Reduction in Acquisition of Vancomycin-Resistant Enterococcus after Enforcement of Routine Environmental Cleaning Measures
Mary K. Hayden,Marc J. M. Bonten,Donald Blom,Elizabeth A. Lyle,David A. M. C. van de Vijver,Robert A. Weinstein +5 more
TLDR
Investigating the effects of improved environmental cleaning with and without promotion of hand hygiene adherence on the spread of vancomycin-resistant enterococci as a marker organism found decreased in period 2 and remained low thereafter, suggesting decreasing environmental contamination may help to control thespread of some antibiotic-resistant bacteria in hospitals.Abstract:
Background The role of environmental contamination in nosocomial cross-transmission of antibiotic-resistant bacteria has been unresolved. Using vancomycin-resistant enterococci (VRE) as a marker organism, we investigated the effects of improved environmental cleaning with and without promotion of hand hygiene adherence on the spread of VRE in a medical intensive care unit. Methods The study comprised a baseline period (period 1), a period of educational intervention to improve environmental cleaning (period 2), a "washout" period without any specific intervention (period 3), and a period of multimodal hand hygiene intervention (period 4). We performed cultures for VRE of rectal swab samples obtained from patients at admission to the intensive care unit and daily thereafter, and we performed cultures of environmental samples and samples from the hands of health care workers twice weekly. We measured patient clinical and demographic variables and monitored intervention adherence frequently. Results Our study included 748 admissions to the intensive care unit over a 9-month period. VRE acquisition rates were 33.47 cases per 1000 patient-days at risk for period 1 and 16.84, 12.09, and 10.40 cases per 1000 patient-days at risk for periods 2, 3, and 4, respectively. The mean (+/-SD) weekly rate of environmental sites cleaned increased from 0.48+/-0.08 at baseline to 0.87+/-0.08 in period 2; similarly high cleaning rates persisted in periods 3 and 4. Mean (+/-SD) weekly hand hygiene adherence rate was 0.40+/-0.01 at baseline and increased to 0.57+/-0.11 in period 2, without a specific intervention to improve adherence, but decreased to 0.29+/-0.26 in period 3 and 0.43+/-0.1 in period 4. Mean proportions of positive results of cultures of environmental and hand samples decreased in period 2 and remained low thereafter. In a Cox proportional hazards model, the hazard ratio for acquiring VRE during periods 2-4 was 0.36 (95% confidence interval, 0.19-0.68); the only determinant explaining the difference in VRE acquisition was admission to the intensive care unit during period 1. Conclusions Decreasing environmental contamination may help to control the spread of some antibiotic-resistant bacteria in hospitals.read more
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Feedback of ATP measurement as a tool for reducing environmental contamination in hospitals in the Dutch/Belgian border area.
Andreas van Arkel,Ina Willemsen,Linda Kilsdonk-Bode,Sindy Vlamings-Wagenaars,Anne J.G. van Oudheusden,Pascal De Waegemaeker,Isabel Leroux-Roels,Martine Verelst,Evelien Maas,Anita van Oosten,Patricia Willemse,Esther van Asselen,Ella Klomp-Berens,Karen Franssen,Elise Van Cauwenberg,Valentijn A. Schweitzer,Valentijn A. Schweitzer,Jan Kluytmans +17 more
TL;DR: In this paper, a two-phase prospective intervention study was conducted to determine if feedback of adenosine triphosphate (ATP) measurements decreases environmental contamination within hospitals in the Dutch/Belgian border area.
Journal ArticleDOI
Biocidal Surfaces May be an Important Adjunct in the Arsenal of Measures to Fight Healthcare-Acquired Infections
TL;DR: Healthcare-acquired infections pose a critical threat to patients and have become a significant medical concern, especially as many microorganisms have developed high resistance to the existent antibiotics armory.
Journal ArticleDOI
Management of vancomycin-resistant enterococci colonization in a neonatal intensive care unit: lessons from an outbreak.
Fatma Kaya Kilic,Şebnem Çalkavur,Özgür Olukman,Gulten Ercan,Yeliz Oruç,Dilek Ozkok,Derya Okur,Gamze Gülfidan,İlker Devrim,Füsun Atlihan +9 more
TL;DR: It’s important to be aware of VRE colonization in hospitalized patients both for preventing sepsis, and for taking necessary infection control measures, especially handwashing and isolation.
Sjuksköterskors och läkares förhållningssätt till basala hygienrutiner inom slutenvård och primärvård
Margret Asplin,Jenny Brink +1 more
TL;DR: The main result of the study shows that the healthcare workers from both hospital and primary care didn´t estimate all routines equally and a significant difference found between the units was that hospital personnel estimated the importance of not to wear private clothes during work higher than personnel from primary care.
Mechanisms of Avian Influenza virus transmission between farms: combining data collection and mathematical modelling
TL;DR: Modelling used to assess the contributions of the wind-borne route and the other (traced) between-farm contacts to the transmission of highly pathogenic avian influenza during an epidemic in the Netherlands in 2003 found that these two routes together could only explain approximately 31% of the infections/cases.
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