A single-center study in Israel highlights the roles that hospital sinks and showers may play in spreading carbapenemase-producing Enterobacterales (CPE), researchers reported yesterday in the American Journal of Infection Control.

The retrospective analysis, conducted at a hospital in Haifa in 2022, examined environmental samples for CPE collected as part of epidemiologic investigations initiated whenever a patient acquired CPE during hospitalization. Samples were collected from various areas within the same wards where CPE acquisition occurred and included samples from hospital surfaces (like wheeled carts, beds, medicine cabinets, and portable x-ray machines), as well as drains and pipes.

Out of 801 environmental samples collected, 337 (42.1%) were from sinks, 57 (7.1%) were from showers, and 407 (50.8%) came from various surfaces around the hospital. The samples were then divided into three categories, with Category 1 including all samples collected within 1 meter of a water source (sink or shower). Within Category 1, 166 samples (41.5%) were CPE positive, compared with 13 samples (11.7%) in Category 2 (1 to 3 meters from a water source) and no positive samples in Category 3 (more than 3 meters from a water source).

Roughly one-fifth of all positive samples (20.6%) were linked to a shower, and positive samples were found in 16 wards, with a higher prevalence found in non-clinical areas like storage areas and staff rooms.

"Our study demonstrates that CPE associated with a water source may not be confined to a specific ward but can spread across multiple wards, potentially explaining the endemicity of CPE within a hospital," the study authors wrote. "This highlights the critical significance of implementing stringent infection control measures and thorough cleaning protocols, even in such non-clinical areas."

The National Institute of Allergy and Infectious Diseases (NIAID) has awarded a team of US researchers $13.7 million to investigate multidrug-resistant organisms (MDROs) in nursing homes.

The team, led by researchers from the City University of New York (CUNY) Graduate School of Public Health, will study more than 16,000 MDRO isolates collected from 50 US nursing homes to identify key sources and drivers of MDRO spread, best detection methods, high-yield interventions for preventing MDRO spread, and the major risk factors associated with colonization, infection, and hospitalization. Their focus will be on six MDROs—five bacteria and one fungus—deemed serious and urgent national health threats.

Though an estimated 65% of the 1.4 million US nursing home residents are colonized with an MDRO, and antibiotic use in nursing home residents is common, the role of nursing homes in MDRO emergence and spread has been understudied.

"Multidrug-resistant organisms have been a major growing threat throughout our country's healthcare system," Bruce Lee, MD, a professor of health policy and management at the CUNY Graduate School of Public Health, said in a university press release. "Nursing homes are key to combating this threat because they are connected to hospitals and other healthcare facilities via patient sharing and have residents who are highly susceptible to MDRO infections interacting in close quarters with each other."

The six MDROs are methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, extended-spectrum beta-lactamase (ESBL) producers, carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, and Candida auris.

The team will include researchers from the Broad Institute of the Massachusetts Institute of Technology and Harvard, the University of Massachusetts-Amherst, and the National Institutes of Health.

RSV/6120/ΔNS2/1030s, an intranasal spray vaccine to protect against respiratory syncytial virus  (RSV) was immunogenic in 6 to 24-month-old RSV-seronegative children, but caused rhinorrhea, or runny nose. Phase 1 trial results of the vaccine, given as a single dose, are published in the Journal of Infectious Diseases.

The live attenuated vaccine contains a deletion of the interferon antagonist NS2 gene. It was developed by researchers at the Johns Hopkins Bloomberg School of Public Health and the National Institute of Allergy, Immunology, and Infectious Diseases (NIAID) at the National Institutes of Health (NIH). The current study was small, enrolling 15 RSV-seropositive children (10 vaccinees, 5 placebo recipients) and 30 RSV-seronegative infants (20 vaccinees, 10 placebo recipients).

Runny nose was common in 90% of vaccine recipients, compared to just 50% in the placebo group. All episodes of runny nose were labeled grade 1 severity.

Of note, there was one episode of lower reparatory infection among the vaccine recipients, which the authors said was a potential safety signal.