Pub Date : 2024-03-15DOI: 10.1177/17571774241239780
Sharon Akinpelu, A. Ajayi, S. I. Smith, A. Adeleye
Multidrug resistant bacterial pathogens employ different mechanisms in evading the action of antibiotics. Multidrug resistance is wide spread among strains of Escherichia coli implicated in several infections including urinary tract infections, gastrointestinal infections, meningitis and bacteraemia. This study investigates the antibiotic resistance profile, efflux pump activity and biofilm formation ability of E. coli strains isolated from clinical samples. A total of 32 E. coli strains isolated from clinical samples were characterized and subjected to antibiotic susceptibility testing using standard methods. Isolates were screened phenotypically for biofilm formation and efflux pump activity. While molecular detection of genes encoding curli fimbriae and efflux pump activity was done by PCR. All 32 (100%) E. coli isolates were resistant to ceftazidime, cefuroxime, cefixime, amoxicillin-clavulanate, ofloxacin and ciprofloxacin. While 30 (93.8%) were resistant to gentamicin, 27 (84.4%) were resistant to cefepime and the least resistance of 15.6% was to imipenem. Efflux pump encoding gene tolC was detected in 13(40.6%) of the isolates, while 1(3.1%) harboured acrA gene. acrB gene was not detected in any of the isolates. Seven (21.9%) of the isolates were strong biofilm formers, while 5 (15.6%) and 20 (62.5%) were moderate and weak biofilm formers respectively. csgA gene was detected in all E. coli isolates. High antibiotic resistance of E. coli strains observed in this study is of public health significance. . It is therefore important to scale up efforts in regular monitoring of antibiotic resistance in both community and hospital settings.
{"title":"Genotypic and phenotypic characterization of determinants that mediate antimicrobial resistance in Escherichia coli strains of clinical origin in South-Western Nigeria","authors":"Sharon Akinpelu, A. Ajayi, S. I. Smith, A. Adeleye","doi":"10.1177/17571774241239780","DOIUrl":"https://doi.org/10.1177/17571774241239780","url":null,"abstract":"Multidrug resistant bacterial pathogens employ different mechanisms in evading the action of antibiotics. Multidrug resistance is wide spread among strains of Escherichia coli implicated in several infections including urinary tract infections, gastrointestinal infections, meningitis and bacteraemia. This study investigates the antibiotic resistance profile, efflux pump activity and biofilm formation ability of E. coli strains isolated from clinical samples. A total of 32 E. coli strains isolated from clinical samples were characterized and subjected to antibiotic susceptibility testing using standard methods. Isolates were screened phenotypically for biofilm formation and efflux pump activity. While molecular detection of genes encoding curli fimbriae and efflux pump activity was done by PCR. All 32 (100%) E. coli isolates were resistant to ceftazidime, cefuroxime, cefixime, amoxicillin-clavulanate, ofloxacin and ciprofloxacin. While 30 (93.8%) were resistant to gentamicin, 27 (84.4%) were resistant to cefepime and the least resistance of 15.6% was to imipenem. Efflux pump encoding gene tolC was detected in 13(40.6%) of the isolates, while 1(3.1%) harboured acrA gene. acrB gene was not detected in any of the isolates. Seven (21.9%) of the isolates were strong biofilm formers, while 5 (15.6%) and 20 (62.5%) were moderate and weak biofilm formers respectively. csgA gene was detected in all E. coli isolates. High antibiotic resistance of E. coli strains observed in this study is of public health significance. . It is therefore important to scale up efforts in regular monitoring of antibiotic resistance in both community and hospital settings.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-14DOI: 10.1177/17571774241238659
Jordan Mitchell, Xiao Li, Phillip Decker, Jae Man Park
Throughout the COVID-19 pandemic, the practice of preventative health behaviours had been used disparately across different racial groups. This study seeks to identify any differences in preventative health behaviours across racial groups, controlling for other socio-demographic factors. A US national survey study was electronically conducted from July through November 2020, to measure racial/ethnic differences in health preventive behaviours about COVID-19. We performed 2-part regression models to assess whether preventive health behaviours differed by race and ethnicity. Specifically, we employed generalized logistic regressions for investigating the predictors of the use of complementary or alternative medicine (CAM), or stay-at-home strategy, then performed ordinal logistic regression to examine the predictors of social distancing, face mask wearing, and hand hygiene strategy practice. The results show that non-White respondents were more likely to practice social distancing, mask wearing, and hand hygiene strategy to prevent COVID-19, compared to their White counterparts. Additionally, the findings indicate that individuals who experienced COVID-19-related racial abuse or depression had a higher likelihood of practicing preventive health behaviours. We found ethnicity can be a predictor of health preventive behaviours, in accordance with previous research. The causes of these disparities will require further investigation in order to be addressed.
{"title":"Preventive health behaviour differences across racial groups during the early stages of COVID-19","authors":"Jordan Mitchell, Xiao Li, Phillip Decker, Jae Man Park","doi":"10.1177/17571774241238659","DOIUrl":"https://doi.org/10.1177/17571774241238659","url":null,"abstract":"Throughout the COVID-19 pandemic, the practice of preventative health behaviours had been used disparately across different racial groups. This study seeks to identify any differences in preventative health behaviours across racial groups, controlling for other socio-demographic factors. A US national survey study was electronically conducted from July through November 2020, to measure racial/ethnic differences in health preventive behaviours about COVID-19. We performed 2-part regression models to assess whether preventive health behaviours differed by race and ethnicity. Specifically, we employed generalized logistic regressions for investigating the predictors of the use of complementary or alternative medicine (CAM), or stay-at-home strategy, then performed ordinal logistic regression to examine the predictors of social distancing, face mask wearing, and hand hygiene strategy practice. The results show that non-White respondents were more likely to practice social distancing, mask wearing, and hand hygiene strategy to prevent COVID-19, compared to their White counterparts. Additionally, the findings indicate that individuals who experienced COVID-19-related racial abuse or depression had a higher likelihood of practicing preventive health behaviours. We found ethnicity can be a predictor of health preventive behaviours, in accordance with previous research. The causes of these disparities will require further investigation in order to be addressed.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140242095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-14DOI: 10.1177/17571774241239222
Megha Anil, Jacki Dopran, A. Claxton, Paul Fleming, Narendra Aladangady
Carbapenemase-producing Enterobacterales (CPE) are a group of Gram-negative bacteria causing global concern due to their resistance to carbapenems. In this report, we detail the learning points from a CPE outbreak in a tertiary neonatal unit (NU) in the UK. Routine surveillance screening (rectal swabs) of babies on the NU identified a potential cluster of CPE carriage. Samples were sent to a reference laboratory for confirmatory testing. Environmental screening and cot mapping were undertaken to determine movements of babies within the unit. Regular audits of cleaning standards, hand hygiene, and maternal hygiene when expressing breast milk were carried out. The outbreak lasted 19 weeks. During the outbreak, there were 360 admissions, with 11 babies being colonised with the outbreak strain. Once the outbreak was declared, there were enhanced Infection Prevention and Control (IPC) precautions (including increased environmental and equipment cleaning frequency). CPE screening frequency was increased and cot capacity was reduced. Hand hygiene compliance improved from 92% at the start of the outbreak to 100% by its close. Cleaning standards remained compliant. Maternal hygiene standards varied from 78% to 100%, but no cross-infection links were identified. Environmental screening was negative. No route of cross-infection was identified. Notably, no babies developed invasive CPE infection. This is the first report of a CPE outbreak in a UK NU. Although no specific mode of cross-transmission was identified and the outbreak’s end cannot be attributed to any single intervention, the bundle of interventions proved successful after a 5-month period.
{"title":"Examining the impact and response to an outbreak of carbapenemase-producing Enterobacterales in a neonatal unit in the United Kingdom: An outbreak report","authors":"Megha Anil, Jacki Dopran, A. Claxton, Paul Fleming, Narendra Aladangady","doi":"10.1177/17571774241239222","DOIUrl":"https://doi.org/10.1177/17571774241239222","url":null,"abstract":"Carbapenemase-producing Enterobacterales (CPE) are a group of Gram-negative bacteria causing global concern due to their resistance to carbapenems. In this report, we detail the learning points from a CPE outbreak in a tertiary neonatal unit (NU) in the UK. Routine surveillance screening (rectal swabs) of babies on the NU identified a potential cluster of CPE carriage. Samples were sent to a reference laboratory for confirmatory testing. Environmental screening and cot mapping were undertaken to determine movements of babies within the unit. Regular audits of cleaning standards, hand hygiene, and maternal hygiene when expressing breast milk were carried out. The outbreak lasted 19 weeks. During the outbreak, there were 360 admissions, with 11 babies being colonised with the outbreak strain. Once the outbreak was declared, there were enhanced Infection Prevention and Control (IPC) precautions (including increased environmental and equipment cleaning frequency). CPE screening frequency was increased and cot capacity was reduced. Hand hygiene compliance improved from 92% at the start of the outbreak to 100% by its close. Cleaning standards remained compliant. Maternal hygiene standards varied from 78% to 100%, but no cross-infection links were identified. Environmental screening was negative. No route of cross-infection was identified. Notably, no babies developed invasive CPE infection. This is the first report of a CPE outbreak in a UK NU. Although no specific mode of cross-transmission was identified and the outbreak’s end cannot be attributed to any single intervention, the bundle of interventions proved successful after a 5-month period.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-14DOI: 10.1177/17571774241238661
K. Hambridge, W. Burt, G. Bettache, M. Keshishian, T. Walvin, E. Cozma
There is evidence available worldwide that nursing, medical and dental students sustain sharps injuries during their programmes of study. However, there is lack of evidence and research relating to the many students of other healthcare professions who may encounter sharps instruments. The aim of the study was to identify the extent, type and impact of sharps injuries sustained by pre-registration healthcare students. An online survey was administered to 3372 healthcare students at a University in the United Kingdom. Some healthcare students other than nursing, medical and dentistry had sustained a sharps injury. The most common device involved were glass ampoules. The common causes were equipment and carelessness. Some healthcare students sustained psychological impacts following the sharps injury. Sharps injuries are common amongst some healthcare students and there is scope for more education for these groups of students relating to the risks, safe handling, reporting and prevention of sharps injuries.
{"title":"An exploration of sharps injuries within healthcare students at a UK university","authors":"K. Hambridge, W. Burt, G. Bettache, M. Keshishian, T. Walvin, E. Cozma","doi":"10.1177/17571774241238661","DOIUrl":"https://doi.org/10.1177/17571774241238661","url":null,"abstract":"There is evidence available worldwide that nursing, medical and dental students sustain sharps injuries during their programmes of study. However, there is lack of evidence and research relating to the many students of other healthcare professions who may encounter sharps instruments. The aim of the study was to identify the extent, type and impact of sharps injuries sustained by pre-registration healthcare students. An online survey was administered to 3372 healthcare students at a University in the United Kingdom. Some healthcare students other than nursing, medical and dentistry had sustained a sharps injury. The most common device involved were glass ampoules. The common causes were equipment and carelessness. Some healthcare students sustained psychological impacts following the sharps injury. Sharps injuries are common amongst some healthcare students and there is scope for more education for these groups of students relating to the risks, safe handling, reporting and prevention of sharps injuries.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-28DOI: 10.1177/17571774241236247
D. Mukona, Rebecca George, Joemol James, Smitha Joseph, Jean Mukasa, Charity Timberlake, Beatrice Monaco, Salimbabu Abdulla, Atika G Adbulla, Emma Burnett
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. Explore the preparedness of undergraduate health science students for IPC practice. The PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, ProQuest, Scopus, Web of Science, ClinicalKey, and Google Scholar databases and grey literature will be searched for relevant articles. Quantitative, and mixed methods studies on teaching and learning, technological methods, strengths and limitations, and challenges of IPC practice in HEI undergraduate curricula. Undergraduate health science students including medical, nursing, pharmacy, dental, physiotherapy, radiology, medical imaging, and paramedicine. Studies published anywhere in the world, in English, and from 2010 to 2023. Preparedness, health science students, infection prevention and control, technology, higher education institutions. The data extracted will be recorded on a data extraction form. This will be conducted according to the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. No ethical approval was required for this protocol. Interim findings will be presented at relevant local and international conferences and a manuscript will be published in a peer reviewed journal. This systematic review will provide a baseline for recommendations for developing innovative ways to improve IPC teaching and learning in HEI.
世界卫生组织（WHO）提倡在高等教育机构（HEIs）中加强感染预防与控制（IPC）方面的教育和培训。这对于确保健康科学专业的学生在临床实践中充满信心并胜任工作至关重要。探讨健康科学专业本科生对 IPC 实践的准备情况。将在 PubMed、Cumulative Index to Nursing and Allied Health Literature、EMBASE、ProQuest、Scopus、Web of Science、ClinicalKey 和 Google Scholar 数据库以及灰色文献中搜索相关文章。有关高等院校本科生课程中的教学、技术方法、IPC 实践的优势和局限性以及挑战的定量和混合方法研究。健康科学专业的本科生，包括医学、护理、药学、牙科、物理治疗、放射学、医学影像和辅助医疗。2010 年至 2023 年期间在世界任何地方以英语发表的研究。准备工作、健康科学专业学生、感染预防与控制、技术、高等教育机构。提取的数据将记录在数据提取表中。这项工作将按照《科克伦干预措施系统综述手册》（Cochrane Handbook for Systematic Reviews of Interventions）中列出的标准进行。本方案无需获得伦理批准。中期研究结果将在相关的本地和国际会议上公布，并在同行评审期刊上发表手稿。本系统综述将为制定创新方法以改善高等院校 IPC 教学提供基准建议。
{"title":"Preparedness for infection prevention and control practice among undergraduate health sciences students: A systematic review protocol","authors":"D. Mukona, Rebecca George, Joemol James, Smitha Joseph, Jean Mukasa, Charity Timberlake, Beatrice Monaco, Salimbabu Abdulla, Atika G Adbulla, Emma Burnett","doi":"10.1177/17571774241236247","DOIUrl":"https://doi.org/10.1177/17571774241236247","url":null,"abstract":"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. Explore the preparedness of undergraduate health science students for IPC practice. The PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, ProQuest, Scopus, Web of Science, ClinicalKey, and Google Scholar databases and grey literature will be searched for relevant articles. Quantitative, and mixed methods studies on teaching and learning, technological methods, strengths and limitations, and challenges of IPC practice in HEI undergraduate curricula. Undergraduate health science students including medical, nursing, pharmacy, dental, physiotherapy, radiology, medical imaging, and paramedicine. Studies published anywhere in the world, in English, and from 2010 to 2023. Preparedness, health science students, infection prevention and control, technology, higher education institutions. The data extracted will be recorded on a data extraction form. This will be conducted according to the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. No ethical approval was required for this protocol. Interim findings will be presented at relevant local and international conferences and a manuscript will be published in a peer reviewed journal. This systematic review will provide a baseline for recommendations for developing innovative ways to improve IPC teaching and learning in HEI.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140419510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pseudomonas aeruginosa is a major cause of morbidity and mortality in neonatal intensive care units (NICUs). Robust infection prevention and control is key to reducing risk. We describe lessons learnt from an NICU outbreak of P.aeruginosa in the main maternity hospital in the country. Cases were identified from clinical samples and active screening. Clinical information was collected from the electronic patient record. Infection prevention and control (IPC) practice observations were made using organisational checklists and unit observations. Microbiological testing was by conventional microbiological methods. Statistical analyses were performed using R program. Associations were assessed using the Mann–Whitney U or Fisher exact test. Isolates were typed by pulsed field gel electrophoresis; gel was analysed in Bionumerics software from Applied Maths, Belgium. Five cases were identified – one was excluded as maternal acquisition. Typing showed a polyclonal outbreak. Widespread contamination of tap outlets of handwashing sinks in clinical areas was found. Main contributing factors were extensive misuse of hand wash sinks for waste disposal, improper sink cleaning, poor hand hygiene compliance and inadequate environmental cleaning. Successful management required a multi-disciplinary approach. All potential water sources and moist environments within and outside the unit were investigated. Interventions successfully addressed the main contributing factors, supported by good communication and robust auditing. With a diverse workforce, the challenge was to ensure housekeeping staff understood handwash sink cleaning procedures; existing training programmes were delivered in multiple languages tailored to the workforce.
铜绿假单胞菌是新生儿重症监护室（NICU）发病和死亡的主要原因。强有力的感染预防和控制是降低风险的关键。我们介绍了该国主要妇产医院新生儿重症监护室铜绿单胞菌爆发的经验教训。病例是通过临床样本和主动筛查确定的。临床信息从电子病历中收集。感染预防与控制（IPC）实践观察是通过组织检查表和病房观察进行的。微生物检测采用常规微生物学方法。统计分析使用 R 程序进行。相关性采用 Mann-Whitney U 或 Fisher exact 检验进行评估。通过脉冲场凝胶电泳对分离物进行分型；凝胶使用比利时应用数学公司的 Bionumerics 软件进行分析。共发现五例病例，其中一例因母体感染而被排除。分型结果显示这是一次多克隆疫情。发现临床区域洗手池的水龙头出水口普遍受到污染。主要诱因包括广泛滥用洗手池处理废物、洗手池清洁不当、手部卫生不达标以及环境清洁不足。成功的管理需要采用多学科方法。对单位内外所有潜在的水源和潮湿环境都进行了调查。在良好沟通和严格审核的支持下，干预措施成功解决了主要诱因。由于员工来源多样，如何确保内务人员了解洗手池的清洁程序是一项挑战；现有的培训计划以多种语言提供，以满足员工的需求。
{"title":"Outbreak of Pseudomonas aeruginosa on a neonatal intensive care unit: Lessons from a Qatari setting","authors":"H. Petkar, Imelda Caseres-Chiuco, Afaf Al-Shaddad, Mahmoud Mohamed, Irshad Ahmed, Rosemary Rao, Roderic Perdon, Moneir Elhaj, Lajish Latheef, Bonnie George, Eman Mustafa, Jameela Al-Ajmi, Huda Saleh","doi":"10.1177/17571774241236248","DOIUrl":"https://doi.org/10.1177/17571774241236248","url":null,"abstract":"Pseudomonas aeruginosa is a major cause of morbidity and mortality in neonatal intensive care units (NICUs). Robust infection prevention and control is key to reducing risk. We describe lessons learnt from an NICU outbreak of P.aeruginosa in the main maternity hospital in the country. Cases were identified from clinical samples and active screening. Clinical information was collected from the electronic patient record. Infection prevention and control (IPC) practice observations were made using organisational checklists and unit observations. Microbiological testing was by conventional microbiological methods. Statistical analyses were performed using R program. Associations were assessed using the Mann–Whitney U or Fisher exact test. Isolates were typed by pulsed field gel electrophoresis; gel was analysed in Bionumerics software from Applied Maths, Belgium. Five cases were identified – one was excluded as maternal acquisition. Typing showed a polyclonal outbreak. Widespread contamination of tap outlets of handwashing sinks in clinical areas was found. Main contributing factors were extensive misuse of hand wash sinks for waste disposal, improper sink cleaning, poor hand hygiene compliance and inadequate environmental cleaning. Successful management required a multi-disciplinary approach. All potential water sources and moist environments within and outside the unit were investigated. Interventions successfully addressed the main contributing factors, supported by good communication and robust auditing. With a diverse workforce, the challenge was to ensure housekeeping staff understood handwash sink cleaning procedures; existing training programmes were delivered in multiple languages tailored to the workforce.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-27DOI: 10.1177/17571774241235101
Bailie Moorhead, Niva Shrestha, Alvin Boyd Newman-Caro, Sydney L. Vangeli, Victoria N. Lussier, Mark I. Grijalva, Margaret E. Giro, Danielle Natividad Jackson, Tianna M. Mack, Zackary L. Herrle, Marcheta Hill, Gretchen Rodriguez, Rachael Singer, Cynthia Williams, A. Nwanguma, Enyinnaya Merengwa, Rachel Pittman, Rebecca L. Sanchez
The Antimicrobial Resistance Laboratory Network (AR Lab Network) was developed by the CDC to detect emerging antimicrobial-resistant (AR) threats and prevent outbreaks. However, low submission rates of AR isolates limit the potential of the AR Lab Network to address antimicrobial resistance (AMR). The aim of this study was to investigate barriers to submission of AR isolates in acute care hospitals (ACHs) and critical access hospitals (CAHs) within Texas Public Health Region 8 (PHR8) counties. A survey was designed and emailed to laboratory professionals to identify barriers to AR isolate submission. Responses were analyzed using 2-sided Fisher’s exact tests to identify associations between responses and respondent characteristics. Of the 33 hospitals within PHR8 invited to participate in the survey, responses were received from 21, a response rate of 63.6%. Lack of awareness of the AR Lab Network was the most frequently cited barrier to submission (65.4% of respondents). Other reported barriers to submission included lack of laboratory staff time (57.7%), lack of training with the submission process (34.6%), lack of personnel certified to ship infectious substances (23.1%), and lack of laboratory/shipping supplies (23.1%). Regardless of the respondent’s role, time in that role, or type of hospital in which they worked, the most common barrier to isolate submission was lack of awareness of the AR Lab Network. In the future, we will address the identified barriers by implementing educational outreach programs about AMR and the AR Lab Network for hospitals and other healthcare facilities within PHR8.
抗菌药耐药性实验室网络（AR Lab Network，AR 实验室网络）由美国疾病预防控制中心（CDC）开发，旨在检测新出现的抗菌药耐药性（AR）威胁并预防疫情爆发。然而，AR 分离物的低提交率限制了 AR 实验室网络解决抗菌药耐药性 (AMR) 问题的潜力。本研究旨在调查德克萨斯州公共卫生第 8 区 (PHR8) 县内的急症护理医院 (ACH) 和重症监护医院 (CAH) 在提交 AR 分离物方面遇到的障碍。我们设计了一份调查问卷，并通过电子邮件发送给实验室专业人员，以确定提交 AR 分离物的障碍。我们使用双侧费雪精确检验对回复进行了分析，以确定回复与受访者特征之间的关联。在受邀参与调查的 33 家 PHR8 医院中，收到了 21 家医院的回复，回复率为 63.6%。对 AR 实验室网络缺乏了解是最常提到的提交障碍（65.4% 的受访者）。其他报告的递交障碍包括实验室工作人员时间不足（57.7%）、缺乏递交流程培训（34.6%）、缺乏有资格运输传染性物质的人员（23.1%）以及缺乏实验室/运输用品（23.1%）。无论受访者的角色、任职时间或所在医院的类型如何，提交分离物的最常见障碍都是缺乏对 AR 实验室网络的了解。今后，我们将通过在 PHR8 内为医院和其他医疗机构实施有关 AMR 和 AR 实验室网络的教育推广计划来解决已发现的障碍。
{"title":"Determining barriers to submitting antimicrobial-resistant isolates among hospitals in Texas Public Health Region 8","authors":"Bailie Moorhead, Niva Shrestha, Alvin Boyd Newman-Caro, Sydney L. Vangeli, Victoria N. Lussier, Mark I. Grijalva, Margaret E. Giro, Danielle Natividad Jackson, Tianna M. Mack, Zackary L. Herrle, Marcheta Hill, Gretchen Rodriguez, Rachael Singer, Cynthia Williams, A. Nwanguma, Enyinnaya Merengwa, Rachel Pittman, Rebecca L. Sanchez","doi":"10.1177/17571774241235101","DOIUrl":"https://doi.org/10.1177/17571774241235101","url":null,"abstract":"The Antimicrobial Resistance Laboratory Network (AR Lab Network) was developed by the CDC to detect emerging antimicrobial-resistant (AR) threats and prevent outbreaks. However, low submission rates of AR isolates limit the potential of the AR Lab Network to address antimicrobial resistance (AMR). The aim of this study was to investigate barriers to submission of AR isolates in acute care hospitals (ACHs) and critical access hospitals (CAHs) within Texas Public Health Region 8 (PHR8) counties. A survey was designed and emailed to laboratory professionals to identify barriers to AR isolate submission. Responses were analyzed using 2-sided Fisher’s exact tests to identify associations between responses and respondent characteristics. Of the 33 hospitals within PHR8 invited to participate in the survey, responses were received from 21, a response rate of 63.6%. Lack of awareness of the AR Lab Network was the most frequently cited barrier to submission (65.4% of respondents). Other reported barriers to submission included lack of laboratory staff time (57.7%), lack of training with the submission process (34.6%), lack of personnel certified to ship infectious substances (23.1%), and lack of laboratory/shipping supplies (23.1%). Regardless of the respondent’s role, time in that role, or type of hospital in which they worked, the most common barrier to isolate submission was lack of awareness of the AR Lab Network. In the future, we will address the identified barriers by implementing educational outreach programs about AMR and the AR Lab Network for hospitals and other healthcare facilities within PHR8.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-23DOI: 10.1177/17571774241236250
E. Viana-Cárdenas, Abel Triana, Jorge Cardenas-Alvarez, Edwin Carvajal-Diaz, Humberto Mendoza, D. Viasus
To describe a multicenter outbreak of R. pickettii that occurred in a large number of critically ill patients in a city in Colombia, during the COVID-19 pandemic. In April 2021, the National Institute for Food and Drug Surveillance (INVIMA) reported an outbreak of R. pickettii infection associated with contaminated intravenous medications. The Municipal Health Department began collecting data for all cases identified by the hospitals and the results of microbiological studies. Medical records and death certificates of included cases were reviewed. Between March and May 2021, 66 cases of R. pickettii bloodstream infections from nine hospitals were documented. The median age of the patients was 60 years (IQR 51–72), and most of them had comorbidities (78.8%), mainly arterial hypertension and diabetes mellitus. At the time of the R. pickettii bloodstream infection, 89.4% had COVID-19, 86.4% were on mechanical ventilation, and 98.5% were receiving corticosteroids. The overall mortality was 81.8%. Nearly 60% of the deaths were related to R. pickettii bloodstream infections. R. pickettii was identified in the cultures from intravenous medications. This large multicenter outbreak caused by intravenous medications contaminated with R. pickettii mainly affected critically ill COVID-19 patients. Mortality was high and largely related to R. pickettii bloodstream infection.
{"title":"A large multicenter Ralstonia pickettii outbreak in critically ill patients during the COVID-19 pandemic: Epidemiological and clinical characteristics of 66 cases","authors":"E. Viana-Cárdenas, Abel Triana, Jorge Cardenas-Alvarez, Edwin Carvajal-Diaz, Humberto Mendoza, D. Viasus","doi":"10.1177/17571774241236250","DOIUrl":"https://doi.org/10.1177/17571774241236250","url":null,"abstract":"To describe a multicenter outbreak of R. pickettii that occurred in a large number of critically ill patients in a city in Colombia, during the COVID-19 pandemic. In April 2021, the National Institute for Food and Drug Surveillance (INVIMA) reported an outbreak of R. pickettii infection associated with contaminated intravenous medications. The Municipal Health Department began collecting data for all cases identified by the hospitals and the results of microbiological studies. Medical records and death certificates of included cases were reviewed. Between March and May 2021, 66 cases of R. pickettii bloodstream infections from nine hospitals were documented. The median age of the patients was 60 years (IQR 51–72), and most of them had comorbidities (78.8%), mainly arterial hypertension and diabetes mellitus. At the time of the R. pickettii bloodstream infection, 89.4% had COVID-19, 86.4% were on mechanical ventilation, and 98.5% were receiving corticosteroids. The overall mortality was 81.8%. Nearly 60% of the deaths were related to R. pickettii bloodstream infections. R. pickettii was identified in the cultures from intravenous medications. This large multicenter outbreak caused by intravenous medications contaminated with R. pickettii mainly affected critically ill COVID-19 patients. Mortality was high and largely related to R. pickettii bloodstream infection.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140436839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-20DOI: 10.1177/17571774241230676
MP Smiddy, E. Burton, L. Kingston, T. T. Poovelikunnel, M. Moyo, A. Flores
Meaningful research creates evidence for Infection Prevention and Control (IPC) practice. To establish Infection Prevention Society (IPS) members’ research priorities to support future research projects. A mixed methods convergent parallel design incorporating a cross-sectional survey of IPS members (2022–2023), and focus group findings from the IPS Consultative Committee, (October 2022). Quantitative data were analysed using descriptive statistics. Qualitative data were transcribed verbatim, entered into NVivo 12, and analysed using a thematic analysis approach. 132 IPS members responded to the survey, including 120 (90.9%) nurses. The three most prevalent priorities were: Quality Improvement and Patient Safety ( n = 84, 16.1%); IPC Training and Education ( n = 77, 14.8%); and IPC Evidence-based Guidelines ( n = 76, 14.6%). Analysis of the focus group transcripts identified six emergent themes ‘Patient Centred Care’, ‘Training and Education’, ‘IPC Role and Identity’, ‘IPC Leadership’, ‘IPC is Everyone’s Responsibility’, and ‘Research Activity’. Triangulation of findings demonstrated concordance between quantitative and qualitative findings with Quality Improvement and Patient Safety (QIPS) and Training and Education identified as priority research areas. This study highlights the necessity of developing support systems and incorporating research priorities in QIPS, as well as Training and Education. The findings of this study align with the recommended core competencies and components for effective infection prevention and control programs, making them relevant to QIPS initiatives. The outcomes of the study will serve as a valuable resource to guide the IPS Research and Development Committee in delivering practical support to IPS members.
{"title":"Identifying research priorities for infection prevention and control. A mixed methods study with a convergent design","authors":"MP Smiddy, E. Burton, L. Kingston, T. T. Poovelikunnel, M. Moyo, A. Flores","doi":"10.1177/17571774241230676","DOIUrl":"https://doi.org/10.1177/17571774241230676","url":null,"abstract":"Meaningful research creates evidence for Infection Prevention and Control (IPC) practice. To establish Infection Prevention Society (IPS) members’ research priorities to support future research projects. A mixed methods convergent parallel design incorporating a cross-sectional survey of IPS members (2022–2023), and focus group findings from the IPS Consultative Committee, (October 2022). Quantitative data were analysed using descriptive statistics. Qualitative data were transcribed verbatim, entered into NVivo 12, and analysed using a thematic analysis approach. 132 IPS members responded to the survey, including 120 (90.9%) nurses. The three most prevalent priorities were: Quality Improvement and Patient Safety ( n = 84, 16.1%); IPC Training and Education ( n = 77, 14.8%); and IPC Evidence-based Guidelines ( n = 76, 14.6%). Analysis of the focus group transcripts identified six emergent themes ‘Patient Centred Care’, ‘Training and Education’, ‘IPC Role and Identity’, ‘IPC Leadership’, ‘IPC is Everyone’s Responsibility’, and ‘Research Activity’. Triangulation of findings demonstrated concordance between quantitative and qualitative findings with Quality Improvement and Patient Safety (QIPS) and Training and Education identified as priority research areas. This study highlights the necessity of developing support systems and incorporating research priorities in QIPS, as well as Training and Education. The findings of this study align with the recommended core competencies and components for effective infection prevention and control programs, making them relevant to QIPS initiatives. The outcomes of the study will serve as a valuable resource to guide the IPS Research and Development Committee in delivering practical support to IPS members.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140449276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.1177/17571774241232063
Amit Bahl, N. Mielke, S. M. Gibson, Julie George
Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections. The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes. This pre–post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs). The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) ( p < .001). The adjusted rate ratio demonstrated the same trend at 1.00 pre- and 0.60 post-intervention ( p < .001). Stratifying the analysis based on the highest level of care showed that the intervention was effective in reducing the unadjusted rate of unscheduled dressing evaluations for both the advanced and regular medical floor subgroups pre- to post-intervention; the advanced subgroup had an reduction from 0.22 to 0.15 per day ( p = .001), while the regular medical floor subgroup had a reduction from 0.21 to 0.09 per day ( p < .001). CLABSIs were similar in both groups (0.6% vs 0.8%; p = 1.00) in pre- and post-intervention groups, respectively. Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed.
{"title":"The use of procedural kits may reduce unscheduled central line dressing changes: A matched pre–post intervention study","authors":"Amit Bahl, N. Mielke, S. M. Gibson, Julie George","doi":"10.1177/17571774241232063","DOIUrl":"https://doi.org/10.1177/17571774241232063","url":null,"abstract":"Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections. The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes. This pre–post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs). The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) ( p < .001). The adjusted rate ratio demonstrated the same trend at 1.00 pre- and 0.60 post-intervention ( p < .001). Stratifying the analysis based on the highest level of care showed that the intervention was effective in reducing the unadjusted rate of unscheduled dressing evaluations for both the advanced and regular medical floor subgroups pre- to post-intervention; the advanced subgroup had an reduction from 0.22 to 0.15 per day ( p = .001), while the regular medical floor subgroup had a reduction from 0.21 to 0.09 per day ( p < .001). CLABSIs were similar in both groups (0.6% vs 0.8%; p = 1.00) in pre- and post-intervention groups, respectively. Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed.","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139854030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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