2 research outputs found
Density and molecular epidemiology of Aspergillus in air and relationship to outbreaks of Aspergillus infection
After five patients were diagnosed with nosocomial invasive aspergillosis
caused by Aspergillus fumigatus and A. flavus, a 14-month surveillance
program for pathogenic and nonpathogenic fungal conidia in the air within
and outside the University Hospital in Rotterdam (The Netherlands) was
begun. A. fumigatus isolates obtained from the Department of Hematology
were studied for genetic relatedness by randomly amplified polymorphic DNA
(RAPD) analysis. This was repeated with A. fumigatus isolates
contaminating culture media in the microbiology laboratory. The density of
the conidia of nonpathogenic fungi in the outside air showed a seasonal
variation: higher densities were measured during the summer, while lower
densities were determined during the fall and winter. Hardly any variation
was found in the numbers of Aspergillus conidia. We found decreasing
numbers of conidia when comparing air from outside the hospital to that
inside the hospital and when comparing open areas within the hospital to
the closed department of hematology. The increase in the number of
patients with invasive aspergillosis could not be explained by an increase
in the number of Aspergillus conidia in the outside air. The short-term
presence of A. flavus can only be explained by the presence of a point
source, which was probably patient related. Genotyping A. fumigatus
isolates from the department of hematology showed that clonally related
isolates were persistently present for more than 1 year. Clinical isolates
of A. fumigatus obtained during the outbreak period were different from
these persistent clones. A. fumigatus isolates contaminating culture media
were all genotypically identical, indicating a causative point source.
Kn
5 years of experience implementing a methicillin-resistant Staphylococcus aureus search and destroy policy at the largest university medical center in the Netherlands
OBJECTIVE: To evaluate the effectiveness of a rigorous search and destroy policy for controlling methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. DESIGN: Hospital-based observational follow-up study. SETTING: Erasmus University Medical Center Rotterdam, a 1,200-bed tertiary care center in Rotterdam, the Netherlands. METHODS: Outbreak control was accomplished by the use of active surveillance cultures for persons at risk, by the preemptive isolation of patients at risk, and by the strict isolation of known MRSA carriers and the eradication of MRSA carriage. For unexpected cases of MRSA colonization or infection, patients placed in strict isolation or contact isolation and healthcare workers (HCWs) were screened. We collected data from 2000-2004. RESULTS: During the 5-year study period, 51,907 MRSA screening culture