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Controlling the concentration of bacteria in patient rooms to prevent airborne injection is one of the important issues in injection control in hospitals. The effects of air inlet/outlet locations, patient styles of reclining, and air change rate on bacteria removal have been studied. A real hospital isolation room was the object for computation and experiment. In computation, commercial CFD software was used to simulate steady and transient air motion. The flow model was incompressible turbulent flow including buoyancy effect. In the experiment, we used fog generated by an ultrasonic nebulizer to put experimental bacteria into the patient room, and then examined the effect of bacteria removal by means of colony counts. Both computational and experimental results showed that the original design of the isolation room could not remove bacteria effectively. The air inlet/outlet locations were rearranged and the computations and experiments were redone to find better designs. Results of the present study revealed that a large air change rate might not be necessary for most cases. Finally, a set of air inlet/outlet locations and the associated air change rate were suggested. [ABSTRACT FROM AUTHOR]

ABSTRACT: Tigecycline In-vitro Surveillance in Taiwan (TIST), initiated in 2006, is a nationwide surveillance programme designed to monitor longitudinally the in-vitro activity of tigecycline against commonly encountered resistant bacteria in Taiwan. This study, part of TIST-2006 study, aimed to compare the in-vitro activity of tigecycline against clinical isolates of Gram-positive bacteria. A total of 805 isolates of Gram-positive bacteria were collected from patients treated at 20 teaching hospitals. Minimum inhibitory concentrations (MICs) of tigecycline for these isolates were determined by the broth microdilution method according to the guidelines of the Clinical and Laboratory Standards Institute, and by the Etest as per the manufacturer''s instructions. Susceptibility results were interpreted by the MIC criteria recommended by the US FDA. Agreement between the two methods was low: 80.7% for methicillin-resistant Staphylococcus aureus (MRSA), 27.2% for Streptococcus pneumoniae, 22.8% for other Streptococcus spp., and 30.8% for vancomycin-resistant E. faecium (VRE). There were no very major or major errors noted. Tigecycline exhibited excellent in-vitro activity against Gram-positive cocci, including MRSA, VRE, S. pneumoniae and other Streptococcus spp. isolates in Taiwan. Correlation between MIC values determined using the broth microdilution and Etest methods for these organisms was poor. [Copyright &y& Elsevier]

ABSTRACT: Tigecycline In-vitro Surveillance in Taiwan (TIST), initiated in 2006, is a nationwide surveillance programme designed to monitor longitudinally the in-vitro activity of tigecycline against commonly encountered resistant bacteria. This study compared the in-vitro activity of tigecycline against clinical isolates of resistant Gram-negative bacteria determined by the broth microdilution and Etest methods. A total of 622 isolates were collected from patients treated at 20 teaching hospitals. Tigecycline had excellent in-vitro activity against extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (N = 275) with MIC 90 0.5 μg/mL and a 99.6% susceptibility rate, and also against ESBL-producing Klebsiella pneumoniae (N = 324) with MIC 90 2 μg/mL and a 98.5% susceptibility rate. For ESBL-producing Proteus mirabilis (N = 15) the MIC 90 was 4 μg/mL with a 73.3% susceptibility rate. For ESBL-producing Klebsiella oxytoca (N = 8) the MIC 50 and MIC 90 were 0.5 and 1 μg/mL, respectively, with a 100% susceptibility rate. Limited agreement (<80%) was found between the broth microdilution and the Etest methods when determining the in-vitro activity of tigecycline against ESBL- producing K. pneumoniae and K. oxytoca. [Copyright &y& Elsevier]

ABSTRACT: A total of 393 isolates of A. baumannii were collected from patients treated at 19 teaching hospitals in Taiwan. Minimum inhibitory concentrations (MICs) and inhibitory zone diameters for tigecycline were determined by the broth microdilution method and the disk diffusion method, respectively. The MIC results were interpreted using the US FDA tigecycline susceptibility breakpoints for Enterobacteriaceae (susceptible [S] ≤2 μg/mL; intermediate [I] 4 μg/mL; resistant [R] ≥8 μg/mL). The disk diffusion results were interpreted by criteria recommended by Jones et al. (S ≥16 mm; I 13–15 mm; R ≤12 mm) and also by those recommended by the US FDA for Enterobacteriaceae (S ≥19 mm; I 15–18 mm; R ≤14 mm). The percentages of susceptible, intermediate and resistant isolates determined by the broth microdilution method were 80.9%, 12.2%, and 6.9%, respectively. The rates of susceptible, intermediate and resistant isolates by the disk diffusion method using the criteria of Jones et al. were 88.3%, 9.9% and 1.8% and using the US FDA criteria were 44.0%, 51.7% and 4.3%. Using the criteria recommended by Jones et al., the total error rate of the disk diffusion method in comparison with the broth microdilution method was 14.2% (56/393). For routine susceptibility testing of tigecycline against A. baumannii the broth microdilution method, not the disk diffusion method, should be used due to the poor correlation of results between these two methods interpreted either by the Jones et al. or US FDA criteria. [Copyright &y& Elsevier]

ABSTRACT: We performed susceptibility testing using the microdilution method to determine the in-vitro activity of tigecycline against 393 Acinetobacter baumannii clinical isolates collected in 2006 from 19 hospitals in Taiwan. Significant proportions of the isolates were resistant to imipenem (44%), ciprofloxacin (75%), amikacin (69%), sulbactam (34%) and all four antibiotics (22%), and susceptibility to tigecycline among these different resistant phenotypes of A. baumannii varied from 71% to 82%. The minimum inhibitory concentration (MIC) of tigecycline ranged from 0.6 to 16 μg/mL (MIC 50 2 μg/mL; MIC 90 4 μg/mL). The cumulative curve of tigecycline MICs showed that when the MIC cut-offs were set at 2 μg/mL and 4 μg/mL, 80.9% and 93.1% of the isolates were susceptible, respectively. As tigecycline will be used in the future for infections caused by multidrug-resistant A. baumannii because of limited antibiotic choice, and as resistance to tigecycline in A. baumannii isolates may develop following antibiotic exposure, continuous monitoring of the susceptibility of A. baumannii isolates to tigecycline is warranted. [Copyright &y& Elsevier]