GMS Hygiene and Infection Control最新文献

英文中文

Development of morbidity and mortality of SARS-CoV-2 in nursing homes for the elderly in Frankfurt am Main, Germany, 2020-2022: What protective measures are still required? 2020-2022年德国美因河畔法兰克福老年人疗养院SARS-CoV-2发病率和死亡率的发展:仍需采取哪些防护措施?

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000431

Ursel Heudorf, Eugen Domann, Markus Förner, Sabine Kunz, Leo Latasch, Bernd Trost, Katrin Steul

Introduction: Nursing-home residents are among the highest risk group in the SARS-CoV-2 pandemic. At the onset of the SARS-CoV-2 pandemic, the majority of all deaths from or with SARS-CoV-2 occurred in long-term care facilities (LTCFs), so that maximum protective measures were mandated for these facilities. This study analyzed the impact of the new virus variants and the vaccination campaign on disease severity and mortality among nursing home residents and staff through 2022 as a basis for determining which protective measures remain necessary and appropriate.Methods: In five homes in Frankfurt am Main, Germany, with a total capacity for 705 residents, all cases occurring in the facility among residents and staff were recorded and documented (date of birth and diagnosis, hospitalization and death, vaccination status) and were descriptively analyzed with SPSS.Results: By 31st August 2022, 496 residents tested positive for SARS-CoV-2, 93 in 2020, 136 in 2021, and 267 in 2022; 14 residents presented with a second SARS-CoV-2 infection in 2022, having previously experienced an infection in 2020 or 2021. The percentage of hospitalizations decreased from 24.7% (2020) and 17.6% (2021) to 7.5% (2022), and the percentage of deaths decreased from 20.4% and 19.1% to 1.5%. In 2021, 61.8% of those infected were vaccinated (at least 2x); in 2022, 86.2% of residents had been vaccinated twice, 84% of whom had already had a booster vaccination. Hospitalization and death rates were significantly higher among the unvaccinated than the vaccinated throughout all years (unvaccinated 21.5% and 18.0%; vaccinated 9.8% and 5.5%; KW test p=0.000). However, this difference was no longer significant under the prevalence of the Omicron variant in 2022 (unvaccinated 8.3% and 0%; p=0.561; vaccinated 7.4% and 1.7%; p=0.604). From 2020 to 2022, 400 employees were documented as infected, with 25 having second infections in 2022. Only one employee showed a second infection in 2021 following the first in 2020. Three employees were hospitalized; no deaths occurred.Discussion and conclusion: Severe COVID-19 courses occurred with the Wuhan Wild type in 2020, with a high death rate among nursing-home residents. In contrast, during the waves in 2022 with the relatively mildly pathogenic Omicron variant, many infections but few severe courses and deaths were observed among the now mostly vaccinated and boostered nursing-home residents. Given the high immunity of the population and the low pathogenicity of the circulating virus - even in nursing-home residents - protective measures in nursing homes that restrict people's right to self-determination and quality of life no longer seem justified. Instead, the general hygiene rules and the recommendations of the KRINKO (German Commission for Hospital Hygiene and Infection Prevention) on infection prevention should be followed, and the recomme

导语:养老院居民是SARS-CoV-2大流行的高危人群之一。在SARS-CoV-2大流行开始时，大多数因SARS-CoV-2死亡或因SARS-CoV-2死亡的病例发生在长期护理设施(ltcf)中，因此这些设施必须采取最大限度的保护措施。本研究分析了到2022年新的病毒变体和疫苗接种运动对养老院居民和工作人员疾病严重程度和死亡率的影响，作为确定哪些保护措施仍然是必要和适当的基础。方法:对德国美因河畔法兰克福的5个住院者和工作人员中发生的所有病例进行记录和记录(出生和诊断日期、住院和死亡、疫苗接种情况)，并使用SPSS进行描述性分析。结果:截至2022年8月31日，共有496名居民SARS-CoV-2检测呈阳性，2020年为93人，2021年为136人，2022年为267人;有14名居民在2022年出现了第二次SARS-CoV-2感染，此前他们曾在2020年或2021年感染过一次。住院率从24.7%(2020年)和17.6%(2021年)降至7.5%(2022年)，死亡率从20.4%和19.1%降至1.5%。2021年，61.8%的感染者接种了疫苗(至少2倍);2022年，86.2%的居民接种了两次疫苗，其中84%已经接种了加强疫苗。在所有年份中，未接种疫苗者的住院率和死亡率显著高于接种疫苗者(未接种疫苗者21.5%和18.0%;接种疫苗的分别为9.8%和5.5%;KW检验p=0.000)。然而，在2022年欧米克隆变异的流行情况下，这种差异不再显著(未接种疫苗的8.3%和0%;p = 0.561;接种疫苗的分别为7.4%和1.7%;p = 0.604)。从2020年到2022年，有400名员工被记录为感染，其中25人在2022年再次感染。继2020年首次感染后，2021年只有一名员工出现了第二次感染。三名员工住院;没有人员死亡。讨论与结论:2020年武汉野生型出现重症病程，养老院居民死亡率高。相比之下，在2022年致病性相对较轻的欧米克隆变异的浪潮中，在现在大多数接种疫苗和加强的养老院居民中，观察到许多感染，但很少出现严重的病程和死亡。鉴于人口的高免疫力和传播病毒的低致病性——即使在养老院的居民中也是如此——养老院限制人们自决和生活质量权利的保护措施似乎不再合理。相反，应遵循一般卫生规则和德国医院卫生和感染预防委员会(KRINKO)关于预防感染的建议，并遵守德国疫苗接种常设委员会(STIKO)关于接种SARS-CoV-2疫苗以及流感和肺炎球菌疫苗的建议。

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引用次数: 0

Excess mortality during the SARS-CoV-2 pandemic in the City of Frankfurt/Main, Germany, in 2020 and 2021, adjusted for age trends and pandemic phases. 2020年和2021年德国法兰克福/美因市SARS-CoV-2大流行期间的超额死亡率，根据年龄趋势和大流行阶段进行了调整。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000434

Katrin Steul, Ursel Heudorf, Helmut Uphoff, Bernd Kowall

Aims: Excess mortality during the SARS-CoV-2 pandemic has been studied in many countries. Accounting for population aging has important implications for excess mortality estimates. We show the importance of adjustment for age trends in a small-scale mortality analysis as well as the importance of analysing different pandemic phases for mortality in an urban population.

Methods: Population data for Frankfurt/Main for 2016-2021 were obtained from the Municipal Office of Statistics, City of Frankfurt/Main. Mortality data from 2016 to 2021 were provided by the Hessian State Authority. For standardized mortality ratios (SMR=observed number of deaths divided by the expected number of deaths), the expected number of deaths was calculated in two ways: For SMR_crude, the mean mortality rate from the years 2016-2019 was multiplied by the total number of residents in 2020 and 2021 separately. For SMR_adjusted, this procedure was performed separately for five age groups, and the numbers of expected deaths per age group were added.

Results: SMR_crude was 1.006 (95% CI: 0.980-1.031) in 2020, and 1.047 (95% CI: 1.021-1.073) in 2021. SMR_adjusted was 0.976 (95% CI: 0.951-1.001) in 2020 and 0.998 (95% CI: 0.973-1.023) in 2021. Excess mortality was observed during pandemic wave 2, but not during pandemic waves 1 and 3.

Conclusion: Taking the aging of the population into account, no excess mortality was observed in Frankfurt/Main in 2020 and 2021. Without adjusting for population aging trends in Frankfurt /Main, mortality would have been greatly overestimated.

目的:在许多国家对SARS-CoV-2大流行期间的超额死亡率进行了研究。考虑人口老龄化对估计超额死亡率具有重要意义。我们展示了在小规模死亡率分析中调整年龄趋势的重要性，以及分析城市人口中不同流行阶段死亡率的重要性。方法:2016-2021年法兰克福/美因的人口数据来自法兰克福/美因市市政统计局。2016年至2021年的死亡率数据由黑森州政府提供。对于标准化死亡率(SMR=观察到的死亡人数除以预期死亡人数)，预期死亡人数通过两种方式计算:对于SMRcrude，将2016-2019年的平均死亡率分别乘以2020年和2021年的居民总数。对于调整smr后的5个年龄组，分别执行该程序，并添加每个年龄组的预期死亡人数。结果:2020年SMRcrude为1.006 (95% CI: 0.980-1.031)， 2021年为1.047 (95% CI: 1.021-1.073)。2020年smr调整为0.976 (95% CI: 0.951-1.001)， 2021年为0.998 (95% CI: 0.973-1.023)。在第2大流行波期间观察到死亡率过高，但在第1和第3大流行波期间没有观察到死亡率过高。结论:考虑到人口老龄化，法兰克福/美因在2020年和2021年没有观察到额外的死亡率。如果没有对法兰克福/美因的人口老龄化趋势进行调整，死亡率将被大大高估。

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引用次数: 0

S2k-Guideline SARS-CoV-2, COVID-19 and (early) rehabilitation - a consensus-based guideline for Germany. s2k指南SARS-CoV-2、COVID-19和(早期)康复——德国基于共识的指南。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000438

Thomas Platz, Peter Berlit, Christian Dohle, Helmut Fickenscher, Manju Guha, Volker Köllner, Axel Kramer, Rembert Koczulla, Axel Schlitt

The consensus-based guideline "SARS-CoV-2, COVID-19 and (early) rehabilitation" for Germany has two sections: In the first part, the guideline addresses infection protection-related procedures during the COVID-19 pandemic. In the second part, it provides practice recommendations for rehabilitation after COVID-19. The specific recommendations for rehabilitation after COVID-19 as issued by 13 German medical societies and two patient-representative organizations are presented together with general background information for their development.

德国基于共识的指南“SARS-CoV-2、COVID-19和(早期)康复”分为两部分:第一部分，该指南涉及COVID-19大流行期间的感染保护相关程序。第二部分为COVID-19后康复提供实践建议。介绍了德国13个医学学会和2个患者代表组织发布的新冠肺炎后康复的具体建议及其发展的一般背景资料。

引用次数: 0

Antibiotic prescribing practices for prophylaxis and therapy of oral/dental infections in pediatric patients - results of a cross-sectional study in Turkey. 预防和治疗儿科患者口腔/牙齿感染的抗生素处方实践-土耳其横断面研究的结果。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000437

Belen Sirinoglu Capan, Canan Duman, Elif Ece Kalaoglu

Aim: Antibiotics are often prescribed for the treatment of various infections and prophylactic purposes in dental practice. Their improper use can cause microbial resistance to antibiotics, which poses a world-wide threat. The aim of this cross-sectional study was to evaluate the knowledge and attitudes of dentists and dentistry students about antibiotic prescription practices for prophylaxis and the treatment of dental infections in pediatric patients.

Methods: A questionnaire was e-mailed to 2,100 dentists and 300 senior dentistry students. The questionnaire was filled out by the participants within a 2-month period (May-June 2020). A 30-point scoring system was developed to assess the knowledge levels of the dentists according to the guidelines. Descriptive statistical analyses were performed. One-way ANOVA test and the Chi-Squared test were used to compare qualitative variables.

Results: The response rate was found to be 24.2% for dentists and 49% for senior dentistry students. 19.4% of the participants were found to be moderately knowledgeable and 80.6% of them were highly knowledgeable. Students' knowledge scores were found to be higher than the general dentists and other specialists (p<0.05). There was no significant difference between students and pedodontists.

Conclusion: Dentists were found to have sufficient knowledge about the usage of antibiotics in children, but there is still a lack of information about circumstances under which antibiotics should not be prescribed. Dentists and dentistry students should attend continuing education programs to keep their information up-to-date and should also prescribe antibiotics in adherence with the current guidelines to prevent antibiotic resistance.

目的:在牙科实践中，抗生素经常用于治疗各种感染和预防目的。它们的不当使用会导致微生物对抗生素产生耐药性，从而构成全球性威胁。本横断面研究的目的是评估牙医和牙科学生对预防和治疗儿科患者牙齿感染的抗生素处方实践的知识和态度。方法:通过电子邮件对2100名牙医和300名牙科专业高年级学生进行问卷调查。该问卷由参与者在两个月内(2020年5月至6月)填写。制定了一个30分的评分系统，根据指南评估牙医的知识水平。进行描述性统计分析。质变量比较采用单因素方差分析和卡方检验。结果:牙科医生和牙科专业高年级学生的回答率分别为24.2%和49%。19.4%的被试具有中等知识水平，80.6%的被试具有高度知识水平。结论:发现牙科医生对儿童抗生素的使用有足够的知识，但在哪些情况下不应开抗生素的信息仍然缺乏。牙医和牙科专业的学生应该参加继续教育计划，以保持他们的信息最新，也应该按照目前的指导方针开抗生素，以防止抗生素耐药性。

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引用次数: 0

Three steps to reduction surgical site infection: presentation of a comprehensive model. 三步减少手术部位感染:一个综合模型的介绍。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000443

Saeid Amini Rarani, Axel Kramer

To prevent surgical site infections (SSIs), a three-step model is proposed, which integrates perioperative measures, multidisciplinary collaboration, and continuous quality improvement (CQI) initiatives.

为了预防手术部位感染(ssi)，提出了一个三步模型，该模型集成了围手术期措施、多学科协作和持续质量改进(CQI)举措。

引用次数: 0

Acute care surgery model in the COVID-19 pandemic era. COVID-19大流行时代的急诊外科模式。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000442

Nader Aghakhani, Bahman Alinezhad, Mehdi Azami, Saied Amini Rarani

Dear editor, The COVID-19 global pandemic caused interruptions in the admission of patients to the emergency unit and a reduction in the incidence of optional surgeries, having a substantial effect on surgical practice. On the other hand, the effects of COVID-19 on surgical professional problems, including the danger of intraoperative viral transmission, illness among health-care staff, and other influences on surgical training, have been discussed many times [1]. The current need for ventilators, staff, and space is a limiting factor for the deployment of surgical resources during the pandemic training, to the point where the provision of essential surgery is being compromised in multiple areas, such as operating rooms, the number of surgeons, and operating staff.Aroung the world, many people who are suffering from surgical complaints are affected both immediately and over time by the strain these limitations impose on the system [2]. Patients should be thoroughly observed after surgery, since there are signs that undetected COVID-19 may make recovery more complicated. Pulmonary complica-

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引用次数: 0

Candida auris: a novel emerging nosocomial pathogen - properties, epidemiological situation and infection control. 耳念珠菌:一种新出现的医院病原体——性质、流行病学现状及感染控制。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000444

Marcelo Caliman Sato, Emilene Cristine Izu Nakamura Pietro, Lucas Marques da Costa Alves, Axel Kramer, Paulo Sérgio da Silva Santos

Immunosuppression and critical illnesses in combination with ecological imbalance open the door for novel opportunistic fungal infections, as in case of Candida (C). auris. C. auris has emerged globally as a multidrug-resistant yeast, causing infections and outbreaks in health care facilities. This narrative review discusses the properties of the yeast, the development of the epidemiological situation, the nosocomial spread and causes for nosocomial outbreaks triggered by C. auris in the hospital environment, and summarizes international recommendations for infection control, supplemented by suggestions on diagnostic, screening and antibiotic stewardship.

免疫抑制和危重疾病与生态失衡相结合，为新的机会性真菌感染打开了大门，如念珠菌(C)耳球菌。耳念珠菌已作为一种多重耐药酵母菌在全球出现，在卫生保健设施中引起感染和暴发。本文讨论了酵母的特性、流行病学形势的发展、auris在医院环境中引发的医院暴发的医院传播和原因，并总结了感染控制的国际建议，并补充了诊断、筛查和抗生素管理方面的建议。

引用次数: 0

Antimicrobial efficacy, mode of action and in vivo use of hypochlorous acid (HOCl) for prevention or therapeutic support of infections. 次氯酸(HOCl)用于预防或治疗性感染的抗菌功效、作用方式和体内使用。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000433

Dirk Boecker, Zhentian Zhang, Roland Breves, Felix Herth, Axel Kramer, Clemens Bulitta

The objective is to provide a comprehensive overview of the rapidly developing field of the current state of research on in vivo use of hypochlorous acid (HOCl) to aid infection prevention and control, including naso-pharyngeal, alveolar, topical, and systemic HOCl applications. Also, examples are provided of dedicated applications in COVID-19. A brief background of HOCl's biological and chemical specifics and its physiological role in the innate immune system is provided to understand the effect of in vivo applications in the context of the body's own physiological defense mechanisms.

目的是全面概述快速发展的体内使用次氯酸(HOCl)的研究现状，以帮助预防和控制感染，包括鼻咽、肺泡、局部和全身的HOCl应用。并举例说明了新冠肺炎疫情下的专用应用。简要介绍HOCl的生物学和化学特性及其在先天免疫系统中的生理作用，以了解在人体自身生理防御机制背景下的体内应用效果。

引用次数: 2

Covid-19 vaccination acceptance and hesitancy among the Turkish adult population. 土耳其成年人对Covid-19疫苗接种的接受度和犹豫度

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000427

Sükran Köse, Aliye Mandiracioglu, Yusuf Özbel, Seheray Zeyrek, Didem Dereli Akdeniz, Hossein Samadi Kafil

Objective: The aim of this study was to determine the acceptance of Covid-19 vaccine among the Turkish adult population.

Methods: A total of 2023 persons participated in this cross-sectional study between October 2020 and January 2021. The questionnaire, which was delivered via social media, was filled out by the participants over "Google Forms".

Results: Questionnaire results showed that 68.7% of the participants might agree to vaccinated against COVID-19. According to univariate analysis, the age group of 50-59, urban residents, healthcare workers, non-smokers, and those with chronic diseases, those who were vaccinated against influenza, pneumonia, and tetanus were all willing to be vaccinated against COVID-19.

Conclusions: It is very important to determine a community's willingness to be vaccinated against COVID-19 so that interventions can be made to solve related problems. Risk of exposure and importance of Prevention play a critical role in vaccination acceptance.

目的:本研究的目的是确定土耳其成人对Covid-19疫苗的接受程度。方法:在2020年10月至2021年1月期间，共有2023人参与了这项横断面研究。调查问卷通过社交媒体发布，由参与者通过“谷歌表格”填写。结果:问卷调查结果显示，68.7%的参与者可能同意接种COVID-19疫苗。单因素分析显示，50-59岁年龄组、城市居民、卫生保健工作者、非吸烟者、慢性病患者、流感、肺炎和破伤风疫苗接种者均愿意接种COVID-19疫苗。结论:确定社区的COVID-19疫苗接种意愿对于采取干预措施解决相关问题非常重要。接触风险和预防的重要性在疫苗接种接受方面发挥着关键作用。

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引用次数: 1

Good handling practice of parenterally administered medicines in neonatal intensive care units - position paper of an interdisciplinary working group. 新生儿重症监护病房内静脉给药的良好处理规范-一个跨学科工作组的立场文件。

IF 3 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

GMS Hygiene and Infection Control

Pub Date : 2023-01-01 DOI: 10.3205/dgkh000436

Irene Krämer, Rangmar Goelz, Christian Gille, Christoph Härtel, Rachel Müller, Thorsten Orlikowsky, Brar Piening, Sebastian Schubert, Arne Simon, Katharina Wolf, Bianka Rösner, Martin Exner

This position paper, developed by an interdisciplinary expert group of neonatologists, paediatric infectious disease physicians, clinical pharmacists and specialists for the prevention and control of nosocomial infections, describes the "Good handling practice of medicines parenterally administered to patients on NICUs". It takes equal account of patient safety and the specialties of neonatal intensive care regarding feasibility and proportionality. The overall concept is perceived as a "learning system", in which open communication within the health-care team relating to medication errors and critical incidents enables continuous development and improvement to ensure patient safety. In our opinion, pharmacists, who are responsible for the supply of ready-to-administer parenteral medicinal products for neonatal intensive care patients, as well as the hygiene staff responsible on site are integral parts of the interdisciplinary treatment team. Risks of the current clinical practice of parenteral treatment of NICU patients are discussed in detail and recommendations for safety-relevant procedures are given.

这份立场文件是由新生儿专家、儿科传染病医生、临床药剂师和预防和控制医院感染专家组成的跨学科专家组编写的，描述了“新生儿重症监护病房患者肠外给药的良好处理做法”。它平等地考虑到患者安全和新生儿重症监护的可行性和相称性。整个概念被认为是一个“学习系统”，在这个系统中，医疗团队内部就药物错误和严重事件进行公开沟通，从而能够不断发展和改进，以确保患者安全。在我们看来，药剂师负责为新生儿重症监护患者提供随时可给药的肠外药品，以及负责现场卫生的工作人员是跨学科治疗团队的组成部分。本文详细讨论了目前NICU患者肠外治疗的临床实践风险，并给出了安全相关程序的建议。

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引用次数: 0

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