The Experts below are selected from a list of 10071 Experts worldwide ranked by ideXlab platform

Petra Gastmeier - One of the best experts on this subject based on the ideXlab platform.

Harald Seifert - One of the best experts on this subject based on the ideXlab platform.

Andreas F. Widmer - One of the best experts on this subject based on the ideXlab platform.

  • Nation-wide survey of screening practices to detect carriers of Multi-Drug Resistant Organisms upon admission to Swiss healthcare institutions.
    Antimicrobial resistance and infection control, 2019
    Co-Authors: Romain Martischang, Andreas F. Widmer, Niccolò Buetti, Carlo Balmelli, Mirko Saam, Stéphan Juergen Harbarth
    Abstract:

    As emergence and spread of Multi-Drug Resistant Organisms (MDRO) requires a standardized preventive approach, we aimed to evaluate current MDRO admission screening practices in Swiss hospitals and to identify potential barriers impeding their implementation. In early 2018, all Swiss public and private healthcare institutions providing inpatient care were contacted with a 34-item questionnaire to investigate current MDRO admission screening policies. Among 139 respondents representing 180 institutions (response rate, 79%), 83% (149) of institutions implemented MDRO admission screening, while 28% of private and 9% of public institutions did not perform any screening. Targeted high-risk screening included carbapenemase producers, extended-spectrum beta-lactamase producers and methicillin-Resistant Staphylococcus aureus at the institutional level for respectively 78% (115), 81% (118) and 98% (145) of screening institutions. Vancomycin-Resistant enterococci (44% of institutions), multi-Resistant Acinetobacter baumanii (41%) and Pseudomonas aeruginosa (37%) were systematically searched only by a minority of screening institutions. A large diversity of risk factors for targeted screening and some heterogeneity in body sites screened were also observed. Admission-screening practices were mostly impeded by a difficulty to identify high-risk patients (44%) and non-compliance of healthcare workers (35%). Heterogeneous practices and gaps in small and privately-owned institutions, as well as a mismatch between current epidemiologic MDRO trends and screening practices were noticed. These results highlight the need for uniform national MDRO screening standards.

  • Variability in contact precautions to control the nosocomial spread of Multi-Drug Resistant Organisms in the endemic setting: a multinational cross-sectional survey.
    Antimicrobial Resistance and Infection Control, 2018
    Co-Authors: Danielle Vuichard Gysin, Henri Saenz, Markus Dettenkofer, Barry Cookson, Andreas F. Widmer
    Abstract:

    Definitions and practices regarding use of contact precautions and isolation to prevent the spread of gram-positive and gram-negative multidrug-Resistant Organisms (MDRO) are not uniform. We conducted an on-site survey during the European Congress on Clinical Microbiology and Infectious Diseases 2014 to assess specific details on contact precaution and implementation barriers. Attendants from 32 European (EU) and 24 non-EU countries participated (n = 213). In EU-respondents adherence to contact precautions and isolation was high for Methicillin-Resistant Staphylococcus aureus (MRSA), carbapenem-Resistant Enterobacteriaceae, and MDR A. baumannii (84.7, 85.7, and 80%, respectively) whereas only 68% of EU-respondents considered any contact precaution measures for extended-spectrum-beta-lactamase (ESBL) producing non-E. coli. Between 30 and 45% of all EU and non-EU respondents did not require health-care workers (HCW) to wear gowns and gloves at all times when entering the room of a patient in contact isolation. Between 10 and 20% of respondents did not consider any rooming specifications or isolation for gram-positive MDRO and up to 30% of respondents abstain from such interventions in gram-negative MDRO, especially non-E. coli ESBL. Understaffing and lack of sufficient isolation rooms were the most commonly encountered barriers amongst EU and non-EU respondents. The effectiveness of contact precautions and isolation is difficult to assess due to great variation in components of the specific measures and mixed levels of implementation. The lack of uniform positive effects of contact isolation to prevent transmission may be explained by the variability of interpretation of this term. Indications for contact isolation require a global definition and further sound studies.

Anna M. Rohde - One of the best experts on this subject based on the ideXlab platform.

Roger Bayston - One of the best experts on this subject based on the ideXlab platform.

  • An antimicrobial impregnated urinary catheter that reduces mineral encrustation and prevents colonisation by Multi-Drug Resistant Organisms for up to 12 weeks.
    Acta biomaterialia, 2019
    Co-Authors: Katherine Belfield, Xinyong Chen, Emily F. Smith, Waheed Ashraf, Roger Bayston
    Abstract:

    Abstract Two major complications of indwelling urinary catheterisation include infection and mineral encrustation of the catheter. Our antimicrobial urinary catheter (AUC) impregnated with rifampicin, triclosan, and sparfloxacin has demonstrated long-term protective activity against major uropathogens. This study aimed to firstly assess the ability of the AUC to resist mineral encrustation in the presence and absence of bacteria. Secondly, it aimed to investigate the AUC’s anti-biofilm activity against Multi-Drug Resistant Organisms. There was no difference in surface roughness between AUC and control segments. In a static and a perfusion model, phosphate deposition was significantly reduced on AUCs challenged with P. mirabilis. Furthermore, none of the AUCs blocked during the 28 day test period, unlike controls. The AUC prevented colonisation by methicillin-Resistant Staphylococcus aureus, methicillin-Resistant Staphylococcus epidermidis, extended-spectrum beta-lactamase producing E. coli, and carbapenemase-producing E. coli for 12 consecutive weekly challenges. All three drugs impregnated into the catheter continued to exert protective activity throughout 12 weeks of constant perfusion. The drugs appear to migrate into the crystalline biofilm to continually protect against bacteria not it direct contact with the catheter surface. In conclusion, the AUC reduces mineral encrustation and may increase time to blockage in the presence of P. mirabilis, and does not predispose to mineral deposition under other conditions. It also offers 12 weeks of protection against Multi-Drug Resistant bacteria. Statement of significance Infection and associated mineral encrustation of urinary catheters are two serious complications of indwelling urinary catheters. Others have attempted to address this through various technologies such as coatings, dips, and surface modifications to prevent infection and/or encrustation. However, all current ‘anti-infective’ urinary catheter technologies are limited to short-term use. Some patients with spinal injuries, multiple sclerosis, stroke survivors and others use long-term catheters for 4–12 weeks at a time with multiple catheterisation possibly throughout the rest of their life. We present a urinary catheter for long-term use that is impregnated with three antimicrobials by a patient-protected process to prevent infection and encrustation for up to 12 weeks, the maximum lifetime of a long-term catheter before it is changed.