Although methicillin (meticillin)-resistant.3%, and specificity, 91.5%), but broth microdilution and our preliminary RVS-MRSA detection method correlated poorly. All isolates were susceptible to linezolid and daptomycin. These data suggest that detailed prospective laboratory identification of RVS-MRSA isolates may be of limited value and that, instead, such in vitro investigation should be reserved for isolates from patients who are failing appropriate anti-MRSA therapy.

Research into naturally occurring antimicrobial substances has yielded effective treatments. One area of interest is peptides and proteins produced by invertebrates as part of their defence system, including the contents of mollusc mucous. Mucous produced by the African giant land snail, Achatina fulica has been reported to contain two proteins with broad spectrum anti-bacterial activity. Mucous from the brown garden snail, Helix aspersa appears to have skin regenerationproperties. This study sought to investigate the antimicrobial properties of H.aspersa mucous.Mucous was collected from H.aspersa snails, diluted in PBS and centrifuged, with the supernatant tested against a wide range of organisms in a disc diffusion antimicrobial assay. This was followed up with comparative experiments involving A.fulica , including bacteriophage assays. Mucous from both species of snail was passed through a series of protein size separation columns in order to determine the approximate size of the antimicrobial substance. Electrophoresis was also carried out on the H.aspersa mucous.Results indicated that H.aspersa mucous had a strong antibacterial effect against several strains of Pseudomonas aeruginosa and a weak effect against Staphylococcus aureus. Mucous from A.fulica also inhibited the growth of S.aureus, but the broad spectrum of activity reported by other workers was not observed. Antimicrobial activity was not caused by bacteriophage. Size separation experiments indicated that the antimicrobial substance(s) in H.aspersa were between 30 and 100 kDa. Electrophoresis revealed two proteins in this region -30-40 kDa and 50-60kDa. These do not correspond with antimicrobial proteins previously reported in A.fulica. This study found one or more novel antimicrobial agents in H.aspersa mucous, with a strong effect against P.aeruginosa . 2

Introduction. The SARS-CoV-2 pandemic of 2020 has resulted in unparalleled requirements for RNA extraction kits and enzymes required for virus detection, leading to global shortages. This has necessitated the exploration of alternative diagnostic options to alleviate supply chain issues. Aim. To establish and validate a reverse transcription loop-mediated isothermal amplification (RT- LAMP) assay for the detection of SARS-CoV-2 from nasopharyngeal swabs. Methodology. We used a commercial RT-LAMP mastermix from OptiGene in combination with a primer set designed to detect the CDC N1 region of the SARS-CoV-2 nucleocapsid (N) gene. A single-tube, single-step fluorescence assay was implemented whereby 1 µl of universal transport medium (UTM) directly from a nasopharyngeal swab could be used as template, bypassing the requirement for RNA purification. Amplification and detection could be conducted in any thermocycler capable of holding 65 °C for 30 min and measure fluorescence in the FAM channel at 1 min intervals. Results. Assay evaluation by assessment of 157 clinical specimens previously screened by E-gene RT-qPCR revealed assay sensitivity and specificity of 87 and 100%, respectively. Results were fast, with an average time-to-positive (Tp) for 93 clinical samples of 14 min (sd±7 min). Using dilutions of SARS-CoV-2 virus spiked into UTM, we also evaluated assay performance against FDA guidelines for implementation of emergency-use diagnostics and established a limit-of-detection of 54 Tissue Culture Infectious Dose 50 per ml (TCID50 ml−1), with satisfactory assay sensitivity and specificity. A comparison of 20 clinical specimens between four laboratories showed excellent interlaboratory concordance; performing equally well on three different, commonly used thermocyclers, pointing to the robustness of the assay. Conclusion. With a simplified workflow, The N1 gene Single Tube Optigene LAMP assay (N1-STOP-LAMP) is a powerful, scalable option for specific and rapid detection of SARS-CoV-2 and an additional resource in the diagnostic armamentarium against COVID-19.

Background: Hand hygiene (HH) is the primary measure in the prevention of healthcare associated infections though from published studies, compliance of healthcare workers to HH guidelines is low. There is currently no review on HH compliance rate in developing countries, specifically Sub-Saharan Africa (SSA) or the barriers to compliance. We therefore, through a narrative review sought to identify the compliance with and the barriers to HH in SSA.Methods: From three databases, we performed a search of peer-reviewed studies from SSA, conducted among healthcare workers, published in English language and between 2005 and 2017. Only studies that reported HH compliance and/or barriers were included.Results: A total of 278 articles were identified and the final sample of 27 analyzed in full length. Overall HH compliance rate was estimated to be 21.1% and doctors had better compliance irrespective of the type of patient contact. The main barriers identified were heavy workload, infrastructural deficit (e.g. lack of water, soap, hand sanitizers and blocked/leaking sinks) and poorly positioned facilities. Conclusion:HH compliance is poor among SSA healthcare workers. There is a need for more reports of HH compliance in SSA and emphasis needs to be placed on surgical wards where surgical sites infections, the commonest form of HCAI in SSA are likeliest. Barriers identified in this review are consistent with the findings of studies conducted elsewhere however it appears that heavy workload, infrastructural deficit and poorly positioned facilities are more likely in developing countries.

High-throughput and rapid serology assays to detect the antibody response specific to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in human blood samples are urgently required to improve our understanding of the effects of COVID-19 across the world. Short-term applications include rapid case identification and contact tracing to limit viral spread, while population screening to determine the extent of viral infection across communities is a longer-term need. Assays developed to address these needs should match the ASSURED criteria. We have identified agglutination tests based on the commonly employed blood typing methods as a viable option. These blood typing tests are employed in hospitals worldwide, are high-throughput, fast (10–30 min), and automated in most cases. Herein, we describe the application of agglutination assays to SARS-CoV-2 serology testing by combining column agglutination testing with peptide–antibody bioconjugates, which facilitate red cell cross-linking only in the presence of plasma containing antibodies against SARS-CoV-2. This simple, rapid, and easily scalable approach has immediate application in SARS-CoV-2 serological testing and is a useful platform for assay development beyond the COVID-19 pandemic.

We examined the rate of fecal carriage of vanB in the absence of cultivable vancomycin-resistant enterococci in three distinct populations (children, community adults, and hemodialysis patients). Nonenterococcal vanB carriage was similarly high in hemodialysis patients (45%) and community adults (63%; P ‫؍‬ 0.066) and significantly more common among community adults than children (27%; P ‫؍‬ 0.001).The emergence of vancomycin-resistant enterococci (VRE) is a serious infection control issue in hospitals worldwide (14,16). Recently the vanB genotype has been described in several nonenterococcal (NE) organisms comprising part of the human bowel flora (2,5,6,15). As both in vitro and in vivo transfer of vanB from these organisms to enterococci has been demonstrated, the presence of NE vanB organisms may contribute to VRE emergence (4, 11).We and others have recently reported high rates of vanB carriage (17 to 85%) in the absence of cultivable VRE in fecal/rectal samples during studies of direct detection of VRE and have attributed this in part to the presence of anaerobic gram-positive bacilli carrying vanB Tn5382/Tn1549 (1, 2, 5, 10, 17, 21).As the presence of NE vanB organisms within stool specimens can impact significantly on the specificity of direct detection for VRE, it is important to better understand the epidemiology of both the vanB gene and VRE genotypes in the local population. Studies to investigate the epidemiology of NE van gene carriage are rare, except for that of Domingo et al. (6), who found a rectal carriage rate of 4.8% for non-VRE vanB compared with 1.6% for vanB VRE in hospitalized patients. With this in mind, we sought to investigate the epidemiology of NE vanB carriage in various populations to assess the hypothesis that patient age and comorbidities may affect carriage of these elements.(This work was presented in part at the 46th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, CA, 2006 [7a].)Participants comprised 56 children aged Ͻ5 years (sourced from eight local preschools), 97 adults recruited from the community, and 50 hemodialysis outpatients with no previous history of colonization or infection with VRE (Austin Hospital, Melbourne, Australia). Community adults were recruited via advertisements, via contact with local social clubs, and from Australians (aged 55 to 74 years) participating in a regular preventive bowel cancer screening program. Participants were required to complete a questionnaire assessing demographic information including age, sex, antibiotics during the previous 2 weeks, hospital admission during the previous 3 and 12 months, and contact with a health-care worker (participant, parent of participant, or household member working in a hospital). Hemodialysis patients were also assessed for the presence of diabetes, an organ transplant, and/or treatment with immunosuppressive medication.Fecal specimens were collected from all participants and stored at Ϫ80°C. A sterile 10-l loop was inserted into the center of the fecal specimen,...

We assessed cutaneous adverse reactions (CARs) to alcohol-based hand rub (ABHR) after the introduction of a hand hygiene culture change program at our institution. CARs were infrequent among exposed health care workers (HCWs) (13/2,750; 0.47%; 1 CAR per 72 years of HCW exposure) and were not influenced by the duration or intensity of ABHR use but were associated with the presence of irritant contact dermatitis.

Objectives: To conduct a pilot study implementing combined genomic and epidemiologic surveillance for hospital-acquired multidrug-resistant organisms (MDROs) to predict transmission between patients and to estimate the local burden of MDRO transmission. Design: Pilot prospective multicenter surveillance study. Setting: The study was conducted in 8 university hospitals (2,800 beds total) in Melbourne, Australia (population 4.8 million), including 4 acute-care, 1 specialist cancer care, and 3 subacute-care hospitals. Methods: All clinical and screening isolates from hospital inpatients (April 24 to June 18, 2017) were collected for 6 MDROs: vanA VRE, MRSA, ESBL Escherichia coli (ESBL-Ec) and Klebsiella pneumoniae (ESBL-Kp), and carbapenem-resistant Pseudomonas aeruginosa (CRPa) and Acinetobacter baumannii (CRAb). Isolates were analyzed and reported as routine by hospital laboratories, underwent whole-genome sequencing at the central laboratory, and were analyzed using open-source bioinformatic tools. MDRO burden and transmission were assessed using combined genomic and epidemiologic data. Results: In total, 408 isolates were collected from 358 patients; 47.5% were screening isolates. ESBL-Ec was most common (52.5%), then MRSA (21.6%), vanA VRE (15.7%), and ESBL-Kp (7.6%). Most MDROs (88.3%) were isolated from patients with recent healthcare exposure. Combining genomics and epidemiology identified that at least 27.1% of MDROs were likely acquired in a hospital; most of these transmission events would not have been detected without genomics. The highest proportion of transmission occurred with vanA VRE (88.4% of patients). Conclusions: Genomic and epidemiologic data from multiple institutions can feasibly be combined prospectively, providing substantial insights into the burden and distribution of MDROs, including in-hospital transmission. This analysis enables infection control teams to target interventions more effectively.