Journal of Infection Prevention最新文献

Diary. 日记

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention

Pub Date : 2024-09-01 Epub Date: 2024-09-18 DOI: 10.1177/17571774241285251

引用次数: 0

Impact of nebulization versus metered-dose inhaler utilization on viral particle dispersion in patients with COVID-19 雾化吸入与计量吸入器的使用对 COVID-19 患者体内病毒颗粒弥散的影响

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention

Pub Date : 2024-07-22 DOI: 10.1177/17571774241266420

Brian M Clemency, Candice Clay, Renoj Varughese, Carli Kennedy, Wayne Yates, Asma Lat, Ai Ling Ching, Doug Clark, David Lewin, Xianyi Chen, Mario Castro

Conflicting guidance exists regarding the characterization of nebulization as an aerosol-generating procedure and subsequent risk of transmission of SARS-CoV-2 to healthcare workers. This study sought to address whether SARS-CoV-2 viral load distribution was impacted by bronchodilator delivery via nebulizer versus metered-dose inhaler (MDI). Adults infected with COVID-19 were enrolled and received a single dose of albuterol sulfate nebulized solution (2.5 mg/3 mL via breath-actuated nebulizer with filtered mouthpiece) or albuterol sulfate hydrofluoroalkane inhalation aerosol (90 µg/actuation; two puffs via MDI with spacer) in a randomized crossover sequence. Air and surfaces were sampled at predefined locations within patients’ hospital rooms to assess SARS-CoV-2 dispersion over three periods (baseline, MDI, and nebulizer). Eleven patients received crossover therapy. Six patients had detectable SARS-CoV-2 RNA during one treatment period ( n = 3 each for MDI and nebulizer) and one during both treatment periods. No viral RNA was found in the rooms of four (36.4%) patients. Overall, few environmental samples (17/397; 4.3%) contained detectable viral RNA, with no meaningful differences in positivity rate across periods; RNA genome copy numbers were low in positive samples. No correlation between dispersion and patient clinical status or environmental parameters was observed. In this first prospective trial evaluating viral load distribution following use of nebulizer versus MDI in hospitalized patients with COVID-19, low environmental contamination was found regardless of administration method. Findings support the use of either device when needed to treat patients with COVID-19.

关于雾化吸入作为气溶胶产生程序的特性以及随后将 SARS-CoV-2 传播给医护人员的风险，存在着相互矛盾的指导意见。本研究旨在探讨通过雾化器和计量吸入器 (MDI) 给药的支气管扩张剂是否会影响 SARS-CoV-2 病毒载量的分布。感染了 COVID-19 的成人被纳入研究，并以随机交叉的顺序接受了单剂量硫酸阿布特罗雾化溶液（2.5 毫克/3 毫升，通过带过滤口罩的呼吸驱动式雾化器）或硫酸氢氟烷烃阿布特罗吸入气雾剂（90 微克/作用剂量；通过带间隔器的计量吸入器吸入两口）。在患者病房内的预定位置对空气和表面进行采样，以评估 SARS-CoV-2 在三个时期（基线期、MDI 期和雾化期）的扩散情况。11 名患者接受了交叉治疗。有六名患者在一个治疗阶段（MDI 和雾化治疗阶段各为 3 人）检测到了 SARS-CoV-2 RNA，有一名患者在两个治疗阶段都检测到了 SARS-CoV-2 RNA。四名患者（36.4%）的房间未发现病毒 RNA。总体而言，很少有环境样本（17/397；4.3%）含有可检测到的病毒 RNA，不同时期的阳性率没有明显差异；阳性样本的 RNA 基因组拷贝数较低。没有观察到分散与患者临床状态或环境参数之间的相关性。在这项首次评估 COVID-19 住院患者使用雾化器和 MDI 后病毒载量分布情况的前瞻性试验中，无论采用哪种给药方法，环境污染都很低。研究结果支持在治疗 COVID-19 患者时使用其中一种设备。

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引用次数: 0

Neonatal complications of premature rupture of membranes in mothers receiving cefotaxime and ampicillin: A randomized clinical trial 接受头孢噻肟和氨苄西林治疗的母亲因胎膜早破引起的新生儿并发症：随机临床试验

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention

Pub Date : 2024-07-21 DOI: 10.1177/17571774241261911

H. Boskabadi, Ali Najafi, N. Saghafi, Sayed J Sayedi, A. Moradi, M. Zakerihamidi

Premature rupture of membranes (PROM) is one of the most common and important causes of premature births and peripartum mortality. Maternal antibiotic treatment affects the infantile prognosis. This study was conducted to compare the efficacy of Ampicillin and Cefotaxime administered for the parturients on neonatal outcomes. A comparison between the effects of Cefotaxime and Ampicillin on infantile complications of PROM was done in this clinical trial. Two hundred and twenty parturients with PROM who needed antibiotic therapy were randomized in two groups of control (Ampicillin) and intervention (Cefotaxime) treatments. The maternal/fetal statuses up to accouchement and the infants’ status up to transfer to neonatal intensive care unit, death, or discharge from hospital were followed. The Apgar score, cardiac, respiratory and nervous systems, infection, immaturity, asphyxia, and mortality rates were compared in both groups. The differences between the two groups were significant in: Apgar score min1 and min5, need for resuscitation, asphyxia, need for hospitalization, infection, and mortality rate. Administration of Cefotaxime in parturients with PROM improved the Apgar scores and decreased respiratory complications, infection, asphyxia, mortality rate, and need for ICU hospitalization in infants.

胎膜早破（PROM）是导致早产和围产期死亡的最常见、最重要的原因之一。产妇的抗生素治疗会影响婴儿的预后。本研究旨在比较氨苄西林和头孢他啶对产妇新生儿预后的疗效。这项临床试验比较了头孢他啶和氨苄西林对 PROM 婴儿并发症的影响。220 名需要抗生素治疗的 PROM 孕妇被随机分为对照组（氨苄西林）和干预组（头孢他啶）两组。对产妇/胎儿在分娩前的状况以及婴儿在转入新生儿重症监护室、死亡或出院前的状况进行了跟踪调查。比较了两组婴儿的阿普加评分、心脏、呼吸和神经系统、感染、不成熟、窒息和死亡率。两组在以下方面差异显著：Apgar评分min1和min5、复苏需求、窒息、住院需求、感染和死亡率均有显著差异。对患有 PROM 的产妇使用头孢他啶可提高婴儿的 Apgar 评分，减少呼吸道并发症、感染、窒息、死亡率和重症监护室住院需求。

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引用次数: 0

A review of mask fit testing data associated with protocols utilized in evaluating the efficacy of N95 masks for health care workers 与用于评估医护人员 N95 口罩功效的规程相关的口罩密合度测试数据回顾

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention

Pub Date : 2024-07-20 DOI: 10.1177/17571774241266400

Jody Hook, Louisa M. Sasko, Sheree M.S. Smith

Quantitative mask fit testing (QNFT) is the gold standard to confirm the correct fit of a N95/P2 mask to ensure health care workers protection from airborne viruses. Using the Occupational Safety and Health Administration (OSHA) guidance indicates a final fit test result is a cumulative score derived from manoeuvres within the OSHA protocol. The protocol-based manoeuvres mimic aspects of clinical care by health professionals and mask fit testing is conducted to provide protection from airborne viruses and pollutants within a care setting. To determine whether studies undertaking QNFT report the results of individual manoeuvres of the OSHA protocol. A comprehensive search strategy for the systematic review was developed to determine eligible studies, published between May 2011 and May 2021. Two researchers independently screened all full text articles retrieved and all disagreements were resolved through discussion. The search found 557 studies. After removing 119 duplicates, 437 articles were reviewed based on title and abstract, 411 studies were excluded. Twenty-seven full text articles were assessed for eligibility, all were excluded for the following reasons: study did not report the results of the long or short OSHA protocol (12), study did not assess mask fit using the long or short OSHA protocol (10), article type (discussion/commentary/editorial) or wrong study type (1). Despite the use of very broad search terms no eligible studies were found and the result was declared an empty review. Internationally accepted QNFT protocols have a number of manoeuvres that reflect health care workers’ physical movements during the delivery of clinical care. Studies of mask fit testing appear to lack the reporting of outcomes for each manoeuvre with only the cumulative results being provided. This finding raises the need to understand potential risk from a mask leak during the delivery of clinical care as evidenced by failing a manoeuvre during mask fit testing. Further research is required to understand the importance of passing each mask fit testing manoeuvre and the relationship to airborne protection during the delivery of clinical care.

口罩密合度定量测试（QNFT）是确认 N95/P2 口罩密合度是否正确的黄金标准，可确保医护人员免受空气传播病毒的侵害。根据职业安全与健康管理局（OSHA）的指导，密合度测试的最终结果是根据 OSHA 协议中的动作得出的累积分数。基于规程的操作模拟了卫生专业人员临床护理的各个方面，进行面罩密合度测试是为了在护理环境中提供保护，防止空气传播病毒和污染物。确定进行 QNFT 的研究是否报告了 OSHA 协议中个别动作的结果。我们为系统性综述制定了全面的搜索策略，以确定符合条件的研究，这些研究发表于 2011 年 5 月至 2021 年 5 月之间。两名研究人员对检索到的所有全文进行了独立筛选，并通过讨论解决了所有分歧。搜索共发现 557 项研究。去除 119 篇重复文章后，根据标题和摘要对 437 篇文章进行了审查，排除了 411 篇研究。对 27 篇全文进行了资格评估，所有文章均因以下原因被排除：研究未报告 OSHA 长或短方案的结果（12 篇）、研究未使用 OSHA 长或短方案评估面罩适合度（10 篇）、文章类型（讨论/评论/编辑）或研究类型错误（1 篇）。尽管使用了非常宽泛的搜索条件，但仍未找到符合条件的研究，因此该结果被宣布为空白综述。国际公认的 QNFT 协议有许多动作反映了医护人员在提供临床护理时的身体动作。有关面罩密合度测试的研究似乎没有报告每个动作的结果，只提供了累积结果。这一发现表明，有必要了解在提供临床护理过程中面罩泄漏的潜在风险，面罩密合度测试中的动作失败就是证明。需要开展进一步研究，以了解通过每个面罩密合度测试动作的重要性，以及在提供临床护理期间与空气传播防护之间的关系。

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引用次数: 0

Factors responsible for student nurses' use of non-sterile gloves: An exploratory qualitative study. 学生护士使用无菌手套的因素：一项探索性定性研究。

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention

Pub Date : 2024-07-01 Epub Date: 2024-03-07 DOI: 10.1177/17571774241238686

Jennifer Bate

Background: Disposable non-sterile gloves are part of the personal protective equipment (PPE) to be considered to protect oneself from the risk of infection. They have subsequently become the topic of concern related to increased use, inappropriate use, and potentially increasing the risk of cross-infection and environmental impact of plastic waste.

Aim/objective: This study aimed to explore the views of pre-registration student nurses about non-sterile glove use in clinical practice and to identify the factors that impact student nurses' decision on whether to wear non- sterile gloves.

Methods: Using a social constructivist approach, the study was organised in a higher education institution. Semi-structured interviews were conducted with second year student nurses, utilising a theoretical domains framework (TDF).

Findings/results: The key findings showed that students had limited awareness of the national infection prevention and control best practice procedures. The primary influential factors for non-sterile gloves use behaviour were personal protection, the type of care interventions required and the observations of peers and role models.

Discussion: The study found limited awareness on the importance of infection prevention and control precautions, including the correct procedure for donning, and doffing of personal protection equipment, along with a lack of confidence to challenge non-compliance.

背景：一次性非无菌手套是个人防护设备（PPE）的一部分，用于保护自己免受感染。随后，非无菌手套的使用量增加、使用不当、可能增加交叉感染的风险以及塑料垃圾对环境的影响等问题引起了人们的关注：本研究旨在探讨注册前学生护士对在临床实践中使用非无菌手套的看法，并确定影响学生护士决定是否佩戴非无菌手套的因素：研究采用社会建构主义方法，在一所高等教育机构内进行。采用理论领域框架（TDF），对二年级护士学生进行了半结构式访谈：主要调查结果显示，学生对国家感染预防与控制最佳实践程序的认识有限。使用非无菌手套行为的主要影响因素是个人防护、所需护理干预的类型以及同伴和榜样的观察：讨论：研究发现，学生对感染预防和控制预防措施（包括穿戴和脱下个人防护设备的正确程序）的重要性认识有限，而且缺乏挑战违规行为的信心。

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引用次数: 0

Diary 日记

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention

Pub Date : 2024-07-01 DOI: 10.1177/17571774241259261

引用次数: 0

Occlusive wound dressings: A greenhouse for bacteria? 闭合性伤口敷料：细菌的温室？

IF 1.2 Q2 Nursing

Journal of Infection Prevention

Pub Date : 2024-06-15 DOI: 10.1177/17571774241261923

V. Scheer, Johan H Scheer, Anders Kalén, Lena Serrander

The modern wound dressing is produced to absorb fluid and protect against external contamination. The choice of which wound dressing to apply after surgery is usually based on local tradition. There are various impervious dressings on the market. Even if the wound is sterile before application, there will be subsequent recolonisation of skin microbiota. Previous studies suggest that a high bacterial load on the skin hampers wound healing and might be a risk for SSI. The aim was to compare bacterial recolonisation on the shoulder under three different wound dressings, 48 h after sterile preparation of the skin as in preparation for surgery. In 25 healthy volunteers, a standard pre-surgical skin disinfection for a deltopectoral incision was made on the left shoulder with 0.5% chlorhexidine solution in 70% ethanol. Three different wound dressings were then placed on the shoulder, and 48 h later the skin beneath each dressing was swabbed, subsequently cultured and bacterial density analysed using viable count. The bacterial recolonisation under air-dry (gauze) dressing was significantly lower ( p = .0001) compared to semipermeable and occlusive wound dressings. Choosing a less permeable wound dressing may lead to an increased bacterial load on the skin during the first 48 h after surgery.

现代伤口敷料的作用是吸收液体和防止外部污染。手术后选择哪种伤口敷料通常是基于当地的传统。市场上有各种不透水的敷料。即使伤口在敷料使用前是无菌的，皮肤微生物群随后也会重新定殖。以往的研究表明，皮肤上的细菌量过高会阻碍伤口愈合，并可能导致 SSI。这项研究的目的是比较三种不同伤口敷料在为手术做准备的皮肤无菌处理 48 小时后，肩部皮肤上细菌的重新定殖情况。在 25 名健康志愿者中，用 0.5% 的洗必泰溶液和 70% 的乙醇对左肩的胸骨下切口进行了标准的术前皮肤消毒。然后在肩部放置三种不同的伤口敷料，48 小时后对每种敷料下的皮肤进行拭抹，随后进行培养，并使用存活计数分析细菌密度。与半透性和闭塞性伤口敷料相比，风干（纱布）敷料下的细菌重新定殖率明显较低（p = .0001）。选择透气性较差的伤口敷料可能会导致术后 48 小时内皮肤上的细菌量增加。

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引用次数: 0

Theoretical models applied to understand infection prevention and control practices of healthcare workers during the COVID-19 pandemic: A systematic review 应用理论模型了解 COVID-19 大流行期间医护人员的感染预防和控制措施：系统回顾

IF 1.2 Q2 Nursing

Journal of Infection Prevention

Pub Date : 2024-05-16 DOI: 10.1177/17571774241251645

Deepti Kc, Jan Smith, Kay Currie, Valerie Ness

Effective infection prevention and control (IPC) practices among healthcare workers are crucial to prevent the spread of COVID-19 and other infections in healthcare settings. To synthesise evidence on behaviour change theories, models, or frameworks applied to understand healthcare workers’ IPC practices during the COVID-19 pandemic. PubMed, EBSCOhost interface, ProQuest interface, MEDLINE (Ovid), and grey literature were searched for primary studies published between December 2019 and May 2023. The Mixed Method Appraisal Tool evaluated the methodological quality of the studies. Two reviewers independently completed study selection, data extraction, and quality assessment. The search yielded 2110 studies, of which 19 were included. Seven behaviour change theories, models, and frameworks were identified, with the Health Belief Model and Theoretical Domains Framework being the most employed. Based on these theories, models, and frameworks, the included studies identified cognitive, environmental, and social factors influencing healthcare workers’ compliance with COVID-19 IPC practices. This review offers insights into the critical role of behavioural change theories, models, or frameworks in understanding the factors influencing healthcare workers’ compliance with IPC practices during COVID-19. It also highlights the potential of these theories in guiding the development of evidence-based interventions to improve healthcare workers’ compliance with IPC practices.

医护人员采取有效的感染预防和控制 (IPC) 措施对于防止 COVID-19 和其他感染在医护环境中的传播至关重要。综合有关行为改变理论、模型或框架的证据，以了解医护人员在 COVID-19 大流行期间的 IPC 实践。在 PubMed、EBSCOhost 界面、ProQuest 界面、MEDLINE (Ovid) 和灰色文献中检索了 2019 年 12 月至 2023 年 5 月间发表的主要研究。混合方法评估工具对研究的方法学质量进行了评估。两名审稿人独立完成了研究选择、数据提取和质量评估。搜索共获得 2110 项研究，其中 19 项被纳入。共确定了七种行为改变理论、模型和框架，其中采用最多的是健康信念模型和理论领域框架。根据这些理论、模型和框架，纳入的研究确定了影响医护人员遵守 COVID-19 IPC 实践的认知、环境和社会因素。本综述深入探讨了行为改变理论、模型或框架在理解影响医护人员在 COVID-19 期间遵守 IPC 实践的因素方面的关键作用。它还强调了这些理论在指导开发循证干预措施以提高医护人员对 IPC 实践的依从性方面所具有的潜力。

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引用次数: 0

Implementing a community-based antimicrobial stewardship intervention in Malaysia 在马来西亚实施基于社区的抗菌药物管理干预措施

IF 1.2 Q2 Nursing

Journal of Infection Prevention

Pub Date : 2024-05-07 DOI: 10.1177/17571774241251650

A. H. Mohammed, Angelina Lim, Bassam Abdul Rasool Hassan, A. Blebil, Juman Dujaili, D. Ramachandram, Hawar Sardar Hassan, Arooj Abid

In Malaysia, the unregulated use of antibiotics and lack of awareness about antimicrobial resistance (AMR) among pharmacists pose significant challenges. Implementing community-based Antimicrobial Stewardship (AMS) initiatives is crucial to address the rising AMR. We developed a bespoke AMS intervention, aligned with the World Health Organization’s AMS modules, as a 2-day online educational seminar for community pharmacists. The effectiveness of the workshop was evaluated using pre- and post-seminar questionnaires, focusing on AMS knowledge and attitudes towards antimicrobial usage. Among 528 participants, 489 completed both questionnaires. Pre-seminar, only 59% correctly understood the concept of antibiotic resistance reversibility, which improved to 85.9% post-seminar ( p = .002). The average AMS knowledge score increased from 5/10 to 8/10 post-intervention ( p < .05). A significant improvement was also noted in pharmacists’ ability to select appropriate antibiotic therapies, particularly for urinary tract infections, with an increase from 78% to 90% correct responses. The AMS seminar was well-received and significantly improved the AMS knowledge of community pharmacists. The results underline the need for more AMS-focused interventions in this demographic in Malaysia, contributing to the development of formalized AMS programs. Such initiatives are expected to enhance antibiotic use awareness, encourage optimal antibiotic practices, and positively shift professional conduct in community settings.

在马来西亚，抗生素的使用不受管制，药剂师对抗菌药耐药性（AMR）缺乏认识，这些都构成了重大挑战。实施以社区为基础的抗菌药物管理 (AMS) 计划对于解决 AMR 上升问题至关重要。我们根据世界卫生组织的 AMS 模块，为社区药剂师量身定制了一个为期 2 天的在线教育研讨会，作为 AMS 干预措施。我们利用研讨会前后的调查问卷对研讨会的效果进行了评估，重点是 AMS 知识和对抗菌药物使用的态度。在 528 名参加者中，有 489 人完成了这两份问卷。研讨会前，只有 59% 的人正确理解了抗生素耐药性可逆性的概念，研讨会后这一比例提高到了 85.9% ( p = .002)。AMS 知识的平均得分从干预后的 5/10 提高到了 8/10 ( p < .05)。药剂师选择适当抗生素疗法的能力也有明显提高，尤其是在治疗尿路感染时，正确率从 78% 提高到 90%。AMS 讲座广受欢迎，大大提高了社区药剂师的 AMS 知识水平。这些结果突出表明，马来西亚有必要在这一人群中开展更多的以抗菌药物治疗为重点的干预活动，从而促进抗菌药物治疗计划的正规化发展。这些举措有望提高抗生素使用意识，鼓励最佳抗生素使用方法，并积极转变社区环境中的职业行为。

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引用次数: 0

World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: Clean Your Hands campaign: Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. 世界卫生组织世界手卫生日，2024 年 5 月 5 日。拯救生命：清洁双手运动：在卫生和护理工作者中推广有关感染预防和控制（包括手部卫生）的知识和能力建设。

IF 1.2 Q2 Nursing

Journal of Infection Prevention

Pub Date : 2024-05-01 Epub Date: 2024-03-19 DOI: 10.1177/17571774241239044

Claire Kilpatrick, Ermira Tartari, Miranda Deeves, Didier Pittet, Benedetta Allegranzi

The World Health Organization's (WHO) World Hand Hygiene Day continues to "bring people together and accelerate hand hygiene action at the point of care in health care to contribute to a reduction in health care-associated infections and the achievement of safer, quality health care for all."

世界卫生组织（WHO）的 "世界手卫生日 "继续 "将人们聚集在一起，加快医疗保健护理点的手卫生行动，为减少与医疗保健相关的感染和为所有人实现更安全、更优质的医疗保健做出贡献"。

引用次数: 0