Download Advances in Environmental Biology AENSI Journals

Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
AENSI Journals
Advances in Environmental Biology
Journal home page: http://www.aensiweb.com/aeb.html
Effective Sources of Food Borne Illness in Iranian Hospitalized Patients: Review Article
Shila Jalalpour
Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
ARTICLE INFO
Article history:
Received 23August 2013
Received in revised form 24 September
2013
Accepted 29 September 2013
Available online 17 November 2013
Keywords:
Food Borne Illness, Hospitalized
Patients, Hands of Staff,
Hospital Surfaces
ABSTRACT
Background: Nosocomial infections (NIs), also called hospital-acquired infections are
infections acquired during hospital care which are not present or incubating at
admission. Food borne Illness remains a major global concern in all countries. Health
care settings are an hospital environment where both infected persons and persons at
increased risk of infection congregate. Staff hands and hospital surfaces have important
role in spread and transmission Food borne Illness Bacteria in hospital. The subject of
this study was survey effective sources of food borne illness in hospitalized patients.
Methodology: Related papers to importance of staff hands and hospital surfaces in
transmission Food borne Illness Bacteria in hospital were extracted of articles in
Pubmed, Elsivier Science, and Yahoo from 1975 to 2013 years. For this study, key
words which were search include hospital surfaces, staff hand, transmission Bacteria
and Food borne Illness. Results: About important staff hands and hospital surfaces in
transmission Food borne Illness Bacteria in hospital in all of articles, there is consensus
that control Bacterial population in these sources, leading to control these Bacteria in
hospital. Hospital surfaces can serve as reservoirs Foodborne Illness Bacteria such
Staphylococcus aureus, Salmonella, Clostridium perfringens, Campylobacter, Listeria
monocytogenes, Vibrio parahaemolyticus, Bacillus cereus and Escherichia coli.
Bacteria on hospital surfaces have low potential to spread and staff hands are the
effective sources to transfer of these Bacteria. Discussion: Staff hands have very
contact with hospital surfaces and are more sources to transmit bacteria into hospital.
Keeping the staff hand and hospital surfaces clean has been considered to be most
important tool in control of transmission Food borne Illness Bacteria.
© 2013 AENSI Publisher All rights reserved.
INTRODUCTION
Antimicrobial resistance is one of the significant problems worldwide leads to curative failure of therapy and
it has been a threat to the patient’s safety not only in developing countries but also indeveloped countries
[3,14,16,35,21-23]. Therefore, awareness of the local prevalence of pathogens and their antimicrobial sensitivity
patterns is essential for clinicians. Establishing surveillance systems integrate clinical and laboratory data and by
it the necessary data can be captured and strengths of both data setscan be combined. There is evidence that the
wiser use of antimicrobials may reduce the rate of resistance emerges [4,5,19,20,42,45]. Thus information from
surveillance of antimicrobial resistance and data on the use of antimicrobials provides a powerful tool for the
control of resistance. The aim of antimicrobial resistance surveillance is to provide information necessary to
obtain an approach to the management of communicable diseases that diminishes morbidity and
mortality[24,25]. The main applications of surveillance information are to optimize the use of antimicrobials
and assist in the prevention and control of antimicrobial resistance at the local, regional and national levels
[42,45,46].
Multidrug-resistant organisms (MDROs), including methicillin-resistant Staphylococcus aureus (MRSA),
vancomycin-resistant enterococci (VRE) and certain Gram-negative bacilli (GNB) have important infection
control implications that either have not been addressed or received only limited consideration in previous
isolation guidelines. Increasing experience with these organisms is improving understanding of the routes of
transmission and effective preventive measures. For epidemiologic purposes, MDROs are defined as
microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents .
Although the names of certain MDROs describe resistance to only one agent (e.g., MRSA, VRE), these
pathogens are frequently resistant to most available antimicrobial agents . These highly resistant organisms
deserve special attention in healthcare facilities [41]. In addition to MRSA and VRE, certain GNB, including
those producing extended spectrum beta-lactamases (ESBLs) and others that are resistant to multiple classes of
antimicrobial agents, are of particular concern. In addition to Escherichia coli and Klebsiella pneumoniae, these
Corresponding Author: Shila Jalalpour, Molecular Medicine Research Center, Rafsanjan University of Medical Sciences,
Rafsanjan, Iran.
E-mail:[email protected]
3561
Shila Jalalpour
Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
include strains of Acinetobacter baumannii resistant to all antimicrobial agents, or all except imipenem and
organisms such as Stenotrophomonas maltophilia, Burkholderia and Ralstonia pickettii that are intrinsically
resistant to the broadest-spectrum antimicrobial agents. In some residential settings (e.g., LTCFs), it is important
to control multidrug-resistant [17-19,41].
Members of the family Enterobacteriaceae commonly express plasmid-encoded β-lactamases (e.g., TEM-1,
TEM-2, and SHV-1), which confer resistance to penicillins but not to expanded-spectrum cephalosporins.
ESBLs are beta-lactamases that hydrolyze extended-spectrum cephalosporins with an oxyimino side chain.
These cephalosporins include cefotaxime, ceftriaxone, and ceftazidime, as well as the oxyimino-monobactam
aztreonam. Thus ESBLs confer resistance to these antibiotics and related oxyimino-beta lactams [28,34,36].
Typically, they derive from genes for TEM-1, TEM-2, or SHV-1 by mutations that alter the amino acid
configuration around the active site of these beta-lactamases. This extends the spectrum of beta-lactam
antibiotics susceptible to hydrolysis by these enzymes [28,34,36]. An increasing number of ESBLs not of TEM
or SHV lineage have recently been described [7]. The ESBLs are frequently plasmid encoded. Plasmids
responsible for ESBL production frequently carry genes encoding resistance to other drug classes (for example,
aminoglycosides). Therefore, antibiotic options in the treatment of ESBL-producing organisms are extremely
limited. Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet
carbapenem-resistant isolates have recently been reported. ESBL-producing organisms may appear susceptible
to some extended-spectrum cephalosporins. However, treatment with such antibiotics has been associated with
high failure rates. While ESBL-producing organisms were previously associated with hospitals and institutional
care, these organisms are now increasingly found in the community [26,27]. CTX-M-15-positive E. coli are a
cause of community-acquired urinary infections in the UK and tend to be resistant to all oral beta-lactam
antibiotics, as well as quinolones and sulfonamides. Treatment options may include nitrofurantoin, fosfomycin,
mecillinam and chloramphenicol. In desperation, once-daily ertapenem or gentamicin injections may also be
used. Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs
because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first
given the designation IRT for inhibitor-resistant TEM beta lactamase; however, all have subsequently been
renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM β-lactamases.
Inhibitor-resistant TEM beta lactamases have been found mainly in clinical isolates of E. coli, but also some
strains of K. pneumoniae, Klebsiella oxytoca, Proterious mirabilis, and Citrobacter freundii .Although the
inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing
clinical resistance to the beta-lactam lactamase inhibitor combinations of amoxicillin-clavulanate (Coamoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by
tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been
described. To date, these beta-lactamases have primarily been detected in France and a few other locations
within Europe [4,30,38].
Extended spectrum beta lactamase (ESBL) production is one of the different mechanisms of drug resistance
in Gram-negative bacilli predominantly present in E. coli and K. pneumoniae [2,6-8,31,32]. Infectious Diseases
Society of America listed ESBL-producing Klebsiella spp and E coli as one of the six drug-resistant microbes to
which new therapies are urgently needed [28,29,44]. Author aimed to determine the prevalence of ESBLproducing E.coli and K. pneumoniae isolated from acquired urinary trace infection hospitalized and non
hospitalized Iranian patients in from 2008 to 2011.Relater papers to prevalence of extended spectrum beta
lactamase in isolated E.coli, K. pneumoniae from hospitalized and non hospitalized patients were extracted of
original and review articles (Available freely to download) in Pubmed, Elsivier Science, and Yahoo from 1995
to 2013 years. For this study key words which were search include multidrug resistant organisms, extended
spectrum beta lactamase, E. coli and K.pneumoni and IRAN.
Discussion:
Study and comparing of ESBLs percentage showed that frequency of occurrence of ESBLs in E. coli
and K. pneumonia were higher in hospitalized patients in comparison to non hospitalized patients, for example
in some study in Iran prevalence of ESBL in isolated E.coli and K. pneumoniae from hospitalized and non
hospitalized patients was 72.22%, 23.73% and 83.33% and 0%, respectively [11-16].
The rapid spread of ESBL-producing bacteria worldwide indicated needing of a continuous monitoring
systems and effective infection control measures [4,35,42]. Comprehensive epidemiologic data and
characterization of ESBL-producing isolates among hospitalized and non hospitalized in Iran are still rarely
documented and previous studies failed in extend number of patients, long-term study and comprehensive
epidemiologic data despite of their useful content leading to a global view on ESBL producing bacteria in Iran.
For example, [1] determine the prevalence of extended spectrum beta-lactamase (ESBL) producing E.coli in one
900-bed general teaching hospital showed 56% (n=140) of E. coli isolates produced ESBLs from 3 university
hospitals in Tehran during six months. Therefore, for first time we (Mobasherizaded and et al) launched a
prospective surveillance study of laboratory based antimicrobial resistance (Antimicrobial Resistance
3562
Shila Jalalpour
Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
Surveillance System) in Isfahan province, Iran. In this surveillance study, the prevalence of ESBL producing E.
coli in hospitalized and non hospitalized infections has been studied during three years (2008 to 2011) and
WHONET software as an analysis program helping in forming hospital drug policy was used. (This WHONET
is free Windows-based database software developed for the management and analysis of microbiology
laboratory data with a special focus on the analysis of antimicrobial susceptibility test results). The prevalence
of ESBL-producing E. coli under antimicrobial resistance surveillance system has been studied in several
countries [5,32,37,39,40,43,45,46].
Establish systems for monitoring antimicrobial resistance in hospitals and the community and link
these findings to resistance and disease surveillance data are fundamental to developing treatment guidelines
accurately and to assessing the effectiveness of interventions appropriately. For first time launched
(Mobasherizaded and et al) a prospective Antimicrobial Resistance Surveillance System in Iran. Present result
showed very high prevalence of ESBL producing E.coli and K. pneumoniae in Iran province that alarm an
emerging public-health concern, showed emergence need for developing a treatment guideline for antibiotic
consumption. Continued surveillance will provide an important function for succeed in the efforts of infection
control programs in future and it is a critical step for controlling of the growing worldwide threat of
antimicrobial drug resistance [9,10].
Nosocomial infections occur worldwide and affect both developed and resource-poor countries. Infections
acquired in health care settings are among the major causes of death and increased morbidity among
hospitalized patients. They are a significant burden both for the patient and for public health [6,13,25]. A
prevalence survey conducted under the auspices of WHO in 55 hospitals of 14 countries representing 4 WHO
Regions (Europe, Eastern Mediterranean, South-East Asia and Western Pacific) showed an average of 8.7% of
hospital patients had nosocomial infections [6]. At any time, over 1.4 million people worldwide suffer from
infectious complications acquired in hospital. The highest frequencies of nosocomial infections were reported
from hospitals in the Eastern Mediterranean and South-East Asia Regions (11.8 and 10.0% respectively), with a
prevalence of 7.7 and 9.0% respectively in the European and Western Pacific Regions [5,6,25,26,37,46].
The health-care environment contains a diverse population of microorganisms. Microorganisms present in
great numbers in moist, organic environments, but some also can persist under dry conditions. Environmental
source or means of transmission of infectious agents, the presence of the pathogen does not establish its causal
role; its transmission from source to host could be through indirect means, e.g., via hand transferability [5,2224,26,46]. The surface would be considered as one of a number of potential reservoirs for the pathogen, but not
the de facto source of exposure. An understanding of how infection occurs after exposure, based on the
principles of the chain of infection is also important in evaluating the contribution of the environment to healthcare–associated disease [44]. All of the components of the chain must be operational for infection to occur:
1.Adequate number of pathogenic organisms (dose); 2.Pathogenic organisms of sufficient virulence; 3.A
susceptible host; 4.An appropriate mode of transmission or transferal of the organism in sufficient number from
source to host; 5.The correct portal of entry into the host [44]. Although microbiologically contaminated
surfaces can be served as reservoirs of potential pathogens, these surfaces generally are not directly associated
with transmission of infections to either staff or patients [44].
The transferral of microorganisms from environmental surfaces to patients is largely via hand contact with
the surface [44]. S. aureus, Escherichia coli and spore forming Bacteria are the most bacterium causing
foodborne diseases in hospital and community.
S. aureus is the most common gram-positive bacterium causing NIs [29,45]. Its frequency among all
pathogens in NIs varies between 11.1 and 17.2% (40; 42; 50).
Methicillin resistance in S. aureus (MRSA) is increasing worldwide [43]. leading not only to NIs but
recently also to community-acquired infection. Colonization of health care workers' hands with S. aureus has
been described to range between 10.5 to 78.3% . Up to 24,000,000 cells had been found per hand [2]. The
colonization rate with S. aureus was higher among doctors (36%) than among nurses (18%), as was the bacterial
density of S. aureus on the hands (21 and 5%, respectively, with more than 1,000 CFU per hand). The carrier
was be up to 28% if the health care worker contacts patients with an atopic dermatitis which was colonized by S.
aureus [51]. MRSA has been isolated from the hands of up to 16.9% of health care workers. VRE can be found
on the hands of up to 41% of health care workers. Hand carriage of pathogens such as S. aureus, MRSA, or S.
epidermidis has repeatedly been associated with different types of NI [11].
The analysis of outbreaks revealed that dermatitis on the hands of health care workers was a risk factor for
colonization or for inadequate hand hygiene, resulting in various types of NI. Transmissibility of VRE has also
been demonstrated. The hands and gloves of 44 health care workers were sampled after care of VRE-positive
patients. Gloves were VRE positive for 17 of 44 healthcare workers, and hands were positive for 5 of 44, even
though they had worn gloves [47]. One health care worker was even VRE positive on the hands although the
culture from the glove was negative [47]
S. aureus can survive on hands for at least 150 min; VRE survives on hands or gloves for up to 60 min. On
inanimate surfaces, S. aureus and MRSA may survive for 7 months, with wild strains surviving longer than
3563
Shila Jalalpour
Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
laboratory strains. VRE may survive on surfaces for 4 months. The long survival on surfaces, together with the
relatively short survival on hands, suggests that contaminated surfaces may well be the source of transient
colonization despite negative hand cultures. Escherichia coli is the most common gram-negative bacterium,
causing mainly NIs [27].Overall, gram-negative bacteria are found in up to 64% of all Nis.Colonization rates of
gram-negative bacteria on the hands of health care workers have been described as ranging from 21 to 86.1% .
with the highest rate being found in ICUs . The number of gram-negative bacteria per hand may be as large as
13,000,000 cells [2]. The colonization may be long-lasting [28]. Even in nursing homes, a rate of 76% has been
described for nurses hands [52]. Colonization with gram-negative bacteria is influenced by various factors. For
example, it is higher before patient contact than after the work shift [9]. Hands with artificial fingernails harbor
gram-negative bacteria more often than those without [10]. Higher colonization rates with gram-negative
bacteria also occur during periods of higher ambient temperature and high air humidity [31].
Transient hand carriage of various gram-negative bacterial species has quite often been suspected to be
responsible for cross-transmission during outbreaks resulting in various types of NI [7]. Most gram-negative
bacteria survive on the hands for 1 h or more. Survival on inanimate surfaces has been reported to be different
for the different gram-negative species, with most of them surviving for many months. In general, gram-negative
bacteria survive for longer on inanimate surfaces than on human skin. The main spore-forming bacterium
causing NIs is Clostridium difficile. It is estimated that between 15 and 55% of all cases of nosocomial
antibiotic-associated diarrhea are caused by C. difficile [3,34]. Patients with diarrhea caused by C. difficile have
on average 3.6 additional hospital days attributable to the NI, The overall mortality is 15% [35]. Extraintestinal
manifestations are very uncommon (1%). Patients can be contaminated from, for instance, the hands of hospital
personnel and from inanimate surfaces [3]. In one study, the hands of 59% of 35 health care workers were C.
difficile positive after direct contact with culture-positive patients. Colonization was found mainly in the
subungual area (43%), on the fingertips (37%), on the palm (37%), and under rings (20%) [32]. In another
study, 14% of 73 health care worker s were culture positive for C. difficile on their hands. The presence of C.
difficile on the hands correlated with the density of environmental contamination [41]. During a third outbreak,
caused by Bacillus cereus in a neonatal ICU, 11 (37%) of 30 fingerprints from health care workers were positive
for Bacillus spp. [48]. Transmission of C. difficile in an endemic setting on a general medical ward has been
shown to occur in 21% of patients, with 37% of them suffering from diarrhea. Another spore-forming bacterium
has been described as well: B. cereus was transmitted to the umbilicus in 49% of newborns on a maternity ward;
the hands of 15% of the health care workers were found to be culture positive [4]. Vegetative cells of C. difficile
can survive for at least 24 h on inanimate surfaces, and spores survive for up to 5 months.
According role of hands of staff and hospital surfaces in nosocomial infection and increase of antibiotic
resistance nosocomial infection in Iranian hospitalized patients, the subject of this study was survey effective
sources of food borne illness in hospitalized patients in Iranian hospital.
RESULTS AND DISCUSSION
About important staff hands and hospital surfaces in transmission Food borne Illness Bacteria in hospital
in articles, there is consensus that control Bacterial population in these sources, lead to control these Bacteria in
hospital [5,13,44].
According result previous study in Iranian hospital, Staphylococcus sp. 101 consist of isolated bacteria
from hospital surfaces and 28 consist of isolated bacteria from hands of staff and according to Acidimetric test
results respectively 73 species of Staphylococcus isolated from hospital surfaces and 19 species of
Staphylococcus isolated from hands of staff was resistance to beta lactame antibiotics [15-17,20,21[.
According previous study 83.33% of Staphylococcus spp. isolated from nosocomial infection in Iran was
resistant to beta lactame antibiotics [14]. According result another study in Iran, 61.9% of bacteria isolated from
biotic condition in hospital was resistance to beta lactame antibiotics, respectively was in Staphylococcus spp.,
Bacillus spp. and Enterobacteriaceae 71%, 64.72% and 50%, According another study in Iran 77.94% of
Bacteria isolated from abiotic condition in hospital was resistant to beta lactame antibiotics, respectively in
Staphylococcus spp., Bacillus spp. and Enterobacteriaceae 82.7%, 68.4% and 80.35% [15,16,17,20].
Nosocomial infections (NIs) remain a major global concern. Overall national prevalence rates have been
described as ranging between 3.5 and 9.9% [26].
They lead to additional days of treatment, increase the risk of death and increase treatment costs. Staff
hands and hospital surfaces have important role in NIs [1,8,12,36]. Bacteria on hospital surfaces have low
potential to spread. Staff hands have very contact with hospital surfaces and are more sources to transmission
Bacteria into hospital. Improving staff hand and hospital surfaces hygiene had been considered the most
important tool in control of transmission Food borne Illness Bacteria [5,13,18,19,44].
Conclusion:
3564
Shila Jalalpour
Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
The importance of hands in the transmission of hospital infections has been well demonstrated and can be
minimized with appropriate hand hygiene. Compliance with hand washing, however, is frequently suboptimal.
This is due to a variety of reasons, including: lack of appropriate accessible equipment, high staff-to-patient
ratios, allergies to hand washing products, insufficient knowledge of staff about risks and procedures, too long a
duration recommended for washing, and the time required [5,13,44]. To minimize the transmission of
microorganisms from equipment and the environment, adequate methods for cleaning, disinfecting and
sterilizing must be in place. Written policies and procedures which are updated on a regular basis must be
developed for each facility [5,13,44].
The director of food services must be knowledgeable in food safety, staff training, storage and preparation
of foodstuffs, job analysis, and use of equipment. The head of catering services is responsible for: 1-defining the
criteria for the purchase of foodstuffs, equipment use, and cleaning procedures to maintain a high level of food
safety 2-ensuring that the equipment used and all working and storage areas are kept clean 3-issuing written
policies and instructions for hand washing, clothing, staff responsibilities and daily disinfection duties 4ensuring that the methods used for storing, preparing and distributing food will avoid contamination by
microorganisms 5-issuing written instructions for the cleaning of dishes after use, including special
considerations for infected or isolated patients where appropriate 6-ensuring appropriate handling and disposal
of wastes 7-establishing programmes for training staff in food preparation, cleanliness, and food safety 8establishing a Hazard Analysis of Critical Control Points (HACCP) programme, if required [5,13,44].
Approximately one third of nosocomial infections are preventable. Cleaning is the necessary first step of
any sterilization or disinfection process. Cleaning is removing organic matter, salts, and visible soils, all of
which interfere with microbial inactivation [5,13,44]. Hand washing frequently is called the single most
important measure to reduce the risks of transmitting microorganisms from one person to another or from one
site to another on the same patient. Although hand hygiene is important to minimize the impact of this transfer,
cleaning and disinfecting environmental surfaces as appropriate is fundamental in reducing their potential
contribution to the incidence of healthcare-associated infections [30,33,38,39,49].
REFERENCES
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13]
Astagneau, P., C. Rioux, F. Golliot, G. Brucker, 2001. Morbidity and mortality associated with surgical
site infections: results from the 1997–1999 INCISO surveillance. J Hosp Infect., 48: 267-274.
Ayliffe, G.A., J.R. Babb, J.G. Davies, H.A. Lilly, 1988. Hand disinfection: a comparison of various agents
in laboratory and ward studies. J Hosp Infect., 11: 226-243.
Barbut, F., J.C. Petit, 2001. Epidemiology of Clostridium difficile-associated infections. Clin Microbiol
Infect., 7: 405-410.
Birch, B.R., B.S. Perera, W.A. Hyde, V. Ruehorn, L.A. Ganguli, J.M. Kramer, P.C. Turnbull, 1981.
Bacillus cereus cross-infection in a maternity-unit. J Hosp Infect., 2: 349-354.
Boyce, J.M., D. Pittet, 2002. Guideline for Hand Hygiene in Health-Care Settings. Recommendations of
the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/ IDSA
Hand Hygiene Task Force. 2002;51/RR-16.
Ducel, G., J. Fabry, L. Nicolle, R. Girard, M. Perraud, A. Pruss, A. Savey, 2002. Prevention of hospitalacquired infections, A practical guide, Department of Communicable Disease, Surveillance and Response,
Editors;, 2nd edition, Available at WHO/CDS/CSR/EPH/ 2002.12.
Ganeswire, R.K., L. Thong, S.D. Puthucheary, 2003. Nosocomial outbreak of Enterobacter gergoviae
bacteraemia in a neonatal intensive care unit. J Hosp Infect., 53: 292-296.
Garcia, M., C. Lardelli, M. Jimenez, C. Bueno, J.D. Luna-del-Castillo, R. Galvez-Vargas, 2001.
Proportion of hospital deaths potentially attributable to nosocomial infections. Infect Control Hosp
Epidemiol., 22: 708-714.
Guenthner, S.H., J.O. Hendley, R.P. Wenzel, 1987. Gram-negative bacilli as nontransient flora on the
hands of hospital personnel. J Clin. Microbiol., 25: 488-490.
Hedderwick, S.A., S.A. McNeil, M.J. Lyons, C.A. Kauffman, 2000. Pathogenic organisms associated with
artificial fingernails worn by health care workers. Infect Control Hosp Epidemiol., 21: 505-509.
Hilton, M., J.M. Chen, C. Barry, M. Vearncombe, A. Simor, 2002. Deoxyribonucleic acid fingerprinting in
an outbreak of Staphylococcus aureus intracranial infection after neurotologic surgery. Otol Neurotol., 23:
550-554.
Hollenbeak, C.S., D. Murphy, W.C. Dunagan, V.J. Fraser, 2002. Nonrandom selection and the attributable
cost of surgical-site infections. Infect Control Hosp Epidemiol., 23: 177-182.
Jalalpoor Sh, R. Kasra Kermanshahi, A. Noohi, H. Zarkesh, 2007. Study of -lactamase and S-layer
Production in some of Isolated Pathogen Bacteria From Clinical and Environmental Hospital Samples.
MSc thesis, Iran, Tehran, Islamic Azad University Science and Research Branch, Tehran, Iran.
3565
Shila Jalalpour
Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
[14] Jalalpoor Sh, R. Kasra Kermanshahi, A.S. Nouhi, H. Zarkesh Esfahani, 2009a. Comparison of the
Frequency β-lactamase Enzyme in Isolated Nosocomial Infectious Bacteria. Rafsanjan University of
Medical Science (JRUMS), 8(3): 203-214.
[15] Jalalpoor Sh, R. Kasra Kermanshahi, A.S. Nouhi, H. Zarkesh Esfahani, 2009b. The comparative frequency
of β-lactamase production and antibiotic susceptibility pattern of bacterial strains isolated from staff hands
and hospital surfaces in Alzahra Hospital–Isfahan. Iranian Journal of Medical Microbiology, 3(4): 37-45.
[16] Jalalpoor Sh, R. Kasra Kermanshahi, A.S. Nouhi, H. Zarkesh Esfahani, 2010a. Survey Frequence of βlactamase Enzyme and Antibiotic Sensitivity Pattern in Isolated Pathogen Bacteria from Low and High
Hospital Contact Surfaces. Pajuhandeh Journal, 15(2): 77-82.
[17] Jalalpoor Sh, R. Kasra Kermanshahi, A.S. Nouhi, H. Zarkesh Esfahani, 2010b. The role of nanostructured
surface layer and production of β–lactamase in penicillin resistant Bacillus cereus strains. Iranian Journal
of Medical Microbiology, 4(1): 18-26.
[18] Jalalpoor Sh, R. Kasra Kermanshahi, A.S. Nouhi, H. Zarkesh Esfahani, 2010c. Prevalence of Nano
Structure S-layer and β-lactamase in Bacillus cereus strains. J Med Sc Islam Azad University 20(3): 157163.
[19] Jalalpoor Sh, R. Kasra Kermanshahi, A.S. Nouhi, Zarkesh Esfahani, S. Mobasherizadeh, 2010d. Survey
Prevalence and Resistance to some Beta lactame antibiotic in B.cereus st. Isolated of Azzahra Hospital.
Iranian Journal of Biology, 23(4): 470-477.
[20] Jalalpour Sh, 2011a. Emergence of Antibiotic Resistance Nano Enzyme in Staphylococcus species Isolated
from Clinical, Biotic and Abiotic Conditions. Biomed. & Pharmacol. J., 4(2): 365-371.
[21] Jalalpour Sh, 2011b. Prevalence of Beta Lactamase Nano Enzyme in Bacteria Isolated from Staff Hand
(Isfahan-Iran). J. Pure & Appl. Microbiol., 5(2): 1045-1050.
[22] Jalalpour Sh, 2011c. Food Borne Diseases: Healthcare Staff, High and Low Hospital Contact Surfaces.
Australian Journal of Basic and Applied Sciences, 5(8): 903-905.
[23] Jalalpoor Sh, Ebadi A Gh., 2011d. Effective Sources of Nosocomial Infection: Staff Hands and Hospital
Surfaces. Int. J. Biol. Biotech., 8(4): 631-636.
[24] Jalalpour Sh., 2012. Food borne diseases bacteria; frequency antibiotic resistance bacteria in Iranian foods.
Afr. J. Microbiol. Res., 6(4): 719-723.
[25] Johnson, L., 2006. Hand Hygiene Guideline From the Centers for Disease Control and Prevention
.P.A.C.E. APPROVED.11/2006, 5(10): 6-7.
[26] Kampf, G., A. Kramer, 2004. Epidemiologic Background of Hand Hygiene and Evaluation of the Most
Important Agents for Scrubs and Rubs. Clin Microbiol Rev., 17(4): 863-893.
[27] Kim, J.M., E.S. Park, J.S. Jeong, K.M. Kim, J.M. Kim, H.S. Oh, 2000. Multicenter surveillance study for
nosocomial infections in major hospitals in Korea. Nosocomial infection surveillance committee of the
Korean Society for Nosocomial Infection Control. Am J Infec Control., 28: 454-458.
[28] Larson, E.L., 1981. Persistant carriage of gram-negative bacteria on hands. A J Infec Control, 9: 112-119.
[29] Mayon, W., G. Ducel, T. Kereselidze, E. Tikomirov, 1988. An international survey of the prevalence of
hospital-acquired infection. J Hosp Infect., 11: 43-48.
[30] Madani, N., V.D. Rosenthal, T. Dendane, K. Abidi, A.A. Zeggwagh, R. Abouqal, 2009. Healthcareassociated infections rates, length of stay, and bacterial resistance in an intensive care unit of Morocco:
findings of the International Nosocomial Infection Control Consortium (INICC). Int Arch Med., 2: 29.
[31] McBride, M.E., W.C. Duncan, G.M. Knox, 1975. Physiological and environmental control of Gram
negative bacteria on skin. Brit J Dermatol., 93: 191-199.
[32] McFarland, L.V., M.E. Mulligan, R.Y. Kwok, W.E. Stamm, 1989. Nosocomial acquisition of Clostridium
difficile infection. N Engl J Med., 320: 204-210.
[33] Mielke, M., 2010. Prevention and control of nosocomial infections and resistance to antibiotics in Europe Primum non-nocere: elements of successful prevention and control of healthcare-associated infections. Int
J Med Microbiol., 300(6): 346-350.
[34] Miller, M.A., M. Hyland, M. Ofner-Agostini, M. Gourdeau, M. Ishak, 2002. Morbidity, mortality, and
healthcare burden of nosocomial Clostridium difficile-associated diarrhea in Canadian hospitals. Infect.
Control Hosp Epidemiol., 23: 137-140.
[35] Morris, A.M., B.A. Jobe, M. Stoney, B.C. Sheppard, C.W. Deveney, K.E. Deveney, 2002. Clostridium
difficile colitis: an increasingly aggressive iatrogenic disease?Arch Surg., 137: 1096-1100.
[36] Orsi, G.B., L. Stefano, N. Noah, 2002. Hospital-acquired, laboratory- confirmed bloodstream infection:
increased hospital stay and direct costs. Infect Control Hosp Epidemiol., 23: 190-197.
[37] Reboli, A.C., J.F. John, A.H. Levkoff, 1989. Epidemic methicillin-gentamicin-resistant Staphylococcus
aureus in a neonatal intensive care unit. Am J Dis Child., 143: 34-39.
[38] Rosenthal Victor, D., G. Maki, D.S. Jamulitrat, 2010a. International Nosocomial Infection Control
Consortium (INICC) report, data summary for 2003-2008, issued June 2009. Am J Infect Control, 38: 95106.
3566
Shila Jalalpour
Advances in Environmental Biology, 7(11) Oct 2013, Pages: 3560-3566
[39] Rosenthal, V.D., D.G. Maki, C. Rodrigues, C. Alvarez-Moreno, H. Leblebicioglu, M. Sobreyra-Oropeza,
et al., 2010b. Impact of International Nosocomial Infection Control Consortium (INICC) strategy on
central line-associated bloodstream infection rates in the intensive care units of 15 developing countries.
Infect Control Hosp Epidemiol., 31(12): 1264-1272.
[40] Ruden, H., F. Daschner, M. Schumacher, 1995. Nosokomiale Infektionen in Deutschland: Erfassung und
Pravention (NIDEP-Studie).1. Pravalenz nosokomialer Infektionen; Qualitatssicherung in der
Krankenhaushygiene, vol. 56. Nomos-Verlagsgesellschaft, Baden-Baden, Germany.
[41] Samore, M.H., L. Venkataraman, P.C. DeGirolami, R.D. Arbeit, A.W. Karchmer, 1996. Clinical and
molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am
J Med., 100: 32-40.
[42] Sartor, C., R. Sambuc, M.C. Bimar, C. Gulian, P. De Micco., 1995. Prevalence surveys of nosocomial
infections using a random method in Marseille hospitals. J Hosp Infect., 29: 209-216.
[43] Schmitz, F.J., J. Verhoef, A.C. Fluit, 1999. Prevalence of resistance to MLS antibiotics in 20 European
university hospitals participating in the European SENTRY surveillance programme. J Antimicrob
Chemother, 43: 783-792.
[44] Sehulster, L., Y.W. Raymond, 2003. Guidelines for Environmental Infection Control in Health-Care
Facilities. U.S. Department of Health and Human Services Centers for Disease Control and Prevention
(CDC), Atlanta GA 30333.
[45] Steinbrecher, E.D., A. Nassauer, F. Daschner, H. Ruden, P. Gastmeier, 2000. Die haufigsten Erreger bel
Intensivpatienten mit noskomialen Infektionen.Chemother J., 9: 179-183.
[46] Stone, P., E. Larson, L. Kawar, 2002. A systematic audit of economic evidence linking nosocomial
infections and infection control interventions: 1990-2000. Americ J Infect Cont., 30: 145-152.
[47] Tenorio, A.R., S.M. Badri, N.B. Sahgal, B. Hota, M. Matushek, 2001. Effectiveness of gloves in the
prevention of hand carriage of vancomycin-resistant Enterococcus species by health care workers after
patient care. Clin Infect Dis., 32: 826-829.
[48] Van der Zwet, W.C., G.A. Parlevliet, J. Savelkoul, A.M. Stoof, 2000. Outbreak of Bacillus cereus
infections in a neonatal intensive care unit traced to balloons used in manual ventilation. J Clin Microbiol.,
38: 4131-4136.
[49] Victor, D., Rosenthal, G. Dennis, Maki, C. Rodrigues, 2010. Impact of International Nosocomial Infection
Control Consortium (INICC) Strategy on Central Line-Associated Bloodstream Infection Rates in the
Intensive Care Units of 15 Developing Countries. Infec cont hosp epidemiol., 31(12).
[50] Wagner, M.B., N.V. da Silva, A.R. Vinciprova, A.B. Becker 1997. Hospital-acquired infections among
surgical patients in a Brazilian hospital. J Hosp Infect., 35: 277-285.
[51] Williams, J.V., B. Vowels, P. Honig, J.J. Leyden, 1999. Staphylococcus aureus isolation from the lesions,
the hands, and anterior nares of patients with atopic dermatitis. J Emerg Med., 17: 207-211.
[52] Wingard, E.J., H. Shlaes, E.A. Mortimer, D.M. Shlaes, 1993. Colonization and cross-colonization of
nursing home patients with trimethoprim-resistant gram-negative bacilli. Clin Infect Dis., 16: 75-81.