Background: Carbapenem-resistant Klebsiella pneumoniae infections are increasingly prevalent in North American hospitals. We describe an outbreak of carbapenem-resistant K. pneumoniae containing the blaOXA-232 gene transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when 9 patients with blaOXA-232 carbapenem-resistant K. pneumoniae infections were identified at a tertiary care hospital. The investigation included 2 case-control studies, review of duodenoscope reprocessing procedures, and culture of devices. Carbapenem-resistant Enterobacteriacieae (CRE) isolates were evaluated with polymerase chain reaction analysis for carbapenemase genes, and isolates with the blaOXA-232 gene were subjected to whole-genome sequencing and chromosome single-nucleotide polymorphism analysis. On recognition of ERCP as a key risk factor for infection, targeted patient notification and CRE screening cultures were performed. Results: Molecular testing ultimately identified 17 patients with blaOxa-232 carbapenem-resistant K. pneumoniae isolates, including 9 with infections, 7 asymptomatic carriers who had undergone ERCP, and 1 additional patient who had been hospitalized in India and was probably the initial carrier. Two case-control studies established a point-source outbreak associated with 2 specific duodenoscopes. A field investigation of the use, reprocessing, and storage of deuodenoscopes did not identify deviations from US Food and Drug Administration or manufacturer recommendations for reprocessing. Conclusions: This outbreak demonstrated the previously underappreciated potential for duodenoscopes to transmit disease, even after undergoing high-level disinfection according to manufacturers’ guidelines.
Fonte: Duodenoscope-Related Outbreak of a Carbapenem-Resistant Klebsiella pneumoniae Identified Using Advanced Molecular Diagnostics | Read by QxMD
A Randomized Trial to Determine Whether Wearing Short-Sleeved White Coats Reduces the Risk for Pathogen Transmission – Volume 39 Issue 2 – Amrita R. John, Heba Alhmidi, Melany I. Gonzalez-Orta, Jennifer L. Cadnum, Curtis J. Donskey
Fonte: A Randomized Trial to Determine Whether Wearing Short-Sleeved White Coats Reduces the Risk for Pathogen Transmission | Infection Control & Hospital Epidemiology | Cambridge Core
A pediatrics professor at UCLA tested the use of a handshake-free zone to reduce the spread of germs.
Fonte: Handshake-Free Zone: Stopping the Spread of Germs in the Hospital
Certas idéias são tão óbivias, que a gente se pergunta por quê não pensou nisso antes
Fonte: Control of multidrug-resistant Gram-negative bacteria in low- and middle-income countries—high impact interventions without much resources – Clinical Microbiology and Infection
Artigo europeu, mas com foco nas nossas dificuldades de como implementar um programa de controle de germes gram negativo multiR em um cenário de restrição orçamentária (cada vez maior).
Atualmente, em países de baixa e média renda, 11% dos pacientes que passam por cirurgias são infectados no procedimento. Nos Estados Unidos, complicações operatórias causadas por microrganismos ger…
Fonte: OMS publica novas diretrizes para acabar com infecções cirúrgicas
If our behavior changes when light, or attention, is shone on it, this is called the ‘Hawthorne effect’ — and it is alive and well in our approach to handwashing, says Dr Lundberg.
Fonte: Doctors and Nurses: Wash Your Hands!
Campanha do Medscape. Quem sabe em inglês a turma acredite…
Acesse a reportagem do Medscape aqui
A bactéria em questão é o Acinetobacter balmani, figurinha carimbada dos serviços de controle de infecção hospitalar.