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According to recent investigations, the risk of M. chimaera contamination of heater-cooler units (HCUs) has reached global proportions. Our aim was to field evaluate a protocol for early detection of M. chimaera contamination. We assessed the presence of viable M. chimaera in 395 water samples obtained from 48 devices (HCUs and extracorporeal membrane oxygenation) by Real Time PCR. Thirty devices were NTM positive, of which 14 were contaminated with M. chimaera. The most frequently contaminated devices were the Stockert 3T. Noteworthy, Stockert 3T devices were positive for M. chimaera. In conclusion, this study introduces novel PMA-PCR designed to specifically detect M. chimaera in HCUs and ECMO devices; this method can replace the culture method for continuous microbiological surveillance. The timely detection of M. chimaera contamination can then be used to improve effective management of the devices. [ABSTRACT FROM AUTHOR]

In this study we evaluated (1) the efficacy of a protocol that combines hydrogen peroxide (shock treatment) and ICX® tablets (continuous treatment) for the control of microbial contamination in dental unit water lines, and (2) the in vitro antimicrobial activity of ICX® tablets on collection and wild strains isolated from dental chair output waters. To assess the treatment effectiveness, the microbial load in the output water samples of three dental chairs were investigated: one control chair received only shock treatment. In vitro bactericidal activity was tested against Staphylococcus aureus and Pseudomonas aeruginosa. Data obtained from samples collected from chairs treated with ICX® and shock treatment and data from the control chair did not differ significantly on the basis of microbial load. In the in vitro study, the product was unable to kill Gram-negative bacteria. These results show that the continuous introduction of ICX® was not effective in maintaining low counts of the heterotrophic bacteria in the output water of dental devices, and shock treatment may be needed more frequently than monthly. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the changes in antimicrobial consumption and multidrug-resistant microorganism trends after introducing an empiric antimicrobial therapy manual to support antimicrobial stewardship., Methods: A 4-year prospective interventional study assessed the effect of introducing an empiric antimicrobial therapy manual in medical and surgical wards during two periods: pre-intervention period (January 2015-May 2017) and post-intervention period (June 2017-December 2019). Outcomes included microorganism trends of bloodstream infections (BSI) for Klebsiella pneumoniae carbapenemase-producing bacteria (KPC), extended spectrum beta-lactamase ESBL- E. coli , meticillin-resistant Staphylococcus aureus (MRSA) and Candida albicans . Also, Clostridioides difficile infection (CDI) episodes were included. Rates were normalised per 1000 patient-days (PD). Antimicrobial consumption was assessed as defined daily dose (DDD)/1000 PD in interrupted time series analysis., Results: In medical wards, we observed a significant decrease in the consumption of piperacillin-tazobactam and a decrease in the trends of tigecycline and vancomycin consumption. In surgical wards, there was a significant decrease in consumption of fluoroquinolones and piperacillin-tazobactam. This decrease was maintained in trend for all the antimicrobials but was significant for tigecycline only. In medical wards, there was a significant reduction of MRSA and C. albicans . In surgical wards, we observed a decrease in MRSA, ESBL- E. coli , C. albicans and CDI. KPC cases decreased by 22.5% in medical wards and 74.3% in surgical wards., Conclusion: The results suggest that a persuasive educational approach to antimicrobial stewardship, with the introduction of an empiric antimicrobial manual and continuous education, resulted in reductions in both antimicrobial use and healthcare-associated BSI caused by multidrug-resistant organisms. More studies with longer follow up are needed to investigate the effect of antimicrobial stewardship on clinical outcomes., (© 2021 The Authors.)

In this study we evaluated (1) the efficacy of a protocol that combines hydrogen peroxide (shock treatment) and ICX ® tablets (continuous treatment) for the control of microbial contamination in dental unit water lines, and (2) the in vitro antimicrobial activity of ICX ® tablets on collection and wild strains isolated from dental chair output waters. To assess the treatment effectiveness, the microbial load in the output water samples of three dental chairs were investigated: one control chair received only shock treatment. In vitro bactericidal activity was tested against Staphylococcus aureus and Pseudomonas aeruginosa. Data obtained from samples collected from chairs treated with ICX ® and shock treatment and data from the control chair did not differ significantly on the basis of microbial load. In the in vitro study, the product was unable to kill Gram-negative bacteria. These results show that the continuous introduction of ICX ® was not effective in maintaining low counts of the heterotrophic bacteria in the output water of dental devices, and shock treatment may be needed more frequently than monthly.