Cross infection in an intensive care unit by Klebsiella pneumoniae from ventilator condensate

Gorman, L.J.; Sanai, Leyla; Notman, A.W.; Grant, I. S.; Masterton, R.G.

doi:10.1016/0195-6701(93)90127-l

Cited by 35 publications

(10 citation statements)

References 11 publications

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“…Cross‐transmission via HCWs’ hands seems to be important in the nosocomial spread of K. pneumoniae strains . Indeed there is extensive evidence for transmission via the hands of HCWs from colonized patients or environmental reservoirs to new patients, in both epidemic and endemic situations . However, in a recent study, an outbreak caused by contaminated food was described, indicating that transmission may also occur via the food chain .…”

Section: Mechanisms Of Transmissionmentioning

confidence: 99%

ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients

Tacconelli

Cataldo

Dancer

et al. 2014

Clinical Microbiology and Infection

717

555

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Healthcare-associated infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) are a leading cause of morbidity and mortality worldwide. These evidence-based guidelines have been produced after a systematic review of published studies on infection prevention and control interventions aimed at reducing the transmission of MDR-GNB. The recommendations are stratified by type of infection prevention and control intervention and species of MDR-GNB and are presented in the form of 'basic' practices, recommended for all acute care facilities, and 'additional special approaches' to be considered when there is still clinical and/or epidemiological and/or molecular evidence of ongoing transmission, despite the application of the basic measures. The level of evidence for and strength of each recommendation, were defined according to the GRADE approach.

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Section: Mechanisms Of Transmissionmentioning

confidence: 99%

ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients

Tacconelli

Cataldo

Dancer

et al. 2014

Clinical Microbiology and Infection

717

555

View full text Add to dashboard Cite

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“…They have been responsible for outbreaks, particularly in intensive care units and in chronic care facilities, but have occasionally spread also to medical and surgical wards [7-131. Hospital colonisation by ESBL-producing bacteria can reflect dissemination of a few clones, or the spread of plasmids and resistance genes [13][14][15][16][17][18][19][20][21], facilitated by antibiotic pressure and inadequate infection-control practice [9-10, [22][23][24]. Several outbreaks of nosocomial infections caused by ESBL-producing K. pneumoniae occurred in our hospital between 1988 and 199 1.…”

Section: Introductionmentioning

confidence: 99%

Long-term investigation of the clonal dissemination of Klebsiella pneumoniae isolates producing extended-spectrum -lactamases in a university hospital

Branger

Lesimple²,

Berry³

et al. 1998

Journal of Medical Microbiology

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Seventy isolates of Klebsiellu pneumoniae with extended-spectrum /3-lactamases (ESBLs) were compared. These were isolated from 51 patients on 10 separate wards in one hospital over an 18-month period between 1992 and 1994. Antibiograms were determined and the isolates were typed by pulsed-field gel electrophoresis of their DNA digestion with Xbu I. The isolates were compared to three genotypically different epidemic strains responsible for previous outbreaks at the hospital between 1988 and 1991. Isolates from 84% of the present patients had closely related Xbul patterns, and most (74%) produced an ESBL with an iso-electric point (PI) of 7.0. A similar pattern was found for one of the previous epidemic strains, but it produced an ESBL with a PI of 7.8; isolates with this latter enzyme variant were found only in six of the present patients. The two other previous epidemic strains had ESBLs with a PI of 6.3 and organisms related to them were found in one and two of the present patients, respectively.

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“…This is important as ventilator circuits are rapidly colonised by bacteria: Craven et al demonstrated that 33% of circuits were colonised after 2 h, 67% after 12 h and 80% after 24 h [74]. Contaminated condensate in ventilator circuits is a known risk factor for cross‐infection and development of pneumonia [75].…”

Section: Breathing System Filtersmentioning

confidence: 99%

Heat and moisture exchangers and breathing system filters: their use in anaesthesia and intensive care. Part 1 – history, principles and efficiency

Wilkes

2010

Anaesthesia

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SummaryHeat and moisture exchangers and breathing system filters are intended to replace the normal warming, humidifying and filtering functions of the upper airways when these structures are bypassed during anaesthesia and intensive care. Guidance on their use continues to evolve. The aim of this part of the review is to describe the principles of their action and efficiency and to summarise the findings from clinical and laboratory studies. Based on previous studies, an appropriate minimum target for moisture output is 30 and 20 g.m )3 for long-duration use in intensive care and short-duration use in anaesthesia, respectively. The practice of reusing a breathing system in anaesthesia, provided it is protected by a filter, assumes that the filter is effective. However, there is wide variation in the gas-borne filtration performance, and contaminated condensate can potentially pass through some filters under typical pressures encountered during mechanical ventilation.

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Cross infection in an intensive care unit by Klebsiella pneumoniae from ventilator condensate

Cited by 35 publications

References 11 publications

ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients

ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients

Long-term investigation of the clonal dissemination of Klebsiella pneumoniae isolates producing extended-spectrum -lactamases in a university hospital

Heat and moisture exchangers and breathing system filters: their use in anaesthesia and intensive care. Part 1 – history, principles and efficiency

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