GMS Hygiene and Infection Control最新文献

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.

Background: For reusable devices and device components, effective reprocessing is essential to prevent nosocomial infections.

Aim: The objective of the study was to evaluate manual cleaning as the first step of reprocessing reusable glass probes of a device for generation of non-invasive physical plasma, in accordance with regulations.

Methods: Two glass probes of the device were contaminated with human blood. For manual cleaning, both probes were cleaned with instrument cleaning agent and instrument brushes. Cleaning efficacy was evaluated by total protein measurement in the rinsing solution.

Results: After manual cleaning of the two test glass probes, no protein from the test contamination with human blood could be detected. Neither the different design of the two probes nor the use of a hard or a soft instrument brush demonstrated any difference.

Conclusion: Our data suggest that manual cleaning of glass probes achieves complete removal of organic contaminants. This should enable safe applications in clinical practice.

Background: Hydatid cysts (HC) are zoonotic diseases that are mainly caused by Echinococcus granulosus. Ovarian HC is a rare condition with different and unspecified presentations. Here we report a rare case of primary ovarian HC.

Case presentation: A 47-year-old woman with chronic abdominal pain and left hemipelvic fullness was referred to the Obstetrics Clinic of the Kowsar Hospital of Qazvin. Abdominopelvic sonography revealed a cystic mass, which primarily suggested a cyst adenoma. The tumor marker levels were within normal limits. After surgical resection, histopathological examination showed a cystic mass with dimensions of 10×6×3 cm, smooth external and internal aspects, wall thickness of 0.3 cm, and multiple pieces of irregular gray membranous tissue. The patient was treated with albendazole 3 months after surgery, and a 6-month follow-up sonogram revealed no signs of recurrence.

Discussion: HC has non-specific presentations. Radiologists, pathologists, and surgeons should consider HC as a differential diagnosis for any cystic mass in the pelvic cavity, especially in endemic areas. Surgical resection and albendazole administration are the chosen treatments.

Background: Healthcare-associated infections cause high mortality and morbidity, and lack of stethoscope disinfection is one of the reasons for healthcare-associated infections. Nurses who frequently use stethoscopes in the clinic do not disinfect stethoscopes at high rates. This study aimed to identify the frequency of stethoscope disinfection by nurses and their knowledge about the same.

Methods: This was a mixed-methods observational study. The quantitative part of the study included 202 nurses, the qualitative part included 12. Two researchers who made observations during stethoscope use recorded the procedures the nurses performed on the "Observation Form". Semi-structured in-depth interviews were conducted based on phenomenological methods.

Results: 23.7% of the nurses disinfected their stethoscopes before contact with patients, 11.8% after contact with patients and 6.4% before and after contact with patients. The nurses used a stethoscope on an average of 7.42 patients without disinfecting it. In the qualitative interview, some nurses stated that they did not have information about the disinfectants to be used for stethoscopes and their effectiveness. Some of the participants in the present study stated that they did not receive training on stethoscope disinfection and that they did not know that there were guidelines about it.

Conclusion: Since there were deficiencies in the implementation of stethoscope disinfection as well as knowledge, the transfer of knowledge in this context must receive more attention in education and training.

Background: Antituberculosis drugs may cause mild, moderate or severe adverse drug reactions (ADR) leading to poor compliance. Description of the pattern of ADR and their related factors can help tuberculosis (TB) control program as part of the WHO programs. This study aims to investigate the incidence of ADR and associated factors among TB patients in northern Iran.

Methods: This is a retrospective cohort study. The required information, including year of diagnosis, age, gender, residence area, nationality, HIV co-morbidity, history of anti TB treatment and ADR, was obtained from the Deputy of Health, Mazandaran University of Medical Sciences, Iran. All data were analyzed using SPSS version 21 software.

Results: Out of 3903 TB patients, 136 (3.5%) experienced major ADR. The incidence of ADR for men and women as well as for those with and without previous treatment history were 3.9% vs. 3.3% and 5.3% vs. 3.4%, respectively (p>0.05). Multiple logistic regression models showed a higher chance of ADR among those aged over 59 compared with those aged under 29 (OR=2.63, 95% confidence interval: 1.54-4.49).

Conclusions: Age over 59 can be considered a risk factor for ADR with anti-TB drug administration.

Aim: The purpose of this study is to undertake an integrative literature review in order to determine the prevalence, etiology, and reactivation of oral HSV infection in patients receiving chemotherapy (CT).

Methods: The study was carried out in the PubMed/MEDLINE, Embase, Virtual Health Library, and Scopus databases, using the descriptors "Herpes Simplex", "Viral Diseases", "Mouth", and "Antineoplastic Agents".

Results: The findings suggest that HSV infection is widespread in this group of patients and can be severe. HSV infection is frequent in CT patients, and treatment should begin as soon as it is feasible, utilizing antivirals to avoid future difficulties, as patients are immunocompromised.

Conclusion: It is critical for health professionals to be fully informed on the dangers and treatment choices available, with the most appropriate therapy for each circumstance. Furthermore, more recent research with acceptable methodological rigor is required to better quantify the prevalence of HSV in these patients.

Background: Special antibiotics are prescribed against Helicobacter (H.) pylori. However, sometimes the bacteria are not completely eliminated, or they are recurrent. Unlike most infections, it is very difficult to eliminate a H. pylori infection. Heteroresistance is defined as the phenomenon in which subpopulations of the same colony of bacteria exhibit a range of susceptibilities to a particular antibiotic. Because of heteroresistant cells, antibiotic failure and chronic infection can occur; thus, the current research aimed to investigate presence of heteroresistant cells in H. pylori collected from patients reffering to clinic in Ilam, Iran. Subsequently, patients who were infected with heteroresistant H. p ylori were treated with antibiotics effective against heteroresistant subpopulations.

Methods: In this cross-sectional descriptive study, 100 patients with clinical symptoms and suspected of being infected with H. pylori were studied in private clinics in Ilam, Iran. Fiftyisolates of H. pylori accompanied by patients' information were obtained from Ilam clinics. We cultured the bacteria to identify heteroresistance and to find the cause of recurrent infection in these patients.

Results: Out of a total of 50 samples, 3 were heteroresistant to clarithromycin (6%). Levofloxacin was applied in cases of heteroresistant samples, and the effectiveness was determined after one month of follow-up of patients.

Conclusion: Patients with heteroresistance showed sensitivity to levofloxacin. After one month of follow-up, it was found that the effectiveness of this antibiotic was good. Therefore, this antibiotic was introduced as a more effective drug in patients with heteroresistant H. pylori.

Aim: To recognize and analyze the 100 most-cited articles on post-operative infections following cardiothoracic surgery and vascular procedures in the past 20 years.

Methods: Articles published on post-operative infections following cardiothoracic surgery and vascular procedures from inception 1986 till 2020 were reviewed and selected by two authors, based on their number of citations using the Scopus database. Their characteristics were recorded, i.e., title, authors, publication date, total no. of citations, citations per year (CPY), country of research, institutional affiliation, journal, research subject, and article type.

Results: The top 100 most influential articles were published between 1968 and 2017, with the peak in 2002. The mean number of total citations was 236.79 (range: 108-1,157). Areas with a medical focus were predominant in the studied research articles on the researched topic. The top-most journals in which these articles were published include Annals of Thoracic Surgery (14), followed by Circulation (8), and the New England Journal of Medicine (8). The number of publications affiliated with an institution were highest in the United States, with the Cleveland Clinic Foundation (6) having the most.

Conclusion: These findings highlight that there is a great potential to conduct research and publish the prevalence, causes, risk factors, pathogenesis and molecular biology of post-cardiac and -vascular surgery infections to prevent their adverse effects. The results can be taken into consideration for policy making to improve post-cardiac-surgery outcomes.

Background: The high prevalence of virulence-associated genes observed in Acinetobacter baumannii isolates underscores the pathogenic potential of this bacterium. The presence of these genes confers enhanced survival, evasion of host defenses, and increased virulence. In this study, we investigate the presence and distribution of genes associated with virulence and assess the antimicrobial susceptibility patterns in clinical isolates of A. baumannii.

Materials and method: This research focused on examining the 50 multi-drugs resistant (MDR) strains that were included in this investigation. The identification of these strains was validated using Oxa-51. The presence of the BauA and BasD genes was determined through conventional PCR techniques.

Results: The results derived from Oxa-51 PCR confirmed the identification of all 50 selected strains of A. baumannii. Additionally, both the BauA and BasD genes were successfully identified in 82% of the MDR strains.

Conclusion: Moreover, the varying antibiotic resistance patterns highlight the challenge in treating A. baumannii infections effectively. Strategies such as combination therapy, antimicrobial stewardship, and infection control measures should be considered to combat this multidrug-resistant pathogen.