Pub Date : 2024-10-28DOI: 10.1016/j.infpip.2024.100414
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":"","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":null,"pages":null},"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 : 2024-10-24DOI: 10.1016/j.infpip.2024.100408
Objectives
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":"","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":null,"pages":null},"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}
Pub Date : 2024-10-24DOI: 10.1016/j.infpip.2024.100412
{"title":"‘The Law of Unintended Consequences’ – Staphylococcus aureus bloodstream infection complicating peripheral intravascular cannulation in an epilepsy monitoring unit","authors":"","doi":"10.1016/j.infpip.2024.100412","DOIUrl":"10.1016/j.infpip.2024.100412","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593456","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 : 2024-09-24DOI: 10.1016/j.infpip.2024.100400
We report an outbreak of PVL-producing MRSA in the Irish National Burns Unit in 2022 involving seven patients, two staff members and two positive environmental samples. This outbreak was successfully controlled using a range of measures including staff screening, environmental screening and enhanced cleaning. The use of real time whole genome sequencing (WGS) allowed for rapid identification of relatedness and for a rapid outbreak response. We share our successful approach to control this outbreak.
{"title":"Successful control of an outbreak of Panton–Valentine leucocidin positive meticillin resistant Staphylococcus aureus in a National Burns Unit through early detection by whole genome sequencing","authors":"","doi":"10.1016/j.infpip.2024.100400","DOIUrl":"10.1016/j.infpip.2024.100400","url":null,"abstract":"<div><div>We report an outbreak of PVL-producing MRSA in the Irish National Burns Unit in 2022 involving seven patients, two staff members and two positive environmental samples. This outbreak was successfully controlled using a range of measures including staff screening, environmental screening and enhanced cleaning. The use of real time whole genome sequencing (WGS) allowed for rapid identification of relatedness and for a rapid outbreak response. We share our successful approach to control this outbreak.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434100","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 : 2024-09-24DOI: 10.1016/j.infpip.2024.100403
Background
For Candida infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions.
Aims
To monitor the epidemiology and antifungal susceptibility of Candida spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8).
Methods
From 2020 to 2022, 675 patients from three ICUs were enrolled. Candida isolates were identified by MALDI-TOF MS and PCR. In vitro antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique.
Results
Out of 988 swabs, 355 isolates were identified as Candida species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all Candida isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 C. albicans, 2 out of 89 C. parapsilosis and 2 out of 24 C. glabrata isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one C. albicans isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three Candida spp. exhibited resistance to anidulafungin, C. albicans, C. tropicalis, and C. parapsilosis.
Conclusions
This study highlights the importance of C. albicans as a frequent coloniser and showed that antifungal resistance remains uncommon among Candida isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.
Aims To monitor the epidemiology and antifungal susceptibility of Candida spp.从重症监护病房（ICU）患者入院（第1天，D1）、第5天（D5）和第8天（D8）的腋窝-胃液联合样本中监测念珠菌属的流行病学和抗真菌敏感性。通过 MALDI-TOF MS 和 PCR 鉴定念珠菌分离物。结果在 988 份拭子中，232 名患者的 355 份分离物被鉴定为念珠菌，其中 89 份分离物来自在第 5 天和第 8 天仍有定植的患者。对所有念珠菌分离物进行了 AFST 检测。对氟康唑的总体耐药率为 2.7%，133 个白色念珠菌分离株中有 3 个、89 个副丝状念珠菌分离株中有 2 个、24 个格氏念珠菌分离株中有 2 个被鉴定为耐药。99.2%的分离株对伏立康唑有敏感性，只有一个白僵菌分离株对该三唑类药物有抗药性。所有分离株都对两性霉素 B 敏感，98.5%对阿尼芬净敏感。该研究强调了白念珠菌作为一种常见定植菌的重要性，并表明抗真菌耐药性在葡萄牙重症监护病房分离出的念珠菌中仍不常见。研究结果可能有助于改善医疗机构的管理，为治疗决策提供指导。
{"title":"Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022","authors":"","doi":"10.1016/j.infpip.2024.100403","DOIUrl":"10.1016/j.infpip.2024.100403","url":null,"abstract":"<div><h3>Background</h3><div>For <em>Candida</em> infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions.</div></div><div><h3>Aims</h3><div>To monitor the epidemiology and antifungal susceptibility of <em>Candida</em> spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8).</div></div><div><h3>Methods</h3><div>From 2020 to 2022, 675 patients from three ICUs were enrolled. <em>Candida</em> isolates were identified by MALDI-TOF MS and PCR. <em>In vitro</em> antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique.</div></div><div><h3>Results</h3><div>Out of 988 swabs, 355 isolates were identified as <em>Candida</em> species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all <em>Candida</em> isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 <em>C. albicans</em>, 2 out of 89 <em>C. parapsilosis</em> and 2 out of 24 <em>C. glabrata</em> isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one <em>C. albicans</em> isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three <em>Candida</em> spp. exhibited resistance to anidulafungin, <em>C. albicans</em>, <em>C. tropicalis</em>, and <em>C. parapsilosis</em>.</div></div><div><h3>Conclusions</h3><div>This study highlights the importance of <em>C. albicans</em> as a frequent coloniser and showed that antifungal resistance remains uncommon among <em>Candida</em> isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422315","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 : 2024-09-23DOI: 10.1016/j.infpip.2024.100405
Background
Benin's healthcare system is characterized by a lack of local guidelines for surgical antibiotic prophylaxis (SAP), which is essential to prevent surgical site infection.
Aim
To audit compliance for SAP practices in gastrointestinal surgery.
Methods
Data were prospectively collected from gastrointestinal surgery departments in five hospitals. Over a four month period, SAP was assessed using five conventional criteria (indication, choice of antibiotic, dosage, timing, and duration of administration) among patients admitted for Altemeier class 1 or 2 procedures. Three guidelines were used as reference: World Health Organization (WHO), American Society of Health-System Pharmacists (ASHP)and French Society of Anaesthesia and Intensive Care Medicine (SFAR).
Findings
Of 68 surgical interventions, overall compliance with WHO, ASHP, and SFAR was observed in zero (0.0%), one case (1.5%) and two cases (2.9%), respectively. Compliance with indication varied according to the guidelines: 65 (95.6%) were compliant with WHO and ASHP and 47 cases (69.11%) with SFAR. Among compliant cases, the antibiotics administered were rarely selected according to guidelines: WHO, 2 (2.9%) and ASHP, 2 (2.9%), and SFAR, 3 (4.4%). Drug dosage compliance varied from 20 (29.4%) (SFAR) to 49 (72.0%) (ASHP). Timings were respected in 47 (69.1%; WHO), 45 (66.2%; ASHP) and 9 cases (13.2%; SFAR). The number of cases compliant with antibiotic prophylaxis duration were 13 (19.1%; WHO), 17 (25.0%; ASHP) and 16 (23.5%; SFAR).
Conclusion
The SAP compliance rate in gastrointestinal surgery based on the five conventional criteria was very low. SAP guidelines must be implemented appropriately for local bacteriological epidemiology.
{"title":"Antibiotic prophylaxis practice in gastrointestinal surgery in five hospitals in southern Benin","authors":"","doi":"10.1016/j.infpip.2024.100405","DOIUrl":"10.1016/j.infpip.2024.100405","url":null,"abstract":"<div><h3>Background</h3><div>Benin's healthcare system is characterized by a lack of local guidelines for surgical antibiotic prophylaxis (SAP), which is essential to prevent surgical site infection.</div></div><div><h3>Aim</h3><div>To audit compliance for SAP practices in gastrointestinal surgery.</div></div><div><h3>Methods</h3><div>Data were prospectively collected from gastrointestinal surgery departments in five hospitals. Over a four month period, SAP was assessed using five conventional criteria (indication, choice of antibiotic, dosage, timing, and duration of administration) among patients admitted for Altemeier class 1 or 2 procedures. Three guidelines were used as reference: World Health Organization (WHO), American Society of Health-System Pharmacists (ASHP)and French Society of Anaesthesia and Intensive Care Medicine (SFAR).</div></div><div><h3>Findings</h3><div>Of 68 surgical interventions, overall compliance with WHO, ASHP, and SFAR was observed in zero (0.0%), one case (1.5%) and two cases (2.9%), respectively. Compliance with indication varied according to the guidelines: 65 (95.6%) were compliant with WHO and ASHP and 47 cases (69.11%) with SFAR. Among compliant cases, the antibiotics administered were rarely selected according to guidelines: WHO, 2 (2.9%) and ASHP, 2 (2.9%), and SFAR, 3 (4.4%). Drug dosage compliance varied from 20 (29.4%) (SFAR) to 49 (72.0%) (ASHP). Timings were respected in 47 (69.1%; WHO), 45 (66.2%; ASHP) and 9 cases (13.2%; SFAR). The number of cases compliant with antibiotic prophylaxis duration were 13 (19.1%; WHO), 17 (25.0%; ASHP) and 16 (23.5%; SFAR).</div></div><div><h3>Conclusion</h3><div>The SAP compliance rate in gastrointestinal surgery based on the five conventional criteria was very low. SAP guidelines must be implemented appropriately for local bacteriological epidemiology.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422318","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 : 2024-09-23DOI: 10.1016/j.infpip.2024.100399
Background
Paediatric acute bronchiolitis normally occurs from October to April in the temperate northern hemisphere, peaking in January. Nonpharmacological measures to control the spread of COVID-19 resulted in a decrease in the number of cases of bronchiolitis during the 2020–21 season. The discontinuation of these measures created an uncertain scenario.
Aim
To describe the epidemiological evolution of acute bronchiolitis seasons and the changes in the demographics of the affected population before, during, and after the implementation of nonpharmacological interventions for COVID-19 in Spain.
Methods
This was a multicentre and descriptive study. A total of 6,334 infants aged up to 12 months who were diagnosed with acute bronchiolitis were recruited from sixteen Spanish hospitals. We collected data from participants from September 1st, 2021, through August 31st, 2023, as part of the ECEALHBA research project. The study periods were before (P1), during (P2), and after (P3) the COVID-19 pandemic.
Findings
In P2 and after the discontinuation of nonpharmacological interventions, an unexpected increase in the number of acute bronchiolitis cases was observed from June–August 2021, resulting in an out-of-season peak. A subsequent peak was observed in November 2021, earlier than expected for the 2021-22 season. In the 2022-23 season, admissions followed a historical trend, with a greater number of cases than in the two previous seasons. Statistically significant differences in the length of stay (p<0.001), number of RSV infections (p=0.021), and number of paediatric intensive care unit admissions (p<0.001) were observed among the periods.
Conclusions
Two out-of-season peaks in the number of acute bronchiolitis cases were observed in 2020–2021 and 2021–2022. However, following the relaxation of nonpharmacological intervention measures, the peak observed in 2022–2023, although occurring 2–6 weeks earlier, was more similar to the peaks observed in the prepandemic seasons. Additionally, increased case severity was observed during these periods.
{"title":"Changes in entire acute bronchiolitis seasons before, during, and after the COVID-19 pandemic in Spain","authors":"","doi":"10.1016/j.infpip.2024.100399","DOIUrl":"10.1016/j.infpip.2024.100399","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric acute bronchiolitis normally occurs from October to April in the temperate northern hemisphere, peaking in January. Nonpharmacological measures to control the spread of COVID-19 resulted in a decrease in the number of cases of bronchiolitis during the 2020–21 season. The discontinuation of these measures created an uncertain scenario.</div></div><div><h3>Aim</h3><div>To describe the epidemiological evolution of acute bronchiolitis seasons and the changes in the demographics of the affected population before, during, and after the implementation of nonpharmacological interventions for COVID-19 in Spain.</div></div><div><h3>Methods</h3><div>This was a multicentre and descriptive study. A total of 6,334 infants aged up to 12 months who were diagnosed with acute bronchiolitis were recruited from sixteen Spanish hospitals. We collected data from participants from September 1st, 2021, through August 31st, 2023, as part of the ECEALHBA research project. The study periods were before (P1), during (P2), and after (P3) the COVID-19 pandemic.</div></div><div><h3>Findings</h3><div>In P2 and after the discontinuation of nonpharmacological interventions, an unexpected increase in the number of acute bronchiolitis cases was observed from June–August 2021, resulting in an out-of-season peak. A subsequent peak was observed in November 2021, earlier than expected for the 2021-22 season. In the 2022-23 season, admissions followed a historical trend, with a greater number of cases than in the two previous seasons. Statistically significant differences in the length of stay (p<0.001), number of RSV infections (p=0.021), and number of paediatric intensive care unit admissions (p<0.001) were observed among the periods.</div></div><div><h3>Conclusions</h3><div>Two out-of-season peaks in the number of acute bronchiolitis cases were observed in 2020–2021 and 2021–2022. However, following the relaxation of nonpharmacological intervention measures, the peak observed in 2022–2023, although occurring 2–6 weeks earlier, was more similar to the peaks observed in the prepandemic seasons. Additionally, increased case severity was observed during these periods.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422317","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 : 2024-09-23DOI: 10.1016/j.infpip.2024.100402
Background
The incidence of nosocomial meningitis, and utility of lumbar puncture, is unclear in hospitalized patients without preceding neurosurgery or head trauma.
Aim
We planned for a systematic review and meta-analysis to evaluate accuracy of clinical features and diagnostic utility of lumbar puncture in nosocomial meningitis.
Methods
We searched MEDLINE, MEDLINE In-Process/ePubs, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science from inception until June 5, 2024. We included studies evaluating utility of clinical features, or lumbar puncture, to rule out nosocomial meningitis in patients without preceding neurosurgery or head trauma. We excluded studies examining community acquired meningitis, outbreaks, HIV positive individuals, and case reports. Outcomes included incidence, risk factors and diagnostic accuracy of clinical features for nosocomial meningitis, and lumbar puncture complications. Given few included studies and heterogeneity, we could only summarize incidence of nosocomial meningitis.
Findings
Of 13,302 citations, we reviewed 197 manuscripts and included 6. There were 23 of 333 (6.9%, very low certainty) positive lumbar punctures among individuals who underwent lumbar puncture to rule out nosocomial meningitis.
Conclusions
There were insufficient data to evaluate the diagnostic accuracy of lumbar puncture in nosocomial meningitis in patients without preceding neurosurgery or head trauma. Very low certainty evidence indicates the incidence of nosocomial meningitis is low in this population. Given complications and costs associated with lumbar puncture, future studies should evaluate its utility in nosocomial meningitis. In the meantime, it may be reasonable to reserve lumbar puncture to instances of high suspicion.
背景在没有接受过神经外科手术或头部外伤的住院患者中，院内脑膜炎的发病率和腰椎穿刺的效用尚不明确。目的我们计划进行一项系统综述和荟萃分析，以评估临床特征的准确性和腰椎穿刺在院内脑膜炎中的诊断效用。方法我们检索了从开始到 2024 年 6 月 5 日的 MEDLINE、MEDLINE In-Process/ePubs、EMBASE、Cochrane Central Register of Controlled Trials、Cochrane Database of Systematic Reviews 和 Web of Science。我们纳入的研究评估了临床特征或腰椎穿刺对排除未接受过神经外科手术或头部外伤患者的鼻源性脑膜炎的效用。我们排除了对社区获得性脑膜炎、疫情爆发、HIV 阳性个体以及病例报告进行研究的结果。研究结果包括鼻疽性脑膜炎的发病率、风险因素、临床特征诊断的准确性以及腰椎穿刺并发症。由于纳入的研究较少且存在异质性，我们只能总结出鼻疽性脑膜炎的发病率。研究结果在 13,302 篇引文中，我们审阅了 197 篇手稿，纳入了 6 篇。结论没有足够的数据评估腰椎穿刺对既往未接受过神经外科手术或头部外伤的患者患上院内脑膜炎的诊断准确性。确定性极低的证据表明，这类人群的鼻腔脑膜炎发病率较低。考虑到腰椎穿刺的并发症和成本，未来的研究应评估其在非病原性脑膜炎中的作用。同时，在高度怀疑的情况下保留腰椎穿刺可能是合理的。
{"title":"Nosocomial meningitis diagnostic test characteristics: a systematic review","authors":"","doi":"10.1016/j.infpip.2024.100402","DOIUrl":"10.1016/j.infpip.2024.100402","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of nosocomial meningitis, and utility of lumbar puncture, is unclear in hospitalized patients without preceding neurosurgery or head trauma.</div></div><div><h3>Aim</h3><div>We planned for a systematic review and meta-analysis to evaluate accuracy of clinical features and diagnostic utility of lumbar puncture in nosocomial meningitis.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, MEDLINE In-Process/ePubs, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science from inception until June 5, 2024. We included studies evaluating utility of clinical features, or lumbar puncture, to rule out nosocomial meningitis in patients without preceding neurosurgery or head trauma. We excluded studies examining community acquired meningitis, outbreaks, HIV positive individuals, and case reports. Outcomes included incidence, risk factors and diagnostic accuracy of clinical features for nosocomial meningitis, and lumbar puncture complications. Given few included studies and heterogeneity, we could only summarize incidence of nosocomial meningitis.</div></div><div><h3>Findings</h3><div>Of 13,302 citations, we reviewed 197 manuscripts and included 6. There were 23 of 333 (6.9%, very low certainty) positive lumbar punctures among individuals who underwent lumbar puncture to rule out nosocomial meningitis.</div></div><div><h3>Conclusions</h3><div>There were insufficient data to evaluate the diagnostic accuracy of lumbar puncture in nosocomial meningitis in patients without preceding neurosurgery or head trauma. Very low certainty evidence indicates the incidence of nosocomial meningitis is low in this population. Given complications and costs associated with lumbar puncture, future studies should evaluate its utility in nosocomial meningitis. In the meantime, it may be reasonable to reserve lumbar puncture to instances of high suspicion.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422316","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 : 2024-09-23DOI: 10.1016/j.infpip.2024.100397
Background
Water, sanitation and hygiene (WASH) and infection prevention and control (IPC) are compromised during emergencies and in the post-conflict period. The IPC-WASH status of primary healthcare facilities in Tigray, Ethiopia, is not known. The aim of the study was to assess the IPC-WASH status of facilities in war-torn Tigray, Ethiopia.
Methods
As part of a cross-sectional study, data were collected from January to February 2024 in 32 randomly selected primary healthcare facilities using an electronic Open Data Kit (ODK) based on a questionnaire. A descriptive analysis was conducted to describe the IPC-WASH services. The analyzed data were compared with the Joint Monitoring Program (JMP) service ladders and presented in texts, figures and tables.
Results
Nearly seven out of ten primary healthcare facilities had improved water sources, nine out of ten had latrines with limited sanitation facilities, and four out of ten had handwashing facilities. Eight out of ten facilities had no access to personal protective equipment, and most facilities surveyed had very limited waste management services, IPC capacity building and IPC committee. According to JMP service ladders, almost one in four primary healthcare facilities had basic water supply, one in ten had basic sanitation, basic hygiene and basic waste disposal.
Conclusions
The overall result of the study shows that access to IPC-WASH is low in primary healthcare facilities in war-torn Tigray, Ethiopia. Collaborative efforts to improve access to basic IPC-WASH facilities and IPC capacity building are essential to improve the quality of care.
{"title":"Water, sanitation, hygiene, and waste management in primary healthcare facilities in war-torn Tigray, Ethiopia: implications for infection prevention and control","authors":"","doi":"10.1016/j.infpip.2024.100397","DOIUrl":"10.1016/j.infpip.2024.100397","url":null,"abstract":"<div><h3>Background</h3><div>Water, sanitation and hygiene (WASH) and infection prevention and control (IPC) are compromised during emergencies and in the post-conflict period. The IPC-WASH status of primary healthcare facilities in Tigray, Ethiopia, is not known. The aim of the study was to assess the IPC-WASH status of facilities in war-torn Tigray, Ethiopia.</div></div><div><h3>Methods</h3><div>As part of a cross-sectional study, data were collected from January to February 2024 in 32 randomly selected primary healthcare facilities using an electronic Open Data Kit (ODK) based on a questionnaire. A descriptive analysis was conducted to describe the IPC-WASH services. The analyzed data were compared with the Joint Monitoring Program (JMP) service ladders and presented in texts, figures and tables.</div></div><div><h3>Results</h3><div>Nearly seven out of ten primary healthcare facilities had improved water sources, nine out of ten had latrines with limited sanitation facilities, and four out of ten had handwashing facilities. Eight out of ten facilities had no access to personal protective equipment, and most facilities surveyed had very limited waste management services, IPC capacity building and IPC committee. According to JMP service ladders, almost one in four primary healthcare facilities had basic water supply, one in ten had basic sanitation, basic hygiene and basic waste disposal.</div></div><div><h3>Conclusions</h3><div>The overall result of the study shows that access to IPC-WASH is low in primary healthcare facilities in war-torn Tigray, Ethiopia. Collaborative efforts to improve access to basic IPC-WASH facilities and IPC capacity building are essential to improve the quality of care.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422544","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 : 2024-09-21DOI: 10.1016/j.infpip.2024.100404
Background
Tuberculosis (TB) is associated with significant morbidity and mortality, causing significant health challenges globally. Meanwhile, Indonesia ranks second worldwide in terms of TB prevalence, with East Java being among the most affected provinces. Surabaya, in particular, a major city reported approximately 4.628 cases in 2021, underscoring the urgent need to prevent transmission through behavior of patients. Therefore, this study aimed to analyze determinants of transmission behavior among TB patients in Surabaya, Indonesia.
Methods
The methodology used in this study was a cross-sectional design and the participants were 144 TB patients at three community health centers in Surabaya, selected using simple random sampling. Variables including knowledge level, supportive behavior, and medication adherence were analyzed and data collection was carried out using a structured questionnaire. Additionally, data analysis was performed with statistical methods to determine the significance of variables.
Results
The results showed that knowledge (P-value = <0.001), supportive behavior (P-value = 0.001), and medication adherence (P-value = 0.004) had a significant effect on transmission prevention behavior among TB patients.
Conclusion
Based on our results, it was concluded that higher knowledge level, supportive behavior, and medication adherence had a significant correlation with increased social support provided by patients in preventing and controlling TB transmission. Therefore, there is a need to implement targeted programs to enhance prevention behavior.
{"title":"Determinants of transmission prevention behavior among Tuberculosis patients in Surabaya, Indonesia","authors":"","doi":"10.1016/j.infpip.2024.100404","DOIUrl":"10.1016/j.infpip.2024.100404","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) is associated with significant morbidity and mortality, causing significant health challenges globally. Meanwhile, Indonesia ranks second worldwide in terms of TB prevalence, with East Java being among the most affected provinces. Surabaya, in particular, a major city reported approximately 4.628 cases in 2021, underscoring the urgent need to prevent transmission through behavior of patients. Therefore, this study aimed to analyze determinants of transmission behavior among TB patients in Surabaya, Indonesia.</div></div><div><h3>Methods</h3><div>The methodology used in this study was a cross-sectional design and the participants were 144 TB patients at three community health centers in Surabaya, selected using simple random sampling. Variables including knowledge level, supportive behavior, and medication adherence were analyzed and data collection was carried out using a structured questionnaire. Additionally, data analysis was performed with statistical methods to determine the significance of variables.</div></div><div><h3>Results</h3><div>The results showed that knowledge (<em>P</em>-value = <0.001), supportive behavior (<em>P</em>-value = 0.001), and medication adherence (<em>P</em>-value = 0.004) had a significant effect on transmission prevention behavior among TB patients.</div></div><div><h3>Conclusion</h3><div>Based on our results, it was concluded that higher knowledge level, supportive behavior, and medication adherence had a significant correlation with increased social support provided by patients in preventing and controlling TB transmission. Therefore, there is a need to implement targeted programs to enhance prevention behavior.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422314","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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