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MSPT 474 Research Proposal

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  • Course Code: MSPT474
  • University: University Of Tabuk

    MyAssignmentHelp.com is not sponsored or endorsed by this college or university

  • Country: Saudi Arabia

Question:

I need an introduction about why multi-antibiotic resistant organisms (MRO) are important and why they are important in biofilms.
They also will want to methods – saying how you are going to detect the bacteria.

Project 1: Superbugs in hospital environments: understanding and eradicating an important source of nosocomial infection
Introduction
Hospitalised patients develop nosocomial infections, which cause increased morbidity and mortality and result in increased healthcare costs. The environment is one important source of cross-infection and we have recently shown that most surfaces in hospitals are contaminated with biofilms which can contain multi-antibiotic resistant organisms (MRO). The risk of obtaining a nosocomial infection is increased by an average of 73% if the previous patient occupying that room had a MRO. The role of biofilms in maintaining MRO viability and transmission of infection is unknown and will be explored in this study.
Hypothesis:
Persistent exposure to antibiotics and disinfectants in the ICU induces biofilm growth, which subsequently promotes maintenance of MROs;
Infection of multiple patients, over time, with the same strain of MRO is due to the periodic release of free swimming bacteria from these biofilms;
Current cleaning methods and auditing do not deal with dry surface biofilms
Aims:
Determine if MRO persist over time as biofilms and contribute to nosocomial infection.
Compare environmental biofilm formation in the face of detergent cleaning compared to detergent cleaning plus chlorine disinfection with respect to MRO persistence.
Show that quadruple monitoring of environmental surfaces with real-time feedback to cleaners, combined with new generation cleaning, will decrease environmental contamination, remove demonstrable MROs and biofilms from the hospital environment and decrease patient acquisition of MROs.
Research Plan:
Aims 1 and 2. Patients admitted to intensive care units in Australia and Scotland will be screened on admission, weekly and on ICU discharge for MRSA, vancomycin resistant enterococci (VRE) and multidrug resistant gram-negative bacilli (MDRG). Line-associated bacteraemia, S. aureus bacteraemia and MRO data will be collected. All MRO patient strains will be collected and stored at -80oC. Patient demographics, date and bed number(s) will be entered into a database. Those patients with no prior history of MRSA, who had been on the ward for >48 hours and have laboratory isolated MRSA from their clinical samples will be regarded as a new MRO acquisition. Collection of environmental samples will be conducted after routine cleaning and disinfection. Ten high "hand-touch" sites will be screened weekly using chromogenic dip slides. 5 environmental samples for biofilm analysis will be collected monthly for 6 mths from 10 patient bed areas and the nurses' station before being divided into sections and processed by culture, quantitative real-time PCR, next generation sequencing, confocal laser scanning microscopy and scanning electron microscopy. Patient, environmental planktonic and biofilm bacterial strains will be subjected to molecular characterisation by whole genome sequencing. We will correlate geographic and time relationships between environmental, biofilm and patient strains to determine the contribution of the environment, in particular biofilms, strains to nosocomial infection.
Aim 3. Validation that cleaning has removed pathogenic organisms from the environment is important for infection control. Cleaning validation tools include visual inspection, fluorescence marker testing, ATP sampling, and microbial sampling for culture and biofilm demonstration. We will use failure mode and effects analysis to identify and grade each failure point in cleaning and the audit process, the frequency of this failure occurring, the effect of this failure, and whether this failure can be detected during normal protocols.
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