Journal of Infection Prevention最新文献

Background: With attempts at lifting most COVID-19 pandemic-related restrictions, other common respiratory viruses have caused more health concern than in earlier seasons in pediatric populations.

Objective: To explore the role of non-pharmaceutical interventions (NPIs) in a rebound in other respiratory viral pathogens, especially in light of general vaccination fatigue, COVID-19 boosters, and operational challenges in the healthcare system.

Methods: A research-based commentary supported with recent literature review.

Findings: Pandemic-related lockdowns in Europe, Australia, and New Zealand have created a significant population of susceptible young children without preexisting immunity due to lack of exposure during the colder months. Relying on NPIs for a prolonged period due to low vaccination rates may lead to increased respiratory infection susceptibility, especially among young children less than 5 years old. The key public health question is whether NPIs should be implemented in the long run and what are the long-term implications on the dynamics of endemic infections and population immunity.

Discussion: Prevention cannot be the only cure for any infectious disease, and long-term impact of NPIs depends on the dynamics of population susceptibility. The SARS-CoV-2 pandemic has reinforced the importance of vaccination and the knowledge on vaccine use combined with NPIs will be of great value in controlling other known and unknown respiratory pathogens. Combining NPIs and vaccination is paramount in disease control, and the discussion on how to prevent collateral damage to sensitive populations while relaxing NPI-related measures should also merit attention.

Aim/objections: The purpose of this study was to assess the efficacy of a central line maintenance bundle in preventing catheter-related (implanted venous access devices, port) Candida bloodstream infections.

Methods: The study encompassed two distinct time periods, namely, pre-bundle and bundle. The number of catheter-related bloodstream infections (CRBSI) episodes per catheter days for each timeframe was determined.

Findings/results: Upon implementation of the central line bundle, the rate of CRBSI reduced significantly from 4.27 per 1000 central line days in the pre-bundle period to 1.0 per 1000 central line days in the bundle period (p < .001).

Discussion: Using a central line bundle to avoid CRBSIs in pediatric cancer patients with ports led to a significant decrease in Candida species-related CRBSIs.

A pilot quality improvement project was conducted to examine the effect of playing an applause sound effect at a busy hospital concourse for three consecutive days whenever hand hygiene behavior was observed. The immediate effect was documented. The project demonstrated observable interest among people passing by, and hand hygiene events triggered by the sound effect represented 10.1% of all hand hygiene events documented. This supports the possible utility of this intervention in generating public awareness and increasing hand hygiene behavior and demonstrates the feasibility of a longer trial utilizing audio devices.

Launch of in-house sensitive cell-free deoxyribonucleic acid (cfDNA) mould polymerase chain reaction (PCR) assays increased detection of moulds meeting suspected healthcare-associated infection (HAI) criteria. Definition was based on time from admission and mould detection in culture or via molecular methods. We created a modified mould HAI algorithm incorporating clinical context into the case definition, which allowed for better capture of possible mould HAIs, decreased number of investigations, and improved utilization of Infection Prevention and Control (IPC) resources.

Background: Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hubs for high transmission and poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities.

Aim: Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness and existing preventive measures at the facilities.

Methods: Onsite assessments were conducted at ALFs using a modified CDC Infection Control Assessment and Response (ICAR) Tool. Data was obtained on IPC measures, training, testing, vaccination etc. Data was analyzed, frequencies generated, and bivariate associations determined.

Results: A total of 118 facilities were assessed and categorized into small scale 46 (39%), medium scale 47 (40%), and large scale 25 (21%). The facilities had 2431 residents and 2290 staff. Thirty-one (26%) facilities reported an outbreak in 2020, while 14 (12%) had an ongoing outbreak. Twenty-three (97%) large-scale and 12 (26%) small-scale facilities had COVID-19 testing program. Vaccination coverage among residents ranged from 99% in large-scale to 40% in small-scale facilities but was smaller among staff at 748 (45%) in large scale, 71 (36%) in small scale, and 193 (45%) in medium scale. While 24 (96%) large-scale and 34 (77%) of small-scale facilities conducted staff training staff on IPC practices, 22 (92%) of large-scale and 19 (56%) of small-scale facility staff demonstrated capacity (p = 0.01), respectively. Visitor screening was done at 100% of large-scale and 80% of small-scale and the medium-scale ALFs.

Discussion: Assisted living facilities within the city of Houston are at various levels of preparedness and interventions with respect to COVID-19 response.

Introduction: Antibiotic resistance is a public health concern in Nigeria and the world, and healthcare workers contributed to the upsurge of antibiotic resistance in hospital settings. This study focused on the knowledge, attitude, and practice (KAP) of antibiotic use and the frequency of prescriptions of antibiotics from the list of WHO Model Essentials Antibiotics (AWaRe) (in the last 6 months) among healthcare workers and established the determining factors in six hospitals in Niger state, Nigeria.

Methodology: A KAP survey was conducted in Niger State, Nigeria, from March to June 2022. A structured self-administered, pretested questionnaire was distributed to six hospitals in the state following a stratified random sampling considering the staff capacity, the population of the city, and patients' patronage.

Results: A total of 350 questionnaires distributed, and 313 (89.4%) completed and returned from the six hospitals. The median scores were knowledge (75%), attitude (69%), practice (62%), and self-reported prescription (70%), and respondents with good scores were knowledge [195 (62.3%)], attitude [185 (59.1%)], practice [201 (64.2%)], and prescription [117 (37.4%)]. In multivariate analysis, older respondents are more likely to have a good prescription (p = 0.006), and prior antimicrobial training improved their knowledge (p < 0.001), attitude (p = 0.007), and prescription pattern (p = 0.009). All the study participants had prescribed one or more of the most prescribed antibiotics; Amoxicillin clavulanate (Access group, 96.5%), Amoxicillin (Access group, 95.9%), and Metronidazole (Access group, 95.7%).

Conclusions: The study suggests that antibiotic education for healthcare workers and antimicrobial stewardship programs are significant interventions to mitigate antibiotic overuse in the state.

Background: Peripherally inserted central catheters (PICCs) are central venous catheters inserted peripherally but terminate in great vessels. PICCs are widely used for patients requiring long-term intravenous therapy in both in-patient and out-patient settings.

Aim: This study was carried out to understand PICC-related complications, specifically infections and causal pathogens, in a tertiary care hospital in Kerala, South India.

Methods: A retrospective analysis of PICC insertions and follow-up during a 9 years period to look at patient demographics and infections related to PICC was carried out.

Results: The overall PICC-related complication rate is 28.1% (4.98 per 1000 PICC days). Commonest complication was thrombosis followed by infection, either PICC-associated bloodstream infection (PABSI) or local infection (LI). PABSI noted in this study was 1.34 per 1000 catheter days. The majority (85%) of PABSI were due to Gram-negative rods. The average duration of PICC days for occurrence of PABSI was 14 days and the majority occurred in in-patients.

Conclusion: Thrombosis and infection were the commonest PICC-related complications. PABSI rate was comparable to that of previous studies.