Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Noble-Wang JA [original query] |
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Surface area matters: An evaluation of swabs and surface area for environmental surface sampling of healthcare pathogens
West RM , Shams AM , Chan MY , Rose LJ , Noble-Wang JA . Infect Control Hosp Epidemiol 2022 44 (5) 1-3 Flocked and foam swabs were used to sample five healthcare pathogens from three sizes of steel and plastic coupons; 26 cm(2), 323 cm(2), and 645 cm(2). As surface area increased, 1-2 log(10) decrease in recovered organisms (P < .05) was observed. Sampling 26-cm(2) yielded the optimal median percent of pathogens recovered. |
The Effect of Disinfectants on the Microbial Community on Environmental Healthcare Surfaces using Next Generation Sequencing.
Perry-Dow KA , de Man T , Halpin AL , Shams AM , Rose LJ , Noble-Wang JA . Am J Infect Control 2021 50 (1) 54-60 BACKGROUND: Healthcare-associated infections (HAIs) are a significant economic burden and cause of avoidable morbidity and mortality within healthcare systems. The contribution of environmental contamination to HAI transmission has been recognized, but the mechanisms by which transmission occurs are still being investigated. The objective of this study was to characterize the microbial communities of disinfected, non-critical healthcare surfaces using next generation sequencing technology. METHODS: Composite environmental surface samples were from high-touch surfaces in rooms of patients isolated for infections with multidrug-resistant organisms during their hospitalization. Information on the disinfectant product used and cleaning type (routine or terminal) was collected. 16S rRNA gene amplicon sequencing and analysis were performed. Community analysis was conducted to determine the bacterial composition and compare the detection of target pathogens by culture from 94 Contact Precaution rooms. RESULTS: Overall percent agreement between culture and sequence methods ranged from 52% to 88%. A significant difference was observed in bacterial composition between rooms cleaned with bleach and those cleaned with a quaternary ammonium compound (QAC) for composite 2 (overbed table, intravenous pole, and inner room door handle) (ANOSIM R2 = 0.66, p = 0.005) but not composite 1 (bed rails, television remote control unit, call buttons, and telephone). CONCLUSIONS: Surfaces in bleach-cleaned rooms contained a higher proportion of gram-positive microbiota, whereas rooms cleaned with QAC contained a higher proportion of gram-negative microbiota, suggesting disinfectant products may impact the healthcare environment microbiome. |
Elution efficiency of healthcare pathogens from environmental sampling tools
West-Deadwyler RM , Moulton-Meissner HA , Rose LJ , Noble-Wang JA . Infect Control Hosp Epidemiol 2019 41 (2) 1-3 Standardizing healthcare surface sampling requires the evaluation of sampling tools for organism adherence. Here, 7 sampling tools were evaluated to assess their elution efficiencies in the presence of 5 pathogens. Foam sponges (80.6%), microfiber wipes (80.5%), foam swabs (77.9%), and cellulose sponges (66.5%) yielded the highest median elution efficiencies. |
Direct Detection of Carbapenem-Resistant Organisms from Environmental Samples Using the GeneXpert Molecular Diagnostic System.
Perry KA , Daniels JB , Reddy SC , Kallen AJ , Halpin AL , Rasheed JK , Noble-Wang JA . mSphere 2018 3 (4) In this pilot study, traditional culture and PCR methods were compared to the Cepheid GeneXpert IV molecular diagnostic system with the Xpert Carba-R assay (Carba-R assay) for detection of carbapenem resistance genes in primary environmental samples collected during a health care-related outbreak. Overall, traditional culture-dependent PCR and the Carba-R assay demonstrated 75% agreement. The Carba-R assay detected carbapenemase genes in five additional samples and in two samples that had additional genes when compared to culture-dependent PCR. The Carba-R assay could be useful for prioritizing further testing of environmental samples during health care-related outbreaks.IMPORTANCE Use of the Carba-R assay for detection of carbapenem-resistant Gram-negative organisms (CROs) can provide data for implementation of a rapid infection control response to minimize the spread of CROs in the health care setting. |
Assessment of the overall and multidrug-resistant organism bioburden on environmental surfaces in healthcare facilities
Shams AM , Rose LJ , Edwards JR , Cali S , Harris AD , Jacob JT , LaFae A , Pineles LL , Thom KA , McDonald LC , Arduino MJ , Noble-Wang JA . Infect Control Hosp Epidemiol 2016 37 (12) 1-7 OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance. RESULTS The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; ≤1-130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; ≤1-4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range ≤1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (≤1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%). CONCLUSIONS This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control. Infect Control Hosp Epidemiol 2016;1-7. |
Persistence of influenza A (H1N1) virus on stainless steel surfaces
Perry KA , Coulliette AD , Rose LJ , Shams AM , Edwards JR , Noble-Wang JA . Appl Environ Microbiol 2016 82 (11) 3239-3245 As annual influenza epidemics continue to cause significant morbidity and economic burden, an understanding of viral persistence and transmission is critical for public health officials and healthcare workers to better protect patients and their family members from infection. The infectivity and persistence of two influenza A (H1N1) strains (A/New Caledonia/20/1999 and A/Brisbane/59/2007) were evaluated on stainless steel (SS) surfaces using three different surfaces matrices (2% fetal bovine serum, 5 mg/mL mucin, and viral medium) at varying absolute humidity conditions (4.1 x 105 mPa, 6.5 x 105 mPa, 7.1 x 105 mPa, 11.4 x 105 mPa, 11.2 x 105 mPa, and 17.9 x 105 mPa) for up to seven days. Influenza virus was deposited onto SS coupons (7.07 cm2) and recovered by agitation and sonicating in viral medium. Viral persistence was quantified using a tissue culture based enzyme-linked immunosorbent assay (ELISA) to determine the median tissue culture infective dose (TCID50) of infectious virus per coupon. Overall, both strains of influenza A virus remained infectious on SS coupons with an approximate 2 log10 loss over seven days. Factors that influenced viral persistence included absolute humidity, strain/absolute humidity interaction, and time (P ≤ 0.01). Further studies into hand transfer of influenza A virus from fomites and the impact of inanimate surface contamination in transmission should be investigated as this study demonstrates prolonged persistence on non-porous surfaces. IMPORTANCE: The study tested the ability of two influenza A H1N1 strains to persist and remain infectious on stainless steel surfaces in varying environmental conditions. It is demonstrated that influenza A H1N1 virus can persist and remain infectious on stainless steel surfaces for 7 days. This raises the question of what role contaminated surfaces play in the transmission of influenza A virus and that additional studies should be conducted to assess this. |
Storage Effects on Sample Integrity of Environmental Surface Sampling Specimens with Bacillus anthracis Spores
Perry KA , O'Connell HA , Rose LJ , Noble-Wang JA , Arduino MJ . Biosafety (Los Angel) 2013 2013 002 The effect of packaging, shipping temperatures and storage times on recovery of Bacillus anthracis. Sterne spores from swabs was investigated. Macrofoam swabs were pre-moistened, inoculated with Bacillus anthracis spores, and packaged in primary containment or secondary containment before storage at -15°C, 5°C, 21°C, or 35°C for 0-7 days. Swabs were processed according to validated Centers for Disease Control/Laboratory Response Network culture protocols, and the percent recovery relative to a reference sample (T(0)) was determined for each variable. No differences were observed in recovery between swabs held at -15° and 5°C, (p ≥ 0.23). These two temperatures provided significantly better recovery than swabs held at 21°C or 35°C (all 7 days pooled, p ≤ 0.04). The percent recovery at 5°C was not significantly different if processed on days 1, 2 or 4, but was significantly lower on day 7 (day 2 vs. 7, 5°C, 10(2), p=0.03). Secondary containment provided significantly better percent recovery than primary containment, regardless of storage time (5°C data, p ≤ 0.008). The integrity of environmental swab samples containing Bacillus anthracis spores shipped in secondary containment was maintained when stored at -15°C or 5°C and processed within 4 days to yield the optimum percent recovery of spores. |
Outbreak of Mycobacterium chelonae infection associated with tattoo ink
Kennedy BS , Bedard B , Younge M , Tuttle D , Ammerman E , Ricci J , Doniger AS , Escuyer VE , Mitchell K , Noble-Wang JA , O'Connell HA , Lanier WA , Katz LM , Betts RF , Mercurio MG , Scott GA , Lewis MA , Goldgeier MH . N Engl J Med 2012 367 (11) 1020-4 BACKGROUND: In January 2012, on the basis of an initial report from a dermatologist, we began to investigate an outbreak of tattoo-associated Mycobacterium chelonae skin and soft-tissue infections in Rochester, New York. The main goals were to identify the extent, cause, and form of transmission of the outbreak and to prevent further cases of infection. METHODS: We analyzed data from structured interviews with the patients, histopathological testing of skin-biopsy specimens, acid-fast bacilli smears, and microbial cultures and antimicrobial susceptibility testing. We also performed DNA sequencing, pulsed-field gel electrophoresis (PFGE), cultures of the ink and ingredients used in the preparation and packaging of the ink, assessment of source water and faucets at tattoo parlors, and investigation of the ink manufacturer. RESULTS: Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved. CONCLUSIONS: The premixed ink was the common source of infection in this outbreak. These findings led to a recall by the manufacturer. |
Contaminated product water as the source of Phialemonium curvatum bloodstream infection among patients undergoing hemodialysis
Rao CY , Pachucki C , Cali S , Santhiraj M , Krankoski KL , Noble-Wang JA , Leehey D , Popli S , Brandt ME , Lindsley MD , Fridkin SK , Arduino MJ . Infect Control Hosp Epidemiol 2009 30 (9) 840-7 OBJECTIVE: We investigated a cluster of cases of bloodstream infection (BSI) due to the mold Phialemonium at a hemodialysis center in Illinois and conducted a cohort study to identify risk factors. DESIGN: Environmental assessment and cohort study. SETTING: A hemodialysis center in a tertiary care hospital. METHODS: A case patient was defined as a person who underwent dialysis at the center and had a blood sample that tested positive for Phialemonium curvatum on culture. We reviewed microbiology and medical records and tested water, surface, and dialysate samples by culture. Molds isolated from environmental and clinical specimens were identified by their morphological features and confirmed by sequencing DNA. RESULTS: We identified 2 case patients with BSI due to P. curvatum. Both became febrile and hypotensive while undergoing dialysis on the same machine at the same treatment station, although on different days. Dialysis machines were equipped with waste handling option ports that are used to discard dialyzer priming fluid. We isolated P. curvatum from the product water (ie, water used for dialysis purposes) at 2 of 19 treatment stations, one of which was the implicated station. CONCLUSION: The source of P. curvatum was likely the water distribution system. To our knowledge, this is the first report of patients acquiring a mold BSI from contaminated product water. The route of exposure in these cases of BSI due to P. curvatum may be related to the malfunction and improper maintenance of the waste handling option ports. Waste handling option ports have been previously implicated as the source of bacterial BSI due to the backflow of waste fluid into a patient's blood line. No additional cases of infection were noted after remediation of the water distribution system and after discontinuing use of waste handling option ports at the facility. |
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