GMS Hygiene and Infection Control最新文献

Hospitalized patients are often more susceptible to infection than healthy people due to their illness, the presence of devices and their reduced immune defenses. At the same time, potentially pathogenic pathogens, which are often characterized by antibiotic resistance, are released into the area close to the patient, including the bed. To prevent hospital beds from becoming a source of nosocomial infections, bed linen and hospital beds, including encasings or pillows and comforters, must be disinfected before reoccupation, in contrast to hotel beds. The guideline outlines the hygienic and ergonomic requirements for hospital beds, ensuring bed hygiene during the patient's stay and the principles of bed reprocessing, including organization, quality assurance and staff protection, in 40 recommendations.

Aim: Due to the effectiveness of guanidine thiocyanate (GdnSCN) for the decontamination of prion protein aggregates, which are the causative agent of transmissible spongiform encephalopathy, the influence on the bending stiffness and torsional strength of endodontic nickel-titanium files should be tested to provide a potential alternative to single-use if necessary.

Method: For the investigation, nitrite-titanium-coated EasyShape^® files of sizes 25.06 and 35.04 were placed in 6 M GdnSCN solution 8 times for 15 min each for decontamination in line with the manufacturer's recommendation, with intermediate drying in each case. To simulate the worst case, the soaking time was extended to 12 h once. Both the bending stiffness and the torsional and fracture behavior were determined in accordance with DIN EN ISO 3630-1:2008-04.

Results: Compared to the untreated control (n=12), decontamination with GdnSCN has no effect on the torsional strength or flexural rigidity of the tested endodontic instruments of sizes 25.06 and 35.04 (n=18 each) when used properly. On the other hand, the exposure time of 12 h reduced the bending moment and torsion angle of instrument size 25.06, while the material properties of size 35.04 files are not affected.

Discussion: Based on the results, the maximum 8-fold application of 6 M GdnSCN solution for 15 min for decontamination of endodontic nickel-titanium files can be considered. Although the sterilization process has no influence on the fracture behavior, it is important to clarify for clinical practice what influence the overall reprocessing process has on the performance of the instruments.

Introduction: Healthcare-associated infections caused by multidrug-resistant (MDR) Staphylococcus strains pose a significant challenge. Healthcare workers (HCWs) are potential vectors in transmitting these strains. This study assessed the prevalence of nasal carriage of staphylococci among HCWs.

Methods: This prospective cohort study was conducted from March to June 2024 at a tertiary care hospital in Central India. Nasal swabs from 178 HCWs were collected and screened for methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-sensitive coagulase-negative staphylococci (MS-CONS), and methicillin-resistant CONS (MR-CONS) using standard microbiological methods. Antimicrobial susceptibility and biofilm production were evaluated.

Results: Of 178 HCWs, 61.8% were Staphylococcus carriers, including 36% MRSA. High MRSA carriage was observed in junior residents, interns, and nursing assistants, particularly in the surgical department. Furthermore, the notifiable carriage rate was observed among HCWs who did not consistently adhere to hand-washing practices and/or frequently picked their noses, and those regularly involved in patients' wound care. All MRSA and MR-CONS were MDR, while 30% of MSSA and 45.5% of MS-CONS were MDR. No vancomycin resistance was detected, but 12.5% of MRSA showed intermediate resistance to vancomycin (VISA). Linezolid resistance was observed in 10% and 37.5% of MRSA (LRSA) and CONS, respectively. Biofilm production was noted in 72.7% of isolates.

Conclusion: The high prevalence of nasal carriers of MRSA and MDR staphylococci strains and the emergence of VISA and linezolid-resistant staphylococci underscores the need for stringent infection control and antimicrobial stewardship measures in healthcare settings. Regular screening and decolonization protocols for HCWs are critical in preventing the spread of resistant pathogens.

Aim: The number of active agents used in hand antiseptics (HA) in Germany was analyzed using the disinfectant lists of the Association for Applied Hygiene (VAH) for the years 2004, 2012 and 2022 to evaluate the development regarding the use of unnecessary or critical active agents in alcohol-based hand rubs (ABHR).

Results: While 20 different active agents were used in the HAs (97 listed HAs) in 2004, only 14 were used in 2012 (201 listed HAs) and 15 in 2022 (332 listed HAs). Benzoic acid, clorocesol, chlorophene, octenidine dihydrochloride, peracetic acid, polihexanide and triclosan are no longer used as additives to ABHR. At the same time, the number of active ingredients per product fell.In the period from 2002 to 2022, there was an increase in ABHR, so that in 2022, only four HAs did not contain alcohol: three were based on PVP iodine and one was based on quaternary ammonium compounds.While 2-propanol still dominated as the first-named active ingredient in 2004 and 2022, in 2022 mainly ABHR with ethanol as the first-named active ingredient were certified. The percentage share of ethanol in ABHR, measured against all VAH-listed HA and as the main active ingredient, increased by 43.4% between 2004 and 2022. At the same time, there has been a 33.2% decrease in ABHR of 2-propanol as active ingredient.

Discussion: There are probably two reasons for the decrease in the total number of active ingredients used. The addition of antiseptic agents to ABHR does not increase their residual effectiveness. In addition, the antimicrobial antiseptics added to ABHR are less well tolerated than alcohols. Consequently, for ethical reasons it makes sense not to add these antimicrobials to the formulas. The increase of ethanol-based hand rubs (EBHR) suggests that these are preferred by users. One explanation may be that, unlike ethanol, 1-propanol can have an irritating effect on both healthy and atopic skin.

Conclusion: Ethanol must be retained as an active ingredient for ABHR for the following reasons: ethanol is the only active ingredient that can be used for HA with comprehensive efficacy against non-enveloped viruses; both propanols are less physiological for the human organism than ethanol; ethanol is better tolerated by the skin than 1-propanol; and an adverse effect on the skin microbiome has been ruled out for ethanol. This must be considered when discussing the possible biocide classification of ethanol as CMR, especially because such a classification has absolutely no scientific basis.

Background: Vaginal candidiasis is induced by abnormal growth of yeast on the mucous membranes of the female genital tract. Approximately 75% of women experience a yeast infection once in their lifetime. This study explored the epidemiological, clinical, and microbiological features of vaginal candidiasis in diabetic women referred to health and treatment centers in Kermanshah in 2023.

Methods: This cross-sectional descriptive study was conducted on 215 diabetic women. A questionnaire was prepared for each participant. The samples were examined microscopically and cultured on Sabouraud dextrose agar (SDA). To identify different species of Candida (C.), various complementary tests were performed, such as the germ tube and differential sugar absorption test (API). A sensitivity test was applied to positive samples by the broth macrodilution method. Data were analyzed using the chi-squared test in SPSS.

Results: Out of the 215 vaginal swabs investigated, 66 specimens were Candida-species positive (30.7%). 11.6% of participants were diagnosed with candidal vulvovaginitis by direct microscopic examination and 20.9% by culturing on SDA. The Candida species isolated were: C. albi ca n s with 36 cases (54.5%), C. glabrata with 14 cases (21.2%), C. tropicalis with 9 cases (13.6%) and C. parapsilosis with 7 cases (10.6%). All species isolated showed the same sensitivity to the antifungal drugs used.

Conclusion: The culture method was more sensitive than the direct microscopic examination. C. albicans was the most prevalent species isolated from patients. Non-albicans species were not prevalent.

Background: Healthcare quality in health facilities relies on the implementation of and providers' adherence to an effective infection control program. The aim of this study was to assess the implementation level of infection prevention and control (IPC) guidelines in healthcare facilities in a low-income country.

Methods: This was a cross-sectional study conducted in 18 healthcare facilities of the Popokabaka health district in the Democratic Republic of Congo. Data were collected and analyzed following the IPC assessment framework developed by the World Health Organization (WHO). The framework consisted of eight different sections, of which each is scored up to 100. The level of implementation in each facility was assessed based on a scoring system: inadequate (0-200), basic (201-400), intermediate (401-600), and advanced (601-800).

Results: The median score of all facilities was 181.3, IQR 145.0-228.1, with a range from inadequate to basic. Ten (55.6%) healthcare facilities had an inadequate IPC implementation level, while eight (44.4%) had a basic level. IPC education and training were the components that were the most poorly implemented in the surveyed facilities. None of these facilities had multimodal strategies to implement IPC interventions.

Conclusion: The level of IPC guideline implementation in healthcare facilities of the Popokabaka health district remains basic as a result of low resource investment in the IPC program. It negatively impacts the quality of care and exposes patients and healthcare providers to healthcare-associated infections.

Background: The mortality rate of meningitis is still alarmingly high in certain regions across the globe. The objective of this research is to identify the most effective primers for detecting Streptococcus (S.) pneumoniae, Haemophilus (H.) influenzae, and Neisseria (N.) meningitidis using Real-Time PCR technology.

Materials and methods: Two sets of primers were developed for detecting S. pneumoniae, H. influenzae, and N. meningitidis using the Primer Biosoft Allele ID 7.6 application. The study examined the minimum bacterial copy numbers detectable by each primer, as well as their specificity.

Results: CtrA and hpd2 could detect the 400 copy numbers/ml of H. influenzae, and N. meningitidis and LytA2 could detect the 40 copy numbers/ml of S. pneumoniae. The sensitivity and specificity of all primers was 100% (CI: 95%).

Conclusion: Using more sensitive primers to detect the bacterial agent responsible for causing bacterial meningitis increases the chance of identifying the causative bacteria. The primers designed in this study could identify the selected bacteria with at least 10 times more sensitivity than the currently available commercial diagnostic kits in Iran.

Background: Shigella (S.) flexneri is one of the most important causes of disease in children with diarrhea in Iran. Today, bacteriophages are an attractive option to resolve the drug resistance problem among pathogenic agents. Accordingly, the present study aimed to isolate a lytic bacteriophage of S. flexneri and investigate its impact on reducing excretion of Shigella in mouse models suffering from bacillary dysentery.

Method: S. flexneri ATCC12022 was used. Identification of the phage isolated from hospital wastewater was performed using Transmission Electron Microscopy (TEM). Stability tests were performed to determine the sensitivity of isolated phages to various factors such as temperature, pH and bile salts. A male Syrian mouse model (C57), with mice 6 weeks of age weighing 22-25 g, was used to ensure safety and efficacy of the bacteriophage in reducing Shigella in stool. Treatment with the phage was performed (I) 1 h before, (II) 1 h after, (III) 5 h after, and (IV) 1 h before +1 h after bacterial challenge.

Results: TEM indicated that the bacteriophage used in this study belongs to the Myoviridae family. Administration of one dose of bacteriophage before the infection can accelerate improvement post-transfection, and administration of bacteriophage post-infection has a therapeutic influence.

Conclusion: In vivo and in vitro results indicate that our bacteriophage causes complete lysis of S. flexneri. Thus, this phage could be a therapeutic option for treating bacillary dysentery resulting from multidrug-resistant S. flexneri.

Background: Early childhood caries (ECC) is a chronic, infectious disease affecting young children. Though several preventive methods/measures are, the awareness about the benefits of a Ayurvedic preparation and its limited side effects is high. Thus, aim of this study was to compare efficacy of Ayurvedic formulations in reduction of the micro-organism causing ECC.

Method: In a double-blind randomized, placebo-controlled trial 60 children between 6 and 71 months age with ECC were divided into group I (n=20, control group), group II (n=20, Acacia catechu group) and group III (n=20, HiOra group). Unstimulated saliva was collected pre and after 16^th day post mouthrinse. The baseline microbiological colony count was performed for Streptococcus mutans and Lactobacillus spp. The results obtained were statistically analysed using non parametric test.

Results: There was significant reduction in the amount of colony-forming units (cfu) between the control and the treatment groups. In the HiOra group the reduction of cfu was tendentially greater (p>0.05) than in the Acacia catechu group. In the HiOra group only significant reduction of Streptococcus (S.) mutans was seen, whereas in the Acacia catechu group significant reduction of S. mutans and Lactobacillus spp. was seen.

Conclusion: Reduction in total microorganisms was less significant among the experimental groups. However the reduction in total colony count was greater in HiOra followed by Acacia catechu and the control group showed lesser reduction value.

Background: Infections with multidrug resistant (MDR) pathogens represent an enormous challenge for the healthcare system. By implementing the principles of Antibiotic Stewardship (ABS), the rational use of antibiotics is promoted to counteract the increasing development of resistance on the one hand and to ensure adequate treatment for patients on the other.

Methods: An interdisciplinary ABS team has therefore been set up at the Bundeswehr Central Hospital and is available to medical staff every working day as part of a consultation and ward-rounds service. The work of the ABS team primarily serves to advise on the treatment, diagnosis and prevention of infectious diseases. It also intends to provide knowledge during the training of young medical officers in order to promote the rational use of antibiotics even outside the Bundeswehr Central Hospital.

Results: Since the implementation of the consultation and ward-rounds service, antibiotic consumption at the Bundeswehr Central Hospital has been reduced by 25%. In this context, the halving of carbapenem consumption is particularly noteworthy. Furthermore, the rising number of consultation requests shows an increasing need for the service and acts as a marker for ABS awareness.

Conclusion: The reduction in antibiotic consumption is not solely due to the mentioned service, but is also the result of interdisciplinary ABS measures.