scholarly journals Candida auris: Emergência Recente de um Fungo Patogénico Multirresistente

2020 ◽  
Vol 33 (10) ◽  
pp. 680
Author(s):  
Francisco Antunes ◽  
Cristina Veríssimo ◽  
Álvaro Ayres Pereira ◽  
Raquel Sabino
Keyword(s):  
Mortality Rates ◽  
Fungal Species ◽  
Species Level ◽  
Control Measures ◽  
Hospital Environment ◽  
Candida Auris ◽  
Infection Control Measures ◽  
The United Kingdom ◽  
Invasive Infections ◽  
A New Species

Candida auris was first described as a new species back in 2009. Although it differs markedly from other Candida species, this species can be misidentified as other yeasts in the routine microbiology laboratories. Therefore, its identification to species level should be confirmed by reference laboratories. Candida auris exhibits potential to cause invasive infections, and frequently shows a multidrugresistance pattern, and it is associated with high mortality rates. Outbreaks caused by Candida auris and associated with health care institutions have been reported in several countries around the world, including some European countries, such as the United Kingdom and Spain. In Portugal, to our knowledge, there are no known infections or colonization cases caused by Candida auris. This species can survive in the environment for several weeks and once introduced into the hospital environment, the risk of transmission is high, requiring strict infection control measures in order to prevent transmission. This paper intends to raise the awareness of the emergence of this fungal species, as well as to discuss the consequences of this situation.

scholarly journals Can Copper Products and Surfaces Reduce the Spread of Infectious Microorganisms and Hospital-Acquired Infections?

Materials ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3444
Author(s):  
Joji Abraham ◽  
Kim Dowling ◽  
Singarayer Florentine
Keyword(s):  
Infection Control ◽  
Hospital Admissions ◽  
Copper Alloys ◽  
Well Being ◽  
Mortality Rates ◽  
Pathogen Transmission ◽  
Control Measures ◽  
Traditional Use ◽  
Healthcare Facilities ◽  
Infection Control Measures

Pathogen transfer and infection in the built environment are globally significant events, leading to the spread of disease and an increase in subsequent morbidity and mortality rates. There are numerous strategies followed in healthcare facilities to minimize pathogen transfer, but complete infection control has not, as yet, been achieved. However, based on traditional use in many cultures, the introduction of copper products and surfaces to significantly and positively retard pathogen transmission invites further investigation. For example, many microbes are rendered unviable upon contact exposure to copper or copper alloys, either immediately or within a short time. In addition, many disease-causing bacteria such as E. coli O157:H7, hospital superbugs, and several viruses (including SARS-CoV-2) are also susceptible to exposure to copper surfaces. It is thus suggested that replacing common touch surfaces in healthcare facilities, food industries, and public places (including public transport) with copper or alloys of copper may substantially contribute to limiting transmission. Subsequent hospital admissions and mortality rates will consequently be lowered, with a concomitant saving of lives and considerable levels of resources. This consideration is very significant in times of the COVID-19 pandemic and the upcoming epidemics, as it is becoming clear that all forms of possible infection control measures should be practiced in order to protect community well-being and promote healthy outcomes.

scholarly journals 855. Significance of Invasive Infections due to Methicillin Sensitive Staphylococcus aureus in the neonatal population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S468-S468
Author(s):  
Mariawy Riollano ◽  
Deena Altman ◽  
shanna kowalsky ◽  
Stephanie Pan
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Characteristics ◽  
Invasive Disease ◽  
Control Measures ◽  
Invasive Infection ◽  
Single Center ◽  
Infection Control Measures ◽  
Invasive Infections ◽  
Mrsa Colonization ◽  
Neonatal Population

Abstract Background Staphylococcus aureus is a well-known cause of hospital acquired infections. Methicillin resistant staphylococcus aureus (MRSA) colonization is a recognized risk factor for invasive infections. The neonatal population in the intensive care unit (NICU) is particularly vulnerable to these types of infections, resulting in high mortality and morbidity. However, only scant data is available to establish the risk for invasive disease in patients with Methicillin sensitive staphylococcus aureus (MSSA). As a result, surveillance and prevention strategies are only address for MRSA colonization. Here, we describe the clinical characteristics of S. aureus colonized patients identified in late 2018 during transmission events in a single center NICU. As a result of the targeted surveillance investigation for MRSA infection control measures, S. aureus colonization was stratified, and we were able to compare the differences in invasive disease between MRSA and MSSA. Methods This is a retrospective chart review of the 47 colonized patients identified during October 2018- January 2019 SA transmission events in single center NICU. Risk factors, clinical characteristics, and the hospital course of these cases, including the proportion of invasive illness were reviewed. Results We found that most clinical characteristic, risk factors, and hospital course were the same between MRSA and MSSA colonized infants (p values > 0.05). Additionally, there was no difference in the proportion of invasive infection between MRSA and MSSA colonized patients (p value > 0.05). The type of invasive infections identified were SSTI, bacteremia, and osteomyelitis. Conclusion The proportion of invasive infection was the same in MSSA and MRSA colonized patients. This data provides us with supportive material for future recommendations of infection control measures for MSSA colonized patients. Disclosures All Authors: No reported disclosures

Molecular Characterization ofStenotrophomonas maltophiliaIsolates from Cystic Fibrosis Patients and the Hospital Environment

2009 ◽  
Vol 30 (8) ◽  
pp. 753-758 ◽  
Author(s):  
Carolina Marzuillo ◽  
Maria De Giusti ◽  
Daniela Tufi ◽  
Alessandra Giordano ◽  
Angela Del Cimmuto ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Monitoring Program ◽  
Control Measures ◽  
Hospital Environment ◽  
Molecular Heterogeneity ◽  
Infection Control Measures ◽  
Clonal Spread ◽  
Multiple Strains ◽  
Outpatient Settings ◽  
And Control

Objectives.To ascertain whether cystic fibrosis (CF) patients are colonized or infected with unique or multiple strains ofStenotrophomonas maltophilia; to understand whether some strains colonize or infect more than 1 patient, indicating clonal spread; and to explore the molecular heterogeneity of hospital water isolates and their correlation with clinical isolates.Setting.The regional CF center of Policlinico “Umberto I” of Rome, Italy.Methods.The study was carried out on a random sample ofS. maltophiliaisolates (n= 110) collected from CF patients (n= 50) during the period 2002–2005 and on 24 water isolates obtained during a monitoring program in the first 6 months of 2005. Home environmental samplings were not performed. All isolates, which were recovered from cultures of specimens obtained in both inpatient and outpatient settings, were genotyped with DNA macrorestriction analysis with the restriction enzymeXbaland pulsed-field gel electrophoresis.Results.One-third of the patients with repeated episodes ofS. maltophiliainfection or colonization hosted more than 1 strain. A potential transmission, defined as the isolation of the same strain in 2 or more patients, occurred 5 times, showing a frequency of potential transmission episodes slightly higher than previously reported. Water, taps, and sinks of the different rooms of the CF center tended to be persistently colonized with the same strain ofS. maltophilia, with no correlation between clinical and water-associated isolates.Conclusions.The study does not provide sufficient data to conclude definitively that isolation of colonized or infected CF patients and control of hospital water systems contamination would be beneficial infection control measures. Epidemiologic analytical studies that correlate the presence ofS. maltophiliawith clinical outcomes are strongly needed.

Management of Candida auris outbreak in a tertiary-care setting in Saudi Arabia

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Majid M. Alshamrani ◽  
Aiman El-Saed ◽  
Azzam Mohammed ◽  
Majed F. Alghoribi ◽  
Sameera M. Al Johani ◽  
...  
Keyword(s):  
Infection Control ◽  
Care Setting ◽  
Tertiary Care ◽  
Sharp Decrease ◽  
Control Measures ◽  
Candida Auris ◽  
Environmental Cleaning ◽  
Infection Control Measures ◽  
Local Experience ◽  
Tertiary Care Setting

Abstract Objective: To describe local experience in managing an outbreak of Candida auris in a tertiary-care setting. Methods: In response to emerging Candida auris, an outbreak investigation was conducted at our hospital between March 2018 and June 2019. Once a patient was confirmed to have Candida auris, screening of exposed patients and healthcare workers (HCWs) was conducted. Postexposure screening included those who had had direct contact with or shared the same unit or ward with a laboratory-confirmed case. In response to the increasing number of cases, new infection control measures were implemented. Results: In total, 23 primary patients were detected over 15 months. Postexposure screening identified 11 more cases, and all were patients. Furthermore, ~28.6% of patients probably caught infection in another hospital or in the community. Infection control measures were strictly implemented including hand hygiene, personal protective equipment, patient hygiene, environmental cleaning, cohorting of patients and HCWs, and avoiding the sharing of equipment. The wave reached a peak in April 2019, followed by a sharp decrease in May 2019 and complete clearance in June 2019. The case patients were equally distributed between intensive care units (51.4%) and wards (48.6%). More infections (62.9%) occurred than colonizations (37.1%). Urinary tract infection (42.9%) and candidemia (17.1%) were the main infections. In total, 7 patients (20.0%) died during hospitalization; among them, 6 (17.1%) died within 30 days of diagnosis. Conclusions: Active screening of exposed patients followed by strict infection control measures, including environmental cleaning, was successful in ending the outbreak. Preventing future outbreaks is challenging due to outside sources of infection and environmental resistance.

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 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.

Candida auris – epidemiology and laboratory diagnostics of infections

2017 ◽  
Vol 53 (4) ◽  
pp. 235-240
Author(s):  
Marta Wróblewska ◽  
Beata Sulik-Tyszka
Keyword(s):  
Molecular Techniques ◽  
Laboratory Diagnostics ◽  
Candida Auris ◽  
Microbial Identification ◽  
Hospitalised Patients ◽  
Short Period ◽  
Invasive Infections ◽  
Control Procedures ◽  
Human Infections ◽  
A New Species

Human infections caused by a new species of a yeast-like fungus of the genus <I>Candida – C. auris </I>– have been described in recent years worldwide. In a short period of time it has spread in several countries on 5 continents. <I>C. auris</I> – in contrast to other Candida species – shows a significant epidemic potential, spreading easily among hospitalised patients. It causes invasive infections with a relatively severe clinical course and high mortality (30 – 72%).<br>Emergence of <I>C. auris</I> poses a serious challenge for laboratory diagnosticians, as this species is usually misidentified or not identified by microbial identification systems commonly used in clinical diagnostic laboratories in Poland and worldwide. At present it is emphasised that a proper identification of <I>C. auris</I> may be obtained only by mass spectrometry or molecular techniques. Laboratory diagnosticians must therefore be aware of this new threat, as improper identification of C. auris may cause a delay in administration of an effective antifungal therapy as well as to the spread of this pathogen within the medical facility due to the lack of implementation of the patient’s isolation (colonised or infected) and other infection control procedures.

scholarly journals Spread of Carbapenem-Resistant Enterobacteriaceae in a Region, China: How to Control?

2021 ◽  
Author(s):  
Jiansheng Wang ◽  
Changfu Yin ◽  
Weiwei Yang ◽  
Yuanpeng Lv ◽  
Peng Zhao
Keyword(s):  
Infection Control ◽  
Average Length ◽  
Mortality Rates ◽  
Control Measures ◽  
Evidence Based ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Epidemiological Characteristics ◽  
Length Of Hospitalization ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background The increasing number of carbapenem-resistant Enterobacteriaceae (CRE) has become a serious problem globally. This study aimed to elucidate their geographically epidemiological characteristics and explore evidence-based infection control measures. Results A total of 930 phenotypically confirmed CRE isolates collected from 19 hospitals were genotypically characterised. K.pneumoniae (KP) and E.coli isolates were 787 (85.17%) and 96 (10.39%) among 924 carbapenemase-producing Enterobacteriaceae (CPE) isolates. Two major carbapenemase genes KPC-2 and NDM in CPE isolates accounted for 84.63% (n = 782) and 13.74% (n = 127). ST11 comprised 86.32% (631/731) of KPC-2 KP isolates. Wzi typing could discriminate ST11 KP clones and precisely track their transmission. Conjugation assays demonstrated that Some KPC-2- and NDM-bearing plasmids could be conjugatively transferred. The transferability was influenced by different STs and different wzis. CRE patients were becoming increasingly younger due to nosocomial CRE acquisition. The average length of hospitalization of these patients showed a downward trend mainly due to significant increases in voluntarily discharged rates and mortality rates. No associations between the rates of antibiotics consumption and CRE prevalence were observed. Evidence-based measures could effectively reduce the prevalence of ST11-wzi209 clone but failed to control the dissemination of ST11-wzi141 KP clone. Conclusions Continued vigilance for the importations should be maintained. Coordinated regional interventions are urgently needed to reduce CRE threat.

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