GMS Hygiene and Infection Control最新文献

Aim: This study was carried out to isolate and detect virulence genes associated with Staphylococcus (S.) aureus clinical isolates from the Federal Medical Center Birnin Kebbi, Nigeria.

Methods: To obtain S. aureus isolates, samples were taken from urine, sputum, blood and wound sources. S. aureus was phenotypically identified using Microgen staph ID system and PSM-mec and PVL genes were detected using polymerase chain reaction (PCR).

Results: A total of 48 non-duplicate S. aureus isolates were obtained (21 from wound swabs, 7 from blood, 15 from urine, and 5 from sputum). From the 14 S. aureus isolates examined by PCR, the most abundant gene was PSM-mec (42.8%), while the PVL was the least abundant with 21.4%.

Conclusion: Because it gives highly specific and accurate results, it is essential to use the PCR technique to detect S. aureus virulence determinants as well as PSM-mec and PVL as targets for antimicrobial agents.

Background: In 2024, there has been a notable surge in the incidence of infections with parvovirus B19 (B19V). This development presents significant challenges, particularly for pregnant women, daycare centers, and medical facilities with vulnerable patients.

Properties of b19v: B19V is transmitted primarily by droplet infection, directly and indirectly through contaminated surfaces. It is highly contagious and can have serious health consequences for at-risk groups, especially for pregnant women and immunocompromised individuals. There is not yet much data available on the specific tenacity/replication capacity of B19V, which is why empirical values from animal parvoviruses regarding sensitivity to disinfectants are used.

Recommendations for hygiene measures: In order to prevent the further spread of B19V, an advisory has been prepared by experts from the Association for Applied Hygiene (VAH), in collaboration with the "Virus Disinfection" commission of the German Association for the Control of Virus Diseases (DVV) and the Society for Virology (GfV). This advisory is based on a risk assessment and the specific properties of B19V, and it outlines the necessary hygiene measures, including the selection of suitable disinfectants, to be taken in various areas in order to prevent the virus from spreading further. In the domestic setting, fundamental hygiene practices include thorough handwashing, refraining from touching the eyes, mouth, and nose, the use of a medical mask in the absence of physical distancing, and the frequent ventilation of rooms. In a medical setting, for example, the disinfection of surfaces in close proximity to the patient with an active virucidal agent and the use of gloves are also recommended when dealing with infected or potentially infected individuals.

Aim: Appendectomy is the most frequent emergency abdominal operation in children, who regularly present with complicated acute appendicitis and thus need targeted antibiotic therapy. While in other fields antibiotic stewardship (ABS) is becoming increasingly well established, these principles are not consistently followed in pediatric surgery. With this study, we aimed to analyze the effects of the implementation of an ABS-compliant SOP on the postoperative care of patients.

Material and methods: We compared the quality of antibiotic therapy before and after the implementation of standard operating procedure (SOP) for the peri-/postoperative antibiotic treatment of appendicitis in 2020. Pediatric patients who had undergone appendectomy were evaluated based on an algorithm presenting recommended antibiotic therapy of appendicitis, according to the current literature and good clinical practice. 165 patients were evaluated before and 209 patients after the implementation of SOP.

Results: The mean number of cases in which antibiotic therapy was given postoperatively was 10.5% lower (p-value 0.036) and the median quality-of-treatment score increased by 31.2% (p<0.0001) after the implementation of the SOP. The median length of antibiotic treatment in cases of advanced-stage appendicitis was 2.0 days shorter (p=0.062). The rate of oral antibiotic treatment after discharge decreased by 25.6% (p<0.0001). We observed no significant effects on the median length of hospital stay or the complication rate.

Conclusion: The implementation of SOP based on the principles of ABS positively influenced the quality of treatment after pediatric appendectomy. The algorithm developed in this study may help pediatric surgeons to improve their antimicrobial assessment.

Background: Inappropriate and excessive use of antimicrobials contributes to the rise of antimicrobial resistance (AMR). To address this, better tools are needed to improve antibiotic prescribing globally. This study evaluates a novel antimicrobial stewardship (AMS) tool - the AWaRe-based microbiology reporting format - developed by the Departments of Microbiology and Infectious Diseases at the Government Medical College, Trivandrum, Kerala state, India. This format incorporates the WHO AWaRe classification into bacterial culture susceptibility reports. The primary objective was to assess the effectiveness of this reporting format in encouraging physicians to choose access antibiotics. The secondary objective was to identify the most preferred microbiology reporting format for antimicrobial susceptibility reports.

Materials and methods: A cross-sectional study was conducted among registered modern-medicine practitioners (physicians) in Kerala via social media platforms using a Google form-based questionnaire over a two-month period. Responses were automatically recorded and analysed using descriptive statistical methods. The study included all physicians who gave informed consent, excluding those who declined to participate. The sample size was determined to be 138 based on a pilot study.

Results: A total of 228 physicians participated in the study, 137 (60.1%) of which were clinicians. Among the participants, 199 (87.2%) preferred the AWaRe-based reporting format over conventional formats for effective implementation of the Antimicrobial Stewardship Programme (AMSP). Using this AMS tool, 76.7% (n=56) of participants were successfully guided to choose appropriate access antibiotics.

Conclusion: The study demonstrates that AWaRe-based susceptibility reporting formats can effectively nudge clinicians towards better antibiotic selection, supporting the successful implementation of AMSP (antibiotic stewardship programs). This format also serves as a continuous IEC (Information, Education and Communication) tool, helping clinicians familiarize themselves with WHO AWaRe classifications and encouraging the preferential selection of access-group antibiotics when appropriate.

In the spring of 2022, SARS-CoV-2 Omicron BA.2 peaked in Germany. The main burden was staff shortage. To achieve effective identification and management of infected persons as well as early reintegration of recovered persons, an infection-control outpatient clinic was established at the Bundeswehr Central Hospital Koblenz. This article reports a secondary data analysis of 663 people with 1,174 visits to the outpatient clinic. For asymptomatic contacts, no correlation was observed between PCR result and testing time or frequency. Although no significant symptoms were documented, a high correlation was found between a positive antigen self-test and positive PCR. For clearance, a median time until a negative test was obtained was 8-11 days. The PCR gold standard was compared with ECLIA antigen testing for all indications. The results of this study challenge the rationale for testing asymptomatic contacts. Solely symptom-driven diagnostics by PCR also do not seem to be effective. However, contact persons or symptomatic persons with a positive rapid antigen test should be tested further. Whether this testing is done by ECLIA or PCR does not seem to matter. Clearance testing after recovery prior to day 8 is also not appropriate.

Aim: Too often, antibiotics are prescribed in the treatment of pharyngitis, which can contribute to antimicrobial resistance. We aimed to assess the in vitro antiviral and antimicrobial activity of sugar-free cetylpyridinium chloride (CPC)/benzocaine lozenges, which can potentially offer a more suitable treatment for pharyngitis.

Methods: The antiviral activity of sugar-free CPC/benzocaine (1.4 mg/10 mg) lozenges (Dolo-Dobendan 1.4 mg/10 mg lozenges) was assessed using the DIN EN 14476:2019-10 suspension test against bovine coronavirus (S379 Reims) or influenza virus A (H1N1/Brisbane/59/2007) under clean and dirty conditions. Viral titers were measured after 1, 5, 10, and 30 min exposure; a reduction of ≥4 lg was considered virucidal. For bovine coronavirus, large volume plating was used due to cytotoxicity. Antimicrobial activity was measured against 11 microorganisms associated with pharyngitis, with contact times of 1, 5, and 10 min (+30 min for positive control).

Results: For influenza, sugar-free lozenges showed ≥4 lg efficacy from 5 and 10 min exposure under clean and dirty conditions, respectively. For bovine coronavirus, sugar-free lozenges exhibited ≥4 lg efficacy at 10 min under both conditions. Bactericidal activity was observed against nine of the challenge microorganisms within 5 min, with plate counts of <10 colony-forming units (CFU)/mL for Pseudomonas aeruginosa, Staphylococcus aureus, Arcanobacterium haemolyticum, Moraxella catarrhalis, Porphyromonas gingivalis, Prevotelia intermedia, Streptococcus dysgalactiae, and Streptococcus pyogenes, and <100 CFU/mL for Streptococcus pneumoniae. Candida albicans and Escherichia coli showed counts of <10 CFU/mL at 30 min.

Conclusions: Sugar-free CPC/benzocaine lozenges can be recommended for uncomplicated pharyngitis and may be more appropriate than antibiotics, helping to mitigate antimicrobial resistance.

Actinomycosis is an endogenous bacterial infection caused by Actinomyces israelii. This bacterium reside on the mucosa of oral cavity, tonsils, and genitourinary tract. Any insult such as trauma, surgery, or foreign body disrupts the mucosal barrier and gives entry to the underlying tissue to cause disease. We describe a rare presentation of Actinomycosis presenting as a nasal polypoidal mass in a young female, an uncommon presentation, thereby causing diagnostic challenge as it may mimic other lesions with similar clinical presentations like fungal polyps, allergic polyps or chronic sinusitis. A 22 year old female presented with history of recurrent upper respiratory tract infection to the ENT Outpatient Department, clinical evaluation showed deviated nasal septum and radiology showed a nasal polyp and patient underwent submucosal resection with middle meatal antrostomy and micro-debrider assisted polypectomy. Histopathology showed respiratory epithelium with underlying stroma showing dense basophilic filamentous organisms surrounded by peripheral eosinophilic clubs that were Gram-positive and Gomori Methanamine Silver stain positive. The disease was diagnosed as Actinomycosis. The disease is a mimicker of various diseases such as nocardiosis, botryomycosis or tuberculosis having a wide range of symptoms and affecting multiple organs. Prevalence of actinomycosis in nasal region is rare thereby increasing the risk of misdiagnosis. Thus, Actinomycosis should be kept as a differential diagnosis in any chronic infectious diseases of the nasal cavity and monitored closely to ensure precise diagnosis and timely management.

Background: Meningitis is highly prevalent in infant because their immune system is immature and they have less resistance to diseases. Among bacterial agents, Escherichia coli is recognized as one of the most important causes of meningitis in infants.

Case presentation: Herein, we report a case of late-onset meningitis, caused by E. coli (Patient:17-day-old female infant). The patient's body temperature was 39°C, and the initial diagnosis was sepsis. At the doctor's request, the patient underwent the basic tests and was hospitalized in the Neonatal Intensive Care Unit (NICU). In this case, blood culture and CSF culture were negative and positive, respectively. Echogenic particles were observed inside the bladder, indicating possible cystitis. The results of the antibiotic susceptibility tests showed that the meningitis-causing strain of E. coli was susceptible only to amikacin.

Conclusion: Conducting LP and CSF culture seems to be the most important strategy for diagnosing meningitis. It is also recommended to perform LP before taking antibiotics. For identifying the infection, some factors such as fever, CRP test results, CSF parameters (leukocyte count, glucose level, and CSF culture results) should be considered to prevent misdiagnosis.