scholarly journals Perioperative Bacterial Contamination from Patients on Contact Precaution in Operating Room Environment

2020 ◽  
Author(s):  
Hajime Kanamori ◽  
William A Rutala ◽  
Maria F Gergen ◽  
David J Weber
Keyword(s):  
Operating Room ◽  
Bacterial Contamination ◽  
Multidrug Resistant ◽  
Aerobic Bacteria ◽  
Contact Precaution ◽  
Contact Precautions

Abstract We investigated the microbial burden on the operating room environment when patients on contact precautions for a multidrug-resistant pathogen received surgery. Our study demonstrated that the perioperative environment was contaminated with aerobic bacteria and MRSA after surgery, and that MRSA persisted environmentally even after cleaning/disinfection, highlighting the need for meticulous cleaning/disinfection in the perioperative environment.

Contact precautions for colonisation with multidrug-resistant organisms and haemodialysis patient quality of life and mood: a pilot case-control study

2019 ◽  
pp. 19-25 ◽  
Author(s):  
Rathika Krishnasamy
Keyword(s):  
Quality Of Life ◽  
Qualitative Interviews ◽  
Social Function ◽  
Multidrug Resistant ◽  
Contact Precautions ◽  
Dialysis Vintage ◽  
Multidrug Resistant Organisms ◽  
And Gender ◽  
The Impact

Background: The rate of multidrug-resistant organisms (MDRO) colonisation in dialysis populations has increased over time. This study aimed to assess the effect of contact precautions and isolation on quality of life and mood for haemodialysis (HD) patients colonised with MDRO. Methods: Patients undergoing facility HD completed the Kidney Disease Quality of Life (KDQOL–SFTM), Beck Depression Inventory (BDI) and Personal Wellbeing-Index Adult (PWI-A). Patients colonised with MDRO were case-matched by age and gender with patients not colonised. Results: A total of 16 MDRO-colonised patients were matched with 16 controls. Groups were well matched for demographics and co-morbidities, other than a trend for older dialysis vintage in the MDRO group [7.2 years (interquartile range 4.6–10.0) compared to 3.2 (1.4–7.6) years, p=0.05]. Comparing MDRO-positive with negative patients, physical (30.5±10.7 vs. 34.6±7.3; p=0.2) and mental (46.5±11.2 vs. 48.5±12.5; p = 0.6) composite scores were not different between groups. The MDRO group reported poorer sleep quality (p=0.01) and sleep patterns (p=0.05), and lower social function (p=0.02). BDI scores were similar (MDRO-positive 10(3.5–21.0) vs. MDRO-negative 12(6.5–16.0), p=0.6). PWI-A scores were also similar in both groups; however, MDRO patients reported lower scores for “feeling safe”, p=0.03. Conclusion: While overall scores of quality of life and depression were similar between groups, the MDRO group reported poorer outcomes in sleep and social function. A larger cohort and qualitative interviews may give more detail of the impact of contact precautions and isolation on HD patients. The necessity for contact precautions for different MDRO needs consideration.

scholarly journals Two Candida auris Cases in Germany with No Recent Contact to Foreign Healthcare—Epidemiological and Microbiological Investigations

2021 ◽  
Vol 7 (5) ◽  
pp. 380
Author(s):  
Joerg Steinmann ◽  
Thomas Schrauzer ◽  
Lisa Kirchhoff ◽  
Jacques F. Meis ◽  
Peter-Michael Rath
Keyword(s):  
South Asian ◽  
Multidrug Resistant ◽  
Health Care Facilities ◽  
Candida Auris ◽  
Contact Precautions ◽  
Asian Clade ◽  
Care Facilities ◽  
Long Time ◽  
European Health ◽  
Healthcare Associated

Candida auris has become a global fungal public health threat. This multidrug-resistant yeast is associated with nosocomial intra- and interhospital transmissions causing healthcare-associated infections. Here, we report on two C. auris cases from Germany. The two patients stayed in Germany for a long time before C. auris was detected during their hospitalization. The patients were isolated in single rooms with contact precautions. No nosocomial transmissions were detected within the hospital. Both C. auris isolates exhibited high minimum inhibitory concentrations (MICs) of fluconazole and one isolate additionally high MICs against the echinocandins. Microsatellite genotyping showed that both strains belong to the South Asian clade. These two cases are examples for appropriate in-hospital care and infection control without further nosocomial spread. Awareness for this emerging, multidrug-resistant pathogen is justified and systematic surveillance in European health care facilities should be performed.

scholarly journals Perioperative Microbial Contamination From Patients on Contact Precaution in Operating Room Environment

2020 ◽  
Vol 41 (S1) ◽  
pp. s348-s349
Author(s):  
Hajime Kanamori ◽  
William Rutala ◽  
Maria Gergen ◽  
David Jay Weber
Keyword(s):  
Small Computer ◽  
Contact Precaution ◽  
Time Points ◽  
Contact Precautions ◽  
Surgery Patient ◽  
Patient Arrival ◽  
The Mean ◽  
Healthcare Associated ◽  
Cleaning And Disinfection ◽  
The Impact

Background: The contaminated healthcare environment, including operating rooms (ORs), can serve as an important role in transmission of healthcare-associated pathogens. Studies are very limited regarding the level of contamination of ORs during the surgery of a patient on contact precautions and the risk to the next surgery patient after standard room cleaning and disinfection. Objective: Here, we investigated the microbial burden on the OR environment when patients on contact precautions receive surgery, and we assessed the impact of cleaning and disinfection on the contamination of OR environmental sites. Methods: This investigation was conducted in the ORs of an academic facility during an 8-month period. It involved 10 patients on contact precautions for multidrug-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA; n = 7); carbapenem-resistant Enterobacteriaceae (CRE) plus MRSA (n = 2); and vancomycin-resistant Enterococcus (VRE) plus MRSA (n = 1), who underwent surgery. Environmental sampling was performed at the following time points: (1) immediately before the surgical patient’s arrival in the OR, (2) after surgery but before the OR cleaning and disinfection, and (3) after the OR cleaning and disinfection. In total, 1,520 environmental samples collected from 15 OR sites for 10 surgical patients at 3 time points were analyzed. Relatedness among environmental MRSA isolates was determined by pulsed-field gel electrophoresis. Results: Overall, the mean CFUs of aerobes per Rodac plate (CFU/25 cm2) were 10.1 before patient arrival, 14.7 before cleaning and disinfection, and 6.3 after cleaning and disinfection (P < .0001, after cleaning and disinfection vs before cleaning and disinfection). Moreover, 7 environmental sites (46.7%) after cleaning and disinfection, including bed, arm rest, pyxis counter, floor (near, door side), floor (far, by door), steel counter (small, near bed), and small computer desk, had significantly lower mean counts of aerobes than before patient arrival or before cleaning and disinfection (Fig. 1). The mean CFUs of MRSA per Rodac plate (CFU/25 cm2) were 0.04 before patient arrival, 0.66 before cleaning and disinfection, and 0.08 after cleaning and disinfection (P = .0006, after cleaning and disinfection vs before cleaning and disinfection). Of environmental sites where MRSA was identified, 87.2% were on floors (41 of 47) and 19.1% were after cleaning and disinfection (9 of 47, 8 from floors and 1 from pyxis touchscreen). The A2/B2 MRSA strain was identified on different environmental sites (eg, floor, computer desk, counter) in various rooms (eg, OR2, OR10, and OR16), even after cleaning and disinfection (Fig. 2). Conclusions: Our study has demonstrated that the OR environment was contaminated with aerobic bacteria and MRSA after surgery and that MRSA persisted in the environment even after cleaning and disinfection. Enhanced environmental cleaning in the perioperative environment used for patients on isolation is necessary to prevent transmission of healthcare-associated pathogens in ORs.Funding: NoneDisclosures: Drs. Rutala and Weber are consultants to PDI (Professional Disposable International)

Effectiveness of antimicrobial hospital curtains on reducing bacterial contamination—A multicenter study

2018 ◽  
Vol 40 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Shik Luk ◽  
Viola Chi Ying Chow ◽  
Kelvin Chung Ho Yu ◽  
Enoch Know Hsu ◽  
Ngai Chong Tsang ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Bacterial Contamination ◽  
Indirect Costs ◽  
Multidrug Resistant ◽  
Clinical Settings ◽  
Carbapenem Resistant ◽  
Colony Forming Units ◽  
Multidrug Resistant Organisms ◽  
Bed Days

AbstractObjectiveTo determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains.DesignA prospective, open-labeled, multicenter study with a follow-up duration of 6 months.SettingThis study included 12 rooms of patients with multidrug-resistant organisms (MDROs) (668 patient bed days) and 10 cubicles (8,839 patient bed days) in the medical, surgical, neurosurgical, orthopedics, and rehabilitation units of 10 hospitals.MethodCulture samples were collected from curtain surfaces twice a week for 2 weeks, followed by weekly intervals.ResultsWith a median hanging time of 173 days, antimicrobial curtain B (quaternary ammonium chlorides [QAC] plus polyorganosiloxane) was highly effective in reducing the bioburden (colony-forming units/100 cm2, 1 vs 57; P < .001) compared with the standard curtain. The percentages of MDRO contamination were also significantly lower on antimicrobial curtain B than the standard curtain: methicillin-resistant Staphylococcus aureus, 0.5% vs 24% (P < .001); carbapenem-resistant Acinetobacter spp, 0.2% vs 22.1% (P < .001); multidrug-resistant Acinetobacter spp, 0% vs 13.2% (P < .001). Notably, the median time to first contamination by MDROs was 27.6 times longer for antimicrobial curtain B than for the standard curtain (138 days vs 5 days; P = .001).ConclusionsAntimicrobial curtain B (QAC plus polyorganosiloxane) but not antimicrobial curtain A (built-in silver) effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use in an active clinical setting. The antimicrobial curtain provided an opportunity to avert indirect costs related to curtain changing and laundering in addition to improving patient safety.

scholarly journals Assessment of Bacteriological Quality of Sheep Carcasses, Effect Level of 2.5% Citric Acid Spray on Bacterial Contamination of Meat, and Hygiene Practices of Workers in a Selected Abattoir in Debrezeit Town, Central Ethiopia

2021 ◽  
Vol 15 ◽  
pp. 117863022110375
Author(s):  
Derebew Aynewa ◽  
Zemichael Gizaw ◽  
Aklilu Feleke Haile
Keyword(s):  
Citric Acid ◽  
Bacterial Contamination ◽  
Total Coliform ◽  
Aerobic Bacteria ◽  
Bacteriological Quality ◽  
Before And After ◽  
Effect Level ◽  
The Mean ◽  
Structured Questionnaire

Background: Meat safety is important for public health. As part of the meat chain abattoirs are required to give attention to meat hygiene and safety in order to minimize hazards. Therefore, the current study was conducted to evaluate the bacteriological quality of sheep carcasses, knowledge and hygienic practices of workers in a selected abattoir and to determine the effect level of 2.5% citric acid spray on total coliforms and aerobic bacteria load of raw sheep carcasses surfaces. Methods: A cross-sectional study design with structured questionnaire and observational checklists observation were used. A systematic random sampling technique was employed. A total of 50 sample swabs (25 swabs before citric acid spray and 25 after citric acid spray) were randomly taken from brisket, flank and rump of sheep’s carcasses. Swabs were moistened with buffered peptone water (BPW) and samples were taken by rubbing 100 cm2 (10 cm × 10 cm) area delineated by sterile aluminum template. In addition, we administered a structured questionnaire and an observational checklists to assess knowledge and hygienic practices of workers. Bacteriological quality of sheep carcasses were analyzed using the methods described by the US bacteriological analytical manual. Results: The mean count for aerobic bacteria of the sheep carcasses before and after citric acid spray were 7.2log10 CFU/ml and 6.4log10 CFU/ml, respectively. The test results also showed that 21 (84%) and 15 (60%) of the swab samples were positive before and after spraying citric acid, respectively. The mean counts for coliform bacterial of the sheep carcasses before and after citric acid spray were 3.5log10 CFU/ml and 2.9log10 CFU/ml, respectively. The mean total aerobic and coliform counts before and after citric acid spray were significantly different ( P < .05). Regarding the hygiene condition of workers, all the respondents reported that they always washed their hands with soap before and after entering the slaughtering room and 23 (53.5%) of the workers reported that they used hot water. Thirty-one (72.1%) of the workers reported that they do not used soap to wash hands after visiting toilet. Thirty-five (81.4%) of the production workers did not wear mouth mask while handling and distribute meat/carcass. On the other hand, all of the workers wore capes, gowns and boots at the time of the observation and only 18 (18.6%) of the production workers wore gloves at the time of the survey. Conclusion: The current study revealed that significant proportion of sheep carcasses were positive for total aerobic bacteria and total coliform. Moreover, the study also showed that spraying of sheep carcasses with 2.5% citric acid significantly reduced the total coliform and aerobic counts. However, we did not assessed how much spray results to this effect. Therefore, we recommended further studies to determine how much spray of 2.5% citric acid significantly reduce bacterial contamination of sheep carcasses. In addition, the abattoir has to follow the food hazard analysis critical control point (HACCP) system to minimize meat contamination during harvesting and processing. The abattoir has to also implement strict operation laws to improve hygiene conditions of the workers. In addition, the abattoir can minimize meat contamination using 2.5% citric acid as a decontaminant.

A controlled trial of universal gloving versus contact precautions for preventing the transmission of multidrug-resistant organisms

2007 ◽  
Vol 35 (10) ◽  
pp. 650-655 ◽  
Author(s):  
Gonzalo M.L. Bearman ◽  
Alexandre R. Marra ◽  
Curtis N. Sessler ◽  
Wally R. Smith ◽  
Adriana Rosato ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Multidrug Resistant ◽  
Contact Precautions ◽  
Multidrug Resistant Organisms

scholarly journals Long-Term Impact of Universal Contact Precautions on Rates of Multidrug-Resistant Organisms in ICUs: A Comparative Effectiveness Study

2018 ◽  
Vol 39 (5) ◽  
pp. 534-540 ◽  
Author(s):  
E. Yoko Furuya ◽  
Bevin Cohen ◽  
Haomiao Jia ◽  
Elaine L. Larson
Keyword(s):  
Comparative Effectiveness ◽  
Baseline Period ◽  
Multidrug Resistant ◽  
Incidence Density ◽  
Research Database ◽  
Longitudinal Impact ◽  
Contact Precautions ◽  
Significant Difference ◽  
Multidrug Resistant Organisms ◽  
The Impact

OBJECTIVETo evaluate the impact of universal contact precautions (UCP) on rates of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) over 9 yearsDESIGNRetrospective, nonrandomized observational studySETTINGAn 800-bed adult academic medical center in New York CityPARTICIPANTSAll patients admitted to 6 ICUs, 3 of which instituted UCP in 2007METHODSUsing a comparative effectiveness approach, we studied the longitudinal impact of UCP on MDRO incidence density rates, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Klebsiella pneumoniae. Data were extracted from a clinical research database for 2006–2014. Monthly MDRO rates were compared between the baseline period and the UCP period, utilizing time series analyses based on generalized linear models. The same models were also used to compare MDRO rates in the 3 UCP units to 3 ICUs without UCPs.RESULTSOverall, MDRO rates decreased over time, but there was no significant decrease in the trend (slope) during the UCP period compared to the baseline period for any of the 3 intervention units. Furthermore, there was no significant difference between UCP units (6.6% decrease in MDRO rates per year) and non-UCP units (6.0% decrease per year; P=.840).CONCLUSIONThe results of this 9-year study suggest that decreases in MDROs, including multidrug-resistant gram-negative bacilli, were more likely due to hospital-wide improvements in infection prevention during this period and that UCP had no detectable additional impact.Infect Control Hosp Epidemiol 2018;39:534–540

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