Central Thailand was severely affected by black-water flooding between September and November 2011, with resultant closure of 30 regional hospitals. Few data are available for the incidence of nosocomial infections and patterns of preflood versus postflood multidrug-resistant organisms (MDROs) and mold. We therefore conducted a survey of the hospitals in central Thailand in order to evaluate the patterns of nosocomial infections, MDROs, mold, and flood preparedness plans after these floods.

On the basis of a hospital list from the Ministry of Public Health, we identified 104 hospitals in 15 provinces of central Thailand that were affected, but not necessarily closed, by extensive floods. We designed and then conducted a survey, from July 1 through October 31, 2012, that inquired about hospital characteristics, postflood hospital preparedness plans, administrative support, institutional safely culture, incidence of nosocomial infections, and prevalence of MDROs and mold colonization or infection. All 104 secondary care (>100 beds) and tertiary care (>250 beds) hospitals in 15 central Thailand provinces were invited to participate.

Recurrent skin and soft-tissue infections (SSTIs) due to Staphylococcus aureus are a common problem in children and adults. Many of these SSTIs are caused by a community-associated methicillin-resistant S. aureus (MRSA) strain designated USA300. Dilute bleach baths are commonly used as part of decolonization regimens for recurrent SSTI, particularly in children. However, limited data are available on the microbiological efficacy of dilute bleach on skin, and optimal concentrations are unknown. Recent practice guidelines for MRSA from the Infectious Diseases Society of America recommend a teaspoon of household bleach per gallon of bath water (1.3 μL/mL or a quarter cup per quarter tub of water) for 15 minutes twice weekly. On the basis of in vitro data, Fisher et al suggested that a higher concentration (2.5 μL/mL or a half cup per quarter tub of water) might be more effective (more than a 3-log reduction in MRSA in 5 minutes versus a 2-log reduction for a 1.2-μL/mL concentration). In contrast, more dilute bleach solutions (eg, a quarter cup of 6% sodium hypochlorite per bathtub full of water) for 5 days in combination with intranasal mupirocin were effective for eradication of colonization in a recent randomized trial, but 29% of patients in the mupirocin/bleach bath group developed recurrent colonization within 4 months. Here, we used a pig skin model to examine the effectiveness of various concentrations of dilute bleach solution and an electrochemically activated saline solution containing 0.025% hypochlorous acid (Vashe; PuriCore) for disinfection of MRSA on skin. Vashe is safe for use on skin and is commercially available as a wound care product.

Over the past decade, large outbreaks of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have occurred in correctional facilities across the country. Although many have been managed with aggressive interventions, response to standard infection control procedures has been variable, highlighting our incomplete understanding of staphylococcal transmission in this setting. Environmental contamination has recently emerged as a possible target for novel prevention and control strategies. This study sought to characterize the relationship between environmental contamination and clinical infection in this vulnerable population.

We conducted a case-control study of S. aureus environmental contamination at 2 New York State (NYS) maximum security prisons: Sing Sing (men) and Bedford Hills (women).

Multidrug-resistant organisms (MDROs) are emerging and disseminating around the globe. The guidelines for the management of MDROs support the use of various interventions to reduce the burden of MDROs. We conducted a study to assess the impact of the creation of a unit for cohorting of patients with infection due to MDROs.

Hospital de Clínicas de Porto Alegre, a 795-bed university, public hospital, is located in the city of Porto Alegre in southern Brazil. In a quasi-experimental study, we assessed the impact of the creation of an MDRO unit for patient cohorting on the overall hospital incidence of infection due to MDROs.

The 34 beds of the unit were located in 16 rooms for adult MDRO-infected patients and 2 additional rooms for respiratory isolation. Patients were transferred to the unit when they were identified as infected or colonized with MDROs. The unit staff was trained for MDRO-infected patient care; unit staff, patients, and families attended weekly meetings for education about MDROs with a multidisciplinary team (doctors, nurses, pharmacists, and social assistants).