Ahmet Celal Başustaoğlu

Assessment of the bacterial contamination on hands of hospital food handlers

This study was performed in order to determine the level of bacterial contamination on the hands of food handlers (n=30) who work in the kitchen of a military training hospital. A total of 180 samples were collected from bare and gloved hands before and during food preparation. A total of 16 different bacteria were isolated, of which the most common was Staphylococcus aureus (126/180; 70%), followed by coagulase-negative staphylococci (102/180; 56.7%), diphtheroid bacilli (39/180; 21.7%), Bacillus spp. (19/180; 10.5%), and Escherichia coli (14/180; 7.8%). Fifty-one of 60 (85%) gloved hand samples were collected during work, 57 (95%) of the bare hand samples were collected before work all of the bare hand samples collected during work were positive. Poor hand hygiene was indicated by high levels of S. aureus and E. coli on samples taken from bare and gloved hands. Although bacterial loads on gloved hand samples were found to be significantly lower (p<0.05) than ungloved hand samples, these loads were not within acceptable limits. These results show that the hands of food handlers are an important contamination source in this establishment. In this study, 203 bacterial isolates were from right hand samples while 166 bacterial isolates were from left hand samples (χ2=1.913; p<0.05). All of the food handlers were right-handed. Bacterial load isolated from the inexperienced food handlers was higher than those from experienced ones (χ2=2.024; p<0.05). As a result, the poor hand hygiene and improper glove use by the food handlers was emphasized and we concluded that the training in personal hygiene and food safety should be improved, and inexperienced personnel should not be employed in kitchens without being well trained. On the other hand, if glove use principles are performed correctly, it may be efficacious for decreasing of bacterial load on hands, particularly, establishments where hand hygiene control can not performed properly or inexperienced personnel are employed.

Acinetobacter septicus sp. nov. Association with a Nosocomial Outbreak of Bacteremia in a Neonatal Intensive Care Unit

ABSTRACT Acinetobacter species other than Acinetobacter baumannii have rarely been reported to be associated with nosocomial outbreaks of bloodstream infections. Within a period of 1 week, seven Acinetobacter-like isolates were recovered from peripheral blood and catheter specimens of five patients at a neonatal intensive care unit (NICU) in a tertiary hospital in Turkey. All five patients had placement of central venous catheters and had received total parenteral nutrition before the onset of bacteremia. Two of the five patients died. Medical devices, tap water, aerators, water samples, various surfaces, intravenous fluids, and the hands of health care workers in the NICU were sampled and were culture negative for the bacterium. All seven of the isolates had identical biochemical reactions, antimicrobial susceptibility results, and pulsed-field gel electrophoresis patterns, indicating a clonal nosocomial outbreak. A panel of standard biochemical reaction profiles and three phenotypic commercial identification systems failed to identify these isolates. Phenotypically, the isolate differed from Acinetobacter ursingii by its hemolysis on sheep blood agar and its negative citrate utilization. Sequences of the full 16S rRNA gene, which contained at least three different gene copies with polymorphic sequences between nucleotide positions 70 and 206, were determined from the first recovered isolate. The complete 1,529- to 1,531-bp 16S rRNA gene sequences and partial 801-bp rpoB gene sequences had similarities of 99.5% and 97.2%, respectively, to an A. ursingii isolate. The DNA-DNA similarities of the strain against the type strain of A. ursingii were 64.7 and 68.7%, which were lower than the recommended threshold value of 70% for the definition of bacterial species. These data indicate that a novel Acinetobacter organism caused the nosocomial outbreak of bacteremia in the NICU unit. We propose the designation of Acinetobacter septicus sp. nov. for these isolates, with isolate AK001 as the type strain.

Development of resistance to imipenem among nosocomial isolates ofPseudomonas aeruginosa

Irnipenem was supplied in powder form by Merck Sharp and Dohme (USA), and a stock solution was prepared in accordance with NCCLS recommendations (3). One hundred nosocomial Pseudornonas aeruginosa strains collected from different clinical sites during the first six months of 1992 and 1994 were obtained from bacteriology laboratories (Department of Microbiology, G~Ihone Military Medical Academy). The patients from whom the cultures obtained were evaluated according to the CDC criteria for nosocomial infection (4). The bacteria were subcultured on sheep blood agar (5-7 %), maintained on Tripticase agar slants and tested for antibiotic susceptibility using Mueller-Hinton broth (Gibco BRL, UK).

Evaluation of microorganisms isolated from blood cultures and their susceptibility to antibiotics in two year period.

Bloodstream infections (BSIs) are a major cause of healthcare-associated morbidity and mortality. Analyses of the frequency of microorganisms isolated from blood cultures and antibiotic susceptibility can provide clinicians with relevant information for the empirical treatment of patients. The purpose of the study was to investigate to frequency of microorganisms isolated from blood cultures and their sensitivity to antimicrobial agents between January 2009 and December 2010 at the Training Hospital of Gulhane Military Medical Faculty. Blood cultures were processed by automatized BACTEC/9050 (Becton Dickinson, Maryland, USA). The observed growth of microorganisms in culture media was identified by conventional methods and PhoenixTM 100 automatized systems (BD Phoenix System, Beckton Dickinson, USA).Antimicrobial susceptibility tests were performed by Kirby-Bauer disc diffusion method and automatized systems (BD Phoenix System, Beckton Dickinson, USA) in accordance with the recommendations of Clinical and Laboratory Standarts Institute (CLSI). In the study period among the 6823 blood culture samples, 957 (14%) yielded positive results. Results of 600 (8.7%) blood culture samples evaluated as contamination. Of the 957 isolated microorganisms, 61.0% were Gram negative, 31.1% were Gram positive and 7.8% were yeast. E.coli was the most frequently isolated species (15.9%), followed by Klebsiella spp (15.4%) and Coagulase Negative Staphylococcus (CNS) (13.2%). Twenty eight percent% of S. aureus and 89% of CNS isolates were resistant to methicillin. Only one isolate (1.73%) was resistant to glycopeptides among Enterococcus spp. ESBL (Extended-spectrum beta lactamase) was detected in 36.8% of E.coli and 51.3% of Klebsiella spp. isolates.