FOOD AND OTHER SOURCES OF PATHOGENIC MICROORGANISMS IN HOSPITALS. A REVIEW

The presence of ants in hospitals is a threat to the health of the hospital community, given the potential to carry pathogenic microorganisms. This study was developed in order to comment on publications related to the occurrence of ants associated with pathogenic microorganisms in hospitals in Brazil. Studies indicated that ants were collected in several wards of 13 hospitals in five States from South and Southeast regions. The microbiological analysis has identified on the ants, microorganisms such as Staphylococcus, Streptococcus, Klebsiella, Escherichia coli, Pseudomonas, and others with microbiological importance.

Objective To investigate the clinical manifestations and pathogenic characteristics of nosocomial bacterial infection in children with infectious mononucleosis (IM). Methods A retrospective analysis was performed for IM children from January to December 2015 in West China Second University Hospital.According to whether there was the process of secondary bacterial infection, the patients were divided into the secondary infection group and the non-infection group.The clinical manifestations and pathogenic bacteria were analyzed. Results Two hundred and sixteen children with IM were enrolled, of whom, 177 cases (81.9%) were in the non-infection group, and 39 cases (18.1%) were in the secondary infection group.The patients in non-infection group were (4.7±3.2) years old, and the patients in secondary infection group were (7.0±3.8) years old, and the difference was statistically significant (t=3.066, P 0.05). C-reactive protein (CRP) level of IM children on admission was (11.3±17.4) mg/L, while the secondary infection group was (10.2±9.7) mg/L and the non-infection group was (11.5±18.1) mg/L, and there was no significant difference between the 2 groups (t=1.309, P>0.05). CD3+ , CD4+ , CD8+ lymphocytes in the secondary infection group were 0.877 6±0.031 8, 0.079 0±0.032 5 and 0.682 1±0.053 5, compared with the non-infection group, while CD3+ lymphocytes (t=12.652, P<0.01) and CD8+ lymphocytes (t=-9.723, P<0.01) increased significantly, but the proportion of CD4+ lymphocytes decreased significantly (t=18.341, P<0.01). Conclusions The IM children are susceptible to nosocomial bacterial infection, which is more obvious in school-age children.Secondary respiratory tract infections are the most common type, and pathogenic bacteria may be caused by the dissemination of colonization bacteria in the pharyngeal tonsils.The CRP and variant lymphocytes on admission could not be used as the marker for predicting nosoco-mial bacterial infection in IM. Key words: Infectious mononucleosis; Nosocomial infection; Retrospective study; Child

During production, harvesting, processing, packaging, transportation, preparation, storage, and service, any food may be exposed to contamination with poisonous substances or infectious or toxigenic microorganisms. Processing or preparation failure may lead to survival of microorganisms or toxins, and time–temperature abuse can allow proliferation of pathogenic bacteria and molds. In addition, some plants are intrinsically toxic. Animals may acquire toxins from their food or metabolize them, or they become infected with or colonized by pathogenic bacteria, viruses, and parasites. If a product contaminated with sufficient quantities of poisonous substances or pathogenic microorganisms is eaten, susceptible persons may develop foodborne illness. The food supply may be local or global. In fact today, fresh as well as shelf stable food is available from sources all over the world. Foodborne illness outbreaks are routinely being linked to sources of contamination far distant from the point of consumption. Whatever the source, an investigation always begins at one or more local levels and can expand from there. Therefore, foodborne illness surveillance, investigation, and response systems require the close collaboration and coordination of food safety and public health agencies at local, state/provincial, federal/national, and international levels.

Impact of nosocomial infections on medical costs, hospital stay, and outcome in hospitalized patients.

The Economics of Enteric Infections: Human Foodborne Disease Costs

Background: Health care workers at the bedside of critically ill babies freely carry their mobile phones in between procedures and handling patients. Concerns are rising as this may contribute to nosocomial infections with pathogenic bacteria. Aim: To determine if mobile phones of health care workers in Intensive care units carry potentially pathogenic bacteria leading to hospital acquired infections. Design: Systematic review.Data sources: Electronic databases (Medline via ovid, CINAHL, Web of science) and hand Searching of references and citations were done to identify studies. Screening and inclusion criteria were used to identify studies with a cross-sectional or cohort design. The search was limited to journal articles published between 2008-2015 and to English language. Quality assessment was done using the National Institute of Health tool for observational studies. Data was extracted on to excel sheets and analysed using SPSS version 22.Results: Six studies with a cohort (1) or cross-sectional design (5) involving 1, 131 health care workers were reviewed. The overall quality of the studies was fair, and a narrative synthesis was done. The colonization rate of the mobile phones ranged between 46.3 % and a 100% with 13-50% carrying potentially pathogenic multidrug resistant microorganisms. Methicillin resistant staphylococcus aureus, Vancomycine resistant enterococci, acinobacter and coagulase negative staphylococci were reported across all studies and were recognized as leading causes of morbidity and mortalityin the ICU. Conclusion: Mobile phones Of HCW are portals of potentially pathogenic microorganisms, which could result in morbidity and mortality.Although no causal relationship could be established, strong associations have been reported. Guidelines by hospital infection control committees are needed on restriction, care and routine cleaning of mobile phones as well as further research. Key words: Health care worker, Intensive care unit, Hospital Acquired Infections, mobile phones

Food-borne diseases — The challenges of 20 years ago still persist while new ones continue to emerge

Background: Pathogenic microorganisms are ubiquitous, and the potential of transferring harmful microorganisms in hospitals has always been a worry. Many studies have concluded that white coats worn by physicians and nurses, as well as other hospital clothes, may have a role in the transfer of dangerous microorganisms in hospitals. Many types of clothing and equipment, including stethoscopes, otoscopes, thermometers, and physicians’ white coats, have been identified as potentially pathogen-carrying. Materials and Methods: This cross-sectional study was conducted in a tertiary care setting, where all participants were informed about the study and offered the option to provide informed consent as well as complete a questionnaire. The participants have accepted and provided informed consent as well as questionnaire. The study comprised 100 aprons from health-care workers (interns, PG students, UG students, and faculty). Results: Males and females made up 27% and 73% of the study’s total participants, respectively. Students made up 80% of the participants, whereas professors made up 20%. Only 11% of those who took part in the study had the practice of switching aprons. Distinct species grew in 85% of aprons’ chests, 81% of aprons’ pockets, and 65% of aprons’ sleeves. Gram-positive bacteria were the most common species discovered on aprons. Gram-negative microbes were also identified in small amounts from several aprons. Conclusion: Aprons can be a cause of cross-contamination, hence, wearing aprons in nonclinical places such as the cafeteria, classroom, and library should be prohibited to prevent bacterial contamination carried by health-care workers’ aprons.

Objective To investigate the status and trends of nosocomial infection in children′s hospital to provide references for prevention and control of nosocomial infection. Methods The retrospective study were conducted to analyze the data of nosocomial infection at Zhejiang University affiliated Children′s Hospital from 2005 to 2014. Results A total of 357 684 discharged patients were studied, nosocomial infection occurred in 13 934 cases. The mean infection rate was 3.9%(1.72%-5.80%). The top five department of nosocomial infection rate were the department of hematology (14.47%), neonatal intensive care unit (NICU, 11.63%), surgical intensive care unit (SICU, 6.45%), gastroenterology (4.52%) and newborn nursery (4.33%). The infection rate in NICU and SICU became the first and second place in 2014, which were 17.55% and 8.30%, respectively. The distributions of nosocomial infection site were upper respiratory tract infection (36.79%), gastrointestinal tract infection (22.76%), lower respiratory tract infection (21.40%) and sepsis (14.55%). The proportion of upper respiratory tract infection had declined year by year from 51.08% to 15.78%, while the proportion of lower respiratory tract infection and sepsis had increased from 15.92% to 35.92% and from 11.18% to 22.50%, respectively. The proportion of gastrointestinal infections remained high. The constitution of infection sites in different departments were different. The digestive tract infection (69.93%) were dominant in the department of neonatology, sepsis (56.51%) in the department of hematology, and the lower respiratory tract infection in NICU, SICU, PICU and cardiothoracic surgery departments were above 60%. Regarding the constitution of the pathogenic microorganisms, 49.29% were virus infection, 34.25% gram negative bacterial infection, 12.75% gram positive bacterial infection and 3.14% fungus infection with no remarkable changes. Rotavirus was the most common pathogen causing nosocomial infection, followed by Klebsiella pneumoniae and Acinetobacter baumannii. The detection rate of (intensive care unit, ICU) multidrug-resistant bacteria increased gradually. Conclusions The mean incidence of nosocomial infection in children′s hospital demonstrats a decreasing trend, while the infection rates in NICU and SICU have increased within years. The contributions of lower respiratory tract infections and sepsis have also increased, as well as the detection rate of ICU multidrug-resistant bacteria. Rotavirus is the most common pathogen causing digestive tract infection. Key words: Nosocomial infections; Children′s hospital; Review; Change trend

Airborne microorganisms in hospitals have been associated with several hospital-acquired infections (HAIs), and various measures of indoor air quality (IAQ) parameters such as temperature, relative humidity, carbon dioxide (CO2 ), particle mass concentration, and particle size have been linked to pathogen survival or mitigation of pathogen spread. To investigate whether there are quantitative relationships between the concentration of airborne microorganisms and the IAQ in the hospital environment. Web of Science, Scopus and PubMed databases were searched for studies reporting airborne microbial levels and any IAQ parameter(s) in hospital environments, from database inception to October 2020. Pooled effect estimates were determined via random-effects models. Seventeen of 654 studies were eligible for the meta-analysis. The concentration of airborne microbial measured as aerobic colony count (ACC) was significantly correlated with temperature (r=0.25 [95% CI=0.06-0.42], p=0.01), CO2 concentration (r=0.53 [95% CI=0.40-0.64], p˂0.001), particle mass concentration (≤5µg/m3 ; r=0.40 [95% CI=0.04-0.66], p=0.03), and particle size (≤5 and ˃5µm), (r=0.51 [95% CI=0.12-0.77], p=0.01 and r=0.55 [95% CI=0.20-0.78], p=0.003), respectively, while not being significantly correlated with relative humidity or particulate matter of size >5µm. Conversely, airborne total fungi (TF) were not significantly correlated with temperature, relative humidity, or CO2 level. However, there was a significant weak correlation between ACC and TF (r=0.31 [95% CI=0.07-0.52], p=0.013). Although significant correlations exist between ACC and IAQ parameters, the relationship is not definitive; the IAQ parameters may affect the microorganisms but are not responsible for the presence of airborne microorganisms. Environmental parameters could be related to the generating source, survival, dispersion, and deposition rate of microorganisms. Future studies should record IAQ parameters and factors such as healthcare worker presence and the activities carried out such as cleaning, sanitizing, and disinfection protocols. Foot traffic would influence both the generation of microorganisms and their deposition rate onto surfaces in the hospital environment. These data would inform models to improve the understanding of the likely concentration of airborne microorganisms and provide an alternative approach for real-time monitoring of the healthcare environment.

ObjectivesSARS-CoV-2 may cause acute lung injury, and secondary infections are thus relevant complications in patients with COVID-19 pneumonia. However, detailed information on community- and hospital-acquired infections among patients with COVID-19 pneumonia is scarce.MethodsWe identified 220 SARS-CoV-2-positive patients hospitalized at the University Hospital Basel, Switzerland (between 25 February and 31 May 2020). We excluded patients who declined the general consent (n = 12), patients without clinical evidence of pneumonia (n = 29), and patients hospitalized for < 24 h (n = 17). We evaluated the frequency of community- and hospital-acquired infections using respiratory and blood culture materials with antigen, culture-based, and molecular diagnostics. For ICU patients, all clinical and microbial findings were re-evaluated interdisciplinary (intensive care, infectious disease, and clinical microbiology), and agreement reached to classify patients with infections.ResultsIn the final cohort of 162 hospitalized patients (median age 64.4 years (IQR, 50.4–74.2); 61.1% male), 41 (25.3%) patients were admitted to the intensive care unit, 34/41 (82.9%) required mechanical ventilation, and 17 (10.5%) of all hospitalized patients died. In total, 31 infections were diagnosed including five viral co-infections, 24 bacterial infections, and three fungal infections (ventilator-associated pneumonia, n = 5; tracheobronchitis, n = 13; pneumonia, n = 1; and bloodstream infection, n = 6). Median time to respiratory tract infection was 12.5 days (IQR, 8–18) and time to bloodstream infection 14 days (IQR, 6–30). Hospital-acquired bacterial and fungal infections were more frequent among ICU patients than other patients (36.6% vs. 1.7%). Antibiotic or antifungal treatment was administered in 71 (43.8%) patients.ConclusionsCommunity-acquired viral and bacterial infections were rare among COVID-19 pneumonia patients. By contrast, hospital-acquired bacterial or fungal infections were frequently complicating the course among ICU patients.

Inhibition of Multidrug-resistant Acinetobacter baumannii by Nonviral Expression of hCAP-18 in a Bioengineered Human Skin Tissue

Food safety really is everyone's business

Hospital patients and personnel are at risk of nosocomial viral infections, as clearly manifested during the COVID-19 pandemic. Transmission of respiratory viral pathogens can occur through contaminated surfaces, including from medical textiles. Copper has potent biocidal properties, and cuprous oxide impregnated medical textiles (CMT) reduce hospital-acquired bacterial infections. In the current study we confirm the antimicrobial properties of CMT and determine their capacity to reduce infectious titres of human coronavirus (HCoV-229E) in an independent laboratory. The antibacterial and antiviral activities of the CMT were determined according to AATCC TM100-2019 and ISO 18184:2019 standards, respectively. The CMT reduced by 4 logs the viable titers of MRSA, Klebsiella pneumoniae, Enterococcus faecalis, and Candida auris after 2 h of incubation. Viable titers of Clostridium difficile were reduced by 2.3, 3, and 4 logs after 2, 6, and 18 h, respectively. Infectious titers of HCoV-229E exposed to CMT for 2 h were reduced by 2.8 and 4 logs (99.85% and 99.99% reductions) as compared to Time-0 control and initial inoculum, respectively. The CMT retain their antibacterial efficacy even after 100 industrial washings. Use of cuprous oxide impregnated textiles in clinical settings may reduce not only hospital acquired infections caused by bacterial and fungal pathogens, but also, and equally important, those caused by coronavirus and other viruses.

The Risk of Development of Antimicrobial Resistance with the Use of Coccidiostats in Poultry Diets