Potential Cross-contamination Research Articles

Revealing microbial community composition and disinfection efficacy evaluation in wholesale pork markets through 16S rDNA sequencing

ABSTRACT This study has employed 16S rDNA analysis to elucidate the characteristics of the microbial community in the surroundings, facilities, and meat samples collected from a pork wholesale market with the aim of revealing bacterial contamination. In addition, the efficacy of sodium hypochlorite disinfectant was assessed by comparing the bacterial communities in the viable samples before and after disinfection. The bacterial abundances in meat, chopping boards, and knives were positively correlated (r > 0.95, p < .05), suggesting potential cross-contamination risks during market transactions. The species richness indices for the external transport vehicles, pork hooks, and floors were significantly different from those of the samples taken after decontamination (p < .05). Linear discriminant analysis Effect Size (LEfSe) analyses showed that Firmicutes, Proteobacteria, and Chloroflexi were significantly more abundant in the transaction period, whereas Bacteroidetes levels decreased compared to the clean-up period. NaClO disinfection altered the composition of bacterial communities.

Mechanochemical degradation of per- and polyfluoroalkyl substances in soil using an industrial-scale horizontal ball mill with comparisons of key operational metrics

Horizontal ball mills (HBMs) have been proven capable of remediating per- and polyfluoroalkyl substances (PFAS) in soil. Industrial-sized HBMs, which could easily be transported to impacted locations for on-site, ex-situ remediation, are readily available. This study examined PFAS degradation using an industrial-scale, 267 L cylinder HBM. This is the typical scale used in the industry before field application. Near-complete destruction of 6:2 fluorotelomer sulfonate (6:2 FTS), as well as the non-target PFAS in a modern fluorotelomer-based aqueous film forming foam (AFFF), was achieved when spiked onto nepheline syenite sand (NSS) and using potassium hydroxide (KOH) as a co-milling reagent. Perfluorooctanesulfonate (PFOS) showed much better and more consistent results with scale-up regardless of KOH. Perfluorooctanoate (PFOA) was examined for the first time using a HBM and behaved similarly to PFOS. Highly challenging field soils from a former firefighting training area (FFTA) were purposefully used to test the limits of the HBM. To quantify the effectiveness, free fluoride analysis was used; changes between unmilled and milled soil were measured up to 7.8 mg/kg, which is the equivalent of 12 mg/kg PFOS. Notably, this does not factor in insoluble fluoride complexes that may form in milled soils, so the actual amount of PFAS destroyed may be higher. Soil health, evaluated through the assessment of key microbial and associated plant health parameters, was not significantly affected as a result of milling, although it was characterized as poor to begin with. Leachability reached 100 % in milled soil with KOH, but already ranged from 81 to 96 % in unmilled soil. A limited assessment of the hazards associated with the inhalation of PFAS-impacted dust from ball-milling, as well as the cross-contamination potential to the environment, showed that the risk was low in both cases; however, precautions should always be taken.

Exploring multi-antibiotic resistance in Arcobacter butzleri isolates from a poultry processing plant in northern Italy: An in-depth inquiry

Arcobacter butzleri is a foodborne pathogen that has been identified in various animal-derived foods, notably in poultry meat. The prevalence of this bacterium in poultry underscores the need for comprehensive investigations into its dissemination within poultry meat processing plants. Such assessments are critical due to the potential cross-contamination that may occur, impacting the safety of the final food product. This study endeavours to evaluate the genomic similarity of 56 A. butzleri isolates obtained from chicken carcasses (specifically neck skins and caecum, post-slaughter) and equipment surfaces following cleaning and sanitizing procedures. All samples originate from a poultry slaughterhouse in Northern Italy. The genomic analysis includes single nucleotide polymorphism, average nucleotide identity, and core genome multi-locus sequence typing analysis, aiming to discern potential cross-contamination between carcasses and equipment. The study evaluates antibiotic resistance, biofilm production, and host cell colonization of A. butzleri strains through in vitro assays. Genomic de-replication reveals the presence of 31 distinct strains. Results elucidate that a portion of these strains is evident in multiple sources, indicative of cross-contamination even post-cleaning and sanitization. The in vitro tests underline multi-antibiotic resistance of A. butzleri with genes associated with antibiotic resistance, among them mexAB-oprM, showing a correlation to the observed resistance. This study establishes the colonization capability of A. butzleri strains on a human gut mucus-secreting cell model, suggesting a potential virulence factor. Detection of various putative virulence genes further supports the hypothesis of strains virulence potential. This study holds importance of A. butzleri as it unveils the antibiotic resistance and pathogenic capabilities inherent in this species, identifying associated genetic traits. Through comprehensive genomic analysis, it was conclusively validated instances of cross-contamination between various sources and equipment surfaces, underscoring the pervasive dissemination of this bacterium within a food processing plant and its persistence. This research serves as an exploration into the intricate dynamics of A. butzleri within poultry processing environments. It accentuates the imperative for stringent hygiene protocols and ongoing surveillance to curtail the risk of cross-contamination, thereby ensuring the safety of poultry products for discerning consumers.

Characterizing the formation and cross-contamination potential of multi-species biofilms in poultry processing environments: S. Enteritidis, C. jejuni and C. perfringens

This study investigated the cross-contamination dynamics of biofilms preformed on stainless steel (SS) coupons on chicken skin and chicken meat by modeling surface-to-food transfer by contact and surface-to-food transfer in fluids. Additionally, mono-, dual-, and multi-species biofilms were examined to understand the effects of environmental conditions on biofilm-forming abilities. The results of crystal violet (CV) assay revealed that a dual-species biofilm of Salmonella Enteritidis with Campylobacter jejuni and a multi-species biofilm of S. Enteritidis with C. jejuni and Clostridium perfringens cultivated for 72 h under aerobic conditions exhibited significantly higher biofilm-forming abilities than the other biofilm types. Consistent with the CV assay findings, the multi-species biofilm exhibited significantly higher extracellular DNA and protein levels than the other biofilm types. Furthermore, the results highlighted the significant increase in cultivable counts when S. Enteritidis formed dual- or multi-species biofilms with C. jejuni or C. perfringens, indicating a synergistic effect among the strains. Additionally, the analysis of cross-contamination models revealed that the pressing method induced greater cross-contamination across most biofilm types irrespective of the food sample or biofilm characteristics. This suggests that surface-to-food contact played a more influential role in cross-contamination than surface-to-food interactions in fluids. Overall, our findings provide insights into the intricate dynamics of preformed biofilms on SS coupons in contact with chicken skin and meat, underscoring the significance of the relationship between biofilm formation and cross-contamination.

Ambrosia beetles adjust dispersal preferences to their degree of exhaustion

Abstract Delayed dispersal of sexually mature offspring is a fundamental component of cooperative breeding in fungus farming ambrosia beetles. These beetles dwell in logs of recently deceased trees, where female offspring postpone reproduction and invest in alloparental care before dispersing to found a new nest. The wood quality affects investment of adult offspring in alloparental care and hence the breeder's reproductive success. This raises the question of whether dispersing breeders choose habitats strategically to optimise breeding prospects and modulate their offspring's helping propensity. To answer this question, here we tested experimentally whether during dispersal, Xyleborinus saxesenii Ratzeburg (Coleoptera: Scolytinae) uses olfactory cues emitted by mutualistic or pathogenic fungi as an information source on prospective habitat quality. As the mutualistic relationship between the fungi and beetles is obligate, fungus scent should provide a reliable source of information on habitat quality, indicating prior successful colonisation by conspecifics. We found no evidence for direct pathogen avoidance. However, the beetles clearly responded to scent of their mutualistic fungi, dependent on dispersal state. At the onset of dispersal, females avoided the scent of fungus mutualists, whereas they were attracted to them after being exhausted by an experimentally prolonged dispersal time. The observed change of preference during dispersal suggests that beetles freshly emerging from their home gallery may choose pristine habitat by avoiding mutualist scent. This might help to avoid competition with conspecifics and potential pathogen and parasite cross contamination. Exhausted beetles, however, may accept these risks and choose successfully colonised habitat to avoid starvation. State‐dependent adjustment of habitat preferences may be exhibited also in other economically impactful bark and ambrosia beetles, which prompts further study of the olfactory cues used by these beetles during dispersal.

Content Analysis of Food Safety Information in Apple-Drying Recipes from YouTube, Blogs, Cookbooks, and Extension Materials.

Recurrent foodborne outbreaks associated with low-moisture foods prompted this study to evaluate apple-handling practices presented in apple-drying recipes available to United States consumers, and to explore the food safety implications of the recipes. Because little research is available on the safety of home fruit-drying, we conducted a systematic search of English-language apple-drying recipes from YouTube videos, blog articles, cookbooks, and university extension sources. Our evaluation found that most recipes excluded handwashing instructions, and potential cross-contamination practices were evident in 12% of the videos. Bruised or damaged apples were selected for drying in 16% of the videos, two blogs, and five cookbook recipes. Although more than half the blogs and videos demonstrated pre-treatment procedures, they did so predominantly to minimize browning with almost no mention of antimicrobial benefits. Drying temperature information was missing in 41% of the videos and 35% of the cookbooks that we evaluated. Even when temperatures were mentioned, most were insufficient for pathogen reduction according to the recommendations of previous studies. These videos, blogs, and cookbooks commonly advocated subjective indicators instead of unit measurements when slicing apples and checking for doneness. Our findings reveal the need for drastic improvements in food safety information dissemination to home apple-dryers and recipe developers.

Powder sheet additive manufacturing of multi-material structures: Experimental and computational characterizations

Selective laser melting (SLM) of multi-material structures (MMS) is of significance because it allows for bespoke structural innovation and high-accuracy process tailoring. However, most of the currently developed loose powder-based SLM techniques for MMS are limited by the long changeover time and potential cross-contamination between materials. To address these issues, a novel Metal Additive Manufacturing using Powder Sheets (MAPS) technique is proposed for printing MMS within a single process. It utilizes flexible powder sheets as the feedstock material, which are composed of metal powder-polymer binder composites. The printability of MMS by MAPS is assessed through the fabrication of three-phase SS304-IN718-SS304 composites with increased geometric dimensions on the SS316 baseplates. The effects of part size on the evolution of the melt-pool morphology and the formation of defects during MAPS are investigated by experimental characterizations and computational modeling. The results show that when fabricating larger MMS, the use of a longer scan-vector easily leads to defects such as lack-of-fusion porosity, balling and cracks. This is due to the longer duration of inter-hatch cooling time, the reduced amount of thermal accumulation and the higher degree of residual stresses. By adopting an island scanning strategy, a defect-free large-size MMS with variations of chemical composition, microstructure and microhardness is successfully printed by MAPS. The proposed MAPS method offers a new solution for producing high-quality MMS.

Emergence of rapidly spreading antimicrobial-resistant Salmonella in traditional blood-based foods

Abstract Objectives This study aims to investigate the survival ability and risk of Salmonella isolated from traditional blood-based food, using both phtnotypic and genotypic analysis. Materials and Methods We characterized and identified seventeen Salmonella isolates using 16s rRNA sequencing, real-time PCR and whole-genome sequencing (WGS). Cell counts were recorded to monitor growth ability and temperature tolerance. Virulence genes and whole genome phylogenies were confirmed by WGS. The minimum inhibitory concentration (MIC) of corresponding strains to different antibiotics and antimicrobial resistance (AMR) genes predicted by WGS were evaluated. Results In this study, we characterized 17 Salmonella isolates obtained from contaminated traditional blood-based food in China. Compared to laboratory strain S. Typhimurium ATCC 14028, these Salmonella isolates generally grew more rapidly and developed less biofilm, but their tolerance to food processing-associated cold and heat stresses was distinct. Whole-genome phylogenies pointed out the potential for cross-contamination during food practices. In addition, 21 antibiotic-resistance genes were found among blood-based food isolates, including high-prevalent resistance genes gyrA (including associated mutations D87G and S83F), blaTEM, and aadA1. Antibiotic susceptibility test confirmed the in-silico prediction and revealed a 41.18% (7/17) multidrug resistance (MDR) rate. Resistance to ceftiofur, kanamycin, and nalidixic acid was observed without corresponding resistance genes, suggesting overlooked resistance mechanisms. Conclusions This study revisited microbial safety concerns associated with traditional blood-based food and underlined the emergence of high-risk MDR Salmonella strains. It also underscores the importance of implementing better hygiene practices in the production and handling of traditional food products.

Radiofrequency Inactivation of Salmonella in Black Pepper and Dried Basil Leaves Using In-package Steaming

Radiofrequency (RF) heating has been extensively studied for pasteurizing low-moisture foods. Currently, bulk foods are treated with radiofrequency; potential cross-contamination may occur during packaging of pasteurized products. As an alternative, in-package RF processing was evaluated for Salmonella inactivation on black peppercorns and dried basil leaves and prevention of cross-contamination during storage postprocessing. In-package steaming refers to the process in which the samples were heated in a steam vent package to generate and retain steam during the treatment. This treatment achieved good heating uniformity which could be because of the circulation of steam within the package. One-way steam vent allowed the release of excess steam once a threshold pressure was achieved and later returned to its original position to seal the package, when the RF energy was removed. In-package RF steaming of black peppercorns and dried basil leaves for 135 s and 40 s, respectively, resulted in more than 5 log reduction of Salmonella. The steam vent remained stable posttreatment and properly sealed the package to protect the product from any external contamination. These results indicate that the use of steam vent could effectively pasteurize black peppercorns and dried basil leaves could be beneficial in preventing the potential cross-contamination postprocessing.

Development of ion torrent-based targeted next-generation sequencing panel for identification of animal species in pet foods

Manufacturers may intentionally or unintentionally incorporate ingredients not specified on the label of canned pet foods. Including any unacknowledged ingredients in a food product is considered food fraud or misbranding. Contamination of pet foods may occur in the processing of the foods, including potential cross-contamination in packaging facilities.Of the methods available to identify meat species in food products, Sanger sequencing and several next-generation sequencing methods are available, but there are limitations including the number of targets analyzed at a time and the method specificity. In this study, we developed a targeted next-generation sequencing panel to detect meat species in canned pet foods using Ion Torrent technology.The panel contains multiple primers targeting mitochondrial genes from as many as 27 animal species, of which 7 major animal species were validated. The meat species targets could be identified from samples spiked with as low as 0.01% w/w of the contaminating meat species in a vegetarian food matrix material. Targeted NGS in the current study enriches species-specific multiple target areas in the mitochondrial genome of the target material, which gives high accuracy in the sequencing results.

Contemplating Catheter Induced Blood Stream Infections and Associated Risk Factors in Diverse Clinical Settings: A Comprehensive Review

Catheter-Related Bloodstream Infections (CRBSIs) are severe healthcare-associated complication that occurs when bacteria enter the bloodstream through a catheter. The risk of CRBSIs is influenced by various factors. Prolonged catheter placement increases the risk, as each day increases the potential for bacterial colonization and bloodstream infection. Proper aseptic technique and a sterile environment during catheter insertion are essential to minimize infection risk. Stringent infection control measures during insertion, including sterile gloves, thorough hand hygiene, and appropriate skin disinfection, are crucial. Inadequate catheter site care and suboptimal catheter management can contribute to CRBSIs. Regular cleaning, disinfection, and dressing changes are necessary to reduce the risk of infection. The type of catheter used also affects infection risk. Central Venous Catheters (CVCs) and arterial catheters, especially those inserted into the jugular or subclavian vein, carry a higher risk of CRBSIs compared to peripheral venous catheters. Individuals with compromised immune systems, such as chemotherapy patients, organ transplant recipients, and those with HIV/AIDS, are more susceptible to CRBSIs. Patients with existing infections, like pneumonia or urinary tract infections, are at a heightened risk of acquiring CRBSIs due to potential cross-contamination. Healthcare professionals who fail to practice thorough hand hygiene before and after catheter-related procedures can introduce pathogens into the bloodstream. Leaving catheters in place when no longer necessary or using them unnecessarily elevates the risk of infection. To prevent CRBSIs, strict infection control protocols, including effective hand hygiene, sterile catheter insertion techniques, routine site care, and prompt catheter removal when no longer needed, are imperative. Healthcare facilities often implement specific protocols to mitigate CRBSI risk and enhance patient safety.

280 Effects of a Yeast Feed Additive for Maternal Programming of the Postweaning Pig Microbiome

Abstract The objective of this study was to determine whether feeding live yeast to sows from day 85 of gestation and through lactation influences pig performance and microbiomes in the postweaning period. Three dietary treatments were imposed on mixed-parity sows during late gestation and lactation based on the inclusion level (%) of Actisaf Sc47 in corn/soybean meal-based diets: Control (C, 0%), Low (L, 0.1%), and High (H, 0.5%). Pigs (n = 240; 80/maternal dietary treatment group) were selected randomly at weaning (~19 days old) for further performance data collection throughout the nursery period. A subset of these pigs (n = 180; 60/maternal treatment group) were selected randomly for microbiome sampling through fecal swabs collected on days 4 (T1) and 28 (T2) postweaning. Pigs were housed in pens in a confinement nursery barn according to maternal dietary treatment group (10 pigs/pen; 0.28 m2/pig of floor space; 8 pens/treatment group). Treatment groups were kept separate from each other by maintaining one empty pen between treatment groups to prevent potential microbial cross-contamination. Pigs were balanced by litter, body weight, and sex during nursery allotment. Pigs had ad libitum access to water and a common industry-relevant diet, fed in four phases from weaning through day 42. Pigs were weighed individually at the end of each dietary phase (d4, d14, d28, d42). DNA was extracted from fecal swabs and sequenced on the MiSeq platform, targeting the V4 variable region of the 16S rRNA bacterial gene. Sequence data were analyzed using QIIME2 and DADA2, plus various packages within the R statistical software. Performance data were analyzed using repeated measures and generalized linear mixed models that included maternal treatment as a fixed effect, maternal parity as a random effect, and pen as the experimental unit. Daily weight gain was greater for L pigs (0.47 kg) compared with H pigs (0.42 kg; P &amp;lt; 0.05), while ADFI was increased for L pigs (0.57 kg) compared with both C and H pigs (0.49 and 0.47 kg, respectively; P &amp;lt; 0.05; see Table). No differences in microbiome diversity were observed at either time-point. However, microbiome composition differed based on maternal treatment group at both time-points (T1: PERMANOVA, R2 = 0.02, P=0.001; T2: PERMANOVA, R2 = 0.04, P=0.001). These results indicate that live yeast supplementation in sow diets in late gestation and lactation may have lasting effects on pig performance and microbiome composition in the post-weaning period.

Dropper method for cytology slide staining: An effective and sustainable approach to eliminating cross contamination.

Cytopathology laboratories must ensure effective measures to prevent cross-contamination during slide staining. As such, slides with high potential for cross-contamination are usually stained separately, by dipping slides into a series of Romanowsky-type stains, with periodic (usually weekly) filtering and replacement of stains used. Our 5-year experience and a validation study of an alternative dropper method is presented. In this method, cytology slides are placed in a staining rack, a small amount of stain is applied to each using a dropper. Because of the small amount of stain used, this dropper method requires no filtering or reuse of stain, eliminating the possibility of cross contamination and reducing the total amount of stain used. In our 5-year experience, we report a complete elimination of cross contamination due to staining, excellent staining quality, and a slight reduction in overall stain expenditure.

Assessing the Risk of Seasonal Effects of Campylobacter Contaminated Broiler Meat Prepared In-Home in the United States.

Campylobacter has consistently posed a food safety issue in broiler meat. This study aimed to create a quantitative microbial risk assessment model from retail to consumption, designed to evaluate the seasonal risk of campylobacteriosis associated with broiler meat consumption in the United States. To achieve this, data was gathered to build distributions that would enable us to predict the growth of Campylobacter during various stages such as retail storage, transit, and home storage. The model also included potential fluctuations in concentration during food preparation and potential cross-contamination scenarios. A Monte Carlo simulation with 100,000 iterations was used to estimate the risk of infection per serving and the number of infections in the United States by season. In the summer, chicken meat was estimated to have a median risk of infection per serving of 9.22 × 10-7 and cause an average of about 27,058,680 infections. During the winter months, the median risk of infection per serving was estimated to be 4.06 × 10-7 and cause an average of about 12,085,638 infections. The risk assessment model provides information about the risk of broiler meat to public health by season. These results will help understand the most important steps to reduce the food safety risks from contaminated chicken products.

HSD40 Workflow Efficiencies for Flexible Cystoscopy: Comparing Single-Use Vs Reusable Cystoscopes

Flexible cystoscopy is a common procedure that is performed to diagnose and treat lower urinary tract conditions. Single-use cystoscopes have been introduced to eliminate time-consuming reprocessing, costly repairs, and potential cross-contamination that occur between cystoscopies with reusable scopes. We aimed to compare the hands-on labor time differences between flexible reusable cystoscopes versus single-use cystoscopes at a large urology Ambulatory Surgery Center (ASC).

Cross-contamination of mature Listeria monocytogenes biofilms from stainless steel surfaces to chicken broth before and after the application of chlorinated alkaline and enzymatic detergents.

The objectives of this study were, firstly, to compare a conventional (i.e., chlorinated alkaline) versus an alternative (chlorinated alkaline plus enzymatic) treatment effectivity for the elimination of biofilms from different L. monocytogenes strains (CECT 5672, CECT 935, S2-bac and EDG-e). Secondly, to evaluate the cross-contamination to chicken broth from non-treated and treated biofilms formed on stainless steel surfaces. Results showed that all L. monocytogenes strains were able to adhere and develop biofilms at approximately the same growth levels (≈5.82 log CFU/cm2). When non-treated biofilms were put into contact with the model food, obtained an average transference rate of potential global cross-contamination of 20.4%. Biofilms treated with the chlorinated alkaline detergent obtained transference rates similar to non-treated biofilms as a high number of residual cells (i.e., around 4 to 5 Log CFU/cm2) were present on the surface, except for EDG-e strain on which transference rate diminished to 0.45%, which was related to the protective matrix. Contrarily, the alternative treatment was shown to not produce cross-contamination to the chicken broth due to its high effectivity for biofilm control (<0.50% of transference) except for CECT 935 strain that had a different behavior. Therefore, changing to more intense cleaning treatments in the processing environments can reduce risk of cross-contamination.

Impacts and Identification of Hearing Aid Refurbishing Programs for People with Hearing Loss: A Scoping Review.

This article consists of a scoping review completed to describe the impacts of refurbished hearing aids (HAs) for people with hearing loss, and to identify existing HA refurbishing programs around the world. In this review, JBI methodological guidance for scoping reviews was followed. All types of sources of evidence were considered. Thirty-six sources of evidence were included, 11 articles and 25 web pages. Results suggest that refurbished HAs may improve communication and social participation for individuals with hearing loss and provide monetary savings to them and to governmental agencies. Twenty-five HA refurbishing programs were identified, all based in developed countries and distributing refurbished HAs mostly locally, but also in developing countries. Issues related to refurbished HAs were highlighted, such as potential cross-contamination, quick obsolescence, and repairing problems. Some facilitators for the success of this intervention are to offer accessible and affordable follow-up services, repairs, and batteries, and to ensure awareness and participation of hearing healthcare professionals and citizens with hearing loss. In conclusion, the use of refurbished HAs appears to be a valuable option for low-income people with hearing loss, but it should be included in a more global intervention program to ensure its sustainability.

High prevalence of multidrug-resistant bacteria in fomites in a tertiary institution in Southwestern Nigeria

&lt;b&gt;Background&lt;/b&gt;&lt;b&gt;: &lt;/b&gt;The emergence and spread of multidrug-resistant (MDR) bacteria have become a major threat to public and environmental health because they limit treatment options against infections. Fomites have been implicated in the spread of pathogenic and resistant bacteria, making them an important source of disease. This study was carried out to determine the frequency and characteristics of resistant bacteria linked with environmental fomites in a tertiary institution in Nigeria as part of global efforts to provide information to contain the spread of antimicrobial resistance.&lt;br /&gt; &lt;b&gt;Methods: &lt;/b&gt;300 swab samples, determined by factorial design, were aseptically collected from 10 fomites in 10 locations in three different facilities at Obafemi Awolowo University, Nigeria, and transported to the laboratory for processing. The isolates were identified by standard procedure and the Microbact&lt;sup&gt;TM&lt;/sup&gt; identification kit. The susceptibility profile of the isolates was determined using Kirby-Bauer disc diffusion technique. MDR bacteria were examined for the presence of plasmids using the alkali lysis method, and plasmid-mediated quinolone resistance, extended-spectrum beta-lactamase, and methicillin resistance genes by polymerase chain reaction.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; 89 diverse bacteria were isolated from fomites in the study environment. &lt;i&gt;Staphylococcus aureus &lt;/i&gt;(49.4%) predominated among the bacteria, followed by &lt;i&gt;Staphylococcus saprophyticus&lt;/i&gt; (10.1%), &lt;i&gt;Providencia stuartti&lt;/i&gt; (5.6%), &lt;i&gt;Proteus vulgaris&lt;/i&gt; (4.5%), and&lt;i&gt; Acinetobacter baumannii&lt;/i&gt; (3.4%). The isolates were commonly (84%-100%) resistant to ceftazidime, cefuroxime, and augmentin, while the least (8%-12.5%) resistance was to ciprofloxacin, amikacin, meropenem, and streptomycin. 58 (65.2%) isolates were MDR, and the majority (27.6%) were isolated from floors. 47 (81%) MDR isolates harbored plasmids, with their molecular weights between 2.697 kbp and 4.011 kbp. &lt;i&gt;mecA&lt;/i&gt;, &lt;i&gt;TEM,&lt;/i&gt; and &lt;i&gt;OqXAB&lt;/i&gt; resistance genes were detected in &lt;i&gt;S. aureus&lt;/i&gt;, &lt;i&gt;P. stuarttii&lt;/i&gt;, &lt;i&gt;Pseudomonas &lt;/i&gt;sp, and &lt;i&gt;K. oxytoca&lt;/i&gt;.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; This study has shown that fomites in the sampled locations are potential reservoirs for MDR bacteria, and may serve as sources of their transmission, thereby posing a threat to public health. Therefore, appropriate sanitary measures are required to prevent any potential cross-contamination. In addition, it is imperative to regularly survey environments for bacterial contamination to increase community awareness and education regarding hygiene standards.

A New Broad-Spectrum Drug Screen for 127 Analytes by LC-MS/MS.

Broad-spectrum drug screening is offered by many clinical laboratories to support investigation of possible drug exposures. The traditional broad-spectrum drug screen employed at our laboratory utilizes several different analytical platforms, thus requiring relatively high volumes of sample and a cumbersome workflow. Here we describe the development and validation of a consolidated broad-spectrum drug screen assay designed to qualitatively detect 127 compounds in urine (Ur) and serum/plasma (S/P) samples. An LC-MS/MS method was developed using the Ultivo LC-MS/MS and designed to be qualitative with a 1-point calibration curve and 50% to 150% controls. Sample preparation included the addition of 122 internal standards (IS) followed by mixed-mode strong cation exchange solid-phase extraction and reverse-phase chromatographic separation on a biphenyl column. For the method described herein, ≥ 95% of analytes in urine and serum control samples had a CV of ≤20% for total imprecision. Accuracy testing included 46 external controls and demonstrated 99.9% accuracy. Method comparison studies to quantitative testing are discussed. The high level of coverage of the analytes with a stable isotope-labeled IS (SIL-IS) helped normalize for matrix effects when significant ion suppression (>25%) was present. Analyte stability in the matrix, the impact of potentially interfering compounds, and method ruggedness were demonstrated. Method limitations include limited detection of glucuronidated drugs and potential cross-contamination with samples at very high concentrations (>>100 × cutoff). The broad-spectrum drug screen method developed here qualitatively detected 127 drugs and select metabolites. This method could be used to support investigations of possible drug exposures in a clinical setting.

Hand hygiene behavior change: a review and pilot study of an automated hand hygiene reminder system implementation in a public hospital.

To review and study implementation of an automated hand hygiene reminder system (AHHRS). Prospective, nonrandomized, before-after quality improvement pilot study conducted over 6 months. Medical-surgical unit (MSU) and medical intensive care unit (MICU) at a public hospital in New York City. There were 2,642 healthcare worker observations in the direct observation (DO) period versus 265,505 in the AHHRS period, excluding AHHRS observations collected during the 1-month crossover period when simultaneous DO occurred. We compared hand hygiene adherence (HHA) measured by DO prior to the pilot and after AHHRS implementation. We compared changes in HHA and potential cross-contamination events (CCEs) (room exit and subsequent entry without HHA) from baseline for each biweekly period during the pilot. Engagement, education/training, data transparency, and optimization period resulted in successful implementation and adoption of the AHHRS. Observations were greater utilizing AHHRS than DO (265,505 vs 2,642, P < .01). Due to the expected Hawthorne effect, HHA was significantly less for AHHRS than DO in MSU (90.99% vs 97.21%, P < .01) and MICU (91.21% vs 98.65%, P < .01). HHA significantly improved from 86.47% to 89.68% in MSU (P < .001) and 85.93% to 91.24% in the MICU (P < .001) from the first biweekly period of AHHRS utilization to the last. CCE decreased from 73.42% to 65.11% in the MSU and significantly decreased from 81.22% to 53.19% in the MICU (P < .05). We describe how an AHHRS approach was successfully implemented at our facility. With ongoing feedback and system optimization, AHHRS improved HHA and reduced CCE over time.