GMS Hygiene and Infection Control最新文献

Background and objectives: Colonization of pregnant women by Streptococcus (S.) agalactiae can lead to intrauterine infections after childbirth and potentially life-threatening infections in newborns. The current effectiveness of available antimicrobials is decreasing, posing a serious threat. Hence, there is an urgent requirement to develop novel categories of antimicrobial agents that can efficiently and swiftly eradicate these infections. To developed new strategies in the management and reduction of infections arising from S. agalactiae, our objective was to evaluate the antibacterial efficacy of tungsten nanoparticles (WO₃) on the expression of tetracycline and erythromycin-resistance genes in S. agalactiae isolated from pregnant women.

Materials and methods: A total of 46 Group-B streptococcus (GBS) isolates from rectovaginal swabs, blood, and urine cultures were obtained from pregnant women (13-35 weeks gestation) attending Central and Gynecological Hospitals in Tehran, Iran. The identification of GBS isolates was conducted using a variety of routine bacteriological techniques and targeted assays for the molecular characterization of the GBS isolates. The antimicrobial susceptibility test was carried out according to the Kirby-Bauer method. PCR was employed to screen for the presence of tetracycline and erythromycin resistance-associated genes. Tungsten oxide (WO₃) nanomaterials were successfully synthesized and characterized using FE-SEM (field emission scanning electron microscopy), and DLS (dynamic light scattering) techniques. The microdilution assay was used to assess the antimicrobial efficacy of WO₃ nanostructures. Furthermore, real-time PCR was employed to investigate the effectiveness of WO₃ nanostructures in the regulation of the expression of the tetM and ermB resistance genes.

Results: The findings of the antibiotic susceptibility assays demonstrated a considerable proportion of S. agalactiae strains with high resistance to tetracycline (87%), erythromycin (71.4%), and clindamycin (63%). Conversely, the resistance rates for chloramphenicol and levofloxacin were 8.7% and 6.5%, respectively. The results of antibiotic susceptibility assays revealed high-resistance S. agalactiae strains to tetracycline (87%), erythromycin (71.4%), and clindamycin (63%), while resistance rates chloramphenicol, levofloxacin, penicillin and ampicillin were 33.3%, 14.8%, 11.1%, and 7.4%, respectively. In addition to the mentioned antibiotics, it is worth noting that all strains exhibited sensitivity to other antibiotics such as ceftriaxone, linezolid, and vancomycin. Of the 24 (88.8%) erythromycin-resistant/intermediate isolates, the ermB gene was found in 16 (66.6%), and the mefA gene in 1 (4.2%) isolates. Furthermore, the tetM and tetO genes were recovered by

Introduction: The aging process is accompanied by a variety of challenges that significantly impact the quality of life and overall well-being of older adults. This study explores several key factors that negatively affect seniors, including loneliness, frailty syndrome, falls, polypharmacy, urinary incontinence, chronic pain, and malnutrition.

Method: The PubMed and Google Scholar databases were searched to find scientific articles in which the terms "elderly", and "quality of life" appear in the title, abstract, or keywords.

Results: Loneliness emerges as a critical issue, contributing to mental health problems such as depression and cognitive decline. Falls, a leading cause of injury among older adults, often result in long-term physical and psychological consequences. Polypharmacy, while intended to manage multiple chronic conditions, increases the risk of adverse drug reactions and medication non-adherence. Frailty syndrome reduces a patient's susceptibility to stressors. Urinary incontinence, often stigmatized, affects physical comfort and social interactions, reducing the dignity of those affected. Chronic pain disrupts daily functioning and exacerbates feelings of helplessness, while malnutrition undermines physical health, leading to frailty and increased susceptibility to illnesses. All of these factors have their impact on quality of life in older adults.

Conclusions: The study identifies key factors negatively affecting the quality of life in older adults, including physical, psychological, and social challenges that require comprehensive and targeted interventions.

Objective: To assess the efficacy and safety of methylprednisolone combined with rivaroxaban versus rivaroxaban monotherapy in mild cases of COVID-19.

Methods: This quasi-experimental study was conducted at three hospitals in Ho Chi Minh City, Vietnam, from September 2021 to March 2022. Patients received either rivaroxaban 10 mg/day (Regimen 1) or methylprednisolone 16 mg/day plus rivaroxaban 10 mg/day (Regimen 2) for 7 days. Outcomes included progression to severe disease, adverse events, and changes in clinical and laboratory parameters. Statistical analysis employed Fisher's exact test and Generalized Estimating Equations (GEE).

Results: Among 108 patients, no progression to severe disease or deaths occurred. Regimen 2 significantly improved laboratory markers, including white blood cell counts (+0.290; p<0.001), platelet counts (+0.102; p=0.032), aspartate aminotransferase (+0.335; p=0.013), alanine aminotransferase (+0.397; p=0.006) and CD4 cells (+0.458; p<0.001), and reduced activated partial thromboplastin time (-0.083; p=0.003) compared to Regimen 1. No significant differences in clinical symptoms were observed. Adverse events were rare, with one non-serious event reported in Regimen 1.

Conclusion: Combination therapy with methylprednisolone and rivaroxaban enhanced immune and coagulation parameters without increasing adverse events. These findings suggest potential benefits of early intervention in mild COVID-19, warranting further research.

Background: The quality of sachet water is increasingly concerning due to the rapid growth of production industries and high consumption rates. Therefore, this study evaluated the bacteriological hazards and critical control points (CCPs) in the production of sachet water in nine factories within Jos metropolis.

Method: Water samples were collected at various production stages and analyzed for total viable bacteria, coliform, and Escherichia (E.) coli counts. Aerial bacterial loads in each factory were also assessed. Bacterial isolates were identified using morphological, microscopic, biochemical features, and Analytical Profile Index (API) kits. Physico-chemical properties of the water products were also evaluated.

Results: The finished water samples contained 1.36 to 2.2×10⁶ colony forming units (cfu)/ml, coliform 1.26 to 2.6×10⁵ cfu/ml, and E. coli 1.00 to 1.98×10⁶ cfu/ml, all exceeding WHO/NIS (Nigerian Standard) standards. The most prevalent bacterial isolates included Staphylococcus aureus (29.63%) and E. coli (20.37%), among others. The physico-chemical parameters conformed to standards. However, the presence of pathogens indicated all 12 bacterial isolates as hazards.

Conclusion: Seven out of ten production stages were identified as CCPs. The study concluded that all water samples from the nine factories were unfit for human consumption due to high bacteriological loads and the presence of pathogens. Stringent quality control measures, ongoing monitoring of production activities, and adherence to CCPs are recommended to meet WHO/NIS and NAFDAC (National Agency for food and Drug Administration and Control) standards.

Background: Hepatitis B virus (HBV) infection remains a significant global public health issue, particularly in sub-Saharan Africa, due to inadequate healthcare and research into its genetic epidemiology. This study aims to determine the frequency of HBV antigens, antibodies, and genotypes among febrile patients attending the University of Abuja Teaching Hospital (UATH), Nigeria.

Methods: This cross-sectional study enrolled 100 patients, whose blood samples were collected and screened for HBV surface antigen (HBsAg) and four other structural antigens and antibodies by Lateral Flow Assay. All HBsAg-positive samples were genotyped using type-specific polymerase chain reactions. Structured questionnaires were used to collate the sociodemographic variables of the patients.

Results: HBsAg-seropositivity was 31%. The distribution of HBV genotypes was as follows: genotype E was predominant (22.6%), followed by genotype B (16.1%). Of the HBsAg-positive individuals, all were HBsAb-seronegative, 3.2%, 74.2%, and 90.3% were HBeAg, HbeAb, and HBcAb seropositive, respectively. Genotypes B, C, and D were detected in 16.1%, 3.2%, and 3.2%, respectively. Based on the number of HBV genotypes per individual, 9.7% had a single genotype, 16.1% had double genotypes, and 74.2% had triple genotypes. Higher educational qualification was significantly associated with triple HBV genotypes per individual (p=0.04).

Conclusion: Very high seroprevalence of HBV was found and genotype E predominated. The presence of within-host multiple HBV genotypes was identified for the first time in Nigeria. This indicates the genetic heterogeneity of HBV in northern Nigeria and suggests potential effects on the control measures available.

Introduction: As part of the global poliovirus containment program (Global Polio Eradication Initiative, GPEI), European laboratories are increasingly restricted from using the long-established poliovirus type 1 strain LSc-2ab as the reference virus in virucidal efficacy testing of disinfectants.This necessitates the identification of an alternative test virus that closely resembles poliovirus in its chemical resistance, belongs to the picornaviridae family, and is suitable for routine laboratory handling.

Materials and methods: In this study, two strains of encephalomyocarditis virus (EMCV) were evaluated as potential substitutes in quantitative suspension tests (according to EN 14476) using five biocidal active substances: ethanol, propan-1-ol, propan-2-ol, glutaral (glutaraldehyde) and peracetic acid.

Results: The results demonstrated a strong correlation between the inactivation profiles of EMCV and Sabin poliovirus type 1 vaccine strain LSc-2ab. Due to this close correlation and EMCV's practical advantages in laboratory settings such as availability in a European virus bank, growth in a high titer, it is proposed as a suitable substitution candidate for future virucidal efficacy testing.

Arboviruses (arthropod-borne viruses) pose an ongoing public health threat in the Eastern Mediterranean Region (EMRO) of the World Health Organization. This review summarizes the epidemiology of major arboviruses - including Crimean-Congo hemorrhagic fever virus (CCHFV), chikungunya virus (CHIKV), dengue virus (DENV), Rift Valley fever virus (RVFV), West Nile virus (WNV), yellow fever virus (YFV), and Zika virus (ZIKV) in EMRO countries based on data from 2014-2023. Reported prevalence rates varied considerably between studies and countries, indicating localized transmission intensity. Overall, serological evidence confirms endemic circulation of CCHFV, CHIKV, DENV, and WNV in parts of the region. Large DENV outbreaks highlight it as a key concern. More systematic surveillance and standardized diagnostics are needed to characterize arbovirus epidemiology across the region and inform control strategies.

Drug-resistant tuberculosis (DR-TB) poses a significant global health threat, particularly in low- and middle-income countries with limited access to quality healthcare. By 2023, 10% of global tuberculosis cases were classified as drug-resistant, with multidrug-resistant (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) showing increasing prevalence. The treatment of DR-TB has been complicated by long regimens, severe side effects and high overall costs, which contribute to non-adherence and treatment failures. Novel pharmacological agents including bedaquiline, linezolid, meropenem and more, have shown promise in improving treatment outcomes, shortening therapy duration, and enhancing patient compliance. These drugs have demonstrated effectiveness in both MDR-TB and XDR-TB cases, particularly when used in combination therapies as BPaLM (the combination of bedaquiline, pretomanid, linezolid and moxifloxacin). However, challenges remain, including limited access to drugs, diagnostic tools, and healthcare infrastructure, particularly in high-burden regions. Although regimens incorporating these agents offer improved treatment success rates, they require careful monitoring due to potential side effects and the risk of resistance. Future research should focus on refining these regimens, optimizing drug use for resource-limited settings, and addressing logistical and economic barriers to ensure more effective and accessible treatment. The ultimate goal is to reduce the global burden of DR-TB and improve outcomes for affected populations.

Aim: The preoperative shower (POS) is strongly recommended in skin preparation before surgery, to remove skin soiling and facilitate the antisepsis of the incision site. The effectiveness of POS to achieve clean skin in routine practice has not been studied in literature. This study aimed to determine how often the operating room (OR) nurse assessed the skin of surgical patients at arrival in the OR as "not adequately clean".

Method: This descriptive survey was carried out in January 2024 in a university hospital in France. An investigator documented patient's age, gender, and body mass index (BMI), the day of surgery, type of surgical procedure, whether it was scheduled or unscheduled, and the site of the site. The patient was asked whether s/he had taken a POS, and its time and place (home or hospital). The OR nurse was asked by the investigator about her assessment of the patient's skin cleanliness (adequate or inadequate), and in case of skin cleanliness deemed unsatisfactory, what decision had been made: proceed as usual, additional skin cleaning in the operating room, postponement of the surgical procedure.

Results: Among the 100 patients included in the study, 18% (95% CI 10.5-25.5%) had a skin cleanliness that was considered unsatisfactory. A scheduled procedure was the sole parameter significantly associated with satisfactory skin cleanliness as compared to unscheduled procedures.

Conclusion: Despite the POS, approximately one-fifth of patients had inadequate skin cleanliness upon arrival in the OR, highlighting an essential area for improvement of preoperative preparation of the surgical field, especially in clean surgery.

Aim: Central line-associated bloodstream infections (CLABSI) remain a major contributor to morbidity and mortality in critically ill patients. The rise of antimicrobial resistance (AMR) exacerbates treatment challenges, making it crucial to examine pathogen resistance patterns. This study analyses CLABSI-associated pathogens' antimicrobial susceptibility using the WHO's AWaRe antimicrobial framework, providing insights to guide targeted treatment and strengthen infection control strategies.

Methods: This observational study (2021-2024) assessed data from adult and pediatric ICUs to evaluate CLABSI incidence, microbial etiology, and antimicrobial susceptibility trends. We categorized antimicrobials based on the WHO's AWaRe classification system, analysing their susceptibility to Access, Watch, and Reserve antimicrobials. Statistical analysis was performed using SPSS version 22.

Results: Among 5,398 patient records, 101 cases of CLABSI were confirmed. The predominant pathogens were Klebsiella (K.) pneumoniae (27.7%), Acinetobacter spp. (19.8%), and Candida spp. (17.8%). A worrying decline in susceptibility to Access- and Watch-category antimicrobials was observed in key pathogens. K. pneumoniae demonstrated a steep decline in susceptibility to Access-category agents, from 27.8% in 2021 to 16.7% in 2023. Conversely, Reserve-category antimicrobials maintained 100% efficacy across the study period. Acinetobacter spp. exhibited resistance to both Access- and Watch-category antimicrobials by 2024. Pseudomonas aeruginosa showed a drastic drop in Watch-category susceptibility, from 44.5% in 2021 to 0% in 2023, while Reserve-agents remained effective. These results underline the growing reliance on Reserve antimicrobials and the diminishing effectiveness of first-line agents. Furthermore, a fluctuation in CLABSI rates was also observed, with a significant reduction in infection rates in 2024 after the implementation of enhanced infection control practices.

Conclusion: This study highlights the escalating resistance patterns of CLABSI pathogens, with a consternating decline in Access- and Watch-category antimicrobial efficacy. The AWaRe framework proves invaluable in identifying critical resistance trends, demonstrating the need for targeted antimicrobial stewardship. Prioritizing Access antimicrobials as first-line therapies, guided by local resistance data, can preserve the effectiveness of Reserve agents. A strategic focus on the AWaRe classification, coupled with rigorous infection control and stewardship programs, is essential to combat the rising AMR threat and optimize patient outcomes in critical care settings.