Gentamicin-resistant Pseudomonas aeruginosa infection from mattresses in a burns unit.

Fujita, Katsuhide; Lilly, H. A.; Kidson, A.; Ayliffe, G.A.J.

doi:10.1136/bmj.283.6285.219

Cited by 41 publications

(10 citation statements)

References 3 publications

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“…[56][57][58] This suggests that hospital bed textiles become contaminated primarily with the patient's flora and to a lesser degree with those microorganisms already present in the healthcare environment, including pathogens that are particularly adept at long-term survival. [56][57][58][59][60][61] However, the epidemiology of outbreaks associated with laundered, reusable HCTs strongly supports the notion that current industrial laundry processes are effective in interrupting patient-to-patient transmission.…”

Section: Epidemiology Of Hais Attributed To Laundered Hctsmentioning

confidence: 84%

Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues

Sehulster

2015

Infect. Control Hosp. Epidemiol.

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Healthcare professionals have questions about the infection prevention effectiveness of contemporary laundry processes for healthcare textiles (HCTs). Current industrial laundry processes achieve microbial reductions via physical, chemical, and thermal actions, all of which result in producing hygienically clean HCTs. European researchers have demonstrated that oxidative laundry additives have sufficient potency to meet US Environmental Protection Agency benchmarks for sanitizers and disinfectants. Outbreaks of infectious diseases associated with laundered HCTs are extremely rare; only 12 such outbreaks have been reported worldwide in the past 43 years. Root cause analyses have identified inadvertent exposure of clean HCTs to environmental contamination (including but not limited to exposure to dust in storage areas) or a process failure during laundering. To date, patient-to-patient transmission of infection has not been associated with hygienically clean HCTs laundered in accordance with industry process standards. Occupationally acquired infection involved mishandling of soiled HCTs and failure to use personal protective equipment properly. Laboratory studies of antimicrobial treatments for HCTs demonstrate a wide range of activity from 1 to 7 log10 reduction of pathogens under various experimental conditions. Clinical studies are needed to evaluate potential use of these treatments for infection prevention. Microbiological testing of clean HCTs for certification purposes is now available in the United States. Key features (eg, microbial sampling strategy, numbers of textiles sampled) and justification of the testing are discussed.

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Section: Epidemiology Of Hais Attributed To Laundered Hctsmentioning

confidence: 84%

Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues

Sehulster

2015

Infect. Control Hosp. Epidemiol.

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“…The deposited microorganisms could be liberated and re-dispersed into the air [5], or transferred to the surrounding environments through direct or indirect contact [6][7][8][9][10]. Therefore, in real applications, contaminated fibrous materials can be important sources of cross-infections, which have already caused serious outbreaks of nosocomial infections in healthcare facilities [11][12][13][14][15][16]. As "one ounce of prevention equals a pound of cure" in dealing with the global concern of emerging and re-emerging infectious diseases [17,18], there is a clear need to control microbial contaminations on fibrous materials in order to reduce the incidence of infections.…”

Section: Introductionmentioning

confidence: 99%

Biocidal efficacy, biofilm-controlling function, and controlled release effect of chloromelamine-based bioresponsive fibrous materials

2007

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In this study, 2-amino-4-chloro-6-hydroxy-s-triazine (ACHT) was synthesized through controlled hydrolysis of 2-amino-4,6-dichloro-s-triazine (ADCT). A simple paddry-cure approach was employed to immobilize ACHT onto cellulosic fibrous materials. After treatment with diluted chlorine bleach, the covalently bound ACHT moieties were transformed into chloromelamines. The structures of the samples were fully characterized with NMR, UV/VIS, DSC, TG, iodometric titration and elemental analyses. The chloromelamine-based fibrous materials provided potent, durable, and rechargeable biocidal functions against bacteria (including multi-drug resistant species), yeasts, viruses, and bacterial spores. SEM studies demonstrated that the new fibrous materials could effectively prevent the formation of biofilms, and controlled release investigations in vitro suggested that the biocidal activities were bioresponsive. Biocidal mechanisms of the chloromelamine-based fibrous materials were further discussed.

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“…An increased risk of infection and pressure sores is associated with contaminated mattresses [ 1 - 6 ]. This is mostly due to disruption of the integrity of the mattress cover surface [ 7 ].…”

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confidence: 99%

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et al. 2006

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We report a multiresistant Enterobacter cloacae outbreak in an intensive care unit, associated with mattresses and with antibacterial-treated and vapour-permeable polyurethane synthetic mattress covers of therapeutic beds.An increased risk of infection and pressure sores is associated with contaminated mattresses [1][2][3][4][5][6]. This is mostly due to disruption of the integrity of the mattress cover surface [7]. Antibacterial-treated and vapour-permeable polyurethane synthetic mattress covers have been developed to reduce bacterial and fungal colonisation of mattresses. These are currently widely used on therapeutic beds. These covers are considered easy to clean and to disinfect.We report an outbreak associated with recently developed therapeutic beds in an intensive care unit in which there appeared to be satisfactory nursing procedures and in which the mattress covers appeared to be visually intact. Our observations allow us to propose additional measures to the recommended maintenance procedure to avoid this type of hospital infection.Between 1 February and 30 May 2005, a cluster of 15 patients infected/colonised (12 infected and three colonised) by a third-generation cephalosporin-resistant Enterobacter cloacae was observed in the surgery intensive care unit of the teaching hospital of Tours, France. Molecular typing of E. cloacae isolates identified a clonal strain responsible for seven of the infection/colonisation cases (Fig. 1). A review of the procedures and techniques of the intensive care unit medical staff revealed a common factor among the infected/colonised patients: all patients had been nursed on therapeutic beds. These beds (n = 6) consisted of a soft, dense, modern foam mattress covered with a waterproof antibacterially treated permeable polyurethane cover. The mattresses and covers had been recently acquired (<18 months) and the covers were cleaned daily using an adequate procedure according to manufacturer recommendations and with a common hospital cleaning agent.As the beds were the only common factor among the infected/colonised patients, we suspected that these beds participated in the outbreak. However, visual inspection of the covers did not reveal any alterations. We therefore removed the covers and noticed that the foam underneath was stained, especially where the patient had been situated (Fig. 2a) and where the seams of the cover were located (Fig. 2b). Microbial swabbing revealed a high level of bacterial contamination of all six permeable polyurethane covers and mattress foams. We found epidemiological links between environmental and clinical strains from 10 patients (Fig. 1), demonstrating that at least three of the mattresses were the probable cause of the outbreak. The outbreak was stopped by discarding the six contaminated mattresses and covers.The observation of stained foam where the seams of the covers were situated suggested a fault in the impermeability of the covers at this point and suggested that fluids penetrated the foam of the mattress through the seams....

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Gentamicin-resistant Pseudomonas aeruginosa infection from mattresses in a burns unit.

Cited by 41 publications

References 3 publications

Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues

Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues

Biocidal efficacy, biofilm-controlling function, and controlled release effect of chloromelamine-based bioresponsive fibrous materials

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