Infection Prevention in Practice最新文献_第6页

CO2 concentration testing as a quick estimate of natural ventilation effectiveness in primary healthcare: experience in war-affected, resource-limited settings 二氧化碳浓度测试作为初级卫生保健自然通风有效性的快速估计：在受战争影响、资源有限的环境中的经验

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-02-04 DOI: 10.1016/j.infpip.2025.100448

M. Dolynska , A. Aleksandrin , O. Vlasenko , S. Gorischak , G. Dolynskyi , A. Vodianyk

Ventilation remains an important component of infection prevention and control programmes. Natural ventilation, as the most affordable measure to control airborne transmission of pathogens, is a crucial area of focus. However, applying natural ventilation encounters challenges in routine practice, especially in emergencies. This study, which aimed to review the most efficient natural ventilation regimen, was performed in Autumn 2023 in two heavily war-affected primary care facilities in Ukraine. The study demonstrated the operational advantage of a regimen built upon a simple approach, where personnel opened windows only after observing an increased CO₂ concentration. This solution has obvious disadvantages, being reactive rather than proactive and requiring continuous monitoring of CO₂ concentration; it turned out to be more acceptable to busy healthcare workers than regimens developed explicitly for each office, considering ventilation rate and workload. Patients' complaints about feeling cold in the offices may be a substantial obstacle to the formal use of natural ventilation. Reported results were considered an acceptable temporary compromise for initiating a natural ventilation policy. Further improvement will require personnel training and raising awareness about reasonable prevention interventions for airborne pathogens among patients.

通风仍然是感染预防和控制规划的重要组成部分。自然通风作为控制病原体空气传播最经济实惠的措施，是一个关键的重点领域。然而，在日常实践中，特别是在紧急情况下，应用自然通风遇到了挑战。这项研究旨在审查最有效的自然通风方案，于2023年秋季在乌克兰两个受战争严重影响的初级保健机构进行。该研究证明了一种建立在简单方法之上的方案的操作优势，即人员只有在观察到二氧化碳浓度增加后才打开窗户。这种解决方案有明显的缺点，是被动的而不是主动的，并且需要连续监测二氧化碳浓度；事实证明，考虑到通风率和工作量，繁忙的医护人员比为每个办公室制定明确的方案更容易接受。病人抱怨在办公室里感到寒冷，这可能是正式使用自然通风的一个重大障碍。报告的结果被认为是启动自然通风政策的可接受的临时妥协。进一步的改进将需要人员培训和提高患者对空气传播病原体的合理预防干预措施的认识。

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引用次数: 0

Effects of disposable pull-through brush types for reprocessing of flexible endoscopes in clinical environment 一次性刷刷对软性内窥镜再加工的影响

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-28 DOI: 10.1016/j.infpip.2025.100445

Remus O. Anders , Adriana M. Airo , Eve Capistran , Anita Chin , Garry Bassi , Tony Mazzulli

Evaluating the effectiveness of different brush types used during the cleaning and reprocessing of flexible endoscopes is challenging. This study compared the yield of microbial growth from endoscopes that had been used clinically before and after cleaning with different brush types (bristle, squeegee, and hybrid). Endoscopes used to perform a total of 91 medical procedures on 82 patients were included. Quantitative bacterial cultures yielded no statistical differences between the different brushes used. Colonoscopes and gastroscopes surveyed after rigorous cleaning steps resulted in a drop in colony counts between pre- and post-cleaning from 1.45E+8 (±5.21E+07) to 2.5 (±0.13) individual colonies suggesting that the overall cleaning process was effective regardless of the brush type used.

评估不同类型的刷在柔性内窥镜的清洁和再加工过程中的有效性是具有挑战性的。本研究比较了临床使用的内窥镜用不同类型的刷（刚毛刷、刮刷刷和混合刷）清洁前后的微生物生长量。对82名患者共进行91次医疗操作的内窥镜纳入研究范围。定量细菌培养在使用的不同刷子之间没有统计学差异。经过严格的清洁步骤后，结肠镜和胃镜检查结果显示，清洁前后的菌落计数从1.45E+8（±5.21E+07）下降到2.5（±0.13）个菌落，这表明无论使用哪种刷，整体清洁过程都是有效的。

引用次数: 0

Infection control Surveillance of dialysis events at outpatient hemodialysis centers in Saudi Arabia: A 3-year national data 沙特阿拉伯门诊血液透析中心透析事件监测：3年全国数据

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-25 DOI: 10.1016/j.infpip.2025.100447

Mohammed ALQahtani , Aiman El-Saed , Faisal Alsheddi , Ahlam H. Alamri , Atef M. Shibl , Khalid H. Alanazi

Background

Monitoring dialysis events is very important in evaluating the risk of infection and antimicrobial use among this group of vulnerable patients. The objective was to calculate rates of dialysis events at outpatient hemodialysis centers in Saudi Arabia.

Methods

A retrospective cohort study of dialysis events collected from 152 outpatient hemodialysis centers in 20 Saudi regions between January 2019 and December 2021. The Saudi Health Electronic System Network (HESN) was used to report data from participating centers. Dialysis events included in-unit intravenous antimicrobial start, positive blood culture, and infection (pus, redness, and swelling) at the vascular access site.

Results

A total of 125,761 patient months of surveillance were monitored. The most frequent type of dialysis event was the in-unit intravenous antimicrobial start at 0.75 per 100 patient months, followed by positive blood culture at 0.41, and finally, local access of the infection site at 0.34. The rates of dialysis events were highest, with temporary central lines at 4.36, permanent central lines at 1.87, arteriovenous graft at 0.35, and finally, arteriovenous fistula at 0.17. After adjusting for the differences in the type of vascular access, the rates of dialysis events in the Saudi HESN were lower, 54%–83%, than those of the American National Healthcare Safety Network (NHSN, P<0.001 for each) and a less extent 27%–55% lower when compared with the published results from Chinese people.

Conclusions

The current findings provide benchmarking data for different dialysis events that can promote fair comparisons and interest in dialysis event surveillance.

监测透析事件对于评估这一脆弱患者群体的感染风险和抗菌药物使用非常重要。目的是计算沙特阿拉伯门诊血液透析中心的透析事件发生率。方法对2019年1月至2021年12月期间沙特20个地区152个门诊血液透析中心的透析事件进行回顾性队列研究。沙特卫生电子系统网络（HESN）用于报告参与中心的数据。透析事件包括单位内静脉抗菌药物开始、血液培养阳性和血管通路部位感染（脓、红肿）。结果共监测125,761例患者月。最常见的透析事件类型是单位内静脉抗菌药物开始（每100个患者月0.75例），其次是血培养阳性（0.41例），最后是感染部位局部接触（0.34例）。透析事件发生率最高，临时中心线为4.36，永久中心线为1.87，动静脉移植为0.35，最后，动静脉瘘为0.17。在调整了血管通路类型的差异后，沙特HESN的透析事件发生率低于美国国家医疗安全网络（NHSN, P<0.001），低于中国公布的结果27%-55%。结论目前的研究结果为不同的透析事件提供了基准数据，可以促进公平的比较和对透析事件监测的兴趣。

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引用次数: 0

Sodium dichloroisocyanurate: a promising candidate for the disinfection of resilient drain biofilm 二氯异氰尿酸钠：弹性排水生物膜消毒的有前途的候选物

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-25 DOI: 10.1016/j.infpip.2025.100446

Abbie Martin , Natasha Doyle , Tom F. O'Mahony

Background

Biofilms are complex multicellular communities of microorganisms embedded within a protective matrix which confers resistance to various antimicrobials, including biocides. Biofilms can cause a range of human diseases and are responsible for 1.7 million hospital-acquired infections in the US annually, providing an economic burden of $11.5 billion in treatment costs. Biofilm contained within drain and plumbing systems may contain pathogenic viruses and bacteria which pose a significant risk to patient safety within healthcare environments.

Aim

The aim of this study was to determine if three hospital-grade disinfectants (sodium dichloroisocyanurate, peracetic acid and sodium hypochlorite) were capable of killing microorganisms within biofilm, and thus, determining their potential as candidates for drain biofilm disinfection.

Methods

Pseudomonas aeruginosa biofilms were cultivated using the CDC biofilm reactor, a standardised method for determining disinfectant efficacy against biofilm within the United States of America. Each disinfectant was tested using a one-minute contact time, using the highest concentration available on the product label.

Findings

The sodium dichloroisocyanurate product was successful in killing biofilm microorganisms, resulting in a log reduction of ≥ 8.70. Peracetic acid reduced biofilm by 3.82 log₁₀ units, followed by sodium hypochlorite, which produced a reduction of 3.78 log₁₀ units.

Conclusions

The use of a highly effective disinfectant with proven biofilm efficacy can help ensure patient safety and reduce infection levels. Drains and plumbing systems provide a reservoir for potential pathogens and biofilm; thus, drain disinfection is critical in reducing the instance of hospital-acquired infections. Sodium dichloroisocyanurate may provide a reliable solution for drain applications and subsequently, patient wellbeing and safety.

生物膜是嵌入在保护性基质内的复杂的多细胞微生物群落，可对包括杀菌剂在内的各种抗菌剂产生耐药性。生物膜可引起一系列人类疾病，每年在美国造成170万例医院获得性感染，造成115亿美元的治疗费用经济负担。排水和管道系统内的生物膜可能含有致病性病毒和细菌，这对医疗保健环境中的患者安全构成重大风险。目的本研究的目的是确定三种医院级消毒剂（二氯异氰尿酸钠、过氧乙酸和次氯酸钠）是否能够杀死生物膜内的微生物，从而确定它们作为排水生物膜消毒候选者的潜力。方法采用CDC生物膜反应器培养铜绿假单胞菌生物膜，CDC生物膜反应器是美国生物膜消毒效果测定的标准方法。每种消毒剂的接触时间为1分钟，使用产品标签上的最高浓度进行测试。结果：二氯异氰尿酸钠产品能成功杀灭生物膜微生物，对数降低≥8.70。过氧乙酸减少了3.82 log10单位的生物膜，次氯酸钠次氯酸钠减少了3.78 log10单位。结论使用经证实具有生物膜功效的高效消毒剂可确保患者安全，降低感染水平。排水管和管道系统为潜在的病原体和生物膜提供了一个储存库；因此，下水道消毒对于减少医院获得性感染至关重要。二氯异氰尿酸钠可以为排水应用提供可靠的解决方案，并随后，病人的健康和安全。

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引用次数: 0

Optimizing epidemic prevention in nursing homes using clinical surveillance of respiratory infections 利用呼吸道感染临床监测优化养老院的防疫工作

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-25 DOI: 10.1016/j.infpip.2025.100444

Philippe Gaspard , Martin Martinot

Background

Respiratory tract infections (RTIs) pose a significant risk in nursing homes (NHs), which makes surveillance crucial for timely intervention.

Aim

To monitor the impacts of seasonal RTIs in NHs, which include frequency, the use of rapid diagnostic tests and antibiotics, mortality, and cluster dynamics, with the use of clinical surveillance.

Methods

During the winter periods from 2015 to 2019 (22 weeks), data on general signs (GSs), and respiratory signs (RSs) were collected to define three respiratory clinical sign patterns (CSPs): GS+/RS+, GS−/RS+, and GS+/RS−. Clusters (≥2 cases) were identified and classified into three intensity levels, namely, L1, L2, and L3 (2, 3–5, and ≥6 GS+/RS+/4 days, respectively). CSP frequencies and the 28-day all-cause mortality were calculated.

Findings

In 13 NHs (N = 3,628 resident inclusions, median age: 87.2 years), 1,538 GS+/RS+, 1,482 GS−/RS+, and 233 GS+/RS− cases were observed, with mortality rates of 8.5%, 2.8%, and 6%, respectively. Among the GS+/RS+ cases, 63% received an antimicrobials. GS+/RS+ cluster analysis identified 141 clusters with L1, 100 with L2, and 26 with L3.

A total of 209 rapid diagnostic tests for influenza were carried out, with 72.2% conducted in L2 or L3 clusters. Within clusters, the first case must be identified promptly with rapid outbreak development taking place within the first 2–3 days, and potentially less effective containment efforts following delayed detection.

Conclusion

Clinical surveillance is a comprehensive method that can be utilized for the rapid implementation of preventive measures and appropriate use of antibiotics.

背景呼吸道感染（RTIs）在疗养院（NHs）中构成重大风险，这使得监测对及时干预至关重要。目的通过临床监测监测国家卫生系统中季节性呼吸道感染的影响，包括频率、快速诊断测试和抗生素的使用、死亡率和群集动态。方法在2015 - 2019年冬季（22周）收集一般体征（GSs）和呼吸体征（RSs）数据，定义3种呼吸临床体征（csp）： GS+/RS+、GS−/RS+和GS+/RS−。对≥2例病例进行分类，并将其分为L1、L2和L3 3个强度级别（分别为2、3-5和≥6 GS+/RS+/4天）。计算CSP发生率和28天全因死亡率。13例NHs （N = 3,628例居民纳入，中位年龄：87.2岁）中，观察到GS+/RS+病例1,538例，GS - /RS+病例1,482例，GS+/RS+病例233例，死亡率分别为8.5%、2.8%和6%。在GS+/RS+病例中，63%接受了抗微生物药物治疗。GS+/RS+聚类分析鉴定出L1聚集141个，L2聚集100个，L3聚集26个。总共进行了209次流感快速诊断检测，其中72.2%是在L2或L3聚集性病例中进行的。在聚集性病例中，必须迅速发现第一例病例，在最初2-3天内迅速爆发疫情，并在发现延迟后采取可能不那么有效的遏制措施。结论临床监测是一种综合性的方法，可快速实施预防措施，合理使用抗生素。

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引用次数: 0

Intrahospital dissemination of multidrug-resistant Acinetobacter baumannii at a teaching hospital in Northeast of Mexico 墨西哥东北部某教学医院耐多药鲍曼不动杆菌的院内传播

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-25 DOI: 10.1016/j.infpip.2025.100443

Samantha Villarreal-Cruz , Adrián Camacho-Ortiz , Samantha Flores-Treviño , Licet Villarreal-Treviño , Paola Bocanegra-Ibarias

Background

Acinetobacter baumannii is an opportunistic drug-resistant Gram-negative coccobacillus associated with nosocomial infections, representing a worldwide public health problem.

Aim

The aim of this study was to analyse the dissemination of A. baumannii in two hospital buildings in Mexico through phenotypic and genotypic characterization of clinical isolates obtained for three years.

Methods

Clinical strains were collected from two buildings in a tertiary-care hospital in Monterrey, Mexico. After species identification by MALDI-TOF MS and PCR, antimicrobial susceptibility was determined by disk diffusion and microdilution methods, carbapenemase-encoding genes (OXA-23, -24, -51, and -58) were searched, and clonal diversity was analysed by PFGE and MLST.

Findings

Among 204 specimens, 87.3% and 50.5% of the isolates were classified as multidrug-resistant (MDR) and difficult-to-treat-resistant (DTR), respectively. The OXA-24 gene was detected in 95% of the isolates. Most isolates (n=181) were grouped into 15 clones, four which predominated and disseminated after five months. Among ST detected (ST1694, ST758, ST124, and ST490), ST124, which belongs to the high-risk CC636 clonal complex, is reported for the first time in Mexico.

Conclusions

Long-term persistence and dissemination of A. baumannii clones were observed in specific hospital wards from two buildings in a tertiary-care hospital in Mexico. High antimicrobial resistance, such as MDR and DTR, were observed in this hospital. DTR surveillance and early recognition of MDR A. baumannii clones should be performed routinely to prevent their dissemination.

鲍曼不动杆菌是一种与医院感染相关的机会性耐药革兰氏阴性球菌，是一个全球性的公共卫生问题。目的通过对三年来获得的临床分离株进行表型和基因型分析，分析鲍曼不动杆菌在墨西哥两所医院的传播情况。方法从墨西哥蒙特雷某三级医院的两栋楼采集临床菌株。采用MALDI-TOF MS和PCR鉴定菌种，采用纸片扩散法和微量稀释法测定药敏，筛选碳青霉烯酶编码基因OXA-23、-24、-51和-58，采用PFGE和MLST分析克隆多样性。结果204份标本中，87.3%为耐多药（MDR）， 50.5%为难治耐药（DTR）。95%的分离株检测到OXA-24基因。多数分离株（n=181）分为15个无性系，其中4个无性系在5个月后占优势并播散。在检测到的ST （ST1694、ST758、ST124、ST490）中，ST124属于高危的CC636克隆复合体，在墨西哥首次报道。结论在墨西哥一家三级医院的两座建筑物的特定病房中观察到鲍曼不稳定杆菌的长期存在和传播。该院观察到耐多药、DTR等高抗菌药物耐药性。应常规进行DTR监测和早期识别耐多药鲍曼杆菌克隆，以防止其传播。

{"title":"Intrahospital dissemination of multidrug-resistant Acinetobacter baumannii at a teaching hospital in Northeast of Mexico","authors":"Samantha Villarreal-Cruz , Adrián Camacho-Ortiz , Samantha Flores-Treviño , Licet Villarreal-Treviño , Paola Bocanegra-Ibarias","doi":"10.1016/j.infpip.2025.100443","DOIUrl":"10.1016/j.infpip.2025.100443","url":null,"abstract":"<div><h3>Background</h3><div><em>Acinetobacter baumannii</em> is an opportunistic drug-resistant Gram-negative coccobacillus associated with nosocomial infections, representing a worldwide public health problem.</div></div><div><h3>Aim</h3><div>The aim of this study was to analyse the dissemination of <em>A. baumannii</em> in two hospital buildings in Mexico through phenotypic and genotypic characterization of clinical isolates obtained for three years.</div></div><div><h3>Methods</h3><div>Clinical strains were collected from two buildings in a tertiary-care hospital in Monterrey, Mexico. After species identification by MALDI-TOF MS and PCR, antimicrobial susceptibility was determined by disk diffusion and microdilution methods, carbapenemase-encoding genes (OXA-23, -24, -51, and -58) were searched, and clonal diversity was analysed by PFGE and MLST.</div></div><div><h3>Findings</h3><div>Among 204 specimens, 87.3% and 50.5% of the isolates were classified as multidrug-resistant (MDR) and difficult-to-treat-resistant (DTR), respectively. The OXA-24 gene was detected in 95% of the isolates. Most isolates (n=181) were grouped into 15 clones, four which predominated and disseminated after five months. Among ST detected (ST1694, ST758, ST124, and ST490), ST124, which belongs to the high-risk CC636 clonal complex, is reported for the first time in Mexico.</div></div><div><h3>Conclusions</h3><div>Long-term persistence and dissemination of <em>A. baumannii</em> clones were observed in specific hospital wards from two buildings in a tertiary-care hospital in Mexico. High antimicrobial resistance, such as MDR and DTR, were observed in this hospital. DTR surveillance and early recognition of MDR <em>A. baumannii</em> clones should be performed routinely to prevent their dissemination.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100443"},"PeriodicalIF":1.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372664","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

Determinants of non-compliance with hand hygiene using a covert direct observation methodology 不遵守手卫生的决定因素使用隐蔽的直接观察方法

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-25 DOI: 10.1016/j.infpip.2025.100442

Majid M. Alshamrani , Aiman El-Saed , Fatmah Othman , Mohammed Al Zunitan , Seema Noushad , Ayham Albadawi , Eman Alghamdi , Saad Almohrij

Background

The Hawthorne effect may result in an overestimation of hand hygiene (HH) compliance during routine observations, which may weaken the significance of factors associated with non-compliance. The aim of this study was to examine professional and healthcare determinants of HH non-compliance using covert observation.

Methods

A cross-sectional study design was conducted among healthcare workers (HCWs) at a tertiary care hospital in Saudi Arabia. HH observations were conducted discreetly by trained observers, followed by a questionnaire and an audit to identify possible determinants of HH non-compliance. HH non-compliance was assessed according to the World Health Organisation's (WHO) five-moments for HH, while inappropriate compliance was evaluated by additionally considering incorrect HH technique.

Results

A total of 6580 HH opportunities were observed by 502 HCWs. The overall non-compliance rate was 54.1% with inappropriate compliance at 71.1%. Significant factors associated (P<0.05) with non-compliance included lack of HH education/training, lack of job promotion, working in the emergency department, lack of HH auditing, absence of pocket-sized alcohol-based handrub (ABHR) bottles, inconveniently placed hand washing sinks and ABHR wall dispensers, infrequent replacement of empty ABHR wall dispensers, and lack of nearby promoting posters. With few exceptions, the determinants of HH inappropriate compliance were similar to those of HH non-compliance, when objectively audited by the researcher.

Conclusions

The findings underscore the importance of HH training and supportive healthcare infrastructures. These insights may assist decision-makers in identifying specific work environment factors that could improve HH compliance through appropriate interventions. Further research is required to evaluate the impact of these suggested modifications on HH compliance.

霍桑效应可能会导致在常规观察中对手部卫生（HH）依从性的高估，这可能会削弱与不依从性相关因素的重要性。本研究的目的是通过隐蔽观察来检查HH不遵守的专业和医疗保健决定因素。方法采用横断面研究设计，对沙特阿拉伯一家三级医院的医护人员进行调查。HH观察是由训练有素的观察员谨慎地进行的，随后是问卷调查和审计，以确定HH不合规的可能决定因素。根据世界卫生组织（WHO） HH的五个时刻来评估HH不合规，而不适当的合规则通过额外考虑不正确的HH技术来评估。结果502名HCWs共观察到6580次HH机会。总体不合规率为54.1%，不适当合规率为71.1%。与不遵守相关的显著因素（P<0.05）包括：缺乏卫生教育/培训、缺乏职位晋升、在急诊科工作、缺乏卫生审计、没有袖口大小的酒精洗手液（ABHR）瓶、不方便放置洗手槽和ABHR壁式洗手液机、不经常更换空的ABHR壁式洗手液机以及附近缺乏宣传海报。当研究者客观审计时，除了少数例外，HH不适当遵守的决定因素与HH不遵守的决定因素相似。结论研究结果强调了卫生保健培训和支持性卫生保健基础设施的重要性。这些见解可以帮助决策者识别特定的工作环境因素，这些因素可以通过适当的干预措施提高HH的依从性。需要进一步的研究来评估这些建议的修改对HH依从性的影响。

{"title":"Determinants of non-compliance with hand hygiene using a covert direct observation methodology","authors":"Majid M. Alshamrani , Aiman El-Saed , Fatmah Othman , Mohammed Al Zunitan , Seema Noushad , Ayham Albadawi , Eman Alghamdi , Saad Almohrij","doi":"10.1016/j.infpip.2025.100442","DOIUrl":"10.1016/j.infpip.2025.100442","url":null,"abstract":"<div><h3>Background</h3><div>The Hawthorne effect may result in an overestimation of hand hygiene (HH) compliance during routine observations, which may weaken the significance of factors associated with non-compliance. The aim of this study was to examine professional and healthcare determinants of HH non-compliance using covert observation.</div></div><div><h3>Methods</h3><div>A cross-sectional study design was conducted among healthcare workers (HCWs) at a tertiary care hospital in Saudi Arabia. HH observations were conducted discreetly by trained observers, followed by a questionnaire and an audit to identify possible determinants of HH non-compliance. HH non-compliance was assessed according to the World Health Organisation's (WHO) five-moments for HH, while inappropriate compliance was evaluated by additionally considering incorrect HH technique.</div></div><div><h3>Results</h3><div>A total of 6580 HH opportunities were observed by 502 HCWs. The overall non-compliance rate was 54.1% with inappropriate compliance at 71.1%. Significant factors associated (<em>P</em><0.05) with non-compliance included lack of HH education/training, lack of job promotion, working in the emergency department, lack of HH auditing, absence of pocket-sized alcohol-based handrub (ABHR) bottles, inconveniently placed hand washing sinks and ABHR wall dispensers, infrequent replacement of empty ABHR wall dispensers, and lack of nearby promoting posters. With few exceptions, the determinants of HH inappropriate compliance were similar to those of HH non-compliance, when objectively audited by the researcher.</div></div><div><h3>Conclusions</h3><div>The findings underscore the importance of HH training and supportive healthcare infrastructures. These insights may assist decision-makers in identifying specific work environment factors that could improve HH compliance through appropriate interventions. Further research is required to evaluate the impact of these suggested modifications on HH compliance.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100442"},"PeriodicalIF":1.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395039","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

Clinical and economic impact of ventilator-associated pneumonia in intensive care units in Japan 日本重症监护病房呼吸机相关肺炎的临床和经济影响

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-21 DOI: 10.1016/j.infpip.2025.100440

Taikan Nanao , Koichi Benjamin Ishikawa , Shunya Ikeda , Tsutomu Yamazaki

Ventilator-associated pneumonia (VAP) has a considerable impact on both clinical outcomes and healthcare costs. This study compared 40 patients having VAP with 40 matched controls from a Japanese ICU dataset. Patients with VAP experienced significantly longer ICU and hospital stays, fewer ventilator-free days, and a higher incidence of tracheostomies. VAP cases also required more broad-spectrum antimicrobials, leading to an additional cost of approximately USD 24,410 per case. These results highlight the importance of implementing effective infection control strategies to mitigate VAP's clinical and economic consequences.

呼吸机相关性肺炎（VAP）对临床结果和医疗保健费用都有相当大的影响。本研究比较了来自日本ICU数据集的40名VAP患者和40名匹配的对照组。VAP患者的ICU和住院时间明显更长，无呼吸机天数更少，气管切开术发生率更高。VAP病例还需要更多的广谱抗微生物药物，导致每例病例的额外费用约为24,410美元。这些结果强调了实施有效的感染控制策略以减轻VAP的临床和经济后果的重要性。

引用次数: 0

Healthcare professionals' knowledge, attitudes, and practices in preventing catheter-associated urinary tract infections: a cross-sectional study in a rehabilitation facility 医疗保健专业人员在预防导尿管相关性尿路感染方面的知识、态度和实践：一项康复机构的横断面研究

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-18 DOI: 10.1016/j.infpip.2025.100438

D.C. Muscat , M. Sciortino , E. Tartari

Background

Catheter-associated urinary tract infections (CAUTIs) are prevalent yet preventable healthcare-associated infections. Effective prevention requires healthcare professionals (HCPs) to possess adequate knowledge, positive attitudes, and adherence to best practices.

Objective

To evaluate the knowledge, attitudes, and practices (KAPs) of HCPs regarding the prevention and management of CAUTI in a Maltese rehabilitation facility.

Methods

A cross-sectional survey was conducted with a self-administered online questionnaire from January to March 2023, using total population sampling of doctors, nurses, and nursing assistants (N = 315). Descriptive and inferential analyses were conducted using SPSS.

Results

Of the 315 HCPs invited, 215 responded (68.3%). KAP levels towards CAUTI prevention were moderate to adequate. The attitude scores of doctors and nurses varied significantly based on nationality (P = 0.011), professional designation (P = 0.010), and educational level (P<0.001). Positive correlations were identified between CAUTI knowledge and practices among doctors' and nurses' (P=0.002, r = 0.309). For nursing assistants, significant differences were observed across knowledge (P<0.001), attitude (P<0.001), and practice scores (P<0.001), based on age, educational level, job experience, and timing of their last infection prevention and control training. Positive correlations were observed between knowledge and attitudes (P<0.001, r = 0.471), knowledge and practice (P<0.001, r = 0.383), and attitudes and practice (P<0.001, r = 0.403) for nursing assistants.

Conclusions

HCP knowledge and attitudes directly influence CAUTI prevention practices. Continuous education and targeted training programmes are critical to improving practices and reducing CAUTI-related patient harm.

导尿管相关性尿路感染（CAUTIs）是一种普遍但可预防的卫生保健相关感染。有效的预防需要医疗保健专业人员（HCPs）拥有足够的知识、积极的态度和遵守最佳实践。目的了解马耳他某康复机构医护人员对CAUTI预防和管理的知识、态度和实践情况。方法采用横断面调查方法，于2023年1月至3月采用在线自填问卷进行调查，对医生、护士和护工进行总体抽样（N = 315）。采用SPSS进行描述性和推断性分析。结果被邀请的315名HCPs中，有215名回应，占68.3%。预防caui的KAP水平为中等至充分。不同国籍（P = 0.011）、不同职称（P = 0.010）、不同学历（P = 0.001）的医生、护士态度得分差异显著。医生和护士的CAUTI知识与实践呈正相关（P=0.002, r = 0.309）。护理助理的知识（P<0.001）、态度（P<0.001）和实践分数（P<0.001）在年龄、教育水平、工作经验和最后一次感染预防和控制培训时间的基础上存在显著差异。护理人员的知识与态度（P<0.001, r = 0.471）、知识与实践（P<0.001, r = 0.383）、态度与实践（P<0.001, r = 0.403）呈正相关。结论shcp知识和态度直接影响CAUTI的预防实践。持续教育和有针对性的培训规划对于改进做法和减少与冠状动脉感染相关的患者伤害至关重要。

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引用次数: 0

Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey 手术预防在海多姆路德医院，坦桑尼亚-从点患病率调查学习

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-09 DOI: 10.1016/j.infpip.2024.100429

T.J. Schrama , K.J. Vliegenthart-Jongbloed , M. Gemuwang , E.Q. Nuwass

Background

Antimicrobial resistance (AMR) is a significant global health concern, with improper antibiotic use contributing to its rise. Tanzania initiated an AMR action plan in 2017, but comprehensive surveillance and stewardship efforts remain limited. This study focused on evaluating antibiotic use, particularly surgical prophylaxis, in a rural Tanzanian hospital.

Methods

The study was conducted at Haydom Lutheran Hospital in Tanzania in May 2023, using a cross-sectional point prevalence survey. Antibiotic use in all patients admitted for >24 h and those undergoing surgery was recorded, including type, dose, indication and duration. Quality indicators for surgical prophylaxis were assessed.

Results

Among 199 inpatients, 55% received antibiotics, with surgical prophylaxis accounting for 23% of prescriptions. Notably, none of the patients who received surgical prophylaxis received a single-dose regimen, and 67% exceeded the recommended 24-h duration. A combination of ampicillin-cloxacillin plus metronidazole was the most commonly prescribed combination for surgical prophylaxis (41% of prescriptions). Thirty-three percent of the antibiotics prescribed for surgical prophylaxis were classified as ‘Not recommended’ by the World Health Organization. Furthermore, 90% of surgical prophylaxis prescriptions lacked documented rationale, and 83% of prescriptions lacked stop/review dates in medical records.

Conclusion

This study reveals a high prevalence of prolonged antibiotic use for surgical prophylaxis, frequent use of antibiotics classified as ‘Not recommended’, and a lack of adequate documentation, which deviates from international standards. These practices highlight the urgent need for contextualized national guidelines, large-scale implementation projects of evidence-based interventions, and local initiatives in antibiotic stewardship, particularly in low-resource settings.

抗生素耐药性（AMR）是一个重大的全球健康问题，抗生素使用不当导致其上升。坦桑尼亚于2017年启动了一项抗菌素耐药性行动计划，但全面的监测和管理工作仍然有限。这项研究的重点是评估坦桑尼亚一家农村医院的抗生素使用情况，特别是手术预防。方法本研究于2023年5月在坦桑尼亚的Haydom Lutheran医院进行，采用横断面点患病率调查。记录所有住院24小时及手术患者的抗生素使用情况，包括类型、剂量、适应证和持续时间。评估手术预防的质量指标。结果199例住院患者中，55%的患者使用抗生素，其中手术预防处方占处方的23%。值得注意的是，没有接受手术预防的患者接受单剂量方案，67%超过推荐的24小时持续时间。氨苄西林-氯西林联合甲硝唑是外科预防最常用的处方组合（占处方的41%）。33%用于手术预防的抗生素被世界卫生组织列为“不推荐”。此外，90%的外科预防处方缺乏书面理由，83%的处方在医疗记录中缺乏停止/审查日期。结论：本研究揭示了外科预防长期使用抗生素的高发率，频繁使用被归类为“不推荐”的抗生素，以及缺乏足够的文件，这与国际标准不符。这些实践突出表明，迫切需要根据具体情况制定国家指南，大规模实施循证干预措施项目，并在抗生素管理方面采取地方行动，特别是在资源匮乏的环境中。

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引用次数: 0