Archive for September 16, 2015

Colonization with resistant microorganisms in patients transferred from abroad: who needs to be screened?

Antimicrobial Resistance and Infection Control (2015) 4:31

Kaspar1*, A. Schweiger2 , S. Droz3 and J. Marschall1



While multi-drug resistant organisms (MDRO) are a global phenomenon, there are significant regional differences in terms of prevalence. Traveling to countries with a high MDRO prevalence increases the risk of acquiring such an organism. In this study we determined risk factors for MDRO colonization among patients who returned from a healthcare system in a high-prevalence area (so-called transfer patients). Factors predicting colonization could serve as screening criteria to better target those at highest risk.


This screening study included adult patients who had been exposed to a healthcare system abroad or in a high-prevalence region in Switzerland over the past six months and presented to our 950-bed tertiary care hospital between January 1, 2012 and December 31, 2013, a 24-month period. Laboratory screening tests focused on Gram-negative MDROs and methicillin-resistant Staphylococcus aureus (MRSA).


A total of 235 transfer patients were screened and analyzed, of which 43 (18 %) were positive for an MDRO. Most of them yielded Gram-negative bacteria (42; 98 %), with only a single screening revealing MRSA (2 %); three screenings showed a combination of Gram-negative bacteria and MRSA. For the risk factor analysis we focused on the 42 Gram-negative MDROs. Most of them were ESBL-producing Escherichia coli and Klebsiella pneumoniae while only two were carbapenemase producers. In univariate analysis, factors associated with screening positivity were hospitalization outside of Europe (p < 0.001), surgical procedure in a hospital abroad (p = 0.007), and – on admission to our hospital – active infection (p = 0.002), antibiotic treatment (p = 0.014) and presence of skin lesions (p = 0.001). Only hospitalization outside of Europe (Odds Ratio, OR 3.2 (95 % CI 1.5- 6.8)) and active infection on admission (OR 2.7 (95 % CI 1.07- 6.6)) remained as independent predictors of Gram-negative MDRO colonization.


Our data suggest that a large proportion of patients (i.e., 82 %) transferred to Switzerland from hospitals in high MDRO prevalence areas are unnecessarily screened for MDRO colonization. Basing our screening strategy on certain criteria (such as presence of skin lesions, active infection, antibiotic treatment, history of a surgical procedure abroad and hospitalization outside of Europe) promises to be a better targeted and more cost-effective strategy



September 16, 2015 at 9:02 pm

Antimicrobial stewardship to optimize the use of antimicrobials for surgical prophylaxis in Egypt: A multicenter pilot intervention study.

Am J Infect Control. 2015 Aug 25. pii: S0196-6553(15)00755-5.

Saied T1, Hafez SF2, Kandeel A3, El-Kholy A4, Ismail G5, Aboushady M6, Attia E3, Hassaan A2, Abdel-Atty O2, Elfekky E4, Girgis SA5, Ismail A6, Abdou E7, Okasha O7, Talaat M7.

1Global Disease Detection and Response Program (GDDRP), US Naval Medical Research Unit No. 3, Cairo, Egypt. Electronic address:

2Microbiology Department and Orthopedic Department, Alexandria University Hospitals, Alexandria, Egypt.

3Division of Preventive Medicine, Ministry of Health and Population, Cairo, Egypt.

4Clinical Pathology Department, Cairo University Hospitals, Cairo, Egypt.

5Clinical Pathology Department, Ain Shams University Hospitals, Cairo, Egypt.

6Infection Control Unit and Obstetric and Gynecology Department, Zahraa University Hospital, Cairo, Egypt.

7Global Disease Detection and Response Program (GDDRP), US Naval Medical Research Unit No. 3, Cairo, Egypt.



To measure the impact of an antimicrobial stewardship (AMS) program on the use of antibiotics for surgical prophylaxis at acute care hospitals in Egypt.


This was a before-and-after intervention study conducted in 5 tertiary, acute-care surgical hospitals. The baseline, intervention, and follow-up periods were 3, 6, and 3 months, respectively. The impact of the intervention was measured by preintervention and postintervention surveys for surgical patients with clean and clean-contaminated wounds. Information was collected on demographic characteristics and antibiotic use. The intervention focused mainly on educating surgical staff on the optimal timing and duration of antibiotics used for surgical prophylaxis. Only 3 hospitals identified a surgeon to audit antibiotic surgical prescriptions. The primary outcome measures were the percentages of surgical patients receiving optimal timing and duration of surgical prophylaxis.


Data were collected for 745 patients before the intervention and for 558 patients after the intervention. The optimal timing of the first dose improved significantly in 3 hospitals, increasing from 6.7% to 38.7% (P < .01), from 2.6% to 15.2% (P < .01), and from 0% to 11% (P < .01). All hospitals showed a significant rise in the optimal duration of surgical prophylaxis, with an overall increase of 3%-28% (P < .01). Days of therapy per 1000 patient-days were decreased significantly in hospitals A, B, C, and D, with no change in hospital E.


An AMS program focusing on education supported by auditing and feedback can have a significant impact on optimizing antibiotic use in surgical prophylaxis practices.


September 16, 2015 at 9:00 pm

Mobile phones: Reservoirs for the transmission of nosocomial pathogens.

Adv Biomed Res. 2015 Jul 27;4:144.

Pal S1, Juyal D1, Adekhandi S2, Sharma M1, Prakash R3, Sharma N1, Rana A1, Parihar A1.

1Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Srinagar Garhwal, Uttarakhand, India.

2Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

3Microbial Containment Complex, Maximum Containment laboratory: BSL-IV, Pashan, National Institute of Virology, Pune, Maharashtra, India.



Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients.

Mobile phones are indispensible part of communication among doctors and other health care workers (HCWs) in hospitals.

Hands of HCWs play an important role in transmission of HAI and mobile phones which are seldom cleaned and often touched during or after the examination of patients without hand washing can act as a reservoir for transmission of potent pathogens.

This study aimed to investigate the rate of bacterial contamination of mobile phones among HCWs in our tertiary care hospital and to compare it with personal mobile phones of non-HCWs (control group).


The mobile phones and dominant hands of 386 participants were sampled from four different groups, hospital doctors and staff (132), college faculty and staff (54), medical students (100) and control group (100). Informed consent and questionnaire was duly signed by all the participants. Samples were processed according to standard guidelines.


316 mobile phones (81.8%) and 309 hand swab samples (80%) showed growth of bacterial pathogens. The most predominant isolates were Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Enterococcus species.


Hundred percent contamination was found in mobile phones and hands of HCWs indicating mobile phones can be the potential source of nosocomial pathogens. Our study results suggest that use of mobile phones in health care setup should be restricted only for emergency calls. Strict adherence to infection control policies such as proper hand hygiene practices should be followed.


September 16, 2015 at 8:58 pm

Antimicrobial stewardship programme (AMSP) practices in India.

Indian J Med Res. 2015 Aug;142(2):130-8.

Walia K1, Ohri VC, Mathai D; Antimicrobial Stewardship Programme of ICMR.

1Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India.


A survey was conducted to ascertain practice of antimicrobial stewardship programme (AMSP) in India for 2013.

A total of 20 health care institutions (HCI) responded to a detailed questionnaire. All the institutions contacted were tertiary care HCI, of which 12 were funded by government (GHCI) and 8 were corporate/private HCI (PHCI).

Further, all catered to both rural and urban populations and were spread across the country. Written documents were available with 40 per cent for AMSP, 75 per cent for hospital infection control (HIC) and HIC guidelines and 65 per cent for antimicrobial agents (AMA) prescription guidelines. Records were maintained for health care associated infections (HCAI) by 60 per cent HCI.

Antimicrobial resistance (AMR) data were being analysed by 80 per cent HCI. AMA usage data were analysed by only 25 per cent HCI and AMA prescription audit and feedback by 30 per cent. PHCI performed better than GHCI across all fields of AMSP.

The main contributory factor was possibly the much higher level of accreditation of PHCI hospitals and their diagnostic laboratories.

The absence of infectious diseases physicians and clinical pharmacists is worrying and demands careful attention.


September 16, 2015 at 8:56 pm


September 2015
« Aug   Oct »

Posts by Month

Posts by Category