What may be lurking in the hospital undergrowth? Inapparent cross-transmission of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae

Skally, Máiréad; Duffy, Fionnuala; Burns, Karen; Doyle, Diana; Foley, Susan; Thomas, T.; Collins, C. B.; Smyth, E.G.; Turton, Jane F.; Humphreys, Hilary

doi:10.1016/j.jhin.2014.07.011

Cited by 9 publications

(6 citation statements)

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“…The paper by Skally et al includes a retrospective epidemiological analysis which revealed two cases of transmission of Klebsiella pneumoniae ESBL (+) as a result of improper hand hygiene of hospital staff. The authors found that identification in patients being carriers of these strains is an important factor of surveillance over nosocomial infections (18). In practice, the hospital recommended hand hygiene procedures are often not respected or improperly used by staff (14)(15)(16)(17).…”

Section: Discussion and Analysismentioning

confidence: 99%

Molecular analysis of Klebsiella pneumoniae ESBL (+) isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute at the Intensive Care Unit

Petroniec¹,

Lutyńska²,

Polak³

et al. 2015

Post N Med

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Introduction. Bacillus from Enterobacteriaceae ESBL (+) including Klebsiella pneumoniae are the most common pathogen of digestive tract. Patients colonized with hospital-acquired infections fall sick on hospital-pneumonia eight times more often than patients with their own bacterial flora. ESBL (+) strains determine serious threat with limited ways of treatment. Transfer of microorganisms in hospitals is followed by nursery and medicinal operations (thermometers, hands of staff). When the epidemic outbreak occurs in the hospital the procedure of contact isolation and microbiological monitoring must be conducted. Aim. The aim of the study was to analyze of genetic relationship between Klebsiella pneumoniae ESBL (+) strains isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute (NTLDRI). Material and methods. Material of analysis were 64 strains of Klebsiella pneumoniae ESBL (+) isolated from 27 patients hospitalized on ICU. The phenotypic qualities were taken to the analysis and also the analysis of genetic relationship was conducted. The identification of species and the drug resistance phenotype were determined by the automatic system Vitek 2 Compact. Results. All of the isolated strains belonged to the Klebsiella pneumoniae species and presented the mechanism of ESBL (+) resistance type. The analysis of genetic relationship of 7 strains indicated the existence of the same molecular pattern for 5 of the isolated strains. Strains which belonged to the same genotype were isolated from patients hospitalized on the same units. Therefore it can be assumed that the transmission of infection occurred in the area of patient's residence. Conclusions. Molecular studies together with an indication of drug resistance should be the duty of laboratories and epidemiological investigation conducted in the supervision of nosocomial infections. S t r e s z c z e n i e Wstęp. Jednym z elementów kontroli zakażeń szpitalnych jest nadzór mikrobiologiczny, którego głównym celem jest analiza czynników etiologicznych zakażenia i określenie wzorów lekooporności na leki. Transmisja zakażenia w warunkach szpitalnych następuje podczas czynności pielęgnacyjnych i leczniczych chorego. W przypadku identyfikacji ogniska epidemicznego należy wprowadzić procedurę izolacji kontaktowej oraz monitorować wyniki badań. Postępowanie to jest konieczne w celu eliminacji lub ograniczenia ryzyka rozprzestrzeniania się zakażenia szpitalnego.

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Section: Discussion and Analysismentioning

confidence: 99%

Molecular analysis of Klebsiella pneumoniae ESBL (+) isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute at the Intensive Care Unit

Petroniec¹,

Lutyńska²,

Polak³

et al. 2015

Post N Med

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“…Infectious patients themselves will have the agent on the body and clothes and transmit it to the environment. The undetected microbes can spread quietly and calmly in many directions via equipment, rooms, surfaces and missing/incorrect procedures [98]. This is often a large and persistent environmental problem and a threat to other patients [23,24,37,49,50,57,[68][69][70][71][72]87].…”

Section: Contact Isolation: "Contact Precautions" (Cp)mentioning

confidence: 99%

“…The most typical spread occurs when people with contaminated hands are depositing microbes on equipment, machinery, knobs, door handles, uniforms, other textiles, furniture, toys, etc. [89][90][91] Fellow-patients on the same room are highly susceptible to infection [16,20,23,24,37,57,[96][97][98][99]. Infection can be spread further via equipment (BP apparatus, stethoscope, medicine tray, blood sugar test equipment, journal, etc.)…”

Section: Contact Isolation: "Contact Precautions" (Cp)mentioning

confidence: 99%

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Background Information: Isolation Routines

Andersen

2019

Prevention and Control of Infections in Hospitals

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Background Information: Isolation Routines 21.1 Isolation The isolation of patients with suspected or documented infections-to not spread to others-has been discussed for hundreds of years. Guidelines are many, methods are different, attitudes show vide variations, routines and procedures are still changing, regulations by law may be absent, and some healthcare professionals may be afraid of adverse outcomes of isolation [1-44]. Microbes that are spread in the environment, on the hands and equipment are invisible. The invisible agent does not call on attention before the infection; clinical disease, hospital infection or nosocomial infection is a factum that can be registered [23, 28, 29, 35-37]. How to stop the transmission is often "to believe and not believe" in infection control. 21.2 History Isolation comes from the Latin word isolare, from solus meaning alone. Isola means a "deserted" island, including Isola outside Venice, Isola di Santa Maria di Nazareth, where the first permanent quarantine hospital-nazaretto changed to Lazaretto (Lazarus)-was created in 1423 [45]. It was the bubonic plague or the Black Death (1347-1352) and leprosy which triggered the need for isolation or quarantine that protected against people who were sick. Quarantine (from Italian quaranta = 40) was introduced in Southern Europe ca. year 1400, to isolate presumed infectious ships, persons, goods, food and equipment from other places at quarantine stations for 40 days, i.e. double the incubation period for most serious infectious diseases, also in our time. In Norway, isolation was created primarily for leprous patients, probably by King Magnus Lagabøter in Bergen, ca. 1270, later on for the Black Death

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“…Particularly neonatal units are relatively often contaminated by resistant bacteria like Pseudomonas [21]. Access to rapid identification of resistant bacteria is important to avoid cross infection in such heavily loaded and complicated departments [22].…”

Section: Intensive Departmentmentioning

confidence: 99%

Tracing and Preventing Infections

Andersen

2019

Prevention and Control of Infections in Hospitals

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A total of 10-20% of somatic patients experience hospital infections during/after hospitalization. Pneumonia, sepsis, surgical site infections and urinary tract infections are most often associated with patient-related use of medical devices for approximately 65% of cases, while nontechnical equipment may be linked to 35% of cases. It is resource-intensive to detect the cause of infection outbreaks and even more expensive not to take action. Unexplained causes of outbreaks may lead to uncertainty and reduced activity at the hospital. To trace and prevent hospital outbreaks, joint efforts from hospital management, microbiology and infection control are needed. This chapter is focused on practical measures to trace and prevent hospital outbreaks.

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What may be lurking in the hospital undergrowth? Inapparent cross-transmission of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae

Cited by 9 publications

References 10 publications

Molecular analysis of Klebsiella pneumoniae ESBL (+) isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute at the Intensive Care Unit

Molecular analysis of Klebsiella pneumoniae ESBL (+) isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute at the Intensive Care Unit

Background Information: Isolation Routines

Tracing and Preventing Infections

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