High-touch surfaces: microbial neighbours at hand

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Abstract

Despite considerable efforts, healthcare-associated infections (HAIs) continue to be globally responsible for serious morbidity, increased costs and prolonged length of stay. Among potentially preventable sources of microbial pathogens causing HAIs, patient care items and environmental surfaces frequently touched play an important role in the chain of transmission. Microorganisms contaminating such high-touch surfaces include Gram-positive and Gram-negative bacteria, viruses, yeasts and parasites, with improved cleaning and disinfection effectively decreasing the rate of HAIs. Manual and automated surface cleaning strategies used in the control of infectious outbreaks are discussed and current trends concerning the prevention of contamination by the use of antimicrobial surfaces are taken into consideration in this manuscript.

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Most cited references 109

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Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options.

Lisa Maragakis, Trish Perl (2008)

Multidrug-resistant Acinetobacter baumannii is recognized to be among the most difficult antimicrobial-resistant gram-negative bacilli to control and treat. Increasing antimicrobial resistance among Acinetobacter isolates has been documented, although definitions of multidrug resistance vary in the literature. A. baumannii survives for prolonged periods under a wide range of environmental conditions. The organism causes outbreaks of infection and health care-associated infections, including bacteremia, pneumonia, meningitis, urinary tract infection, and wound infection. Antimicrobial resistance greatly limits the therapeutic options for patients who are infected with this organism, especially if isolates are resistant to the carbapenem class of antimicrobial agents. Because therapeutic options are limited for multidrug-resistant Acinetobacter infection, the development or discovery of new therapies, well-controlled clinical trials of existing antimicrobial regimens and combinations, and greater emphasis on the prevention of health care-associated transmission of multidrug-resistant Acinetobacter infection are essential.

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First hospital outbreak of the globally emerging Candida auris in a European hospital

Silke Schelenz, Ferry Hagen, Johanna L. Rhodes … (2016)

Background Candida auris is a globally emerging multidrug resistant fungal pathogen causing nosocomial transmission. We report an ongoing outbreak of C. auris in a London cardio-thoracic center between April 2015 and July 2016. This is the first report of C. auris in Europe and the largest outbreak so far. We describe the identification, investigation and implementation of control measures. Methods Data on C. auris case demographics, environmental screening, implementation of infection prevention/control measures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively. Speciation of C. auris was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragment length polymorphism (AFLP). Results This report describes an ongoing outbreak of 50 C. auris cases over the first 16 month (April 2015 to July 2016) within a single Hospital Trust in London. A total of 44 % (n = 22/50) patients developed possible or proven C. auris infection with a candidaemia rate of 18 % (n = 9/50). Environmental sampling showed persistent presence of the yeast around bed space areas. Implementation of strict infection and prevention control measures included: isolation of cases and their contacts, wearing of personal protective clothing by health care workers, screening of patients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorine based reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that C. auris isolates from the same geographic region clustered. Conclusion This ongoing outbreak with genotypically closely related C. auris highlights the importance of appropriate species identification and rapid detection of cases in order to contain hospital acquired transmission.

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P. E. Fournier, H Richet, R. A. Weinstein (2006)

Acinetobacter baumannii is a ubiquitous pathogen capable of causing both community and health care-associated infections (HAIs), although HAIs are the most common form. This organism has emerged recently as a major cause of HAI because of the extent of its antimicrobial resistance and its propensity to cause large, often multifacility, nosocomial outbreaks. The occurrence of outbreak is facilitated by both tolerance to desiccation and multidrug resistance, contributing to the maintenance of these organisms in the hospital environment. In addition, the epidemiology of A. baumannii infection is often complex, with the coexistence of epidemic and endemic infections, the latter of which often is favored by the selection pressure of antimicrobials. The only good news is that potentially severe A. baumannii infection, such as bacteremia or pneumonia in patients in the intensive care unit who are undergoing intubation, do not seem to be associated with a higher attributable mortality rate or an increased length of hospital stay.

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Author and article information

Contributors

L. Cobrado:

ORCID: http://orcid.org/0000-0002-0763-9769

lcobrado@med.up.pt

Journal

Journal ID (nlm-ta): Eur J Clin Microbiol Infect Dis

Journal ID (iso-abbrev): Eur. J. Clin. Microbiol. Infect. Dis

Title: European Journal of Clinical Microbiology & Infectious Diseases

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0934-9723

ISSN (Electronic): 1435-4373

Publication date (Electronic): 25 June 2017

Publication date (Print): 2017

Volume: 36

Issue: 11

Pages: 2053-2062

Affiliations

[1 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Division of Microbiology, Department of Pathology, Faculty of Medicine, , University of Porto, ; Alameda Prof. Hernâni Monteiro, 4200 Porto, Portugal

[2 ]ISNI 0000 0000 9375 4688, GRID grid.414556.7, Burn Unit, Department of Plastic and Reconstructive Surgery, , Centro Hospitalar São João, ; Porto, Portugal

[3 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, CINTESIS, Center for Health Technology and Services Research, Faculty of Medicine, , University of Porto, ; Porto, Portugal

Author information

L. Cobrado http://orcid.org/0000-0002-0763-9769

Article

Publisher ID: 3042

DOI: 10.1007/s10096-017-3042-4

PMC ID: 7087772

PubMed ID: 28647859

SO-VID: ac68b75f-2594-468a-896a-390b43b7451d

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.