Frequency of Contamination of Single-Patient-Use Nebulizers Over Time

2014 ◽  
Vol 35 (12) ◽  
pp. 1543-1546 ◽  
Author(s):  
David J. Weber ◽  
Maria F. Gergen ◽  
Emily E. Sickbert-Bennett ◽  
Kathleen A. Short ◽  
Kendra E. Lanza-Kaduce ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Hospitalized Patients ◽  
Infect Control Hosp ◽  
Single Patient ◽  
Colony Forming Units ◽  
Patient Use ◽  
Over Time

Adult hospitalized patients with cystic fibrosis commonly receive nebulized medications. For single-patient-use nebulizers that are cleaned after each use, there is infrequent nebulizer contamination (0%–11%) with only low numbers of epidemiologically important pathogens (less than 100 colony-forming units), and this contamination is similar after 24, 48, and 72 hours of use.Infect Control Hosp Epidemiol 2014;35(12):1553–1546

Association Between Storage Interval and Contamination of Reprocessed Flexible Endoscopes in a Pediatric Gastrointestinal Procedural Unit

2016 ◽  
Vol 38 (2) ◽  
pp. 131-135 ◽  
Author(s):  
Patricia Scanlon ◽  
Kathleen Flaherty ◽  
Erik A. Reilly ◽  
Ellen G. Barth ◽  
Gail Potter-Bynoe ◽  
...  
Keyword(s):  
Phase 1 ◽  
Infect Control Hosp ◽  
Phase 2 ◽  
Safe Storage ◽  
Colony Forming Units ◽  
Skin Flora ◽  
Hand Piece ◽  
Patient Use ◽  
Insertion Tube

OBJECTIVEThe maximum safe storage interval after endoscope reprocessing remains unknown. We assessed the association between storage interval and endoscope contamination to evaluate the need for scope reprocessing prior to use.METHODSWe conducted a study in 2 phases. In phase 1, we cultured 9 gastrointestinal (GI) endoscopes that had been stored for at least 7 days since reprocessing. Each scope was cultured in 3 places: external surfaces of hand piece, insertion tube, and internal channels. In phase 2, after reprocessing these scopes, we hung and cultured them prospectively in a similar fashion at 1-, 2-, 4-, 6-, and 8-week intervals without patient use. We defined clinically relevant contamination as >100 colony-forming units per milliliter (CFU/mL).RESULTSIn phase 1, median hang time was 69 days (range, 8–555 days). Considering the 27 total cultures, 3 of 27 GI endoscopes (11.1%) had positive cultures, all with nonpathogenic skin flora at ≤100 CFU/mL. Median hang time was not statistically different between scopes with positive and negative cultures (P=.82). In phase 2, 7 of 131 prospective cultures (5.3%) from 6 of 9 GI endoscopes at varying storage intervals were positive, all at ≤100 CFU/mL. At 56 days after reprocessing (the longest storage interval studied), 1 of 24 cultures (4.2%) was positive (100 CFU/mL ofBacillusspecies from external biopsy/suction ports).CONCLUSIONSNo endoscopes demonstrated clinically relevant contamination at hang times ranging from 7 to 555 days, and most scopes remained uncontaminated up to 56 days after reprocessing. Our data suggest that properly cleaned and disinfected GI endoscopes could be stored safely for longer intervals than currently recommended.Infect. Control Hosp. Epidemiol.2017;38:131–135

Assessment of Clostridium difficile Burden in Patients Over Time With First Episode Infection Following Fidaxomicin or Vancomycin

2015 ◽  
Vol 37 (2) ◽  
pp. 215-218 ◽  
Author(s):  
Seth T. Housman ◽  
Abrar K. Thabit ◽  
Joseph L. Kuti ◽  
Richard Quintiliani ◽  
David P. Nicolau
Keyword(s):  
Clostridium Difficile ◽  
Clinical Response ◽  
Infect Control Hosp ◽  
First Episode ◽  
Colony Forming Units ◽  
Over Time

In patients with first episode Clostridium difficile infection treated with vancomycin or fidaxomicin, more patients receiving fidaxomicin achieved at least 2 log10 colony-forming units/g reduction in spores at the follow-up visit (P=.02). Similar to published literature, a higher proportion of patients receiving fidaxomicin demonstrated sustained clinical response.Infect. Control Hosp. Epidemiol. 2016;37(2):215–218

Assessment of a Mandatory Tetanus, Diphtheria, and Pertussis Vaccination Requirement on Vaccine Uptake over Time

2012 ◽  
Vol 33 (1) ◽  
pp. 81-83 ◽  
Author(s):  
David J. Weber ◽  
Stephanie A. Consoli ◽  
Emily Sickbert-Bennett ◽  
William A. Rutala
Keyword(s):  
Patient Care ◽  
Infect Control Hosp ◽  
Vaccine Uptake ◽  
University Hospital ◽  
Healthcare Personnel ◽  
Direct Patient Care ◽  
Tdap Vaccine ◽  
Newly Hired ◽  
Termination Date ◽  
Over Time

Tetanus, diphtheria, and pertussis (Tdap) vaccine is recommended for all healthcare personnel who provide direct patient care unless medically contraindicated. Our university hospital made employment conditional upon receipt of Tdap vaccine. Implementation for newly hired employees quickly resulted in complete compliance, but achieving adherence among current workers required setting a termination date for noncompliance.Infect Control Hosp Epidemiol 2012;33(1):81-83

scholarly journals Change in Pseudomonas aeruginosa prevalence in cystic fibrosis adults over time

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Mathew R. Crull ◽  
Kathleen J. Ramos ◽  
Ellen Caldwell ◽  
Nicole Mayer-Hamblett ◽  
Moira L. Aitken ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Over Time

scholarly journals Natural history of glucose tolerance, beta-cell function and peripheral insulin sensitivity in cystic fibrosis patients with fasting euglycemia

2003 ◽  
Vol 149 (1) ◽  
pp. 53-59 ◽  
Author(s):  
F Lombardo ◽  
F De Luca ◽  
M Rosano ◽  
C Sferlazzas ◽  
C Lucanto ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Insulin Sensitivity ◽  
Natural History ◽  
Glucose Tolerance ◽  
Pancreatic Beta Cells ◽  
Cell Function ◽  
Glucose Levels ◽  
Peripheral Insulin Resistance ◽  
History Of ◽  
Over Time

OBJECTIVE: The loss of pancreatic beta-cells is thought to be one of the principal causes of diabetes mellitus (DM) in cystic fibrosis (CF), but the role of peripheral insulin resistance (IR) in the pathogenesis of DM in CF remains unclear. The aim of this study was to evaluate whether eventual changes of glucose tolerance (GT) over time were associated with modifications of insulin secretion or sensitivity. METHODS: Plasma glucose and insulin responses to an oral GT test (OGTT) were investigated and reinvestigated 13 Years later in 14 CF patients with initial and persistent fasting euglycemia and no history of insulin treatment. Insulin sensitivity (IS) at both tests was assessed on the basis of insulin and glucose levels both in the fasting state and during OGTTs. RESULTS: From the 1st to the 2nd OGTT: (a) the prevalence of DM responses significantly increased; (b) the areas beneath the respective glucose and insulin curves significantly increased and decreased respectively; (c) IR and IS indices decreased and increased respectively, even in the patients who developed DM; (d) pulmonary function significantly worsened in the entire series, especially in the patients who developed DM. CONCLUSIONS: (i) the natural history of glyco-metabolic status in CF is characterized by deteriorating GT over time; (ii) insulinopenia plays a prominent role in the pathogenesis of GT worsening; (iii) IR does not play any significant part in the pathogenesis of DM development; (iv) deterioration of lung function tests is more severe in the subjects who develop DM over time.

scholarly journals Serial Analysis of the Gut and Respiratory Microbiome in Cystic Fibrosis in Infancy: Interaction between Intestinal and Respiratory Tracts and Impact of Nutritional Exposures

mBio ◽  
2012 ◽  
Vol 3 (4) ◽  
Author(s):  
J. C. Madan ◽  
D. C. Koestler ◽  
B. A. Stanton ◽  
L. Davidson ◽  
L. A. Moulton ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Tract ◽  
Microbial Communities ◽  
Effective Means ◽  
Significant Proportion ◽  
Gut Colonization ◽  
Pulmonary Damage ◽  
Chronic Colonization ◽  
High Degree ◽  
Over Time

ABSTRACT Pulmonary damage caused by chronic colonization of the cystic fibrosis (CF) lung by microbial communities is the proximal cause of respiratory failure. While there has been an effort to document the microbiome of the CF lung in pediatric and adult patients, little is known regarding the developing microflora in infants. We examined the respiratory and intestinal microbiota development in infants with CF from birth to 21 months. Distinct genera dominated in the gut compared to those in the respiratory tract, yet some bacteria overlapped, demonstrating a core microbiota dominated by Veillonella and Streptococcus. Bacterial diversity increased significantly over time, with evidence of more rapidly acquired diversity in the respiratory tract. There was a high degree of concordance between the bacteria that were increasing or decreasing over time in both compartments; in particular, a significant proportion (14/16 genera) increasing in the gut were also increasing in the respiratory tract. For 7 genera, gut colonization presages their appearance in the respiratory tract. Clustering analysis of respiratory samples indicated profiles of bacteria associated with breast-feeding, and for gut samples, introduction of solid foods even after adjustment for the time at which the sample was collected. Furthermore, changes in diet also result in altered respiratory microflora, suggesting a link between nutrition and development of microbial communities in the respiratory tract. Our findings suggest that nutritional factors and gut colonization patterns are determinants of the microbial development of respiratory tract microbiota in infants with CF and present opportunities for early intervention in CF with altered dietary or probiotic strategies. IMPORTANCE While efforts have been focused on assessing the microbiome of pediatric and adult cystic fibrosis (CF) patients to understand how chronic colonization by these microbes contributes to pulmonary damage, little is known regarding the earliest development of respiratory and gut microflora in infants with CF. Our findings suggest that colonization of the respiratory tract by microbes is presaged by colonization of the gut and demonstrated a role of nutrition in development of the respiratory microflora. Thus, targeted dietary or probiotic strategies may be an effective means to change the course of the colonization of the CF lung and thereby improve patient outcomes.

scholarly journals Randomized double-blind evaluation of ceftazidime dose ranging in hospitalized patients with cystic fibrosis.

1987 ◽  
Vol 31 (5) ◽  
pp. 698-702 ◽  
Author(s):  
M D Reed ◽  
R C Stern ◽  
C A O'Brien ◽  
D A Crenshaw ◽  
J L Blumer
Keyword(s):  
Cystic Fibrosis ◽  
Hospitalized Patients ◽  
Double Blind ◽  
Dose Ranging

scholarly journals Stenotrophomonas maltophilia phenotypic and genotypic features through 4-year cystic fibrosis lung colonization

2020 ◽  
Author(s):  
Eliana Alcaraz ◽  
Daniela Centrón ◽  
Gabriela Camicia ◽  
María Paula Quiroga ◽  
José Di Conza ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Adult Patient ◽  
Virulence Factors ◽  
Stenotrophomonas Maltophilia ◽  
Type Species ◽  
Mutation Frequency ◽  
Content Type ◽  
Link Type ◽  
Clonal Relatedness ◽  
Over Time

Introduction. Stenotrophomonas maltophilia has emerged as one of the most common multi-drug-resistant pathogens isolated from people with cystic fibrosis (CF). However, its adaptation over time to CF lungs has not been fully established. Hypothesis. Sequential isolates of S. maltophilia from a Brazilian adult patient are clonally related and show a pattern of adaptation by loss of virulence factors. Aim. To investigate antimicrobial susceptibility, clonal relatedness, mutation frequency, quorum sensing (QS) and selected virulence factors in sequential S. maltophilia isolates from a Brazilian adult patient attending a CF referral centre in Buenos Aires, Argentina, between May 2014 and May 2018. Methodology. The antibiotic resistance of 11 S. maltophilia isolates recovered from expectorations of an adult female with CF was determined. Clonal relatedness, mutation frequency, QS variants (RpfC–RpfF), QS autoinducer (DSF) and virulence factors were investigated in eight viable isolates. Results. Seven S. maltophilia isolates were resistant to trimethoprim–sulfamethoxazole and five to levofloxacin. All isolates were susceptible to minocycline. Strong, weak and normomutators were detected, with a tendency to decreased mutation rate over time. XbaI PFGE revealed that seven isolates belong to two related clones. All isolates were RpfC–RpfF1 variants and DSF producers. Only two isolates produced weak biofilms, but none displayed swimming or twitching motility. Four isolates showed proteolytic activity and amplified stmPr1 and stmPr2 genes. Only the first three isolates were siderophore producers. Four isolates showed high resistance to oxidative stress, while the last four showed moderate resistance. Conclusion. The present study shows the long-time persistence of two related S. maltophilia clones in an adult female with CF. During the adaptation of the prevalent clones to the CF lungs over time, we identified a gradual loss of virulence factors that could be associated with the high amounts of DSF produced by the evolved isolates. Further, a decreased mutation rate was observed in the late isolates. The role of all these adaptations over time remains to be elucidated from a clinical perspective, probably focusing on the damage they can cause to CF lungs.

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