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Hastane genel tuvaletlerinin karbapenem dirençli gram negatif mikroorganizmaların bulaşında katkısı olabilir mi? Sosyal el yıkama gözlemleri ile birlikte değerlendirme

Year 2020, Volume: 6 Issue: 3, 338 - 342, 03.12.2020
https://doi.org/10.30569/adiyamansaglik.813329

Abstract

Amaç: Çalışmamızda birçok insanın ortak kullanım alanı olan hastane genel tuvaletlerinin epidemiyolojik açıdan önemli karbapenem dirençli Gram negatif mikroorganizmaların bulaşında, yayılmasında rollerinin araştırılması ve saptanması halinde yoğun bakımlarımızda etken olan izolatlar ile benzerliklerinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmamızda, hastanemizde aktif kullanımda olan ve daha çok hasta yakınlarının kullandığı tuvaletlerden el hijyeni öğrenci grubu ile örnekler alındı. Ayrıca belirlenen tuvaletlerden sosyal el yıkama uyumu ve uygunluğu gözlemleri yapıldı.
Bulgular: On dört tuvaletten alınan 85 örnekte, 115 bakteri üremesi gözlendi. İzole edilen bakterilerden %26’sı gram negatifti. Ancak epidemiyolojik olarak önemli olduğu düşünülen karbapenem direnci varlığına Gram negatif izolatlarda rastlanmadı.
Sonuç: Hastaların ve hasta yakınlarının elleri ve çevresel yüzeyler yoluyla bu alanlardan karbapenem dirençli Gram negatif mikroorganizma bulaşının önemli bir sorun olmadığı kanaatine varıldı.

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References

  • Duszynska W, Litwin A, Rojek S, Szczesny A, Ciasullo A, Gozdzik W. Analysis of Acinetobacter baumannii hospital infections in patients treated at the intensive care unit of the University Hospital, Wroclaw, Poland: a 6-year, single-center, retrospective study. Infect Drug Resist 2018; 11: 629-635.
  • Villar M, Cano ME, Gato E, Garnacho-Montero J, Miguel Cisneros J, Ruíz de Alegría C, Fernández-Cuenca F, Martínez-Martínez L, Vila J, Pascual A, Tomás M, Bou G, Rodríguez-Bano J; Geih/Gemara/Reipi-Ab20101 Group. Epidemiologic and clinical impact of Acinetobacter baumannii colonization and infection: a reappraisal. Medicine (Baltimore) 2014;93:202-210.
  • Cücen Z, Erden Y, Gamberzade Ş, Açıkgöz ZC. Hastane Ortamındaki Lavabo Musluklarının ve Sıvı-sabun rezervuarlarının Mikrobiyal Kirliliklerinin Araştırılması. Türk Hij Den Biyol Derg 2003; 60(1) : 23 – 26.
  • Boyce J.M, Pittet D. Guideline for Hand Hygiene in Health-Care Settings. Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002;51.
  • Casewell M, Phillips I. Hands as route of transmission for Klebsiella species. British Medical Journal, 1977, 2, 1315-1331.
  • Evans BA, Hamouda A, Amyes SG. The rise of carbapenem-resistant Acinetobacter baumannii. Curr Pharm Des. 2013; 19(2):223-238.
  • Marsh JW, Mustapha MM, Griffith MP, Evans DR, Ezeonwuk C, Pasculle AW, Shutt KA, Sundermann, Ayres AM, Shields RK, Babiker A, Cooper VS, Tyne DV, Harrison LH. Evolution of Outbreak-Causing Carbapenem-Resistant Klebsiella pneumoniae ST258 at a Tertiary Care Hospital over 8 Years. mbio.asm.org. 2019;10(5), e01945-19.
  • Larson EL, Norton Hughes CA, Pyrak JD, Sparks SM, Cagatay EU, Bartkus JM. Changes in bacterial flora associated with skin damage on hands of health care personnel. Am J Infect Control 1998;26:513–521.
  • Çaylan R. El Hijyeni. Hastane İnfeksiyonları Dergisi 2007; 11: 54-59.
  • Ayliffe GAJ, Babb JR, Taylor LJ. The hospital environment. In: Hospital-acquired infection: principles and prevention. Oxford: Butterworth-Heinemann 1999: 109-121.
  • Bonneault M, Andrianoelina VH, Herindrainy P, Rabenandrasana MAN, Garin B, Breurec S, Delarocque-Astagneau E, Guillemot D, Zo Andrianirina Z, Collard JM, Huynh BT, Opatowski L. Transmission Routes of Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae in a Neonatology Ward in Madagascar. The Am J of Trop Medicine and Hygiene, 2019;100:1355 -1362.
  • Nordmann P, Poirel L. The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide. Clinical Microbiology and Infection. 2014; 20(9): 821–30.(Van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence 2017;8: 460-469.
  • Duman Y, Ersoy Y, Gürsoy NC, Toplu SA, Otlu B. A silent outbreak due to Klebsiella pneumoniae that co-produced NDM-1 and OXA-48 carbapenemases, and infection control measures. Iran J Basic Med Sci 2020 ; 23:46-50.
  • Duman Y, Kuzucu C, Tekerekoglu MS, Cakil B, Yakupogullari Y, Kaysadu H. Changing trends of carbapenem resistance of Escherichia coli and Klebsiella pneumoniae strains isolated from intensive care units, inpatient services and outpatient’s clinics: a five years retrospective analysis. Med Science 2018;7(3):536-539.
  • Schwaber MJ, Klarfeld-Lidji S, Navon-Venezia S, Schwartz D, Leavitt A, Carmeli Y. Predictors of Carbapenem-Resistant Klebsiella pneumoniae Acquisition among Hospitalized Adults and Effect of Acquisition on Mortality. Antimicrobial Agents and Chemotherapy. 2008;1028–1033.
  • Quinio P, Savry C, Deghelt A, Guilloux M, Catineau J, de Tinteniac A.A multicenter survey of visiting policies in French intensive care units. Intensive Care Med 2002;28:1389-1394.

Can public toilets in hospitals contribute to the spread of carbapenem resistant gram-negative microorganisms? Assessment with social handwashing observations

Year 2020, Volume: 6 Issue: 3, 338 - 342, 03.12.2020
https://doi.org/10.30569/adiyamansaglik.813329

Abstract

Aim: The goal of our study is to investigate the role that public toilets in hospitals have in spreading and transmitting significant carbapenem resistant Gram negative microorganisms, and potentially compare them to the isolates present in our intensive care units.
Materials and Methods: In our study, student groups took samples from the toilets that were actively used, mostly by patient companions, in our hospital. In addition, social hand washing compliance and reliability was observed from the specified toilets.
Results: In 85 samples taken from fourteen toilets, Gram negative bacteria accounted for 26% of 115 bacterial growths. However, carbapenem-resistance, which is thought to have epidemiological significance, was not present in Gram negative isolates.
Conclusion: It was concluded that no major problem was associated with the transmission of Carbapenem-resistant Gram negative microorganisms from these areas through the hands and peripheral surfaces of patients and their companions.

Project Number

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References

  • Duszynska W, Litwin A, Rojek S, Szczesny A, Ciasullo A, Gozdzik W. Analysis of Acinetobacter baumannii hospital infections in patients treated at the intensive care unit of the University Hospital, Wroclaw, Poland: a 6-year, single-center, retrospective study. Infect Drug Resist 2018; 11: 629-635.
  • Villar M, Cano ME, Gato E, Garnacho-Montero J, Miguel Cisneros J, Ruíz de Alegría C, Fernández-Cuenca F, Martínez-Martínez L, Vila J, Pascual A, Tomás M, Bou G, Rodríguez-Bano J; Geih/Gemara/Reipi-Ab20101 Group. Epidemiologic and clinical impact of Acinetobacter baumannii colonization and infection: a reappraisal. Medicine (Baltimore) 2014;93:202-210.
  • Cücen Z, Erden Y, Gamberzade Ş, Açıkgöz ZC. Hastane Ortamındaki Lavabo Musluklarının ve Sıvı-sabun rezervuarlarının Mikrobiyal Kirliliklerinin Araştırılması. Türk Hij Den Biyol Derg 2003; 60(1) : 23 – 26.
  • Boyce J.M, Pittet D. Guideline for Hand Hygiene in Health-Care Settings. Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002;51.
  • Casewell M, Phillips I. Hands as route of transmission for Klebsiella species. British Medical Journal, 1977, 2, 1315-1331.
  • Evans BA, Hamouda A, Amyes SG. The rise of carbapenem-resistant Acinetobacter baumannii. Curr Pharm Des. 2013; 19(2):223-238.
  • Marsh JW, Mustapha MM, Griffith MP, Evans DR, Ezeonwuk C, Pasculle AW, Shutt KA, Sundermann, Ayres AM, Shields RK, Babiker A, Cooper VS, Tyne DV, Harrison LH. Evolution of Outbreak-Causing Carbapenem-Resistant Klebsiella pneumoniae ST258 at a Tertiary Care Hospital over 8 Years. mbio.asm.org. 2019;10(5), e01945-19.
  • Larson EL, Norton Hughes CA, Pyrak JD, Sparks SM, Cagatay EU, Bartkus JM. Changes in bacterial flora associated with skin damage on hands of health care personnel. Am J Infect Control 1998;26:513–521.
  • Çaylan R. El Hijyeni. Hastane İnfeksiyonları Dergisi 2007; 11: 54-59.
  • Ayliffe GAJ, Babb JR, Taylor LJ. The hospital environment. In: Hospital-acquired infection: principles and prevention. Oxford: Butterworth-Heinemann 1999: 109-121.
  • Bonneault M, Andrianoelina VH, Herindrainy P, Rabenandrasana MAN, Garin B, Breurec S, Delarocque-Astagneau E, Guillemot D, Zo Andrianirina Z, Collard JM, Huynh BT, Opatowski L. Transmission Routes of Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae in a Neonatology Ward in Madagascar. The Am J of Trop Medicine and Hygiene, 2019;100:1355 -1362.
  • Nordmann P, Poirel L. The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide. Clinical Microbiology and Infection. 2014; 20(9): 821–30.(Van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence 2017;8: 460-469.
  • Duman Y, Ersoy Y, Gürsoy NC, Toplu SA, Otlu B. A silent outbreak due to Klebsiella pneumoniae that co-produced NDM-1 and OXA-48 carbapenemases, and infection control measures. Iran J Basic Med Sci 2020 ; 23:46-50.
  • Duman Y, Kuzucu C, Tekerekoglu MS, Cakil B, Yakupogullari Y, Kaysadu H. Changing trends of carbapenem resistance of Escherichia coli and Klebsiella pneumoniae strains isolated from intensive care units, inpatient services and outpatient’s clinics: a five years retrospective analysis. Med Science 2018;7(3):536-539.
  • Schwaber MJ, Klarfeld-Lidji S, Navon-Venezia S, Schwartz D, Leavitt A, Carmeli Y. Predictors of Carbapenem-Resistant Klebsiella pneumoniae Acquisition among Hospitalized Adults and Effect of Acquisition on Mortality. Antimicrobial Agents and Chemotherapy. 2008;1028–1033.
  • Quinio P, Savry C, Deghelt A, Guilloux M, Catineau J, de Tinteniac A.A multicenter survey of visiting policies in French intensive care units. Intensive Care Med 2002;28:1389-1394.
There are 16 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Sibel Altunışık Toplu 0000-0002-2915-4666

Yücel Duman 0000-0002-9090-2096

Yasemin Ersoy This is me 0000-0001-5730-6682

Emine Parmaksiz This is me 0000-0002-5364-5641

Project Number yoktur
Publication Date December 3, 2020
Submission Date October 20, 2020
Acceptance Date November 11, 2020
Published in Issue Year 2020 Volume: 6 Issue: 3

Cite

AMA Altunışık Toplu S, Duman Y, Ersoy Y, Parmaksiz E. Can public toilets in hospitals contribute to the spread of carbapenem resistant gram-negative microorganisms? Assessment with social handwashing observations. ADYÜ Sağlık Bilimleri Derg. December 2020;6(3):338-342. doi:10.30569/adiyamansaglik.813329