GMS Hygiene and Infection Control最新文献

The consensus-based guideline "hand antisepsis and hand hygiene" for Germany has the following sections: Prevention of nosocomial infections by hygienic hand antisepsis, prevention of surgical site infections by surgical hand antisepsis, infection prevention in the community by hand antisepsis in epidemic or pandemic situations, hand washing, selection of alcohol-based hand rubs and wash lotions, medical gloves and protective gloves, preconditions for hand hygiene, skin protection and skin care, quality assurance of the implementation of hand hygiene measures and legal aspects. The guideline was developed by the German Society for Hospital Hygiene in cooperation with 22 professional societies, 2 professional organizations, the German Care Council, the Federal Working Group for Self-Help of People with Disabilities and Chronic Illness and their Family Members, the General Accident Insurance Institution Austria and the German-speaking Interest Group of Infection Prevention Experts and Hospital Hygiene Consultants.

Introduction: Since 2007, the classification of ethanol under the Biocidal Products Regulation has paradoxically remained unresolved due to conflicting views among experts and authorities. Initially, there was a discussion about classifying ethanol as carcinogenic. The current proposal to extend its harmonized classification includes, among other things, categorizing it as reproductive toxicity category 2 ("suspected to have CMR potential for humans"; carcinogenic, mutagenic, reprotoxic). If ethanol were classified under reproductive toxicity category 2, it would mean that the only active ingredient in hand antiseptics effective against non-enveloped viruses would no longer be available.

Scientific assessment of the safety of ethanol-based hand rubs ebhr: Available epidemiological studies do not confirm an increased risk for cancer from EBHR in exposed individuals, except under uncommon or unlikely routes or levels of exposure.The evidence for ethanol's reprotoxic effect originates from the consumption of alcoholic beverages by pregnant women, where ethanol uptake is incomparably higher. The amount of transdermal ethanol absorption during hand antisepsis is up to ten times lower than the oral intake of beverages containing hidden ethanol, such as apple juice, kefir, or non-alcoholic beer. Blood alcohol levels after using EBHR remain within the physiological range associated with food intake.

Conclusion: There is no epidemiological evidence of toxicity for workers handling ethanol-containing products in industry or using EBHR in healthcare settings. Given that the classification of EBHR as reproductive toxicity category 2 is not supported by current scientific research and that no alternative biocidal active substance in hand rubs is effective against non-enveloped viruses, medical associations and expert committees from Europe, the USA, Canada, the Asia-Pacific region, and the World Society for Virology unequivocally recommend, with the highest priority, that EBHR be approved as an active substance for PT1 biocides and not be classified as a reproductive toxicant in category 2.

Aim: Correct hand hygiene is widely regarded as an important measure to prevent healthcare-associated infections. Guidelines on how to perform hand antisepsis are often inspired by laboratory tests that focus on reproducibility rather than ease of use. These cumbersome recommendations can become barriers to hand hygiene, as optimal user acceptance requires a small rub volume and a short application time with an intuitive rubbing technique. Here we modified the EN 1500 to test the efficacy of hand rubs under more user-friendly conditions, using a highly intuitive rubbing technique in 15 seconds.

Methods: The efficacy of an ethanolic and a propanolic hand rub in inactivating E. coli on the hands of volunteers was tested according to EN 1500 with modifications in rubbing technique and time. Pre-tests were conducted to find a suitable volume for "responsible application", a procedure without clearly defined steps. Finally, 20 volunteers applied both rubs for 15 seconds using 3 mL and "responsible application" and 5 mL using the WHO 6-step technique.

Results: Both hand rubs, ethanolic and propanolic, were non-inferior to an unmodified EN 1500 reference for both application methods, 3 mL with "responsible application" and 5 mL with the WHO 6-step method.

Conclusion: Reducing the complexity of hand rub application can have a positive impact on hand hygiene adherence. With our results showing that antimicrobial efficacy comparable to an unmodified EN 1500 can be achieved in 15 seconds using an intuitive rubbing technique, further barriers to more user-friendly hand rub application have been removed.

Introduction: Healthcare workers (HCWs) are on the frontline of infections. To safeguard HCWs from occupational exposure to infections and to curb nosocomial infection a set of vaccines has been recommended for them by the WHO. Hence, we aimed to assess the vaccination status, awareness, and its correlates amongst HCWs in the Delhi-NCR.

Method: The study used a cross-sectional mixed-method approach from January to April 2023. For the quantitative arm, a structured questionnaire was circulated to the participants in conveniently-selected private and government tertiary care hospitals of the Delhi-NCR, both through e-survey using Google form, and in person, data were collected on socio-demographics, vaccination status, and awareness. SPSS version 25 was used for the analysis. For the qualitative arm, in-depth interviews were conducted and data were analyzed manually.

Results: Out of 387 participants (62.8% males, 37.2% females), the awareness about the vaccines recommended for HCWs was 64.1%. However, only 15.3% of HCWs were completely aware of all the recommended vaccines. SARS CoV-2, Polio, Hepatitis B, and BCG had the highest vaccination coverage, 97.4%, 87.9%, 83.7%, and 50.9%, respectively. It was found that gender, education, type (private or governmental) of tertiary care hospital, and profession had a significance (p<0.05) on the vaccination status score and awareness of all WHO-recommended vaccines (AOR=7.6, 95% CI, 3.24-18.0). The qualitative arm further augmented the findings.

Conclusion: The study reveals insufficient awareness and vaccination status regarding recommended vaccines. Prioritizing the preparation of unified standard guidelines for Indian HCWs and involving concerned stakeholders is crucial.

Background: Monkeypox, a re-emerging zoonotic disease caused by the monkeypox virus (MPXV), poses a public health challenge in Nigeria. To effectively combat this disease, it is essential to assess the knowledge of healthcare workers (HCWs) in Nigeria concerning monkeypox outbreak.

Methods: A cross-sectional web-based survey with 609 healthcare workers in Nigeria was conducted using a structured questionnaire to assess their knowledge of monkeypox. Data were coded and analyzed with Microsoft Excel and Python in Anaconda Jupyter Notebook.

Results: The majority of respondents (n=318, 52.2%) had good knowledge of MPXV but also had knowledge gaps regarding certain symptoms and disease similarities. Interestingly, respondents were completely unaware of the possibility of sexual transmission of the disease. However, they recognized the possible significant impact of monkeypox on the social and economic lifestyle of Nigerians (n=582, 95.6%, adjOR=21.181, 95% CI: 14.450-31.051). Respondents had mixed knowledge regarding the use of smallpox vaccines and antiviral agents for monkeypox prevention and treatment. Furthermore, a significant proportion (n=526, 86.4%, adjOR=0.159, 95% CI: 0.126-0.201) attributed the outbreak to bioterrorism. The logistic regression highlighted a strong influence of academic qualification, type of healthcare provider, years of experience, and geopolitical zone of practice, on monkeypox knowledge in Nigeria.

Conclusion: The study highlights the importance of continuous education for healthcare professionals in Nigeria to improve monkeypox outbreak management. Despite their moderate performance, there are knowledge gaps in critical areas among HCWs, necessitating further research to explore reasons and influencing factors for knowledge levels.

Introduction: The aim of the study was to investigate whether the virucidal effectiveness of chlorine dioxid against adenovirus and murine norovirus can be improved by combining it with carboxylic acids and surfactants.

Method: The virucidal efficacy against polio-, adeno- and murine norovirus has been tested in presence of interfering substances in the quantitative suspension test according to EN 14476, the carrier test without mechanical action according to EN 16777, and in the four-field test according to EN 16615.Three chlorine-dioxide-based surface disinfectants were tested: a two-component cleaning disinfectant concentrate for large surfaces, a ready-to-use (RTU) foam, and an RTU gel.

Results: Cleaning and disinfecting preparations based on chlorine dioxide, applied at various concentrations, in combination with acetic acid or citric acid and surfactants, are virucidally active against polio-, adeno-, and norovirus after an exposure time of 5 minutes in presence of interfering substances.

Introduction: Acinetobacter baumannii, renowned for its exceptional multidrug resistance and its role as a prevalent nosocomial pathogen, poses a formidable challenge to conventional antibiotic therapies. The primary objective of this investigation was to evaluate the efficacy of Secapin, an antimicrobial peptide, against multidrug-resistant (MDR) baumannii. Furthermore, the mechanisms underlying Secapin's antibacterial and antibiofilm activities were elucidated.

Methods: The antimicrobial and antibiofilm effectiveness of Secapin against MDR A. baumannii was assessed through a series of experiments. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Secapin were determined using established protocols. Time-kill kinetic analysis was performed to assess the concentration-dependent bactericidal effect of Secapin. Additionally, the capacity of Secapin to impede biofilm formation and eradicate A. b aumannii biofilms was investigated. Hemolytic potential was evaluated using human red blood cells, while mammalian cell viability was examined at varying Secapin concentrations.

Results: Secapin exhibited robust bactericidal activity at minimal concentrations, with an MIC of 5 µg/mL and an MBC of 10 µg/mL against MDR A. baumannii. The time-kill kinetic analysis confirmed the concentration-dependent efficacy of Secapin in diminishing bacterial viability. Moreover, Secapin demonstrated the ability to prevent biofilm formation and eliminate established A. baumannii biofilms. Notably, Secapin exhibited no hemolytic activity and preserved mammalian cell viability up to a concentration of 100 µg/mL.

Conclusion: These findings underscore the substantial potential of Secapin as a potent agent against multidrug-resistant A. baumannii, showcasing its efficacy in both antibacterial and antibiofilm capacities. The favorable attributes of Secapin, characterized by its minimal hemolytic effects and high mammalian cell viability, position it as a promising contender in the fight against antibiotic resistance.

Background: Ocular hygiene encompasses a spectrum of measures to initiate and maintain adequate ocular cleanliness to prevent eye infections and their further transmission. These infections affect all age groups and can lead to severe complications such as blindness. Nearly 1 billion cases could have been prevented out of over 2.2 billion people that are visually impaired worldwide. This bibliometric analysis focuses on the papers published on ocular hygiene and infections.

Methods: We searched in the Scopus database from 2004 to 2024. After manual screening, a list of the 100 most-cited original articles was obtained, which was analysed for various factors, including temporal trends, subject areas, authorship patterns, country of origin, funding bodies, etc.

Results: There has been a gradual decline over the past two decades in the number of publications. The United States was affiliated with the highest number of publications (n=61), followed by The United Kingdom (n=12) and Gambia (n=8). Several authors had 4 or more publications, with the highest number of publications by Rouse, B. T. (n=14). The American Journal of Ophthalmology takes the lead with 15 publications, while the National Eye Institute (n=23) was the leading funding body. Examination of institutional contributions shows that The University of Tennessee, Knoxville and UT College of Veterinary Medicine stand out with twelve publications each. Nearly half the publications belong to the field of medicine. However, significant publications also come from the fields Neuroscience, Microbiology and Immunology, Biochemistry, Genetics and Molecular Biology, etc. These findings highlight that there is great potential to conduct research to propagate ocular hygiene to prevent adverse effects of infections.

Background: Health care workers (HCW) in Emergency Medical Services (EMS) frequently come into contact with carriers of methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) strains and may acquire and transmit them to patients. However, there is little data on MSSA and MRSA colonization of medical personnel in the emergency services. Additionally, few studies have analyzed the association between personal hygiene of staff and colonization. Therefore, we examined the prevalence of MSSA and MRSA in EMS staff of two German regions and evaluated their personal hygiene behavior.

Method: Throat and nasal swabs from 300 EMS workers were analyzed. Both direct and pre-enriched cultures of the swabs were cultivated on culture media to identify MSSA and MRSA. Results were analyzed together with questionnaires about sociodemographic data and a self-assessment of hygiene behavior. Statistical analysis was done using the R statistical software.

Results: Of the total 300 swabs, 55% were from paramedics, 39% were from emergency medical technicians (EMT) and 5% were from emergency physicians. With 1%, the MRSA prevalence was comparable to that of the German population, while the MSSA rate - 43.7% - was higher than expected. Colonization with MSSA was significantly associated with poor hand hygiene and male sex, and was inversely correlated to time on the job in EMS.

Conclusion: The sample size of 300 and a MRSA prevalence of 1% made a meaningful analysis of potential influencing factors on the prevalence of MRSA infeasible. The comparatively high prevalence of MSSA and the association with decreasing frequency of hand antisepsis suggests an influence of personal hygiene on MSSA colonization. HCW in EMS should be encouraged to make use of their personal protective equipment and practice frequent hand hygiene. The implementation of diagnostic tools such as the Hand Hygiene Self-Assessment Framework of the WHO could be utilized to reveal problems in organizations, followed by an individual program to promote hand hygiene.

The aim of this study was to assess whether toothbrushing with a dentifrice containing an antimicrobial phthalocyanine derivative (APD) can reduce the intraoral viral load of SARS-CoV-2. Twenty COVID-19-positive dentate patients aged ≥18 years were selected instructed to brush their teeth for 2 min with a dentifrice containing APD. Self-collected samples of unstimulated saliva were carried out three times: T0 (baseline), T5 (5 min after toothbrushing), and T30 (30 min after toothbrushing). The analysis of viral RNA was performed by RT-qPCR for detection of three viral genes (ORF1ab, N and S genes). Results were statistically tested using Friedman's test and pairwise comparison with Bonferroni corrections, with a significance level of 5%. There was an increase in the cycle threshold (Ct) value from T0 to T5 in 13 patients (72.2%), and from T0 to T30 in 14 patients (77.8%). In two patients (11.1%) no SARS-CoV-2 was detected at T5 and five patients (27.8%) at T30. The Ct values were statistically significantly higher (p=0.020) at T30 in comparison to T0 and T5. This pilot study suggests that toothbrushing with a dentifrice containing APD could reduce the SARS-CoV-2 viral load in the oral cavity. However, further studies are needed to confirm this possible beneficial effect against SARS-CoV-2.