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https://www.readbyqxmd.com/read/28341262/pulsed-xenon-ultraviolet-light-disinfection-in-a-burn-unit-impact-on-environmental-bioburden-multidrug-resistant-organism-acquisition-and-healthcare-associated-infections
#1
Caroline Green, Jeremy C Pamplin, Kristine N Chafin, Clinton K Murray, Heather C Yun
Portable pulsed xenon ultraviolet disinfection (PPX-UVD) may reduce healthcare associated infections (HAI). There is limited data to inform use in burn intensive care units (BICU), where multidrug-resistant organisms (MDRO), especially gram negative rods (GNR), commonly cause disease. We evaluated PPX-UVD effects on environmental bioburden and rates of HAI and MDRO acquisition in a BICU. PPX-UVD was used for 3 months after standard cleaning of patient and operating rooms (ORs). Settle and touch plates in patient rooms and ORs were obtained after standard cleaning, pre-and post-PPX-UVD...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28322345/nursing-staff-fluctuation-and-pathogenic-burden-in-the-nicu-effective-outbreak-management-and-the-underestimated-relevance-of-non-resistant-strains
#2
Kai O Hensel, Rhea van den Bruck, Ingo Klare, Michael Heldmann, Beniam Ghebremedhin, Andreas C Jenke
In the course of a hospital management takeover, a microbial outbreak took place in a tertiary neonatal intensive care unit (NICU). Here, we characterize the outbreak and its management. About 4 months prior to takeover, there was a sharp increase in positive isolates for MSSA and multidrug-resistant organisms (MDROs). Simultaneously, the nursing staff sick leave rate increased dramatically which directly correlated with the number of infection/colonization per week (r(2) = 0.95, p = 0.02). During the following months we observed several peaks in positive isolates of methicillin-sensitive staphylococcus aureus (MSSA), MDROs and subsequently a vancomycin-resistant enterococcus (VRE) outbreak...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28319476/anesthesia-in-patients-with-infectious-disease-caused-by-multi-drug-resistant-bacteria
#3
Sharon Einav, Yonit Wiener-Well
PURPOSE OF REVIEW: Up to 50% of specific bacterial strains in healthcare admission facilities are multidrug-resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). RECENT FINDINGS: Anesthesiologists, their work area and tools have all been implicated in MDRO outbreaks. Causes include contamination of external ventilation circuits and noncontribution of filters to prevention, inappropriate decontamination procedures for nondisposable equipment (e...
March 17, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291632/necessity-of-carbapenem-use-when-prescribed-per-infectious-diseases-specialists
#4
Kellie J Goodlet, Michael D Nailor
Preauthorization strategies, including restricting broad-spectrum antimicrobials such as carbapenems to infectious diseases physicians (ID) are commonly employed by stewardship programs. The appropriateness, or "necessity" of empiric carbapenem therapy by ID, defined as an isolated organism sensitive to the carbapenem and resistant to cefepime, was evaluated over a 6month span and included 84 patients. Additionally, 30 patients followed by ID who were not prescribed a carbapenem until final susceptibilities were included as a definitive therapy group...
February 27, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28285725/universal-versus-targeted-additional-contact-precautions-for-multidrug-resistant-organism-carriage-for-patients-admitted-to-an-intensive-care-unit
#5
Michel Djibré, Samuel Fedun, Pierre Le Guen, Sophie Vimont, Mehdi Hafiani, Jean-Pierre Fulgencio, Antoine Parrot, Michel Denis, Muriel Fartoukh
BACKGROUND: Although additional contact precautions (ACPs) are routinely used to reduce cross-transmission of multidrug-resistant organisms (MDROs), the relevance of isolation precautions remains debated. We hypothesized that the collection of recognized risk factors for MDRO carriage on intensive care unit (ICU) admission might be helpful to target ACPs without increasing MDRO acquisition during ICU stays, compared with universal ACPs. MATERIALS AND METHODS: This is a sequential single-center observational study performed in consecutive patients admitted to a French medical and surgical ICU...
March 10, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28270258/the-impact-of-reducing-antibiotics-on-the-transmission-of-multidrug-resistant-organisms
#6
Sean L Barnes, Clare Rock, Anthony D Harris, Sara E Cosgrove, Daniel J Morgan, Kerri A Thom
OBJECTIVE Antibiotic resistance is a major threat to public health. Resistance is largely driven by antibiotic usage, which in many cases is unnecessary and can be improved. The impact of decreasing overall antibiotic usage on resistance is unknown and difficult to assess using standard study designs. The objective of this study was to explore the potential impact of reducing antibiotic usage on the transmission of multidrug-resistant organisms (MDROs). DESIGN We used agent-based modeling to simulate interactions between patients and healthcare workers (HCWs) using model inputs informed by the literature...
March 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28216179/the-17th-international-congress-on-infectious-diseases-workshop-on-developing-infection-prevention-and-control-resources-for-low-and-middle-income-countries
#7
Sangeeta Sastry, Nadia Masroor, Gonzalo Bearman, Rana Hajjeh, Alison Holmes, Ziad Memish, Britta Lassmann, Didier Pittet, Fiona Macnab, Rachel Kamau, Evelyn Wesangula, Paras Pokharel, Paul Brown, Frances Daily, Fatma Amer, Jaime Torres, Miguel O'Ryan, Revathi Gunturu, Andre Bulabula, Shaheen Mehtar
Hospital-acquired infections (HAIs) are a major concern to healthcare systems around the world. They are associated with significant morbidity and mortality, in addition to increased hospitalization costs. Recent outbreaks, including those caused by the Middle East respiratory syndrome coronavirus and Ebola virus, have highlighted the importance of infection control. Moreover, HAIs, especially those caused by multidrug-resistant Gram-negative rods, have become a top global priority. Although adequate approaches and guidelines have been in existence for many years and have often proven effective in some countries, the implementation of such approaches in low- and middle-income countries (LMICs) is often restricted due to limited resources and underdeveloped infrastructure...
February 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28211567/isolation-precautions-use-for-multidrug-resistant-organism-infection-in-nursing-homes
#8
Catherine C Cohen, Andrew Dick, Patricia W Stone
OBJECTIVES: To examine factors associated with isolation precaution use in nursing home (NH) residents with multidrug-resistant organism (MDRO) infection. DESIGN: Retrospective, cross-sectional analysis. SETTING: Nursing homes with Centers for Medicare and Medicaid Services' certification from October 2010 to December 2013. PARTICIPANTS: Elderly, long-stay NH residents with positive MDRO infection assessments. MEASUREMENTS: Data were obtained from the Minimum Data Set (MDS) 3...
March 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28135011/multidrug-resistant-organisms-in-allogeneic-hematopoietic-cell-transplantation
#9
Daniela Heidenreich, Sebastian Kreil, Florian Nolte, Wolf K Hofmann, Thomas Miethke, Stefan A Klein
OBJECTIVE: Multidrug-resistant organisms (MDRO) are a challenge in allogeneic hematopoietic cell transplantation (HCT). However, in the literature there is no comprehensive analysis on MDRO in HCT. In this retrospective, single-center analysis, we appraised prevalence and clinical impact of MDRO in 98 consecutive allogeneic HCT patients. METHOD: Prior to the conditioning (baseline) and whenever clinically indicated patients underwent a full screening for MDRO (stool and urine cultures, swabs from several body regions)...
January 30, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28056820/prevalence-of-multidrug-resistant-organisms-in-refugee-patients-medical-tourists-and-domestic-patients-admitted-to-a-german-university-hospital
#10
Claudia Reinheimer, Volkhard A J Kempf, Katalin Jozsa, Thomas A Wichelhaus, Michael Hogardt, Fiona O'Rourke, Christian Brandt
BACKGROUND: Patients with contact to healthcare-system in high-prevalence countries (HPC) and refugee patients in hospital settings (REF) have previously been identified to be at risk of carrying multidrug-resistant organisms (MDRO). Comparative studies addressing the epidemiology of MDRO in patients transferred from hospitals abroad (ABROAD) and REF are lacking but are necessary to introduce refined infection control measures. METHODS: From December 2015 to June 2016, 117 REF, 84 ABROAD and 495 patients admitted to intensive care unit, with no refugee history or pre-treatment abroad (ICU), at University Hospital Frankfurt, Germany (UHF) were screened for MDRO on day of admittance...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28018930/intra-abdominal-infections-the-role-of-anaerobes-enterococci-fungi-and-multidrug-resistant-organisms
#11
Gil Marcus, Samuel Levy, Ghaleb Salhab, Bethlehem Mengesha, Oran Tzuman, Shira Shur, Erica Burke, Rebecca Cruz Mayeda, Lior Cochavi, Idan Perluk, Ronit Zaidenstein, Tsilia Lazarovitch, Mor Dadon, Dror Marchaim
BACKGROUND: Intra-abdominal infections (IAI) constitute a common reason for hospitalization. However, there is lack of standardization in empiric management of (1) anaerobes, (2) enterococci, (3) fungi, and (4) multidrug-resistant organisms (MDRO). The recommendation is to institute empiric coverage for some of these organisms in "high-risk community-acquired" or in "healthcare-associated" infections (HCAI), but exact definitions are not provided. METHODS: Epidemiological study of IAI was conducted at Assaf Harofeh Medical Center (May-November 2013)...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27984411/multiple-drug-resistance-in-burn-patients-a-retrospective-study-on-the-impact-of-antibiotic-resistance-on-survival-and-length-of-stay
#12
Ilse van Langeveld, Robin C Gagnon, Peggie F Conrad, Richard L Gamelli, Brendan Martin, Mashkoor A Choudhry, Michael J Mosier
Despite improvements in early treatment, survival following burn injury remains challenged by sepsis and multiple organ dysfunction syndrome (MODS). Additionally, susceptibility to infections and growing antibiotic resistance places burn patients at increased risk for infections with multiple-drug resistant organisms (MDROs). We therefore aimed to evaluate the impact of MDRO infections on survival and hospital length of stay, as well as examine the role of these organisms in the development of complications, such as acute kidney injury, sepsis, and MODS...
March 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27942218/ceftolozane-tazobactam-and-ceftazidime-avibactam-for-the-treatment-of-complicated-intra-abdominal-infections
#13
REVIEW
Kellie J Goodlet, David P Nicolau, Michael D Nailor
Complicated intra-abdominal infections (cIAI) represent a large proportion of all hospital admissions and are a major cause of morbidity and mortality in the intensive care unit. Rising rates of multidrug resistant organisms (MDRO), including extended-spectrum β-lactamase producing Enterobacteriaceae and carbapenem-nonsusceptible Pseudomonas spp., for which there are few remaining active antimicrobial agents, pose an increased challenge to clinicians. Patients with frequent exposures to the health care system or multiple recurrent IAIs are at increased risk for MDRO; however, treatment options have traditionally been limited, in some cases necessitating the utilization of last-line agents with unfavorable side-effect profiles...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27942042/faecal-carriage-of-gram-negative-multidrug-resistant-bacteria-among-patients-hospitalized-in-two-centres-in-ulaanbaatar-mongolia
#14
Bayaraa Baljin, Ganbaatar Baldan, Battogtokh Chimeddorj, Khosbayar Tulgaa, Batbaatar Gunchin, Tsogtsaikhan Sandag, Klaus Pfeffer, Colin R MacKenzie, Andreas F Wendel
Gram-negative multidrug-resistant organisms (GN-MDRO) producing β-lactamases (ESBL, plasmid-mediated AmpC β-lactamases and carbapenemases) are increasingly reported throughout Asia. The aim of this surveillance study was to determine the rate of bacterial colonization in patients from two hospitals in the Mongolian capital Ulaanbaatar. Rectal swabs were obtained from patients referred to the National Traumatology and Orthopaedics Research Centre (NTORC) or the Burn Treatment Centre (BTC) between July and September 2014, on admission and again after 14 days...
2016: PloS One
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#15
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27868317/comparative-testing-of-disinfectant-efficacy-on-planktonic-bacteria-and-bacterial-biofilms-using-a-new-assay-based-on-kinetic-analysis-of-metabolic-activity
#16
F Günther, M Scherrer, S J Kaiser, A DeRosa, N T Mutters
AIMS: The aim of our study was to develop a new reproducible method for disinfectant efficacy testing on bacterial biofilms and to evaluate the efficacy of different disinfectants against biofilms. Clinical multidrug-resistant strains were chosen as test isolates to ensure practical relevance. METHODS AND RESULTS: We compared the standard qualitative suspension assay for disinfectant testing, which does not take into account biofilm formation, to the new biofilm viability assay that uses kinetic analysis of metabolic activity in biofilms after disinfectant exposure to evaluate disinfectant efficacy...
November 21, 2016: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/27817759/status-of-the-prevention-of-multidrug-resistant-organisms-in-international-settings-a-survey-of-the-society-for-healthcare-epidemiology-of-america-research-network
#17
Nasia Safdar, Sharmila Sengupta, Jackson S Musuuza, Manisha Juthani-Mehta, Marci Drees, Lilian M Abbo, Aaron M Milstone, Jon P Furuno, Meera Varman, Deverick J Anderson, Daniel J Morgan, Loren G Miller, Graham M Snyder
OBJECTIVE To examine self-reported practices and policies to reduce infection and transmission of multidrug-resistant organisms (MDRO) in healthcare settings outside the United States. DESIGN Cross-sectional survey. PARTICIPANTS International members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. METHODS Electronic survey of infection control and prevention practices, capabilities, and barriers outside the United States and Canada. Participants were stratified according to their country's economic development status as defined by the World Bank as low-income, lower-middle-income, upper-middle-income, and high-income...
November 7, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27810070/high-rate-of-multidrug-resistant-organism-colonization-among-patients-hospitalized-overseas-highlights-the-need-for-preemptive-infection-control
#18
Kayoko Hayakawa, Kazuhisa Mezaki, Yuko Sugiki, Maki Nagamatsu, Tohru Miyoshi-Akiyama, Teruo Kirikae, Satoshi Kutsuna, Nozomi Takeshita, Kei Yamamoto, Yuichi Katanami, Norio Ohmagari
We performed 4 years of active screening for multidrug resistant organism (MDRO) colonization among patients with a history of overseas hospitalization. Thirteen (56.5%) of 23 cases were positive for MDROs, which highlights the importance of preemptive infection control to prevent the spread of MDROs in this population.
November 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27810066/correlations-between-quality-ratings-of-skilled-nursing-facilities-and-multidrug-resistant-urinary-tract-infections
#19
Azad L Gucwa, Veronika Dolar, Chao Ye, Stephanie Epstein
BACKGROUND: The purpose of this study was to determine risk factors for the acquisition of urinary tract infections (UTIs) and multidrug-resistant organisms (MDROs) in residents of skilled nursing facilities (SNFs). METHODS: Using the informational database provided by the Centers for Medicare and Medicaid Services (CMS), a retrospective logistic regression was performed on 1,523 urine cultures from 12 SNFs located in Long Island, New York. RESULTS: Of the 1,142 positive urine cultures, Escherichia coli was most prevalent...
November 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27751631/examining-the-relationship-between-multidrug-resistant-organism-acquisition-and-exposure-to-antimicrobials-in-long-term-care-populations-a-review
#20
REVIEW
Michele L Shaffer, Erika M C D'Agata, Daniel Habtemariam, Susan L Mitchell
PURPOSE: Methodological approaches to examine the association between antimicrobial exposure and multidrug-resistant organism (MDRO) acquisition are complex. This report's objectives are to review approaches used in and findings of prior studies in the long-term care setting, illustrate how these challenges were addressed in a recently completed large prospective study, and discuss strategies for future studies. METHODS: Key design and analytic approaches used in studies conducted since 2000 examining the association between antimicrobial exposure and MDRO acquisition in the long-term care setting were reviewed...
November 2016: Annals of Epidemiology
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