Cross-sectional point prevalence survey to study the environmental contamination of nosocomial pathogens in intensive care units under real-life conditions

Wille, I.; Mayr, A; Kreidl, Peter; Brühwasser, Christina; Hinterberger, Guido; Fritz, Andreas; Posch, Wilfried; Fuchs, Stefan; Obwegeser, Alois Albert; Orth‐Höller, Dorothea; Lass‐Flörl, Cornelia

doi:10.1016/j.jhin.2017.09.019

Cited by 44 publications

(31 citation statements)

References 30 publications

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“…; Wille et al . ) has been reported. It also highlights the interdependence of some preventative measures like environmental surfaces cleaning/disinfection and hand hygiene.…”

Section: Resultsmentioning

confidence: 90%

Biofilm contamination of high‐touched surfaces in intensive care units: epidemiology and potential impacts

Costa

Johani

Melo

et al. 2019

Lett Appl Microbiol

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Significance and Impact of the Study: Contamination of healthcare facilities surfaces has been shown to play a major role in transmission of pathogens. The findings of this study show that dry surface biofilms are widespread and can incorporate pathogens and multidrug-resistant organisms (MROs). Biofilms on highly touched surfaces pose a risk to patients, as dry surface biofilms persist for long period and microorganisms within biofilm have been shown to be transmitted. This study also provides a better understanding of microbial populations in hospital environments, reinforcing that pathogens and MROs are found incorporated into biofilm, which impacts the difficulty in cleaning/disinfection. AbstractThe aim of this study was to determine the epidemiology (location, microbial load, microbiome, presence/absence of biofilm and pathogens, including ESKAPE-Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species, and antimicrobial susceptibility profiles) of the bacterial contamination on intensive care units (ICUs) surfaces. Fifty-seven high-touched surfaces were collected from adult, paediatric and neonatal ICUs from two large public Brazilian hospitals from central and north regions. Samples (c. 4 cm 2 ) were subjected to culture (qualitative), qPCR targeting 16s rRNA gene (microbial load-bacteria per cm 2 ), 16s rRNA amplicon sequencing (microbiome analysis) and scanning electron (SEM) or confocal laser scanning microscopy (CLSM) (biofilm presence). Multidrug resistant organisms (MROs) were detected using specific chromogenic agar. The average bacterial load was 1Á32 9 10 4 bacteria per cm 2 , container for newborn feeding bottles, stretcher mattress, humidicrib mattress filling and computer keyboards presented the higher bioburden. However, only 45Á6% (26/57) were culture-positive, including 4/26 with MROs. ESKAPE organisms were detected in 51Á8% of the samples subjected to next-generation sequencing. Viability staining and CLSM demonstrated live bacteria on 76Á7% of culture-negative samples. Biofilm was present on all surfaces subjected to microscopy (n = 56), demonstrating that current cleaning practices are suboptimal and reinforcing that MROs are incorporated into hospital surfaces biofilm.

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“…; Wille et al . ) has been reported. It also highlights the interdependence of some preventative measures like environmental surfaces cleaning/disinfection and hand hygiene.…”

Section: Resultsmentioning

confidence: 90%

Biofilm contamination of high‐touched surfaces in intensive care units: epidemiology and potential impacts

Costa

Johani

Melo

et al. 2019

Lett Appl Microbiol

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“…The relatively high rate of acquiring CR-GNB during an ICU stay could be due to the transmission of CR-GNB between patients via health care workers, ICU environments (inanimate objects/surfaces), or medical devices, since GNB can survive for a long period of time in the environment (23). These explanations were supported by several studies from different countries, including Thailand, which showed that CR-GNB isolates from colonized or infected patients were clonally related to those present on medical devices or in hospital environments (24)(25)(26). In our study, one of the risk factors for acquiring CR-GNB during an ICU stay was the use of an enteral feeding tube (Table 3), similar to the findings of a recent study by Yamamoto et al, who reported that the use of an enteral feeding tube was significantly associated with carbapenem-resistant Enterobacteriaceae carriage among hospitalized patients in Japan (27).…”

Section: Discussionmentioning

confidence: 89%

Risk Factors for Gastrointestinal Colonization and Acquisition of Carbapenem-Resistant Gram-Negative Bacteria among Patients in Intensive Care Units in Thailand

Kiddee

Assawatheptawee

Na-udom

et al. 2018

Antimicrob Agents Chemother

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This study was conducted to investigate the prevalence of and risk factors for colonization and acquisition of carbapenem-resistant (CR) Gram-negative bacteria (GNB) among patients admitted to intensive care units (ICUs) in two tertiary care hospitals in northern Thailand. Screening of rectal swab specimens for CR-GNB was performed on patients at ICU admission and discharge. The phenotypes and genotypes of all isolates were determined. Risk factors were analyzed by logistic regression analysis. The overall carriage rate of CR-GNB at admission was 11.6% (32/275), with the most predominant species carried being ( = 15), followed by ( = 9). The risk factor for CR-GNB colonization was hospitalization within the previous 6 months ( = 0.002). During the ICU stay, the rate of CR-GNB acquisition was 25.2% (52/206), with the most predominant species carried being ( = 28) and ( = 13). Risk factors associated with CR-GNB acquisition were the use of an enteral feeding tube ( = 0.008) and administration of third-generation cephalosporins ( = 0.032) and carbapenems ( = 0.045). The most common carbapenemase genes in and were and, respectively. Patient-to-patient transmission was demonstrated in three cases, resulting in the acquisition of CR (2 cases) and (1 case) isolates from other patients who were admitted during the same period of time. This is the first Indochinese study screening patients, examining patients for the carriage of CR-GNB, and further demonstrating the transfer of CR-GNB isolates in ICUs. Our study suggests that effective infection control measures are required to limit the spread of CR-GNB within hospitals.

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“…51,[91][92][93][94][95][96] Microorganisms colonizing these wounds are typically the patient's normal flora [97][98][99][100][101] or may be transferred via contact with contaminated water, fomites, or the soiled hands of health care workers. [102][103][104][105][106] Gram-positive bacteria such as Staphylococcus aureus, Enterococcus spp., and Gramnegative organisms such as Pseudomonas aeruginosa, Acinetobacter spp., fungi like Candida spp., Aspergillus spp., are all among a list of common pathogens that can cause acute wound infections, and several of them are resistant to antibiotics. 107 An important factor in the failure of a sore to heal is the presence of polymicrobial consortia, living cooperatively in highly organized biofilms.…”

Section: Infectionmentioning

confidence: 99%

Human Wounds and Its Burden: An Updated Compendium of Estimates

Sen

2019

Advances in Wound Care

678

504

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A 2018 retrospective analysis of Medicare beneficiaries identified that *8.2 million people had wounds with or without infections. Medicare cost estimates for acute and chronic wound treatments ranged from $28.1 billion to $96.8 billion. Highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient. Increasing costs of health care, an aging population, recognition of difficult-to-treat infection threats such as biofilms, and the continued threat of diabetes and obesity worldwide make chronic wounds a substantial clinical, social, and economic challenge. Recent Advances: Chronic wounds are not a problem in an otherwise healthy population. Underlying conditions ranging from malnutrition, to stress, to metabolic syndrome, predispose patients to chronic, nonhealing wounds. From an economic point of view, the annual wound care products market is expected to reach $15-22 billion by 2024. The National Institutes of Health's (NIH) Research Portfolio Online Reporting Tool (RePORT) now lists wounds as a category. Future Directions: A continued rise in the economic, clinical, and social impact of wounds warrants a more structured approach and proportionate investment in wound care, education, and related research.

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Cross-sectional point prevalence survey to study the environmental contamination of nosocomial pathogens in intensive care units under real-life conditions

Cited by 44 publications

References 30 publications

Biofilm contamination of high‐touched surfaces in intensive care units: epidemiology and potential impacts

Biofilm contamination of high‐touched surfaces in intensive care units: epidemiology and potential impacts

Risk Factors for Gastrointestinal Colonization and Acquisition of Carbapenem-Resistant Gram-Negative Bacteria among Patients in Intensive Care Units in Thailand

Human Wounds and Its Burden: An Updated Compendium of Estimates

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