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Portable medical equipment (PME) may contribute to transmission of multidrug-resistant organisms without proper disinfection. We studied whether a Disinfection Tracking System (DTS) with feedback prompt, attached to PME, can increase the frequency of PME disinfection.DTS devices were placed on 10 workstations-on-wheels (WOWs) and 5 vitals machine (VM). After a 25 day "screen-off" period, the DTS device screens were turned on to display the number of hours since the last recorded disinfection event for a 42 day period. We used a Bayesian multilevel zero-inflated negative binomial model to compare the number of events in the display "screen-off" to the "screen-on" period.During the "screen-off" period, there were 1.26 and 0.49 mean disinfection events and during the "screen-on" period, there were 1.76 and 0.50 mean disinfection events for WOWs and VM, respectively, per day. The model estimated mean events per device per day in the the "screen-on" period for WOW's were 1.32 (1.10 - 1.57) times greater than those in the "screen-off" period and the "screen-on" period for VM devices was 1.37 (0.89 - 2.01) times greater than those in the "screen-off" period.The rate of disinfection events for WOWs increased following the implementation of the DTS feedback prompt.

ObjectivesThe Filtered Far-UVC (FFUV) handheld disinfection device is a small portable device that emits far UVC at 222nm. The objective of this study was to evaluate the device’s ability to kill microbial pathogens on hospital surfaces and compare it to manual disinfection using germicidal sodium hypochlorite wipes.MethodsA total of 344 observations (4 observations from 86 objects’ surfaces) were sampled with 2 paired samples per surface: a pre- and a post-sodium hypochlorite, and a pre- and a post-FFUV samples. The results were analyzed via a Bayesian multilevel negative binomial regression model. Additionally, the bacterial flora recovered were identified using mass spectrometry.ResultsThe estimated mean colony counts for the sodium hypochlorite control and treatment groups were 20.5 (11.7 – 36.0) and 0.1 (0.0 – 0.2) colony forming units (CFUs) respectively. The FFUV control and treatment groups had mean colony counts of 22.2 (12.5 – 40.1) and 4.1 (2.3 – 7.2) CFUs. The sodium hypochlorite samples had an estimated 99.4% (99.0% – 99.7%) reduction in colony counts, while those from the FFUV group had an 81.4% (76.2% − 85.7%) reduction.ConclusionsOur study demonstrated that FFUV handheld device effectively reduced microbial bioburden on surfaces in the healthcare setting. Several healthcare-associated infections (HAIs) causing pathogens (gram positive and negative bacteria) were retrieved from the pre-clean surfaces. The major benefit of FFUV is likely seen when manual disinfection is not possible or when supplementing cleaners or disinfectants with the low-level disinfection properties.

Background Enterococcus faecium (E. faecium) is a common hospital-associated infection (HAI) that can lead to increased costs, morbidity, and mortality. Pulsed Xenon Ultraviolet light (PX-UV) has been shown to reduce bacterial bioburden levels on surfaces. This study aims to assess the effect of the addition of PX-UV to terminal cleaning on the clonal recovery of E. faecium sequence types (STs) using Whole Genome Sequencing (WGS) on patient isolates. Methods During 2017 to 2020 a prospective, randomized, double-blinded, sham-controlled, interventional, crossover trial in 2 separate Detroit hospitals (H1 and H2) compared HAI counts after the addition of either PX-UV or a non-UV sham device to terminal cleaning methods. The trial consisted of a total of 16 units randomized to have either the treatment of PX-UV (Group Q) or the sham control device with no UV (Group W) for 12 months. A washout period (Group R) of 6 months followed and the trial concluded with a 12-month crossover of treatments. A total of 60 E. faecium samples were collected, then WGS was performed by the Illumina Nextseq 550 instrument. de novo assembly was preformed using the SPAdes program. Whole Genome Multilocus Sequence Type (wgMLST) analysis was performed by BioNumerics (v7.6) to construct minimum spanning tree (MST). Results A total of 7 STs were obtained across the 2 hospitals (H1 and H2). ST117, ST17, and ST80 all had more than 10 total recovered isolates, ST117 being the most frequent with 24 isolates. Less than 3 isolates were recovered for all other STs. For all STs, Group Q (PX-UV) had 14, Group R (washout period) had 22, and Group W (non-UV sham) had 24. ST18 was only found in Group Q. ST412, ST584, and ST736 were not found in Group W. The data shows that the intervention PX-UV group had a reduction of clonal recovery by 10 STs as compared to the sham UV group. Table 1:Total number of each sequence type (ST) in H1 and H2 Conclusion The overall reductions in the number of isolates in the real UV units was driven by reductions in the ST117 a predominant strain in a hospital environment reported previously in Detroit and ST80. There were negligible differences in recovery of other ST between the groups. The reduction in clonal recovery of E. faecium isolates in Group Q as compared to Group R might be related to use of PX-UV following terminal room cleaning. Disclosures Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System Keith S. Kaye, MD, MPH, Allecra: Advisor/Consultant|GlaxoSmithKline plc.: Receiving symposia honoraria|GlaxoSmithKline plc.: GlaxoSmithKline plc.-sponsored study 212502|Merck: Advisor/Consultant|qpex: Advisor/Consultant|Shionogi: Grant/Research Support|Spero: Advisor/Consultant Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background Multidrug resistant (MDR) bacteria which resist at least three different antibiotic classes are serious threat to public health and patient treatment. Antimicrobial resistant (AMR) genes are often mediated through plasmids due to its horizontal transferability from bacteria to bacteria. Here, we assessed the prevalence of AMR genes in the USA by analyzing longitudinal K. pneumoniae plasmid genome data obtained from PATRIC (Pathosystems Resources Integration Center) database. Methods The PATRIC database have 176 K. pneumoniae plasmid genome data collected in 9 states of US from 2004 to 2019. The isolation source are various patient samples including urine, blood, etc. The sequence information was downloaded from GeneBank. The AMR genes on plasmids of K. pneumoniae were identified using open-source AMR database, Resfinder which search AMR genes for 16 types of antibiotic classes. Results Multidrug resistance was spread all over the US as most of isolates have AMR genes against more than one antibiotic classes, and some isolates contain against up to 8 antibiotic classes AMR genes. Most common AMR genes are against 9 classes including Aminoglycosides, beta-lactamase (carbapenem), Chloramphenicol, Macrolide, Quinolone, Rifampicin, Sulfonamide, Tetracycline, and Trimethoprim. Aminoglycosides and beta-lactamase including carbapenem resistance genes showed higher frequency than other classes of antibiotics. Carbapenem resistance genes, especially blaKPC showed higher frequency in east region of US including NY, PA, and VA (Fig 1A). While some resistances reduced over time, Aminoglycosides and beta-lactamase resistance genes are sharply increased (Fig 1B). Many isolates contain 3∼4 plasmids and plasmid amplicon types were various by isolates but no co-relation between plasmid types and AMR genes was observed. Conclusion Database analysis of K. pneumoniae isolates from different regions and time provides insight of the prevalence of AMR genes. The prevalence of the multidrug resistance obtained from databases analysis showed the abundance of AMR genes regardless of the region or time, especially for Aminoglycoside and beta-lactamase. Bacterial sequence database such as PATRIC is a useful tool for tracking the existence and emergence of AMR genes. Disclosures Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background Healthcare-associated infections (HAIs) can be caused by some multidrug-resistant Escherichia coli, most commonly due to production of an extended spectrum beta-lactamase (ESBL), and lead to increased morbidity and mortality. Pulsed Xenon Ultraviolet light (PX-UV), in combination with terminal cleaning, has been shown to improve disinfection and has the potential to lower HAIs by reducing the horizontal spread of infections in hospitals. Here, we assess the effect of PX-UV on the clonal recovery pattern of several E. coli sequence types (STs) using Whole Genome Sequencing (WGS). Methods A prospective, sham-controlled, double-blinded, interventional, crossover trial was conducted to compare standard terminal cleaning with PX-UV (intervention, Group Q) and standard terminal cleaning with sham UV (control, Group W) in 2 Detroit hospitals from 2017 to 2020. Treatments lasted 12 months before crossover, with a 6-month washout period in between (Group R) during which UV was not used. A total of 67 E. coli samples were collected. WGS of the isolates was performed using the Nextseq 550 (Illumina). After de novo assembly, BioNumerics calculation engine (v7.6) was used to complete Whole Genome Multilocus Sequence Type (wgMLST) analysis, assembly free and assembly-based call, and construction of minimum spanning tree (MST). Results The total number of different STs found for the intervention UV device group (Q) and the sham UV device group (W) was 6 while the washout group (R) was 5. Out of the 9 total STs obtained, the most common was ST131 (Table 1). In Group Q, 11 of ST131 were found; 15 were found in Group W. During the washout period (R) 17 of ST131 were found. All other STs had 3 or less circulating clusters. After UV treatment ST1193, ST399, and ST7394 were not recovered. Fig. 1:Minimum spanning tree (MST) for E. coliTable 1:Total number of each sequence type (ST) per treatment group Conclusion During UV intervention 3 different STs (ST1193, ST399, ST7394) were not recovered, but there were negligible changes to the frequency of recovery of the other 6 STs as compared to sham UV treatment. ST131 was the dominant E. coli ST found in Detroit, which is consistent with previously published data stating ST131 as the predominant strain. While PX-UV has previously demonstrated effectiveness on decreasing bioburden, our data does not indicate any remarkable change in clonality and prevalence of E. coli STs after PX-UV use. Disclosures Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System Keith S. Kaye, MD, MPH, Allecra: Advisor/Consultant|GlaxoSmithKline plc.: Receiving symposia honoraria|GlaxoSmithKline plc.: GlaxoSmithKline plc.-sponsored study 212502|Merck: Advisor/Consultant|qpex: Advisor/Consultant|Shionogi: Grant/Research Support|Spero: Advisor/Consultant Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background The COVID-19 pandemic is an ongoing global health emergency. Wastewater-based epidemiology is a valuable tool for supplementing clinical testing in identifying infected individuals early thus containing disease transmission. To assess early detection of COVID-19, a building-level wastewater-based surveillance pilot project was implemented within VHA. Here, we report the results from 2 methods of polymerase chain reaction (PCR) testing of 1073 wastewater samples from VHA CLCs (i.e., nursing homes). Methods Daily (Monday-Friday) wastewater samples were collected (January 11, 2021, to July 2, 2021) at eight CLCs located across the US and shipped overnight for processing. The samples were heat inactivated by incubating samples in a 65±1°C heating circulating water bath for 90 minutes. The virus in the wastewater was concentrated using InnovaPrep concentrating pipette select, and RNA was isolated from the concentrate and subjected to reverse transcription quantitative PCR (RT-qPCR) and RT-digital PCR. If SARS-CoV-2 was detected in the wastewater within the prior 10 days of a virus-positive occupant, the wastewater positivity was regarded as an early warning. Results Twenty-seven positives and 7 inconclusive results were reported by RT-qPCR during the surveillance. Among the 27, 15 wastewater positives qualified as early warning and 12 positives were not verified by occupant positivity. Digital PCR with a cutoff value of 0.25 copies/uL of RNA for defining positivity had 28 positives qualifying as early warnings, and 115 positives were not verified by occupant positivity (Figure 1). Figure 1Differences between RT-PCR and Digital PCR Positivity Conclusion The overall viral loads of the wastewater samples were very low corresponding to the dip in cases seen in the US during the pilot period. Although sensitivity of digital PCR appears (based on 0.25 copies/uL of RNA for defining positivity) higher than that of RT-qPCR, there were more occurrences of unverified early warning that could impact precision. The cut-off selected for RT-digital PCR reported here is arbitrary and lacks industry consensus. More controlled studies are needed to determine sensitivity and precision as well as to standardize RT-digital PCR cutoffs to define positivity for routine use. Disclosures Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background PX-UV has shown great effectiveness at reducing Staphylococcus aureus (S. aureus) on healthcare surfaces. S. aureus is one of the most prevalent causes of healthcare-associated infections (HAIs). Here we assess the clonal recovery pattern and the disruption caused by PX-UV on S. aureus collected from patients, using Whole Genome Multilocus Sequence Type (wgMLST) analysis. Methods During a 3-year period, 2017 to 2020, a prospective sham-controlled double-blinded interventional crossover trial designed to assess the effectiveness of post-discharge PX-UV room disinfection on HAIs in 2 Detroit hospitals. The interventional group (Q) and the control group (W) was treated with PX-UV and sham UV light after terminal cleaning respectively, both treatments lasting 12 months. Crossover occurred after a 6-month washout period (R) during which no UV light was used. Whole Genome Sequencing (WGS) of the 291 S. aureus samples collected was performed using the Nextseq 550 (Illumina). Following de novo assembly, construction of minimum spanning tree (MST) and wgMLST analysis was completed using BioNumerics calculation engine (v7.6). Results A total of 20 sequence types (STs) were found throughout the trial, the most common being ST5 and ST8 with roughly 20 to 50 each found in all 3 treatment groups (Table 1. The other 18 STs were only found 7 times or less in each treatment group. ). During intervention (Q) 9 STs were found, however 11 were not recovered after PX-UV (ST1, ST1508, ST22, ST231, ST3287, ST3462, ST398, ST59, ST6790, ST840, ST97). During the sham treatment (W) 15 STs were found while 7 were found during the washout period (R). The minimum spanning tree (MST) shows clusters of related ST groups color coded by treatment type (Figure 1). Fig. 1:Minimum spanning tree (MST) for S. aureusTable 1:Total number of each sequence type (ST) per treatment group Conclusion The difference between the STs recovered during intervention and during sham UV treatment was inconsequential because many factors influence the amount of STs recovered (treatment, number of patients, sampling bias, and terminal cleaning methods). There was no clonality noted among any of the intervention group (Fig. 1). Both dominant strains (ST5, ST8) have been characterized as hypervirulent and predominant previously, consistent with our data. Our data does not demonstrate any notable change in the clonal prevalence of S. aureus after PX-UV use. Disclosures Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System Keith S. Kaye, MD, MPH, Allecra: Advisor/Consultant|GlaxoSmithKline plc.: Receiving symposia honoraria|GlaxoSmithKline plc.: GlaxoSmithKline plc.-sponsored study 212502|Merck: Advisor/Consultant|qpex: Advisor/Consultant|Shionogi: Grant/Research Support|Spero: Advisor/Consultant Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background Clostridioides difficile (C. diff) is one of the most common causes of healthcare-associated infections (HAIs), leading to increased hospital stay, cost, and mortality. Elimination of C. diff spores is difficult as they are resistant to kill by common hospital grade disinfectants. Copper impregnated self-sanitizing surfaces (SSSCu) provide continuous reduction of vegetative pathogens, potentially lowering the risk of infections, but their efficacy on C. diff spores has not been previously evaluated. Methods Control (no copper) and copper coupons containing 20% copper-oxide were inoculated with varying C. diff spore loads ranging from 105 to 107 spores, prepared using environmental protection agency protocol, with or without 5% fetal bovine serum (FBS) soil load. After 4 hours of contact time, the C. diff spores were recovered and tested for viability. The efficacy of copper (log10 kill) was estimated using a Bayesian linear multilevel model. Results After 4 hours, the copper coupons, at mean initial spore load (6.67 log10) and no soil load, had a mean 1.21 (95% uncertainty interval: 1.13 - 1.31) log10 reduction compared to control coupons. With soil load, the treatment effect of copper decreased by 0.50 (95% uncertainty interval: 0.37 - 0.64) log10. Also, for each additional standard deviation (SD) increase in initial spore load there was a 0.59 (95% uncertainty interval: 0.47 - 0.72) log10 decrease in the treatment effect of copper. The soil load in combination with increasing initial spore load further decreased the treatment effect of copper by an additional 0.19 (95% uncertainty interval: 0.01 - 0.38) log10 for each SD increase in initial spore load. Conclusion Copper coupons can substantially reduce C. diff spores after 4 hours by 50%-97% depending on the initial spore concentration and presence or absence of organic material. Higher initial spore loads or excess organic material may prevent the spores from coming in contact with the copper-impregnated surface thus decreasing the kill efficacy. Continuous sporicidal effect of copper-impregnated surfaces might prevent transmission of spores and help reduce HAIs. Further studies are needed to evaluate the efficacy on C. diff HAI rates. Disclosures Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background Enterococci are leading causes of infections, and many strains are multidrug-resistant. Identification of antibiotic resistance can be achieved either phenotypically using Clinical & Laboratory Standards Institute (CLSI) minimum inhibitory concentration (MIC) cut-offs, or genotypically using whole genome sequencing (WGS). Here we compare the output from two software pipelines: EPISEQ CSTM (BIOMÉRIEUX, Marcy l ‘Etoile, France) and ResFinder to understand the similarities and differences in their ability to identify antibiotic resistance genes. Methods We performed WGS on 89 clinical isolates of Enterococci (both E. faecalis and faecium) from two distinct tertiary care Detroit hospitals admitted to 16 intensive care units (ICU) and non-ICU wards between 2017-2019. WGS was performed using the NextSeq (Illumina Inc., CA) and analyzed using two bioinformatics pipelines mentioned above. The antibiotic resistance outputs were compared to identify both similarities and differences. Results There was a significant difference in the genetic mutation output from both software. EPISEQ was able to identify 13 & 15 different genetic mutations for Enterococcus faecalis and faecium respectively which were not identified by ResFinder (Table 1). There were 9 & 12 common genetic mutations for Enterococcus faecalis and faecium respectively which were identified by both software. ResFinder was able to identify only two different gene mutations which were not identified by EPISEQ. Table 1:Genetic mutations identified by EPISEQ and ResFinder arranged by resistance to its respective drug class. Conclusion The ability to identify different genetic mutations by both software products likely depends on databases used to determine the antibiotic resistant genes. EPISEQ CS uses 4 different databases (including ResFinder) as well as other proprietary databases making it more sensitive, thereby able to identify more genetic mutations compared to ResFinder alone. The costs for analyzing the WGS data through proprietary software is steep compared to open-source software. Standards metrics and methods for interpretations are needed before these methods can be adapted for clinical applications. Further studies are needed to understand the value of identifying these additional genes by comparing it to phenotypic susceptibilities. Disclosures Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System Keith S. Kaye, MD, MPH, Allecra: Advisor/Consultant|GlaxoSmithKline plc.: Receiving symposia honoraria|GlaxoSmithKline plc.: GlaxoSmithKline plc.-sponsored study 212502|Merck: Advisor/Consultant|qpex: Advisor/Consultant|Shionogi: Grant/Research Support|Spero: Advisor/Consultant Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing.

Background Antimicrobial resistance (AMR) genes of bacteria can be found in chromosomes or plasmids. Due to horizontal transfer from one bacterium to another, AMR genes on plasmids can be easily spread. However, distinguishing whether AMR genes are from plasmids or chromosomes is difficult. Here, we assessed two different approaches for identifying AMR genes on the plasmids of A. baumannii. Table 1.Comparison of informatics and experimental approach in studying AMR genes on plasmids in A. baumannii*Highlights indicate blaOXA-23 genes found in both approaches.*S-Susceptible isolates with no blaOXA-23 gene serve as control Methods Genomic DNA from 30 clinical isolates was sequenced using Illumina NextSeq 550. Two approaches were applied to identify which AMR genes were on plasmids: isolation of plasmid DNA experimentally using plasmid isolation kit (Qiagen, CA), and deduction of plasmid sequence from genomic DNA using the bioinformatic tool, plasmidSPAdes, which distinguishes the plasmid sequence based on the copy number. AMR genes from both approaches were identified using the open-source AMR database, ResFinder. The AMR gene data obtained from plasmids utilizing each approach were compared based on information from whole genome sequencing (WGS) data. Results As shown in Table 1, both approaches produced differences in the number of contigs, largest contig size, and number of AMR genes identified. The average number of contigs using plasmidSPAdes with WGS data was 7.4 and the largest contig size was 52939 base pairs, while with isolated plasmid DNA and analyzed by SPAdes was 1025 and 32274 bp, respectively. Plasmid DNA contigs are more fragmented. The average number of AMR genes identified using plasmidSPAdes was 1.2 and using plasmid DNA was 4. AMR information from WGS data showed 73.3% isolates have blaOXA-23, a carbapenem resistant gene. However, blaOXA-23 was found from 40% isolates using plasmidSpades and 50% isolates using plasmid DNA. In 36.7% isolates, blaOXA-23 was found by both approaches. Conclusion The information obtained by the two approaches for identifying resistance genes on plasmids mostly agreed with some exceptions. The bla OXA-23 identified in both could be on plasmids, while genes not identified from both could be on chromosomes. PlasmidSPAdes was a useful tool to discriminate plasmid sequence from WGS data. Stringent infection control measures can prevent spread of AMR gene containing plasmids in hospital settings. Disclosures Chetan Jinadatha, MD, MPH, AHRQ R01 Grant-5R01HS025598: Grant/Research Support|EOS Surfaces: Copper Coupons and materials for testing Keith S. Kaye, MD, MPH, Allecra: Advisor/Consultant|GlaxoSmithKline plc.: Receiving symposia honoraria|GlaxoSmithKline plc.: GlaxoSmithKline plc.-sponsored study 212502|Merck: Advisor/Consultant|qpex: Advisor/Consultant|Shionogi: Grant/Research Support|Spero: Advisor/Consultant Piyali Chatterjee, PhD, AHRQ Grant # 1R03HS027667-01: Grant/Research Support|AHRQ Grant # 1R03HS027667-01: Central Texas Veterans Health Care System.

Background Portable Medical Equipment (PME) such as workstations-on-wheels (WOWs) and vital signs machines (VMs) have been linked to healthcare-associated infections. Routine visual monitoring of PME disinfection is difficult. An automated D isinfection T racking S ystem (DTS) was used to record and report the number of disinfection events of PME in a hospital setting. Methods The study was conducted in 2 acute-care units for 25-days to determine the pattern of recorded events from DTS on PME. Devices record disinfection events as moisture events and automatically store on a central database. DTS devices with “screen-on” feedback and “screen-off” devices with no display were placed on 10 WOWs and 5 VMs on separate units. Results A total of 421 moisture events were recorded for the “screen-on” and 345 for the “screen-off”, during the 25-day implementation period on the 2 different hospital units. The highest number of events occurred between 6:00am-7:00am, with 69 & 75 moisture events recorded for Units 1 and 2, respectively. Conclusions The pattern of disinfection events for WOWs and VMs demonstrated that most events occurred regularly at the times corresponding with nursing shift change. The DTS has the potential to continuously record, and report data related to PME disinfection.

Objectives:No-touch disinfection systems like xenon- or mercury-based ultraviolet (UV) are now commonly being used for hospital room disinfection. However, serial exposure to UV light can potentially lead to the development of bacterial resistance. We sought to determine whether UV resistance develops due to serial exposure to UV light using 3 epidemiologically important multidrug-resistant microbial strains.Methods:Methicillin-resistant Staphylococcus aureus (MRSA), carbapenemase–producing Klebsiella pneumoniae (KPC) and metallo-β-lactamase–producing Klebsiella pneumoniae (MBL) were serially exposed to 25 growth-irradiation cycles of UV produced by a xenon-based UV (Xe-UV) lamp for 5 minutes or a mercury-based UV (Hg-UV) lamp for 10 minutes. After each UV exposure cycle, the surviving colony-forming units (CFUs) were measured and compared with the initial inoculum of each cycle for each strain, respectively.Results:In each cycle, ˜1–10 million of MRSA, KPC, and MBL were used to test the effect of UV irradiation. Postexposure colony counts remained low (3–100 colonies) throughout the 25 serial exposures to both xenon- and mercury-based UV. The log-kill rate after each exposure showed no changes following UV disinfection by Xe-UV. The MRSA log-kill rate increased after repeated exposure to Hg-UV unlike KPC and MBL K. pneumoniae, which did not change. Whole-genome sequencing (WGS) analyses performed on these 3 strains demonstrated no significant genetic changes after multiple UV irradiation cycles.Conclusions:Exposure of multidrug-resistant bacteria to UV produced from 2 different UV sources did not engender UV resistance after 25 serial exposures, as demonstrated by WGS analysis; thus, UV disinfection is unlikely to generate UV-resistant hospital flora.

Background:Infants asymptomatically excrete Clostridioides difficile during their first year of life, suggesting that they may represent a source of infection for adults who acquire community-associated C. difficile infection (CA-CDI). The genetic relationship of C. difficile strains from asymptomatic infants and adults with CA-CDI is not well defined.Methods:In this study, 50 infants were recruited at birth, and stool samples were collected at routine well-child visits. Adult stool samples collected during the same period and geographical area from patients who were diagnosed with CA-CDI were selected for comparison. C. difficile was cultivated and probed by PCR for toxin genes and were typed by PCR fluorescent ribotyping. Isolates from adults and infants with shared ribotypes were subjected to whole-genome sequencing (WGS).Results:Of these 50 infants, 36 were positive for C. difficile at least once in their first year of life, with a peak incidence at 6 months. Among 180 infant stool samples, 48 were positive. Of 48 isolates from positive stools, 29 were toxigenic by polymerase chain reaction (PCR) and 8 of 48 stool samples were positive for toxin by enzyme immunoassays (EIAs). Ribotypes F106 and F014-020 were present in both colonized infants and adults with CA-CDI. WGS identified 1 adult–infant pair that differed by 5 single-nucleotide polymorphisms (SNPs). Also, 4 additional adult–infant clusters differed by ≤16 SNPs.Conclusions:Infants that are colonized with C. difficile share ribotypes with adults from the same geographical region with CA-CDI. Selected isolates in the 2 populations show a genetic relationship by WGS.

Background:Candida auris is an emerging and often multidrug-resistant fungal pathogen with an exceptional ability to persist on hospital surfaces. These surfaces can act as a potential source of transmission. Therefore, effective disinfection strategies are urgently needed. We investigated the efficacy of ultraviolet C light (UV-C) disinfection for C. auris isolates belonging to 4 different clades.Methods:In vitro testing of C. auris isolates was conducted using 106 colony-forming units (CFU) spread on 20-mm diameter steel carriers and exposed to a broad-spectrum UV-C light source for 10, 20, and 30 minutes at a 1.5 m (5 feet) distance. Post-UV survivors on the coupons were subsequently plated. Colony counts and log reductions were recorded, calculated, and compared to untreated control carriers. Identification of all isolates were confirmed by MALDI-TOF and morphology was visualized by microscopy.Results:We observed an increased susceptibility of C. auris to UV-C in 8 isolates belonging to clades I, II and IV with increasing UV exposure time. The range of log kill (0.8–1.19) was highest for these isolates at 30 minutes. But relatively no change in log kill (0.04–0.35) with increasing time in isolates belonging to clade III were noted. Interestingly, C. auris isolates susceptible to UV-C were mostly nonaggregating, but the isolates that were more resistant to UV exposure formed aggregates.Conclusions:Our study suggests variability in susceptibility to UV-C of C. auris isolates belonging to different clades. More studies are needed to assess whether a cumulative impact of prolonged UV-C exposure provides additional benefit.

Persistent severe acute respiratory syndrome coronavirus 2 infection is difficult to treat. Here, we report a case of 5-month persistent coronavirus disease 2019 in an immunocompromised patient who was successfully treated with 30 consecutive days of remdesivir. Prolonged remdesivir infusion with concurrent cycle threshold monitoring might provide a potential solution to cure these patients with difficult-to-treat infections.

The whole genomic sequencing (WGS) of SARS-CoV-2 has been performed extensively and is playing a crucial role in fighting against COVID-19 pandemic. Obtaining sufficient WGS data from clinical samples is often challenging especially from the samples with low viral load. We evaluated two SARS-CoV-2 sequencing protocols for their efficiency/accuracy and limitations. Sequence coverage of >95% was obtained by Swift normalase amplicon SARS-CoV-2 panels (SNAP) protocol for all the samples with Ct ≤ 35 and by COVIDSeq protocol for 97% of samples with Ct ≤ 30. Sample RNA quantitation obtained using digital PCR provided more precise cutoff values. The quantitative digital PCR cutoff values for obtaining 95% coverage are 10.5 copies/μL for SNAP protocol and 147 copies/μL for COVIDSeq protocol. Combining FASTQ files obtained from 2 protocols improved the outcome of sequence analysis by compensating for missing amplicon regions. This process resulted in an increase of sequencing coverage and lineage call precision.

The Cepheid Xpert® Xpress SARS-CoV-2 assay is 1 of the several real-time reverse transcription polymerase chain reaction (RT-PCR) assays that received Emergency Use Authorization from the United States Food and Drug Administration (FDA) for detection of SARS-CoV-2. Here we report 4 SARS-CoV-2 samples that were reported as presumptive positives on the Cepheid platform while reported as positives on alternative RT-PCR platforms. Whole genome sequencing indicated that the samples were Delta variants and had point mutations in the N gene which potentially interfered with SARS-CoV-2 detection. Two types of point mutations were found in these samples in the US CDC 2019-nCoV Real time PCR N2 Probe region: C29203T and C29200T. C29203T is a novel point mutation, and C29200T has not been previously reported in the Delta variants. This underlines the fact that mutations in the real-time RT-PCR assay target region could hinder accurate detection of SARS-CoV-2.

National audience; SARS-CoV-2 pandemic continues with emergence of new variants of concerns. These variants are fueling the third and fourth waves of pandemic across many nations. Here we describe the new emerging variants of SARS-CoV-2 and why they have enhanced infectivity and possess the ability to evade immunity.

This study conducts research on an architectural design based on energy harvesting technology. The research subject is a pergola-style structure to be built in a square in Arrecife, the Spanish territory of Lanzarote Island. The architectural design based on the energy harvesting technology developed in this research utilizes solar energy. To install a solar panel on the roof of the pergola, the optimal tilt angle from January to December was derived by using a function that considered the latitude and solar declination value of the study site, and the amount of renewable energy generation was calculated. The architectural design based on energy harvesting also utilizes wind power. To transform wind power into renewable energy, piezoelectric materials that trigger renewable energy with the micro-vibrations generated by wind power are applied to the architectural design. The amount of energy generation was calculated considering the wind power and wind direction in the location where the pergola should be built; in addition, this calculation used information from prior studies on piezoelectric materials. This article is significant, as it has developed an architectural design where hybrid energy harvesting technology that utilizes two types of natural energy (solar and wind) is applied to a building façade.

As part of the development and testing of an innovative technology for tracking disinfection of portable medical equipment, end-user feedback was obtained during an initial trial on two acute care hospital units. The disinfection tracking device was installed on the computers-on-wheels and vital signs machines. Each device had the capability of detecting a cleaning event, reporting the event to an online database, and displaying the time since last cleaning event on a visual display. End-user feedback regarding functionality, usefulness of information provided, and impact on workflow was obtained by survey and facilitated group discussions. Seventeen frontline nurses completed the anonymous survey, and 22 participated in the facilitated group discussions. End users found the system functionally easy to use and the information about time since last cleaning useful and reported minimum disruption of workflow. Functionality of the system was confirmed by consistency between recorded and self-reported cleaning patterns. Managers found the data on cleaning of portable medical equipment helpful in validating compliance with hospital equipment cleaning policy. Frontline staff expressed appreciation for technology that helps them and improves outcomes but also discussed concerns about the potential for technology that creates extra work and disruption in the busy frontline nursing care delivery environment. Nurses were appreciative of opportunities to provide feedback and input into efforts to develop and introduce technology. Recorded cleaning events coincided with self-reported equipment cleaning patterns and illustrated that the device efficiently collects information deemed useful by the end user.

Background Klebsiella pneumoniae is among the leading causes of healthcare-associated infections (HAI). Multidrug-resistant (MDR) Klebsiella variants are difficult to treat and have been reported with increasing frequency in hospitals. Whole genome multi-locus sequence typing (wg-MLST) of K. pneumoniae HAI isolates was used to compare antibiotic resistance genetic patterns against epidemiologic typing. Figure 1. Prevalence of ABX resistance genes for each drug class. Figure 2. Prevalence of ABX resistance genes by hospital. Methods Forty-six clinical bacterial HAI isolates were collected from patients admitted to two disparate tertiary care hospitals in Detroit, Michigan between 2017 and 2019. Data output from wg-MLST was de novo assembled using SPAdes (version 3.7.1) assembler on the Bionumerics calculation engine. Minimum spanning tree (MST) analysis categorized isolates into unique MLST Pasteur serotypes (ST). Antimicrobial resistance genes and/or chromosomal mutations were identified using the ResFinder Database (version 3.2). K. pneumoniae isolates were compared for antibiotic-resistance patterns by hospital, unit, and ST. Figure 3. Hospital 1 clusters and strains that detected gene qnr1, arranged by unit for visual comparison. Figure 4. Sample of clinically significant genes and prevalence, excluding SHV family of genes for simplicity. Results There was significant genetic diversity among the isolates, and no predominant strain was identified. MST analysis revealed 17 unique strains. Only six strains had genetically unique resistance genes detected in more than one isolate, and only three of six were hospital-specific; none were unit-specific. Out of the 75 unique resistance genes detected, only 8 genes had a prevalence >50%: oqxA (100%), oqxB (100%), fosA (89%), blaCTX-M-15 (76%), aac(6’)-Ib-cr (61%), blaTEM-1B (52%), blaOXA-1 (52%), and catB3 (52%). No colistin resistance genes were detected. Of the remaining 69 low-prevalence resistance genes, only 8 hospital-specific genes were detected in more than one isolate (qnrB1, blaSHV-1, blaSHV-110, ac(6’)-Ib3, blaCTX-M-3, blaSHV-36, blaSHV-80, blaSHV-178) with a prevalence range of 4%-22%. Conclusion Our genetic analysis of antibiotic resistance patterns and wg-MLST revealed significant heterogeneity among the isolates, indicating no common source of transmission for either hospital. Although K. pneumoniae is a very common nosocomial pathogen, etiologic analysis suggests diverse community strains (e.g., gut colonization) may actually be responsible for previously-designated HAI. Disclosures Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support) Mark Stibich, PhD MHS, Xenex Disinfection Services, Inc (Board Member, Employee)

Purpose: To investigate the therapeutic efficacy of tumor necrosis factor (TNF)-α stimulated gene/protein 6 (TSG-6) in a rat model of corneal alkali injury. Methods: Corneal alkali injury was produced by placing an NaOH-soaked filter paper disk on the central cornea of the right eye of an anesthetized male Lewis (LEW/Crl) rat. Recombinant human TSG-6, or an equal volume of phosphate-buffered saline (PBS), was administered intravenously (IV), by anterior chamber (AC) injection, or as a topical drop. The affected eyes were photographed daily using a dissecting microscope and documented for clinical time course analysis of corneal opacification. Corneal tissue was excised at pre-determined therapeutic endpoints, with subsequent qRT-PCR or histological analyses. Results: The continuous monitoring of corneal alkali injury progression revealed TSG-6 treatments do not show sufficient effectiveness in vivo regardless of IV injection, AC injection, or topical application. Corneal opacification and neovascularization were not diminished, and gene expression was not impacted by these treatments. However, both IV and AC administration of TSG-6 significantly suppressed pro-inflammatory cytokines compared to PBS-treated eyes. Conclusion: We conclude that the therapeutic potential of TSG-6 is insufficient in a rat corneal alkali injury model.

Purpose: We assessed the in vivo efficacy of a cosmetic formulation comprising a transdermal delivery system of model bile acid nanoparticles after the development of a phytosphingosine-1-phosphate (PhS1P)/phytosterol (PS) carrier based on chemically modified lecithin with sodium deoxycholate, using cholesterol as a hydrophobic component. Methods: PhS1P/PS was loaded into a bile acidconjugated nanoparticle (PhS1P/PS-MBA nanoparticle) model via sonication. Franz diffusion cell experiment was performed to evaluate the skin penetration efficacy of the prepared nanoparticles and to comprehend the feasibility of applying the raw material. The nanoparticles were confirmed using a particle size analyzer, scanning electron microscope, and high-performance liquid chromatography system. In order to understand the effectiveness of the nanoparticles on the skin, we performed an in vivo test in human volunteers using the finished product. The elasticity, thickness, and dermal density of the applied skin were examined by using Cutometer (Courage+Khazaka electronic GmbH, Germany). Results: We confirmed through our tests that the nanoparticles could be successfully prepared with 85% yield and were approximately 120.3 nm in diameter. The product showed more efficient skin permeation than the control, thereby suggesting an easier uptake within the cells and a concomitant fast release of cleaved PhS1P/PS into the human skin. Safety assessment, elasticity, thickness, and dermal density of the nanoparticles on the human skin were examined to test the possible applicability of the nanoparticles to cosmetics. No adverse symptoms were observed. Conclusion: It is therefore recommended that cosmetic products should use PhS1P/PS-MBA nanoparticles in their formulation for easier absorbability into the skin. Our experiment confirms that this new material may have valuable influences on the human skin.

Background Health care personnel and patients are at risk to acquire severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in health care settings, including in outpatient clinics and ancillary care areas. Methods Between May 1, 2020, and January 31, 2021, we identified clusters of 3 or more coronavirus disease 2019 (COVID-19) cases in which nosocomial transmission was suspected in a Veterans Affairs health care system. Asymptomatic employees and patients were tested for SARS-CoV-2 if they were identified as being at risk through contact tracing investigations; for 7 clusters, all personnel and/or patients in a shared work area were tested regardless of exposure history. Whole-genome sequencing was performed to determine the relatedness of SARS-CoV-2 samples from the clusters and from control employees and patients. Results Of 14 clusters investigated, 7 occurred in community-based outpatient clinics, 1 in the emergency department, 3 in ancillary care areas, and 3 on hospital medical/surgical wards that did not provide care for patients with known COVID-19 infection. Eighty-one of 82 (99%) symptomatic COVID-19 cases and 31 of 35 (89%) asymptomatic cases occurred in health care personnel. Sequencing analysis provided support for several transmission events between coworkers and in 2 cases supported transmission from health care personnel to patients. There were no documented transmissions from patients to personnel. Conclusions Clusters of COVID-19 with nosocomial transmission predominantly involved health care personnel and often occurred in outpatient clinics and ancillary care areas. There is a need for improved measures to prevent transmission of SARS-CoV-2 by health care personnel in inpatient and outpatient settings.

Extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae strain 9120005127 was isolated from a wound infection. We describe the draft genome sequence and antibiotic susceptibility of this strain., Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae strain 9120005127 was isolated from a wound infection. We describe the draft genome sequence and antibiotic susceptibility of this strain.

This study proposes an architectural design for renewable energy production to increase energy independence in the architectural field. Among natural energy sources, solar panels that can be applied to building façades have been developed to use solar energy. To maximize renewable energy generation, solar panels can be adjusted according to the optimal tilt for each month. They can be attached to and detached from the building façade and installed on an existing building elevation. Thus, it is possible to increase the energy independence of old buildings. The solar panel developed in this study increases energy independence and presents a creative “kinetic façade,” in which solar panels move each month according to the optimal tilt angle.

En accès libre; International audience; Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can appear in feces within three days of infection, which is much sooner than the time taken for people to develop symptoms and get an official diagnosis (Mallapaty 2020). Therefore, earlier identification in wastewater of the virus’s arrival in a community might limit the health and economic damage caused by the coronavirus disease 2019 (COVID-19). Despite centuries of technological advances, the COVID-19 pandemic is highlighting the limitations of our ability to control viral spread and infections worldwide. This knowledge gap has induced highly variable and sometimes contradictory government decisions in many countries, such as whether to wear a mask or not, and various strategies for testing, contact tracing and isolation of infected patients. The failure of control strategies has led many countries to lockdowns. In particular, powerful and rapid analytical techniques are actually still missing because virus detection is a key step in controlling viral transmission. The biomarker approach, which was initially developed in geochemistry to measure the maturity of dead organic matterand to link molecular fossils with biological homologs, has been applied to modern samples such as soils, sediments, wastewaters and plants (Albrecht and Ourisson 1971; Lichtfouse et al. 1994 1997; Bryselbout et al. 1998; Payet et al. 1999; Dsikowitzky and Schwarzbauer 2014; Choi et al. 2020). Here, we discuss the emergence of wastewater epidemiology based on ribonucleic acid (RNA) biomarkers, a discipline linking biomedical and environmental sciences for the detection of pathogens, with focus on analytical challenges.

International audience; The coronavirus disease COVID-19 has spread throughout the world and has been declared as a pandemic by the World Health Organization on March 11th, 2020. The COVID-19 is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). One possible mode of virus transmission is through surfaces in the healthcare settings. This paper reviews currently used disinfection strategies to control SARS-CoV-2 at the healthcare facilities. Chemical disinfectants include hypochlorite, peroxymonosulfate, alcohols, quaternary ammonium compounds, and hydrogen peroxide. Advanced strategies include no-touch techniques such as engineered antimicrobial surfaces and automated room disinfection systems using hydrogen peroxide vapor or ultraviolet light.

The novel coronavirus disease (COVID-19) has rapidly spread across the world and was subsequently declared as a pandemic in 2020. To overcome this public health challenge, comprehensive understanding of the disease transmission is urgently needed. Recent evidences suggest that the most common route of transmission for SARS-CoV-2 is likely via droplet, aerosol, or direct contact in a person-to-person encounter, although the possibility of transmission via fomites from surfaces cannot be ruled out entirely. Environmental contamination in COVID-19 patient rooms is widely observed due to viral shedding from both asymptomatic and symptomatic patients, and SARS-CoV-2 can survive on hospital surfaces for extended periods. Sequence of contact events can spread the virus from one surface to the other in a hospital setting. Here, we review the studies related to viral shedding by COVID-19 patients that can contaminate surfaces and survival of SARS-CoV-2 on different types of surfaces commonly found in healthcare settings, as well as evaluating the importance of surface to person transmission characteristics. Based on recent evidences from the literature, decontamination of hospital surfaces should constitute an important part of the infection control and prevention of COVID-19.

Infants asymptomatically excrete Clostridioides difficile during their first year of life, suggesting that they may represent a source of infection for adults who acquire community-associated C. difficile infection (CA-CDI). The genetic relationship of C. difficile strains from asymptomatic infants and adults with CA-CDI is not well defined.In this study, 50 infants were recruited at birth, and stool samples were collected at routine well-child visits. Adult stool samples collected during the same period and geographical area from patients who were diagnosed with CA-CDI were selected for comparison. C. difficile was cultivated and probed by PCR for toxin genes and were typed by PCR fluorescent ribotyping. Isolates from adults and infants with shared ribotypes were subjected to whole-genome sequencing (WGS).Of these 50 infants, 36 were positive for C. difficile at least once in their first year of life, with a peak incidence at 6 months. Among 180 infant stool samples, 48 were positive. Of 48 isolates from positive stools, 29 were toxigenic by polymerase chain reaction (PCR) and 8 of 48 stool samples were positive for toxin by enzyme immunoassays (EIAs). Ribotypes F106 and F014-020 were present in both colonized infants and adults with CA-CDI. WGS identified 1 adult-infant pair that differed by 5 single-nucleotide polymorphisms (SNPs). Also, 4 additional adult-infant clusters differed by ≤16 SNPs.Infants that are colonized with C. difficile share ribotypes with adults from the same geographical region with CA-CDI. Selected isolates in the 2 populations show a genetic relationship by WGS.

BackgroundMicrobial bio-burden on high-touch surfaces in patient rooms may lead to acquisition of health care–associated infections in acute care hospitals. This study examined the effect of a novel copper-impregnated solid material (16%–20% copper oxide in a polymer-based resin) on bacterial contamination on high-touch surfaces in patient rooms in an acute care hospital.MethodsFive high-touch surfaces were sampled for aerobic bacterial colonies (ABCs) 3 times per day over a 3-day period in 16 rooms with copper installed and 16 rooms with standard noncopper laminate installed on high-touch surfaces. A Bayesian multilevel negative binomial regression model was used to compare ABC plate counts from copper-impregnated surfaces with standard hospital laminate surfaces.ResultsThe mean and median (interquartile range [IQR]) ABC counts from copper-impregnated surfaces were 25.5 and 11 (4–27), and for standard hospital laminate surfaces they were 60.5 and 29 (10–74.3). The negative binomial regression model–estimated incidence rate for ABC counts on plates taken from copper-impregnated surfaces was 0.40 (0.21–0.70) times the incidence rate of ABC counts on plates taken from standard hospital laminate surfaces.ConclusionsCopper-impregnated solid surfaces may reduce the level of microbial contamination on high-touch surfaces in patient rooms in the acute care environment, as our study demonstrated a decline in microbial bio-burden on samples taken from copper-impregnated compared with standard hospital laminate high-touch surfaces.

Achromobacter xylosoxidans strain DN2019 was isolated from blood of a septicemia patient. We describe the draft genome and antibiotic susceptibility of this strain.

Identification of clinical bacterial isolates is an essential first step to provide guidelines for treatment of pathogenic bacterial infection. Infection occurred in a laceration along the medial aspect of left upper arm of a 71-year-old female. Conventional biochemical testing and MALDI-TOF MS identification failed to correctly identify a bacterial isolate. Using whole genome sequencing, the isolate was identified as Lelliottia nimipressuralis. WGS can overcome the limitations of conventional phenotypic and molecular identification methods and successfully identified a rare pathogen. This case is the first report of a human infection of L. nimipressuralis.

Background Healthcare-associated infections (HAIs) caused by Acinetobacter baumannii, an opportunistic gram-negative pathogen, often contribute to morbidity and mortality among hospitalized patients. To determine molecular epidemiology of circulating hospital Acinetobacter strains in Detroit area in a non-outbreak situation, we performed whole genome sequencing (WGS) and whole genome multilocus sequence typing (wgMLST) analysis to characterize genomic diversity. Methods We performed WGS on patient isolates from two disparate, geographically distinct tertiary care Detroit hospitals admitted to 16 intensive care units (ICU) and non-ICU wards between 2017-2019. The samples were obtained 48 hours following admission and WGS was performed using the Illumina NextSeq instrument. The contigs were de novo assembled using SPAdes and WgMLST analysis was performed using BioNumerics software v7.6. Minimum spanning tree (MST) was constructed to demonstrate the clusters in each hospital and their wards. Results WgMLST analysis was performed on a total of 62 Acinetobacter baumannii patient isolates, 33 of which were from hospital # 1 (H1) and 29 were from hospital # 2 (H2). ST2 (52%) was the predominant sequence type for both hospitals. In addition to ST2, ST93 (8%) and ST406 (8%) clusters were also found in H1. Most of the isolates were predominantly clustered in the intensive care unit (ICU) setting. Several identical sequence types of ST93 (2 identical in H1), ST36 (2 identical in H1) and ST2 (5 identical for H1 and 2 identical for H2) were also observed from different patients in both hospitals. Unlike H1, H2 only has ST2 as a predominant cluster. Other sporadic sequence types such as ST119, ST36, ST49, ST212, ST667 for H1 and ST395, ST214, ST427 and ST268 for H2 were also observed. Figure 1. MInimum Spanning Tree of Acinetobacter strains in hospitals (H1 and H2) and different wards (U1-U12). For identical strains circles are marked with dividing lines. Different sequence types (STs) are marked om the side bar. Conclusion Our data suggests that ST2 is the predominant sequence type circulating in both the geographically distinct hospitals and is endemic to the ICU. There was in hospital spread of this distinct Acinetobacter sequence type from one patient to the other, raising concerns about infection control practices and the role of environment in the spread of these infections. Early detection of these endemic strains within the hospital may be critical in preventing healthcare-associated infections in the future. Disclosures Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support) Mark Stibich, PhD MHS, Xenex Disinfection Services, Inc (Board Member, Employee)

Background Ultraviolet (UV) light disinfection following a manual terminal cleaning process for hospital rooms has been proposed as an additional method to reduce the bacterial burden on surfaces. The impact of UV light disinfection and the level of interdependence between the modalities remains unclear. Methods Samples were collected from 5 high touch surfaces from 10 patients room following discharge prior to manual disinfection, following manual disinfection, and following pulsed xenon UV disinfection using Rodac contact plates (total 150 samples). Colonies were identified using MALDI-TOF mass spectrometry. The bacterial colony counts were recorded and analyzed as pathogenic or commensal organisms (based on CDC criteria) to assess the efficacy of the disinfection process. Results Average colony counts for the rooms prior to disinfection, post disinfection, and post UV light were 185.8 CFU +/- SD 280, 43 CFU +/- 121, and 20 CFU +/- 36.7 respectively. The average drop in colony-forming units of the five high touch areas in patient’s rooms can be seen in table 1. Twelve commensal bacterial species were isolated: Bacillus species (sp.), Corynebacterium sp., Enhydrobacter sp., Kocuria sp., Lysinibacillus sp., Macrococcus sp., Micrococcus sp., Paenibacillus sp., Pantoea sp., Psychrobacter sp., Siccibacter sp., Coagulase negative staphylococcus. Seven pathogenic bacteria were isolated: Acinetobacter sp., Brucella sp., Proteus sp., Staphylococcus aureus, Escherichia sp., Enterococcus, and Pseudomonas aeruginosa. Reductions in the predominant bacterial species following disinfection modality are noted in table 2. Table 1: Colony forming units (CFUs) average Pre-disinfection (Pre-Dis), Post Disinfection (Post-Dis), and Post PX-UV Light (PX-UV). Table 2: Sub-analysis of commensal and pathogen isolation Pre-Disinfection (Pre-Dis), Post-Disinfection (Post-Dis), and Post PX-UV light (PX-UV). Conclusion A combination of manual disinfection and UV has shown a notable additional reduction in overall bacterial contamination of the patient rooms, including the majority of high touch areas as compared with manual disinfection alone. No additional reduction in commensal bacteria isolates was noted after UV light, however a further decrease in pathogenic bacteria (Acinetobacter and Enterococcus) was noted. UV light may be considered as an additional room disinfection method to reduce overall bacterial burden and pathogenic bacterial contamination of rooms as a comprehensive strategy to reduce nosocomial infections. Disclosures Mark Stibich, n/a, Xenex Germ-Zapping Robots (Board Member, Grant/Research Support) Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support)