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Microorganisms
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Research in Hospital Infection Control
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Research in Hospital Infection Control

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (7 March 2023) | Viewed by 17601

Special Issue Editors

Dr. Brian Crook

E-Mail Website
Guest Editor
Health and Safety Executive Science and Research Centre, Buxton, UK
Interests: hospital infection; virus disease outbreak; healthcare worker protection
Special Issues, Collections and Topics in MDPI journals
Dr. Catherine Makison Booth

E-Mail Website
Guest Editor
Health and Safety Executive Science and Research Centre, Buxton, UK
Interests: norovirus; infection control; biosafety

Special Issue Information

Dear Colleagues,

Infection control in healthcare settings is of paramount importance, not only to protect vulnerable patients, but also for healthcare staff. Effective infection control interventions could potentially save patients from serious health complications that could prolong hospital stays, creating pressure on bed capacity and adding to the cost of healthcare provision. They also allow healthcare staff to continue their care provision with confidence.

Never has hospital infection control been more critical, or been of such a high profile, than in the current Covid-19 pandemic. Amidst a plethora of information, advice, and guidance ranging in quality, what are the most important and effective interventions? Undoubtedly, they will be a combination of measures, including hygiene practices, supported by appropriate personal protective equipment, tailored to the needs of the care provision and healthcare settings.

This Special Issue of the journal Microorganisms aims to bring together up to date information on the most effective and practical hospital infection control interventions, and invites papers from researchers and infection control specialists. We welcome papers describing original research, or reviews providing a critical and constructive analysis of the existing published literature. Manuscripts that only deal with clinical management/policy/healthcare will only be acceptable in rare cases.

Dr. Brian Crook
Dr. Catherine Makison Booth
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hospital infection control
  • hospital acquired infection
  • healthcare worker
  • personal protective equipment, hygiene
  • disease transmission
  • disinfection
  • Covid-19

Published Papers (6 papers)

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Research

11 pages, 624 KiB  
Article
A Better Disinfectant for Low-Resourced Hospitals? A Multi-Period Cluster Randomised Trial Comparing Hypochlorous Acid with Sodium Hypochlorite in Nigerian Hospitals: The EWASH Trial
by Giorgia Gon, Lucia Dansero, Alexander M. Aiken, Christian Bottomley, Stephanie J. Dancer, Wendy J. Graham, Olivia C. Ike, Michelle Lewis, Nick Meakin, Obiora Okafor, Nkolika S. Uwaezuoke and Tochi Joy Okwor
Microorganisms 2022, 10(5), 910; https://doi.org/10.3390/microorganisms10050910 - 26 Apr 2022
Cited by 2 | Viewed by 2744
Abstract
Environmental hygiene in hospitals is a major challenge worldwide. Low-resourced hospitals in African countries continue to rely on sodium hypochlorite (NaOCl) as major disinfectant. However, NaOCl has several limitations such as the need for daily dilution, irritation, and corrosion. Hypochlorous acid (HOCl) is [...] Read more.
Environmental hygiene in hospitals is a major challenge worldwide. Low-resourced hospitals in African countries continue to rely on sodium hypochlorite (NaOCl) as major disinfectant. However, NaOCl has several limitations such as the need for daily dilution, irritation, and corrosion. Hypochlorous acid (HOCl) is an innovative surface disinfectant produced by saline electrolysis with a much higher safety profile. We assessed non-inferiority of HOCl against standard NaOCl for surface disinfection in two hospitals in Abuja, Nigeria using a double-blind multi-period randomised cross-over study. Microbiological cleanliness [Aerobic Colony Counts (ACC)] was measured using dipslides. We aggregated data at the cluster-period level and fitted a linear regression. Microbiological cleanliness was high for both disinfectant (84.8% HOCl; 87.3% NaOCl). No evidence of a significant difference between the two products was found (RD = 2%, 90%CI: −5.1%–+0.4%; p-value = 0.163). We cannot rule out the possibility of HOCl being inferior by up to 5.1 percentage points and hence we did not strictly meet the non-inferiority margin we set ourselves. However, even a maximum difference of 5.1% in favour of sodium hypochlorite would not suggest there is a clinically relevant difference between the two products. We demonstrated that HOCl and NaOCl have a similar efficacy in achieving microbiological cleanliness, with HOCl acting at a lower concentration. With a better safety profile, and potential applicability across many healthcare uses, HOCl provides an attractive and potentially cost-efficient alternative to sodium hypochlorite in low resource settings. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control)
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12 pages, 1008 KiB  
Article
Management of a Major Carbapenem-Resistant Acinetobacter baumannii Outbreak in a French Intensive Care Unit While Maintaining Its Capacity Unaltered
by Clémence Risser, Julien Pottecher, Anne Launoy, Axel Ursenbach, Laure Belotti, Pierre Boyer, Rosalie Willemain, Thierry Lavigne and Stéphanie Deboscker
Microorganisms 2022, 10(4), 720; https://doi.org/10.3390/microorganisms10040720 - 27 Mar 2022
Cited by 4 | Viewed by 1968
Abstract
We describe bundle measures implemented to overcome a protracted carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak in an 18-bed trauma Intensive Care Unit (ICU) at Strasbourg University Hospital, a tertiary referral center in France. Outbreak cases were defined by a positive CRAB sample with OXA-23 [...] Read more.
We describe bundle measures implemented to overcome a protracted carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak in an 18-bed trauma Intensive Care Unit (ICU) at Strasbourg University Hospital, a tertiary referral center in France. Outbreak cases were defined by a positive CRAB sample with OXA-23 profile during or after ICU say. To sustain the capacity of the busy trauma ICU, infection control bundles were purposely selected to control the outbreak without closing the ICU. During the outbreak, from May 2015 to January 2019, 141 patients were contaminated by CRAB, including 91 colonized and 50 infected patients. The conventional infection and prevention control (IPC) measures implemented included weekly active surveillance of patients’ samples, enhancement of environmental cleaning, interventions to improve hand hygiene compliance and antibiotic stewardship with audits. Supplemental measures were needed, including environmental samplings, health care workers’ (HCWs) hand sampling, chlorhexidine body-washing, relocation of the service to implement Airborne Disinfection System (ADS), replication of crisis cells, replacement of big environmental elements and improvement of HCW organization at the patient’s bedside. The final measure was the cohorting of both CRAB patients and HCW caring for them. Only the simultaneous implementation of aggressive and complementary measures made it possible to overcome this long-lasting CRAB epidemic. Facing many CRAB cases during a rapidly spreading outbreak, combining simultaneous aggressive and complementary measures (including strict patients and HCW cohorting), was the only way to curb the epidemic while maintaining ICU capacity. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control)
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11 pages, 7854 KiB  
Article
Validation of the Decontamination of a Specialist Transport System for Patients with High Consequence Infectious Diseases
by Claire Bailey, Catherine Makison-Booth, Jayne Farrant, Alan Beswick, John Chewins, Michael Eimstad, Fridtjof Heyerdahl and Brian Crook
Microorganisms 2021, 9(12), 2575; https://doi.org/10.3390/microorganisms9122575 - 13 Dec 2021
Cited by 1 | Viewed by 2645
Abstract
When transferring highly infective patients to specialist hospitals, safe systems of work minimise the risk to healthcare staff. The EpiShuttle is a patient transport system that was developed to fit into an air ambulance. A validated decontamination procedure is required before the system [...] Read more.
When transferring highly infective patients to specialist hospitals, safe systems of work minimise the risk to healthcare staff. The EpiShuttle is a patient transport system that was developed to fit into an air ambulance. A validated decontamination procedure is required before the system can be adopted in the UK. Hydrogen peroxide (H2O2) vapour fumigation may offer better penetration of the inaccessible parts than the liquid disinfectant wiping that is currently suggested. To validate this, an EpiShuttle was fumigated in a sealed test chamber. Commercial bacterial spore indicators (BIs), alongside organic liquid suspensions and dried surface samples of MS2 bacteriophage (a safe virus surrogate), were placed in and around the EpiShuttle, for the purpose of evaluation. The complete kill of all of the BIs in the five test runs demonstrated the efficacy of the fumigation cycle. The log reduction of the MS2 that was dried on the coupons ranged from 2.66 to 4.50, but the log reduction of the MS2 that was in the organic liquids only ranged from 0.07 to 1.90, confirming the results of previous work. Fumigation with H2O2 alone may offer insufficient inactivation of viruses in liquid droplets, therefore a combination of fumigation and disinfectant surface wiping was proposed. Initial fumigation reducing contamination with minimal intervention allows disinfectant wipe cleaning to be completed more safely, with a second fumigation step inactivating the residual pathogens. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control)
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10 pages, 1998 KiB  
Article
Influence of the Incubator as Direct Patient Environment on Bacterial Colonization of Neonates
by Isabel Lange, Birgit Edel, Kristin Dawczynski, Hans Proquitté, Mathias W. Pletz, Frank Kipp and Claudia Stein
Microorganisms 2021, 9(12), 2533; https://doi.org/10.3390/microorganisms9122533 - 7 Dec 2021
Cited by 1 | Viewed by 2500
Abstract
Background: Preventing healthcare-associated infections (HAI) in neonatal intensive care units is a challenge of highest priority. For further insight into the incubator as direct patient environment and potential source for contamination, we present data correlating microbiological samples of very low birthweight infants in [...] Read more.
Background: Preventing healthcare-associated infections (HAI) in neonatal intensive care units is a challenge of highest priority. For further insight into the incubator as direct patient environment and potential source for contamination, we present data correlating microbiological samples of very low birthweight infants in the form of colonization results of surveillance screenings with samples of their associated incubator in this study. Methods: Samples were taken via rectal and throat swabs of neonates as well as Polywipe® sponges for the incubator. If the same bacterial species was found in corresponding neonate and incubator samples, whole genome sequencing via Illumina technology was performed. Results: 52 microbiological species matches were found, and 30 matches were sequenced where we found 26 clonal pairs (12 E. faecalis, 10 S. aureus, 2 E. coli, 1 E. cloacae, and 1 E. faecium). Conclusion: The combinations of measurements of weekly screenings swabs, probing of surfaces with Polywipes®, and whole genome sequencing showed transmissions of microorganism and risk for potential non-physiological colonization of neonatal infants. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control)
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7 pages, 667 KiB  
Article
Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System
by Paz Aranega-Bou, Nicholas Ellaby, Matthew J. Ellington and Ginny Moore
Microorganisms 2021, 9(9), 1868; https://doi.org/10.3390/microorganisms9091868 - 3 Sep 2021
Cited by 4 | Viewed by 2319
Abstract
Sink waste traps and drains are a reservoir for multi-drug resistant Gram-negative bacteria in the hospital environment. It has been suggested that these bacteria can migrate through hospital plumbing. Hospital waste traps were installed in a laboratory model system where sinks were connected [...] Read more.
Sink waste traps and drains are a reservoir for multi-drug resistant Gram-negative bacteria in the hospital environment. It has been suggested that these bacteria can migrate through hospital plumbing. Hospital waste traps were installed in a laboratory model system where sinks were connected through a common wastewater pipe. Enterobacterales populations were monitored using selective culture, MALDI-TOF identification and antibiotic resistance profiling before and after a wastewater backflow event. When transfer between sinks was suspected, isolates were compared using whole-genome sequencing. Immediately after the wastewater backflow, two KPC-producing Enterobacter cloacae were recovered from a waste trap in which Carbapenemase-producing Enterobacterales (CPE) had not been detected previously. The isolates belonged to ST501 and ST31 and were genetically indistinguishable to those colonising sinks elsewhere in the system. Following inter-sink transfer, KPC-producing E. cloacae ST501 successfully integrated into the microbiome of the recipient sink and was detected in the waste trap water at least five months after the backflow event. Seven weeks and three months after the backflow, other inter-sink transfers involving Escherichia coli ST5295 and KPC-producing E. cloacae ST501 were also observed. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control)
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14 pages, 16471 KiB  
Article
Microbial Sharing between Pediatric Patients and Therapy Dogs during Hospital Animal-Assisted Intervention Programs
by Kathryn R. Dalton, Kathy Ruble, Laurel E. Redding, Daniel O. Morris, Noel T. Mueller, Roland J. Thorpe, Jr., Jacqueline Agnew, Karen C. Carroll, Paul J. Planet, Ronald C. Rubenstein, Allen R. Chen, Elizabeth A. Grice and Meghan F. Davis
Microorganisms 2021, 9(5), 1054; https://doi.org/10.3390/microorganisms9051054 - 13 May 2021
Cited by 10 | Viewed by 4182
Abstract
Microbial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs is unknown. Understanding microbial transmission between patients and therapy dogs can provide important [...] Read more.
Microbial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs is unknown. Understanding microbial transmission between patients and therapy dogs can provide important insights into potential health benefits for patients, in addition to addressing concerns regarding potential pathogen transmission that limits program utilization. This study evaluated for potential microbial sharing between pediatric patients and therapy dogs and tested whether patient–dog contact level and a dog decolonization protocol modified this sharing. Patients, therapy dogs, and the hospital environment were sampled before and after every group therapy session and samples underwent 16S rRNA sequencing to characterize microbial communities. Both patients and dogs experienced changes in the relative abundance and overall diversity of their nasal microbiome, suggesting that the exchange of microorganisms had occurred. Increased contact was associated with greater sharing between patients and therapy dogs, as well as between patients. A topical chlorhexidine-based dog decolonization was associated with decreased microbial sharing between therapy dogs and patients but did not significantly affect sharing between patients. These data suggest that the therapy dog is both a potential source of and a vehicle for the transfer of microorganisms to patients but not necessarily the only source. The relative contribution of other potential sources (e.g., other patients, the hospital environment) should be further explored to determine their relative importance. Full article
(This article belongs to the Special Issue Research in Hospital Infection Control)
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