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1. Infection Risks Faced by Public Health Laboratory Services Teams When Handling Specimens Associated With Coronavirus Disease 2019 (COVID-19)

Author

Dominic Ngai-Chong Tsang, Kwok-Kwan Jong, Rickjason Chi-Wai Chan, Edman T.K. Lam, and Chun-Kwan Wong

Subjects
Face shield, Hand washing, medicine.medical_specialty, business.product_category, media_common.quotation_subject, Article, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Hygiene, medicine, Infection control, 030212 general & internal medicine, Safety, Risk, Reliability and Quality, Personal protective equipment, Occupational safety, media_common, Risk assessment, Chemical Health and Safety, business.industry, Public health, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, COVID-19, lcsh:RA1-1270, medicine.disease, 030210 environmental & occupational health, Medical emergency, business, Laboratory workers, Safety Research, Hand hygiene
Abstract

Infection risks of handling specimens associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by public health laboratory services teams were assessed to scrutinize the potential hazards arising from the work procedures. Through risk assessments of all work sequences, laboratory equipment, and workplace environments, no aerosol-generating procedures could be identified except the procedures (mixing and transfer steps) inside biological safety cabinets. Appropriate personal protective equipment (PPE) such as surgical masks, protective gowns, face shields/safety goggles, and disposable gloves, together with pertinent safety training, was provided for laboratory work. Proper disinfection and good hand hygiene practices could minimize the probability of SARS-CoV-2 infection at work. All residual risk levels of the potential hazards identified were within the acceptable level. Contamination by gloved hands was considered as a major exposure route for SARS-CoV-2 when compared with eye protection equipment. Competence in proper donning and doffing of PPE accompanied by hand washing techniques was of utmost importance for infection control.

Published
2020

2. Whole genome amplicon sequencing and phylogenetic analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from lineage B.1.36.27 isolated in Hong Kong

Author

Hin Fung Tsang, Allen Chi Shing Yu, Heong Ting Wong, Wai Ming Stanley Leung, Jiachi Chiou, Yin Kwan Evelyn Wong, Aldrin Kay Yuen Yim, Dominic Ngai Chong Tsang, Alan KL Tsang, Wing Tak Wong, Sze Chuen Cesar Wong, and William Chi Shing Cho

Subjects
SARS-CoV-2, Genetics, Molecular Medicine, COVID-19, Hong Kong, Humans, Genome, Viral, Molecular Biology, Phylogeny, Pathology and Forensic Medicine
Abstract

The import of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineage B.1.36.27 has sparked the fourth wave of COVID-19 outbreak in Hong Kong. This strain has been circulating in Hong Kong since September 2020 but rarely found in other countries (1%).A total of 14 SARS-CoV-2 genome sequences collected from patients in Hong Kong between July 2020 and March 2021 were determined by whole viral genome sequencing using Illumina next-generation sequencing platform, followed by phylogenetic analysis.Of the 14 SARS-CoV-2 genome sequences analyzed, 9 strains belonged to the PANGO lineage B.1.36.27, GISAID clade GH, and Nextclade clade 20A. Compared to the reference genome, 31 nucleotide differences and 11 amino acid differences were identified in the genome of the SARS-CoV-2 from PANGO lineage B.1.36.27.We reported the nucleotides and amino acids mutations identified in the SARS-CoV-2 from PANGO lineage B.1.36.27. Our viral genome sequences enriched the understanding of SARS-CoV-2 mutational landscape and improved the repertoire of known SARS-CoV-2 variants for tracking and tracing. From this study, we found no evidence to show that SARS-CoV-2 from lineage B.1.36.27 can compromise existing vaccines and antibody therapies.

Published
2021

3. Effectiveness of antimicrobial hospital curtains on reducing bacterial contamination-A multicenter study

Author

Mamie Hui, Rodney A. Lee, Vivien W M Chuang, Andrew T.Y. Wong, Kelvin Chung Ho Yu, Sau Chun Fung, Christopher K C Lai, Wing Kin To, Vincent C.C. Cheng, Viola Chi Ying Chow, Tak-Lun Que, Shik Luk, Wai Man Lai, Enoch K. Hsu, and Ngai Chong Tsang

Subjects
Microbiology (medical), medicine.medical_specialty, biology, Epidemiology, business.industry, Clinical settings, Bed days, 030501 epidemiology, Contamination, Acinetobacter, Antimicrobial, biology.organism_classification, Bioburden, 03 medical and health sciences, Infectious Diseases, Multicenter study, Median time, Internal medicine, medicine, 0305 other medical science, business
Abstract

ObjectiveTo determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains.DesignA prospective, open-labeled, multicenter study with a follow-up duration of 6 months.SettingThis study included 12 rooms of patients with multidrug-resistant organisms (MDROs) (668 patient bed days) and 10 cubicles (8,839 patient bed days) in the medical, surgical, neurosurgical, orthopedics, and rehabilitation units of 10 hospitals.MethodCulture samples were collected from curtain surfaces twice a week for 2 weeks, followed by weekly intervals.ResultsWith a median hanging time of 173 days, antimicrobial curtain B (quaternary ammonium chlorides [QAC] plus polyorganosiloxane) was highly effective in reducing the bioburden (colony-forming units/100 cm2, 1 vs 57; P < .001) compared with the standard curtain. The percentages of MDRO contamination were also significantly lower on antimicrobial curtain B than the standard curtain: methicillin-resistant Staphylococcus aureus, 0.5% vs 24% (P < .001); carbapenem-resistant Acinetobacter spp, 0.2% vs 22.1% (P < .001); multidrug-resistant Acinetobacter spp, 0% vs 13.2% (P < .001). Notably, the median time to first contamination by MDROs was 27.6 times longer for antimicrobial curtain B than for the standard curtain (138 days vs 5 days; P = .001).ConclusionsAntimicrobial curtain B (QAC plus polyorganosiloxane) but not antimicrobial curtain A (built-in silver) effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use in an active clinical setting. The antimicrobial curtain provided an opportunity to avert indirect costs related to curtain changing and laundering in addition to improving patient safety.

Published
2018

4. Occurrence of Highly Conjugative IncX3 Epidemic Plasmid Carrying

Author

Ya, Wang, Man-Ki, Tong, Kin-Hung, Chow, Vincent Chi-Chung, Cheng, Cindy Wing-Sze, Tse, Alan Ka-Lun, Wu, Raymond Wai-Man, Lai, Wei-Kwang, Luk, Dominic Ngai-Chong, Tsang, and Pak-Leung, Ho

Subjects
resistance plasmid, Enterobacteriaceae, antimicrobial resistance epidemiology, carbapenems, Microbiology, molecular epidemiology, Original Research
Abstract

The emergence of New Delhi metallo-β-lactamase (NDM) in common enterobacterial species is a major concern for healthcare. Early reports have revealed that the spread of NDM involved diverse and heterogeneous plasmids. Recently, the involvement of a rare, IncX3 subtype plasmid has been increasingly recognized. Here, we studied the prevalence of IncX plasmid subtypes in 198 carbapenem-resistant Enterobacteriaceae, originating from a territory-wide active surveillance in Hong Kong in 2016. The complete sequences and biological features of the blaNDM-carrying plasmids were investigated. A total of 62 NDM-type, 21 OXA-48 type, 14 IMP-type, 8 KPC-type, 4 IMI-type producers, and 89 non-carbapenemase-producers were tested for presence of IncX subtypes. IncX3 (n = 60) was the most common subtype, followed by IncX4 (n = 6) and IncX1 (n = 2). The prevalence of IncX3 subtype in isolates producing NDM, other carbapenemase types and non-carbapenemase producers were 75.8, 21.3, and 3.4%, respectively (P < 0.001). An IncX3 plasmid (size ∼50 kb) was confirmed to carry blaNDM in 47 isolates of different enterobacterial species. Thirteen IncX3 plasmids originating from six healthcare regions in Hong Kong were completely sequenced. The results showed that the IncX3 plasmids carrying blaNDM share a high degree of sequence identity with a previously reported plasmid, pNDM-HN380 (GenBank accession JX104760), over the backbone and genetic load regions. A blast search further revealed the occurrence of identical or nearly identical IncX3 plasmids carrying blaNDM in other part of China, Korea, Myanmar, India, Oman, Kuwait, Italy, and Canada. Two IncX3 carrying blaNDM were investigated further. Conjugation experiments demonstrated that the IncX3 plasmids could be efficiently transferred to multiple enterobacterial species at frequencies that are comparable or higher than the epidemic IncFII plasmid carrying blaCTX-M (pHK01). In addition, efficient transfer of the NDM plasmids occurred over a range of temperatures. In conclusion, this study demonstrated the important role played by IncX3 in the dissemination of NDM and the occurrence of pNDM-HN380-like plasmids in geographically widespread areas. The high mobility of IncX3 plasmid across different enterobacterial species highlights the ability of this plasmid replicon to be an important vehicle in worldwide dissemination of NDM.

Published
2018

5. Abstracts from the 8th International Congress of the Asia Pacific Society of Infection Control (APSIC)

Author

Nantanit Sutthiruk, Mari Botti, Julie Considine, Andrea Driscoll, Ana Hutchinson, Kumthorn Malathum, Cucunawangsih Cucunawangsih, Veronica Wiwing, Vivien Puspitasari, Rathina Kumar Shanmugakani, Yukihiro Akeda, Takuya Kodera, Pitak Santanirand, Kazunori Tomono, Takayuki Yamanaka, Hiroyuki Moriuchi, Hiroyuki Kitajima, Yuho Horikoshi, Alyona Lavrinenko, Ilya Azizov, Nurlan Tabriz, Margulan Kozhamuratov, Yekatherine Serbo, Dahae Yang, Woonhyoung Lee, Il Kwon Bae, Jae Hyun Lee, Hyukmin Lee, Jung Ok Kim, Seok Hoon Jeong, Kyungwon Lee, Thiba Peremalo, Priya Madhavan, Sharina Hamzah, Leslie Than, Eng Hwa Wong, Mohd Nasir Mohd Desa, Kee Peng Ng, Marionne Geronimo, Maria Fe Tayzon, Maria Jesusa Maño, Angela Chow, Pei-Yun Hon, Mar-Kyaw Win, Brenda Ang, Yee-Sin Leo, Tina See, Rocio Alvarez Marin, Marta Aires de Sousa, Nicolas Kieffer, Patrice Nordmann, Laurent Poirel, Wison Laochareonsuk, Sireekul Petyu, Pawin Wanasitchaiwat, Sutasinee Thana, Chollathip Bunyaphongphan, Woranan Boonsomsuk, Pakpoom Maneepongpermpoon, Silom Jamulitrat, Dorairajan Sureshkumar, Kalyanaraman Supraja, Soundararajan Sharmila, Benny Setiawan, Nicolaski Lumbuun, Haruo Nakayama, Toshiko Ota, Naoko Shirane, Chikako Matuoka, Kentaro Kodama, Masanobu Ohtsuka, Silverose Ann Andales Bacolcol, Melecia Velmonte, Allan Alde, Keithleen Chavez, Arlene Joy Esteban, Aisa Jensen Lee, Tai-Chin Hsieh, null Shio-ShinJean, Huey-Jen Huang, Shu-Ju Huang, Yu-Huan Huang, Pei-Chen Cheng, Su-Fang Yu, Shih-Ming Tsao, Yuan-Ti Lee, Chien-Feng Li, Min-Chi Lu, Nattapol Pruetpongpun, Thana Khawcharoenporn, Pansachee Damronglerd, Nuntra Suwantarat, Anucha Apisarnthanarak, Sasinuch Rutjanawech, Lisa Cushinotto, Patty McBride, Harding Williams, Hans Liu, Phan Thi Hang, Dinh Pham Phuong Anh, Ngai Le, Dung Khu, Lam Nguyen, Roel Beltran Castillo, Ram Gopalakrishnan, Venkatasubramanian Ramasubramanian, Subramanian Sreevidya, Ranganathan Jayapradha, Atsushi Umetsu, Tetsuhiro Noda, Kenyuu Hashimoto, Akihiro Hayashi, Mikie Kabashima, Ursula Jadczak, Knut Elvelund, Marit Johnsen, Bente Borgen, Egil Lingaas, Chia-Hua Mao, Fu-Chieh Chang, Chang-Pan Liu, Ru-Hui Chao, Fu-chieh Chang, Chang-pan Liu, Junpen Pawapotako, Chadanan Prasertpan, Wantanee Malaihuan, Phisit Uirungroj, Chalermpong Saenjum, Teerapat Ouirungrog, Sue Borrell, Pauline Bass, Leon Worth, Zhao Xian-li, Li Xiao-long, Yao Xue-hua, Ren Wei, Zhang Xia Zeng, Man Ying Kong, Christopher Koon Chi Lai, Suet Yi Lee, Ngai Chong Tsang, M. M. O’Donoghue, M. V. Boost, L. K. P. Suen, G. K. Siu, K. W. Mui, C. K. C. Lai, D. N. C. Tsang, Yuka Sato, Mariko Tateishi, Mutsuko Mihashi, Jose Paulo Flor, Marko Bautista, V. Jay De Roxas, Justine Vergara, Nicolo Andrei Añonuevo, Marion Kwek, Jose Acuin, Anna Josea Sanchez, Avel Bathan, Jamilah Binte Jantan, Chua Chor Guek, Eu Chiow Kian, Pampe Anak Pirido, Nur Fadilah Binte Mohd Aron, Leah May Estacio, Francis Alvarez Palana, Michelle Gracia, Nur Syafiqah Binte Shamsuddin, Kersten Timbad Castro, Madonna Baloria, Faezah Binte Adam, Zhang Wei, Poh Bee Fong, Marimuthu Kalisvar, I-Ju Chuang, null Yi-ChunCho, Yu-Fen Chiu, Lung-Chih Chen, Yi-Chun Lin, Shao-Xing Dong, Yi-Chieh Lee, Hui-Chen Kuan, Hsin-Hua Lin, Chia-Chun Chi, Chin-Te Lu, Tang Ya-Fen, Su Li-Hsiang, Liu Jien-Wei, Hsuehlan Chao, PinRu ChangChien, WeiFang Chen, ChungHsu Lai, Lutfe Ara, Syed Mohammad Niaz Mowla, Shaikh Mahmud Kamal Vashkar, Wai Fong Chan, Mabel Yin ChunYau, Karen Kam LingChong, Tze OnLi, Rajwinder Kaur, Ng Po Yan, Gloria Chor Shan Chiu, Christina W. Y. Cheung, Patricia T. Y. Ching, Radley H. C. Ching, Conita H. S. Lam, C. H. Kan, Shirley S. Y. Lee, C. P. Chen, Regina F. Y. Chan, Annie F. Y. Leung, Isadora L. C. Wong, S. S. Lam, Queenie W. L. Chan, Cecilia Chan, Seyed Sadeq Seyed Nematian, Charles John Palenik, Mehrdad Askarian, Nahid Hatam, Itaru Nakamura, Hiroaki Fujita, Ayaka Tsukimori, Takehito Kobayashi, Akihiro Sato, Shinji Fukushima, Tetsuya Matsumoto, V. James De Roxas, V James De Roxas, Nicolo AndreiAñonuevo, Yeng May Ho, Jia Qi Kum, Bee Fong Poh, Kalisvar Marimuthu, Tzu-Yin Liu, Sin-Man Chu, Hui-Zhu Chen, Tun-chieh Chen, Yichun Chen, Ya-Ching Tsao, Sumawadee Skuntaniyom, Pirawadee Tipluy, Sangwan Paengta, Ratchanee wongsaen, Sutthiphun thanomphan, Samettanet Tariyo, Buachan Thongchuea, Pattama Khamfu, Sutthiphan Thanomphan, Wipaporn Natalie Songtaweesin, Suvaporn Anugulruengkit, Rujipat Samransamruajkit, Darintr Sosothikul, Ornanong Tansrijitdee, Anry Nakphunsung, Patchareeyawan Srimuan, Jirachaya Sophonphan, null ThanyaweePuthanakit, Kunyanut Payuk, Wilawan Picheansathian, Nongkran Viseskul, Elizabeth DeNardo, Rachel Leslie, Todd Cartner, Luciana Barbosa, Heinz-Peter Werner, Florian H. H. Brill, Julia Yaeko Kawagoe, Elizabeth De Nardo, Sarah Edmonds- Wilson, David Macinga, Patricia Mays-Suko, Collette Duley, Tran Thi Thuy Hang, Tran Thi My Hanh, Christopher Gordon, Roopa Durairaj, Anusha Rohit, Saujanya Saravanakumar, Jothymani Hemalatha, Ryuichi Hirano, Yuichi Sakamoto, Shoji Yamamoto, Naoki Tachibana, Miho Miura, Fumiyo Hieda, Yoshiro Sakai, Hiroshi Watanabe, Silverose Ann Bacolcol, Keitleen Chavez, Jia-Wei Lim, Aung-Aung Hein, Grace Tin, Vanessa Lim, Huwi-chun Chao, Chiu-Yin Yeh, Mei-feng Lo, Chonlada Piwpong, Songyos Rajborirug, Ploypailin Preechawetchakul, Yada Pruekrattananapa, Tharntip Sangsuwan, Ratchanee Wongsaen, Sungwan Paengta, Napatnun Nilchon, Sutthipun Thanompan, Samattanet Tariyo, Svetlana Kolesnichenko, Yerbol Tishkambayev, Asylkhan Alibecov, Yekaterina Serbo, Youngwon Nam, Jae Hyeon Park, Yun Ji Hong, Taek Soo Kim, Jeong Su Park, Kyoung Un Park, Eui-Chong Kim, Samuel Abumhere Aziegbemhin, Onaiwu Enabulele, Yao-Shen Tung, An-Chi Chen, Shen-Min Huang, Yui-Yein Yang, Li-Hung Wu, Chin-cheng Lin, Tzu Hao Lien, Jia Hao Chang, Yu Shan Huang, Yi Shun Chen, Sasithorn Sirilun, Phisit Ouirungroj, Suwanna Trakulsomboon, Patcharee Prasajak, Maryanne W. N. Kwok, Lady S. H. Ng, Lindy M. T. Wong, Lenina S. L. Poon, Mary K. L. Lai, Holly H. S. Cheng, S. K. Fong, Cindy F. Y. Leung, Jumpei Hasegawa, Hiroki Shirakawa, Sachiko Wakai, Makiko Mieno, Shuji Hatakeyama, Manu Deeudom, Prasit Tharavichitkul, Terrence Chinniah, Jackson Tan, Kavitha Prabu, Sartaj Alam, Aung Kyaw Wynn, Rashidah Ahmad, Amalina Sidek, Dg Azizah Samsuddin, Noraini Ajis, Aliyah Ahmad, Susylawathi Magon, Boon Chu, Jiqiu Kuang, Yan Gao, Shoujun Wang, Yunxiao Hao, Rong Liu, Dongmei Li, Hui Wang, Hisanori Nishio, Hitomi Mori, Yoshiko Morokuma, Takaaki Yamada, Makiko Kiyosuke, Sachie Yasunaga, Kazuhiro Toyoda, Nobuyuki Shimono, Dmitriy Babenko, Anar Turmuhambetova, Antonella Cheşcă, Mark A. Toleman, Lyudmila L. Akhmaltdinova, Mark Albert Magsakay, Angelo Macatibag, Jeannica Kriselle Lerios, Alyona Lavrineko, Dmitry Babenko, Eugene Sheck, Mikhail Edelstein, Lih-Yue Li, Chiung-Wen Chan, Hui-Chuan Pan, Wipa Vanishakije, Warisra Jaikampun, Su-Yin Li, Jian-Feng Li, Yu-Ping Wu, Chiao-Hui Lin, Ping-Chin Chang, Samatanet Tariyo, Suttsiphan Thanompan, Suchada Sukkra, Khalequ Zaman, Sheikh Farzana Zaman, Farzana Zaman, Asma Aziz, Sayeed-Bin Faisal, Magali Traskine, Javier Ruiz-Guiñazú, Dorota Borys, Wendy Wai Yee Lam, May Chow, Lucy Choy, Joseph Kam, Sharifah Azura Salleh, Razila Yacob, Siti Rokiah Yusof, Nordiah Awang Jalil, Maria Lourdes Millan, Jose Lito Acuin, Melecia A. Velmonte, Silverose Ann A. Bacolcol, Ching-I Ting, Sunisa Dissayasriroj, Terrence Rohan Chinniah, Jauharatud DiniSuhaimi, Aizzuddin Mirasin, Nurul Morni, Azizah Samsuddin, Amalina AbuBakar, Amanie Shafiee, Julaini Safar, Leung Annie, Fung Yuk Ling, Lau Edna, Luk Kristine, Satoshi Shinomiya, Kumiko Yamamoto, Kayoko Kjiwara, Mitsuhiro Yamaguchi, Wei Zhang, Bee-Fong Poh, Ming-Chin Chan, Chih-Chien Wang, Huan-Yu Huang, Chiung-Ling Lai, Sajeerat Kosol, Wantana Sakolwirat, Patchanee Paepong, Sawalee Jansanga, Pattarin Jaisamoot, Nuttha Thongnuanual, Chittima Srithong, Somporn Somsakul, Sutima Plongpunth, Mukkapon Punpop, Porntip Malathum, Kulada Peautiwat, Nattawipa boon kirdram, Pimpaporn Klunklin, Geetha Samethadka, Naoko Suzuki, Hitomi Asada, Masao Katayama, Atsushi Komano, Hidehiro Watanabe, Hye Kyung Seo, Joo-Hee Hwang, Myoung Jin Shin, Su Young Kim, Eu Suk Kim, Kyoung-Ho Song, Hong Bin Kim, Lai-Si Un, Choi-Ian Vong, Jocelyn Koh, Sherly Agustinus, Rozita Bte Abu Hassan, Yin Phyu Thinn, Benjamin Ng, Soe Pyae Tun, Su Mon Thi Ha, Xue Xiaoting, Lin Li, Leyland Chuang, Attanayaka Mudiyanselage Chulani Niroshika, Kaluarachchige Anoma Kaluarachchi Perera, Dimingo Kankanamalage Diana Grace Fernando, Bodhipakshage Rohini Hemamala, Chiu-yin Yeh, Hui-Chun Yang, Hsiang-Ju Chiu, Ya-Ling Shih, Yu-Shan Chien, Wan-Yi Lin, Chia-Yun Pan, Ying-Yun Chang, Chiu-Yuch Yea, Ming-Hsien Chu, Li-Chu Lee, Lin Yu-Hsiu, Guo Siao-Pei, Leung Pak-On, Sie Mei-Fe, Chen Jyh-Jou, Chang Yong-Yuan, Shu-Yuan Kuo, Yu-Hsiu Lin, Ji-Sheng Zhang, Pak-On Leung, Mei-Fe Sie, Jyh-Jou Chen, Yan-Ru Chen, Ying-Ling Chen, Chi-Fen Taou, Hsiao-Shan Chen, Hung-Jen Tang, Shin Yu Chen, Yin Yin Chen, Fu Der Wang, Tzu-Ping Shih, Chin-Yu Chen, Su-Jung Chen, Mei-chi Wu, Wan-ju Yang, Mei-ling Chou, Man-Ling Yu, Li-Chu Li, Cheng-Wei Chu, Wen-Hao Tsou, Wen-Chih Wu, Wen-Chi Cheng, Cho-Ching Sun, Shu-Hua Lu, Hsin-Ling Yang, Cheng-Yu Lu, Nitchawan Hirunprapakorn, Sirilux Apivanich, Ttipakorn Pornmee, Chonnikarnt Beowsomboon, Itthaporn Kumkoom, Nongyao Kasatpibal, Jittaporn Chitreecheur, JoAnne D. Whitney, Surasak Saokaew, Kirati Kengkla, Margaret M. Heitkemper, Thanomvong Muntajit, Siriluk Apivanich, Hang Thi Phan, Anh Pham Phuong Dinh, and Tuyet Thi Kim Nguyen

Subjects
0301 basic medicine, Microbiology (medical), business.industry, 030106 microbiology, Public Health, Environmental and Occupational Health, 03 medical and health sciences, Infectious Diseases, Asia pacific, Environmental protection, International congress, Medicine, Infection control, Pharmacology (medical), Socioeconomics, business
Published
2017
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6. Prevalence, Prediction, and Clonality of Methicillin-ResistantStaphylococcus aureusCarriage at Admission to Medical Units in Hong Kong, China

Author

Rodney A. Lee, Kin Wing Choi, Alex Yat Man Ho, Shik Luk, Ngai Chong Tsang, Wai Man Lai, Iris Hoi Ling Tsang, Sau Chun Fung, Tak-Lun Que, Tak Keung Ng, Andrew Tin Yau Wong, Vincent C.C. Cheng, and Eliza Hoi Ying Chan

Subjects
Male, Methicillin-Resistant Staphylococcus aureus, 0301 basic medicine, Microbiology (medical), Pediatrics, medicine.medical_specialty, Time Factors, Epidemiology, 030106 microbiology, medicine.disease_cause, Sensitivity and Specificity, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, Risk Factors, Prevalence, medicine, Homes for the Aged, Humans, Infection control, 030212 general & internal medicine, Screening cultures, Staphylococcal Protein A, Aged, Aged, 80 and over, Molecular Epidemiology, Molecular epidemiology, business.industry, Odds ratio, Middle Aged, Staphylococcal Infections, Methicillin-resistant Staphylococcus aureus, Hospitals, Confidence interval, Bacterial Typing Techniques, Cross-Sectional Studies, Infectious Diseases, Carriage, Staphylococcus aureus, Carrier State, Hong Kong, Female, business
Abstract

Objective.To determine the prevalence, risk factors, and molecular epidemiology of methicillin-resistantStaphylococcus aureus(MRSA) colonization at the time of admission to acute medical units and to develop a cost-effective screening strategy.Methods.Nasal and groin screening cultures were performed for patients at admission to 15 acute medical units in all 7 catchment regions in Hong Kong. All MRSA isolates were subjected tospatyping.Results.The overall carriage rate of MRSA was 14.3% (95% confidence interval [CI], 13.5–15.1). MRSA history within the past 12 months (adjusted odds ratio [OR], 4.60 [95% CI, 3.28–6.44]), old age home residence (adjusted OR, 3.32 [95% CI, 2.78–3.98]), and bedbound state (adjusted OR, 2.19 [95% CI, 1.75–2.74]) were risk factors selected as MRSA screening criteria that provided reasonable sensitivity (67.4%) and specificity (81.8%), with an affordable burden (25.2%).spatyping showed that 89.5% (848/948) of the isolates were clustered into the 4spaclonal complexes (CCs):spaCC1081,spaCC032,spaCC002, andspaCC4677. Patients colonized with MRSAspatypes t1081 (OR, 1.77 [95% CI, 1.49–2.09]) and t4677 (OR, 3.09 [95% CI, 1.54–6.02]) were more likely to be old age home residents.Conclusions.MRSA carriage at admission to acute medical units was prevalent in Hong Kong. Our results suggest that targeted screening is a pragmatic approach to increase the detection of the MRSA reservoir. Molecular typing suggests that old age homes are epicenters in amplifying the MRSA burden in acute hospitals. Enhancement of infection control measures in old age homes is important for the control of MRSA in hospitals.

Published
2014
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8. Clostridium difficile infection outbreak in a male rehabilitation ward, Hong Kong (China), 2011

Author

Man-ha Wong, Shuk-Kwan Chuang, Tsz-sum Lam, Man-ting Yuk, and Ngai-chong Tsang

Subjects
medicine.medical_specialty, Activities of daily living, Rehabilitation, business.industry, Potential risk, medicine.medical_treatment, Medical record, lcsh:Public aspects of medicine, lcsh:R, Outbreak, lcsh:Medicine, lcsh:RA1-1270, General Medicine, Clostridium difficile, Ribotyping, Emergency medicine, medicine, Hong Kong, Intensive care medicine, business, male rehabilitation ward
Abstract

Clostridium difficile is an anaerobic, gram-positive bacterium, capable of sporulation when environmental conditions no longer support its growth. The sporulation capacity enables the organism to persist in the environment for extended periods of time. Clostridium difficile is the main pathogen accountable for antibiotic-associated colitis and for 15% to 25% of cases of nosocomial antibiotic-associated diarrhoea. Major risk factors such as increased severity of underlying illness, increased age, prior antimicrobial use and gastric acid suppressors have been identified for Clostridium difficile.

Published
2012

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