Infection Prevention in Practice最新文献_第2页

Methicillin and vancomycin-resistant Staphylococcus aureus and associated risk factors among patients with wound infection in East Wallaga Zone, Western Ethiopia 埃塞俄比亚西部东瓦拉加区伤口感染患者中的耐甲氧西林和耐万古霉素金黄色葡萄球菌及相关风险因素

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-10-24 DOI: 10.1016/j.infpip.2024.100409

Milkias Abebe , Getachew Alemkere , Gizachew Ayele

Background

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.

背景近年来，耐甲氧西林和耐万古霉素金黄色葡萄球菌的问题日益严重。这可能与滥用这种抗生素有关。本研究旨在确定埃塞俄比亚西部东瓦拉加区伤口感染患者中耐甲氧西林和耐万古霉素金黄色葡萄球菌（VRSA）的流行率及相关风险因素。方法对在内克姆特专科医院就医的 384 名伤口感染（包括手术伤口）患者进行了医院横断面前瞻性研究。采用无菌技术采集伤口样本，并在血琼脂和甘露醇盐琼脂上进行培养。万古霉素 E 试验和头孢西丁（30 μg）抗生素盘扩散试验分别用于检测 MRSA 和 VRSA。数据采用 SPSS 23 版进行分析，P 值小于 0.05 为具有统计学意义。其中，40.4%（44/109）被鉴定为 MRSA，7.3%（8/109）为 VRSA。32株（72.7%）MRSA分离物显示出多重耐药性。伤口深度、患者环境、伤口感染史和抗生素使用史与 MRSA 伤口感染率显著相关。因此，实施有效的感染预防和控制措施以防止抗菌药耐药性的传播至关重要。

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引用次数: 0

Asymptomatic bacteriuria and urinary tract infection in geriatric inpatients after indwelling urinary catheter removal: a descriptive two-centre study 老年住院病人拔除留置导尿管后的无症状菌尿和尿路感染：一项描述性双中心研究

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-10-24 DOI: 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).

背景在老年护理中，留置导尿管（IUC）的患者很常见。导尿会增加无症状菌尿（ASB）和尿路感染（UTI）的风险。关于 IUC 拔除后 ASB 的发生率的研究很少。本研究旨在比较有导尿史和无导尿史的老年患者ASB和UTI的发生率，并探讨与ASB相关的因素。收集了有关导尿史、抗生素治疗和糖尿病的数据。对尿液样本进行了分析。住院期间发生的尿路感染通过患者记录进行确认。与过去四周内未使用 IUC 的患者（19/92，20.6%，P=0.018）相比，有导尿史的患者（38/104，36.5%）更容易出现无症状菌尿（19/92，20.6%，P=0.018）。有导管插入史的患者更常发现肠球菌。在 124 名可能接受随访的患者中，住院期间发现了 5 例尿路感染病例。在对混杂因素进行调整后，导管插入与 ASB 有显著相关性（OR 2.79，CI 1.31-5.91，P=0.008）。试验注册该研究已在 clinicaltrials.gov 注册，识别号为 NCT05039203 (09/09/2021).

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引用次数: 0

Assessing the state of infection prevention and control in cameroon: a cross-sectional workshop evaluation using socioecological models 评估喀麦隆的感染预防和控制状况：利用社会生态模型进行跨部门讲习班评估

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-10-24 DOI: 10.1016/j.infpip.2024.100408

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

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.

感染预防与控制（IPC）有助于减少医疗相关感染。尽管全球都在关注现有的指南和工具，但中低收入国家（LMICs）仍在努力实施有效的 IPC 计划。在此，我们采用社会生态学的方法总结了最近在喀麦隆举办的关于实施 IPC 活动的研讨会的结果。研究设计我们对喀麦隆的 IPC 评估进行了横断面研究。编写了研讨会讨论和建议的详细摘要。在世界卫生组织 IPC 核心内容的指导下，对数据进行了主题分组。采用布朗芬布伦纳（Bronfenbrenner）、麦克勒罗伊（McLeroy）的社会生态模型以及格罗尔（Grol）和温辛格（Wensing）关于在医疗机构成功实施实践的理论对结果进行了分析。结果喀麦隆尚未制定有效的 IPC 计划，但已在指南层面、个人层面、组织层面和政治层面发展了世界卫生组织（WHO）IPC 核心组成部分的某些领域。当前分析得出的证据应有助于改进政策和战略，从而在喀麦隆和其他低收入和中等收入国家实施有效的 IPC 计划。

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引用次数: 0

Analysis of COVID-19 nosocomial clusters in an Omicron strain epidemic: importance of patient education on infection control measures 分析 Omicron 菌株流行中的 COVID-19 医院内群集：对患者进行感染控制措施教育的重要性

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-10-24 DOI: 10.1016/j.infpip.2024.100410

Tomonori Takano , Yoshiko Nakatani , Akihiro Nagai , Natsuki Izumoto , Yuta Ono , Atsushi Inoue , Hiromu Takemura , Hiroyuki Kunishima

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.

在 Omicron 病毒株流行期间，对 129 名冠状病毒病 2019（COVID-19）院内感染患者进行了分析。结果发现，Omicron株鼻腔感染的潜伏期为3天。在这些病例群中，每个病房中第一个感染 COVID-19 （FCP）的病人的传播途径是一个关键因素。医护人员传染给患者的病例很少，而且大多数 FCP 患者在日常生活中保持着较高的活动水平。FCP 中的主要院内感染途径可能是探视病人或病人之间的直接交谈。因此，可以通过教育病人采取感染控制措施（如正确佩戴口罩和保持手部卫生）来减少医院群感染。

引用次数: 0

‘The Law of Unintended Consequences’ – Staphylococcus aureus bloodstream infection complicating peripheral intravascular cannulation in an epilepsy monitoring unit 意外后果法则"--癫痫监护病房外周血管内插管并发金黄色葡萄球菌血流感染

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-10-24 DOI: 10.1016/j.infpip.2024.100412

Niamh Reidy , Julian Larkin , Peter Widdess-Walsh , Karen Burns

引用次数: 0

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 通过全基因组测序及早发现耐甲氧西林金黄色葡萄球菌，成功控制国家烧伤科爆发潘通-瓦伦丁白细胞介素阳性耐甲氧西林金黄色葡萄球菌疫情

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-09-24 DOI: 10.1016/j.infpip.2024.100400

R. Traynor , G.I. Brennan , T. Hoban , A.M. Dolan , B. Boyle , B. O’ Connell , O. Shelley , T.K. Teoh

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.

我们报告了 2022 年爱尔兰国家烧伤科爆发的 PVL 产 MRSA疫情，涉及 7 名患者、2 名工作人员和 2 份阳性环境样本。我们采取了一系列措施，包括员工筛查、环境筛查和加强清洁，成功控制了疫情。实时全基因组测序 (WGS) 的使用可快速识别相关性并快速应对疫情。我们分享了控制疫情的成功方法。

引用次数: 0

Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022 从葡萄牙重症监护室采集的念珠菌菌种的易感性模式：2020-2022 年前瞻性研究

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-09-24 DOI: 10.1016/j.infpip.2024.100403

Teresa Nascimento , João Inácio , Daniela Guerreiro , Priscila Diaz , Patrícia Patrício , Luís Proença , Cristina Toscano , Helena Barroso

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":"Teresa Nascimento , João Inácio , Daniela Guerreiro , Priscila Diaz , Patrícia Patrício , Luís Proença , Cristina Toscano , Helena Barroso","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":"6 4","pages":"Article 100403"},"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}

引用次数: 0

Knowledge, attitudes and practices on prevention and control of high-consequence infectious diseases and critical care among intensive care personnel in Rwanda: a cross-sectional survey 卢旺达重症监护人员对高危传染病防控和重症监护的认识、态度和做法：横断面调查

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-09-23 DOI: 10.1016/j.infpip.2024.100398

L. Schneider , M. Umutoni , V. Ndagijimana , M. Abdelrhman , T. Cronen , M. Nkeshimana , P. Banguti , C. Karamira , E. Seruyange , T. Piening , A. Phuti , T. Paerisch , F. Mockenhaupt , C. Mambo Muvunyi , M. Gertler , E. Rwagasore

Introduction

Intensive care personnel in countries prone to outbreaks of high-consequence infectious diseases (HCIDs), such as Ebola virus disease, stand at the forefront of caring for affected patients. This study describes the knowledge, attitudes and practices (KAP) of intensive care personnel in Rwanda on the management and infection prevention and control (IPC) of HCIDs.

Methods

A cross-sectional survey was carried out among staff working in the 4 operational intensive care units in September 2022. The self-administered questionnaire collected information on participants' background and their KAP on critical care (CC), HCIDs and IPC.

Results

Of the 107 participants, 67 (62.6%) had less than 4 years' work experience in CC. 41 (38.3%) of them had attended trainings on IPC since 2020. In univariate analyses, a higher knowledge score was associated with being a physician, years of working in CC and differed by hospital. A large proportion perceived their knowledge on CC as good or very good (58.0%) and their everyday risk of acquiring an infection as at least high (48.6%). Overall, 72.9% reported compliance with hand hygiene measures. However, around a quarter of participants reported rarely or never avoiding recapping of needles or never or rarely taking additional precautions during aerosol-generating procedures.

Conclusions

Staff had a moderate knowledge base and might benefit from continuous learning on CC and HCIDs. The perception of high risk of infection at work stands in contrast with lack of compliance with basic IPC practices which should be reinforced to avoid preventable and potentially fatal infections.

引言在埃博拉病毒病等高致病性传染病（HCID）容易爆发的国家，重症监护人员站在护理受影响病人的最前沿。本研究描述了卢旺达重症监护人员对 HCIDs 的管理和感染预防与控制 (IPC) 的知识、态度和实践 (KAP)。方法：2022 年 9 月，对在 4 个运行中的重症监护病房工作的人员进行了横断面调查。结果在 107 名参与者中，67 人（62.6%）拥有少于 4 年的重症监护工作经验。其中 41 人（38.3%）自 2020 年以来参加过 IPC 培训。在单变量分析中，较高的知识得分与医生身份、在社区卫生中心的工作年限有关，并因医院而异。很大一部分人认为他们对 CC 的了解程度为良好或非常好（58.0%），而他们日常感染的风险至少为高（48.6%）。总体而言，72.9%的参与者表示遵守了手部卫生措施。然而，约四分之一的参与者表示很少或从未避免重新盖针，或从未或很少在产生气溶胶的程序中采取额外的预防措施。他们认为工作场所感染的风险很高，但却不遵守基本的 IPC 操作规范，而这些规范应得到加强，以避免可预防的、可能致命的感染。

{"title":"Knowledge, attitudes and practices on prevention and control of high-consequence infectious diseases and critical care among intensive care personnel in Rwanda: a cross-sectional survey","authors":"L. Schneider , M. Umutoni , V. Ndagijimana , M. Abdelrhman , T. Cronen , M. Nkeshimana , P. Banguti , C. Karamira , E. Seruyange , T. Piening , A. Phuti , T. Paerisch , F. Mockenhaupt , C. Mambo Muvunyi , M. Gertler , E. Rwagasore","doi":"10.1016/j.infpip.2024.100398","DOIUrl":"10.1016/j.infpip.2024.100398","url":null,"abstract":"<div><h3>Introduction</h3><div>Intensive care personnel in countries prone to outbreaks of high-consequence infectious diseases (HCIDs), such as Ebola virus disease, stand at the forefront of caring for affected patients. This study describes the knowledge, attitudes and practices (KAP) of intensive care personnel in Rwanda on the management and infection prevention and control (IPC) of HCIDs.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was carried out among staff working in the 4 operational intensive care units in September 2022. The self-administered questionnaire collected information on participants' background and their KAP on critical care (CC), HCIDs and IPC.</div></div><div><h3>Results</h3><div>Of the 107 participants, 67 (62.6%) had less than 4 years' work experience in CC. 41 (38.3%) of them had attended trainings on IPC since 2020. In univariate analyses, a higher knowledge score was associated with being a physician, years of working in CC and differed by hospital. A large proportion perceived their knowledge on CC as good or very good (58.0%) and their everyday risk of acquiring an infection as at least high (48.6%). Overall, 72.9% reported compliance with hand hygiene measures. However, around a quarter of participants reported rarely or never avoiding recapping of needles or never or rarely taking additional precautions during aerosol-generating procedures.</div></div><div><h3>Conclusions</h3><div>Staff had a moderate knowledge base and might benefit from continuous learning on CC and HCIDs. The perception of high risk of infection at work stands in contrast with lack of compliance with basic IPC practices which should be reinforced to avoid preventable and potentially fatal infections.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100398"},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653446","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}

引用次数: 0

Antibiotic prophylaxis practice in gastrointestinal surgery in five hospitals in southern Benin 贝宁南部五家医院胃肠道手术中的抗生素预防措施

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-09-23 DOI: 10.1016/j.infpip.2024.100405

Dessièdé Ariane Fiogbe , Angèle Modupè Dohou , Carine Laurence Yehouenou , Séverine Henrard , Françoise Van Bambeke , Francis Moïse Djidénou Dossou , Olivia Dalleur

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.

背景贝宁医疗系统的特点是缺乏手术抗生素预防（SAP）的地方指南，而这对于预防手术部位感染至关重要。在四个月的时间内，采用五项常规标准（适应症、抗生素选择、剂量、给药时间和持续时间）对接受 Altemeier 1 级或 2 级手术的患者进行 SAP 评估。参考了三份指南：在 68 例手术干预中，符合世界卫生组织（WHO）、美国卫生系统药剂师协会（ASHP）和法国麻醉与重症监护医学会（SFAR）标准的病例分别为 0 例（0.0%）、1 例（1.5%）和 2 例（2.9%）。不同指南对适应症的遵守情况各不相同：65例（95.6%）符合WHO和ASHP标准，47例（69.11%）符合SFAR标准。在符合要求的病例中，很少根据指南选择抗生素：符合 WHO 和 ASHP 标准的病例分别为 2 例（2.9%）和 2 例（2.9%），符合 SFAR 标准的病例为 3 例（4.4%）。遵守药物剂量规定的情况从 20 例（29.4%）（SFAR）到 49 例（72.0%）（ASHP）不等。47例（69.1%；WHO）、45例（66.2%；ASHP）和9例（13.2%；SFAR）遵守了用药时间。符合抗生素预防期限的病例数分别为 13 例（19.1%；WHO）、17 例（25.0%；ASHP）和 16 例（23.5%；SFAR）。必须根据当地的细菌流行病学情况适当执行 SAP 指南。

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引用次数: 0

Nosocomial meningitis diagnostic test characteristics: a systematic review 非典型脑膜炎诊断测试的特点：系统综述

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2024-09-23 DOI: 10.1016/j.infpip.2024.100402

David Granton , Joseph Brown , Shannon M. Fernando , Dipayan Chaudhuri , Isaac I. Bogoch , Christine Soong , Marina Englesakis , Bram Rochwerg , Eddy Fan

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。

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引用次数: 0