Outbreak response management of a COVID-19 patient diagnosed on an open ward in Singapore

10.3396/ijic.v16i1.003.20International Journal of Infection Control16

Effectiveness of a Ward level target accountability strategy for hand hygiene

10.1186/s13756-019-0641-0ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL8

The impact of a 'milking the COW' campaign in a regional hospital in Singapore

10.1186/s13756-021-00948-1ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL10

Impact of COVID-19 pandemic on carbapenem-resistant Enterobacterales incidence in the South-East Asia region: an observational study

The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness

Antecedent carbapenem exposure as a risk factor for non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae and carbapenemase-producing Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) can be mechanistically classified into carbapenemase-producing Enterobacteriaceae (CPE) and non-carbapenemase-producing carbapenem nonsusceptible Enterobacteriaceae (NCPCRE). We sought to investigate the effect of antecedent carbapenem exposure as a risk factor for NCPCRE versus CPE. Among all patients with CRE colonization and infection, we conducted a case-control study comparing patients with NCPCRE (cases) and patients with CPE (controls). The presence of carbapenemases was investigated with phenotypic tests followed by PCR for predominant carbapenemase genes. We included 843 unique patients with first-episode CRE, including 387 (45.9%) NCPCRE and 456 (54.1%) CPE. The resistance genes detected in CPEs were bla(NDM) (42.8%), bla(KPC) (38.4%), and bla(OXA-48-like) (12.1%). After adjusting for confounders and clustering at the institutional level, the odds of prior 30-day carbapenem exposure was three times higher among NCPCRE than CPE patients (adjusted odds ratio (aOR), 3.48; 95% confidence interval (CI), 2.39 to 5.09; P < 0.001). The odds of prior carbapenem exposure and NCPCRE detection persisted in stratified analyses by Enterobacteriaceae species (Kleb-siella pneumoniae and Escherichia coh) and carbapenemase gene (bla(NDM) and bla(KPC)). CPE was associated with male gender (aOR, 1.45; 95% CI, 1.07 to 1.97; P = 0.02), intensive care unit stay (aOR, 1.84; 95% CI, 1.24 to 2.74; P = 0.003), and hospitalization in the preceding 1 year (aOR, 1.42; 95% CI, 1.01 to 2.02; P = 0.05). In a large nationwide study, antecedent carbapenem exposure was a significant risk factor for NCPCRE versus CPE, suggesting a differential effect of antibiotic selection pressure

Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales

10.1038/s41467-022-30637-5NATURE COMMUNICATIONS131complete