Molecular Epidemiology of an Outbreak of
            <i>Enterobacter cloacae</i>
            in the Neonatal Intensive Care Unit of a Provincial Hospital in Gauteng, South Africa

Nierop, W. H. van; Duse, Adrian; Stewart, R. G.; Bilgeri, Y.R.; Koornhof, H. J.

doi:10.1128/jcm.36.10.3085-3087.1998

Cited by 37 publications

(13 citation statements)

References 7 publications

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“…Twenty published outbreak reports from African NNUs over the last two decades were identified, with the majority from Sub-Saharan Africa (n = 16), including South Africa (n = 12) ( Table 3). [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Very few of these published reports included an outbreak definition, but those that did usually cited an outbreak as a single pathogen affecting two or more patients with a temporal and spatial link (between 7 and 10 days, occurring on the same ward or unit). One-third of reports described outbreaks restricted to NICU settings.…”

Section: Resultsmentioning

confidence: 99%

Infectious disease exposures and outbreaks at a South African neonatal unit with review of neonatal outbreak epidemiology in Africa

Dramowski

Aucamp

Bekker

et al. 2017

International Journal of Infectious Diseases

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Section: Resultsmentioning

confidence: 99%

Infectious disease exposures and outbreaks at a South African neonatal unit with review of neonatal outbreak epidemiology in Africa

Dramowski

Aucamp

Bekker

et al. 2017

International Journal of Infectious Diseases

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“…Role of hand colonization in cross-transmission. Transient hand carriage of various gram-negative bacterial species has quite often been suspected to be responsible for cross-transmission during outbreaks resulting in various types of NI (155,426,514,571). Most reports of cross-transmission of specific gram-negative bacteria come from critical-care areas, such as neonatal ICUs and burn units.…”

Section: Gram-negative Bacteriamentioning

confidence: 99%

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

2004

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The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data from comparative trials are available to reliably rank triclosan. Personnel should be reminded that it is neither necessary nor recommended to routinely wash hands after each application of an alcohol-based hand rub. Long-lasting improvement of compliance with hand hygiene protocols can be successful if an effective and accessible alcohol-based hand rub with a proven dermal tolerance and an excellent user acceptability is supplied, accompanied by education of health care workers and promotion of the use of the product

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“…Antibiograms and Analytical Profile Index profiles of the isolates are considerably less discriminatory than molecular techniques. 16 By providing comprehensive feedback from the investigation and through the use of molecular epidemiology of the outbreak as an educational tool, this study underscores the importance of practicing basic infection control procedures at all times, such as hand washing, isolation, and appropriate antibiotic usage. Such principles have contributed to the termination of the outbreaks and helped stop the development of new outbreaks in the hospital despite a shortage of staff and funding.…”

Section: Discussionmentioning

confidence: 96%

Study of an outbreak of Enterobacter cloacae sepsis in a neonatal intensive care unit: The application of epidemiologic chromosome profiling by pulsed-field gel electrophoresis

Liu¹,

Leu²,

Yen³

et al. 2002

American Journal of Infection Control

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Molecular Epidemiology of an Outbreak of Enterobacter cloacae in the Neonatal Intensive Care Unit of a Provincial Hospital in Gauteng, South Africa

Cited by 37 publications

References 7 publications

Infectious disease exposures and outbreaks at a South African neonatal unit with review of neonatal outbreak epidemiology in Africa

Infectious disease exposures and outbreaks at a South African neonatal unit with review of neonatal outbreak epidemiology in Africa

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

Study of an outbreak of Enterobacter cloacae sepsis in a neonatal intensive care unit: The application of epidemiologic chromosome profiling by pulsed-field gel electrophoresis

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