Effects of environmental disinfection on the isolation of vancomycin-resistant Enterococcus after a hospital-associated outbreak of Middle East respiratory syndrome

Ko, Jae-Hoon; Kim, Si-Ho; Lee, Nam Yong; Kim, Yae-jin; Cho, Sun Young; Kang, Cheol-In; Chung, Doo Ryeon; Peck, Kyong Ran

doi:10.1016/j.ajic.2019.05.032

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…High efficiency particulate air (HEPA) filters were installed in the breathing circuits, both on the inspiratory and expiratory limbs of the ventilators and at the patient's site that connected to endotracheal tube. After operations with MERS-exposed patients, 30 minutes of room ventilation was followed by surface disinfection with diluted chlorine bleach (500 ppm) 18,19 . Cleaners wore standard PPE while disinfecting surfaces.…”

Section: Equipment Preparation and Disinfectionmentioning

confidence: 99%

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Park

Yoo

et al. 2020

Sci Rep

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In 2015, we experienced the largest in-hospital Middle East respiratory syndrome (MERS) outbreak outside the Arabian Peninsula. We share the infection prevention measures for surgical procedures during the unexpected outbreak at our hospital. We reviewed all forms of related documents and collected information through interviews with healthcare workers of our hospital. After the onset of outbreak, a multidisciplinary team devised institutional MERS-control guidelines. Two standard operating rooms were converted to temporary negative-pressure rooms by physically decreasing the inflow air volume (−4.7 Pa in the main room and −1.2 Pa in the anteroom). Healthcare workers were equipped with standard or enhanced personal protective equipment according to the MERS-related patient's profile and symptoms. Six MERS-related patients underwent emergency surgery, including four MERS-exposed and two MERS-confirmed patients. Negative conversion of MERS-CoV polymerase chain reaction tests was noticed for MERS-confirmed patients before surgery. MERS-exposed patients were also tested twice preoperatively, all of which were negative. All operative procedures in MERSrelated patients were performed without specific adverse events or perioperative MERS transmission. Our experience with setting up a temporary negative-pressure operation room and our conservative approach for managing MERS-related patients can be referred in cases of future unexpected MERS outbreaks in non-endemic countries.The Middle East respiratory syndrome (MERS) is a serious acute respiratory disease caused by the MERS coronavirus (MERS-CoV), and the mortality rates in infected patients are estimated at 20-40% 1 . Since the first case report in Saudi Arabia in 2012 2 , MERS outbreaks have occurred mainly in Middle Eastern countries and a small number of imported cases arose in Europe, Asia, United States, and Africa 3-7 . From May to July 2015, South Korea experienced the largest MERS outbreak outside the Arabian Peninsula 8,9 . The South Korean outbreak resulted in 186 laboratory-confirmed MERS cases, 92 of which were associated with our tertiary care hospital 10,11 . According to our institutional policy during the MERS outbreak, all elective surgeries for MERS-related patients were postponed when possible. However, several MERS-related patients inevitably required emergency operations under anesthesia. Two of the 92-MERS confirmed cases and four MERS-exposed patients underwent surgery. Although there is some literature regarding infection prevention during operative procedures for severe acute respiratory syndrome (SARS) coronavirus 12,13 , guidelines or references for MERS prevention during perioperative patient care were very limited. Therefore, we developed institutional guidelines for perioperative MERS infection prevention and we set up a temporary negative-pressure operating room.In this globalized era, along with small and large outbreaks that persist in the Arabian Peninsula, MERS outbreaks may recur in any other regions, especially if a super spreader i...

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Section: Equipment Preparation and Disinfectionmentioning

confidence: 99%

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Park

Yoo

et al. 2020

Sci Rep

Self Cite

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“…Theoretical models and scoring systems exist but are mostly difficult to implement in practice [29]. units, operating theatres and clean rooms, respectively, considered high-risk areas.…”

Section: Key Components I) Risk Assessmentmentioning

confidence: 99%

“…In addition, Dancer et al were able to show that introducing an additional environmental services staff member for enhanced cleaning of hand-touch sites in surgical wards with endemic Another prospective study by Rutala et al found a 35% reduction in colonization and/or infection with epidemiologically important pathogens when the contamination was reduced by 94% due to enhanced terminal cleaning [26]. Further studies confirmed the positive impact of enhanced environmental cleaning and disinfection protocols on infection and/or colonization rates of MRSA [27], VRE [17,28,29] and Clostridioides difficile [16,[30][31][32][33][34].…”

Section: Introductionmentioning

confidence: 98%

Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review

Assadian

Harbarth

Vos

et al. 2021

Journal of Hospital Infection

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…The middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic beta coronavirus which can infect various kinds of animals such as humans, camels, and bats. [118][119][120][121][122][123] It belongs to the Beta-coronavirus genus, of the coronavirus family. 124,125 It was first discovered in September 2012 as the cause of death in a patients who had died of severe pneumonia in June 2012 in Jeddah, Saudi Arabia, 126,127 and 1,348 cases of MERS-CoV infection confirmed globally, with at least 479 related deaths until June 23, 2015.…”

Section: The Middle East Respiratory Syndrome Coronavirus (Mers-cov)mentioning

confidence: 99%

Product of natural evolution (SARS, MERS, and SARS-CoV-2); deadly diseases, from SARS to SARS-CoV-2

Shahrajabian

Sun

Cheng

2020

Human Vaccines & Immunotherapeutics

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SARS-CoV-2, the virus causing COVID-19, is a single-stranded RNA virus belonging to the order Nidovirales, family Coronaviridae, and subfamily Coronavirinae. SARS-CoV-2 entry to cellsis initiated by the binding of the viral spike protein (S) to its cellular receptor. The roles of S protein in receptor binding and membrane fusion makes it a prominent target for vaccine development. SARS-CoV-2 genome sequence analysis has shown that this virus belongs to the beta-coronavirus genus, which includes Bat SARS-like coronavirus, SARS-CoV and MERS-CoV. A vaccine should induce a balanced immune response to elicit protective immunity. In this review, we compare and contrast these three important CoV diseases and how they inform on vaccine development.

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Effects of environmental disinfection on the isolation of vancomycin-resistant Enterococcus after a hospital-associated outbreak of Middle East respiratory syndrome

Cited by 4 publications

References 9 publications

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review

Product of natural evolution (SARS, MERS, and SARS-CoV-2); deadly diseases, from SARS to SARS-CoV-2

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