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Antimicrobial Performance of Innovative Functionalized Surfaces Based on Enamel Coatings: The Effect of Silver-Based Additives on the Antibacterial and Antifungal Activity. Int J Mol Sci 2023; 24:ijms24032364. [PMID: 36768684 PMCID: PMC9916675 DOI: 10.3390/ijms24032364] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Frequently touched surfaces (FTS) that are contaminated with pathogens are one of the main sources of nosocomial infections, which commonly include hospital-acquired and healthcare-associated infections (HAIs). HAIs are considered the most common adverse event that has a significant burden on the public's health worldwide currently. The persistence of pathogens on contaminated surfaces and the transmission of multi-drug resistant (MDR) pathogens by way of healthcare surfaces, which are frequently touched by healthcare workers, visitors, and patients increase the risk of acquiring infectious agents in hospital environments. Moreover, not only in hospitals but also in high-traffic public places, FTS play a major role in the spreading of pathogens. Consequently, attention has been devoted to developing novel and alternative methods to tackle this problem. This study planned to produce and characterize innovative functionalized enameled coated surfaces supplemented with 1% AgNO3 and 2% AgNO3. Thus, the antimicrobial properties of the enamels against relevant nosocomial pathogens including the Gram-positive Staphylococcus aureus and the Gram-negative Escherichia coli and the yeast Candida albicans were assessed using the ISO:22196:2011 norm.
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2
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Huriez P, Lourtet-Hascoet J, Zahar JR, Le Monnier A, Pilmis B. Frequency of surface bacterial contamination in family physicians' offices. Infect Dis Now 2021; 51:603-606. [PMID: 34118487 DOI: 10.1016/j.idnow.2021.06.001] [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: 04/13/2021] [Revised: 05/08/2021] [Accepted: 06/07/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The environment is perceived as a potential source of healthcare-associated infections. While this infection source has been well studied in hospital settings, little data on the risk of contamination in general medical practice is available. We aimed to assess the frequency of environmental contamination in family practice (FP), and to describe pathogens isolated, at-risk surfaces, and factors associated with this contamination. PATIENTS AND METHODS We conducted a cross-sectional point prevalence study over six months in 51 FP offices. In each office, six environmental samples were collected after and before consultations on high-touch surfaces (stethoscope, examination table, physician's desktop, blood pressure cuff, medical equipment tray, computer keyboard and mouse). RESULTS A total of 580 samples were obtained. All offices were contaminated at any time with at least 2.5 colony forming units. The median rate of examination room bio-cleaning was twice a week. For all equipment and surfaces, a lower bacterial load was found before consultations when the last cleaning had occurred less than 24hours prior to testing. CONCLUSION High environmental contamination was observed in FP offices. Less than one practice in five used an effective cleaning agent; family physicians' awareness of practice hygiene is an important step for prevention.
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Affiliation(s)
- Pauline Huriez
- Équipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France.
| | - Julie Lourtet-Hascoet
- Service de microbiologie clinique et plateforme de dosage des anti-infectieux, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France
| | - Jean-Ralph Zahar
- Service de Microbiologie Clinique et Unité de Contrôle et de Prévention du risque infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France; IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, France
| | - Alban Le Monnier
- Service de microbiologie clinique et plateforme de dosage des anti-infectieux, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France
| | - Benoît Pilmis
- Équipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris 75014, France; Service de maladies infectieuses et tropicales, Hôpital Necker Enfants-Malades, Centre médicale de l'institut Pasteur, Université de Paris, Paris, France; Institut Micalis, UMR1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Chatenay-Malabry, France
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3
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Use of a cohorting-unit and systematic surveillance cultures to control a Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae outbreak. Infect Control Hosp Epidemiol 2019; 40:767-773. [PMID: 31084655 DOI: 10.1017/ice.2019.99] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Describe the epidemiological and molecular characteristics of an outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing organisms and the novel use of a cohorting unit for its control. DESIGN Observational study. SETTING A 566-room academic teaching facility in Milwaukee, Wisconsin. PATIENTS Solid-organ transplant recipients. METHODS Infection control bundles were used throughout the time of observation. All KPC cases were intermittently housed in a cohorting unit with dedicated nurses and nursing aids. The rooms used in the cohorting unit had anterooms where clean supplies and linens were placed. Spread of KPC-producing organisms was determined using rectal surveillance cultures on admission and weekly thereafter among all consecutive patients admitted to the involved units. KPC-positive strains underwent pulsed-field gel electrophoresis and whole-genome sequencing. RESULTS A total of 8 KPC cases (5 identified by surveillance) were identified from April 2016 to April 2017. After the index patient, 3 patients acquired KPC-producing organisms despite implementation of an infection control bundle. This prompted the use of a cohorting unit, which immediately halted transmission, and the single remaining KPC case was transferred out of the cohorting unit. However, additional KPC cases were identified within 2 months. Once the cohorting unit was reopened, no additional KPC cases occurred. The KPC-positive species identified during this outbreak included Klebsiella pneumoniae, Enterobacter cloacae complex, and Escherichia coli. blaKPC was identified on at least 2 plasmid backbones. CONCLUSIONS A complex KPC outbreak involving both clonal and plasmid-mediated dissemination was controlled using weekly surveillances and a cohorting unit.
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Hawkey PM, Warren RE, Livermore DM, McNulty CAM, Enoch DA, Otter JA, Wilson APR. Treatment of infections caused by multidrug-resistant Gram-negative bacteria: report of the British Society for Antimicrobial Chemotherapy/Healthcare Infection Society/British Infection Association Joint Working Party. J Antimicrob Chemother 2019. [PMID: 29514274 DOI: 10.1093/jac/dky027] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The Working Party makes more than 100 tabulated recommendations in antimicrobial prescribing for the treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) and suggest further research, and algorithms for hospital and community antimicrobial usage in urinary infection. The international definition of MDR is complex, unsatisfactory and hinders the setting and monitoring of improvement programmes. We give a new definition of multiresistance. The background information on the mechanisms, global spread and UK prevalence of antibiotic prescribing and resistance has been systematically reviewed. The treatment options available in hospitals using intravenous antibiotics and in primary care using oral agents have been reviewed, ending with a consideration of antibiotic stewardship and recommendations. The guidance has been derived from current peer-reviewed publications and expert opinion with open consultation. Methods for systematic review were NICE compliant and in accordance with the SIGN 50 Handbook; critical appraisal was applied using AGREE II. Published guidelines were used as part of the evidence base and to support expert consensus. The guidance includes recommendations for stakeholders (including prescribers) and antibiotic-specific recommendations. The clinical efficacy of different agents is critically reviewed. We found there are very few good-quality comparative randomized clinical trials to support treatment regimens, particularly for licensed older agents. Susceptibility testing of MDR GNB causing infection to guide treatment needs critical enhancements. Meropenem- or imipenem-resistant Enterobacteriaceae should have their carbapenem MICs tested urgently, and any carbapenemase class should be identified: mandatory reporting of these isolates from all anatomical sites and specimens would improve risk assessments. Broth microdilution methods should be adopted for colistin susceptibility testing. Antimicrobial stewardship programmes should be instituted in all care settings, based on resistance rates and audit of compliance with guidelines, but should be augmented by improved surveillance of outcome in Gram-negative bacteraemia, and feedback to prescribers. Local and national surveillance of antibiotic use, resistance and outcomes should be supported and antibiotic prescribing guidelines should be informed by these data. The diagnosis and treatment of both presumptive and confirmed cases of infection by GNB should be improved. This guidance, with infection control to arrest increases in MDR, should be used to improve the outcome of infections with such strains. Anticipated users include medical, scientific, nursing, antimicrobial pharmacy and paramedical staff where they can be adapted for local use.
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Affiliation(s)
- Peter M Hawkey
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | | | | | - Cliodna A M McNulty
- Microbiology Department, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK
| | - David A Enoch
- Public Health England, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - A Peter R Wilson
- Department of Microbiology and Virology, University College London Hospitals, London, UK
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5
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Clemente A, Ramsden JJ, Wright A, Iza F, Morrissey JA, Li Puma G, Malik DJ. Staphylococcus aureus resists UVA at low irradiance but succumbs in the presence of TiO2 photocatalytic coatings. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 193:131-139. [PMID: 30851512 DOI: 10.1016/j.jphotobiol.2019.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/14/2019] [Accepted: 02/25/2019] [Indexed: 11/25/2022]
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6
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Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks. Infect Control Hosp Epidemiol 2018; 39:972-979. [DOI: 10.1017/ice.2018.138] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AbstractFor many years, patient-area wastewater drains (ie, sink and shower drains) have been considered a potential source of bacterial pathogens that can be transmitted to patients. Recently, evolving genomic epidemiology tools combined with new insights into the ecology of wastewater drain (WWD) biofilm have provided new perspectives on the clinical relevance and hospital-associated infection (HAI) transmission risks related to these fixtures. To further clarify the clinical relevance of WWD-associated pathogen transmission, reports of outbreaks attributed to WWDs were selected for review that (1) investigated the outbreak epidemiology of WWD-associated transmission of bacterial pathogens, (2) utilized advanced microbiologic methods to establish clonality of outbreak pathogens and/or resistance genes, or (3) described interventions implemented to mitigate transmission of the outbreak pathogens from WWDs. These reports were collated, compared, and analyzed, and the results are presented here.
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An Effective Surrogate Tracer Technique for S. aureus Bioaerosols in a Mechanically Ventilated Hospital Room Replica Using Dilute Aqueous Lithium Chloride. ATMOSPHERE 2017. [DOI: 10.3390/atmos8120238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Finding a non-pathogenic surrogate aerosol that represents the deposition of typical bioaerosols in healthcare settings is beneficial from the perspective of hospital facility testing, general infection control and outbreak analysis. This study considers aerosolization of dilute aqueous lithium chloride (LiCl) and sodium chloride (NaCl) solutions as surrogate tracers capable of representing Staphylococcus aureus bioaerosol deposition on surfaces in mechanically ventilated rooms. Tests were conducted in a biological test chamber set up as a replica hospital single patient room. Petri dishes on surfaces were used to collect the Li, Na and S. aureus aerosols separately after release. Biological samples were analyzed using cultivation techniques on solid media, and flame atomic absorption spectroscopy was used to measure Li and Na atom concentrations. Spatial deposition distribution of Li tracer correlated well with S. aureus aerosols (96% of pairs within a 95% confidence interval). In the patient hospital room replica, results show that the most contaminated areas were on surfaces 2 m away from the source. This indicates that the room’s airflow patterns play a significant role in bioaerosol transport. NaCl proved not to be sensitive to spatial deposition patterns. LiCl as a surrogate tracer for bioaerosol deposition was most reliable as it was robust to outliers, sensitive to spatial heterogeneity and found to require less replicates than the S. aureus counterpart to be in good spatial agreement with biological results.
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Doll M, Masroor N, Major Y, Fleming M, Doern C, Cooper K, Stevens M, Bearman G. Carbapenem-resistant Enterobacteriaceae at a low prevalence tertiary care center: Patient-level risk factors and implications for an infection prevention strategy. Am J Infect Control 2017; 45:1286-1288. [PMID: 28571982 DOI: 10.1016/j.ajic.2017.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 11/25/2022]
Abstract
Limited treatment options and a growing global threat from carbapenem-resistant Enterobacteriaceae (CRE) infections illustrate the importance of understanding the epidemiology of CRE. Using a retrospective chart review and point prevalence testing demonstrated specific patient risk factors for CRE-positive clinical cultures in a tertiary medical center with a low CRE prevalence.
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Yulistiani R, Praseptiangga D, Supyani, Sudibya, Raharjo D, Shirakawa T. Prevalence of Antibiotic-resistance Enterobacteriaceae strains Isolated from Chicken Meat at Traditional Markets in Surabaya, Indonesia. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1757-899x/193/1/012007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Gomila A, Badia JM, Carratalà J, Serra-Aracil X, Shaw E, Diaz-Brito V, Castro A, Espejo E, Nicolás C, Piriz M, Brugués M, Obradors J, Lérida A, Cuquet J, Limón E, Gudiol F, Pujol M. Current outcomes and predictors of treatment failure in patients with surgical site infection after elective colorectal surgery. A multicentre prospective cohort study. J Infect 2017; 74:555-563. [PMID: 28315721 DOI: 10.1016/j.jinf.2017.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/27/2017] [Accepted: 03/08/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery. METHODS A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery. RESULTS Of 3701 patients, 669 (18.1%) developed SSI; 336 (9.1%) were organ-space infections. Among patients with organ-space SSI, 81.2% required source control: 60.4% reoperation and 20.8% percutaneous/transrectal drainage. Overall treatment failure rate was 21.7%: 9% in incisional SSIs and 34.2% in organ-space SSIs (p < 0.001). Median length of stay was 15 days (IQR 9-22) for incisional SSIs and 24 days (IQR 17-35) for organ-space SSIs (p < 0.001). One hundred and twenty-seven patients (19%) required readmission and 35 patients died (5.2%). Risk factors for treatment failure among patients with organ-space SSI were age ≥65 years (OR 1.83, 95% CI: 1.07-1.83), laparoscopy (OR 1.7, 95% CI: 1.06-2.77), and reoperation (OR 2.8, 95% CI: 1.7-4.6). CONCLUSIONS Rates of SSI and treatment failure in organ-space SSI after elective colorectal surgery are notably high. Careful attention should be paid to older patients with previous laparoscopy requiring reoperation for organ-space SSI, so that treatment failure can be identified early.
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Affiliation(s)
- Aina Gomila
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain.
| | - Josep Ma Badia
- Department of General Surgery, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain; VINCat Program, Spain.
| | - Jordi Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain; University of Barcelona, Barcelona, Spain.
| | - Xavier Serra-Aracil
- Department of Surgery and Infection Control Team, Corporació Sanitària Parc Taulí, Barcelona, Spain; VINCat Program, Spain.
| | - Evelyn Shaw
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain.
| | - Vicens Diaz-Brito
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu de Sant Boi, Barcelona, Spain.
| | - Antoni Castro
- Department of Internal Medicine, Hospital Universitari Sant Joan de Reus, Tarragona, Spain; VINCat Program, Spain.
| | - Elena Espejo
- Department of Infectious Diseases, Consorci Sanitari de Terrassa, Barcelona, Spain; VINCat Program, Spain.
| | - Carmen Nicolás
- Department of Infectious Diseases, Hospital Universitari Mútua de Terrassa, Barcelona, Spain; VINCat Program, Spain.
| | - Marta Piriz
- Department of Surgery and Infection Control Team, Corporació Sanitària Parc Taulí, Barcelona, Spain; VINCat Program, Spain.
| | - Montserrat Brugués
- Department of Internal Medicine, Consorci Sanitari de l'Anoia, Barcelona, Spain; VINCat Program, Spain.
| | - Josefina Obradors
- Department of Internal Medicine, Fundació Althaia, Barcelona, Spain; VINCat Program, Spain.
| | - Ana Lérida
- Department of Internal Medicine, Hospital de Viladecans, Barcelona, Spain; VINCat Program, Spain.
| | - Jordi Cuquet
- Department of General Surgery, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain; VINCat Program, Spain.
| | | | - Francesc Gudiol
- VINCat Program, Spain; University of Barcelona, Barcelona, Spain.
| | - Miquel Pujol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain.
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Chapuis A, Amoureux L, Bador J, Gavalas A, Siebor E, Chrétien ML, Caillot D, Janin M, de Curraize C, Neuwirth C. Outbreak of Extended-Spectrum Beta-Lactamase Producing Enterobacter cloacae with High MICs of Quaternary Ammonium Compounds in a Hematology Ward Associated with Contaminated Sinks. Front Microbiol 2016; 7:1070. [PMID: 27462306 PMCID: PMC4940370 DOI: 10.3389/fmicb.2016.01070] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/27/2016] [Indexed: 11/21/2022] Open
Abstract
Objective: To investigate an outbreak of extended-spectrum beta-lactamase (ESBL) producing Enterobacter cloacae that occurred in the Hematology ward (24-bed unit) of the François Mitterrand University Hospital (Dijon, France) between January 2011 and December 2013. The outbreak involved 43 patients (10 infected and 33 colonized). Design: We performed environmental analysis to detect multiresistant E. cloacae for comparison with clinical isolates (genotyping by pulsed-field gel electrophoresis and MLST as well as ESBL-typing) and determined the MICs of the quaternary ammonium compounds (QACs) alkyldimethylbenzylammonium chloride (ADBAC) and didecyldimethylammonium chloride (DDAC). A bleach-based cleaning-disinfection program was implemented in December 2012 after mechanical removal of the biofilm in all sinks. Results: We have detected 17 ESBL-producing E. cloacae in patients sink drains, shower drains and medical sink drains. Sequencing of the bla genes performed on 60 strains recovered from patients and environment (n = 43 clinical and n = 17 environmental) revealed that blaCTX−M15 was predominant (37 isolates) followed by blaCTX−M9 plus blaSHV−12 (20 isolates). We observed a great diversity among the isolates: 14 pulsotypes (11 STs) in clinical isolates and 9 pulsotypes (7 STs) in environmental isolates. Six pulsotypes were identical between clinical and environmental isolates. MICs of the quaternary ammonium compounds widely used for disinfection were very high in clinical and environmental isolates. Immediately after the implementation of the disinfection program we noticed a substantial fall in cases number. Our findings demonstrate the role of drains as important reservoir of ESBL-producing E. cloacae and highlight the necessity to settle drains accessible to achieve correct cleaning as well as to use disinfectant with proved activity against nosocomial pathogens.
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Affiliation(s)
- Angélique Chapuis
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | - Lucie Amoureux
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | - Julien Bador
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | - Arthur Gavalas
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | - Eliane Siebor
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | | | - Denis Caillot
- Service d'Hématologie Clinique, Hôpital Universitaire de Dijon Dijon, France
| | - Marion Janin
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | - Claire de Curraize
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
| | - Catherine Neuwirth
- Laboratoire de Bactériologie Médicale et de Surveillance Environnementale, Hôpital Universitaire de Dijon Dijon, France
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Dettenkofer M, Humphreys H, Saenz H, Carlet J, Hanberger H, Ruef C, Widmer A, Wolkewitz M, Cookson B. Key priorities in the prevention and control of healthcare-associated infection: a survey of European and other international infection prevention experts. Infection 2016; 44:719-724. [PMID: 27225779 DOI: 10.1007/s15010-016-0904-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/03/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE Prevention and control of healthcare-associated infection (HCAI) are important within and beyond Europe. However, it is unclear which areas are considered important by HCAI prevention and control professionals. This study assesses the priorities in the prevention and control of HCAI as judged by experts in the field. METHODS A survey was conducted by the European Society of Clinical Microbiology and Infectious Diseases focussing on seven topics using SurveyMonkey®. Through a newsletter distributed by email, about 5000 individuals were targeted throughout the world in February and March 2013. Participants were asked to rate the importance of particular topics from one (low importance) to ten (extraordinary importance), and there was no restriction on giving equal importance to more than one topic. RESULTS A total of 589 experts from 86 countries participated including 462 from Europe (response rate: 11.8 %). Physicians accounted for 60 % of participants, and 57 % had ten or more years' experience in this area. Microbial epidemiology/resistance achieved the highest priority scoring with 8.9, followed by surveillance 8.2, and decolonisation/disinfection/antiseptics with 7.9. Under epidemiology/resistance, highly resistant Gram-negative bacilli scored highest (9.0-9.2). The provision of computerised healthcare information systems for the early detection of outbreaks was accorded the top priority under surveillance. The prevention of surgical site and central line infections ranked highest under the category of specific HCAI and HCAI in certain settings. Differences between regions are described. CONCLUSION These findings reflect the concerns of experts in HCAI prevention and control. The results from this survey should inform national and international agencies on future action and research priorities.
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Affiliation(s)
- Markus Dettenkofer
- Medical Centre, University of Freiburg, Institute for Environmental Health Sciences and Hospital Infection Control, Freiburg, Germany.
| | - Hilary Humphreys
- Department of Clinical Microbiology, The Royal College of Surgeons, Dublin, Ireland.,Department of Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Henri Saenz
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Basel, Switzerland
| | - Jean Carlet
- Consultant, Groupe Hospitalier Paris St Joseph, Paris, France
| | - Håkan Hanberger
- Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University and Östergötland County Council, Linköping, Sweden
| | - Christian Ruef
- Division of Infectious Diseases and Hospital Epidemiology, Hirslanden Klinik, Zurich, Switzerland
| | - Andreas Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Martin Wolkewitz
- Institute of Medical Biometry and Medical Informatics, University of Freiburg, Freiburg, Germany
| | - Barry Cookson
- Division of Infection and Immunity, University College London, Gower Street, London, UK
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Pinet E, Franceschi C, Davin-Regli A, Zambardi G, Pagès JM. Role of the culture medium in porin expression and piperacillin-tazobactam susceptibility in Escherichia coli. J Med Microbiol 2015; 64:1305-1314. [PMID: 26242994 DOI: 10.1099/jmm.0.000152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The continuing emergence of the multidrug resistance phenotype in Gram-negative bacteria makes the development of rapid susceptibility tests mandatory. To achieve this goal, proprietary specific media for bacterial growth can be used but may have some adverse effects. In this study, we dissected the role of media on porin, efflux pump and β-lactamase expression. Depending on the medium used, we observed a change in piperacillin-tazobactam susceptibility for some isolates, such as increases in MIC values. No significant alteration in efflux activity or in β-lactamase production was detected after changing the incubation medium. The ratio of piperacillinase:nitrocefinase showed no specific alteration, indicating that the various media did not affect significantly the relative enzymic affinity for the substrates. In contrast, osmotic variation was able to modulate both porin expression and OmpC : OmpF balance, thus modulating the antibiotic uptake. This study suggests that porin expression may be impacted by a susceptibility testing medium, which may modify the antibiotic diffusion into the bacteria, thus affecting MIC results.
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Affiliation(s)
- Elizabeth Pinet
- UMR-MD-1, Aix-Marseille Université, IRBA, Transporteurs Membranaires, Chimiorésistance et Drug Design, Marseille, France
| | | | - Anne Davin-Regli
- UMR-MD-1, Aix-Marseille Université, IRBA, Transporteurs Membranaires, Chimiorésistance et Drug Design, Marseille, France
| | - Gilles Zambardi
- R&D Microbiology Innovation, bioMérieux, La Balme les Grottes, France
| | - Jean-Marie Pagès
- UMR-MD-1, Aix-Marseille Université, IRBA, Transporteurs Membranaires, Chimiorésistance et Drug Design, Marseille, France
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Cheng VCC, Chau PH, Lee WM, Ho SKY, Lee DWY, So SYC, Wong SCY, Tai JWM, Yuen KY. Hand-touch contact assessment of high-touch and mutual-touch surfaces among healthcare workers, patients, and visitors. J Hosp Infect 2015; 90:220-5. [PMID: 25929790 DOI: 10.1016/j.jhin.2014.12.024] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 12/23/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND Unlike direct contact with patients' body, hand hygiene practice is often neglected by healthcare workers (HCWs) and visitors after contact with patients' environment. Contact with hospital environmental items may increase risk of pathogen transmission. AIM To enumerate the number of hand-touch contacts by patients, HCWs and visitors with any hospital environmental items. METHODS All contact-episodes between person and item were recorded by direct observation in a six-bed cubicle of acute wards for 33 working days. High-touch and mutual-touch items with high contact frequencies by HCWs, patients, and visitors were analysed. FINDINGS In total, 1107 person-episodes with 6144 contact-episodes were observed in 66 observation hours (average: 16.8 person-episodes and 93.1 contact-episodes per hour). Eight of the top 10 high-touch items, including bedside rails, bedside tables, patients' bodies, patients' files, linen, bed curtains, bed frames, and lockers were mutually touched by HCWs, patients, and visitors. Bedside rails topped the list with 13.6 contact-episodes per hour (mean), followed by bedside tables (12.3 contact-episodes per hour). Using patients' body contacts as a reference, it was found that medical staff and nursing staff contacted bedside tables [rate ratio (RR): 1.741, 1.427, respectively] and patients' files (RR: 1.358, 1.324, respectively) more than patients' bodies, and nursing staff also contacted bedside rails (RR: 1.490) more than patients' bodies. CONCLUSION Patients' surroundings may be links in the transmission of nosocomial infections because many are frequently touched and mutually contacted by HCWs, patients, and visitors. Therefore, the focus of hand hygiene education, environmental disinfection, and other system changes should be enhanced with respect to high-touch and mutual-touch items.
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Affiliation(s)
- V C C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong SAR, China; Infection Control Team, Queen Mary Hospital, Hong Kong SAR, China
| | - P H Chau
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - W M Lee
- Infection Control Team, Queen Mary Hospital, Hong Kong SAR, China
| | - S K Y Ho
- Infection Control Team, Queen Mary Hospital, Hong Kong SAR, China
| | - D W Y Lee
- Infection Control Team, Queen Mary Hospital, Hong Kong SAR, China
| | - S Y C So
- Department of Microbiology, Queen Mary Hospital, Hong Kong SAR, China
| | - S C Y Wong
- Department of Microbiology, Queen Mary Hospital, Hong Kong SAR, China
| | - J W M Tai
- Infection Control Team, Queen Mary Hospital, Hong Kong SAR, China
| | - K Y Yuen
- Department of Microbiology, Queen Mary Hospital, Hong Kong SAR, China.
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15
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Dananché C, Bénet T, Allaouchiche B, Hernu R, Argaud L, Dauwalder O, Vandenesch F, Vanhems P. Targeted screening for third-generation cephalosporin-resistant Enterobacteriaceae carriage among patients admitted to intensive care units: a quasi-experimental study. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:38. [PMID: 25879192 PMCID: PMC4344746 DOI: 10.1186/s13054-015-0754-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/19/2015] [Indexed: 12/14/2022]
Abstract
Introduction Identification of third-generation, cephalosporin-resistant Enterobacteriaceae (3GC-RE) carriers by rectal screening at admission seems to be an important step in the prevention of transmission and outbreaks; however, little is known about its effectiveness. The aim of this study was to evaluate the impact of ‘targeted screening’ at patient admission to intensive care units (ICUs) on the incidence of 3GC-RE hospital-acquired infections (HAIs) and compare it to ‘universal screening’. Methods We undertook a quasi-experimental study of two ICUs (unit A: intervention group; unit B: control group) at a university-affiliated hospital between 1 January 2008 and 31 December 2011. In unit A, patients were screened universally for 3GC-RE at admission during period 1 (1 January 2008 through 30 September 2010). During period 2 (2011 calendar year), the intervention was implemented in unit A; patients transferred from another unit or hospital were screened selectively. In unit B, all patients were screened throughout periods 1 and 2. 3GC-RE-related HAI incidence rates were expressed per 1,000 patient-days. Incidence rate ratios (IRRs) were examined by multivariate Poisson regression modelling. Results In unit A, 3GC-RE-related HAI incidence rates decreased from 5.4 (95% confidence interval (CI), 4.1 to 7.0) during period 1 to 1.3 (95% CI, 0.5 to 2.9) during period 2 (P < 0.001). No changes were observed in unit B between periods 1 and 2 (P = 0.5). In unit A, the adjusted incidence of 3GC-RE-related HAIs decreased in period 2 compared with period 1 (adjusted IRR, 0.3; 95% CI, 0.1 to 0.9; P = 0.03) independently of temporal trend, trauma and age. No changes were seen in unit B (P = 0.4). The total number of rectal swabs taken showed an 85% decrease in unit A between period 1 and 2 (P < 0.001). Conclusions Targeted screening of 3GC-RE carriers at ICU admission was not associated with an increase in 3GC-RE-related HAI incidence compared with universal screening. Total number of rectal swabs decreased significantly. These findings suggest that targeted screening may be worth assessing as an alternative to universal screening.
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Affiliation(s)
- Cédric Dananché
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, Cedex 03, France.
| | - Thomas Bénet
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, Cedex 03, France. .,Epidemiology and Public Health Group, University of Lyon 1, 8, avenue Rockefeller, 69373, Lyon, Cedex 08, France.
| | - Bernard Allaouchiche
- Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, Cedex 03, France.
| | - Romain Hernu
- Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, Cedex 03, France.
| | - Laurent Argaud
- Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, Cedex 03, France.
| | - Olivier Dauwalder
- Institut of Microbiology, Department of Bacteriology, East Hospital Complex, Hospices Civils de Lyon, 59 boulevard Pinel, 69677, Bron, France.
| | - François Vandenesch
- Institut of Microbiology, Department of Bacteriology, East Hospital Complex, Hospices Civils de Lyon, 59 boulevard Pinel, 69677, Bron, France.
| | - Philippe Vanhems
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, Cedex 03, France. .,Epidemiology and Public Health Group, University of Lyon 1, 8, avenue Rockefeller, 69373, Lyon, Cedex 08, France.
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16
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Reno J, Schenck C, Scott J, Clark LA, Wang YFW, Ray S, Vagnone PS, Jacob JT. Querying automated antibiotic susceptibility testing instruments: a novel population-based active surveillance method for multidrug-resistant gram-negative bacilli. Infect Control Hosp Epidemiol 2014; 35:336-41. [PMID: 24602936 DOI: 10.1086/675608] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To describe the implementation of a population-based surveillance system for multidrug-resistant gram-negative bacilli (MDR-GNB). DESIGN Population-based active surveillance by the Georgia Emerging Infections Program. SETTING Metropolitan Atlanta, starting November 2010. PATIENTS Residents with MDR-GNB isolated from urine or a normally sterile site culture. METHODS Surveillance was implemented in 3 phases: (1) surveying laboratory antibiotic susceptibility testing practices, (2) piloting surveillance to estimate the proportion of GNB that were MDR, and (3) maintaining ongoing active surveillance for carbapenem-nonsusceptible Enterobacteriaceae and Acinetobacter baumannii using the 2010 Clinical and Laboratory Standards Institute (CLSI) breakpoints. Pilot surveillance required developing and installing queries for GNB on the 3 types of automated testing instruments (ATIs), such as MicroScan, in Atlanta's clinical laboratories. Ongoing surveillance included establishing a process to extract data from ATIs consistently, review charts, manage data, and provide feedback to laboratories. RESULTS Output from laboratory information systems typically used for surveillance would not reliably capture the CLSI breakpoints, but queries developed for the 3 ATIs did. In November 2010, 0.9% of Enterobacteriaceae isolates and 35.7% of A. baumannii isolates from 21 laboratories were carbapenem nonsusceptible. Over a 5-month period, 82 Enterobacteriaceae and 59 A. baumannii were identified as carbapenem nonsusceptible. CONCLUSIONS Directly querying ATIs, a novel method of active surveillance for MDR-GNB, proved to be a reliable, sustainable, and accurate method that required moderate initial investment and modest maintenance. Ongoing surveillance is critical to assess the burden of and changes in MDR-GNB to inform prevention efforts.
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Affiliation(s)
- Jessica Reno
- Atlanta Research and Education Foundation, Decatur, Georgia
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17
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What may be lurking in the hospital undergrowth? Inapparent cross-transmission of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. J Hosp Infect 2014; 88:156-61. [DOI: 10.1016/j.jhin.2014.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/01/2014] [Indexed: 11/17/2022]
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18
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Dancer SJ. Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clin Microbiol Rev 2014; 27:665-90. [PMID: 25278571 PMCID: PMC4187643 DOI: 10.1128/cmr.00020-14] [Citation(s) in RCA: 380] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.
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Affiliation(s)
- Stephanie J Dancer
- Department of Microbiology, Hairmyres Hospital, East Kilbride, Lanarkshire, Scotland, United Kingdom
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19
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Curran ET, Otter JA. Outbreak Column 15: Carbapenemase-producing Enterobacteriaceae. J Infect Prev 2014; 15:193-198. [PMID: 28989384 DOI: 10.1177/1757177414546707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Evonne T Curran
- NHS National Services Scotland, Health Protection Scotland, Glasgow
| | - Jonathan A Otter
- Centre for Clinical Infection and Diagnostics Research, Guy's and St. Thomas NHS Foundation Trust / King's College London, and Bioquell
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20
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Los pacientes trasladados desde otro centro: fuente de infección de microorganismos multiresistentes. resultados de seis años de programa de vigilancia activa. REVISTA MÉDICA CLÍNICA LAS CONDES 2014. [DOI: 10.1016/s0716-8640(14)70062-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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21
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Oteo J, Calbo E, Rodríguez-Baño J, Oliver A, Hornero A, Ruiz-Garbajosa P, Horcajada JP, Del Pozo JL, Riera M, Sierra R, Bou G, Salavert M. [The threat of the carbapenemase-producing enterobacteriaceae in Spain: positioning report of the SEIMC study groups, GEIH and GEMARA]. Enferm Infecc Microbiol Clin 2014; 32:666-70. [PMID: 24767691 DOI: 10.1016/j.eimc.2014.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 12/16/2022]
Abstract
The emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE), as the current paradigm of extensive drug-resistance and multi-drug resistance to antibiotics, is a serious threat to patient health and public health. The increase in OXA-48- and VIM-1-producing Klebsiella pneumoniae isolates represents the greatest impact of CPE in Spain. This evidence has lead the members of a representative panel of the Spanish Study Groups of Nosocomial Infections and Mechanisms of Action and Resistance to Antimicrobials of the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIH/GEMARA-SEIMC) to make a position statement expressing the need for: (i) definitive and coordinated action by all health professionals and authorities involved, and (ii) an adaptation of health systems to facilitate their early control and minimize their impact.
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Affiliation(s)
- Jesús Oteo
- Laboratorio de Antibióticos, Servicio de Bacteriología, Centro Nacional de Microbiología, Majadahonda, Madrid, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España.
| | - Esther Calbo
- Servicio de Medicina Interna, Hospital Universitario Mútua de Terrassa, Terrassa, Barcelona, España; Facultad de Medicina, Universidad Internacional de Catalunya, Barcelona, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Jesús Rodríguez-Baño
- Unidad Clínica Intercentros de Enfermedades Infecciosas y Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Sevilla, España; Departamento de Medicina, Universidad de Sevilla, Sevilla, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Antonio Oliver
- Servicio de Microbiología, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, España; Grupo de Estudio de los Mecanismos de Acción y de la Resistencia a Antimicrobianos de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEMARA-SEIMC), España
| | - Ana Hornero
- Enfermería Clínica del Control de la Infección, Hospital Universitario de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Patricia Ruiz-Garbajosa
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Juan Pablo Horcajada
- Servicio de Enfermedades Infecciosas, Hospital Universitario del Mar, Barcelona, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - José Luis Del Pozo
- Servicio de Enfermedades Infecciosas, Clínica Universidad de Navarra, Pamplona, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Montserrat Riera
- Enfermería Clínica del Control de la Infección, Hospital Universitaro Mútua de Terrassa, Terrasa, Barcelona, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Rafael Sierra
- Servicio de Cuidados Críticos, Hospital Puerta del Mar, Cádiz, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
| | - Germán Bou
- Servicio de Microbiología-INIBIC, Complejo Hospitalario Universitario A Coruña, La Coruña, España; Grupo de Estudio de los Mecanismos de Acción y de la Resistencia a Antimicrobianos de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEMARA-SEIMC), España
| | - Miguel Salavert
- Unidad de Enfermedades Infecciosas, Hospital Universitario y Politécnico La Fe, Valencia, España; Grupo de Estudio de la Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC), España
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22
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Fernández Fuentes MÁ, Ortega Morente E, Abriouel H, Pérez Pulido R, Gálvez A. Antimicrobial resistance determinants in antibiotic and biocide-resistant gram-negative bacteria from organic foods. Food Control 2014. [DOI: 10.1016/j.foodcont.2013.08.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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23
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Vergara-López S, Domínguez M, Conejo M, Pascual Á, Rodríguez-Baño J. Wastewater drainage system as an occult reservoir in a protracted clonal outbreak due to metallo-β-lactamase-producing Klebsiella oxytoca. Clin Microbiol Infect 2013; 19:E490-8. [DOI: 10.1111/1469-0691.12288] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 04/17/2013] [Accepted: 05/27/2013] [Indexed: 11/28/2022]
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24
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Panisello C, Peña B, Gilabert Oriol G, Constantí M, Gumí T, Garcia-Valls R. Polysulfone/Vanillin Microcapsules for Antibacterial and Aromatic Finishing of Fabrics. Ind Eng Chem Res 2013. [DOI: 10.1021/ie3036096] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Cinta Panisello
- Departament d’Enginyeria
Química, Universitat Rovira i Virgili, Av. Països Catalans,
26, 43007 Tarragona, Spain
| | - Brisa Peña
- Departament d’Enginyeria
Química, Universitat Rovira i Virgili, Av. Països Catalans,
26, 43007 Tarragona, Spain
| | - Guillem Gilabert Oriol
- Departament d’Enginyeria
Química, Universitat Rovira i Virgili, Av. Països Catalans,
26, 43007 Tarragona, Spain
| | - Magda Constantí
- Departament d’Enginyeria
Química, Universitat Rovira i Virgili, Av. Països Catalans,
26, 43007 Tarragona, Spain
| | - Tània Gumí
- Departament d’Enginyeria
Química, Universitat Rovira i Virgili, Av. Països Catalans,
26, 43007 Tarragona, Spain
| | - Ricard Garcia-Valls
- Departament d’Enginyeria
Química, Universitat Rovira i Virgili, Av. Països Catalans,
26, 43007 Tarragona, Spain
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