干燥过氧化氢对耳念珠菌环境污染的影响

Jennifer Sanguinet, Gerard Marshall, Julia Moody, Kenneth Sands
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DHP-emitting systems were installed in the ventilation systems dedicated to the adult burn intensive care and children’s cardiac intensive care units. Composite surface samples were collected in a sample of patient rooms and shared clinical workspaces among units with current C. auris patients, before and after installation of the DHP system, and from areas with and without exposure to DHP. The samples included “high touch” surfaces near the patient, the general area of the patient room, shared medical equipment for the unit, shared staff work areas, and equipment dedicated to individual staff members (Table 1). Presence of C. auris was determined by polymerase chain reaction (PCR). Association between DHP exposure and C. auris contamination was determined using the Fisher exact test. Results: In the presence of C. auris patients, 5 baseline samples per unit were taken before DHP was installed, and then 5 samples per unit were taken on days 7, 14, and 28 after installation. 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摘要

背景:耳念珠菌是一种新兴的病原体,表现出广泛的抗微生物药物耐药性并引起高度病态的感染。已证明在表面上存活时间长,标准消毒剂可能无法达到充分的消毒效果。持续的患者定植和持续的环境再污染构成感染风险,可通过无接触消毒系统减轻感染风险。我们评估了连续干燥过氧化氢(DHP)暴露对金黄色葡萄球菌环境污染的影响。方法:该研究是在一个大型三级保健中心进行的,其中多名患者被确定为感染或定植了金黄色葡萄球菌。在成人烧伤重症监护病房和儿童心脏重症监护病房专用的通风系统中安装了dhp排放系统。在安装DHP系统之前和之后,以及在暴露于DHP和未暴露于DHP的地区,在现有auris患者的单位之间的病房和共用临床工作空间的样本中收集复合表面样本。样本包括患者附近的“高接触”表面、病房的一般区域、共用医疗设备、共用工作人员工作区和专用于个人工作人员的设备(表1)。通过聚合酶链反应(PCR)确定了金黄色葡萄球菌的存在。使用Fisher精确试验确定DHP暴露与耳球菌污染之间的关系。结果:在auris患者存在的情况下,DHP安装前每单位采集5个基线样本,安装后第7、14、28天每单位采集5个样本。DHP开始前,10份样品中有7份(70%)为金黄色葡萄球菌PCR阳性。安装DHP后,30个样品中有5个(16.7%)下降,具有统计学意义(P < 0.05)。当天共从未安装DHP的机组中采集20个样品(安装前5个,安装后15个)。在基线时,5个样本中有2个(40%)为金黄色葡萄球菌PCR阳性。在随后的时间里,4(27%)15个样本呈阳性(P = 0.66)。患者、访客或与DHP系统操作相关的人员均未报告不良反应。结论:这些发现表明DHP可有效减少各种患者和医护人员表面的耳c菌污染。披露:没有
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Effect of dry hydrogen peroxide on Candida auris environmental contamination
Background: Candida auris is an emerging pathogen that exhibits broad antimicrobial resistance and causes highly morbid infections. Prolonged survival on surfaces has been demonstrated, and standard disinfectants may not achieve adequate disinfection. Persistent patient colonization and constant environmental recontamination poses an infection risk that may be mitigated by no touch disinfection systems. We evaluated the efficacy of continuous dry hydrogen peroxide (DHP) exposure on C. auris environmental contamination. Methods: The study was conducted in a large tertiary-care center where multiple patients were identified as either infected or colonized with C. auris . DHP-emitting systems were installed in the ventilation systems dedicated to the adult burn intensive care and children’s cardiac intensive care units. Composite surface samples were collected in a sample of patient rooms and shared clinical workspaces among units with current C. auris patients, before and after installation of the DHP system, and from areas with and without exposure to DHP. The samples included “high touch” surfaces near the patient, the general area of the patient room, shared medical equipment for the unit, shared staff work areas, and equipment dedicated to individual staff members (Table 1). Presence of C. auris was determined by polymerase chain reaction (PCR). Association between DHP exposure and C. auris contamination was determined using the Fisher exact test. Results: In the presence of C. auris patients, 5 baseline samples per unit were taken before DHP was installed, and then 5 samples per unit were taken on days 7, 14, and 28 after installation. Prior to initiation of DHP, 7 (70%) of 10 samples were PCR positive for C. auris . After DHP installation, a statistically significant decrease to 5 (16.7%) of 30 samples ( P <.05) was observed. In total, 20 samples (5 before installation and 15 after installation) were collected from units without DHP on the same days. At baseline, 2 (40%) of 5 samples were PCR positive for C. auris . During subsequent periods, 4 (27%) 15 samples were positive ( P = .66). No adverse effects were reported by patients, visitors, or personnel in association with the operation of the DHP systems. Conclusions: These findings suggest that DHP is effective in reducing surface C. auris contamination in a variety of patient and healthcare worker surfaces. Disclosures: None
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