Surgical site infections (SSIs) are a global concern affecting patient recovery, prolonging hospital stay and raising healthcare costs.
Aim
To address this, a structured training module was implemented to enhance the efficacy of surgical painting and draping among the interns, reducing SSI risk.
Methods
A questionnaire was distributed to 194 interns, covering fundamental inquiries on SSIs, aseptic practices and an assessment of the participant's knowledge regarding preoperative skin preparation and draping. Students then attended lectures, demonstrations, hands-on sessions and an operating room workshop dedicated to surgical painting and draping techniques. Proficiency was evaluated through a follow-up questionnaire.
Results
There was a significant increase in the percentage of good score from 27.6% to 86.9%. A comparative analysis of surgical site infection (SSI) rates at our institution was performed before and after integrating a cohort of trained clinicians.
Conclusion
Although a significant reduction in SSI rates was observed, it cannot be definitively attributed solely to the introduction of the trained personnel. Nonetheless, the findings underscore the potential impact of rigorous training in aseptic techniques on reducing SSI incidence.
{"title":"Development and impact of a structured training module for surgical painting and draping among interns","authors":"Tharun Ganapathy Chitrambalam , Abinayaah Suresh , Nidhi Mariam George , Sharmila Aristotle","doi":"10.1016/j.infpip.2025.100439","DOIUrl":"10.1016/j.infpip.2025.100439","url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infections (SSIs) are a global concern affecting patient recovery, prolonging hospital stay and raising healthcare costs.</div></div><div><h3>Aim</h3><div>To address this, a structured training module was implemented to enhance the efficacy of surgical painting and draping among the interns, reducing SSI risk.</div></div><div><h3>Methods</h3><div>A questionnaire was distributed to 194 interns, covering fundamental inquiries on SSIs, aseptic practices and an assessment of the participant's knowledge regarding preoperative skin preparation and draping. Students then attended lectures, demonstrations, hands-on sessions and an operating room workshop dedicated to surgical painting and draping techniques. Proficiency was evaluated through a follow-up questionnaire.</div></div><div><h3>Results</h3><div>There was a significant increase in the percentage of good score from 27.6% to 86.9%. A comparative analysis of surgical site infection (SSI) rates at our institution was performed before and after integrating a cohort of trained clinicians.</div></div><div><h3>Conclusion</h3><div>Although a significant reduction in SSI rates was observed, it cannot be definitively attributed solely to the introduction of the trained personnel. Nonetheless, the findings underscore the potential impact of rigorous training in aseptic techniques on reducing SSI incidence.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100439"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437844","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 : 2025-06-01Epub Date: 2025-03-14DOI: 10.1016/j.infpip.2025.100457
A.A. Arabzadeh , M. Iranikia , F. Pourfarzi , B. Shahrami , S. M Kebar
Background
Haemodialysis patients with tunnelled central venous catheters (CVCs) are at high risk for catheter-related infections (CRIs), which can lead to serious complications, prolonged hospitalizations, and increased healthcare costs. The use of antibiotic lock solutions may help prevent these infections. This study evaluates the efficacy of a heparin–vancomycin–amikacin combination lock solution in preventing CRIs compared with heparin alone in haemodialysis patients.
Methods
This single-centre, double-blind randomized clinical trial involved 60 haemodialysis patients with tunnelled CVCs. Patients were randomly assigned to receive either a heparin 5000 units/mL lock (Group A) or a combination of heparin 5000 units/mL, vancomycin 500 mg/mL, and amikacin 500 mg/mL lock (Group B). The primary outcome was the incidence of CRIs, diagnosed using CDC criteria, over a 6-month follow-up period.
Findings
Group B demonstrated a significantly lower incidence of CRIs compared to Group A (P=0.001). Additionally, the mean number of CRI episodes per patient and the CRI rate per 1000 catheter days were significantly lower in Group B (P=0.028 and 0.042, respectively). The rate of catheter removal due to infection was also significantly reduced in Group B (P=0.029). No significant differences in infection timing were observed, although Group B showed later infection onset. No adverse drug reactions were reported.
Conclusions
The heparin–vancomycin–amikacin combination lock solution was more effective in preventing CRIs than heparin alone in haemodialysis patients. Further studies with larger sample sizes and longer follow-up are needed to confirm its long-term benefits and assess potential risks, including antibiotic resistance.
{"title":"Efficacy of heparin–vancomycin–amikacin combination lock in preventing catheter-related infections in haemodialysis patients: a double-blind randomized clinical trial","authors":"A.A. Arabzadeh , M. Iranikia , F. Pourfarzi , B. Shahrami , S. M Kebar","doi":"10.1016/j.infpip.2025.100457","DOIUrl":"10.1016/j.infpip.2025.100457","url":null,"abstract":"<div><h3>Background</h3><div>Haemodialysis patients with tunnelled central venous catheters (CVCs) are at high risk for catheter-related infections (CRIs), which can lead to serious complications, prolonged hospitalizations, and increased healthcare costs. The use of antibiotic lock solutions may help prevent these infections. This study evaluates the efficacy of a heparin–vancomycin–amikacin combination lock solution in preventing CRIs compared with heparin alone in haemodialysis patients.</div></div><div><h3>Methods</h3><div>This single-centre, double-blind randomized clinical trial involved 60 haemodialysis patients with tunnelled CVCs. Patients were randomly assigned to receive either a heparin 5000 units/mL lock (Group A) or a combination of heparin 5000 units/mL, vancomycin 500 mg/mL, and amikacin 500 mg/mL lock (Group B). The primary outcome was the incidence of CRIs, diagnosed using CDC criteria, over a 6-month follow-up period.</div></div><div><h3>Findings</h3><div>Group B demonstrated a significantly lower incidence of CRIs compared to Group A (<em>P</em>=0.001). Additionally, the mean number of CRI episodes per patient and the CRI rate per 1000 catheter days were significantly lower in Group B (<em>P</em>=0.028 and 0.042, respectively). The rate of catheter removal due to infection was also significantly reduced in Group B (<em>P</em>=0.029). No significant differences in infection timing were observed, although Group B showed later infection onset. No adverse drug reactions were reported.</div></div><div><h3>Conclusions</h3><div>The heparin–vancomycin–amikacin combination lock solution was more effective in preventing CRIs than heparin alone in haemodialysis patients. Further studies with larger sample sizes and longer follow-up are needed to confirm its long-term benefits and assess potential risks, including antibiotic resistance.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100457"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799468","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 : 2025-06-01Epub Date: 2025-02-28DOI: 10.1016/j.infpip.2025.100450
Asmamaw Deguale Worku , Abayneh Melaku
Background
Hand hygiene is an easy step to reduce healthcare-acquired infections, and improve patient safety. Major progress in facility accessibility was made during the coronavirus disease 2019 (COVID-19) pandemic, and this led to greater adherence to hand hygiene practices. However, handwashing practices have now returned to the pre-COVID-19 era. Most of the studies that have investigated hand hygiene adherence are quantitative. As such, this study aimed to explore barriers to hand hygiene practice in the health centres of Kirkos and Akaki Kality sub-cities in Addis Ababa, Ethiopia.
Methods
Twenty-four healthcare professionals employed at the aforementioned health centres were interviewed using the key informant interview method. Data were analysed using a qualitative content analysis technique.
Results
Based on the findings, there were three main categories of barriers to hand hygiene practice: barriers related to individuals (including three sub-categories: lack of knowledge and skill, improper attitude, and poor attention and negligence of healthcare workers); leadership barriers (including two sub-categories: lack of dedicated staff and low attention of leaders); and institutional barriers (including three sub-categories: inappropriate infrastructure and lack of resources, shortage of water, and high work load and staff turnover).
Conclusion
There were several reasons why hand hygiene guidance was not followed. Hand hygiene barriers can be minimized by displaying colour-coded notice boards, making washing facilities easily accessible, monitoring the availability of soap, offering training, and providing accurate evidence about the need to enhance hand hygiene.
{"title":"Barriers to hand hygiene practice among healthcare workers in health centres of Kirkos and Akaki Kality sub-cities, Addis Ababa, Ethiopia: a qualitative study","authors":"Asmamaw Deguale Worku , Abayneh Melaku","doi":"10.1016/j.infpip.2025.100450","DOIUrl":"10.1016/j.infpip.2025.100450","url":null,"abstract":"<div><h3>Background</h3><div>Hand hygiene is an easy step to reduce healthcare-acquired infections, and improve patient safety. Major progress in facility accessibility was made during the coronavirus disease 2019 (COVID-19) pandemic, and this led to greater adherence to hand hygiene practices. However, handwashing practices have now returned to the pre-COVID-19 era. Most of the studies that have investigated hand hygiene adherence are quantitative. As such, this study aimed to explore barriers to hand hygiene practice in the health centres of Kirkos and Akaki Kality sub-cities in Addis Ababa, Ethiopia.</div></div><div><h3>Methods</h3><div>Twenty-four healthcare professionals employed at the aforementioned health centres were interviewed using the key informant interview method. Data were analysed using a qualitative content analysis technique.</div></div><div><h3>Results</h3><div>Based on the findings, there were three main categories of barriers to hand hygiene practice: barriers related to individuals (including three sub-categories: lack of knowledge and skill, improper attitude, and poor attention and negligence of healthcare workers); leadership barriers (including two sub-categories: lack of dedicated staff and low attention of leaders); and institutional barriers (including three sub-categories: inappropriate infrastructure and lack of resources, shortage of water, and high work load and staff turnover).</div></div><div><h3>Conclusion</h3><div>There were several reasons why hand hygiene guidance was not followed. Hand hygiene barriers can be minimized by displaying colour-coded notice boards, making washing facilities easily accessible, monitoring the availability of soap, offering training, and providing accurate evidence about the need to enhance hand hygiene.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100450"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628104","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 : 2025-06-01Epub Date: 2025-02-11DOI: 10.1016/j.infpip.2025.100441
Leonia Hiu Wan Lau , Fion Wai Fong Tse , Lorna Kwai Ping Suen , Simon Ching Lam
Background
Increased risk of healthcare-associated infections (HAIs) in radiology departments has been reported in recent years. Optimal infection control practices (ICPs) are the key to controlling HAIs, but few studies have investigated the ICP compliance of healthcare workers (HCWs) in radiology departments.
Aim
To assess the level of ICP compliance of HCWs in a radiology department.
Methods
A participant observation supplemented with adenosine triphosphate (ATP) bioluminescence assay evaluation of environmental cleanliness was conducted. More than 1000 hand hygiene (HH) opportunities and 960 opportunities for the other core ICP elements were observed in different study units of a radiology department. An online checklist powered by eRub was used to record the HCWs' ICP performance. A total of 125 environmental samples were collected for ATP assay evaluation.
Results
In the participants observation, the overall performance score was 41.4%. The lowest score was found in HH (10.4%), followed by use of personal protective equipment (29.4%) and gloves (68.2%). The HH performance was significantly associated with study units (χ2 = 42.55, P < 0.001), professional groups (χ2 = 110.21, P < 0.001), and patient-to-staff ratio (F = 8.76, P < 0.001). With relative light units of ≤250 set as a pass benchmark, less than two-thirds of the environmental samples passed the ATP assay.
Conclusion
The overall ICP compliance among the HCWs in the radiology department was suboptimal. Revisions of current ICP guidelines and policies that are tailored to the setting-specific needs and barriers in radiology departments is necessary.
背景：近年来，有报道称放射科的医疗保健相关感染（HAIs）风险增加。最佳感染控制措施（ICP）是控制HAIs的关键，但很少有研究调查放射科医护人员（HCWs）对ICP的依从性。目的评价某放射科医护人员对ICP的依从性。方法采用参与观察加三磷酸腺苷（ATP）生物发光法评价环境洁净度。在某放射科的不同研究单位观察到1000多个手部卫生（HH）机会和960多个其他核心ICP要素的机会。使用由eRub提供支持的在线检查表记录医护人员的ICP表现。共收集125份环境样品进行ATP测定评价。结果在参与者观察中，整体表现得分为41.4%。HH（10.4%）得分最低，其次是使用个人防护装备（29.4%）和手套（68.2%）。HH表现与研究单位显著相关(χ2 = 42.55, P <；0.001)，专业组(χ2 = 110.21, P <；0.001)，患者与工作人员比率(F = 8.76, P <；0.001)。以相对光单位≤250作为通过基准，不到三分之二的环境样品通过ATP测定。结论放射科医护人员总体ICP依从性不理想。有必要修订现行的ICP指南和政策，以适应放射科的具体需要和障碍。
{"title":"Compliance with infection control practices among healthcare workers in radiology departments: a participant observation study and adenosine triphosphate assay evaluation of environmental cleanliness","authors":"Leonia Hiu Wan Lau , Fion Wai Fong Tse , Lorna Kwai Ping Suen , Simon Ching Lam","doi":"10.1016/j.infpip.2025.100441","DOIUrl":"10.1016/j.infpip.2025.100441","url":null,"abstract":"<div><h3>Background</h3><div>Increased risk of healthcare-associated infections (HAIs) in radiology departments has been reported in recent years. Optimal infection control practices (ICPs) are the key to controlling HAIs, but few studies have investigated the ICP compliance of healthcare workers (HCWs) in radiology departments.</div></div><div><h3>Aim</h3><div>To assess the level of ICP compliance of HCWs in a radiology department.</div></div><div><h3>Methods</h3><div>A participant observation supplemented with adenosine triphosphate (ATP) bioluminescence assay evaluation of environmental cleanliness was conducted. More than 1000 hand hygiene (HH) opportunities and 960 opportunities for the other core ICP elements were observed in different study units of a radiology department. An online checklist powered by eRub was used to record the HCWs' ICP performance. A total of 125 environmental samples were collected for ATP assay evaluation.</div></div><div><h3>Results</h3><div>In the participants observation, the overall performance score was 41.4%. The lowest score was found in HH (10.4%), followed by use of personal protective equipment (29.4%) and gloves (68.2%). The HH performance was significantly associated with study units (χ<sup>2</sup> = 42.55, <em>P</em> < 0.001), professional groups (χ<sup>2</sup> = 110.21, <em>P</em> < 0.001), and patient-to-staff ratio (<em>F</em> = 8.76, <em>P</em> < 0.001). With relative light units of ≤250 set as a pass benchmark, less than two-thirds of the environmental samples passed the ATP assay.</div></div><div><h3>Conclusion</h3><div>The overall ICP compliance among the HCWs in the radiology department was suboptimal. Revisions of current ICP guidelines and policies that are tailored to the setting-specific needs and barriers in radiology departments is necessary.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100441"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509338","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 : 2025-06-01Epub Date: 2025-02-13DOI: 10.1016/j.infpip.2025.100451
Ali El Roz , Taghrid Chaaban , Hawraa Issa , José-Noel Ibrahim , Zeinab Ezzeddine , Ghassan Ghssein
Background
Methicillin-Resistant Staphylococcus aureus (MRSA) is a well-known cause of hospital acquired infections (HAIs), associated with high rates of morbidity and mortality. In healthcare settings, MRSA can spread via contaminated surfaces and direct contact.
Objective
This study aims to assess the knowledge and awareness of MRSA risks, prevention methods (such as hand hygiene), proper antibiotics use, and multidrug resistance among various groups of healthcare workers (HCWs) in Southern Lebanon.
Methods
A total of 244 HCWs, including those in medical services (MS), paramedical services (PS), and non-medical services (NMS), were conveniently selected for this study. Data was gathered using a structured, validated questionnaire that explored their knowledge and awareness of MRSA risks, prevention measures, hand hygiene practices, and multidrug resistance.
Results
The findings revealed that 68% of HCWs were aware of the origin of MRSA infection, and 61.5% and 51.6% were familiar with its treatment and transmission, respectively. Only 24.2% of HCWs were able to differentiate between hospital-acquired and community-acquired MRSA, 14.7% were aware of the institution's written MRSA control protocols, and 17.6% had heard of MRSA infections. Notably, knowledge and hand hygiene practices were significantly better among MS HCWs than PS and NMS groups (P<0.0001). While all HCWs were familiar with antibiotic usage and drug resistance, NMS HCWs were more likely to use antibiotics without a prescription compared to MS and PS groups (P<0.003).
Conclusion
HCWs in South-Lebanon demonstrated a knowledge gap regarding MRSA risks and prevention guidelines. These findings underscore the need for targeted educational intervention on MRSA, as well as coordinated efforts by healthcare authorities and centres to control MRSA infections.
{"title":"Assessment of Methicillin-Resistant Staphylococcus aureus (MRSA) knowledge and awareness among healthcare workers in South-Lebanon","authors":"Ali El Roz , Taghrid Chaaban , Hawraa Issa , José-Noel Ibrahim , Zeinab Ezzeddine , Ghassan Ghssein","doi":"10.1016/j.infpip.2025.100451","DOIUrl":"10.1016/j.infpip.2025.100451","url":null,"abstract":"<div><h3>Background</h3><div>Methicillin-Resistant <em>Staphylococcus aureus</em> (MRSA) is a well-known cause of hospital acquired infections (HAIs), associated with high rates of morbidity and mortality. In healthcare settings, MRSA can spread via contaminated surfaces and direct contact.</div></div><div><h3>Objective</h3><div>This study aims to assess the knowledge and awareness of MRSA risks, prevention methods (such as hand hygiene), proper antibiotics use, and multidrug resistance among various groups of healthcare workers (HCWs) in Southern Lebanon.</div></div><div><h3>Methods</h3><div>A total of 244 HCWs, including those in medical services (MS), paramedical services (PS), and non-medical services (NMS), were conveniently selected for this study. Data was gathered using a structured, validated questionnaire that explored their knowledge and awareness of MRSA risks, prevention measures, hand hygiene practices, and multidrug resistance.</div></div><div><h3>Results</h3><div>The findings revealed that 68% of HCWs were aware of the origin of MRSA infection, and 61.5% and 51.6% were familiar with its treatment and transmission, respectively. Only 24.2% of HCWs were able to differentiate between hospital-acquired and community-acquired MRSA, 14.7% were aware of the institution's written MRSA control protocols, and 17.6% had heard of MRSA infections. Notably, knowledge and hand hygiene practices were significantly better among MS HCWs than PS and NMS groups (<em>P</em><0.0001). While all HCWs were familiar with antibiotic usage and drug resistance, NMS HCWs were more likely to use antibiotics without a prescription compared to MS and PS groups (<em>P</em><0.003).</div></div><div><h3>Conclusion</h3><div>HCWs in South-Lebanon demonstrated a knowledge gap regarding MRSA risks and prevention guidelines. These findings underscore the need for targeted educational intervention on MRSA, as well as coordinated efforts by healthcare authorities and centres to control MRSA infections.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100451"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480442","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 : 2025-06-01Epub Date: 2025-04-26DOI: 10.1016/j.infpip.2025.100465
Siobhain Kelly , Gemma Winzor , Simon Ching Lam
{"title":"World Hand Hygiene Day 2025: A perspective from the Infection Prevention in Practice Editors","authors":"Siobhain Kelly , Gemma Winzor , Simon Ching Lam","doi":"10.1016/j.infpip.2025.100465","DOIUrl":"10.1016/j.infpip.2025.100465","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100465"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-08DOI: 10.1016/j.infpip.2025.100458
Guangxu Mao , Wensen Chen , Liyun Wang , Sheng Zhao , Feng Zang
Background
Postoperative infection remains a serious problem for patients undergoing open-heart surgery and is associated with poor prognosis and mortality.
Aim
To determine the incidence, characteristics and associated risk factors for nosocomial infections in adult cardiac surgery patients and to develop a nomogram prediction model.
Methods
Data were retrospectively collected from patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) at a tertiary hospital in 2023. Patients were divided into an infected group (N = 130) and a non-infected group (N = 192). Multivariate logistic regression analysis was used to analyse the independent risk factors for healthcare-associated infections after cardiac surgery under CPB.
Results
Of the 1584 patients, 130 (8.21%) developed postoperative infections (infection group). Lower respiratory tract was the most common site of infection (N = 74, 56.9%), while Gram-negative bacteria were the predominant isolates overall (N = 81, 62.3%). Among the Gram-negative bacteria, Acinetobacter baumannii was the most frequently identified, whereas Staphylococcus aureus was the leading strain among Gram-positive bacteria. Multivariate logistic regression analysis of the 322 patients included in the study revealed that CPB duration, American Society of Anaesthesiologists score, procalcitonin concentration on the first postoperative day, monocyte:lymphocyte ratio, preinfection mechanical ventilation duration, and preinfection central venous catheterization duration were the six independent predictors of postoperative infection. The area under the receiver operating characteristic curve was 0.824 (0.778–0.870), and the model showed good predictive performance.
Conclusion
A nomogram has been developed to predict postoperative infection via commonly available data. This tool could assist clinicians in optimising the perioperative care of patients undergoing cardiac surgery with CPB, but further external validation is needed.
{"title":"Clinical risk factors for postoperative infection in adult cardiac surgery with cardiopulmonary bypass: a retrospective study","authors":"Guangxu Mao , Wensen Chen , Liyun Wang , Sheng Zhao , Feng Zang","doi":"10.1016/j.infpip.2025.100458","DOIUrl":"10.1016/j.infpip.2025.100458","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative infection remains a serious problem for patients undergoing open-heart surgery and is associated with poor prognosis and mortality.</div></div><div><h3>Aim</h3><div>To determine the incidence, characteristics and associated risk factors for nosocomial infections in adult cardiac surgery patients and to develop a nomogram prediction model.</div></div><div><h3>Methods</h3><div>Data were retrospectively collected from patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) at a tertiary hospital in 2023. Patients were divided into an infected group (<em>N</em> = 130) and a non-infected group (<em>N</em> = 192). Multivariate logistic regression analysis was used to analyse the independent risk factors for healthcare-associated infections after cardiac surgery under CPB.</div></div><div><h3>Results</h3><div>Of the 1584 patients, 130 (8.21%) developed postoperative infections (infection group). Lower respiratory tract was the most common site of infection (<em>N</em> = 74, 56.9%), while Gram-negative bacteria were the predominant isolates overall (<em>N</em> = 81, 62.3%). Among the Gram-negative bacteria, <em>Acinetobacter baumannii</em> was the most frequently identified, whereas <em>Staphylococcus aureus</em> was the leading strain among Gram-positive bacteria. Multivariate logistic regression analysis of the 322 patients included in the study revealed that CPB duration, American Society of Anaesthesiologists score, procalcitonin concentration on the first postoperative day, monocyte:lymphocyte ratio, preinfection mechanical ventilation duration, and preinfection central venous catheterization duration were the six independent predictors of postoperative infection. The area under the receiver operating characteristic curve was 0.824 (0.778–0.870), and the model showed good predictive performance.</div></div><div><h3>Conclusion</h3><div>A nomogram has been developed to predict postoperative infection via commonly available data. This tool could assist clinicians in optimising the perioperative care of patients undergoing cardiac surgery with CPB, but further external validation is needed.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100458"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-02-06DOI: 10.1016/j.infpip.2025.100449
Y.-C. Wang , W.-C. Chen , K.-P. Lin , W.-C. Tseng
Background
Controlling healthcare-associated infections (HAIs) remains one of the major challenges faced by healthcare systems worldwide. Effective management of HAIs has become a critical indicator for evaluating the quality of services provided by medical institutions.
Aim
This study aims to compare the outcomes of environmental and instrument cleaning audits using an adenosine triphosphate (ATP) bioluminescence assay to prevent the spread of micro-organisms within medical environments.
Methods
The ATP monitoring system employs a cold light instrument integrated with bioluminescence enzyme detection technology. One hundred and ninety-one points were evaluated in 2020, 158 points in 2021, and 146 points in 2022.
Findings
From 2020 to 2022, the rate of environmental cleaning compliance (<200 relative light units (RLU)) in the radiology department increased from 82% to 92%, while the rate of excellent cleanliness (<100 RLU) improved significantly from 58% to 86% (P<0.001). Our findings indicate that medical instruments and high-touch clinical instrument surfaces (HTCIS) in areas frequently contacted by patients are the primary contributors to the spread of pathogenic bacteria.
Conclusions
HTCIS should remain a focal point for improving environmental cleanliness and subsequent inspections in the radiology department. Enhancing the cleanliness of these surfaces is a vital strategy to prevent further nosocomial transmission.
{"title":"Utilizing an adenosine triphosphate bioluminescence assay as an indicator of instrument and environmental cleanliness in the radiology department: a pilot study","authors":"Y.-C. Wang , W.-C. Chen , K.-P. Lin , W.-C. Tseng","doi":"10.1016/j.infpip.2025.100449","DOIUrl":"10.1016/j.infpip.2025.100449","url":null,"abstract":"<div><h3>Background</h3><div>Controlling healthcare-associated infections (HAIs) remains one of the major challenges faced by healthcare systems worldwide. Effective management of HAIs has become a critical indicator for evaluating the quality of services provided by medical institutions.</div></div><div><h3>Aim</h3><div>This study aims to compare the outcomes of environmental and instrument cleaning audits using an adenosine triphosphate (ATP) bioluminescence assay to prevent the spread of micro-organisms within medical environments.</div></div><div><h3>Methods</h3><div>The ATP monitoring system employs a cold light instrument integrated with bioluminescence enzyme detection technology. One hundred and ninety-one points were evaluated in 2020, 158 points in 2021, and 146 points in 2022.</div></div><div><h3>Findings</h3><div>From 2020 to 2022, the rate of environmental cleaning compliance (<200 relative light units (RLU)) in the radiology department increased from 82% to 92%, while the rate of excellent cleanliness (<100 RLU) improved significantly from 58% to 86% (<em>P</em><0.001). Our findings indicate that medical instruments and high-touch clinical instrument surfaces (HTCIS) in areas frequently contacted by patients are the primary contributors to the spread of pathogenic bacteria.</div></div><div><h3>Conclusions</h3><div>HTCIS should remain a focal point for improving environmental cleanliness and subsequent inspections in the radiology department. Enhancing the cleanliness of these surfaces is a vital strategy to prevent further nosocomial transmission.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100449"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437843","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 : 2025-06-01Epub Date: 2025-02-04DOI: 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.
{"title":"CO2 concentration testing as a quick estimate of natural ventilation effectiveness in primary healthcare: experience in war-affected, resource-limited settings","authors":"M. Dolynska , A. Aleksandrin , O. Vlasenko , S. Gorischak , G. Dolynskyi , A. Vodianyk","doi":"10.1016/j.infpip.2025.100448","DOIUrl":"10.1016/j.infpip.2025.100448","url":null,"abstract":"<div><div>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 CO<sub>2</sub> concentration. This solution has obvious disadvantages, being reactive rather than proactive and requiring continuous monitoring of CO<sub>2</sub> 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.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100448"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452859","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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