Journal of Infection Prevention最新文献

Background: Healthcare-associated infections (HAIs) are a risk to patient safety and health. Several initiatives have been studied to reduce surface contamination; however, there is lack of work investigating emerging technologies such as 3D gestural human-computer interaction (HCI).

Aim/objective: This study investigates a touchless 3D gestural display and traditional HCI to quantify the differences in surface contamination.

Methods: A between-subjects experimental study was performed to study the spread of surface contamination in a simulated primary care clinic. Participants (N = 30) wore gloves with a blacklight-sensitive powder that would identify what surfaces were contaminated. The number of surfaces of contamination was collected for all participants as well as overall process times.

Findings/results: The findings showed that participants who used gestural technology spread contamination to significantly less surfaces that the traditional HCI group (p < .05). However, the gestural group took a significantly longer time to complete the process than the HCI group (p < .05).

Discussion: The implementation of 3D gestural HCI has the opportunity to reduce surface contamination and potentially reduce the risk of HAIs. Because the process was found to take longer with the 3D gestural technology, this technology could affect overall healthcare processes. Future work should investigate how the technology should be developed for use in healthcare systems as well as explore other high-risk areas in healthcare.

Purpose: Approximately 50%-60% of adult women experience at least one episode of urinary tract infection (UTI) during their lifetime, with 20%-24% of them experiencing recurrence within a year. Several randomized controlled trials have explored the efficacy and safety of D-mannose for the prevention of UTI in adult women but reported conflicting results.

Objective: We performed a meta-analysis comparing D-mannose with placebo or no treatment for the prevention of UTI in adult women.

Methods: We systematically searched PubMed, Scopus, and Cochrane Central databases for studies comparing D-mannose with placebo or no treatment for the prevention of UTI in adult women. The outcomes of interest were recurrent UTIs during follow-up and adverse events. Heterogeneity was assessed using I² statistics. Analysis followed the PRISMA guideline and was registered in the PROSPERO database.

Results: The systematic review identified 4 randomized controlled trials (RCTs) including 890 participants (D-mannose n = 447, 50.22%). Recurrent UTI (RR 0.44; 95% CI 0.18-1.11; p = .082; I² = 90%) and adverse events (RR 2.19; 95% CI 0.68-7.05; p = .190; I² = 79%) did not differ significantly between the groups at the end of follow-up.

Conclusion: Prophylaxis with D-mannose did not cause any difference in the risk of recurrent UTI during follow-up and adverse events in adult women. Fewer number of studies and heterogeneity in the results make it difficult to draw conclusions about the efficacy of D-mannose in preventing recurrent UTI. More placebo-controlled RCTs are required to confirm the efficacy and safety.

Background: In early spring 2020, the spread of SARS-CoV-2, began which developed into a global pandemic of the disease COVID-19. Nursing homes (NHs) for older adults in Sweden experienced a significant spread of the virus resulting in many deaths among the residents and cases of illness among the employees.

Aim: To explore how supply and use of products for protection of residents and staff against infection as well as IPC (infection prevention and control) training changed in Swedish NHs for older adults between the years 2019 and 2023.

Methods: A web-based survey form with questions concerning supply and use of products as well as training of employees in IPC and use of governing and supporting documents concerning IPC in 2019 and 2023 was sent out to 300 NHs in Stockholm County in January 2024. This was the total number of NHs which were in operation both in 2019 and 2023.

Results: Answers were obtained from 130 NHs with a total of 7377 residents. The response rate was 43.3%. Supply of all products was improved in 2023. There was a significant association between improved supply and improved use for all products (p < .01) except for single use gloves. The number of employees who received training on IPC had risen significantly from 2019 to 2023 (p < .01). In 2023, all respondents used guiding documents on IPC.

Discussion: The COVID-19-pandemic resulted in several improvements concerning IPC in NHs for older adults in Sweden. After the pandemic staff got better training, managers used governing and supporting documents to a higher degree and the supply and use of protective products was improved, except for the use of single use gloves. The difficulties in correct use of gloves were found in 2019 and remained in 2023.

Clostridioides difficile is recognised as the most common cause of healthcare-acquired diarrhoea and is a leading infectious cause of morbidity and mortality. The symptoms vary from mild diarrhoea to fulminating infection, leading to pseudomembranous colitis and death. In 2008, the Southern Health and Social Care Trust (SHSCT) noticed a rise in the number of new episodes of C. difficile infection (CDI). As a result, the SHSCT developed a multifaceted approach to reduce CDI, which decreased CDI episodes in hospitals from February 2009 onwards. The reduction of CDI episodes was noted in patients aged >65, per year, from 164 episodes in 2008-09 to 37 episodes in 2009-10, a 77% reduction within 1 year. The number of episodes of CDI continued to decrease until 2021/2022, a 64% reduction since 2008/09. In summary, the successful implementation of a multifaceted intervention strategy is needed to decrease the incidence of healthcare-acquired CDI.

Background: A clean healthcare environment is the foundation of both antimicrobial stewardship and delivery of sustainable healthcare. Clinical staff are responsible for cleaning medical equipment and some aspects of the healthcare environment.

Aim: To improve the clinical cleaning on a busy PICU in a tertiary referral hospital in England.

Methods: This was an educational continuous Quality Improvement (QI) project using opportunistic and targeted one-to-one education and training for clinical staff. Cleaning audits were conducted weekly throughout the study period and the results mapped against monthly bed occupancy data. The PDSA cycle (plan, do, study, act) was used to review actions, outcomes, and impact and consider further work every month by the study team.

Results: Key themes emerged for improvement around the training delivered on cleaning, both formally through mandatory study days and informally through the cascade of knowledge to new starters. The cleaning 'hotspots' identified via audit and how these were communicated to the team were also targeted. The multi-mode interventions, delivered by both Infection Prevention link nurse unit staff and a Clinical Auditor/ Educator, were successful in building and maintaining excellent cleaning standards within the ward.

Discussion: Co-creation of cleaning interventions enabled a supportive environment to be developed with staff demonstrating a high level of understanding and commitment to environmental cleanliness. This approach would be scalable across multiple areas of the hospital with the short-term support of a Clinical Educator or Infection Prevention Nurse.

Background: Infection Prevention Control (IPC) education is a key aspect of training for all staff as it forms a fundamental aspect of patient safety. The majority of IPC education is carried out in the classroom, by e-learning or through simulation. Different models of education delivery have been evaluated in healthcare outside of IPC with some success, including ward rounds. Therefore, a ward round intervention was utilised using an action research model to evaluate if it was feasible to carry out IPC education in the clinical environment and determine if it improved education opportunities and knowledge for staff.

Methods: A mixed methods approach was used to collect qualitative and quantitative data in the form of questionnaires, interventions and reflections using thematic analysis.

Discussion: The results suggest that a ward round intervention for IPC education provides opportunities for staff to receive education. It also could contribute to an improved relationship between ward and IPC staff through collaborative working.

Conclusion: Whilst this was only a small action research study in one ward with limitations the findings suggest that IPC education can be delivered in the clinical environment and that IPC education delivery is an area that requires more research.

Background: Preventing healthcare associated infection has never been so prominent and challenging as it is today across the globe. It is therefore crucial to ensure that healthcare professionals are as prepared for current challenges and future unknowns as much as possible. As equally important are our healthcare professionals of the future.

Aim: The aim of this study (part of a wider study) was to explore how higher educational institutions prepare our future healthcare professionals for safe and effective infection prevention and control practice.

Methods: This was a qualitative exploratory phase utilizing semi-structured interviews with 18 healthcare students and 10 clinical healthcare professionals to explore the preparedness of undergraduate healthcare students for IPC practice in the UAE.

Results: Findings suggest that while some students felt adequately prepared academically, they faced several challenges in clinical practice, such as differences in practice, guidance, and mentorship which impacted their practice. Additionally, the disconnect between HEIs and healthcare professionals around curriculum development exacerbated these challenges.

Conclusion: This part of the study phase argues for stronger collaboration between higher education institutions and healthcare settings to better align curriculum with current IPC practices. Addressing the gaps in curriculum development and execution and clinical mentorship is crucial for ensuring that future healthcare professionals are fully equipped to manage infection risks effectively.

Background: Every year, the number of deaths caused by antibiotic-resistant infections continues to rise. It is predicted that by 2050, antibiotic-resistant bacteria will surpass cancer as the leading cause of death.

Aim: The aim of this research is to assess the prevalence of antibiotic resistance among Klebsiella pneumoniae strains in hospitalized patients across Iran.

Methods: To address this issue, we conducted a thorough search of electronic databases, including PubMed, Scopus, and Web of Science, on March 13, 2023. Using the random-effects meta-analysis model and assessing heterogeneity with Cochran's Q test and I² statistic, we estimated the prevalence of antibiotic resistance in Klebsiella pneumoniae. Our analyzes were done by STATA v 14. 21 articles met the inclusion criteria.

Result: In total, 20 studies were included in the final analysis. The number of studies obtained for ceftazidime, cefotaxime, gentamicin, ciprofloxacin, and imipenem were 17, 13, 13, 14, and 14, respectively. The sample sizes for each were 2,200, 1,557, 1,896, 2,026, and 1779. The pooled estimated prevalence of resistance to Ceftazidime, Cefotaxime, Ciprofloxacin, Gentamicin and Imipenem in Klebsiella pneumoniae were 60%, 63%, 46%, 48% and 26%.

Conclusion: These findings highlight that Klebsiella pneumoniae strains in Iran have shown high resistance to commonly used antibiotics, particularly third-generation Cephalosporins which can significantly impact the treatment of infectious diseases. Therefore, it is advisable to explore alternative antibiotics for treating infections caused by this microorganism.

Surveillance for surgical site infections (SSIs) after intraocular surgery may enable the detection of outbreaks and reveal opportunities for quality improvement. The reported incidence of SSIs after intraocular surgery varies widely, and there are no benchmark studies for SSI surveillance based on surveillance case definitions. We performed surveillance for SSIs after intraocular surgery at a regional ophthalmology surgical center in Winnipeg, Manitoba, Canada, from April 2014 to March 2023. Intraocular infection was defined according to the United States Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network definition (eye infection, other than conjunctivitis). We defined an SSI as an intraocular infection occurring within 1 year after intraocular surgery, in contrast with the CDC definition of 30 or 90 days for other types of surgery. There were 96,322 intraocular operations performed during the 9-year surveillance period. The incidence of SSI for all types of intraocular surgery was 0.03% (3.0 infections per 10,000 operations), with substantially greater incidence after glaucoma valve implant surgery. We found that the incidence of SSI, identified using surveillance definitions, is lower than reported previously. This report provides benchmark data that may be useful for ophthalmological SSI surveillance initiatives at other institutions.