Journal of Infection Prevention最新文献

Background: Clostridioides difficile infection (CDI) is highly contagious, characterized by a high recurrence rate, and poses a significant challenge in hospital infection control and healthcare economics.

Objective: This study aimed to investigate the impact of educational and antimicrobial stewardship interventions targeting healthcare workers on the incidence of CDI, treatment prescription patterns, and healthcare costs.

Methods: This retrospective, observational study was conducted in a single acute-care hospital. Educational and antimicrobial stewardship interventions aimed at improving CDI control and treatment were implemented among healthcare workers. These interventions included hospital-wide training sessions, revision of the Infection Control Manual, dissemination of information to individual wards, and case-specific interventions. The primary outcome was changes in CDI incidence per 10,000 patient-days, comparing the 19-month periods before and after the intervention. The secondary outcomes included changes in CDI treatment prescription rates and an economic evaluation of drug costs, hospitalization fees, and infection control-related expenses between the two periods.

Results: A total of 75 developed CDI in the pre-intervention period and 40 developed in the post-intervention period. The CDI incidence decreased from 4.148 to 2.103 per 10,000 patient-days, representing a 49% reduction. Additionally, the prescription rate of metronidazole decreased, whereas that of fidaxomicin increased. Although drug costs increased, the total monthly healthcare expenditures, including hospitalization expenses, decreased by 55%.

Discussion: Educational and antimicrobial stewardship interventions targeting healthcare workers effectively reduced CDI incidence and improved cost-effectiveness in hospital care.

Background: An antimicrobial stewardship programme (AMS) aims to combat antimicrobial resistance and healthcare-associated infections (HCAIs). While studies in developed countries show AMS's effectiveness in reducing AMR and HCAIs, its impact in African countries, given differing socioeconomics, remains unclear.

Objectives: To review the impact of AMS on HCAIs, antibiotic prescriptions, cost of antimicrobial procurement, and compliance with diagnostic measures for detecting resistant HCAIs in African countries.

Methods: Two reviewers (S.S. and U.C.) searched databases like CINAHL, Medline, and PubMed for studies on AMS interventions in African countries, focussing on their impact on healthcare-associated infections (HCAIs) and antibiotic prescriptions. We excluded studies on outpatients, children, or those not in English and conducted a meta-analysis using data collected from changes in HCAIs before and after intervention using a random-effects model.

Results: The search identified 1153 studies, of which 14 were included in the review, while four eligible studies were included in the meta-analysis. Thirteen of the 14 studies were designed using pre- and post-study methods, and one study employed a case-control method. AMS interventions effectively reduce antibiotic consumption, the cost of antibiotic procurement, and improve diagnostic measures for the detection of resistant microorganisms. The forest plot suggested a 34% reduction in HCAIs.

Conclusions: In Africa, AMS interventions, whether combined or single, reduce HCAIs and antibiotic prescriptions in healthcare settings. Surgical antibiotic prophylaxis lowers HCAIs in hospitals by one-third. However, findings are cautiously generalised due to the varied quality of studies and the limited number of African countries involved.

Introduction: The World Health Organization (WHO) advocates for the strengthening of education and training in infection prevention and control (IPC) in higher educational institutions (HEIs). This is fundamental to ensure health science students are confident and competent in clinical practice.

Aim: To explore the existing evidence on undergraduate health science students' preparedness for IPC practice.

Methods: A systematic search was conducted in PubMed, CINAHL, Ovid, MEDLINE Complete, ProQuest, Scopus, Google Scholar, and gray literature. Quantitative and mixed-methods studies on teaching, learning, and technological approaches to Infection Prevention and Control (IPC) in undergraduate health science curricula were included. Participants were undergraduate students in medical, nursing, pharmacy, dental, physiotherapy, radiology, medical imaging, and paramedic programs. Studies published in English between 2010 and 2023 were considered.

Results: Twenty studies were identified for this review. Most of the studies 11 (55%) reported improved knowledge, practice, attitudes, and confidence in IPC after implementation of technological approaches. The most reported technological approaches were didactic instruction 12 (65%) followed by virtual simulation.

Discussion: There is considerable variation in the scope, content, and delivery methods for IPC in undergraduate programs. The use of traditional face-to-face teaching methods remains widespread despite its lack of interactive or practical aspects. It is important to incorporate technological methods that promote experiential learning in IPC and to develop standardized curricula for IPC at national, regional, and international levels.

Introduction: Antimicrobial Stewardship Programs (ASPs) are critical in addressing Antimicrobial Resistance (AMR). Surgical Antibiotic Prophylaxis (SAP) guidelines provide essential guidance on antibiotic selection, administration, and duration for surgical procedures. This study evaluates the impact of department-level audit and feedback interventions within an ASP on compliance with SAP guidelines.

Objective: To assess the effect of a biannual audit and feedback initiative by the Antimicrobial Stewardship Committee over 2 years on compliance with SAP guidelines regarding antibiotic selection, timing, and duration at a secondary care hospital in the UAE.

Material & methods: A quasi-experimental study was conducted at a secondary care hospital in Ras Al Khaimah, UAE, comparing data from the year before (2021) and 2 years after (2022-2023) the intervention. Statistical analysis was performed using the Open Epi system. All clean and clean-contaminated surgeries meeting SAP criteria were included; contaminated and dirty surgeries were excluded.

Results: The intervention significantly improved compliance with SAP guidelines. Appropriate antibiotic duration increased from 17% to 50%, and correct timing improved from 42% to 87%, both with a statistically significant p-value of 0.0001.

Conclusions: The audit and feedback intervention significantly enhanced compliance with SAP guidelines, particularly in timing and duration, contributing to reduced surgical site infections and costs. Implementing institute-wide SAP guidelines based on local antibiogram data is recommended to support clinicians and improve compliance.

Background: COVID-19 has claimed millions of lives, with severe economic impacts, particularly in resource-limited developing nations. Despite vaccines, face masks remain vital to curb transmission. However, variable adherence poses risks amid emerging variants.

Objectives: To identify mask-wearing determinants and associations with demographics, knowledge, perceived laws/enforcement, and concerns about disadvantages.

Study design and methods: Using survey data from 1200 respondents in the Philippines, Vietnam, and Indonesia (July-September 2021), binary logistic regression determined factors influencing individuals' face mask-wearing behaviour.

Results: Socio-demographic factors significantly predicted mask-wearing. Compliance increased with better knowledge of the virus and pandemic. Positive perceptions of relevant laws and enforcement improved behaviour, while individuals unconcerned about the disadvantages of masks were more likely to adopt recommended practices.

Conclusions: While mask-wearing is strongly recommended to prevent COVID-19, adherence varies significantly with socio-demographics, knowledge, perceptions of law enforcement, and personal concerns.

Background: Clinical students, like healthcare workers, are at risk of sharp or needlestick injuries and potential percutaneous exposure to blood and body fluids. They can acquire infections such as HIV and hepatitis B virus (HBV) through these injuries. This study determined the prevalence and factors associated with sharp injuries among clinical students at Mbale Regional Referral Hospital.

Methods: A cross-sectional study was carried out at Mbale Regional Referral Hospital among randomly selected clinical students. Data was entered in Microsoft Excel, cleaned, and exported to STATA version 14 for analysis.

Results: One hundred sixty (55.2%) clinical students had sustained a sharp injury in their clinical practice, with a self-reported prevalence of 46.6% in the last year. A significant proportion of these students, 93 (68.9%), experienced multiple sharp injuries. The common cause and site of injury were solid needles (72; 45%) and fingers (83.1%), respectively. Most students, 197 (67.9%), reported ward procedures not being supervised, and 124 (42%) students worked on ≥ 15 patients daily. Students who worked on ≥15 patients were more likely to sustain a sharp injury than those who attended to <15 patients daily (P = .000, OR: 6.3, 95% CI: 3.7%-10.8%).

Conclusion: This study showed a high prevalence of needlestick injuries among clinical students. The risk factors were the year of study, having not learned about infection control, and the number of patients attended to daily.

Background: Preventing multidrug-resistant organism (MDRO) transmission in inpatient settings remains challenging due to gaps in infection control practices which facilitate their transmission and compromise patient safety.

Purpose: This project evaluated the impact of implementing two Centers for Disease Control and Prevention (CDC) guidelines-Management of Multidrug-Resistant Organisms in Healthcare Settings and Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting-on time to initiation of transmission-based precautions (TBPs) for inpatients who were, or had a history of being, colonized or infected with one or more targeted MDROs.

Methods: Using a quantitative methodology and quasi-experimental design, pre- and post-implementation data were analyzed via independent samples t-test to assess TBPs initiation times.

Results: Implementation of the CDC guidelines significantly reduced TBPs initiation times by a mean of 16.32 hours (t (23.21) = 2.91, p = .008). This change reflects both statistical and clinical significance in reducing transmission risk.

Conclusions: The intervention had a positive impact on time to TBPs initiation. Translation of the CDC guidelines into nursing practice may facilitate timelier identification of patients with MDROs and reduce time to initiation of TBPs, thereby reducing the risk of transmission in the hospital setting.

Infection prevention and control (IPC) education is critical in reducing healthcare-associated infections, yet traditional teaching methods often lack engagement and practical relevance. Simulation-based education, particularly game-based learning, offers an innovative approach to improve knowledge retention and learner motivation. This study explores the use of a simulation game, Microbe Hunters, designed to enhance IPC awareness and practice among IPC link practitioners through an immersive escape room format. Microbe hunters is an escape-room style simulation that creates a more immersive educational experience. The simulation tasked participants with identifying an outbreak organism, completing the chain of infection, and recommending appropriate transmission-based precautions, PPE, and terminal cleaning. The activity concluded with team presentations and a structured debrief. A qualitative evaluation was conducted to assess learning experiences. Participants reported high levels of engagement, enjoyment, and improved understanding of IPC principles. They valued the hands-on problem-solving, teamwork, and realistic scenario design. The experience promoted critical thinking and practical application of knowledge. Microbe Hunters demonstrated that simulation-based, game-style learning is an effective and enjoyable method for IPC education. Grounded in experiential and constructivist learning theories, the approach supports active engagement and knowledge construction. Future research should investigate broader implementation, long-term outcomes, and scalability across healthcare teams.