The unintended contribution of clinical microbiology laboratories to climate change and mitigation strategies:a combination of descriptive study, short survey, literature review and opinion

Objective: Climate change poses a significant threat to humanity and human activity is largely responsible for it. Clinical microbiology laboratories have their unintended shares in carbon dioxide (CO2) emissions. The aim of this study is to estimate CO2 emission of a clinical microbiology laboratory and to propose initiatives to reduce the emissions. Methods: CO2 emission of instruments was estimated based on their electricity consumption. CO2 emitted in producing consumables was estimated by weighing the consumables needed to perform major tests in a large academic hospital. A systematic literature review was performed to identify studies on the impact of clinical microbiology laboratories on the environment. A short survey was sent to four major manufacturers of agar plates on initiatives to reduce the environmental impact of their products. Opinion was given on activities that can reduce CO2 emission in laboratories. Results: The study shows that the largest amount of CO2 emission in the microbiological laboratories comes from consumables and personnel commuting. For example, the production and transportation of agar plates needed to culture samples for a year in a hospital with 1320 beds result in 16 590 kg CO2 is emitted. All survey participants mentioned that they were committed to reduce environmental impact of their products. The initiatives to reduce CO2 emission can be performed at the laboratory and at policy level, such as reducing the number of tests to only the necessary amount to reduce consumables. Discussion: The calculations contribute to map CO2-related emissions in clinical microbiology laboratory activities, and the proposed initiatives to reduce the CO2 may serve as starting point for further discussions

Combating the complex global challenge of antimicrobial resistance:What can antimicrobial stewardship contribute?

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Sulfate-Reducing Microorganisms in Wetlands – Fameless Actors in Carbon Cycling and Climate Change

Freshwater wetlands are a major source of the greenhouse gas methane but at the same time can function as carbon sink. Their response to global warming and environmental pollution is one of the largest unknowns in the upcoming decades to centuries. In this review, we highlight the role of sulfate-reducing microorganisms (SRM) in the intertwined element cycles of wetlands. Although regarded primarily as methanogenic environments, biogeochemical studies have revealed a previously hidden sulfur cycle in wetlands that can sustain rapid renewal of the small standing pools of sulfate. Thus, dissimilatory sulfate reduction, which frequently occurs at rates comparable to marine surface sediments, can contribute up to 36–50% to anaerobic carbon mineralization in these ecosystems. Since sulfate reduction is thermodynamically favored relative to fermentative processes and methanogenesis, it effectively decreases gross methane production thereby mitigating the flux of methane to the atmosphere. However, very little is known about wetland SRM. Molecular analyses using dsrAB [encoding subunit A and B of the dissimilatory (bi)sulfite reductase] as marker genes demonstrated that members of novel phylogenetic lineages, which are unrelated to recognized SRM, dominate dsrAB richness and, if tested, are also abundant among the dsrAB-containing wetland microbiota. These discoveries point toward the existence of so far unknown SRM that are an important part of the autochthonous wetland microbiota. In addition to these numerically dominant microorganisms, a recent stable isotope probing study of SRM in a German peatland indicated that rare biosphere members might be highly active in situ and have a considerable stake in wetland sulfate reduction. The hidden sulfur cycle in wetlands and the fact that wetland SRM are not well represented by described SRM species explains their so far neglected role as important actors in carbon cycling and climate change

Pseudomonas aeruginosa and Staphylococcus aureus virulence factors as biomarkers of infection

The gold standard for the diagnosis of bacterial infections in clinical samples is based on culture tests that are time-consuming and labor-intense. For these reasons, an extraordinary effort has been made to identify biomarkers as the tools for sensitive, rapid and accurate identification of pathogenic microorganisms. Moreover, biomarkers have been tested to distinguish colonization from infection, monitor disease progression, determine the clinical status of patients or predict clinical outcomes. This mini-review describes Pseudomonas aeruginosa and Staphylococcus aureus biomarkers, which contribute to pathogenesis and have been used in culture-independent bacterial identification directly from patient samples

Information technology in management personnel on the example of KC "Jobs"

Analysis of the workings and personnel decisions in the field of human resource management. They are inextricably linked to the processes of information processing. The higher the effect of the use of personnel information, the more objective decisions will be made by the heads of a wide variety of human resources issues. In this regard, there is a need in the compilation and dissemination of the experience gained in the application of modern technologies, as well the creation of new software products. Consideration of "human process management" module. It is designed to automate the management processes in terms of the conduct of personnel information in the context of positions and employees in order to provide the head of information for management decision making and carrying out related activities. Consideration of the positive and negative sides of the module, as its distinctivefeatures

Enterococcus faecium:from microbiological insights to practical recommendations for infection control and diagnostics

Early in its evolution, Enterococcus faecium acquired traits that allowed it to become a successful nosocomial pathogen. E. faecium inherent tenacity to build resistance to antibiotics and environmental stressors that allows the species to thrive in hospital environments. The continual wide use of antibiotics in medicine has been an important driver in the evolution of E. faecium becoming a highly proficient hospital pathogen.For successful prevention and reduction of nosocomial infections with vancomycin resistant E. faecium (VREfm), it is essential to focus on reducing VREfm carriage and spread. The aim of this review is to incorporate microbiological insights of E. faecium into practical infection control recommendations, to reduce the spread of hospital-acquired VREfm (carriage and infections). The spread of VREfm can be controlled by intensified cleaning procedures, antibiotic stewardship, rapid screening of VREfm carriage focused on high-risk populations, and identification of transmission routes through accurate detection and typing methods in outbreak situations. Further, for successful management of E. faecium, continual innovation in the fields of diagnostics, treatment, and eradication is necessary

Analysis of collection of hemolytic uremic syndrome-associated enterohemorrhagic Escherichia coli

Multilocus sequence typing of 169 non-O157 enterohemorrhagic Escherichia coli (EHEC) isolated from patients with hemolytic uremic syndrome (HUS) demonstrated 29 different sequence types (STs); 78.1% of these strains clustered in 5 STs. From all STs and serotypes identified, we established a reference panel of EHEC associated with HUS (HUSEC collection).</p

Exploration of oxygen-mediated disinfection of medical devices reveals a high sensitivity of Pseudomonas aeruginosa to elevated oxygen levels

The microbiological safety of medical devices is of paramount importance for patients and manufacturers alike. However, during usage medical devices will inevitably become contaminated with microorganisms, including opportunistic pathogens. This is a particular problem if these devices come in contact with body sites that carry high bacterial loads, such as the oral cavity. In the present study, we investigated whether high oxygen concentrations can be applied to disinfect surfaces contaminated with different Gram-positive and Gram-negative bacteria. We show that some opportunistic pathogens, exemplified by Pseudomonas aeruginosa, are particularly sensitive to oxygen concentrations above the atmospheric oxygen concentration of 21%. Our observations also show that high oxygen concentrations can be applied to reduce the load of P. aeruginosa on nebulizers that are used by cystic fibrosis patients, who are particularly susceptible to colonization and infection by this bacterium. We conclude that the efficacy of oxygen-mediated disinfection depends on the bacterial species, duration of oxygen exposure and the oxygen concentration. We consider these observations relevant, because gas mixtures with high oxygen content can be readily applied for microbial decontamination. However, the main challenge for oxygen-based disinfection approaches resides in a potentially incomplete elimination of microbial contaminants, which makes combined usage with other disinfectants like ethanol or hydrogen peroxide recommendable

Microbiological evaluation of a new growth-based approach for rapid detection of methicillin-resistant Staphylococcus aureus

OBJECTIVES: Recently, a rapid screening tool for methicillin-resistant Staphylococcus aureus (MRSA) has been introduced that applies a novel detection technology allowing the rapid presence or absence of MRSA to be determined from an enrichment broth after only a few hours of incubation. To evaluate the reliability of this new assay to successfully detect MRSA strains of different origin and clonality, well-characterized S. aureus strains were tested in this study. METHODS: More than 700 methicillin-susceptible and methicillin-resistant strains covering >90% of all registered European MRSA spa types within the SeqNet network were studied. RESULTS: All 513 MRSA strains tested were recognized as methicillin-resistant: among these, 96 MRSA strains were from an institutional collection, each presenting a unique spa type. None of the 211 methicillin-susceptible strains were detected as positive. CONCLUSIONS: The new growth-based rapid MRSA assay was shown to detect without exception all MRSA strains of large collections of strains comprising highly diverse genetic backgrounds, indicating that such a phenotypic test might be potentially more likely to cope with new strains

Diagnostic Evasion of Highly-Resistant Microorganisms:A Critical Factor in Nosocomial Outbreaks

Highly resistant microorganisms (HRMOs) may evade screening strategies used in routine diagnostics. Bacteria that have evolved to evade diagnostic tests may have a selective advantage in the nosocomial environment. Evasion of resistance detection can result from the following mechanisms: low-level expression of resistance genes not resulting in detectable resistance, slow growing variants, mimicry of wild-type-resistance, and resistance mechanisms that are only detected if induced by antibiotic pressure. We reviewed reports on hospital outbreaks in the Netherlands over the past 5 years. Remarkably, many outbreaks including major nation-wide outbreaks were caused by microorganisms able to evade resistance detection by diagnostic screening tests. We describe various examples of diagnostic evasion by several HRMOs and discuss this in a broad and international perspective. The epidemiology of hospital-associated bacteria may strongly be affected by diagnostic screening strategies. This may result in an increasing reservoir of resistance genes in hospital populations that is unnoticed. The resistance elements may horizontally transfer to hosts with systems for high-level expression, resulting in a clinically significant resistance problem. We advise to communicate the identification of HRMOs that evade diagnostics within national and regional networks. Such signaling networks may prevent inter-hospital outbreaks, and allow collaborative development of adapted diagnostic tests