ABSTRACT
This study explored perceptions of the role of infection preventionists (IPs) in antimicrobial stewardship programs (ASPs) among IPs, pharmacists, infectious diseases physicians, and hospital executives. Expert telephone interviews, using a validated survey tool, were conducted from November 1, 2016 to December 12, 2016 (nâ¯=â¯28). Participants with clinical responsibilities reported modest expectations of the IP in ASPs. Competing IP job responsibilities and limited ASP role clarity were cited as common barriers to IP engagement.
Subject(s)
Antimicrobial Stewardship , Attitude of Health Personnel , Infection Control Practitioners/psychology , Pharmacists/psychology , Physicians/psychology , Adult , Female , Hospital Administration , Humans , Infectious Disease Medicine , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
A retrospective investigation of skin and soft tissue infections caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA) strains among inmates in a Wisconsin correctional facility suggested a shift in MRSA genotype. Case timeline indicated a displacement of USA400 clone by USA300 clone. The USA300 index case was associated with an infected new tattoo.
Subject(s)
Disease Outbreaks , Prisoners , Staphylococcal Skin Infections/epidemiology , Staphylococcus aureus/classification , Staphylococcus aureus/genetics , Tattooing/adverse effects , Adult , Anti-Bacterial Agents/pharmacology , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Electrophoresis, Gel, Pulsed-Field , Humans , Male , Methicillin Resistance , Microbial Sensitivity Tests , Middle Aged , Soft Tissue Infections/epidemiology , Soft Tissue Infections/microbiology , Staphylococcal Skin Infections/microbiology , Staphylococcus aureus/drug effects , Staphylococcus aureus/isolation & purification , Wisconsin/epidemiologyABSTRACT
BACKGROUND: Studies examining the incidence of microorganisms isolated from surgical site infections (SSIs) have been conducted primarily at large academic health care centers. Results from these studies have revealed that methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant pathogen in SSIs. Minimal data are available from smaller, community hospitals on the incidence of microorganisms associated with SSIs, particularly the incidence of MRSA in SSIs. METHODS: A retrospective study was performed to identify the microorganisms associated with SSIs in patients who underwent class I and II surgeries at a small urban to rural community hospital from January 2003 through December 2004. RESULTS: A total of 10,672 surgeries was performed, and 89 SSIs were identified. Staphylococcus aureus was the most common pathogen (25.8%). Enterobacteriaceae were the second most frequently isolated organisms (12.4%), followed by streptococci species (11.2%), coagulase-negative staphylococci (10.1%), enterococci species (7.9%), and Pseudomonas aeruginosa (6.7%). MRSA was isolated from 4.5% of the SSIs. CONCLUSION: We have demonstrated that the spectrum of microorganisms isolated in SSIs at a community hospital is comparable with that reported in studies conducted at large academic health care centers, including the emergence of MRSA as a pathogen in SSIs. This information will guide future infection control initiatives to reduce SSIs.
Subject(s)
Bacterial Infections/microbiology , Cross Infection/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Surgical Wound Infection/microbiology , Bacterial Infections/epidemiology , Gram-Negative Bacteria/classification , Gram-Positive Bacteria/classification , Hospitals , Humans , Incidence , Midwestern United States/epidemiology , Retrospective StudiesABSTRACT
This study documents the first reported transmission of Salmonella enterica serotype Typhimurium definitive type 104 (DT104) to premature fraternal twins via their mother's breast milk. When premature twin neonates developed severe enteritis in the neonatal intensive care unit (NICU), stool samples and the mother's breast milk were cultured for the presence of Salmonella. Antibacterial susceptibility patterns were determined. Semiquantitative organism abundance data were retrospectively gathered on 54 stored breast milk samples collected on 34 different days using a rapid, real-time polymerase chain reaction (PCR) methodology (LightCycler PCR). Fecal samples from other infants in the NICU at that time were also tested. Pulsed-field gel electrophoresis (PFGE) was used to assess the genetic composition of the isolated organisms. The twins' neonatal stools and mother's breast milk cultures revealed a resistance pattern (R-type) to ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline. LightCycler PCR analysis of sequential breast milk samples confirmed this to be the likely source of transmission. In the subsequent outbreak investigation, none of the NICU surveillance fecal samples proved positive for this organism. The genetic composition of organisms isolated from the maternal breast milk was indistinguishable from those isolated from neonatal specimens as determined by PFGE. Antibiotic susceptibility tests coupled with PFGE patterns suggested that these Salmonella isolates were DT104. Because the prevalence of DT104 infections is rising in the United States, neonatologists should be aware of breast milk as a potential mode of transmission.
