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At least 127 records · Page 7
All sourcesNASA NTRSDOE OSTI
DOE OSTI2020

A microbiological survey of handwashing sinks in the hospital built environment reveals differences in patient room and healthcare personnel sinks

Handwashing sinks and their associated premise plumbing are an ideal environment for pathogen-harboring biofilms to grow and spread throughout facilities due to the connected system of wastewater plumbing. This study was designed to understand the distribution of pathogens and antibiotic resistant organisms (ARO) within and among handwashing sinks in healthcare settings, using culture-dependent methods to quantify Pseudomonas aeruginosa, opportunistic pathogens capable of growth on a cefotaxime-containing medium (OPP-C), and carbapenem-resistant Enterobacteriaceae (CRE). Isolates from each medium identified as P. aeruginosa or Enterobacteriaceae were tested for susceptibility to aztreonam, ceftazidime, and meropenem; Enterobacteriaceae were also tested against ertapenem and cefotaxime. Isolates exhibiting resistance or intermediate resistance were designated ARO. Pathogens were quantified at different locations within handwashing sinks and compared in quantity and distribution between healthcare personnel (HCP) and patient room (PR) sinks. ARO were compared between samples within a sink (biofilm vs planktonic samples) and between sink types (HCP vs. PR). The drain cover was identified as a reservoir within multiple sinks that was often colonized by pathogens despite daily sink cleaning. P. aeruginosa and OPP-C mean log 10 CFU/cm 2 counts were higher in p-trap and tail pipe biofilm samples from HCP compared to PR sinks (2.77 ± 2.39 vs. 1.23 ± 1.62 and 5.27 ± 1.10 vs. 4.74 ± 1.06) for P. aeruginosa and OPP-C, respectively. P. aeruginosa and OPP-C mean log 10 CFU/ml counts were also higher (p < 0.05) in HCP compared to PR sinks p-trap water (2.21 ± 1.52 vs. 0.89 ± 1.44 and 3.87 ± 0.78 vs. 3.21 ± 1.11) for P. aeruginosa and OPP-C, respectively. However, a greater percentage of ARO were recovered from PR sinks compared to HCP sinks (p < 0.05) for Enterobacteriaceae (76.4 vs. 32.9%) and P. aeruginosa (25.6 vs. 0.3%). This study supports previous work citing that handwashing sinks are reservoirs for pathogens and ARO and identifies differences in pathogen and ARO quantities between HCP and PR sinks, despite the interconnected premise plumbing.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Fitness cost of vancomycin-resistant Enterococcus faecium plasmids associated with hospital infection outbreaks

Abstract Background Vancomycin resistance is mostly associated with Enterococcus faecium due to Tn1546-vanA located on narrow- and broad-host plasmids of various families. This study’s aim was to analyse the effects of acquiring Tn1546-carrying plasmids with proven epidemicity in different bacterial host backgrounds. Methods Widespread Tn1546-carrying plasmids of different families RepA_N (n = 5), Inc18 (n = 4) and/or pHTβ (n = 1), and prototype plasmids RepA_N (pRUM) and Inc18 (pRE25, pIP501) were analysed. Plasmid transferability and fitness cost were assessed using E. faecium (GE1, 64/3) and Enterococcus faecalis (JH2-2/FA202/UV202) recipient strains. Growth curves (Bioscreen C) and Relative Growth Rates were obtained in the presence/absence of vancomycin. Plasmid stability was analysed (300 generations). WGS (Illumina-MiSeq) of non-evolved and evolved strains (GE1/64/3 transconjugants, n = 49) was performed. SNP calling (Breseq software) of non-evolved strains was used for comparison. Results All plasmids were successfully transferred to different E. faecium clonal backgrounds. Most Tn1546-carrying plasmids and Inc18 and RepA_N prototypes reduced host fitness (–2% to 18%) while the cost of Tn1546 expression varied according to the Tn1546-variant and the recipient strain (9%–49%). Stability of Tn1546-carrying plasmids was documented in all cases, often with loss of phenotypic resistance and/or partial plasmid deletions. SNPs and/or indels associated with essential bacterial functions were observed on the chromosome of evolved strains, some of them linked to increased fitness. Conclusions The stability of E. faecium Tn1546-carrying plasmids in the absence of selective pressure and the high intra-species conjugation rates might explain the persistence of vancomycin resistance in E. faecium populations despite the significant burden they might impose on bacterial host strains.

Tedim, Ana P.↗
DOE OSTI2020

Clusters of COVID ‐19 in long‐term care hospitals and facilities in Japan from 16 January to 9 May 2020

Aim To clarify the association of cluster number and size of coronavirus disease 2019 (COVID‐19) in long‐term care (LTC) hospitals/facilities, general medical/welfare facilities and non‐medical/welfare facilities with morbidity and mortality in 47 prefectures during 16 January to 9 May 2020 in Japan. Methods Information on COVID‐19 clusters ( n ≥2), and morbidity and mortality of COVID‐19 was collected. Results A total of 381 clusters with 3786 infected cases were collected, accounting for 23.9% of 15 852 cumulated cases on 9 May 2020. Although the cluster number (/10 7 subjects) in LTC hospitals/facilities was significantly smaller compared with those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non‐medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non‐medical/welfare facilities were significantly positively correlated with morbidity (/10 5 ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LTC hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis showed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (≥median 0.64/10 5 subjects) after adjustment. Conclusions Preventive efforts against COVID‐19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, as both the larger number and size of clusters only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. Geriatr Gerontol Int 2020; 20: 715–719 .

Iritani, Osamu↗
DOE OSTI2014

Poster — Thur Eve — 11: Validation of the orthopedic metallic artifact reduction tool for CT simulations at the Ottawa Hospital Cancer Centre

Metallic implants in patients can produce image artifacts in kilovoltage CT simulation images which can introduce noise and inaccuracies in CT number, affecting anatomical segmentation and dose distributions. The commercial orthopedic metal artifact reduction algorithm (O-MAR) (Philips Healthcare System) was recently made available on CT simulation scanners at our institution. This study validated the clinical use of O-MAR by investigating its effects on CT number and dose distributions. O-MAR corrected and uncorrected images were acquired with a Philips Brilliance Big Bore CT simulator of a cylindrical solid water phantom that contained various plugs (including metal) of known density. CT number accuracy was investigated by determining the mean and standard deviation in regions of interest (ROI) within each plug for uncorrected and O-MAR corrected images and comparing with no-metal image values. Dose distributions were calculated using the Monaco treatment planning system. Seven open fields were equally spaced about the phantom around a ROI near the center of the phantom. These were compared to a “correct” dose distribution calculated by overriding electron densities a no-metal phantom image to produce an image containing metal but no artifacts. An overall improvement in CT number and dose distribution accuracy was achieved by applying the O-MAR correction. Mean CT numbers and standard deviations were found to be generally improved. Exceptions included lung equivalent media, which is consistent with vendor specified contraindications. Dose profiles were found to vary by ±4% between uncorrected or O-MAR corrected images with O-MAR producing doses closer to ground truth.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Hospitalized Premature Infants Are Colonized by Related Bacterial Strains with Distinct Proteomic Profiles

During the first weeks of life, microbial colonization of the gut impacts human immune system maturation and other developmental processes. In premature infants, aberrant colonization has been implicated in the onset of necrotizing enterocolitis (NEC), a life-threatening intestinal disease. To study the premature infant gut colonization process, genome-resolved metagenomics was conducted on 343 fecal samples collected during the first 3 months of life from 35 premature infants housed in a neonatal intensive care unit, 14 of whom developed NEC, and metaproteomic measurements were made on 87 samples. Microbial community composition and proteomic profiles remained relatively stable on the time scale of a week, but the proteome was more variable. Although genetically similar organisms colonized many infants, most infants were colonized by distinct strains with metabolic profiles that could be distinguished using metaproteomics. Microbiome composition correlated with infant, antibiotics administration, and NEC diagnosis. Communities were found to cluster into seven primary types, and community type switched within infants, sometimes multiple times. Interestingly, some communities sampled from the same infant at subsequent time points clustered with those of other infants. In some cases, switches preceded onset of NEC; however, no species or community type could account for NEC across the majority of infants. In addition to a correlation of protein abundances with organism replication rates, we found that organism proteomes correlated with overall community composition. Thus, this genome-resolved proteomics study demonstrated that the contributions of individual organisms to microbiome development depend on microbial community context.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2019

Draft Genome Sequences of Two Staphylococcus warneri Clinical Isolates, Strains SMA0023-04 (UGA3) and SMA0670-05 (UGA28), from Siaya County Referral Hospital, Siaya, Kenya

We report the complete draft genome sequences of two Staphylococcus warneri clinical isolates, strains SMA0023-04 (UGA3) and SMA0670-05 (UGA28), each of which contains one chromosome and at least one plasmid. Isolate SMA0023-04 (UGA3) contains tetracycline efflux major facilitator superfamily (MFS) transporter ( tetK ), macrolide resistance ( msrC and mphC ), and beta-lactamase ( blaZ ) genes on its plasmids.

Xie, Gary↗
DOE OSTI2019

Target Folder General Hospital Example

The facility described here within as well as associated documented Target Folder information is hypothetical in nature and provided only to serve as an example of the type and detail of information that should be collected to generate a thorough Target Folder.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2020

Uncertainty Analysis Framework for the Hospital Resource Supply Model for Covid-19

In March and April of 2020 there was widespread concern about availability of medical resources required to treat Covid-19 patients who become seriously ill. A simulation model of supply management was developed to aid understanding of how to best manage available supplies and channel new production. Forecasted demands for critical therapeutic resources have tremendous uncertainty, largely due to uncertainties about the number and timing of patient arrivals. It is therefore essential to evaluate any process for managing supplies in view of this uncertainty. To support such evaluations, we developed a modeling framework that would allow an integrated assessment in the context of uncertainty quantification. At the time of writing there has been no need to execute this framework because adaptations of the medical system have been able to respond effectively to the outbreak. This report documents the framework and its implemented components should need later arise for its application.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗