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Objectives: To quantify the microorganism burden of rehabilitation gym equipment surfaces as well as to assess the effectiveness of patient’s practice of hand hygiene and our current disinfection methods to reduce burden and transmission of microorganisms during rehabilitation sessions. Methods: A prospective study of environmental contamination using microbiology culture in Khoo Teck Puat Hospital Geriatric Medicine Outpatient Rehabilitation Gym. Results: For both the control and intervention group, the total aerobic bacterial count on the gym equipment after patient use is significant and increase up to 360 CFU per swab. In the control and intervention groups, the total aerobic bacterial counts on the gym equipment before patients’ use were negligible (<10 CFU per swab). The total aerobic bacterial count of the equipment remained negligible (<10 CFU per swab) after patient use and immediate disinfection. We detected discrepancies between the results of the total aerobic bacterial count after patient use between the control and intervention groups. Conclusions: Outpatient rehabilitation gyms are potential reservoirs of microorganisms, which may further contribute to the transmission of healthcare-associated pathogens. In this study, an intervention in which cleaning equipment was wiped with alcohol wipes was effective in reducing microorganism transmission in the rehabilitation gym environment and should be considered as part of our infection control strategy. The additional step of involving our patients in using hand rub before the start of their therapy sessions can provide additional benefit in reducing microorganism transmission only if patients adhere to the World Health Organization (WHO) recommended 7 steps of proper hand rub. Good patient education on hand hygiene is equally as important as that for healthcare professionals to control environmental contamination.
Objectives: The increase in carbapenemase-producing organism (CPO) transmission among hospitalized patients is a growing concern. Studies investigating the transmission of CPO to epidemiologically linked contacts are scarce. We conducted an interim subgroup analysis of the ongoing multicenter household transmission of CPO in Singapore (CaPES-C) study to identify the acquisition rate of CPO among epidemiologically linked contacts of hospitalized CPO patients. Methods: This multicenter prospective cohort study was conducted between January and December 2021. We recruited CPO-positive patients and their epidemiologically linked contacts. Stool samples were collected from the patients at baseline, day 3, day 7, and at weeks 2, 3, 4, 5, 6, 12, 24, 36, and 48. Additionally, a sample was collected at the time of discharge from the hospital. Xpert Carba-R test was used to detect CPO genotypes in the stool samples. In this interim analysis, we calculated the acquisition rate of CPO among the epidemiologically linked hospital contacts of CPO positive patients using Stata version 15 software. Results: We recruited 22 (56.4%) CPO-positive index patients [blaNDM, n = 7 (31.8%); blaIMP, n = 3 (13.6%); blaOXA-48, n = 10 (45.5%), others, n = 2 (9.1%)] and 14 (35.9%) epidemiologically linked hospital contacts. The median age of CPO-positive patients was 72.5 years (IQR, 62–82) and 15 (68.2%) were female. The median age for the epidemiologically linked contacts was 82.5 years (IQR, 70–85) and 4 (28.6%) were female. After 1,082 patient days, 2 (14.3%) epidemiologically linked contacts tested positive for CPO giving an acquisition rate of 1.85 per 1,000 patient days (95% CI, 0.46 – 7.39). One of these participants acquired a concordant genotype (blaOXA-48) at day 7 and the other acquired a discordant genotype (CPO positive index, blaIMP; epidemiologically linked contact, blaNDM) at week 12 of follow-up. Conclusions: This small interim analysis revealed a high conversion rate among epidemiologically linked hospital contacts. A larger study is needed to understand the influence of genotypes, hospital environment, and human behavior on the transmission of CPO in hospitals.