In vivo and in vitro evaluation of alcohol-based hand antiseptics by national/international standards

Hastane enfeksiyonlarının önlenmesi ile ilgili en önemli unsurlar arasında el hijyeni yer almaktadır. El hijyeni el yıkama yanı sıra antiseptiklerin ele uygulanması ile de sağlanmaktadır. El hijyenini sağlamak üzere hastanelerde yaygın kullanım alanı bulan alkol bazlı antiseptiklerin etkililiğini değerlendirmeye yönelik çeşitli standartlar bulunmaktadır. EN1500 standardı Avrupa?da kullanılan en yaygın standart olup Türk Standartları Enstitüsü tarafından da aynen kabul edilerek yürürlüğe konmuştur. Çalışmamızda beş adet ticari el antiseptiği ve Dünya Sağlık Örgütü tarafından önerilen el antiseptik formülasyonu-II?nin etkililiği 3 ml x 30 saniye x 1 ve 3 ml x 30 saniye x 2 uygulama şekilleri için EN1500 standardı ile değerlendirilmiştir. 3 ml x 30 saniye x 1 şeklinde uygulandığında test edilen antiseptiklerin hiçbiri standardın gereğini sağlayamamıştır. 3 ml x 30 saniye x 2 şeklinde uygulandıklarında bütün antiseptikler EN1500 standardını sağlamaktadır. Etiketlerinde genellikle 3 ml x 30 saniye x 1 şeklinde uygulanmaları önerilen alkol bazlı el antiseptiklerinin uygulama süreleri uzatılmalı ya da 30 saniyede etkinlik sağlamak isteniyorsa alkol oranı daha yüksek el antiseptikleri kullanılmalıdır.Hand hygiene is among the most important measures in preventing hospital acquired infections. Hand hygiene is achieved through hand washing as well as application of antiseptics to hands. There are various standards on the evaluation of the efficacy of alcohol-based antiseptics that are in widespread use in hospitals. The EN1500 standard is the most commonly used standard in this field in Europe and has also been accepted in its entirety and entered into force by the Turkish Standards Institution. In our study, efficacies of five commercially available hand antiseptics as well as that of the hand antiseptic Formulation-II suggested by the World Health Organization have been evaluated with the EN1500 standard for the 3 ml x 30 seconds x 1 and 3 ml x 30 seconds x 2 application patterns. When applied in the 3 ml x 30 seconds x 1 pattern, none of the tested antiseptics has been able to meet the requirements of the standard. When applied in the 3 ml x 30 seconds x 2 pattern, all the tested antiseptics meet the requirements of the EN1500 standard. The application times of the alcohol-based hand antiseptics, which are generally recommended to be applied in a 3 ml x 30 seconds x 1 pattern in product labeling, should be extended, or if achieving efficiency within 30 seconds is desired, hand antiseptics with high alcohol content should be used

Investigation of methicillin resistant Staphylococcus aureus in neonatal intensive care unit

Methicillin resistant Staphylococcus aureus (MRSA) strains lead to severe infections in immunosupressive patients, geriatric population and premature infants. 27 MRSA strains isolated in the Neonatal Intensive Care Unit was considered as an outbreak and it was aimed to investigate the genetic and epidemiologic relation of the MRSA outbreak. MecA gene was investigated in the S. aureus strains and pulsed field gel electrophoresis (PFGE) was used to investigate the genetic relation between outbreak strains. MecA gene was showed in all isolates. PFGE revealed that there were two different strains and most of the isolates (25/27) were owing to same clone. One of the samples were found closely related with the common strain and the other sample was found genetically unrelated. To terminate the outbreak; liquid baby food was gained to the baby food kitchen, no more new patient was imported to the neonatal unit and none of the patients were exported from neonatal unit to other clinics during outbreak, education about infection control precautions was given to all the staff and nursing bottle dishwasher was obtained. To manage and terminate the outbreak, besides the infection control precautions, tests to determine the genetic relation between outbreak strains which are done in the microbiology laboratory are needed. Molecular analysis of outbreak strains will contribute to prove the epidemiologic and evolution of outbreaks

Frequency of azole resistance in clinical and environmental strains of Aspergillus fumigatus in Turkey: a multicentre study.

Objectives Aspergillus fumigatus causes several diseases in humans and azole resistance in A. fumigatus strains is an important issue. The aim of this multicentre epidemiological study was to investigate the prevalence of azole resistance in clinical and environmental A. fumigatus isolates in Turkey. Methods Twenty-one centres participated in this study from 1 May 2018 to 1 October 2019. One participant from each centre was asked to collect environmental and clinical A. fumigatus isolates. Azole resistance was screened for using EUCAST agar screening methodology (EUCAST E.DEF 10.1) and was confirmed by the EUCAST E.DEF 9.3 reference microdilution method. Isolates with a phenotypic resistance pattern were sequenced for the cyp51A gene and microsatellite genotyping was used to determine the genetic relationships between the resistant strains. Results In total, resistance was found in 1.3% of the strains that were isolated from environmental samples and 3.3% of the strains that were isolated from clinical samples. Mutations in the cyp51A gene were detected in 9 (47.4%) of the 19 azole-resistant isolates, all of which were found to be TR34/L98H mutations. Microsatellite genotyping clearly differentiated the strains with the TR34/L98H mutation in the cyp51A gene from the strains with no mutation in this gene. Conclusions The rate of observed azole resistance of A. fumigatus isolates was low in this study, but the fact that more than half of the examined strains had the wild-type cyp51A gene supports the idea that other mechanisms of resistance are gradually increasing