Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada

Ocampo, Wrechelle; Geransar, Rose; Clayden, Nancy; Jones, Jenny M.; Grood, Jill de; Joffe, Mark; Taylor, Geoffrey; Missaghi, Bayan; Pearce, Craig; Ghali, William A.; Conly, John

doi:10.1016/j.ajic.2017.05.014

Cited by 13 publications

(13 citation statements)

References 11 publications

(16 reference statements)

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“…The presence of Klebsiella pneumoniae colonization was defined as any patient who had Klebsiella pneumoniae -positive culture results from a rectal swab screening and no clinical infection symptoms were found [4]. Nosocomial-acquired infection was defined as infectious diseases acquired after 48 h of hospitalization [5]. Patients included in the study were categorized into the CRKP group and the carbapenem-susceptible Klebsiella pneumoniae (CSKP) group (control group).…”

Section: Methodsmentioning

confidence: 99%

Carbapenem-ResistantKlebsiella pneumoniaeInfections among ICU Admission Patients in Central China: Prevalence and Prediction Model

Shen

Zhu

et al. 2019

BioMed Research International

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Objective. To investigate the prevalence of infections due to carbapenem-resistant Klebsiella pneumoniae (CRKP) among ICU admission patients in central China and develop a reliable prediction model. Methods. Five hundred and seven consecutive ICU admission patients with Klebsiella pneumoniae (KP) infection were enrolled in this retrospective multicenter case-control study from January 2014 to June 2018. The prevalence and antimicrobial susceptibility pattern were analyzed. Multivariate analysis was performed by logistic regression modeling to determine the risk factors. A prediction model was developed and verified using data from six hospitals in central China. Results. Of the total 507 isolates of KP, 244 (48.1%) strains were carbapenem resistant. The majority of these isolates were from sputum (30.9%) and blood (20.9%) samples. Tigecycline had good activity against CRKP (95.5%). The most common sequence type (ST) of CRKP was ST11 (84.4%), and 98.6% of them had the blaKPC-2 antimicrobial resistance gene. Thirteen variables were identified as independent risk factors for CRKP infection, including KP colonization or infection in the preceding year (OR=3.32, 95% CI 2.01-4.38), CD4/CD8 ratio <1 (OR=2.98, 95% CI 2.02-4.19), and parenteral nutrition ⩾48 h (OR=1.88, 95% CI 1.22-3.04). The model developed to predict CRKP infection was effective, with an area under the receiver-operating characteristic curve of 0.854 (95% CI 0.821-0.884, p<0.001). Conclusions. ST11 carrying the blaKPC-2 antimicrobial resistance gene was the most common type of CRKP among the ICU admission patients in central China. The model demonstrated excellent predictive performance and exhibited good discrimination.

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Section: Methodsmentioning

confidence: 99%

Carbapenem-ResistantKlebsiella pneumoniaeInfections among ICU Admission Patients in Central China: Prevalence and Prediction Model

Shen

Zhu

et al. 2019

BioMed Research International

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“…The infectious diseases include skin and soft tissue infection, pneumonia, bacteremia, and urinary tract infection which were defined in accordance with uniform diagnostic criteria of European Society of Clinical Microbiology and Infectious Diseases (ESCMID) [5]. Nosocomial acquired infection was defined as the infectious diseases acquired after 48h of hospitalization [6]. The pathogen was acquired either from the hospital or community and patients were categorized into ESBL producing group or non-ESBL producing group.…”

Section: Methodsmentioning

confidence: 99%

Infections Caused by Extended-Spectrum β-Lactamase Producing Escherichia Coli in Systemic Lupus Erythematosus Patients: Prevalence, Risk Factors, and Predictive Model

Shen

Zhu

et al. 2018

BioMed Research International

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Objective To investigate the prevalence and risk factors of infections caused by Extended-Spectrum β-Lactamase (ESBL) producing Escherichia coli (E. coli) in systemic lupus erythematosus (SLE) patients and develop a predictive model. Methods Three hundred and eighty-four consecutive SLE patients with E. coli infection were enrolled in this retrospective case control study from January 2012 to December 2017. Prevalence and antimicrobial susceptibility pattern of ESBL producing E. coli were analyzed. Multivariate analysis was performed to determine the risk factors. Sensitivity and specificity were obtained at various point cutoffs and area under the receiver operator characteristic curve (AuROC) was determined to confirm the prediction power of the model. Results Of the total 384 E. coli strains tested, 212 (55.2%) produced ESBL. The majority of these isolates were from urine (44.3%). Carbapenems (>80%) and amikacin (89.6%) had good activity against ESBL producing E. coli. Eleven variables were identified as independent risk factors for ESBL producing E. coli infection including Enterobacteriaceae colonization or infection in preceding year (OR=8.15, 95%CI 5.12–21.71), daily prednisone dose > 30mg (OR=5.48, 95%CI 3.12–13.72), low C3 levels (OR=2.17, 95%CI 1.62–6.71), nosocomial acquired infection (OR=4.12, 95%CI 1.98–8.85), etc. The model developed to predict ESBL producing E. coli infection was effective, with the AuROC of 0.840 (95% CI 0.799-0.876). Conclusions The prevalence of ESBL producing E. coli was increasing with high antibiotics resistance in patients with SLE. The model revealed excellent predictive performance and exhibited a good discrimination.

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“…While improved cleaning practices have led to a decrease in the transmission of hospital-acquired infections [7][8][9], in general, hospital cleanliness is still not sufficient to control infections [10][11][12]. This is confirmed by the fact that outbreaks of hospital-acquired infections still occur worldwide [13][14][15]. It is therefore possible that there are other unknown factors responsible for bacterial survival, particularly on dry surfaces, in hospitals.…”

Section: Introductionmentioning

confidence: 99%

Effect of thermal control of dry fomites on regulating the survival of human pathogenic bacteria responsible for nosocomial infections

et al. 2019

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We monitored the survival of human pathogenic bacteria [Escherichia coli (ATCC), extended-spectrum β-lactamase-producing E. coli (Clinical isolate), New Delhi metallo-β-lactamase-producing E. coli (clinical isolate), Staphylococcus aureus (ATCC)] on dry materials (vinyl chloride, aluminum, plastic, stainless steel) at distinct temperatures (room temperature or 15°C–37°C). These bacteria favored a lower temperature for their prolonged survival on the dry fomites, regardless of the material type. Interestingly, when mixed with S. aureus, E. coli survived for a longer time at a lower temperature. Cardiolipin, which can promote the survival of S. aureus in harsh environments, had no effect on maintaining the survival of E. coli. Although the trends remained unchanged, adjusting the humidity from 40% to 60% affected the survival of bacteria on dry surfaces. Scanning electron microscopic analysis revealed no morphological differences in these bacteria immediately before or after one day of dry conditions. In addition, ATP assessment, a method used to visualize high-touch surfaces in hospitals, was not effective at monitoring bacterial dynamics. A specialized handrail device fitted with a heater, which was maintained at normal human body core temperature, successfully prohibited the prolonged survival of bacteria [Enterococcus faecalis (ATCC), E. coli (ATCC), Pseudomonas aeruginosa (ATCC), S. aureus (ATCC), Acinetobacter baumannii (clinical isolate), and Serratia marcescens (clinical isolate)], with the exception of spore-forming Bacillus subtilis (from our laboratory collection) and the yeast-like fungus Candida albicans (from our laboratory collection)] on dry surfaces. Taken together, we concluded that the tested bacteria favor lower temperatures for their survival in dry environments. Therefore, the thermal control of dry fomites has the potential to control bacterial survival on high-touch surfaces in hospitals.

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Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada

Cited by 13 publications

References 11 publications

Carbapenem-ResistantKlebsiella pneumoniaeInfections among ICU Admission Patients in Central China: Prevalence and Prediction Model

Carbapenem-ResistantKlebsiella pneumoniaeInfections among ICU Admission Patients in Central China: Prevalence and Prediction Model

Infections Caused by Extended-Spectrum β-Lactamase Producing Escherichia Coli in Systemic Lupus Erythematosus Patients: Prevalence, Risk Factors, and Predictive Model

Effect of thermal control of dry fomites on regulating the survival of human pathogenic bacteria responsible for nosocomial infections

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