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Coppée R, Sarrasin V, Zaffaroulah R, Bouzayene A, Thellier M, Noël H, Clain J, Houzé S. Nosocomial Malaria Transmissions Resolved by Genomic Analyses-A Retrospective Case Report Study in France: 2007-2021. Clin Infect Dis 2023; 76:631-639. [PMID: 36208204 PMCID: PMC9619641 DOI: 10.1093/cid/ciac813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Exposure of blood to malaria parasites can lead to infection even in the absence of the mosquito vector. During a stay in a healthcare facility, accidental inoculation of the skin with blood from a malaria patient might occur, referred to as nosocomial malaria. METHODS Between 2007 and 2021, we identified 6 autochthonous malaria cases that occurred in different French hospitals, originating from nosocomial transmission and imported malaria cases being the infection source. Four cases were observed during the coronavirus disease 2019 pandemic. The genetic relatedness between source and nosocomial infections was evaluated by genome-wide short tandem repeats (STRs) and single-nucleotide polymorphisms (SNPs). RESULTS None of the patients with autochthonous malaria had travel history to an endemic area nor had been transfused. For each case, both the source and recipient patients stayed a few hours in the same ward. After diagnosis, autochthonous cases were treated with antimalarials and all recovered except 1. Genetically, each pair of matched source/nosocomial parasite infections showed <1% of different STRs and <6.9% (<1.5% for monoclonal infections) of different SNPs. Similar levels of genetic differences were obtained for parasite DNA samples that were independently sequenced twice as references of identical infections. Parasite phylogenomics were consistent with travel information reported by the source patients. CONCLUSIONS Our study demonstrates that genomics analyses may resolve nosocomial malaria transmissions, despite the uncertainty regarding the modes of contamination. Nosocomial transmission of potentially life-threatening parasites should be taken into consideration in settings or occasions where compliance with universal precautions is not rigorous.
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Affiliation(s)
- Romain Coppée
- Université Paris Cité and Sorbonne Paris Nord, Inserm, IAME, F-75018 Paris, France
| | - Véronique Sarrasin
- Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France.,Université Paris Cité, IRD, MERIT, F-75006 Paris, France
| | - Rizwana Zaffaroulah
- Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France
| | - Azza Bouzayene
- Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France
| | - Marc Thellier
- Centre National de Référence du Paludisme, AP-HP, GHU Pitié-Salpêtrière, F-75013 Paris, France
| | - Harold Noël
- Infectious Diseases Division, Santé Publique France, F-91410 Saint Maurice, France
| | - Jérôme Clain
- Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France.,Université Paris Cité, IRD, MERIT, F-75006 Paris, France
| | - Sandrine Houzé
- Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France.,Université Paris Cité, IRD, MERIT, F-75006 Paris, France
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Recrudescence of Plasmodium falciparum Malaria in a Patient With Progressive Sarcoidosis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2019. [DOI: 10.1097/ipc.0000000000000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gruell H, Hamacher L, Jennissen V, Tuchscherer A, Ostendorf N, Löffler T, Hallek M, Kochanek M, Tannich E, Böll B, Fätkenheuer G. On Taking a Different Route: An Unlikely Case of Malaria by Nosocomial Transmission. Clin Infect Dis 2017; 65:1404-1406. [DOI: 10.1093/cid/cix520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 05/31/2017] [Indexed: 11/13/2022] Open
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Healthcare-Associated Transmission of Plasmodium falciparum in New York City. Infect Control Hosp Epidemiol 2015; 37:113-5. [PMID: 26498730 DOI: 10.1017/ice.2015.236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patient transmission in a hospital setting. Infect. Control Hosp. Epidemiol. 2015;37(1):113-115.
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Metagenomic Human Repiratory Air in a Hospital Environment. PLoS One 2015; 10:e0139044. [PMID: 26431488 PMCID: PMC4592066 DOI: 10.1371/journal.pone.0139044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/07/2015] [Indexed: 01/22/2023] Open
Abstract
Hospital-acquired infection (HAI) or nosocomial infection is an issue that frequent hospital environment. We believe conventional regulated Petri dish method is insufficient to evaluate HAI. To address this problem, metagenomic sequencing was applied to screen airborne microbes in four rooms of Beijing Hospital. With air-in amount of sampler being setup to one person’s respiration quantity, metagenomic sequencing identified huge numbers of species in the rooms which had already qualified widely accepted petridish exposing standard, imposing urgency for new technology. Meanwhile,the comparative culture only got small portion of recovered species and remain blind for even cultivable pathogens reminded us the limitations of old technologies. To the best of our knowledge, the method demonstrated in this study could be broadly applied in hospital indoor environment for various monitoring activities as well as HAI study. It is also potential as a transmissible pathogen real-time modelling system worldwide.
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Kwak YG, Lee SO, Kim TH, Choo EJ, Jeon MH, Jun JB, Kim KM, Jeong JS, Kim YS. The use of multidose vials and fingerstick blood sampling devices in Korean emergency departments and intensive care units. Int J Nurs Pract 2012; 18:77-83. [PMID: 22257334 DOI: 10.1111/j.1440-172x.2011.01994.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was performed to compare compliance with standard precautions for the use of multidose vials (MDVs) and fingerstick devices in emergency departments (EDs) and intensive care units (ICUs). Between December 2007 and February 2008, 389 nurses from the EDs or ICUs of six university-affiliated hospitals in Korea were asked to complete the questionnaire. A total of 338 (86.9%) nurses completed the survey, corresponding to 159 of 184 ED and 179 of 205 ICU nurses. A comparison of MDV use in EDs and ICUs indicated a significant difference only in disinfection of the rubber septum of heparin vials; 88.1% of ED nurses and 96.6% of ICU nurses stated that they always disinfected the rubber septum of heparin vials whenever drawing medication (P = 0.003). The use of separate fingerstick devices for each patient (71.7% vs. 54.5%) and disinfection of these devices after each use (36.5% vs. 26.0%) were more common in ED nurses. The rate of good hand hygiene was lower in ED nurses, both before (43.7% vs. 74.3%) and after (64.6% vs. 91.6%) the use of fingerstick devices (P < 0.001 for both). There is a need to improve compliance with standard precautions, especially hand hygiene, in EDs.
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Affiliation(s)
- Yee Gyung Kwak
- Department of Infectious Diseases, Inje University College of Medicine, Busan, Republic of Korea
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Abstract
The preparation of intravenous drugs is a common yet inherently dangerous nursing procedure. Potential errors associated with this procedure include incorrect drugs, doses and routes of administration. As a consequence of these recognized risks, a variety of checks are used to optimize safety. This paper explores the literature around infusate contamination, which can cause infusate-related bloodstream infection (IR-BSI). In addition, this paper will discuss the mechanisms of infusate contamination, as well as details of the types of microorganisms that cause contamination and the types of drugs that enable proliferation of microorganisms. Deficits within current guidance are revealed. The paper concludes that IR-BSI is a significant but under-recognized risk to patients. As microbial contamination sufficient to cause IR-BSI is not detectable to the naked eye, those who prepare intravenous drugs must be more aware of contamination risks and how to reduce them.
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Sikora C, Chandran AU, Joffe AM, Johnson D, Johnson M. Population risk of syringe reuse: estimating the probability of transmitting bloodborne disease. Infect Control Hosp Epidemiol 2010; 31:748-54. [PMID: 20509761 DOI: 10.1086/653200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND In 2008, the Medical Officer of Health at Alberta Health Services (Edmonton, Canada) was notified that, in some practice settings, a syringe was used to administer medication through the side port of an intravenous circuit and then the syringe, with residual drug, was used to administer medication to other patients in the same manner. This practice has been implicated in several outbreaks of bloodborne infection in hospital and clinic settings. METHODS A risk assessment model was developed to predict the risk of a patient contracting a bloodborne viral infection from the practice. The risk of transmission was defined as the product of 5 factors: (1) the population prevalence of a specific bloodborne pathogen, (2) the probability of finding a viral bloodborne pathogen in an intravenous circuit, (3) the rate of syringe reuse, (4) the probability of causing disease given a bloodborne pathogen exposure, and (5) the susceptibility of the exposed person. RESULTS The risk was modeled first with consistent use of the proximal port of the intravenous circuit. The risk of transmission of hepatitis B virus was approximately 12-53 transmission events per 1,000,000 exposure events for a range of practice probabilities (ie, frequency of the risk practice) from 20% to 80%, respectively. The risk of transmission of hepatitis C virus was approximately 1.0-4.3 transmission events per 1,000,000 exposure events for the same practice probability range, and the risk of transmission of human immunodeficiency virus was approximately 0.03-0.15 transmission events per 1,000,000 exposure events for the same practice probability range. The use of the distal port was associated with a 10-fold decrease in the risk. CONCLUSIONS Practitioners must practice safe, aseptic injection techniques. The model presented here can be used to estimate the risk of disease transmission in situations where reuse has occurred and can serve as a framework for informing public health action.
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Affiliation(s)
- Christopher Sikora
- Community Medicine Residency Program, School of Public Health, University of Alberta, Edmonton, Canada.
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Kim JY, Kim JS, Park MH, Kang YA, Kwon JW, Cho SH, Lee BC, Kim TS, Lee JK. A locally acquired falciparum malaria via nosocomial transmission in Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2009; 47:269-73. [PMID: 19724701 DOI: 10.3347/kjp.2009.47.3.269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 06/03/2009] [Accepted: 06/09/2009] [Indexed: 11/23/2022]
Abstract
A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.
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Affiliation(s)
- Jung-Yeon Kim
- Division of Malaria and Parasitic Disease, Korea Centers for Disease Control and Prevention (KCDC), Seoul, Korea
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Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control 2007; 35:S65-164. [PMID: 18068815 PMCID: PMC7119119 DOI: 10.1016/j.ajic.2007.10.007] [Citation(s) in RCA: 1630] [Impact Index Per Article: 95.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Mlambo G, Sullivan D, Mutambu SL, Soko W, Mbedzi J, Chivenga J, Jaenisch T, Gemperli A, Kumar N. Analysis of genetic polymorphism in select vaccine candidate antigens and microsatellite loci in Plasmodium falciparum from endemic areas at varying altitudes. Acta Trop 2007; 102:201-5. [PMID: 17568548 PMCID: PMC2692884 DOI: 10.1016/j.actatropica.2007.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Revised: 05/01/2007] [Accepted: 05/03/2007] [Indexed: 11/24/2022]
Abstract
Plasmodium falciparum parasites obtained from symptomatic patients attending clinics in Bindura (altitude 1100 m), Chiredzi (600 m) and Kariba (<600 m), previously reported to differ in malaria endemicity were genotyped on the msp-1, msp-2 and glurp loci to examine the extent of parasite genetic diversity. While the parasites were monomorphic for msp-1 allele RO33 from the three locations, the K1 allele was over-represented in Kariba (p=0.02) and Mad20 alleles occurred at a higher frequency in Bindura. A similar PCR analysis for glurp and the two main allelic families of msp-2, i.e. IC/3D7 and FC-27 revealed minimal differences in the parasite population. A total of 8 msp-1 Block 2 and 11 msp-2 genotypes were identified from the three locations combined. On the glurp locus, 13 different genotypes ranging in size from 660 to 1160 bp were detected in parasites obtained from Bindura and Kariba. To gain further insight into P. falciparum genetic diversity in the three different geographical locations, parasites were examined for neutral microsatellite markers (C4M8, C13M30 and TA81). The number of microsatellite alleles ranged from 8 to 17 and the average expected heterozygosity (HE) for the three areas combined was 0.83 suggesting that the parasite population of Zimbabwe is genetically heterogeneous. These findings have implications in understanding the impact of genetic variation on immunity and possibly emergence of drug resistance.
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Affiliation(s)
- Godfree Mlambo
- Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205
- National Institute of Health Research, P. O Box CY 573, Causeway, Harare Zimbabwe
| | - David Sullivan
- Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205
| | - Susan L. Mutambu
- National Institute of Health Research, P. O Box CY 573, Causeway, Harare Zimbabwe
| | - White Soko
- National Institute of Health Research, P. O Box CY 573, Causeway, Harare Zimbabwe
| | - Joel Mbedzi
- National Institute of Health Research, P. O Box CY 573, Causeway, Harare Zimbabwe
| | - James Chivenga
- National Institute of Health Research, P. O Box CY 573, Causeway, Harare Zimbabwe
| | - Thomas Jaenisch
- Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205
| | - Armin Gemperli
- Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205
| | - Nirbhay Kumar
- Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205
- Corresponding author; Dr. Nirbhay Kumar, Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205, Tel: 410 955 7177, Fax: 410 955 0105,
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Gkrania-Klotsas E, Lever AML. An update on malaria prevention, diagnosis and treatment for the returning traveller. Blood Rev 2007; 21:73-87. [PMID: 16815604 DOI: 10.1016/j.blre.2006.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The diagnosis of malaria needs to be considered for every returning traveller with a fever. Compliance with prevention, both pharmaceutical and non-pharmaceutical, is essential for every traveller. New tests for diagnosis are now available. Treatment options have recently expanded to include the artemisinin derivatives that used to be unavailable in the western countries.
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Snapshots for September 2005. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2005. [DOI: 10.1097/01.idc.0000179878.90431.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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