Pub Date : 2024-11-02DOI: 10.1016/j.infpip.2024.100417
Saira Butt , Amy B. Kressel , Brian L. Haines , Katherine Merrill , Amber M. Ryan , Kenneth C. Gavina , Bree Weaver , Michael Kays , Molly Tieman , Margaret Muciarelli , Phillip Clapham
Background
The United States Food and Drug Administration recently announced a national blood culture (BC) bottle shortage; the exact date of restoration is still being determined.
Aim
Implement a workflow to mitigate the BC bottle shortage at our hospital.
Methods
We created the following clinical decision support workflow in electronic medical record to help mitigate BC bottle use: (a) limit to two BC in 24 hours, (b) only repeat BC if 72 hours have passed from the prior sets, (c) do not repeat BC for coagulase-negative Staphylococcus bacteremia when considered a contaminant (i.e., no implanted vascular device), (d) do not repeat BC for Streptococcus bacteremia, (e) do not repeat cultures for Gram-negative rod bacteremia unless an unknown source, immunosuppression, or clinical worsening.
Findings
Post implementation, our weekly average BC bottle use decreased to 29.5%.
Conclusion
Within three weeks of the BC bottle shortage announcement, we successfully deployed evidence-based BC restrictions in the electronic medical record (EMR), reducing our BC orders by 29.5%. We encourage others to consider and potentially replicate our workflow to contribute to diagnostic stewardship.
背景美国食品和药物管理局最近宣布全国性血液培养（BC）瓶短缺；具体恢复日期仍在确定中。方法我们在电子病历中创建了以下临床决策支持工作流程，以帮助减少 BC 瓶的使用：(a) 限制在 24 小时内进行两次 BC，(b) 只有在距离上一次 BC 已过去 72 小时时才重复 BC，(c) 如果认为凝固酶阴性葡萄球菌菌血症是污染物（即：没有植入血管装置），则不重复 BC、结论在 BC 瓶短缺公告发布后的三周内，我们成功地在电子病历 (EMR) 中部署了循证 BC 限制，将 BC 订单减少了 29.5%。我们鼓励其他人考虑并有可能复制我们的工作流程，为诊断监管做出贡献。
{"title":"Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage","authors":"Saira Butt , Amy B. Kressel , Brian L. Haines , Katherine Merrill , Amber M. Ryan , Kenneth C. Gavina , Bree Weaver , Michael Kays , Molly Tieman , Margaret Muciarelli , Phillip Clapham","doi":"10.1016/j.infpip.2024.100417","DOIUrl":"10.1016/j.infpip.2024.100417","url":null,"abstract":"<div><h3>Background</h3><div>The United States Food and Drug Administration recently announced a national blood culture (BC) bottle shortage; the exact date of restoration is still being determined.</div></div><div><h3>Aim</h3><div>Implement a workflow to mitigate the BC bottle shortage at our hospital.</div></div><div><h3>Methods</h3><div>We created the following clinical decision support workflow in electronic medical record to help mitigate BC bottle use: (a) limit to two BC in 24 hours, (b) only repeat BC if 72 hours have passed from the prior sets, (c) do not repeat BC for coagulase-negative <em>Staphylococcus</em> bacteremia when considered a contaminant (i.e., no implanted vascular device), (d) do not repeat BC for <em>Streptococcus</em> bacteremia, (e) do not repeat cultures for Gram-negative rod bacteremia unless an unknown source, immunosuppression, or clinical worsening.</div></div><div><h3>Findings</h3><div>Post implementation, our weekly average BC bottle use decreased to 29.5%.</div></div><div><h3>Conclusion</h3><div>Within three weeks of the BC bottle shortage announcement, we successfully deployed evidence-based BC restrictions in the electronic medical record (EMR), reducing our BC orders by 29.5%. We encourage others to consider and potentially replicate our workflow to contribute to diagnostic stewardship.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100417"},"PeriodicalIF":1.8,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Infection prevention and control (IPC) helps prevent disease transmission in healthcare facilities. There is a dearth of information on the implementation of IPC during the COVID-19 outbreak in Cameroon using the recommended WHO COVID-19 IPC scorecard tool. The present study assessed healthcare facilities' compliance to IPC by continuous assessments, with an evaluation of the tool using the hierarchy of control theory.
Methods
This cross-sectional study was conducted in the 10 administrative regions of Cameroon by evaluating healthcare facilities prioritized by the Ministry of Public Health as high-risk facilities between March 2020 and November 2023. Comparisons were made regarding the facilities' ownership, level and status.
Results
2,188 assessments from 1,358 healthcare facilities were collected. The median IPC scores at each evaluation were between the intermediate and advanced level, with a bias linked with decreasing selection of facilities. However, only 172 (13%) healthcare facilities achieved advanced IPC score (≥75%). Higher IPC scores were found in hospitals (p<0.001) and in private facilities (p=0.02). Predictors of good IPC compliance were hospital (OR=3.7, CI: 1.4–9.8) and private facility (OR=2.3, CI: 1.6–3.3). The tool met the five domains of the hierarchy of control model.
Conclusion
Repeated IPC assessments using recommended tools contribute to a better compliance of IPC by healthcare facilities in resources constrained settings.
{"title":"Status of infection prevention and control in Cameroon healthcare facilities: lessons learned from the WHO COVID-19 scorecard tool under the hierarchy of control model","authors":"Boris Arnaud Kouomogne Nteungue , Erick Tandi , Chanceline Bilounga Ndongo , Tania Bissouma-Ledjou , Alphonse Acho , Jeffrey Campbell , Dieudonnée Reine Ndougou , Reverien Habimana , Ambomo Sylvie Myriam , Bertolt Brecht Kouam Nteungue , Oyono Yannick , Louis Joss Bitang , Georges Alain Etoundi Mballa , Yap Boum","doi":"10.1016/j.infpip.2024.100407","DOIUrl":"10.1016/j.infpip.2024.100407","url":null,"abstract":"<div><h3>Background</h3><div>Infection prevention and control (IPC) helps prevent disease transmission in healthcare facilities. There is a dearth of information on the implementation of IPC during the COVID-19 outbreak in Cameroon using the recommended WHO COVID-19 IPC scorecard tool. The present study assessed healthcare facilities' compliance to IPC by continuous assessments, with an evaluation of the tool using the hierarchy of control theory.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in the 10 administrative regions of Cameroon by evaluating healthcare facilities prioritized by the Ministry of Public Health as high-risk facilities between March 2020 and November 2023. Comparisons were made regarding the facilities' ownership, level and status.</div></div><div><h3>Results</h3><div>2,188 assessments from 1,358 healthcare facilities were collected. The median IPC scores at each evaluation were between the intermediate and advanced level, with a bias linked with decreasing selection of facilities. However, only 172 (13%) healthcare facilities achieved advanced IPC score (≥75%). Higher IPC scores were found in hospitals (p<0.001) and in private facilities (p=0.02). Predictors of good IPC compliance were hospital (OR=3.7, CI: 1.4–9.8) and private facility (OR=2.3, CI: 1.6–3.3). The tool met the five domains of the hierarchy of control model.</div></div><div><h3>Conclusion</h3><div>Repeated IPC assessments using recommended tools contribute to a better compliance of IPC by healthcare facilities in resources constrained settings.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100407"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prompt treatment for Staphylococcus aureus bloodstream infections is often dependent on known diagnostic testing modalities to differentiate between methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). Borderline-oxacillin resistant S. aureus (BORSA), a rare, non-mecA mediated phenotype, has unclear resistance mechanisms but potentially significant consequences as it is frequently misidentified as MSSA but behaves more like MRSA. A retrospective analysis was performed of MSSA bloodstream infections to determine the prevalence of BORSA. Our institution found BORSA prevalence of 0.1%, consistent with literature. Though prevalence is low, due to unclear mechanisms and unreliable detection methods, BORSA may pose a therapeutic and epidemiological threat.
{"title":"Low prevalence of borderline oxacillin resistant Staphylococcus aureus (BORSA) in a tertiary care hospital in South Carolina","authors":"Connor Horne , Gabrielle DiMattia , Nicholas Perkins , Prerana Roth","doi":"10.1016/j.infpip.2024.100414","DOIUrl":"10.1016/j.infpip.2024.100414","url":null,"abstract":"<div><div>Prompt treatment for <em>Staphylococcus aureus</em> bloodstream infections is often dependent on known diagnostic testing modalities to differentiate between methicillin-susceptible <em>S. aureus</em> (MSSA) and methicillin-resistant <em>S. aureus</em> (MRSA). Borderline-oxacillin resistant S. aureus (BORSA), a rare, non-mecA mediated phenotype, has unclear resistance mechanisms but potentially significant consequences as it is frequently misidentified as MSSA but behaves more like MRSA. A retrospective analysis was performed of MSSA bloodstream infections to determine the prevalence of BORSA. Our institution found BORSA prevalence of 0.1%, consistent with literature. Though prevalence is low, due to unclear mechanisms and unreliable detection methods, BORSA may pose a therapeutic and epidemiological threat.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100414"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.infpip.2024.100416
Agnese Comelli , Camilla Genovese , Giulia Renisi , Luigia Scudeller , Martina Zanforlini , Giulia Macaluso , Arianna Mazzone , Antonio Muscatello , Giorgio Bozzi , Alessia Zoncada , Angelo Pan , Marianna Rossi , Paolo Bonfanti , Stefania Chiappetta , Salvatore Casari , Marco Ripa , Antonella Castagna , Liana Signorini , Francesco Castelli , Margherita Chiamenti , Alessandra Bandera
A Delphi consensus-seeking procedure was conducted to validate a list of ICD-9-CM codes that could help identify hospital admissions in which antimicrobials are more likely to be prescribed. The panel agreed to include 2967 codes out of 16229 (18.28%). Such codes could support AMS strategies by large-scale monitoring of drug consumption.
{"title":"Use of ICD-9-CM coding for identifying antibiotic prescriptions during hospitalization: a Delphi consensus model","authors":"Agnese Comelli , Camilla Genovese , Giulia Renisi , Luigia Scudeller , Martina Zanforlini , Giulia Macaluso , Arianna Mazzone , Antonio Muscatello , Giorgio Bozzi , Alessia Zoncada , Angelo Pan , Marianna Rossi , Paolo Bonfanti , Stefania Chiappetta , Salvatore Casari , Marco Ripa , Antonella Castagna , Liana Signorini , Francesco Castelli , Margherita Chiamenti , Alessandra Bandera","doi":"10.1016/j.infpip.2024.100416","DOIUrl":"10.1016/j.infpip.2024.100416","url":null,"abstract":"<div><div>A Delphi consensus-seeking procedure was conducted to validate a list of ICD-9-CM codes that could help identify hospital admissions in which antimicrobials are more likely to be prescribed. The panel agreed to include 2967 codes out of 16229 (18.28%). Such codes could support AMS strategies by large-scale monitoring of drug consumption.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100416"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-26DOI: 10.1016/j.infpip.2024.100415
Meike M. Neuwirth , Benedikt Marche , Jerome Defosse , Frauke Mattner , Robin Otchwemah
Background
The German Infection Protection Act and KRINKO recommend nominating one authorized medical specialist in every medical department as an infection prevention link physician (PLP). Detailed evidence on the contribution of PLPs to reducing infection rates is not available in Germany.
Aim
The "HygArzt"-study investigated whether, and to what extent, a PLP in orthopaedics/trauma surgery is able to improve hand hygiene adherence (HHA), process steps of dressing change, nosocomial infection (NI) and surgical site infection (SSI) rates by implementing an infection prevention bundle (IPB).
Methods
In consideration of a literature review on infection prevention measures in orthopaedics/trauma surgery and existing departmental hygiene standards, supported by the responsible infection control specialist, an IPB was developed by an interdisciplinary team and implemented by a PLP. The effects of IPB on NI, SSI, and HHA were determined in a pre-post study design on three trauma surgery/orthopaedic wards of a university hospital.
Findings
In pre-post comparison HHA was significantly increased, and NI rates were reduced significantly. The greatest increase in adherence occurred in the pre-indications "Before touching a patient" (pre: 37.3%; post: 73.0%), "Before clean/aseptic procedure" (pre: 34.2%; post: 75.5%) and "Before surgery" (pre: 9.7%; post: 57.0%). The analysis of NI and SSI rates (NI: p=0.03; SSI: p=0.01; relative risk (RR) of 0.53 in each case) revealed rate reductions.
Conclusion
The implementation of an IPB by a PLP led to an optimisation of processes and to a reduction of SSIs and NIs. PLPs seem to have the potential for targeted, group-specific implementation of complex IPBs.
{"title":"Effect of the implementation of infection prevention measures by an infection prevention link physician in trauma and orthopaedic surgery on hygiene-relevant processes and nosocomial infections","authors":"Meike M. Neuwirth , Benedikt Marche , Jerome Defosse , Frauke Mattner , Robin Otchwemah","doi":"10.1016/j.infpip.2024.100415","DOIUrl":"10.1016/j.infpip.2024.100415","url":null,"abstract":"<div><h3>Background</h3><div>The German Infection Protection Act and KRINKO recommend nominating one authorized medical specialist in every medical department as an infection prevention link physician (PLP). Detailed evidence on the contribution of PLPs to reducing infection rates is not available in Germany.</div></div><div><h3>Aim</h3><div>The \"HygArzt\"-study investigated whether, and to what extent, a PLP in orthopaedics/trauma surgery is able to improve hand hygiene adherence (HHA), process steps of dressing change, nosocomial infection (NI) and surgical site infection (SSI) rates by implementing an infection prevention bundle (IPB).</div></div><div><h3>Methods</h3><div>In consideration of a literature review on infection prevention measures in orthopaedics/trauma surgery and existing departmental hygiene standards, supported by the responsible infection control specialist, an IPB was developed by an interdisciplinary team and implemented by a PLP. The effects of IPB on NI, SSI, and HHA were determined in a pre-post study design on three trauma surgery/orthopaedic wards of a university hospital.</div></div><div><h3>Findings</h3><div>In pre-post comparison HHA was significantly increased, and NI rates were reduced significantly. The greatest increase in adherence occurred in the pre-indications \"Before touching a patient\" (pre: 37.3%; post: 73.0%), \"Before clean/aseptic procedure\" (pre: 34.2%; post: 75.5%) and \"Before surgery\" (pre: 9.7%; post: 57.0%). The analysis of NI and SSI rates (NI: <em>p</em>=0.03; SSI: <em>p</em>=0.01; relative risk (RR) of 0.53 in each case) revealed rate reductions.</div></div><div><h3>Conclusion</h3><div>The implementation of an IPB by a PLP led to an optimisation of processes and to a reduction of SSIs and NIs. PLPs seem to have the potential for targeted, group-specific implementation of complex IPBs.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100415"},"PeriodicalIF":1.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-26DOI: 10.1016/j.infpip.2024.100413
Matthew JG. Sigakis , Joseph Posluszny , Michael D. Maile , Elizabeth S. Jewell , Milo Engoren
Background
To determine if colonisation with drug resistant organisms is associated with worse outcomes in patients who subsequently develop sepsis.
Methods
Retrospective study of patients with sepsis employing logistic regression and linear regression to determine the independent association of colonisation with adverse outcomes.
Results
Mortality was higher in patients colonized with VRE [501 of 1937 (26%) v. 1052 of 5624 (19%) non-VRE colonised patients, difference 7% (95% confidence interval (5,9%), p<0.001] and MRSA [168 of 708 (24%) v 1342 of 6804 (20%) non-MRSA colonised patients, difference 4% (1,7%), p = 0.014]. CDiff colonisation was not associated with increased mortality [153 of 757 (21%) v 762 of 7432 (18%), difference 3% (0,6%), p=0.052]. After multivariable logistic regression, VRE colonisation remained associated with increased hospital mortality [odds ratio = 1.273, 95% confidence interval (1.099, 1.475), p = 0.001]. VRE colonisation was also associated with subsequent receipt of mechanical ventilation [odds ratio = 1.179, 95% confidence interval (1.043, 1.334), p = 0.009] and with receipt of renal replacement therapy (RRT) [OR = 1.36 (1.11, 1.66), p = 0.003].
Conclusions
We found that VRE colonisation, but not MRSA or C. diff colonisation, was associated with increased hospital mortality in septic patients.
{"title":"Is there an association between colonisation of vancomycin resistant Enterococci, methicillin resistant Staphylococcus Aureus, or Clostridiodes Difficile and mortality in sepsis?","authors":"Matthew JG. Sigakis , Joseph Posluszny , Michael D. Maile , Elizabeth S. Jewell , Milo Engoren","doi":"10.1016/j.infpip.2024.100413","DOIUrl":"10.1016/j.infpip.2024.100413","url":null,"abstract":"<div><h3>Background</h3><div>To determine if colonisation with drug resistant organisms is associated with worse outcomes in patients who subsequently develop sepsis.</div></div><div><h3>Methods</h3><div>Retrospective study of patients with sepsis employing logistic regression and linear regression to determine the independent association of colonisation with adverse outcomes.</div></div><div><h3>Results</h3><div>Mortality was higher in patients colonized with VRE [501 of 1937 (26%) v. 1052 of 5624 (19%) non-VRE colonised patients, difference 7% (95% confidence interval (5,9%), p<0.001] and MRSA [168 of 708 (24%) v 1342 of 6804 (20%) non-MRSA colonised patients, difference 4% (1,7%), p = 0.014]. CDiff colonisation was not associated with increased mortality [153 of 757 (21%) v 762 of 7432 (18%), difference 3% (0,6%), p=0.052]. After multivariable logistic regression, VRE colonisation remained associated with increased hospital mortality [odds ratio = 1.273, 95% confidence interval (1.099, 1.475), p = 0.001]. VRE colonisation was also associated with subsequent receipt of mechanical ventilation [odds ratio = 1.179, 95% confidence interval (1.043, 1.334), p = 0.009] and with receipt of renal replacement therapy (RRT) [OR = 1.36 (1.11, 1.66), p = 0.003].</div></div><div><h3>Conclusions</h3><div>We found that VRE colonisation, but not MRSA or C. diff colonisation, was associated with increased hospital mortality in septic patients.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100413"},"PeriodicalIF":1.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Methicillin and vancomycin-resistant S. aureus have become increasingly problematic in recent years. This may be explained by the indiscriminate use of this antibiotic. The aim of this study was to determine the prevalence of methicillin-resistant and vancomycin-resistant Staphylococcus aureus (VRSA) and associated risk factors in patients with wound infections in the East Wallaga Zone, Western Ethiopia.
Methods
A hospital-based cross-sectional prospective study was conducted on 384 patients with wound infections including surgical wound who sought healthcare at Nekemte Specialized Hospital. Wound samples were collected using aseptic techniques and cultured on blood agar and mannitol salt agar. Vancomycin E-test and cefoxitin (30 μg) antibiotic disc diffusion were used to detect MRSA and VRSA, respectively. Data were analyzed using SPSS version 23, and a P-value of less than 0.05 was considered statistically significant.
Results
Of the 384 wound samples collected, 109 (28.4%) were identified as Staphylococcus aureus. Of these, 40.4% (44/109) were identified as MRSA, and 7.3% (8/109) were VRSA. Thirty-two (72.7%) MRSA isolates were showed multidrug resistance. The depth of the wound, patient setting, history of wound infection, and history of antibiotic use became significantly associated with the prevalence of MRSA wound infection.
Conclusions
This study found significant levels of S. aureus, MRSA, and VRSA in patients with wound infection. Therefore, it is crucial to implement effective infection prevention and control measures to prevent the spread of antimicrobial resistance.
{"title":"Methicillin and vancomycin-resistant Staphylococcus aureus and associated risk factors among patients with wound infection in East Wallaga Zone, Western Ethiopia","authors":"Milkias Abebe , Getachew Alemkere , Gizachew Ayele","doi":"10.1016/j.infpip.2024.100409","DOIUrl":"10.1016/j.infpip.2024.100409","url":null,"abstract":"<div><h3>Background</h3><div>Methicillin and vancomycin-resistant <em>S. aureus</em> have become increasingly problematic in recent years. This may be explained by the indiscriminate use of this antibiotic. The aim of this study was to determine the prevalence of methicillin-resistant and vancomycin-resistant <em>Staphylococcus aureus</em> (VRSA) and associated risk factors in patients with wound infections in the East Wallaga Zone, Western Ethiopia.</div></div><div><h3>Methods</h3><div>A hospital-based cross-sectional prospective study was conducted on 384 patients with wound infections including surgical wound who sought healthcare at Nekemte Specialized Hospital. Wound samples were collected using aseptic techniques and cultured on blood agar and mannitol salt agar. Vancomycin E-test and cefoxitin (30 μg) antibiotic disc diffusion were used to detect MRSA and VRSA, respectively. Data were analyzed using SPSS version 23, and a <em>P</em>-value of less than 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of the 384 wound samples collected, 109 (28.4%) were identified as <em>Staphylococcus aureus</em>. Of these, 40.4% (44/109) were identified as MRSA, and 7.3% (8/109) were VRSA. Thirty-two (72.7%) MRSA isolates were showed multidrug resistance. The depth of the wound, patient setting, history of wound infection, and history of antibiotic use became significantly associated with the prevalence of MRSA wound infection.</div></div><div><h3>Conclusions</h3><div>This study found significant levels of <em>S. aureus</em>, MRSA, and VRSA in patients with wound infection. Therefore, it is crucial to implement effective infection prevention and control measures to prevent the spread of antimicrobial resistance.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100409"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.infpip.2024.100411
Aysel Kulbay , Eva Joelsson-Alm , Karin Amilon , Ann Tammelin
Background
Patients with indwelling urinary catheters (IUC) are common in geriatric care. Catheterization increases the risk of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI). The prevalence of ASB after IUC-removal is only sparsely studied. This study aimed to compare the occurrence of ASB and UTI in geriatric patients with and without a history of catheterization and to explore factors associated with ASB.
Methods
Patients were included at two geriatric rehabilitation wards in Stockholm, Sweden. Data were collected about history of catheterization, antibiotic treatment, and diabetes mellitus. Urine samples were analysed. Occurrence of UTI during inpatient care was identified by patient records.
Results
In total 196 asymptomatic patients were included in the analysis. Asymptomatic bacteriuria was significantly more common in patients with a history of catheterization (38/104, 36.5%) compared to those without IUC during the past four weeks (19/92, 20.6%, P=0.018). Enterococci were more commonly found in patients with a history of catheterization. Of 124 patients possible to follow up, five UTI-cases were found during hospital stay. All cases had had ASB and 4/5 had had an IUC on admission.
Catheterization was significantly associated with ASB after adjustment for confounders (OR 2.79, CI 1.31–5.91, P=0.008).
Conclusions
Catheterization is associated with ASB, this persists after IUC-removal. The results indicate that colonisation by Enterococcus species linked to catheterization may persist for at least four weeks after IUC-removal.
Trial registration
The study is registered at clinicaltrials.gov with the identification number NCT05039203 (09/09/2021).
{"title":"Asymptomatic bacteriuria and urinary tract infection in geriatric inpatients after indwelling urinary catheter removal: a descriptive two-centre study","authors":"Aysel Kulbay , Eva Joelsson-Alm , Karin Amilon , Ann Tammelin","doi":"10.1016/j.infpip.2024.100411","DOIUrl":"10.1016/j.infpip.2024.100411","url":null,"abstract":"<div><h3>Background</h3><div>Patients with indwelling urinary catheters (IUC) are common in geriatric care. Catheterization increases the risk of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI). The prevalence of ASB after IUC-removal is only sparsely studied. This study aimed to compare the occurrence of ASB and UTI in geriatric patients with and without a history of catheterization and to explore factors associated with ASB.</div></div><div><h3>Methods</h3><div>Patients were included at two geriatric rehabilitation wards in Stockholm, Sweden. Data were collected about history of catheterization, antibiotic treatment, and diabetes mellitus. Urine samples were analysed. Occurrence of UTI during inpatient care was identified by patient records.</div></div><div><h3>Results</h3><div>In total 196 asymptomatic patients were included in the analysis. Asymptomatic bacteriuria was significantly more common in patients with a history of catheterization (38/104, 36.5%) compared to those without IUC during the past four weeks (19/92, 20.6%, <em>P</em>=0.018). Enterococci were more commonly found in patients with a history of catheterization. Of 124 patients possible to follow up, five UTI-cases were found during hospital stay. All cases had had ASB and 4/5 had had an IUC on admission.</div><div>Catheterization was significantly associated with ASB after adjustment for confounders (OR 2.79, CI 1.31–5.91, <em>P=</em>0.008).</div></div><div><h3>Conclusions</h3><div>Catheterization is associated with ASB, this persists after IUC-removal. The results indicate that colonisation by <em>Enterococcus</em> species linked to catheterization may persist for at least four weeks after IUC-removal.</div></div><div><h3>Trial registration</h3><div>The study is registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> with the identification number NCT05039203 (09/09/2021).</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100411"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Infection prevention and control (IPC) contributes to the reduction of healthcare associated infections. Notwithstanding the global attention with available guidelines and tools, low- and middle-income countries (LMICs) still struggle to put into place effective IPC programmes. Here, we use a socioecological approach to summarize the findings of a recent workshop on the implementation of IPC activities in Cameroon.
Study design
We conducted a cross-sectional study on the assessment of the IPC in Cameroon.
Methods
Experts and key stakeholders involved in IPC in Cameroon evaluated the implementation of infection prevention and control during a 4-day workshop. Detailed summaries of workshop discussions and recommendations were created. Data were clustered into themes guided by the WHO core component of IPC. Results were analyzed using the socioecological model of Bronfenbrenner, McLeroy and the theory of Grol and Wensing on successful implementation of practices in healthcare settings.
Results
Cameroon does not have an effective IPC programme in place but has developed some areas of the World Health Organization (WHO) IPC core components across the guideline level, the individual level, the organizational level, and the political level.
Conclusion
Cameroon is still far from the norms and standards laid out by the WHO. The evidence generated from the current analysis should contribute to improve policies and strategies towards an effective IPC programme in Cameroon and other LMICs.
{"title":"Assessing the state of infection prevention and control in cameroon: a cross-sectional workshop evaluation using socioecological models","authors":"Boris Arnaud Kouomogne Nteungue , Erick Tandi , Jeffrey Campbell , Chanceline Bilounga Ndongo , Bissouma-Ledjou Tania , Alphonse Acho , Dieudonnée Reine Ndougou , Reverien Habimana , Ambomo Sylvie Myriam , Bertolt Brecht Kouam Nteungue , Oyono Yannick , Louis Joss Bitang , Georges Alain Etoundi Mballa , Yap Boum","doi":"10.1016/j.infpip.2024.100408","DOIUrl":"10.1016/j.infpip.2024.100408","url":null,"abstract":"<div><h3>Objectives</h3><div>Infection prevention and control (IPC) contributes to the reduction of healthcare associated infections. Notwithstanding the global attention with available guidelines and tools, low- and middle-income countries (LMICs) still struggle to put into place effective IPC programmes. Here, we use a socioecological approach to summarize the findings of a recent workshop on the implementation of IPC activities in Cameroon.</div></div><div><h3>Study design</h3><div>We conducted a cross-sectional study on the assessment of the IPC in Cameroon.</div></div><div><h3>Methods</h3><div>Experts and key stakeholders involved in IPC in Cameroon evaluated the implementation of infection prevention and control during a 4-day workshop. Detailed summaries of workshop discussions and recommendations were created. Data were clustered into themes guided by the WHO core component of IPC. Results were analyzed using the socioecological model of Bronfenbrenner, McLeroy and the theory of Grol and Wensing on successful implementation of practices in healthcare settings.</div></div><div><h3>Results</h3><div>Cameroon does not have an effective IPC programme in place but has developed some areas of the World Health Organization (WHO) IPC core components across the guideline level, the individual level, the organizational level, and the political level.</div></div><div><h3>Conclusion</h3><div>Cameroon is still far from the norms and standards laid out by the WHO. The evidence generated from the current analysis should contribute to improve policies and strategies towards an effective IPC programme in Cameroon and other LMICs.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100408"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A cluster of 129 patients with coronavirus disease 2019 (COVID-19) nosocomial infections was analysed during the Omicron strain epidemic. The incubation period for nosocomial Omicron strain infections was found to be 3 days. The transmission route of the first patient with COVID-19 (FCP) in each room is a critical factor within these clusters. There have been few cases of healthcare-worker-to-patient transmission, and most FCPs maintained high levels of activity in daily living. The primary routes of nosocomial infection among FCPs likely involved patient visits or direct conversations between patients. Therefore, hospital clusters can potentially be mitigated by educating patients on infection control measures, such as proper mask-waring and hand hygiene.
{"title":"Analysis of COVID-19 nosocomial clusters in an Omicron strain epidemic: importance of patient education on infection control measures","authors":"Tomonori Takano , Yoshiko Nakatani , Akihiro Nagai , Natsuki Izumoto , Yuta Ono , Atsushi Inoue , Hiromu Takemura , Hiroyuki Kunishima","doi":"10.1016/j.infpip.2024.100410","DOIUrl":"10.1016/j.infpip.2024.100410","url":null,"abstract":"<div><div>A cluster of 129 patients with coronavirus disease 2019 (COVID-19) nosocomial infections was analysed during the Omicron strain epidemic. The incubation period for nosocomial Omicron strain infections was found to be 3 days. The transmission route of the first patient with COVID-19 (FCP) in each room is a critical factor within these clusters. There have been few cases of healthcare-worker-to-patient transmission, and most FCPs maintained high levels of activity in daily living. The primary routes of nosocomial infection among FCPs likely involved patient visits or direct conversations between patients. Therefore, hospital clusters can potentially be mitigated by educating patients on infection control measures, such as proper mask-waring and hand hygiene.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100410"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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