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Wesgate R, Bentley K, Stanton R, Maddalena R, Khosravi C, Teska P, Duggan K, Maillard JY. Impact of artificial accelerated ageing of PVC surfaces and surface degradation on disinfectant efficacy. J Hosp Infect 2024; 149:1-13. [PMID: 38734184 DOI: 10.1016/j.jhin.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/06/2023] [Accepted: 12/17/2023] [Indexed: 05/13/2024]
Abstract
BACKGROUND Standardized efficacy surface tests for disinfectants are performed on pristine surfaces. There is a growing interest in understanding the impact of surface ageing on disinfectant activity, owing for example to the increased usage of ultraviolet (UV) radiation and oxidative chemistries for surface decontamination. This acknowledges that general surface 'wear and tear' following UV radiation and oxidative biocide exposure may impact biocidal product efficacy. METHODS PVC surfaces were aged through thermal and UV-A radiation (340 nm wavelength) following the use of standard ageing surface protocols to simulate natural surface degradation. Surface roughness, contact angle and scanning electron microscopy were performed to evaluate physical changes in PVC surfaces before and after artificial ageing. The efficacy of five pre-impregnated disinfectant wipes were evaluated using the ASTM E2967-15 on stainless-steel (control) and PVC surfaces (aged and non-aged). RESULTS The type of formulation and the organism tested remained the most significant factors impacting disinfectant efficacy, compared with surface type. Both thermal ageing and UV-A exposure of PVC surfaces clearly showed signs of surface degradation, notably an increase in surface roughness. Physical changes were observed in the roughness of PVC after artificial ageing. A difference in disinfectant efficacy dependent on aged PVC surfaces was observed for some, but not all formulations. CONCLUSION We showed that surface type and surface ageing can affect biocidal product efficacy, although in a non-predictable manner. More research is needed in this field to ascertain whether surface types and aged surfaces should be used in standardized efficacy testing.
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Affiliation(s)
- R Wesgate
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - K Bentley
- Infection & Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - R Stanton
- Infection & Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - R Maddalena
- School of Engineering, Cardiff University, Cardiff, UK
| | - C Khosravi
- School of Engineering, Cardiff University, Cardiff, UK
| | - P Teska
- Diversey, Fontenay-sous-Bois, France
| | - K Duggan
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - J-Y Maillard
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
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2
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Fijan S, Kürti P, Rozman U, Šostar Turk S. A critical assessment of microbial-based antimicrobial sanitizing of inanimate surfaces in healthcare settings. Front Microbiol 2024; 15:1412269. [PMID: 38933019 PMCID: PMC11199901 DOI: 10.3389/fmicb.2024.1412269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
The global rise in antimicrobial resistance (AMR) poses a significant public health threat, especially in healthcare settings, where controlling the spread of antimicrobial genes is crucial. While person-to-person transmission remains the primary route for healthcare-associated infections (HAIs), hospital surfaces serve as key reservoirs for antimicrobial-resistant microorganisms. Regular cleaning and disinfection of these surfaces are essential. Microbial-based products for sanitizing hospital surfaces have emerged as promising tools to combat HAIs and AMR. However, a review of 32 publications found inconsistencies and potential risks. A total of 15 publications included hospital-based trials, while the rest were either in vitro or in situ assays, reviews, book chapters, or commentaries. In most of the hospital-based studies, specific strains of applied microorganisms were not identified, and the term "probiotic" was inaccurately used. These products mainly featured spores from Bacillus and Priestia genera, which was mainly hypothesized to work through competitive exclusion. Most hospital-based studies have shown that the application of microbial-based products resulted in a significant reduction in pathogens on surfaces, thereby contributing to a decrease in the incidence of healthcare-associated infections (HAIs). Further research is however needed to understand the effectiveness, mechanisms of action, and safety of microbial-based sanitizing agents. Strain-level identification is crucial for safety assessments, yet many reviewed products lacked this information. Consequently, there is a need for rigorous safety evaluations within existing regulatory frameworks to ensure the efficacy and safety of microbial-based cleaning products in healthcare settings.
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Affiliation(s)
- Sabina Fijan
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | | | - Urška Rozman
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Sonja Šostar Turk
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
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3
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Watkin S, Cloutman-Green E, Kiernan M, Ciric L. Trends in viable microbial bioburden on surfaces within a paediatric bone marrow transplant unit. J Hosp Infect 2024; 148:167-177. [PMID: 38621514 DOI: 10.1016/j.jhin.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Despite their role being historically overlooked, environmental surfaces have been shown to play a key role in the transmission of pathogens causative of healthcare-associated infection. To guide infection prevention and control (IPC) interventions and inform clinical risk assessments, more needs to be known about microbial surface bioburdens. AIM To identify the trends in culturable bacterial contamination across communal touch sites over time in a hospital setting. METHODS Swab samples were collected over nine weeks from 22 communal touch sites in a paediatric bone marrow transplant unit. Samples were cultured on Columbia blood agar and aerobic colony counts (ACC) per 100 cm2 were established for each site. Individual colony morphologies were grouped and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or 16s rDNA sequencing. FINDINGS Highest mean counts were observed for sites associated with ward management activity and computer devices (3.29 and 2.97 ACC/100 cm2 respectively). A nurses' station keyboard had high mean ACC/100 cm2 counts (10.67) and diversity, while laundry controls had high mean ACC/100 cm2 counts (4.70) and low diversity. Micrococcus luteus was identified in all sampling groups. Clinical staff usage sites were contaminated with similar proportions of skin and environmental flora (52.19-46.59% respectively), but sites associated with parental activities were predominantly contaminated by environmental microflora (86.53%). CONCLUSION The trends observed suggest patterns in microbial loading based on site activities, surface types and user groups. Improved understanding of environmental surface contamination could help support results interpretation and IPC interventions, improving patient safety.
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Affiliation(s)
- S Watkin
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK.
| | - E Cloutman-Green
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK; Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - M Kiernan
- Richard Wells Research Centre, University of West London, London, UK
| | - L Ciric
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK
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4
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Alves PGV, Menezes RDP, Silva NBS, Faria GDO, Bessa MADS, de Araújo LB, Aguiar PADF, Penatti MPA, Pedroso RDS, Röder DVDDB. Virulence factors, antifungal susceptibility and molecular profile in Candida species isolated from the hands of health professionals before and after cleaning with 70% ethyl alcohol-based gel. J Mycol Med 2024; 34:101482. [PMID: 38763122 DOI: 10.1016/j.mycmed.2024.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/10/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024]
Abstract
Fungal infections in neonatal intensive care units (NICU) are mainly related to Candida species, with high mortality rates. They are predominantly of endogenous origin, however, cross-infection transmitted by healthcare professionals' hands has occurred. The aim of this study was to identify Candida species isolated from the hands of healthcare professionals in a NICU before and after hygiene with 70% ethanol-based gel and evaluate virulence factors DNase, phospholipase, proteinase, hemolysin, biofilm biomass production, and metabolic activity. In vitro antifungal susceptibility testing and similarity by random amplified polymorphic DNA (RAPD) were also performed. C. parapsilosis complex was the most frequent species (57.1%); all isolates presented at least one virulence factor; three isolates (Candida parapsilosis complex) were resistant to amphotericin B, two (Candida famata [currently Debaryomyces hansenii] and Candida guilliermondii [currently Meyerozyma guilliermondii]) was resistant to micafungin, and six (Candida parapsilosis complex, Candida guilliermondii [=Meyerozyma guilliermondii], Candida viswanathi, Candida catenulata [currently Diutina catenulata] and Candida lusitaniae [currently Clavispora lusitaniae]) were resistant to fluconazole. Molecular analysis by RAPD revealed two clusters of identical strains that were in the hands of distinct professionals. Candida spp. were isolated even after hygiene with 70% ethanol-based gel, highlighting the importance of stricter basic measures for hospital infection control to prevent nosocomial transmission.
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Affiliation(s)
- Priscila Guerino Vilela Alves
- Postgraduate Program in Health Sciences, Medicine, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - Ralciane de Paula Menezes
- Technical School of Health, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - Nagela Bernadelli Sousa Silva
- Postgraduate Program in Applied Immunology and Parasitology, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | | | | | - Lúcio Borges de Araújo
- Clinical Hospital, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
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Hanczvikkel A, Tóth Á, Kopcsóné Németh IA, Bazsó O, Závorszky L, Buzgó L, Lesinszki V, Göbhardter D, Ungvári E, Damjanova I, Erőss A, Hajdu Á. Nosocomial outbreak caused by disinfectant-resistant Serratia marcescens in an adult intensive care unit, Hungary, February to March 2022. Euro Surveill 2024; 29:2300492. [PMID: 38940004 PMCID: PMC11212457 DOI: 10.2807/1560-7917.es.2024.29.26.2300492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/01/2024] [Indexed: 06/29/2024] Open
Abstract
In 2022, an outbreak with severe bloodstream infections caused by Serratia marcescens occurred in an adult intensive care unit (ICU) in Hungary. Eight cases, five of whom died, were detected. Initial control measures could not stop the outbreak. We conducted a matched case-control study. In univariable analysis, the cases were more likely to be located around one sink in the ICU and had more medical procedures and medications than the controls, however, the multivariable analysis was not conclusive. Isolates from blood cultures of the cases and the ICU environment were closely related by whole genome sequencing and resistant or tolerant against the quaternary ammonium compound surface disinfectant used in the ICU. Thus, S. marcescens was able to survive in the environment despite regular cleaning and disinfection. The hospital replaced the disinfectant with another one, tightened the cleaning protocol and strengthened hand hygiene compliance among the healthcare workers. Together, these control measures have proved effective to prevent new cases. Our results highlight the importance of multidisciplinary outbreak investigations, including environmental sampling, molecular typing and testing for disinfectant resistance.
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Affiliation(s)
- Adrienn Hanczvikkel
- ECDC Fellowship Programme, Public Health Microbiology path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | - Ákos Tóth
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | | | - Orsolya Bazsó
- North-Pest Central Hospital - Military Hospital (ÉPC-HK), Budapest, Hungary
| | - Lőrinc Závorszky
- North-Pest Central Hospital - Military Hospital (ÉPC-HK), Budapest, Hungary
| | - Lilla Buzgó
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | - Virág Lesinszki
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | - Dániel Göbhardter
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | - Erika Ungvári
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | - Ivelina Damjanova
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
| | - Attila Erőss
- North-Pest Central Hospital - Military Hospital (ÉPC-HK), Budapest, Hungary
| | - Ágnes Hajdu
- National Center for Public Health and Pharmacy (NNGYK), Budapest, Hungary
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6
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Qin H, Qiu H, Liu K, Hong B, Liu Y, Li C, Li M, An X, Song L, Robert E, Tong Y, Fan H, Wang R. Cold atmospheric plasma can effectively disinfect SARS-CoV-2 in the wastewater. EXPLORATION (BEIJING, CHINA) 2024; 4:20230012. [PMID: 38939868 PMCID: PMC11189572 DOI: 10.1002/exp.20230012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/01/2023] [Indexed: 06/29/2024]
Abstract
COVID-19 is currently pandemic and the detection of SARS-CoV-2 variants in wastewater is causing widespread concern. Herein, cold atmospheric plasma (CAP) is proposed as a novel wastewater disinfection technology that effectively inactivates SARS-CoV-2 transcription- and replication-competent virus-like particles, coronavirus GX_P2V, pseudotyped SARS-CoV-2 variants, and porcine epidemic diarrhoea virus in a large volume of water within 180 s (inhibition rate > 99%). Further, CAP disinfection did not adversely affect the viability of various human cell lines. It is identified that CAP produced peroxynitrite (ONOO-), ozone (O3), superoxide anion radicals (O2 -), and hydrogen peroxide (H2O2) as the major active substances for coronavirus disinfection. Investigation of the mechanism showed that active substances not only reacted with the coronavirus spike protein and affected its infectivity, but also destroyed the nucleocapsid protein and genome, thus affecting virus replication. This method provides an efficient and environmentally friendly strategy for the elimination of SARS-CoV-2 and other coronaviruses from wastewater.
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Affiliation(s)
- Hongbo Qin
- College of Mechanical and Electrical EngineeringBeijing University of Chemical TechnologyBeijingChina
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Hengju Qiu
- College of Mechanical and Electrical EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Ke Liu
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Bixia Hong
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Yuchen Liu
- College of Mechanical and Electrical EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Chun Li
- College of Mechanical and Electrical EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Mengzhe Li
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Xiaoping An
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Lihua Song
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | | | - Yigang Tong
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
- Beijing Advanced Innovation Center for Soft Matter Science and EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Huahao Fan
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Ruixue Wang
- College of Mechanical and Electrical EngineeringBeijing University of Chemical TechnologyBeijingChina
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7
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de Souto Sobrinho JD, de Valença Silva AK, de Medeiros KB, Silva MLCR, de Medeiros ABM, de Sousa DLC, de Azevedo SS, de Sousa Américo Batista Santos C. Antimicrobial resistance, enterotoxin and biofilm production genes in Staphylococcus spp. isolated from facilities and fomites in veterinary hospital in the Caatinga biome. Braz J Microbiol 2024:10.1007/s42770-024-01400-3. [PMID: 38819774 DOI: 10.1007/s42770-024-01400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024] Open
Abstract
The Caatinga biome occurs only in Brazil and offers epidemiological conditions that should be assessed differently from other regions of Brazil and the world. Thus, the aim of this survey was to identify antimicrobial resistance, enterotoxin and biofilm production genes in Staphylococcus spp. isolated from facilities and fomites in a veterinary hospital in Caatinga biome. Samples were collected from surfaces of small animal clinical care tables (n =8), cages in the dog and cat hospitalisation sector and animals with infectious diseases (n = 21), small animal surgical centre (n =8), sterilisation sector (n =7) and stethoscopes (n = 32) by using sterile swabs. Bacterial isolation and identification, antimicrobial resistance phenotypic test and molecular detection of antimicrobial resistance, biofilm formation and enterotoxin genes were carried out. Ninety-five bacterial isolates were obtained, and 29 (30.5%) were identified as Staphylococcus spp. Overall, 13 isolates (44.8%) of six species of Staphylococcus spp. showed antimicrobial resistance profile, as well as S. haemolyticus expressed phenotypic profile of multidrug resistance. The antimicrobials with the highest resistance rates were penicillin and tetracycline. The most frequent resistance genes were blaZ and tetM, both detected in 10 (76.9%) isolates. The mecA, tetL and tetK genes had frequencies of 38.5% (5/13), 23.1% (3/13) and 15.4% (2/13), respectively. The biofilm production marker, icaD gene, was detected in one S. sciuri strain. SEE gene, which encodes enterotoxins, was detected in 15.4% (2/13) of the strains (S. pseudintermedius and S. intermedius). The occurrence of Staphylococcus spp. carrying resistance genes to diferent classes of antimicrobials, presenting MDR phenotypic pattern and carrying enterotoxins and biofim encoding genes recovered from veterinary hospital facilities and fomites in the Caatinga biome reinforce the need to implement prevention cares in veterinary practices to avoid One Health-concerning conditions.
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Affiliation(s)
| | | | | | | | | | | | - Sérgio Santos de Azevedo
- Federal University of Campina Grande, Post-Graduate Program in Animal Science and Health, Patos, PB, Brazil
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8
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Lordelo R, Branco R, Gama F, Morais PV. Assessment of antimicrobial resistance, biofilm formation, and surface modification potential in hospital strains of Pseudomonas aeruginosa and Klebsiella pneumoniae. Heliyon 2024; 10:e30464. [PMID: 38711646 PMCID: PMC11070870 DOI: 10.1016/j.heliyon.2024.e30464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
The occurrence of healthcare-associated infections is a multifactorial phenomenon related to hospital space contamination by bacteria. The ESKAPE group, specifically Pseudomonas aeruginosa and Klebsiella pneumoniae, play a relevant role in the occurrence of these infections. Therefore, comprehensive research is needed to identify characteristics that justify the prevalence of these species in the healthcare environment. In this line, the study aimed to determine the antimicrobial resistance, biofilm formation, and the potential for polymer degradation in a collection of 33 P. aeruginosa strains and 2 K. pneumoniae strains sampled from various equipment and non-critical surfaces in a Portuguese hospital. Antimicrobial susceptibility tests revealed that none of the strains was categorized as multidrug-resistant (non-MDR). An assessment of their biofilm-forming capabilities indicated that 97 % of the strains exhibited biofilm-producing characteristics. Notably, within this group, the majority of P. aeruginosa and half of K. pneumoniae strains were classified as strong biofilm producers. Furthermore, the strains were evaluated for their potential to cause damage or change medical devices, namely infusion sets, nasal cannula, and urinary catheters. Three P. aeruginosa strains, two strong and one moderate biofilm producers, showed the highest ability to modify surfaces of the nasal cannula and infusion sets. Additionally, the Chi-square test revealed a statistically significant relationship between the presence of P. aeruginosa strains and the water accession spots. In conclusion, this work suggests that bacteria from this group hold a significant ability to grow in the healthcare environment through the degradation of non-critical materials. This suggests a potential concern for the persistence and proliferation of these organisms in hospital environments, emphasizing the importance of robust infection control measures to mitigate the risks associated with bacterial growth on such surfaces.
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Affiliation(s)
- Roberta Lordelo
- University of Coimbra, Centre for Mechanical Engineering Material and Processes, ARISE, Department of Life Sciences, Coimbra, Portugal
| | - Rita Branco
- University of Coimbra, Centre for Mechanical Engineering Material and Processes, ARISE, Department of Life Sciences, Coimbra, Portugal
| | - Fernando Gama
- Health Sciences Research Unit: Nursing (UICISA: E), Portugal and Health School of the Polytechnic Institute of Viseu, Portugal
| | - Paula V. Morais
- University of Coimbra, Centre for Mechanical Engineering Material and Processes, ARISE, Department of Life Sciences, Coimbra, Portugal
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9
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Bajetto G, Scutera S, Menotti F, Banche G, Chiaradia G, Turesso C, De Andrea M, Vallino M, Es DSV, Biolatti M, Dell’Oste V, Musso T. Antimicrobial Efficacy of a Vegetable Oil Plasticizer in PVC Matrices. Polymers (Basel) 2024; 16:1046. [PMID: 38674966 PMCID: PMC11054656 DOI: 10.3390/polym16081046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
The growing prevalence of bacterial and viral infections, highlighted by the recent COVID-19 pandemic, urgently calls for new antimicrobial strategies. To this end, we have synthesized and characterized a novel fatty acid epoxy-ester plasticizer for polymers, named GDE. GDE is not only sustainable and user-friendly but also demonstrates superior plasticizing properties, while its epoxy components improve the heat stability of PVC-based matrices. A key feature of GDE is its ability to confer antimicrobial properties to surfaces. Indeed, upon contact, this material can effectively kill enveloped viruses, such as herpes simplex virus type 1 (HSV-1) and the β-coronavirus prototype HCoV-OC43, but it is ineffective against nonenveloped viruses like human adenovirus (HAdV). Further analysis using transmission electron microscopy (TEM) on HSV-1 virions exposed to GDE showed significant structural damage, indicating that GDE can interfere with the viral envelope, potentially causing leakage. Moreover, GDE demonstrates antibacterial activity, albeit to a lesser extent, against notorious pathogens such as Staphylococcus aureus and Escherichia coli. Overall, this newly developed plasticizer shows significant potential as an antimicrobial agent suitable for use in both community and healthcare settings to curb the spread of infections caused by microorganisms contaminating physical surfaces.
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Affiliation(s)
- Greta Bajetto
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
- Center for Translational Research on Autoimmune and Allergic Disease—CAAD, 28100 Novara, Italy
| | - Sara Scutera
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
| | - Francesca Menotti
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
| | - Giuliana Banche
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
| | | | | | - Marco De Andrea
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
- Center for Translational Research on Autoimmune and Allergic Disease—CAAD, 28100 Novara, Italy
| | - Marta Vallino
- Institute for Sustainable Plant Protection, National Research Centre (CNR), 10135 Turin, Italy;
| | - Daan S. Van Es
- Wageningen Food & Biobased Research, 6708 WG Wageningen, The Netherlands;
| | - Matteo Biolatti
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
| | - Valentina Dell’Oste
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
| | - Tiziana Musso
- Department of Public Health and Pediatric Sciences, University of Turin, 10100 Turin, Italy; (G.B.); (S.S.); (F.M.); (G.B.); (M.D.A.); (V.D.); (T.M.)
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10
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Liu Y, Xu Y, Wen Q. Carbon dots for staining bacterial dead cells and distinguishing dead/alive bacteria. Anal Biochem 2024; 687:115432. [PMID: 38113980 DOI: 10.1016/j.ab.2023.115432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Abstract
The small molecular dyes such as propidium iodide (PI) always suffer from photo-bleaching and potential toxicity. To tackle the problems, a type of nontoxic carbon dots (CDs) was obtained for dead/alive bacterial distinguishing. This kind of carbon dots has an average size of 1.91 nm and owns carboxyl groups, emerging as excellent candidates for imaging bacterial cells. The negative charges of carboxyl groups lead their avoidance of alive cells while their small size facilitates penetration of dead cells. This kind of nontoxic CDs has effectively differentiated between and alive ones, presenting a highly promising green dye comparing with traditional small molecular dyes.
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Affiliation(s)
- Yuting Liu
- Institute of Biomedical Engineering, College of Life Science, Qingdao University, Qingdao, 266071, China
| | - Yuanhong Xu
- Institute of Biomedical Engineering, College of Life Science, Qingdao University, Qingdao, 266071, China
| | - Qin Wen
- Institute of Biomedical Engineering, College of Life Science, Qingdao University, Qingdao, 266071, China.
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11
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Wright D, Christie J, Lawrence J, Vaughn KL, Walsh TF. Effectiveness of dry hydrogen peroxide in reducing air and surface bioburden in a multicenter clinical setting. Infect Control Hosp Epidemiol 2024; 45:501-508. [PMID: 38017626 PMCID: PMC11007363 DOI: 10.1017/ice.2023.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/04/2023] [Accepted: 06/09/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To determine the effectiveness of dry hydrogen peroxide (DHP) in reducing environmental bioburden in occupied areas. DESIGN Prospective environmental cohort study. SETTING The study was conducted in 2 tertiary-care hospitals and 1 free-standing emergency department. INTERVENTION Environmental air and surface sites were cultured before and after continuous deployment of DHP systems in targeted hospital areas. METHODS In total, 1,554 surface and 1,036 air samples were collected from 74 patient areas among the 3 facilities on 3 consecutive days before DHP deployment and on days 14, 30, 60, and 90 after deployment. At each sampling time, 2 air samples were collected at each facility from 1 room without DHP, along with 2 outdoor samples from each facility. The impact of negative-pressure usage on the efficacy of DHP was also evaluated, with 1 hospital continuously using negative pressure, another utilizing it only in patient isolation scenarios, and another without negative pressure. RESULTS In the 2 facilities without continuous negative pressure, exposure to DHP was associated with a significant reduction in surface bioburden, characterized as total colony-forming units (P = .019; P = .002). Significant associations between DHP exposure and reductions in airborne bacterial load at the 2 hospitals were observed (P ≤ .001; P = .041), and the free-standing emergency department experienced a reduction that did not achieve statistical significance (P = .073). CONCLUSIONS Our findings confirm that DHP has the potential to reduce microbial air and surface bioburden in occupied patient rooms with standard ventilation parameters.
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Affiliation(s)
- Don Wright
- Universal Health Services, King of Prussia, Pennsylvania
| | | | - Jordan Lawrence
- Department of Infection Prevention and Control, Aiken Regional Medical Centers, Aiken, South Carolina
| | - Kimberly L. Vaughn
- Department of Infection Prevention and Control, Henderson Hospital, Henderson, Nevada
| | - Timothy F. Walsh
- Department of Infection Prevention and Control, Valley Hospital Medical Center, Las Vegas, Nevada
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Aranega-Bou P, Cornbill C, Rodger G, Bird M, Moore G, Roohi A, Hopkins KL, Hopkins S, Ribeca P, Stoesser N, Lipworth SI. WITHDRAWN: Evaluation of Fourier Transform Infrared spectroscopy (IR Biotyper) as a complement to Whole genome sequencing (WGS) to characterise Enterobacter cloacae , Citrobacter freundii and Klebsiella pneumoniae isolates recovered from hospital sinks. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.04.24.23289028. [PMID: 37214917 PMCID: PMC10193520 DOI: 10.1101/2023.04.24.23289028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The authors have withdrawn their manuscript due to becoming aware of methodology issues related to the curation of the training set used to determine cut-off values for Biotyper cluster assignation and lack of replicate measurements on different days for the isolates analysed. It is therefore unclear whether the conclusions of the manuscript are founded and no further work is possible to correct these issues as the instrument is no longer available to the authors. If you have any questions, please contact the corresponding author.
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Hygiene requirements for cleaning and disinfection of surfaces: recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc13. [PMID: 38655122 PMCID: PMC11035912 DOI: 10.3205/dgkh000468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
This recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) addresses not only hospitals, but also outpatient health care facilities and compiles current evidence. The following criteria are the basis for the indications for cleaning and disinfection: Infectious bioburden and tenacity of potential pathogens on surfaces and their transmission routes, influence of disinfecting surface cleaning on the rate of nosocomial infections, interruption of cross infections due to multidrug-resistant organisms, and outbreak control by disinfecting cleaning within bundles. The criteria for the selection of disinfectants are determined by the requirements for effectiveness, the efficacy spectrum, the compatibility for humans and the environment, as well as the risk potential for the development of tolerance and resistance. Detailed instructions on the organization and implementation of cleaning and disinfection measures, including structural and equipment requirements, serve as the basis for their implementation. Since the agents for surface disinfection and disinfecting surface cleaning have been classified as biocides in Europe since 2013, the regulatory consequences are explained. As possible addition to surface disinfection, probiotic cleaning, is pointed out. In an informative appendix (only in German), the pathogen characteristics for their acquisition of surfaces, such as tenacity, infectious dose and biofilm formation, and the toxicological and ecotoxicological characteristics of microbicidal agents as the basis for their selection are explained, and methods for the evaluation of the resulting quality of cleaning or disinfecting surface cleaning are presented.
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14
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Sundermann AJ, Javaid W. Whole-genome sequencing surveillance: Growing evidence for a future potential practice standard of infection prevention. Infect Control Hosp Epidemiol 2024; 45:135-136. [PMID: 38073562 DOI: 10.1017/ice.2023.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
- Alexander J Sundermann
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Waleed Javaid
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York
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15
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Omardien S, Pingulkar S, Thayagan M, Buniotto L, de Oliveira Negreiros M. The antibacterial performance of a residual disinfectant against Staphylococcus aureus on environmental surfaces. Front Microbiol 2024; 15:1338238. [PMID: 38351915 PMCID: PMC10861741 DOI: 10.3389/fmicb.2024.1338238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Environmental surfaces play a key role in transmitting pathogens that can survive on surfaces for long durations. The interest in long-lasting or residual disinfectants are, therefore, growing as it might protect surfaces for longer than traditional disinfectants. In this study, a quat-based product claiming residual disinfecting performance against bacteria, among other microorganisms, was tested using an approved standardized method, in a controlled laboratory study and on environmental surfaces in an office building. The results obtained showed that the residual disinfectant can reduce the bacterial counts significantly compared to a traditional quat-based disinfectant when used on horizontal surfaces, twenty-four hours after application. During the standardized test method, the residual disinfectant provided a 6-log reduction, whereas the traditional disinfectant provided only a 1.9-log reduction. Similarly, the residual disinfectant provided a 2.5 log reduction in the laboratory study, whereas the traditional disinfectant had too-numerous-to-count colonies. When tested on environmental surfaces, an ANOVA statistical analysis indicated that surfaces treated with the residual disinfectant had significantly less bacteria present twenty-four hours after application. The antibacterial performance of the residual disinfectant showed to be limited by the orientation of the treated surface, and the thickness of the product film dried on the surface. This study showed the potential of residual disinfectants that warrants further investigation and could potentially aid the further development of the technology.
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Valzano F, Coda ARD, Marangi M, La Bella G, Liso A, Arena F. Activity of a foam in preventing rebound of vancomycin-resistant Enterococcus faecium-containing droplets generated from the toilet bowl. Arch Microbiol 2024; 206:57. [PMID: 38189992 PMCID: PMC10774183 DOI: 10.1007/s00203-023-03775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/10/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024]
Abstract
In hospital environments, droplets generated by urination within shared toilets may represent a route of dissemination for bacteria such as vancomycin-resistant Enterococcus faecium (VREfm), which contributes significantly to the burden of hospital-acquired infections. We investigated the potential activity of a foam in preventing the generation of droplets containing Enterococcus spp. during urination. A uniform layer of foam was deposited in the inner walls and at the bottom of an experimental toilet contaminated with suspensions of Enterococcus strains (including a VREfm strain). Human urination was simulated, and colonies of Enterococcus were recovered through a toilet lid where agar plates had been placed. Results showed that the foam was able to suppress production of droplets containing Enterococcus spp. generated by a liquid hitting inner toilet walls. Conversely, Enterococcus colonies were recovered in absence of foam. Moreover, the foam did not show antibacterial activity. We propose a new non-antimicrobial approach aimed at limiting transmission of multidrug-resistant bacteria, particularly in healthcare settings.
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Affiliation(s)
- Felice Valzano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 20, 71122, Foggia, Italy
| | - Anna Rita Daniela Coda
- Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122, Foggia, Italy
| | - Marianna Marangi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 20, 71122, Foggia, Italy
| | - Gianfranco La Bella
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 20, 71122, Foggia, Italy
- Istituto Zooprofilattico Sperimentale Della Puglia E Della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Arcangelo Liso
- Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122, Foggia, Italy
| | - Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 20, 71122, Foggia, Italy.
- IRCCS Don Carlo Gnocchi Foundation, Via Di Scandicci 269, 50143, Florence, Italy.
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Thompson E, Badu AT, Abban E, Eyeson EB, Afutu LL, Amankwaah B, Buabeng SD, Frimpong AA, Anning AS, Ghartey-Kwansah G. Bacterial contamination on clinical surfaces and oxygen device accessories in the emergency unit of a tertiary health facility in Ghana. BMC Infect Dis 2024; 24:14. [PMID: 38166624 PMCID: PMC10763297 DOI: 10.1186/s12879-023-08894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Nosocomial infections have gradually become an emerging threat to the healthcare system over the past decades and have been attributed to poor decontamination of hospital articles and weak antibacterial stewardship policies. This study sought to investigate the effect of disinfection on the prevalence and resistance profile of bacterial contaminants on oxygen device accessories, and clinical surfaces at the emergency unit of a tertiary health facility in Ghana. METHODS The study employed a cross-sectional study design to evaluate the occurrence of bacteria on surfaces in a tertiary hospital. Luminal swabs of the oxygen device accessories and swabs from clinical surfaces used by healthcare providers were collected for isolation and identification of bacteria. The identified bacteria isolates were then tested for their susceptibility to antibacterial agents. Data from this study were analyzed using Excel (Microsoft Office Suite), and GraphPad Prism 8 software programs. RESULTS A quarter of the total 44 bacterial isolates obtained from both post-disinfected and pre-disinfected surfaces were Gram-positive, with the remaining isolates being Gram-negative. Pseudomonas aeruginosa was the most frequent bacteria species isolated (41%) followed by Citrobacter sp. (21%). P. aeruginosa, S. aureus, and S. pneumoniae were found to be highly resistant to Chloramphenicol (36%), and Sulfamethoxazole (100%); whereas Ciprofloxacin (91%) was the most effective antibacterial drug used. CONCLUSION The almost equal prevalence of multidrug-resistant bacteria from both post-disinfected and pre-disinfected surfaces of inanimate objects, and oxygen device accessories connote an ineffective disinfection process which may influence resistance in bacterial contaminants. This requires the overhaul of disinfection protocol and training of hospital staff, and rational use of antibacterial agents at the hospital to mitigating the burden of nosocomial infections.
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Affiliation(s)
- Evans Thompson
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Akua Tutuwaa Badu
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Emmanuella Abban
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | | | - Bless Amankwaah
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Suzzana Dickson Buabeng
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Abigail Agyen Frimpong
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Alberta Serwah Anning
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - George Ghartey-Kwansah
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
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Fu H, Shewfelt S, Sylvan LD, Gaillard JF, Gray KA. Polyaniline-metal oxide coatings for biocidal applications: Mechanisms of activation and deactivation. CHEMOSPHERE 2024; 346:140543. [PMID: 37918530 DOI: 10.1016/j.chemosphere.2023.140543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
Metal oxide (MO) coatings (e.g. TiO2, ZnO, and CuO) have shown great promise to inactivate pathogenic bacteria, maintain self-cleaning surfaces, and prevent infectious diseases spread via surface contact. Under light illumination, the antibacterial performance of photoactive MO coatings is determined by reactive oxygen species (ROS) generation. However, several drawbacks, such as photo-corrosion and rapid electron-hole recombination, hinder the ROS production of MO coatings and diminish their antibacterial efficiency. In this study, we employed polyaniline (PANI), an inexpensive and easy-to-synthesize conductive polymer, to fabricate polyaniline-metal oxide composite (PMC) films. The antibacterial performance of PMC films was tested using E. coli as the model bacterium and Lake Michigan water (LMW) as the background medium and revealed enhanced antibacterial performance relative to MO coatings alone (approximately 75-90 % kill of E. coli by PMC coatings in comparison to 20-40 % kill by MO coatings), which is explained by an increase in the ROS yields of PMC. However, with repeated use, the antibacterial performance of the PMC coatings is diminished due to deprotonation of the PANI in the neutral/slightly basic aqueous environment of LMW. Overall, PANI can enhance the antibacterial performance of MO coatings, but efforts need to be directed to preserve or regenerate PMC stability under environmental conditions and applications.
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Affiliation(s)
- Han Fu
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Sofia Shewfelt
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Lena D Sylvan
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Jean-François Gaillard
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Kimberly A Gray
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA.
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Abou Yassine K, El-Saed A, Othman F, Ramou S, Al Alwan BH, Ameer K, Hawthan M, Al Zunitan M, Alshamrani MM. Awareness of health care workers with appropriate infection control practices related to multi-patient use of Close Loop Medication Administration device. Infect Prev Pract 2023; 5:100323. [PMID: 38028360 PMCID: PMC10665828 DOI: 10.1016/j.infpip.2023.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/01/2023] [Indexed: 12/01/2023] Open
Abstract
Background Portable computerized devices represent a potential source of healthcare infections. The objective was to assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) toward infection control practices used with Close Loop Medication Administration (CLMA) devices. Additionally, to quantify the impact of education and training on the bacterial burden on CLMA devices. Methods The study design consisted of two steps: a cross-sectional study was conducted among HCWs working in a tertiary care center in Riyadh, Saudi Arabia. A 32-item questionnaire was used to assess KAP information. The second step was environmental samples collected from the surfaces of CLMA devices before and after implementing a multifaceted intervention. Result A total of 325 HCWs were included in the study. The mean age was 32.6±7.4 years. The majority were females (92%) and nurses (91.3%). The overall KAP score was 74.8%, 74.2% adequate knowledge, 79.3% positive attitude, and 71.3% appropriate practices. KAP score was better (≥ median KAP score) among HCWs working in laboratory and organ transplant units (P<0.001). It was also better among those with a longer duration of work experience (P<0.001) and those who received related training (P<0.001). Approximately 75% of HCWs expressed their need for more information about CLMA. Post-interventional samples had much lower bacterial burden, with the positive rate reduced from 51.4% before intervention to 16.8% after intervention (P<0.001). Conclusions Awareness and behavior of HCWs about appropriate infection control practices related to portable devices is still inadequate. A multifaceted intervention including education and training significantly reduces the bioburden on portable devices.
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Affiliation(s)
- Kassem Abou Yassine
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Aiman El-Saed
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Fatmah Othman
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sarr Ramou
- Microbiology Laboratory, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia
| | - Bassam H. Al Alwan
- Microbiology Laboratory, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia
| | - Kholoud Ameer
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mustafa Hawthan
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed Al Zunitan
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Majid M. Alshamrani
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Asghar MU, Ain NU, Zaidi AH, Tariq M. Molecular distribution of biocide resistance genes and susceptibility to biocides among vancomycin resistant Staphylococcus aureus (VRSA) isolates from intensive care unit (ICU) of cardiac hospital- A first report from Pakistan. Heliyon 2023; 9:e22120. [PMID: 38046134 PMCID: PMC10686860 DOI: 10.1016/j.heliyon.2023.e22120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/01/2023] [Accepted: 11/05/2023] [Indexed: 12/05/2023] Open
Abstract
Background The study was conducted with the aim to investigate the VRSA isolates in terms of their susceptibility to routinely used biocides influenced by the co-occurrence of biocide resistant gene (BRGs) and efflux pumps genes. Methodology Frequently touched surfaces within intensive care unit (ICU) of cardiac hospital were classified into three primary sites i.e., structure, machines and miscellaneous. Over a period of six months (January 2021 to July 2021) twenty three swabs samples were collected from these sites. Subsequently, these samples underwent both phenotypic and molecular methods for VRSA isolation and identification. Susceptibility and efficacy testing of biocides (benzalkonium chloride (BAC), cetrimide (CET) and chlorhexidine gluconate (CHG)) were evaluated using microdilution broth and suspension method. Furthermore, specific primers were used for singleplex PCR targeting BRGs (cepA, qacA, and qacE) and efflux pump (norA, norB, norC, sepA, mepA and mdeA) associated genes. Results We found that 72.2 % S. aureus demonstrate the presence of vanA or vanB genes with no significant difference among three sites (p > 0.05). cepA is the most dominant BRGs followed by qacA and qacE from structure site as compared to other sites (p < 0.05). BAC showed reduced biocide susceptibility and MIC50. There was no significant difference between presence or absence of BRGs and high MIC values of VRSA isolates from all three sites. However, efflux pump genes (EFPGs) particularly norA and norA + sepA had a significant association with BRGs and reduced biocide. Conclusion BAC is the most effective disinfectant against VRSA. Proper and controlled use of BAC is required to overcome the VRSA contamination. We recommend continuous monitoring of the BRGs prevalence for better prevention of microorganism dissemination and infection control in hospitals.
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Affiliation(s)
- Muhammad Umer Asghar
- National Probiotic Lab, National Institute for Biotechnology and Genetic Engineering-College (NIBGE-C), Faisalabad, 38000, Pakistan
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad, 45650, Pakistan
| | - Noor Ul Ain
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Arsalan Haseeb Zaidi
- National Probiotic Lab, National Institute for Biotechnology and Genetic Engineering-College (NIBGE-C), Faisalabad, 38000, Pakistan
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad, 45650, Pakistan
| | - Muhammad Tariq
- National Probiotic Lab, National Institute for Biotechnology and Genetic Engineering-College (NIBGE-C), Faisalabad, 38000, Pakistan
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad, 45650, Pakistan
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Kindu M, Moges F, Ashagrie D, Tigabu Z, Gelaw B. Multidrug-resistant and carbapenemase-producing critical gram-negative bacteria isolated from the intensive care unit environment in Amhara region, Ethiopia. PLoS One 2023; 18:e0295286. [PMID: 38033134 PMCID: PMC10688904 DOI: 10.1371/journal.pone.0295286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Intensive care units are units where healthcare-associated infections (HAIs) are common and antimicrobial resistance rates are increasing. Microbial contamination in hospital environment plays an important role in the development of HAIs. Intervention-based improvements in infection prevention and control at national and facility level are critical for the containment of antimicrobial resistance and prevention of HAIs. OBJECTIVES This study aimed to determine the distribution of multidrug-resistant and carbapenemase-producing critical gram negative bacteria (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter species) and their antibiotic resistance in intensive care unit environmental surfaces at the University of Gondar and Felege Hiwot Comprehensive Specialized Hospitals. METHODS This was multicenter hospital-based cross sectional study. Environmental samples were swabbed from all intensive care units using a normal saline moistened-sterile cotton tip stick. Bacteria culturing and antibiotic susceptibility testing were performed following standard microbiological techniques. Selected meropenem-resistant isolates were phenotypically assessed for carbapenemase production using modified and simplified carbapenem inactivation methods. RESULTS From a total of 384 environmental samples analyzed, 126 (32.8%) showed growth and 162 isolates were identified. K. pneumoniae (79/162, 48.8%) was the commonest isolate followed by Acinetobacter species (51/162, 31.5%), E. coli (19/162, 11.7%) and P. aeruginosa (13/162, 8.0%). Multidrug-resistant and carbapenemase-producing isolates were detected on most hospital environment surface types, especially from the baby bed sets and incubators. The most common multidrug-resistant and principal carbapenemase producer was K. pneumoniae, with rates of 71(89.9%) and 24(85.7%), respectively. CONCLUSION This study revealed the distribution of multidrug-resistant and carbapenemase-producing critical gram negative bacteria in the environment of intensive care unit. Higher detection rate of multidrug-resistant and carbapenemase-producing K. pneumoniae on most environmental surfaces calls for urgent control action and further attention.
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Affiliation(s)
- Mizan Kindu
- Department of Medical Microbiology, University of Gondar, Gondar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, University of Gondar, Gondar, Ethiopia
| | - Degu Ashagrie
- Medical Microbiology Laboratory, Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia
| | - Zemene Tigabu
- Department of Pediatrics and Child health, University of Gondar, Gondar, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, University of Gondar, Gondar, Ethiopia
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Smith JL, Tzouganakis I, Allen R, Adams VJ, Rhodes M. An assessment of bacterial contamination of indirect ophthalmoscopes and condensing lenses used in clinical practice: A multi-center study. Vet Ophthalmol 2023. [PMID: 37985395 DOI: 10.1111/vop.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/23/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE To investigate bacterial contamination of indirect ophthalmoscopes and condensing lenses used in three UK veterinary referral centers, and the impact of an implemented cleaning protocol. METHODS Bacteriology samples from 10 indirect ophthalmoscopes and 10 condensing lenses were taken at each center (n = 30 T0), before initiating one of three cleaning frequencies (every 2 weeks/once weekly/daily) for 28 days. The most contaminated indirect ophthalmoscope and condensing lens from each center were re-sampled 30 min prior to (T1; n = 9) and 30 min after (T2; n = 9) the final clean. Sensitivity testing was completed using MIC. RESULTS Seventy-three isolates representing 15 different bacterial populations (genus/species) were cultured from 36 of 48 (75%) swabs tested. The most frequently cultured isolates were Staphylococcus spp. 30%, Micrococcus 22%, and Bacillus 14%. Pseudomonas aeruginosa, Pantoea, and Staphylococcus pseudintermedius demonstrated resistance to >50% of antibiotics against which they were tested. Eighty-three percent of T0 samples (54 isolates across 11 species, median 2 isolates/swab), all T1 samples (15 isolates across 8 species, median 2 isolates/swab), and 22% of T2 samples (4 isolates across 4 species, median 0 isolates/swab) were contaminated. Head contact points were most contaminated irrespective of time point. A T1 sample was 57 times more likely (95% CI: 2.4-1376) to have a positive culture than a T2 sample (p = .01). CONCLUSIONS Baseline contamination was high, representing a potential source of nosocomial infection in ophthalmic patients and handlers of diagnostic equipment. No center implemented a cleaning protocol prior to this study. Routine cleaning reduces bacterial contamination.
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Weber DJ, Rutala WA, Anderson DJ, Sickbert-Bennett EE. ..úNo touch..Ñ methods for health care room disinfection: Focus on clinical trials. Am J Infect Control 2023; 51:A134-A143. [PMID: 37890944 DOI: 10.1016/j.ajic.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Hospital patient room surfaces are frequently contaminated with multidrug-resistant organisms. Since studies have demonstrated that inadequate terminal room disinfection commonly occurs, ..úno touch..Ñ methods of terminal room disinfection have been developed such as ultraviolet light (UV) devices and hydrogen peroxide (HP) systems. METHODS This paper reviews published clinical trials of ..úno touch..Ñ methods and ..úself-disinfecting..Ñ surfaces. RESULTS Multiple papers were identified including clinical trials of UV room disinfection devices (N.ß=.ß20), HP room disinfection systems (N.ß=.ß8), handheld UV devices (N.ß=.ß1), and copper-impregnated or coated surfaces (N.ß=.ß5). Most but not all clinical trials of UV devices and HP systems for terminal disinfection demonstrated a reduction of colonization/infection in patients subsequently housed in the room. Copper-coated surfaces were the only ..úself-disinfecting..Ñ technology evaluated by clinical trials. Results of these clinical trials were mixed. DISCUSSION Almost all clinical trials reviewed used a ..úweak..Ñ design (eg, before-after) and failed to assess potential confounders (eg, compliance with hand hygiene and environmental cleaning). CONCLUSIONS The evidence is strong enough to recommend the use of a ..úno-touch..Ñ method as an adjunct for outbreak control, mitigation strategy for high-consequence pathogens (eg, Candida auris or Ebola), or when there are an excessive endemic rates of multidrug-resistant organisms.
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Affiliation(s)
- David J Weber
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC.
| | - William A Rutala
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, NC
| | - Emily E Sickbert-Bennett
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC
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Pandya VS, Morsy MS, Hassan AAHAA, Alshawkani HA, Sindi AS, Mattoo KA, Mehta V, Mathur A, Meto A. Ultraviolet disinfection (UV-D) robots: bridging the gaps in dentistry. FRONTIERS IN ORAL HEALTH 2023; 4:1270959. [PMID: 38024151 PMCID: PMC10646406 DOI: 10.3389/froh.2023.1270959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Maintaining a microbe-free environment in healthcare facilities has become increasingly crucial for minimizing virus transmission, especially in the wake of recent epidemics like COVID-19. To meet the urgent need for ongoing sterilization, autonomous ultraviolet disinfection (UV-D) robots have emerged as vital tools. These robots are gaining popularity due to their automated nature, cost advantages, and ability to instantly disinfect rooms and workspaces without relying on human labor. Integrating disinfection robots into medical facilities reduces infection risk, lowers conventional cleaning costs, and instills greater confidence in patient safety. However, UV-D robots should complement rather than replace routine manual cleaning. To optimize the functionality of UV-D robots in medical settings, additional hospital and device design modifications are necessary to address visibility challenges. Achieving seamless integration requires more technical advancements and clinical investigations across various institutions. This mini-review presents an overview of advanced applications that demand disinfection, highlighting their limitations and challenges. Despite their potential, little comprehensive research has been conducted on the sterilizing impact of disinfection robots in the dental industry. By serving as a starting point for future research, this review aims to bridge the gaps in knowledge and identify unresolved issues. Our objective is to provide an extensive guide to UV-D robots, encompassing design requirements, technological breakthroughs, and in-depth use in healthcare and dentistry facilities. Understanding the capabilities and limitations of UV-D robots will aid in harnessing their potential to revolutionize infection control practices in the medical and dental fields.
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Affiliation(s)
- Visha Shailesh Pandya
- Department of Public Health Dentistry, Vaidik Dental College & Research Centre, Dadra and Nagar Haveli and Daman and Diu, India
| | - Mohamed S.M. Morsy
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Hamed A. Alshawkani
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abdulelah Sameer Sindi
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Khurshid A. Mattoo
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Vini Mehta
- Department of Dental Research Cell, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Ankita Mathur
- Department of Dental Research Cell, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Aida Meto
- Department of Dental Research Cell, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, Tirana, Albania
- Clinical Microbiology, School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
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25
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Marek A, Meijer EFJ, Tartari E, Zakhour J, Chowdhary A, Voss A, Kanj SS, Bal AM. Environmental monitoring for filamentous fungal pathogens in hematopoietic cell transplant units. Med Mycol 2023; 61:myad103. [PMID: 37793805 DOI: 10.1093/mmy/myad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 10/06/2023] Open
Abstract
The incidence of invasive fungal disease (IFD) is on the rise due to increasing numbers of highly immunocompromized patients. Nosocomial IFD remains common despite our better understanding of its risk factors and pathophysiology. High-efficiency particulate air filtration with or without laminar air flow, frequent air exchanges, a positive pressure care environment, and environmental hygiene, amongst other measures, have been shown to reduce the mould burden in the patient environment. Environmental monitoring for moulds in areas where high-risk patients are cared for, such as hematopoietic cell transplant units, has been considered an adjunct to other routine environmental precautions. As a collaborative effort between authors affiliated to the Infection Prevention and Control Working Group and the Fungal Infection Working Group of the International Society of Antimicrobial Chemotherapy (ISAC), we reviewed the English language literature and international guidance to describe the evidence behind the need for environmental monitoring for filamentous fungi as a quality assurance approach with an emphasis on required additional precautions during periods of construction. Many different clinical sampling approaches have been described for air, water, and surface sampling with significant variation in laboratory methodologies between reports. Importantly, there are no agreed-upon thresholds that correlate with an increase in the clinical risk of mould infections. We highlight important areas for future research to assure a safe environment for highly immunocompromized patients.
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Affiliation(s)
- Aleksandra Marek
- Department of Microbiology, Glasgow Royal Infirmary, Glasgow, UK
- Infection Control Working Group, International Society of Antimicrobial Chemotherapy
| | - Eelco F J Meijer
- Canisius-Wilhelmina Hospital (CWZ), Medical Microbiology and Infectious Diseases, Nijmegen, The Netherlands
- Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, The Netherlands
- Fungal Infection Working Group, International Society of Antimicrobial Chemotherapy
| | - Ermira Tartari
- Faculty of Health Sciences, University of Malta, Msida, Malta
- Infection Control Working Group, International Society of Antimicrobial Chemotherapy
| | - Johnny Zakhour
- Division of Infectious Diseases, Department of Internal Medicine and Center for Infectious Diseases Research, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anuradha Chowdhary
- Medical Mycology Unit, Department of Microbiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
- National Reference Laboratory for Antimicrobial Resistance in Fungal Pathogens, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
- Fungal Infection Working Group, International Society of Antimicrobial Chemotherapy
| | - Andreas Voss
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands
- Infection Control Working Group, International Society of Antimicrobial Chemotherapy
| | - Souha S Kanj
- Division of Infectious Diseases, Department of Internal Medicine and Center for Infectious Diseases Research, American University of Beirut Medical Center, Beirut, Lebanon
- Fungal Infection Working Group, International Society of Antimicrobial Chemotherapy
| | - Abhijit M Bal
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
- Fungal Infection Working Group, International Society of Antimicrobial Chemotherapy
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Oh E, Choi SJ, Han S, Lee KH, Choi HJ. Highly Effective Salt-Activated Alcohol-Based Disinfectants with Enhanced Antimicrobial Activity. ACS NANO 2023; 17:17811-17825. [PMID: 37639494 DOI: 10.1021/acsnano.3c03315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Surfaces contaminated with pathogens raise concerns about the increased risk of disease transmission and infection. To clean biocontaminated surfaces, alcohol-based disinfectants have been predominantly used for disinfecting high-touch areas in diverse settings. However, due to its limited antimicrobial activities and concern over the emergence of alcohol-tolerant strains, much effort has been made to develop highly efficient disinfectant formulations. In this study, we hypothesize that the addition of a physical pathogen inactivation mechanism by salt recrystallization (besides the existing chemical inactivation mechanism by alcohol in such formulations) can improve inactivation efficiency by preventing the emergence of alcohol tolerance. To this end, we employed the drying-induced salt recrystallization process to implement the concept of highly efficient alcohol-based disinfectant formulations. To identify the individual and combined effects of isopropyl alcohol (IPA) and NaCl, time-dependent morphological/structural changes of various IPA solutions containing NaCl have been characterized by optical microscopy/X-ray diffraction analysis. Their antimicrobial activities have been tested on surfaces (glass slide, polystyrene Petri dish, and stainless steel) contaminated with Gram-positive/negative bacteria (methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Salmonella enterica subsp. enterica Typhimurium) and viruses (A/PR8/34 H1N1 influenza virus and HCoV-OC43 human coronavirus). We found that additional salt crystallization during the drying of the alcohol solution facilitated stronger biocidal effects than IPA-only formulations, regardless of the types of solid surfaces and pathogens, including alcohol-tolerant strains adapted from wild-type Escherichia coli MG1655. Our findings can be useful in developing highly effective disinfectant formulations by minimizing the use of toxic antimicrobial substances to improve public health and safety.
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Affiliation(s)
- Euna Oh
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada
| | - Seung Joon Choi
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada
- Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Sumin Han
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada
| | - Kyu Hyoung Lee
- Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Hyo-Jick Choi
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada
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Jarelnape AA. The Assessment of Nursing Staff Knowledge and Barriers Regarding Aseptic Techniques in Khartoum Teaching Hospital, Sudan. Cureus 2023; 15:e45265. [PMID: 37846261 PMCID: PMC10576657 DOI: 10.7759/cureus.45265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/18/2023] Open
Abstract
Background Aseptic techniques are crucial in preventing healthcare-associated infections, which are an integral part of standard precautions, and encompass a range of practices designed to safeguard patients from healthcare-associated infections. Objective The objective of this study was to evaluate the level of knowledge and identify the barriers faced by nursing staff in implementing aseptic techniques. Methodology This study employed a stratified random sampling technique to ensure the representation of the research sample. A cross-sectional, descriptive research design was used to assess the knowledge and barriers of nursing staff in maintaining aseptic techniques in their medical practice at Khartoum Teaching Hospital, Sudan. The nursing staff members were divided into different units, and a proportionate number of participants were randomly selected from each stratum. A total of 83 nursing staff members were recruited for this study. Data collection was conducted using a structured questionnaire specifically designed for this study. The questionnaire consisted of items that assessed the nursing staff's knowledge and barriers to aseptic technique implementation. Results The study findings revealed that the mean knowledge score of nursing staff was 14.12, with a median score of 15. The knowledge score had a standard deviation of 3.22. Approximately two-thirds of the nurses (66.3%) had an average level of knowledge, while 33.7% had a below-average level of knowledge. The chi-square analysis indicated a significant association between educational level, years of experience, and knowledge scores (P value=0.010) at a significance level of 0.05. Additionally, 65% of the participants reported facing multiple challenges in maintaining aseptic techniques, including insufficient training, limited resources, and inadequate support. Conclusion In conclusion, the evaluation revealed that a significant proportion of participants felt that their unit lacked adequate training and resources for aseptic techniques. Many had observed colleagues not adhering to aseptic practices, and the participants faced multiple challenges in maintaining aseptic techniques, including insufficient training, limited resources, time constraints, and inadequate support.
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Affiliation(s)
- Ahmed A Jarelnape
- Department of Nursing, Faculty of Applied Medical Sciences, Al Baha University, Al Baha, SAU
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28
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Peng Y, Wang L, Jin J, Jiang Y, Xu Q, Yang L, Liu J. Flexible ureteroscopy under local anesthesia for stone management: initial exploration and two-year experience. Postgrad Med 2023; 135:755-762. [PMID: 37773585 DOI: 10.1080/00325481.2023.2265991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/28/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Flexible ureteroscopy (f-URS) is a minimally invasive surgical technique used for treating urinary tract stones. While general anesthesia (GA) is the standard method used, it comes with risks. Local anesthesia (LA) is a safer and more cost-effective alternative to GA, and its use in f-URS could potentially reduce patients' risks and increase accessibility to treatment. This study aims to investigate the feasibility, safety, and efficacy of using LA for f-URS in treating stones, as an initial experience in the diagnosis related group (DRG) era of China. METHODS Patients who met the inclusion and exclusion criteria and were continuously included in the study Between 2021 and 2023. We analyzed the stone free status, postoperative complication rate, hospitalization costs, and presented key points of the procedure performed under LA that we had summarized over the past two years. RESULTS A study of 614 patients undergoing f-URS under LA for urinary stones in our hospital showed 83.4% stone-free rate with a mean operative time of 44.12 ± 16.63 minutes; 18 patients experienced fever postoperatively, and 12 had ureteral injuries. No severe complication was reported. The cost of LA was found to be only 1.7% of the DRG payment, which is around $40. The highest VAS scores were observed during the sheath insertion, with STAI scores decreasing during and after surgery. CONCLUSIONS The study revealed that f-URS administered under LA was a well-tolerated, efficient, safe, and economical procedure. In the DRG era, this new anesthetic option for f-URS provides urologists with a more cost-effective alternative.
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Affiliation(s)
- Yueqiang Peng
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linfeng Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiajia Jin
- Psychological department, Chongqing University Cancer Hospital, Chongqing, China
| | - Yu Jiang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiao Xu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lei Yang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiayu Liu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Anderson TL, Nande A, Merenstein C, Raynor B, Oommen A, Kelly BJ, Levy MZ, Hill AL. Quantifying individual-level heterogeneity in infectiousness and susceptibility through household studies. Epidemics 2023; 44:100710. [PMID: 37556994 PMCID: PMC10594662 DOI: 10.1016/j.epidem.2023.100710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/17/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. "Superspreading," or "over-dispersion," is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities given data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.
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Affiliation(s)
- Thayer L Anderson
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America
| | - Anjalika Nande
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America
| | - Carter Merenstein
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Brinkley Raynor
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Anisha Oommen
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States of America
| | - Brendan J Kelly
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America; Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America; Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Michael Z Levy
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States of America.
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Leite DPDSBM, Barbosa IC, da Silva RA, Fernandes PR, Abad ACA, da Silva JG, Mota RA, Porto TS. Occurrence of antimicrobial-resistant Staphylococcus aureus in a Brazilian veterinary hospital environment. Braz J Microbiol 2023; 54:2393-2401. [PMID: 37407882 PMCID: PMC10485224 DOI: 10.1007/s42770-023-01035-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 06/07/2023] [Indexed: 07/07/2023] Open
Abstract
Antimicrobial resistance is a threat to public health. The emergence of antibiotic-resistant Staphylococcus aureus represents a priority for the implementation of preventive measures. The objective was to isolate S. aureus in humans, animals, and animal health care environment, and to characterize the genotypic and phenotypic profile of antimicrobial resistance in these isolates. We isolated S. aureus from staff, animals, and environment of a veterinary hospital, and identified their antimicrobial resistance profiles. Samples were collected from 20 humans, 13 animals, 14 surfaces, 8 mobile phones, and 7 veterinarians' stethoscopes by using sterile swabs. S. aureus was isolated by culturing on mannitol salt agar and preliminary identification was done by Gram staining and catalase test. Subsequently, a polymerase chain reaction was performed for species confirmation and investigating their antimicrobial-resistant genotypic profiles. Phenotypic profiles of resistant isolates were determined using the disk-diffusion technique. Ten S. aureus isolates were recovered from 5/20 humans (25%), it was also recovered from 2/13 animals (15.38%), including 1 dog and 1 cat, and from 1/14 of surfaces (7.14%). The oxacillin-susceptible mecA-positive Staphylococcus aureus phenotype was identified in a feline. Most of the isolates carried at least two resistance genes of different antimicrobial classes, with 90% (9/10) presenting the gene blaZ, with 10% (1/10) presenting the gene mecA, 20% (2/10) presenting tet38, 10% (1/10) presenting tetM, 90% (9/10) presenting norA, 50% (5/10) presenting norC, 10% (1/10) presenting ermA, and 60% (6/10) presenting ermB. In antibiograms, resistance to penicillin was identified in all the isolates, resistance to erythromycin was identified in 80% (8/10), and all the isolate's resistance to erythromycin presented erythromycin-induced resistance to clindamycin. Antimicrobial resistance in the veterinary hospital requires attention due to the risk of interspecies transmission, gene transfer between bacteria that colonize companion animals and humans and, can make antimicrobial therapy difficult.
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Affiliation(s)
- Denny Parente de Sá Barreto Maia Leite
- Department of Veterinary Medicine, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
| | - Iago Carvalho Barbosa
- Department of Veterinary Medicine, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
| | - Renato Amorim da Silva
- Department of Veterinary Medicine, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
| | - Pollyanne Raysa Fernandes
- Department of Veterinary Medicine, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
| | - Atzel Candido Acosta Abad
- Department of Veterinary Medicine, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil
| | - José Givanildo da Silva
- Department of Preventive Veterinary Medicine and Animal Production, School of Veterinary Medicine and Zootechnics, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rinaldo Aparecido Mota
- Department of Veterinary Medicine, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil.
| | - Tatiana Souza Porto
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil.
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Serra Neto A, Marques SG, Bomfim MRQ, Monteiro SG, de Souza RC, Nunes RA. Microbiological Analysis of Surgeons' Hands in a Public Hospital in São Luis, Maranhão State, Brazil: A Cross-Sectional Study. Microorganisms 2023; 11:1895. [PMID: 37630455 PMCID: PMC10456775 DOI: 10.3390/microorganisms11081895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private clinical analysis laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 and Phoenix-BD automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p < 0.05) to 27.5%. The gram-positive species most detected were Staphylococcus spp. and Micrococcus luteus, representing 83.9%, followed by gram-negative species, Stenotrophomonas maltophilia, Acinetobacter baumanii, Pseudomonas aeruginosa, Pseudomonas gessardi, Pantoea septica, Serratia marcescens, and Burkholderia lata. The effectiveness of hand antisepsis was 72.5%, demonstrating that surgeons' hands are an important source of microorganisms that can cause infections in hospitalized patients in different care settings.
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Affiliation(s)
- Artur Serra Neto
- Departamento de Cirurgia Geral, Hospital Universitário da Universidade Federal do Maranhão (HUUFMA), São Luís 65020-070, Brazil
| | - Sirlei G. Marques
- Departamento de Planejamento de Gestão da Qualidade e Vigilância em Saúde, Hospital Universitário da Universidade Federal do Maranhão (HUUFMA), São Luís 65020-070, Brazil;
| | - Maria Rosa Q. Bomfim
- Departamento de Biologia Molecular, Universidade Ceuma (UNICEUMA), São Luís 65075-120, Brazil;
| | - Silvio G. Monteiro
- Departamento de Biologia, Universidade Federal do Maranhão (UFMA), São Luís 65080-805, Brazil;
| | - Rosangela C. de Souza
- Departamento de Medicina, Universidade Federal do Maranhão (UFMA), São Luís 65080-805, Brazil;
| | - Rodolfo A. Nunes
- Departamento de Cirurgia Geral, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20550-900, Brazil;
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Biondo C, Ponzo E, Midiri A, Ostone GB, Mancuso G. The Dark Side of Nosocomial Infections in Critically Ill COVID-19 Patients. Life (Basel) 2023; 13:1408. [PMID: 37374189 DOI: 10.3390/life13061408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a potentially serious acute respiratory infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since the World Health Organization (WHO) declared COVID-19 a global pandemic, the virus has spread to more than 200 countries with more than 500 million cases and more than 6 million deaths reported globally. It has long been known that viral respiratory tract infections predispose patients to bacterial infections and that these co-infections often have an unfavourable clinical outcome. Moreover, nosocomial infections, also known as healthcare-associated infections (HAIs), are those infections that are absent at the time of admission and acquired after hospitalization. However, the impact of coinfections or secondary infections on the progression of COVID-19 disease and its lethal outcome is still debated. The aim of this review was to assess the literature on the incidence of bacterial co-infections and superinfections in patients with COVID-19. The review also highlights the importance of the rational use of antibiotics in patients with COVID-19 and the need to implement antimicrobial stewardship principles to prevent the transmission of drug-resistant organisms in healthcare settings. Finally, alternative antimicrobial agents to counter the emergence of multidrug-resistant bacteria causing healthcare-associated infections in COVID-19 patients will also be discussed.
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Affiliation(s)
- Carmelo Biondo
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
| | - Elena Ponzo
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
| | - Angelina Midiri
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
| | | | - Giuseppe Mancuso
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
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Maurici M, Pica F, D'Alò GL, Cicciarella Modica D, Distefano A, Gorjao M, Simonelli MS, Serafinelli L, De Filippis P. Bacterial Contamination of Healthcare Students' Mobile Phones: Impact of Specific Absorption Rate (SAR), Users' Demographics and Device Characteristics on Bacterial Load. Life (Basel) 2023; 13:1349. [PMID: 37374131 DOI: 10.3390/life13061349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
We quantitatively and qualitatively evaluated the bacterial contamination of mobile phones (MPs) in relation to users' demographics, habits, and device characteristics by administering questionnaires to 83 healthcare university students and sampling their MPs by following a cross-sectional design. The heterotrophic plate count (HPC) at 22 °C (HPC 22 °C) and 37 °C (HPC 37 °C), Enterococci, Gram-negative bacteria, and Staphylococci were evaluated. Higher bacterial loads were detected for HPC 37 °C and Staphylococci (416 and 442 CFU/dm2, respectively), followed by HPC 22 °C, Enterococci, and Gram-negative bacteria; the vast majority of samples were positive for HPC 37 °C, HPC 22 °C, and Staphylococci (98%), while Enterococci (66%) and Gram-negative bacteria (17%) were detected less frequently. A statistically significant positive correlation (r = 0.262, p < 0.02) was found between the European head specific absorption rate (SAR) and both HPC 37 °C and Staphylococci; Enterococci showed a strong, significant correlation with HPC 37 °C, HPC 22 °C, and Gram-negative bacteria (r = 0.633, 0.684, 0.884) and a moderate significant correlation with Staphylococci (r = 0.390). Significant differences were found between HPC 22 °C and the type of internship attendance, with higher loads for Medicine. Students with a daily internship attendance had higher HPC 22 °C levels than those attending <6 days/week. Our study showed that bacteria can survive on surfaces for long periods, depending on the user's habits and the device's characteristics.
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Affiliation(s)
- Massimo Maurici
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesca Pica
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gian Loreto D'Alò
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- District 6, Local Health Authority Roma 2, 00100 Rome, Italy
| | | | - Alessandra Distefano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Margarida Gorjao
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Maria Sofia Simonelli
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Livio Serafinelli
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Patrizia De Filippis
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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Ahmed G, Rasheed A, Munawar KS, Bandaru S, Khan J, Liu Z, Ahmad MS. Visible light-driven photocatalytic bacterial inactivation on PPE, supported by the DFT and bactericidal study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27867-5. [PMID: 37273042 DOI: 10.1007/s11356-023-27867-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/18/2023] [Indexed: 06/06/2023]
Abstract
A novel ZnO-MoO3-ZnMoO3@graphene GZM composite catalyst prepared by microwave hydrothermal process for personal protective equipment textiles (PPE) is presented in this study. The results indicated that the GZM with defect vacancy sites of two types as observed by EPR showed significantly superior inactivation of the E. coli bacteria compared to GZM without the lower defect vacancy sites and concomitant lower electron densities. Photocatalytic activated oxidation by the GZM composites coatings was observed to proceed in acceptable times as well as the bacterial inactivation (log bact. C/Co > 107 within 3 h). Defect sites in the GZM seem to be important leading to the bacterial inactivation process. DFT calculations on the GZM with and without catalyst defect sites were carried out. The electron densities were estimated by the Fourier mapping. The results found in this study showed the potential of GZM-PPE for practical applications.
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Affiliation(s)
- Gulzar Ahmed
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510640, China.
| | - Adeel Rasheed
- Department of Physics, University of Mianwali, Mianwali, 42200, Pakistan
| | | | - Satesh Bandaru
- College of Material Science and Environmental Engineering, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Javid Khan
- College of Material Science and Engineering, Hunan University, Changsha, 410082, China
| | - Zhongwu Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510640, China
| | - Muhammad Sheraz Ahmad
- Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, New Taipei City, 24301, Taiwan
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Cassone M, Wang J, Lansing BJ, Mantey J, Gibson KE, Gontjes KJ, Mody L. Diversity and Persistence of MRSA and VRE in Skilled Nursing Facilities: Environmental Screening, Whole Genome Sequencing, Development of a Dispersion Index. J Hosp Infect 2023:S0195-6701(23)00140-8. [PMID: 37160232 DOI: 10.1016/j.jhin.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) in skilled nursing facilities (SNFs) may contribute to patient acquisition. We assessed diversity and association of MRSA and VRE isolates in a SNF wing and developed a mathematical index to define each strain's tendency to persist in rooms and spread horizontally. METHODS Longitudinal study of MRSA and VRE colonization and contamination among successive patient occupancies in a cluster of nine SNF private rooms during eight months characterized by microbiological testing and whole genome isolate typing. 'Dispersion index" of a strain is defined as the number of rooms it was found in (including the patient), divided by the average of times it was found consecutively in the same room. FINDINGS MRSA (ten strain types) and VRE (seven types) were recovered from room or patient in 16.4% and 35.6% of the occupancies, respectively. MRSA showed moderate horizontal spread and several episodes of same-room persistence (three distinct strain types) (overall dispersion index: 1.08). VRE showed high tendency towards horizontal spread /new introductions (overall dispersion index: 3.25), and only one confirmed persistence episode. INTERPRETATION The emerging picture of high diversity among contaminating strains and high likelihood of room persistence despite terminal cleaning (MRSA) and horizontal spread between rooms (VRE) in this setting calls for improved cleaning practices, heightened contact precautions, and most of all to establish individually tailored facility screening programs to enable informed choices based on local, measurable and actionable epidemiologic parameters. FUNDING University of Michigan OAIC REC Scholarship to M.C. National Institutes of Health K24 AG050685 to L.M.
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Affiliation(s)
- M Cassone
- Division of Geriatric & Palliative Medicine, Michigan Medicine.
| | - J Wang
- Department of Microbiology and Immunology, Michigan Medicine
| | - B J Lansing
- Division of Geriatric & Palliative Medicine, Michigan Medicine
| | - J Mantey
- Division of Geriatric & Palliative Medicine, Michigan Medicine
| | - K E Gibson
- Division of Geriatric & Palliative Medicine, Michigan Medicine
| | - K J Gontjes
- Division of Geriatric & Palliative Medicine, Michigan Medicine; Department of Epidemiology, University of Michigan School of Public Health
| | - L Mody
- Division of Geriatric & Palliative Medicine, Michigan Medicine; Geriatrics Research Education & Clinical Center, VA Ann Arbor Healthcare System
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Jann J, Gascon S, Drevelle O, Fradette J, Auclair-Gilbert M, Soucy G, Fortier LC, Faucheux N. Assessment of antibacterial properties and skin irritation potential of anodized aluminum impregnated with various quaternary ammonium. BIOMATERIALS ADVANCES 2023; 150:213433. [PMID: 37104962 DOI: 10.1016/j.bioadv.2023.213433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 04/07/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
The importance of the inert environment in the transmission of pathogens has been reassessed in recent years. To reduce cross-contamination, new biocidal materials used in high touch surfaces (e.g., stair railings, door handles) have been developed. However, their impact on skin remains poorly described. The present study aimed to evaluate the antibacterial properties and the risk of skin irritation of two materials based on hard-anodized aluminum (AA) impregnated with quaternary ammonium compound solutions (QAC#1 or QAC#2). The QAC#1 or QAC#2 solutions vary in composition, QAC#2 being free of dioctyl dimethyl ammonium chloride (Dio-DAC) and octyl decyl dimethyl ammonium chloride (ODDAC). Unlike AA used as a control, both AA-QAC#1 and AA-QAC#2 had excellent and rapid antibacterial efficacy, killing 99.9 % of Staphylococcus aureus and Escherichia coli bacteria, in 15 s and 1 min, respectively. The impregnation solutions (QAC#1 and QAC#2) did not show any skin sensitizing effect on transformed human keratinocytes. Nevertheless, these solutions as well as the materials (AA-QAC#1, AA-QAC#2), and the liquid extracts derived from them, induced a very rapid cytotoxicity on L929 murine fibroblasts (>70 % after 1 h of contact) as shown by LDH, MTS and neutral red assays. This cytotoxicity can be explained by the fast QACs release occurring when AA-QAC#1 and AA-QAC#2 were immersed in aqueous medium. To overcome the limitation of assays based on liquid condition, an in vitro skin irritation assay on reconstructed human epidermis (RHE) was developed. The effect of the materials upon their direct contact with the epidermis grown at the liquid-air interface was determined by evaluating tissue viability and quantifying interleukin-1 alpha (IL-1α) which is released in skin during injury or infection. AA-QAC#1 induced a significant decrease in RHE viability, close to OECD and ISO 10993-10 acceptability thresholds and enhanced the pro-inflammatory IL-1α secretion compared with AA-QAC#2. Finally, these results were corroborated by in vivo assays on mice using erythema and edema visual scores, histological observations, and epidermal thickness measurement. AA had no effect on the skin, while a stronger irritation was induced by AA-QAC#1 compared with AA-QAC#2. Hence, these materials were classified as moderate and slight irritants, respectively. In summary, this study revealed that AA-QAC#2 without Dio-DAC and ODDAC could be a great candidate for high touch surface applications, showing an extremely effective and rapid bactericidal activity, without inducing adverse effects for skin tissue.
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Affiliation(s)
- Jessica Jann
- Department of Chemical and Biotechnological Engineering, Faculty of Engineering, Université de Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Québec J1K 2R1, Canada; Clinical Research Center of Centre Hospitalier Universitaire de Sherbrooke, 12e avenue N, Sherbrooke, Québec J1H 5N4, Canada
| | - Suzanne Gascon
- Department of Chemical and Biotechnological Engineering, Faculty of Engineering, Université de Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Québec J1K 2R1, Canada
| | - Olivier Drevelle
- Department of Chemical and Biotechnological Engineering, Faculty of Engineering, Université de Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Québec J1K 2R1, Canada
| | - Julie Fradette
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Centre de Recherche du CHU de Québec-Université Laval, Axe Médecine Régénératrice, 1401, 18(e) rue, Québec City, Québec G1J 1Z4, Canada; Department of Surgery, Faculty of Medicine, Université Laval, 1050 avenue de la Médecine, Québec City, Québec G1V 0A6, Canada
| | | | - Gervais Soucy
- Department of Chemical and Biotechnological Engineering, Faculty of Engineering, Université de Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Québec J1K 2R1, Canada
| | - Louis-Charles Fortier
- Clinical Research Center of Centre Hospitalier Universitaire de Sherbrooke, 12e avenue N, Sherbrooke, Québec J1H 5N4, Canada; Department of Microbiology and Infectious Diseases, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3201 rue Jean Mignault, Sherbrooke, Québec J1E 4K8, Canada.
| | - Nathalie Faucheux
- Department of Chemical and Biotechnological Engineering, Faculty of Engineering, Université de Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Québec J1K 2R1, Canada; Clinical Research Center of Centre Hospitalier Universitaire de Sherbrooke, 12e avenue N, Sherbrooke, Québec J1H 5N4, Canada.
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Odoyo E, Matano D, Tiria F, Georges M, Kyanya C, Wahome S, Mutai W, Musila L. Environmental contamination across multiple hospital departments with multidrug-resistant bacteria pose an elevated risk of healthcare-associated infections in Kenyan hospitals. Antimicrob Resist Infect Control 2023; 12:22. [PMID: 36978195 PMCID: PMC10053033 DOI: 10.1186/s13756-023-01227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are often caused by multidrug-resistant (MDR) bacteria contaminating hospital environments which can cause outbreaks as well as sporadic transmission. METHODS This study systematically sampled and utilized standard bacteriological culture methods to determine the numbers and types of MDR Enterococcus faecalis/faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species, and Escherichia coli (ESKAPEE) from high-touch environments of five Kenyan hospitals; level 6 and 5 hospitals (A, B, and C), and level 4 hospitals (D and E), in 2018. Six hundred and seventeen high-touch surfaces across six hospital departments; surgical, general, maternity, newborn, outpatient and pediatric were sampled. RESULTS 78/617 (12.6%) of the sampled high-touch surfaces were contaminated with MDR ESKAPEE; A. baumannii, 23/617 (3.7%), K. pneumoniae, 22/617 (3.6%), Enterobacter species, 19/617 (3.1%), methicillin resistant S. aureus (MRSA), 5/617 (0.8%), E. coli, 5/617 (0.8%), P. aeruginosa, 2/617 (0.3%), and E. faecalis and faecium, 2/617 (0.3%). Items found in patient areas, such as beddings, newborn incubators, baby cots, and sinks were the most frequently contaminated. Level 6 and 5 hospitals, B, 21/122 (17.2%), A, 21/122 (17.2%), and C, 18/136 (13.2%), were more frequently contaminated with MDR ESKAPEE than level 4 hospitals; D, 6/101 (5.9%), and E, 8/131 (6.1%). All the sampled hospital departments were contaminated with MDR ESKAPEE, with high levels observed in newborn, surgical and maternity. All the A. baumannii, Enterobacter species, and K. pneumoniae isolates were non-susceptible to piperacillin, ceftriaxone and cefepime. 22/23 (95.6%) of the A. baumannii isolates were non-susceptible to meropenem. In addition, 5 K. pneumoniae isolates were resistant to all the antibiotics tested except for colistin. CONCLUSION The presence of MDR ESKAPEE across all the hospitals demonstrated gaps in infection prevention practices (IPCs) that should be addressed. Non-susceptibility to last-line antibiotics such as meropenem threatens the ability to treat infections.
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Affiliation(s)
- Erick Odoyo
- United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Nairobi, Kenya
| | - Daniel Matano
- Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Fredrick Tiria
- United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Nairobi, Kenya
| | - Martin Georges
- United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Nairobi, Kenya
| | - Cecilia Kyanya
- United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Nairobi, Kenya
| | | | - Winnie Mutai
- Department of Medical Microbiology, Faculty of Health Sciences, University of Nairobi, P.O. Box 30197- 00100, Nairobi, Kenya
| | - Lillian Musila
- United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Nairobi, Kenya.
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Joachim A, Manyahi J, Issa H, Lwoga J, Msafiri F, Majigo M. Predominance of Multidrug-Resistant Gram-Negative Bacteria on Contaminated Surfaces at a Tertiary Hospital in Tanzania: A Call to Strengthening Environmental Infection Prevention and Control Measures. Curr Microbiol 2023; 80:148. [PMID: 36964831 DOI: 10.1007/s00284-023-03254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023]
Abstract
The spreading of multidrug resistance (MDR) strains in the hospital settings via contaminated surfaces have been increasingly reported where Gram-negative bacteria have been implicated in causing most nosocomial infections. This study aimed to determine the rate of contamination with multi-resistant gram-negative bacteria in the hospital environment. A cross-sectional study was conducted at Muhimbili National Hospital paediatric department, between July and August 2020. Non-repetitive surface swab samples were collected from predefined surfaces and medical device surfaces, and cultured on MacConkey agar with and without antibiotics. Isolates were identified using biochemical test and tested for antibiotic susceptibility using the Kirby-Bauer disk diffusion method. The rate of hospital contamination with Gram-negative bacteria across the Pediatrics units was 30%, with a high rate observed in oncology units (34.8%) and the malnutrition/diarrhoea ward (32.1%). Sink/washing basin had the highest frequency of bacterial contamination (74.2%). We observed a high rate of ESBL (32.5%), with Acinetobacter baumannii, Klebsiella pneumoniae, and E. coli being the predominant ESBL-producing Gram-negative bacteria, while carbapenemase-producing Gram-negative bacteria was detected at 22.8%. Highest resistance rates (63-100%) were observed against ceftriaxone and trimethoprim-sulfamethoxazole. Up to 51% of the Gram-negative bacteria showed resistant to meropenem. MDR strains were detected in 61.4% of Gram-negative bacteria isolated. In conclusion, we observed a high rate of MDR bacteria contaminating hospital surfaces. The higher rate of MDR calls for a need to strengthen infectious prevention control measures, including cleaning practices in the hospital environment, to reduce the risk of transmission of resistant strains to patients and healthcare workers.
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Affiliation(s)
- Agricola Joachim
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania.
| | - Joel Manyahi
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Habiba Issa
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Jackline Lwoga
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Frank Msafiri
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
| | - Mtebe Majigo
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. 65001, Dar Es Salaam, Tanzania
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Mogul R, Miller DR, Ramos B, Lalla SJ. Metabolomic and cultivation insights into the tolerance of the spacecraft-associated Acinetobacter toward Kleenol 30, a cleanroom floor detergent. Front Microbiol 2023; 14:1090740. [PMID: 36950167 PMCID: PMC10025500 DOI: 10.3389/fmicb.2023.1090740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/20/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Stringent cleaning procedures during spacecraft assembly are critical to maintaining the integrity of life-detection missions. To ensure cleanliness, NASA spacecraft are assembled in cleanroom facilities, where floors are routinely cleansed with Kleenol 30 (K30), an alkaline detergent. Methods Through metabolomic and cultivation approaches, we show that cultures of spacecraft-associated Acinetobacter tolerate up to 1% v/v K30 and are fully inhibited at ≥2%; in comparison, NASA cleanrooms are cleansed with ~0.8-1.6% K30. Results For A. johnsonii 2P08AA (isolated from a cleanroom floor), cultivations with 0.1% v/v K30 yield (1) no changes in cell density at late-log phase, (2) modest decreases in growth rate (~17%), (3) negligible lag phase times, (4) limited changes in the intracellular metabolome, and (5) increases in extracellular sugar acids, monosaccharides, organic acids, and fatty acids. For A. radioresistens 50v1 (isolated from a spacecraft surface), cultivations yield (1) ~50% survivals, (2) no changes in growth rate, (3) ~70% decreases in the lag phase time, (4) differential changes in intracellular amino acids, compatible solutes, nucleotide-related metabolites, dicarboxylic acids, and saturated fatty acids, and (5) substantial yet differential impacts to extracellular sugar acids, monosaccharides, and organic acids. Discussion These combined results suggest that (1) K30 manifests strain-dependent impacts on the intracellular metabolomes, cultivation kinetics, and survivals, (2) K30 influences extracellular trace element acquisition in both strains, and (3) K30 is better tolerated by the floor-associated strain. Hence, this work lends support towards the hypothesis that repeated cleansing during spacecraft assembly serve as selective pressures that promote tolerances towards the cleaning conditions.
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Affiliation(s)
- Rakesh Mogul
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
- Blue Marble Institute of Science, Seattle, WA, United States
| | - Daniel R. Miller
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
| | - Brian Ramos
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
| | - Sidharth J. Lalla
- Chemistry and Biochemistry Department, California State Polytechnic University, Pomona, CA, United States
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van der Schoor AS, Severin JA, Klaassen CHW, Gommers D, Bruno MJ, Hendriks JM, Voor In 't Holt AF, Vos MC. Environmental contamination with highly resistant microorganisms after relocating to a new hospital building with 100% single-occupancy rooms: A prospective observational before-and-after study with a three-year follow-up. Int J Hyg Environ Health 2023; 248:114106. [PMID: 36621268 DOI: 10.1016/j.ijheh.2022.114106] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Inanimate surfaces within hospitals can be a source of transmission for highly resistant microorganisms (HRMO). While many hospitals are transitioning to single-occupancy rooms, the effect of single-occupancy rooms on environmental contamination is still unknown. We aimed to determine differences in environmental contamination with HRMO between an old hospital building with mainly multiple-occupancy rooms and a new hospital building with 100% single-occupancy rooms, and the environmental contamination in the new hospital building during three years after relocating. METHODS Environmental samples were taken twice in the old hospital, and fifteen times over a three-year period in the new hospital. Replicate Organism Direct Agar Contact-plates (RODACs) were used to determine colony forming units (CFU). Cotton swabs premoistened with PBS were used to determine presence of methicillin-resistant Staphylococcus aureus, carbapenemase-producing Pseudomonas aeruginosa, highly resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, and vancomycin-resistant Enterococcus faecium. All identified isolates were subjected to whole genome sequencing (WGS) using Illumina technology. RESULTS In total, 4993 hospital sites were sampled, 724 in the old and 4269 in the new hospital. CFU counts fluctuated during the follow-up period in the new hospital building, with lower CFU counts observed two- and three years after relocating, which was during the COVID-19 pandemic. The CFU counts in the new building were equal to or surpassed the CFU counts in the old hospital building. In the old hospital building, 24 (3.3%) sample sites were positive for 49 HRMO isolates, compared to five (0.1%) sample sites for seven HRMO isolates in the new building (P < 0.001). In the old hospital, 89.8% of HRMO were identified from the sink plug. In the new hospital, 71.4% of HRMO were identified from the shower drain, and no HRMO were found in sinks. DISCUSSION Our results indicate that relocating to a new hospital building with 100% single-occupancy rooms significantly decreases HRMO in the environment. Given that environmental contamination is an important source for healthcare associated infections, this finding should be taken into account when considering hospital designs for renovations or the construction of hospitals.
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Affiliation(s)
- Adriënne S van der Schoor
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Juliëtte A Severin
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Corné H W Klaassen
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Diederik Gommers
- Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Marco J Bruno
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Johanna M Hendriks
- Department of Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Anne F Voor In 't Holt
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - Margreet C Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Kuzina ES, Kislichkina AA, Sizova AA, Skryabin YP, Novikova TS, Ershova ON, Savin IA, Khokhlova OE, Bogun AG, Fursova NK. High-Molecular-Weight Plasmids Carrying Carbapenemase Genes blaNDM-1, blaKPC-2, and blaOXA-48 Coexisting in Clinical Klebsiella pneumoniae Strains of ST39. Microorganisms 2023; 11:microorganisms11020459. [PMID: 36838424 PMCID: PMC9961262 DOI: 10.3390/microorganisms11020459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Klebsiella pneumoniae, a member of the ESKAPE group of bacterial pathogens, has developed multi-antimicrobial resistance (AMR), including resistance to carbapenems, which has increased alarmingly due to the acquisition of carbapenemase genes located on specific plasmids. METHODS Four clinical K. pneumoniae isolates were collected from four patients of a neuro-intensive care unit in Moscow, Russia, during the point prevalence survey. The AMR phenotype was estimated using the Vitec-2 instrument, and whole genome sequencing (WGS) was done using Illumina and Nanopore technologies. RESULTS All strains were resistant to beta-lactams, nitrofurans, fluoroquinolones, sulfonamides, aminoglycosides, and tetracyclines. WGS analysis revealed that all strains were closely related to K. pneumoniae ST39, capsular type K-23, with 99.99% chromosome identity. The novelty of the study is the description of the strains carrying simultaneously three large plasmids of the IncHI1B, IncC, and IncFIB groups carrying the carbapenemase genes of three types, blaOXA-48, blaNDM-1, and blaKPC-2, respectively. The first of them, highly identical in all strains, was a hybrid plasmid that combined two regions of the resistance genes (blaOXA-48 and blaTEM-1 + blaCTX-M-15 + blaOXA-1 + catB + qnrS1 + int1) and a region of the virulence genes (iucABCD, iutA, terC, and rmpA2::IS110). CONCLUSION The spread of K. pneumoniae strains carrying multiple plasmids conferring resistance even to last-resort antibiotics is of great clinical concern.
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Affiliation(s)
- Ekaterina S. Kuzina
- Department of Training and Improvement of Specialists, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Angelina A. Kislichkina
- Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Angelika A. Sizova
- Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Yury P. Skryabin
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Tatiana S. Novikova
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Olga N. Ershova
- Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia
| | - Ivan A. Savin
- Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia
| | - Olga E. Khokhlova
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Alexander G. Bogun
- Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
| | - Nadezhda K. Fursova
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia
- Correspondence:
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Salmanov A, Shchehlov D, Artyomenko V, Svyrydiuk O, Maliarchuk R, Bortnik I, Mamonova M, Korniyenko S, Rud V, Gudym M, Shuba V, Loskutov O. Nosocomial transmission of multi-drug-resistant organisms in Ukrainian hospitals: results of a multi-centre study (2019-2021). J Hosp Infect 2023; 132:104-115. [PMID: 36565933 DOI: 10.1016/j.jhin.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The increasing emergence and spread of multi-drug-resistant organisms (MDROs) in hospitals is a public health problem and continues to challenge infection control and hospital epidemiology practice worldwide. AIM The aim of this study was to characterize the epidemiology of transmission of MDROs via healthcare workers (HCWs) and the environment in the hospital wards/patient rooms. METHODS A multi-centre prospective observational study was conducted in 17 hospitals in Ukraine. Species identification was performed with standard microbial methods. β-Lactamase genes were investigated by polymerase chain reaction. Pulsed-field gel electrophoresis (PFGE) was used to determine the genetic similarity between isolates. FINDINGS Among 51,656 isolates, 19.5% were MDROs. The proportions of MDROs among isolates from patients with healthcare-associated infections, environmental surfaces and HCWs (hands, gown/gloves) were 29.2%, 16.3% and 24.2%, respectively. In 51.9% of the tested isolates, identical MDROs were found in clinical isolates, environmental samples and HCWs' hands. Meticillin resistance was found in 32.4% of Staphylococcus aureus (MRSA) isolates, and vancomycin resistance was found in 28.9% of enterococci (VRE). Resistance to third-generation cephalosporins was detected in 48.4% of Enterobacterales, and carbapenem resistance in 19.1%. Overall, 37.4% of MDROs had broad-spectrum β-lactamase genes, including extended-spectrum β-lactamase (35.8%), OXA-type (29.7%), AmpC-type (25.1%), KPC-type (25.7%) and metallo-β-lactamases, including IMP-type (5.7%), VIM-type (31.7%) and NDM-1 (21.3%). CONCLUSIONS In Ukrainian hospitals the prevalence of healthcare-associated infections caused by MDROs continues to increase, while infection control gaps in healthcare settings facilitate their transmission between patients.
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Affiliation(s)
- A Salmanov
- Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine.
| | - D Shchehlov
- Scientific-practical Centre of Endovascular Neuroradiology and Surgery of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - V Artyomenko
- Odessa National Medical University, Odessa, Ukraine
| | - O Svyrydiuk
- Scientific-practical Centre of Endovascular Neuroradiology and Surgery of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - R Maliarchuk
- Amosov National Institute of Cardiovascular Surgery, Kyiv, Ukraine
| | - I Bortnik
- Scientific-practical Centre of Endovascular Neuroradiology and Surgery of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - M Mamonova
- Bogomolets National Medical University, Kyiv, Ukraine
| | - S Korniyenko
- Odessa National Medical University, Odessa, Ukraine
| | - V Rud
- National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - M Gudym
- Scientific-practical Centre of Endovascular Neuroradiology and Surgery of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - V Shuba
- Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - O Loskutov
- Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
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Extending outbreak investigation with machine learning and graph theory: Benefits of new tools with application to a nosocomial outbreak of a multidrug-resistant organism. Infect Control Hosp Epidemiol 2023; 44:246-252. [PMID: 36111457 PMCID: PMC9929710 DOI: 10.1017/ice.2022.66] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE From January 1, 2018, until July 31, 2020, our hospital network experienced an outbreak of vancomycin-resistant enterococci (VRE). The goal of our study was to improve existing processes by applying machine-learning and graph-theoretical methods to a nosocomial outbreak investigation. METHODS We assembled medical records generated during the first 2 years of the outbreak period (January 2018 through December 2019). We identified risk factors for VRE colonization using standard statistical methods, and we extended these with a decision-tree machine-learning approach. We then elicited possible transmission pathways by detecting commonalities between VRE cases using a graph theoretical network analysis approach. RESULTS We compared 560 VRE patients to 86,684 controls. Logistic models revealed predictors of VRE colonization as age (aOR, 1.4 (per 10 years), with 95% confidence interval [CI], 1.3-1.5; P < .001), ICU admission during stay (aOR, 1.5; 95% CI, 1.2-1.9; P < .001), Charlson comorbidity score (aOR, 1.1; 95% CI, 1.1-1.2; P < .001), the number of different prescribed antibiotics (aOR, 1.6; 95% CI, 1.5-1.7; P < .001), and the number of rooms the patient stayed in during their hospitalization(s) (aOR, 1.1; 95% CI, 1.1-1.2; P < .001). The decision-tree machine-learning method confirmed these findings. Graph network analysis established 3 main pathways by which the VRE cases were connected: healthcare personnel, medical devices, and patient rooms. CONCLUSIONS We identified risk factors for being a VRE carrier, along with 3 important links with VRE (healthcare personnel, medical devices, patient rooms). Data science is likely to provide a better understanding of outbreaks, but interpretations require data maturity, and potential confounding factors must be considered.
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Liu Y, Zhong D, Yu L, Shi Y, Xu Y. Primary Amine Functionalized Carbon Dots for Dead and Alive Bacterial Imaging. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:437. [PMID: 36770398 PMCID: PMC9920602 DOI: 10.3390/nano13030437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Small molecular dyes are commonly used for bacterial imaging, but they still meet a bottleneck of biological toxicity and fluorescence photobleaching. Carbon dots have shown high potential for bio-imaging due to their low cost and negligible toxicity and anti-photobleaching. However, there is still large space to enhance the quantum yield of the carbon quantum dots and to clarify their mechanisms of bacterial imaging. Using carbon dots for dyeing alive bacteria is difficult because of the thick density and complicated structure of bacterial cell walls. In this work, both dead or alive bacterial cell imaging can be achieved using the primary amine functionalized carbon dots based on their small size, excellent quantum yield and primary amine functional groups. Four types of carbon quantum dots were prepared and estimated for the bacterial imaging. It was found that the spermine as one of precursors can obviously enhance the quantum yield of carbon dots, which showed a high quantum yield of 66.46% and high fluorescence bleaching-resistance (70% can be maintained upon 3-h-irradiation). Furthermore, a mild modifying method was employed to bound ethylenediamine on the surface of the spermine-carbon dots, which is favorable for staining not only the dead bacterial cells but also the alive ones. Investigations of physical structure and chemical groups indicated the existence of primary amine groups on the surface of spermine-carbon quantum dots (which own a much higher quantum yield) which can stain alive bacterial cells visibly. The imaging mechanism was studied in detail, which provides a preliminary reference for exploring efficient and environment-friendly carbon dots for bacterial imaging.
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Affiliation(s)
- Yuting Liu
- Institute of Biomedical Engineering, College of Life Science, Basic Medical College, Qingdao University, Qingdao 266071, China
| | - Di Zhong
- Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, No. 308 Ningxia Road, Qingdao 266000, China
| | - Lei Yu
- Institute of Biomedical Engineering, College of Life Science, Basic Medical College, Qingdao University, Qingdao 266071, China
| | - Yanfeng Shi
- Institute of Biomedical Engineering, College of Life Science, Basic Medical College, Qingdao University, Qingdao 266071, China
| | - Yuanhong Xu
- Institute of Biomedical Engineering, College of Life Science, Basic Medical College, Qingdao University, Qingdao 266071, China
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Kuo SH, Liu TY, Chen TC, Yang CJ, Chen YH. Impact of Plastic-Wrap Properties and Cleaning Intervals on the Disinfection of Elevator Buttons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1649. [PMID: 36674403 PMCID: PMC9863425 DOI: 10.3390/ijerph20021649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
Fomite transmission is a possible route by which different pathogens spread within facilities. In hospital settings, elevator buttons are widely observed to be covered with various types of plastic wraps; however, limited information is available concerning the impact of different plastic materials on cleaning. Our study aimed to identify which plastic material is suitable for the coverage of elevator buttons and the optimal intervals for their cleaning. We tested six plastic covers, including polyethylene (PE), polymethylpentene (PMP), polyvinyl chloride (PVD), and polyvinylidene chloride (PVDC) plastic wraps; a thermoplastic polyurethane (TPU) keyboard cover; and a polyethylene terephthalate-ethylene vinyl acetate (PET-EVA) laminating film, which are plastic films. The bioburden on the elevator buttons at different time intervals was measured using an adenosine triphosphate (ATP) bioluminescence assay. Our results show that wraps made of PVDC had superior durability compared with those of PMP, PVC, and PVDC, in addition to the lowest detectable ATP levels among the six tested materials. Regarding different button locations, the highest ATP values were found in door-close buttons followed by door-open, and first-floor buttons after one- and three-hour intervals (p = 0.024 and p < 0.001, respectively). After routine disinfection, the ATP levels of buttons rapidly increased after touching and became more prominent after three hours (p < 0.05). Our results indicate that PVDC plastic wraps have adequate durability and the lowest residual bioburden when applied as covers for elevator buttons. Door-close and -open buttons were the most frequently touched sites, requiring more accurate and precise disinfection; therefore, cleaning intervals of no longer than three hours may be warranted.
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Affiliation(s)
- Shin-Huei Kuo
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, No. 68, Jhonghua 3rd Road, Kaohsiung 80145, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
| | - Tzu-Yin Liu
- Infection Control Office, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, No. 68, Jhonghua 3rd Road, Kaohsiung 80145, Taiwan
| | - Tun-Chieh Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, No. 68, Jhonghua 3rd Road, Kaohsiung 80145, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- Infection Control Office, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, No. 68, Jhonghua 3rd Road, Kaohsiung 80145, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
| | - Chih-Jen Yang
- School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
| | - Yen-Hsu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, No. 70, Lien-Hai Road, Kaohsiung 80424, Taiwan
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Brigando G, Sutton C, Uebelhor O, Pitsoulakis N, Pytynia M, Dillon T, Elliott-Burke T, Hubert N, Martinez-Guryn K, Bolch C, Ciancio MJ, Evans CC. The microbiome of an outpatient rehabilitation clinic and predictors of contamination: A pilot study. PLoS One 2023; 18:e0281299. [PMID: 37141300 PMCID: PMC10159339 DOI: 10.1371/journal.pone.0281299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 01/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Understanding sources of microbial contamination in outpatient rehabilitation (REHAB) clinics is important to patients and healthcare providers. PURPOSE The purpose of this study was to characterize the microbiome of an outpatient REHAB clinic and examine relationships between clinic factors and contamination. METHODS Forty commonly contacted surfaces in an outpatient REHAB clinic were observed for frequency of contact and swiped using environmental sample collection kits. Surfaces were categorized based on frequency of contact and cleaning and surface type. Total bacterial and fungal load was assessed using primer sets specific for the 16S rRNA and ITS genes, respectively. Bacterial samples were sequenced using the Illumina system and analyzed using Illumina-utils, Minimum Entropy Decomposition, QIIME2 (for alpha and beta diversity), LEfSe and ANCOM-BC for taxonomic differential abundance and ADONIS to test for differences in beta diversity (p<0.05). RESULTS Porous surfaces had more bacterial DNA compared to non-porous surfaces (median non-porous = 0.0016ng/μL, 95%CI = 0.0077-0.00024ng/μL, N = 15; porous = 0.0084 ng/μL, 95%CI = 0.0046-0.019 ng/μL, N = 18. p = 0.0066,DNA. Samples clustered by type of surface with non-porous surfaces further differentiated by those contacted by hand versus foot. ADONIS two-way ANOVA showed that the interaction of porosity and contact frequency (but neither alone) had a significant effect on 16S communities (F = 1.7234, R2 = 0.0609, p = 0.032). DISCUSSION Porosity of surfaces and the way they are contacted may play an underestimated, but important role in microbial contamination. Additional research involving a broader range of clinics is required to confirm results. Results suggest that surface and contact-specific cleaning and hygiene measures may be needed for optimal sanitization in outpatient REHAB clinics.
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Affiliation(s)
- Gabriella Brigando
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, United States of America
| | - Casey Sutton
- College of Health Sciences, Physical Therapy Program, Midwestern University, Downers Grove, IL, United States of America
| | - Olivia Uebelhor
- College of Health Sciences, Physical Therapy Program, Midwestern University, Downers Grove, IL, United States of America
| | - Nicholas Pitsoulakis
- College of Health Sciences, Physical Therapy Program, Midwestern University, Downers Grove, IL, United States of America
| | - Matthew Pytynia
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, United States of America
| | - Thomas Dillon
- Physical Therapy Institute, Midwestern University Multispecialty Clinic, Downers Grove, IL, United States of America
| | - Teresa Elliott-Burke
- Physical Therapy Institute, Midwestern University Multispecialty Clinic, Downers Grove, IL, United States of America
| | - Nathaniel Hubert
- Independent Consultant, Bioinformatics Specialist, Chicago, IL, United States of America
| | - Kristina Martinez-Guryn
- College of Graduate Studies, Biomedical Sciences Program, Midwestern University, Downers Grove, IL, United States of America
| | - Charlotte Bolch
- Office of Research and Sponsored Programs, Midwestern University, Glendale, AZ, United States of America
| | - Mae J Ciancio
- College of Graduate Studies, Biomedical Sciences Program, Midwestern University, Downers Grove, IL, United States of America
| | - Christian C Evans
- College of Health Sciences, Physical Therapy Program, Midwestern University, Downers Grove, IL, United States of America
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Fahy S, O’Connor JA, Lucey B, Sleator RD. Hospital Reservoirs of Multidrug Resistant Acinetobacter Species-The Elephant in the Room! Br J Biomed Sci 2023; 80:11098. [PMID: 37020476 PMCID: PMC10069268 DOI: 10.3389/bjbs.2023.11098] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/09/2023] [Indexed: 04/07/2023]
Abstract
Environmental contamination is estimated to contribute to up to 20% of all hospital acquired infections. Acinetobacter baumannii is an example of one the most prevalent opportunistic pathogens causing severe and persistent infections in immunocompromised patients. It has proven ability to form biofilms, has significant associated multi-drug resistance and is able to transfer mobile genetic elements to other clinically relevant pathogens. All of these factors point to a definite utility of A. baumannii as an indicator organism for effectiveness of decontamination regimens as well as environmental screening. There is an increased cost, both financial and clinical, associated with multi drug resistant organisms, carbapenem resistant A. baumannii. With a dearth of new antimicrobials in development, now is the time to radically transform and lead the introduction of scientifically based environmental screening and microbiological verified decontamination to control the dissemination of further resistance.
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Affiliation(s)
- S. Fahy
- Department of Clinical Microbiology, Mercy University Hospital, Cork, Ireland
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - J. A. O’Connor
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - B. Lucey
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
- *Correspondence: B. Lucey,
| | - R. D. Sleator
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
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Anderson TL, Nande A, Merenstein C, Raynor B, Oommen A, Kelly BJ, Levy MZ, Hill AL. Quantifying individual-level heterogeneity in infectiousness and susceptibility through household studies. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.12.02.22281853. [PMID: 36523404 PMCID: PMC9753792 DOI: 10.1101/2022.12.02.22281853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. "Superspreading," or "over-dispersion," is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities with data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.
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Affiliation(s)
- Thayer L Anderson
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
| | - Anjalika Nande
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
| | - Carter Merenstein
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Brinkley Raynor
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Anisha Oommen
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218
| | - Brendan J Kelly
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Michael Z Levy
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218
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Shi Q, Zhao J, Wei L, Zhu F, Ji J, Meng Y, Wu Z, Jiang Z, Han X, Jiang Y, Yu Y, Chen Y, Yuan Y, Du X. Transmission of ST45 and ST2407 extended-spectrum β-lactamase-producing Klebsiella pneumoniae in neonatal intensive care units, associated with contaminated environments. J Glob Antimicrob Resist 2022; 31:309-315. [PMID: 36265800 DOI: 10.1016/j.jgar.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/27/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Given the increasing frequency of infections due to extended-spectrum β-lactamase (EBSL)-producing Klebsiella pneumoniae in humans over recent decades, infection control against this pathogen is of high importance. METHODS In this study, the transmission mode of ESBL-producing K. pneumoniae in neonatal intensive care units (NICU) was investigated. We collected K. pneumoniae isolates from patients admitted to the NICU and performed environmental screening of the NICU and nearby obstetrics department. All isolates were analysed using antimicrobial susceptibility testing, whole-genome sequencing, molecular typing, and antimicrobial and virulence determinant screening. The phylogenetic relationships of all the isolates were analysed using core-genome multi-locus sequence type and single-nucleotide polymorphism-based analysis, and their plasmids harbouring antimicrobial resistance genes in ST2407 were compared. RESULTS Eighteen K. pneumoniae isolates were collected, of which 10 isolates from patients belonged to ST45 and ST2407, and eight isolates from the environment belonged to various other clones. Although 80% and 100% of isolates from patients were ESBL-positive (blaCTX-M-14 and blaCTX-M-55) and possessed siderophores, respectively; fewer environmental isolates harboured antimicrobial resistance and virulence genes. For both ST45 and ST2407 isolates, the phylogenetic assessment revealed a close relationship between clinical and environmental isolates, indicating that bloodstream infections were associated with the contaminated environments. CONCLUSIONS Based on these results, the environmental prevalence of K. pneumoniae should be considered given its pathogenicity in humans. Early and active infection control measures could decrease the spread of multidrug-resistant K. pneumoniae.
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Affiliation(s)
- Qiucheng Shi
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Zhao
- Department of Hospital Epidemiology and Infection Control, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Wei
- Neonatal Intensive Care Unit and Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feiteng Zhu
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingshu Ji
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Meng
- Department of Clinical Laboratory, Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenbo Wu
- Department of Hospital Epidemiology and Infection Control, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhou Jiang
- Neonatal Intensive Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinhong Han
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Jiang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunsong Yu
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Chen
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Department of Hospital Epidemiology and Infection Control, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuhua Yuan
- Department of Hospital Epidemiology and Infection Control, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xiaoxing Du
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China; Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Healthcare-Associated Infections (HAIs): Challenges and Measures Taken by the Radiology Department to Control Infection Transmission. Vaccines (Basel) 2022; 10:vaccines10122060. [PMID: 36560470 PMCID: PMC9781912 DOI: 10.3390/vaccines10122060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Infections contracted during healthcare delivery in a hospital or ambulatory setting are collectively referred to as healthcare-associated infections (HAIs). Healthcare workers and patients alike are vulnerable to serious problems as a result of the risk of HAIs. In the healthcare system, HAIs are considered among the most common and serious health problems. However, the occurrence of HAIs differs between different types of clinical departments within the hospital. Recently, the risk of HAIs has been increasing in radiology departments globally due to the central role of radiology in guiding clinical decisions for the diagnosis, treatment, and monitoring of different diseases from almost all medical specialties. The radiology department is particularly vulnerable to HAIs because it serves as a transit hub for infected patients, non-infected patients, and healthcare workers. Furthermore, as the number of patients referred to radiology and the length of patient contact time has increased, thanks to modern imaging techniques such as computed tomography and magnetic resonance imaging, the risk of HAIs has also increased significantly. With the increasing use of interventional radiological procedures, patients and healthcare workers face a potentially greater risk of contracting HAIs due to the invasive nature of such procedures. Although not exhaustive, we attempted through a literature search to provide a general overview of infection prevention and control practices, address HAIs in the radiology departments, and highlight the challenges and measures taken to control infection transmission in the radiology departments.
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