distribution: bla CMY and blaEBC (n=1), and blaCMY and blaMOX (n=2). Neither blaFOX nor blaACC was detected in all tested isolates. All AmpC positive strains were resistant to cefoxitin and isolated from patients admitted to intensive care units. Conclusion: Further studies are needed for detection of other AmpC variant enzyme production among such isolates. Continued surveillance and judicious antibiotic usage together with the implementation of efficient infection control measures are absolutely required.

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