scholarly journals Clinical and Molecular Features of Decreased Chlorhexidine Susceptibility among Nosocomial Staphylococcus aureus Isolates at Texas Children's Hospital

2015 ◽  
Vol 60 (2) ◽  
pp. 1121-1128 ◽  
Author(s):  
J. Chase McNeil ◽  
Eric Y. Kok ◽  
Jesus G. Vallejo ◽  
Judith R. Campbell ◽  
Kristina G. Hulten ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Setting ◽  
Bloodstream Infections ◽  
Hospital Environment ◽  
Content Type ◽  
Children's Hospital ◽  
Molecular Features ◽  
Children’S Hospital ◽  
Topical Antimicrobials ◽  
Mupirocin Resistance

ABSTRACTOne of the strategies utilized to decrease infections in the hospital setting relies on topical antimicrobials and antiseptics. While their use is beneficial, concerns arise over the potential to develop resistance or tolerance to these agents. We examined nosocomialStaphylococcus aureusisolates from 2007 to 2013 for the presence of genes associated with tolerance to chlorhexidine. Isolates and patients were identified from anS. aureussurveillance study at Texas Children's Hospital. NosocomialS. aureusisolates (those causing infection at ≥72 h of hospitalization) were identified and underwent PCR for theqacAorqacB(qacA/B) andsmrgenes associated with elevated minimum bactericidal concentrations of chlorhexidine. Molecular typing with pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), andagrtyping and a review of the medical record were performed. Two hundred forty-seven nosocomialS. aureusinfections were identified. Overall, 111 isolates carried one or both genes (44.9%); 33.1% were positive forsmr, 22.7% were positive forqacA/B, and 10.9% of the isolates possessed both genes. Thesmr-positive isolates were more often resistant to methicillin, ciprofloxacin, and/or clindamycin. The isolates positive forqacA/Bwere more often associated with indwelling central venous catheters and a vancomycin MIC of ≥2 μg/ml. Isolates carrying eithersmrorqacA/Bwere associated with a diagnosis of bacteremia. Thesmr-positive isolates more often belonged to sequence type 8 (ST8) than the isolates that were positive forqacA/B. Mupirocin resistance was detected in 2.8% of the isolates. Antiseptic-tolerantS. aureusstrains are common in our children's hospital and are associated with decreased susceptibility to other systemic antimicrobials and with bloodstream infections. Further work is needed to understand the implications that these organisms have on the hospital environment and antiseptic use in the future.

scholarly journals Mupirocin Resistance in Staphylococcus aureus Causing Recurrent Skin and Soft Tissue Infections in Children

2011 ◽  
Vol 55 (5) ◽  
pp. 2431-2433 ◽  
Author(s):  
J. Chase McNeil ◽  
Kristina G. Hulten ◽  
Sheldon L. Kaplan ◽  
Edward O. Mason
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Trna Synthetase ◽  
Soft Tissue Infections ◽  
Methicillin Resistant ◽  
Content Type ◽  
Plasmid Gene ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Mupirocin Resistance

ABSTRACTStaphylococcus aureusresistance to mupirocin is often caused by acquisition of a novel isoleucyl-tRNA synthetase encoded on the plasmid genemupA. We testedS. aureusisolates from children at Texas Children's Hospital with recurrent skin and soft tissue infections for mupirocin resistance andmupA. Of 136 isolates, 20 were resistant to mupirocin (14.7%). Fifteen isolates (11%) carriedmupA, and the gene was more common in methicillin-susceptibleS. aureus(21.4%) than methicillin-resistantS. aureus(8.3%;P= 0.03). Seven of 20 mupirocin-resistant isolates displayed clindamycin resistance.

scholarly journals Animal assisted interventions in the children's hospital: protocol for a scoping review

2021 ◽  
Vol 3 ◽  
pp. 74
Author(s):  
Rachel Howe ◽  
Sandra Nicholson ◽  
Attracta Lafferty ◽  
Carmel Davies ◽  
Diarmuid Stokes ◽  
...  
Keyword(s):  
Scoping Review ◽  
Scientific Evidence ◽  
Companion Animals ◽  
Hospital Setting ◽  
Evidence Base ◽  
Hospital Environment ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Review Protocol ◽  
Long Term Impact

The introduction of Animal Assisted Interventions (AAIs) in healthcare is relatively common; however, their actual effectiveness and long-term impact are not so well known, especially in relation to the children’s hospital setting.  It is important to plot where and why animal interventions take place but also to focus on how the human animal bond impacts on children in a children’s hospital setting.  Family members, including companion animals, are important supports which help children to relax and give them a sense of familiarity to navigate the busy and stressful hospital environment.  The scoping review of the literature proposed will explore the scientific evidence base for AAIs in children’s hospitals and will map results prior to undertaking a full scale research project.   Arksey and O’Malley’s framework guided by the Joanna Briggs Institute will frame this review protocol.  Appendices are used to ensure transparency of methods. The protocol is presented in narrative style to demonstrate flow, fluency, and appeal to wider readership.

Ideal physical features of environmental design in children’s hospital

Facilities ◽  
2020 ◽  
Vol 38 (5/6) ◽  
pp. 445-466 ◽  
Author(s):  
Sara Nourmusavi Nasab ◽  
Amir Reza Karimi Azeri ◽  
Seyedjalal Mirbazel
Keyword(s):  
Environmental Design ◽  
Developed Countries ◽  
Design Guidelines ◽  
Hospital Environment ◽  
Content Type ◽  
Children's Hospital ◽  
Hospital Design ◽  
Children’S Hospital ◽  
Physical Disorders ◽  
Physical Features

Purpose During hospitalization, children are faced with physical disorders and many psychological challenges. One important factor affecting children is the environmental design of the hospital. The inappropriate design of hospitals may contribute to an increase in fear, anxiety and behavioral disorders. The purpose of this study is to use children’s perspectives to evaluate the importance and impact of effective environmental factors to generate children’s hospital design guidelines. Design/methodology/approach In this study, children’s desired atmosphere during treatment was examined via 16 drawings and 24 interviews from children at a children’s hospital in Iran. Findings The encoding of information extracted environmental components such as window view, color, hobby, playing, decorations, family presence, structure of hospital, presence of nurse, furniture, water features, light and green space. The results indicate that children prefer a hospital environment that provides entertainment facilities while also offering design features such as the presence of light, colorful decorations, the existence of green spaces and conditions suitable for their families to be present. Research limitations/implications Depending on the location and their living conditions, the children’s prioritization can be different in any society. In addition, the data of this research was descriptive; thus, the conclusions must be considered tentative. Originality/value A number of studies focus on the needs of populations in developed countries. This topic has not been investigated in a major way via professionals in non-western countries such as Iran. Thus, the context of this study and present findings can be deemed unique.

scholarly journals Impact of a Rapid Blood Culture Diagnostic Test in a Children's Hospital Depends on Gram-Positive versus Gram-Negative Organism and Day versus Night Shift

2019 ◽  
Vol 58 (4) ◽  
Author(s):  
Lillian J. Juttukonda ◽  
Sophie Katz ◽  
Jessica Gillon ◽  
Jonathon Schmitz ◽  
Ritu Banerjee
Keyword(s):  
Blood Culture ◽  
Night Shift ◽  
Bloodstream Infections ◽  
Negative Resistance ◽  
Gram Positive ◽  
Antibiotic Selection ◽  
Gram Negative ◽  
Content Type ◽  
Children's Hospital ◽  
Children’S Hospital

ABSTRACT Rapid diagnostic tests (RDTs) for bloodstream infections (BSIs) decrease the time to organism identification and resistance detection. RDTs are associated with early deescalation of therapy for Gram-positive BSIs. However, it is less clear how RDTs influence antibiotic management for Gram-negative BSIs and whether RDT results are acted on during off-hours. We performed a single-center, retrospective review of children with BSI and Verigene (VG) testing at a children’s hospital. Of the 301 positive cultures included in the study (196 Gram-positive, 44 Gram-negative, 32 polymicrobial, and 29 non-VG targets), the VG result had potential to impact antibiotic selection in 171 cases; among these, antibiotic changes occurred in 119 (70%) cases. For Gram-negative cultures, the Verigene result correlated with unnecessary antibiotic escalation and exposure to broader-spectrum antibiotics than needed. In contrast, for Gram-positive cultures, the VG results correlated with appropriate antibiotic selection. VG results permitted early deescalation for methicillin-susceptible Staphylococcus aureus (MSSA) (19/24 [79%]) and avoidance of antibiotics for skin contaminants (30/85 [35%]). Antibiotic changes occurred more quickly during the day than at night (4.6 versus 11.7 h, respectively; P < 0.05), and antibiotic escalations occurred more quickly than did deescalations (4.1 versus 10.1 h, P < 0.01). In a pediatric institution with a low prevalence of Gram-negative resistance, the VG RDT facilitated antibiotic optimization for Gram-positive BSIs but led to unnecessary escalation of antibiotics for Gram-negative BSIs. The time to action was slower for RDT results reported at night than during the day. Laboratories should consider these factors when implementing blood culture RDTs.

scholarly journals Animal assisted activities in the children's hospital: protocol for a scoping review

2020 ◽  
Vol 3 ◽  
pp. 74
Author(s):  
Rachel Howe ◽  
Sandra Nicholson ◽  
Attracta Lafferty ◽  
Carmel Davies ◽  
Diarmuid Stokes ◽  
...  
Keyword(s):  
Scoping Review ◽  
Scientific Evidence ◽  
Companion Animals ◽  
Hospital Setting ◽  
Hospital Environment ◽  
Children's Hospital ◽  
Human Animal Bond ◽  
Children’S Hospital ◽  
Review Protocol ◽  
Actual Effectiveness

The introduction of animal interventions in healthcare are relatively common; however, their actual effectiveness and longer term findings are not so well known or published, especially in relation to the children’s hospital setting.  It is important to plot where and why animal interventions take place but also to focus on how the human animal bond impacts on children, their parents and staff in a children’s hospital setting.  Family members, including companion animals, are important supports which help children to relax and give them a sense of familiarity to navigate the busy and stressful hospital environment.  The scoping review of the literature proposed will explore the scientific evidence for animal assisted activities (AAA) in children’s hospitals and will map results prior to undertaking a full scale research project.   Arksey and O’Malley’s framework guided by the Joanna Briggs Institute will frame this review protocol.  Appendices are used to ensure transparency of methods. The protocol is presented in narrative style to demonstrate flow and fluency and appeal to wider readership.

scholarly journals 976Antiseptic tolerance and antimicrobial susceptibility of nosocomial Staphylococcus aureus at Texas Children's Hospital: 2007-2013

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S284-S284
Author(s):  
Jonathon Mcneil ◽  
Eric Kok ◽  
Kristina Hulten ◽  
Edward O. Mason ◽  
Sheldon L. Kaplan
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Children's Hospital ◽  
Children’S Hospital

An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit

2003 ◽  
Vol 24 (5) ◽  
pp. 317-321 ◽  
Author(s):  
Lisa Saiman ◽  
Alicia Cronquist ◽  
Fann Wu ◽  
Juyan Zhou ◽  
David Rubenstein ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Methicillin Resistant ◽  
Children's Hospital ◽  
Surveillance Cultures ◽  
Children’S Hospital ◽  
Incident Cases

AbstractObjective:To describe the epidemiologic and molecular investigations that successfully contained an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit (NICU).Design:Isolates of MRSA were typed by pulsed-field gel electrophoresis (PFGE) and S. aureus protein A (spa).Setting:A level III-IV, 45-bed NICU located in a children's hospital within a medical center.Patients:Incident cases had MRSA isolated from clinical cultures (eg, blood) or surveillance cultures (ie, anterior nares).Interventions:Infected and colonized infants were placed on contact precautions, cohorted, and treated with mupirocin. Surveillance cultures were performed for healthcare workers (HCWs). Colonized HCWs were treated with topical mupirocin and hexachlorophene showers.Results:From January to March 2001, the outbreak strain of MRSA PFGE clone B, was harbored by 13 infants. Three (1.3%) of 235 HCWs were colonized with MRSA. Two HCWs, who rotated between the adult and the pediatric facility, harbored clone C. One HCW, who exclusively worked in the children's hospital, was colonized with clone B. From January 1999 to November 2000, 22 patients hospitalized in the adult facility were infected or colonized with clone B. Spa typing and PFGE yielded concordant results. PFGE clone B was identified as spa type 16, associated with outbreaks in Brazil and Hungary.Conclusions:A possible route of MRSA transmission was elucidated by molecular typing. MRSA appears to have been transferred from our adult facility to our pediatric facility by a rotating HCW. Spa typing allowed comparison of our institution's MRSA strains with previously characterized outbreak clones.

The effects of traffic light labelling versus cartoon labelling on food and beverage purchases in a children's hospital setting

2017 ◽  
Vol 13 (4) ◽  
pp. 265-268 ◽  
Author(s):  
O. R. Whitt ◽  
S.B. Jilcott Pitts ◽  
A. P. Rafferty ◽  
C. R. Payne ◽  
S. W. Ng
Keyword(s):  
Hospital Setting ◽  
Traffic Light ◽  
Children's Hospital ◽  
Food And Beverage ◽  
Children’S Hospital

scholarly journals Evaluation of Ceftaroline Alone and in Combination against Biofilm-Producing Methicillin-Resistant Staphylococcus aureus with Reduced Susceptibility to Daptomycin and Vancomycin in anIn VitroPharmacokinetic/Pharmacodynamic Model

2015 ◽  
Vol 59 (8) ◽  
pp. 4497-4503 ◽  
Author(s):  
Katie E. Barber ◽  
Jordan R. Smith ◽  
Cortney E. Ireland ◽  
Blaise R. Boles ◽  
Warren E. Rose ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Device ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Content Type ◽  
Elimination Half ◽  
Antimicrobial Protection ◽  
Mrsa Strains ◽  
Post Hoc

ABSTRACTAnnually, medical device infections are associated with >250,000 catheter-associated bloodstream infections (CLABSI), with up to 25% mortality.Staphylococcus aureus, a primary pathogen in these infections, is capable of biofilm production, allowing organism persistence in harsh environments, offering antimicrobial protection. With increases inS. aureusisolates with reduced susceptibility to current agents, ceftaroline (CPT) offers a therapeutic alternative. Therefore, we evaluated whether CPT would have a role against biofilm-producing methicillin-resistantS. aureus(MRSA), including those with decreased susceptibilities to alternative agents. In this study, we investigated CPT activity alone or combined with daptomycin (DAP) or rifampin (RIF) against 3 clinical biofilm-producing MRSA strains in anin vitrobiofilm pharmacokinetic/pharmacodynamic (PK/PD) model. Simulated antimicrobial regimens were as follows: 600 mg of CPT every 8 h (q8h) (free maximum concentration of drug [fCmax], 17.04 mg/liter; elimination half-life [t1/2], 2.66 h), 12 mg/kg of body weight/day of DAP (fCmax, 14.7 mg/liter;t1/2, 8 h), and 450 mg of RIF q12h (fCmax, 3.5 mg/liter;t1/2, 3.4 h), CPT plus DAP, and CPT plus RIF. Samples were obtained and plated to determine colony counts. Differences in log10CFU/cm2were evaluated by analysis of variance with Tukey'spost hoctest. The strains were CPT and vancomycin susceptible and DAP nonsusceptible (DNS). CPT displayed activity throughout the experiment. DAP demonstrated initial activity with regrowth at 24 h in all strains. RIF was comparable to the drug-free control, and little benefit was observed when combined with CPT. CPT plus DAP displayed potent activity, with an average log10CFU/cm2reduction of 3.33 ± 1.01 from baseline. CPT demonstrated activity against biofilm-producing DNS MRSA. CPT plus DAP displayed therapeutic enhancement over monotherapy, providing a potential option for difficult-to-treat medical device infections.

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