Subject(s)
Mycobacterium Infections, Nontuberculous , Mycobacterium chelonae , Pneumonia, Ventilator-Associated , Humans , Pneumonia, Ventilator-Associated/diagnosis , Pneumonia, Ventilator-Associated/drug therapy , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/microbiology , Anti-Bacterial Agents/therapeutic useABSTRACT
We describe a sudden 2-week outbreak due to a blaNDM-1Citrobacter amalonaticus strain in a 22-bed digestive rehabilitation center. Three of the 5 colonized patients received long-term rifaximin treatment to prevent hepatic encephalopathy. The strains were genotypically identical, phenotypically resistant to rifampin, and harbored arr-3, a rifampin adenosine diphosphate-ribosyl transferase.
Subject(s)
Anti-Bacterial Agents , Rifampin , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Disease Outbreaks , Humans , Microbial Sensitivity Tests , Rehabilitation Centers , Rifampin/pharmacology , RifaximinABSTRACT
Contamination of a point-of-care ultrasound system (POCUS) mainly involved electrocardiography accessories and included pathogenic microorganisms. The use of a glass-sealed control panel significantly facilitated its cleaning and reduced its bacterial contamination compared with a standard control panel. Overall hand hygiene compliance during examinations with POCUS was poor.
Subject(s)
Cross Infection/prevention & control , Electrocardiography/instrumentation , Equipment Contamination/prevention & control , Bacteria/classification , Bacteria/isolation & purification , Disease Transmission, Infectious/prevention & control , Hand Hygiene/standards , Humans , Infection Control/methods , Infection Control/standards , Point-of-Care SystemsABSTRACT
OBJECTIVE: To describe the course and management of a protracted outbreak after intercontinental transfer of 2 patients colonized with multidrug-resistant Acinetobacter baumannii (MDRAB). DESIGN: An 18-month outbreak investigation. SETTING: An 860-bed university hospital in France. PATIENTS: Case patients (ie, carriers) were those colonized or infected with an MDRAB isolate. METHODS: During the epidemic period, all intensive care unit (ICU) patients and contacts of carriers who were transferred to wards were screened for MDRAB carriage. Contact precautions, environmental screening, and auditing of healthcare worker (HCW) practices were implemented; rooms were cleaned with hydrogen peroxide mist disinfection. One ICU, in which most of the cases occurred, was closed on 4 occasions for thorough cleaning and disinfection. RESULTS: The 2 index case patients were identified as 2 patients who carried the same MDRAB strain and who were admitted to the hospital after repatriation from Tahiti 5 months apart. During an 18-month period, a total of 84 secondary cases occurred. Reintroduction of MDRAB into the ICUs occurred from patients previously colonized or from healthcare personnel. Termination of the outbreak was only achieved when all carriers from wards or the ICU were cohorted to an isolation unit with dedicated healthcare personnel. CONCLUSIONS: Intercontinental transfer of carriers of MDRAB can result in extensive outbreaks and serious disruption of the hospital's organization. Transmission from carriers most likely occurred via the hands of HCWs, poor cleaning protocols, airborne spread, and contaminated water from sink traps. This protracted outbreak was controlled only after implementation of an extensive control program and eventual cohorting of all carriers in an isolation unit with dedicated healthcare personnel.
Subject(s)
Acinetobacter Infections/epidemiology , Acinetobacter baumannii/drug effects , Cross Infection/epidemiology , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Acinetobacter Infections/drug therapy , Acinetobacter Infections/transmission , Acinetobacter baumannii/isolation & purification , Carrier State/microbiology , Contact Tracing , Cross Infection/drug therapy , Cross Infection/transmission , France/epidemiology , Hospitals, University , Humans , Incidence , Intensive Care Units , Internationality , Patient Transfer , TravelABSTRACT
OBJECTIVE: To compare bacterial contamination associated with electronic faucets and manual faucets in wards admitting patients highly susceptible to infection. DESIGN: Water samples from electronic faucets and manual faucets were taken according to the French recommendations on water surveillance in healthcare settings. SETTING: Hematology and intensive care units (ICUs) of a 900-bed university hospital and a 500-bed general hospital. MEASUREMENTS AND RESULTS: Overall 227 water samples were collected, 92 from electronic faucets and 135 from manual faucets. Thirty-six (39%) of the water samples from electronic faucets and 2 (1%) from manual faucets yielded pathogenic bacteria. In hematology wards 17 (30%) samples from electronic faucets and 2 (2%) from manual faucets were contaminated. In ICUs 19 (53%) samples from electronic faucets and none of 48 from manual faucets were contaminated. All samples were contaminated with various strains of Pseudomonas aeruginosa (8 to >100 CFU/100 ml). Despite hyperchlorination the electronic faucets remained contaminated. Replacing the contaminated electronic faucets by manual faucets led to a complete and sustained elimination of bacterial contamination. Contamination was not associated with a particular brand of electronic faucets. CONCLUSIONS: Our findings demonstrate that electronic faucets are significantly more frequently contaminated than manual faucets and could be a major reservoir for P. aeruginosa. Wards admitting patients highly susceptible to infection and using electronic faucets should be aware of this potential threat. Moreover, units already equipped with these devices, should check water quality periodically.
