The effectiveness of patient participation in hand hygiene (HH) programmes in Japan is unclear. This study examines the effect of a patient empowerment HH programme at a Japanese hospital. Two periods were analysed: January 2020 to November 2020 as the baseline, and December 2020 to April 2021 as the intervention period. The intervention involved inpatients observing the HH practices of healthcare workers. The average number of HH events per patient-day increased from 23.4 at baseline to 37.3 during the intervention. HH events were positively correlated with the number of patient observations. Patient empowerment programmes may therefore help to improve HH.
{"title":"The effect of a patient empowerment hand hygiene programme: a single-centre study in Japan","authors":"Yusuke Watanabe , Asami Okugawa , Hiroshi Soeda , Tomohide Shimodaira , Satoko Sato , Hiroaki Fujita , Takehito Kobayashi , Itaru Nakamura , Hidehiro Watanabe","doi":"10.1016/j.infpip.2025.100456","DOIUrl":"10.1016/j.infpip.2025.100456","url":null,"abstract":"<div><div>The effectiveness of patient participation in hand hygiene (HH) programmes in Japan is unclear. This study examines the effect of a patient empowerment HH programme at a Japanese hospital. Two periods were analysed: January 2020 to November 2020 as the baseline, and December 2020 to April 2021 as the intervention period. The intervention involved inpatients observing the HH practices of healthcare workers. The average number of HH events per patient-day increased from 23.4 at baseline to 37.3 during the intervention. HH events were positively correlated with the number of patient observations. Patient empowerment programmes may therefore help to improve HH.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100456"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643588","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: 2025-03-05DOI: 10.1016/j.infpip.2025.100452
Prasanna Kumar Sistla, P. Kanaka Raju
Background
Relative humidity is a key factor in the disinfection process.
Aim
To examine the distribution of relative humidity, and the time required to reach its mean value in the target area when using a robotic fogger with 7.4% hydrogen peroxide.
Methods
The study evaluated the device in both stationary and mobile operation modes. In each mode, relative humidity sensors, along with chemical, biological, and enzyme indicators, were employed to assess the disinfection's effectiveness and consistency.
Results
The device dispersed disinfectant at a rate of 30 mL/min over 45 min in both modes. A shorter time to reach the mean relative humidity is desirable for effective disinfection. It was observed that the mobile mode reached the mean relative humidity 50% faster, maintained this level for an additional 30 min, and achieved an 11% higher relative humidity compared to the stationary mode.
Conclusion
These advancements could assist pharmaceutical manufacturing and healthcare facilities in minimizing downtime during periodic disinfection.
{"title":"Investigation of relative humidity distribution and its impact on disinfection using a combination of robotic fogger and hydrogen peroxide","authors":"Prasanna Kumar Sistla, P. Kanaka Raju","doi":"10.1016/j.infpip.2025.100452","DOIUrl":"10.1016/j.infpip.2025.100452","url":null,"abstract":"<div><h3>Background</h3><div>Relative humidity is a key factor in the disinfection process.</div></div><div><h3>Aim</h3><div>To examine the distribution of relative humidity, and the time required to reach its mean value in the target area when using a robotic fogger with 7.4% hydrogen peroxide.</div></div><div><h3>Methods</h3><div>The study evaluated the device in both stationary and mobile operation modes. In each mode, relative humidity sensors, along with chemical, biological, and enzyme indicators, were employed to assess the disinfection's effectiveness and consistency.</div></div><div><h3>Results</h3><div>The device dispersed disinfectant at a rate of 30 mL/min over 45 min in both modes. A shorter time to reach the mean relative humidity is desirable for effective disinfection. It was observed that the mobile mode reached the mean relative humidity 50% faster, maintained this level for an additional 30 min, and achieved an 11% higher relative humidity compared to the stationary mode.</div></div><div><h3>Conclusion</h3><div>These advancements could assist pharmaceutical manufacturing and healthcare facilities in minimizing downtime during periodic disinfection.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 2","pages":"Article 100452"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686274","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 : 2025-03-01Epub Date: 2024-12-26DOI: 10.1016/j.infpip.2024.100431
Raija Auvinen , Kaisa Huotari , Hanna Nohynek , Ritva K. Syrjänen , Kirsi Skogberg
Background
While nosocomial influenza is common, the risk of transmission in acute care remains unclear in the absence of systematic surveillance. Even less is known about the risk of nosocomial respiratory syncytial virus (RSV) among immunocompetent adults.
Aim
To compare the proportions and incidences of nosocomial cases caused by these two similar respiratory infections among hospitalized adults.
Methods
A retrospective study was conducted at two tertiary care hospitals in Southern Finland. Data on all hospitalized adult patients with a positive RSV or influenza test during 2016–22 were used to detect all nosocomial and community-acquired RSV and influenza cases. The proportion of nosocomial cases of all hospitalized cases was calculated. The incidences of nosocomial cases per 1000 bed-days were calculated by season and ward type for the five seasons before the COVID-19 pandemic.
Results
Nosocomial RSV and influenza occurred in 2.8% and 8.1% of all hospitalized adult patients with a laboratory-confirmed infection. Over five seasons, 2016–20, the total incidences of nosocomial RSV and influenza cases per 1000 bed-days were 0.027 (95% confidence interval: 0.013, 0.050) and 0.32 (0.27, 0.39). Nosocomial RSV infections were especially poorly recorded with a virus-specific ICD-10 diagnosis code listed for only 16.7% of RSV and 59.8% of nosocomial influenza patients.
Conclusion
Despite preventive measures, the incidence of nosocomial influenza was more than tenfold, and the proportion of nosocomial cases was almost threefold compared with RSV among hospitalized adults in acute care. Prevention and surveillance of both nosocomial influenza and RSV should be improved also among immunocompetent adult patients.
{"title":"Risk of nosocomial respiratory syncytial virus versus influenza among adult patients in acute care hospitals","authors":"Raija Auvinen , Kaisa Huotari , Hanna Nohynek , Ritva K. Syrjänen , Kirsi Skogberg","doi":"10.1016/j.infpip.2024.100431","DOIUrl":"10.1016/j.infpip.2024.100431","url":null,"abstract":"<div><h3>Background</h3><div>While nosocomial influenza is common, the risk of transmission in acute care remains unclear in the absence of systematic surveillance. Even less is known about the risk of nosocomial respiratory syncytial virus (RSV) among immunocompetent adults.</div></div><div><h3>Aim</h3><div>To compare the proportions and incidences of nosocomial cases caused by these two similar respiratory infections among hospitalized adults.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted at two tertiary care hospitals in Southern Finland. Data on all hospitalized adult patients with a positive RSV or influenza test during 2016–22 were used to detect all nosocomial and community-acquired RSV and influenza cases. The proportion of nosocomial cases of all hospitalized cases was calculated. The incidences of nosocomial cases per 1000 bed-days were calculated by season and ward type for the five seasons before the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>Nosocomial RSV and influenza occurred in 2.8% and 8.1% of all hospitalized adult patients with a laboratory-confirmed infection. Over five seasons, 2016–20, the total incidences of nosocomial RSV and influenza cases per 1000 bed-days were 0.027 (95% confidence interval: 0.013, 0.050) and 0.32 (0.27, 0.39). Nosocomial RSV infections were especially poorly recorded with a virus-specific ICD-10 diagnosis code listed for only 16.7% of RSV and 59.8% of nosocomial influenza patients.</div></div><div><h3>Conclusion</h3><div>Despite preventive measures, the incidence of nosocomial influenza was more than tenfold, and the proportion of nosocomial cases was almost threefold compared with RSV among hospitalized adults in acute care. Prevention and surveillance of both nosocomial influenza and RSV should be improved also among immunocompetent adult patients.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100431"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081264","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}
Meticillin resistant S. aureus (MRSA) is a major contributor to surgical site infections in post-operative patients. Hospital environments harbor MRSA, contributing to higher risk of nosocomial infections. Meticillin resistance is conferred by acquisition of mecA gene, typically carried on mobile genetic element called Staphylococcal Cassette Chromosome mec (SCCmec).
Objective
This study aimed to determine the prevalence of MRSA, detect mecA, characterize SCCmec types and compare their concurrent presence in clinical and environmental isolates.
Methods
A cross sectional study was conducted at Bhaktapur Hospital, Nepal among clinical specimens collected from postoperative patients. Air and environmental samples were collected by plate exposure and swabbing methods. Samples were processed for culture and antibiotic susceptibility testing by Kirby-Bauer Disc diffusion method, and identification of MRSA using cefoxitin disc. SCCmec typing was done by conventional PCR.
Results
The culture positivity among samples from post-operative patients was 13.9% (326/2350) with S.aureus (39.7%,29/73) being predominating Gram positive bacteria. MRSA accounted for 68 % (20/29) of clinical isolates and 66% (22/33) of environmental isolates, with mecA detected in 85% (17/20) and 72.8% (16/22) respectively. SCCmec Type II predominated followed by Type V and I, while other types were absent. Comparison of SCCmec elements between post-operative patients and hospital environmental samples revealed concurrent presence in both setting, with Type II being the most prevalent.
Conclusions
SCCmec Type I, II, V and mecA elements were concurrently present in both post-operative patients and hospital environments. Effective preventive measures are warranted to break the MRSA transmission between these settings.
{"title":"Concurrent presence of Staphylococcal Cassette Chromosome mec types of Meticillin-Resistant Staphylococcus aureus in hospital environments and post-operative patients at a hospital in Kathmandu, Nepal","authors":"Krishma Pandit , Supriya Sharma , Shreedhar Aryal , Asmita Lamichhane , Sushma Regmi , Prativa Paudel , Sirjana Koirala , Suprina Sharma , Sanjib Adhikari , Komal Raj Rijal , Pramod Poudel","doi":"10.1016/j.infpip.2024.100436","DOIUrl":"10.1016/j.infpip.2024.100436","url":null,"abstract":"<div><h3>Introduction</h3><div>Meticillin resistant <em>S. aureus</em> (MRSA) is a major contributor to surgical site infections in post-operative patients. Hospital environments harbor MRSA, contributing to higher risk of nosocomial infections. Meticillin resistance is conferred by acquisition of <em>mecA</em> gene, typically carried on mobile genetic element called Staphylococcal Cassette Chromosome <em>mec</em> (SCC<em>mec</em>).</div></div><div><h3>Objective</h3><div>This study aimed to determine the prevalence of MRSA, detect <em>mecA</em>, characterize SCC<em>mec</em> types and compare their concurrent presence in clinical and environmental isolates.</div></div><div><h3>Methods</h3><div>A cross sectional study was conducted at Bhaktapur Hospital, Nepal among clinical specimens collected from postoperative patients. Air and environmental samples were collected by plate exposure and swabbing methods. Samples were processed for culture and antibiotic susceptibility testing by Kirby-Bauer Disc diffusion method, and identification of MRSA using cefoxitin disc. SCC<em>mec</em> typing was done by conventional PCR.</div></div><div><h3>Results</h3><div>The culture positivity among samples from post-operative patients was 13.9% (326/2350) with <em>S.aureus</em> (39.7%,29/73) being predominating Gram positive bacteria. MRSA accounted for 68 % (20/29) of clinical isolates and 66% (22/33) of environmental isolates, with <em>mecA</em> detected in 85% (17/20) and 72.8% (16/22) respectively. SCC<em>mec</em> Type II predominated followed by Type V and I, while other types were absent. Comparison of SCC<em>mec</em> elements between post-operative patients and hospital environmental samples revealed concurrent presence in both setting, with Type II being the most prevalent.</div></div><div><h3>Conclusions</h3><div>SCC<em>mec</em> Type I, II, V and <em>mecA</em> elements were concurrently present in both post-operative patients and hospital environments. Effective preventive measures are warranted to break the MRSA transmission between these settings.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100436"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068386","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 : 2025-03-01Epub Date: 2025-01-06DOI: 10.1016/j.infpip.2024.100434
H. Carter , A. Sharp , L. Davidson , C. Foster , E. McGuire , C. Brown , D. Weston
Background
Whilst healthcare workers (HCWs) are at high risk of contracting infectious viral diseases, such as COVID-19, measures can be put in place to reduce the spread of diseases in healthcare settings. These currently include the use of different types of masks: fluid-resistant surgical masks (FRSM) and filtering facepiece (FFP3) respirators. However, for mask policies to be effective, compliance with their use must be high.
Aim
To understand any barriers to face mask use, and to promote compliance with face mask policy.
Methods
Twelve HCWs from a variety of backgrounds were interviewed during the COVID-19 pandemic in England in 2022 to understand their experiences of mask use. We explored factors associated with compliance with mask use and potential impacts on HCW wellbeing.
Findings
Overall, participants reported good understanding of the benefits of masks and high compliance levels with policy. However, factors that reduced their compliance with mask policy and impacted their ability to carry out their role were highlighted. These included wearing masks for longer durations, policy being perceived as out of proportion with risk, communication challenges, and discomfort.
Conclusion
This study highlights the importance of clear communication of guidance, particularly when it has changed, ensuring staff are familiar with up-to-date research on efficacy of masks, and ensuring guidance aligns with risk. Furthermore, this study highlights the importance of masks being required for an appropriate duration (based on risk).
{"title":"Understanding healthcare workers' experiences of face mask use in healthcare settings during the COVID-19 pandemic: an interview study","authors":"H. Carter , A. Sharp , L. Davidson , C. Foster , E. McGuire , C. Brown , D. Weston","doi":"10.1016/j.infpip.2024.100434","DOIUrl":"10.1016/j.infpip.2024.100434","url":null,"abstract":"<div><h3>Background</h3><div>Whilst healthcare workers (HCWs) are at high risk of contracting infectious viral diseases, such as COVID-19, measures can be put in place to reduce the spread of diseases in healthcare settings. These currently include the use of different types of masks: fluid-resistant surgical masks (FRSM) and filtering facepiece (FFP3) respirators. However, for mask policies to be effective, compliance with their use must be high.</div></div><div><h3>Aim</h3><div>To understand any barriers to face mask use, and to promote compliance with face mask policy.</div></div><div><h3>Methods</h3><div>Twelve HCWs from a variety of backgrounds were interviewed during the COVID-19 pandemic in England in 2022 to understand their experiences of mask use. We explored factors associated with compliance with mask use and potential impacts on HCW wellbeing.</div></div><div><h3>Findings</h3><div>Overall, participants reported good understanding of the benefits of masks and high compliance levels with policy. However, factors that reduced their compliance with mask policy and impacted their ability to carry out their role were highlighted. These included wearing masks for longer durations, policy being perceived as out of proportion with risk, communication challenges, and discomfort.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of clear communication of guidance, particularly when it has changed, ensuring staff are familiar with up-to-date research on efficacy of masks, and ensuring guidance aligns with risk. Furthermore, this study highlights the importance of masks being required for an appropriate duration (based on risk).</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100434"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081267","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 : 2025-03-01Epub Date: 2024-11-30DOI: 10.1016/j.infpip.2024.100427
Eun Jo Kim , JaHyun Kang , HyeonSuk Byeon
Background
This study describes the outbreak investigations and control measures for a coronavirus disease 2019 (COVID-19) outbreak at a long-term care hospital (LTCH) in Seoul.
Methods
The outbreak occurred from February 24, 2021 to March 2, 2021 at a 228-bed LTCH in Seoul. Monitoring of the outbreak continued until March 16, 2021. The LTCH investigated the outbreak in cooperation with the district public health centre. After approval from the institutional review board, the hospital's COVID-19 outbreak-related data were collected and analysed.
Results
The outbreak commenced when a new caregiver tested positive for COVID-19 in routine employee screening tests. During this outbreak, eight of 342 people including 175 patients and 64 caregivers were positive for the COVID-19 virus SARS-CoV-2. The mean age of the confirmed cases was 75.1 years (range 55–90). Of the eight, four (50%) were males; two (25%) were caregivers; six (75%) were asymptomatic; six (75%) had previously visited a rehabilitation centre, which was located on the basement level; and one visited different hospitals' outpatient clinics. Three of the 22 environmental specimens were test-positive at the corridor's handrail and the bed rails of confirmed patients. The outbreak ended with the immediate transfer of the confirmed cases to hospitals dedicated to infectious diseases and the transfer of close contacts of these cases to designated hospitals which were organised by the health authorities.
Conclusions
We found a potential link between the rehabilitation centre and the outbreak. To prevent future outbreaks at LTCHs, it is necessary to enhance each LTCH's infection control resources and competencies based on its specific requirements, with support from the government.
{"title":"Coronavirus disease-2019 (COVID-19) outbreak in a long-term care hospital in Korea in early 2021","authors":"Eun Jo Kim , JaHyun Kang , HyeonSuk Byeon","doi":"10.1016/j.infpip.2024.100427","DOIUrl":"10.1016/j.infpip.2024.100427","url":null,"abstract":"<div><h3>Background</h3><div>This study describes the outbreak investigations and control measures for a coronavirus disease 2019 (COVID-19) outbreak at a long-term care hospital (LTCH) in Seoul.</div></div><div><h3>Methods</h3><div>The outbreak occurred from February 24, 2021 to March 2, 2021 at a 228-bed LTCH in Seoul. Monitoring of the outbreak continued until March 16, 2021. The LTCH investigated the outbreak in cooperation with the district public health centre. After approval from the institutional review board, the hospital's COVID-19 outbreak-related data were collected and analysed.</div></div><div><h3>Results</h3><div>The outbreak commenced when a new caregiver tested positive for COVID-19 in routine employee screening tests. During this outbreak, eight of 342 people including 175 patients and 64 caregivers were positive for the COVID-19 virus SARS-CoV-2. The mean age of the confirmed cases was 75.1 years (range 55–90). Of the eight, four (50%) were males; two (25%) were caregivers; six (75%) were asymptomatic; six (75%) had previously visited a rehabilitation centre, which was located on the basement level; and one visited different hospitals' outpatient clinics. Three of the 22 environmental specimens were test-positive at the corridor's handrail and the bed rails of confirmed patients. The outbreak ended with the immediate transfer of the confirmed cases to hospitals dedicated to infectious diseases and the transfer of close contacts of these cases to designated hospitals which were organised by the health authorities.</div></div><div><h3>Conclusions</h3><div>We found a potential link between the rehabilitation centre and the outbreak. To prevent future outbreaks at LTCHs, it is necessary to enhance each LTCH's infection control resources and competencies based on its specific requirements, with support from the government.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100427"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932822","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}
Antimicrobial resistance and difficult-to-treat resistance (DTR) in ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) is a threat to human health. The aim of this study was to determine the prevalence of antimicrobial resistance and DTR rates in ESKAPE pathogens over six years in a third-level hospital from Monterrey, Mexico.
Methods
Antimicrobial susceptibility testing was determined by either disk diffusion or broth microdilution in strains from 2018 to 2023. Isolates were screened for carbapenemase genes. Multidrug resistance (MDR), extensively drug resistance (XDR), carbapenem resistance (CR), extended-spectrum cephalosporin-resistance (ESCR), fluoroquinolone resistance (FQR), and DTR were determined.
Results
From 3,239 strains, 48.5% were from respiratory infections, resistance was 87.5% to meticillin in Staphylococcus spp. and 39.8% in S. aureus, and 13.9% to vancomycin in Enterococcus spp. MDR, FQR and ESCR rates were between 54−90% in A. baumannii, 20–60% in Enterobacterales and 17−25% in P. aeruginosa. CR was 85.7% in A. baumannii, 33.3% in P. aeruginosa and <5% in Enterobacterales. Most frequent CR genes were OXA-24/40-like in A. baumannii and NDM and OXA-48 in carbapenem-resistant Enterobacterales. DTR rates were 59.7% in A. baumannii (49.2% in 2018 vs 62.9% in 2023), 8.9% in P. aeruginosa and <3% in Enterobacterales. XDR in A. baumannii was 14.4%.
Conclusions
Antimicrobial resistance rates were high in Gram-negative pathogens. CR and DTR rates were higher in A. baumannii than P. aeruginosa and Enterobacterales. DTR surveillance in healthcare providers should be continuous updating local and regional DTR trends among Gram-negative bacteria.
{"title":"Prevalence of difficult-to-treat resistance in ESKAPE pathogens in a third level hospital in Mexico","authors":"Adrián Camacho-Ortiz, Samantha Flores-Treviño, Paola Bocanegra-Ibarias","doi":"10.1016/j.infpip.2024.100426","DOIUrl":"10.1016/j.infpip.2024.100426","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance and difficult-to-treat resistance (DTR) in ESKAPE pathogens (<em>Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa,</em> and <em>Enterobacter</em> species) is a threat to human health. The aim of this study was to determine the prevalence of antimicrobial resistance and DTR rates in ESKAPE pathogens over six years in a third-level hospital from Monterrey, Mexico.</div></div><div><h3>Methods</h3><div>Antimicrobial susceptibility testing was determined by either disk diffusion or broth microdilution in strains from 2018 to 2023. Isolates were screened for carbapenemase genes. Multidrug resistance (MDR), extensively drug resistance (XDR), carbapenem resistance (CR), extended-spectrum cephalosporin-resistance (ESCR), fluoroquinolone resistance (FQR), and DTR were determined.</div></div><div><h3>Results</h3><div>From 3,239 strains, 48.5% were from respiratory infections, resistance was 87.5% to meticillin in <em>Staphylococcus</em> spp. and 39.8% in <em>S. aureus,</em> and 13.9% to vancomycin in <em>Enterococcus</em> spp. MDR, FQR and ESCR rates were between 54−90% in <em>A. baumannii</em>, 20–60% in Enterobacterales and 17−25% in <em>P. aeruginosa</em>. CR was 85.7% in <em>A. baumannii,</em> 33.3% in <em>P. aeruginosa</em> and <5% in Enterobacterales. Most frequent CR genes were OXA-24/40-like in <em>A. baumannii</em> and NDM and OXA-48 in carbapenem-resistant Enterobacterales. DTR rates were 59.7% in <em>A. baumannii</em> (49.2% in 2018 vs 62.9% in 2023), 8.9% in <em>P. aeruginosa</em> and <3% in Enterobacterales. XDR in <em>A. baumannii</em> was 14.4%.</div></div><div><h3>Conclusions</h3><div>Antimicrobial resistance rates were high in Gram-negative pathogens. CR and DTR rates were higher in <em>A. baumannii</em> than <em>P. aeruginosa</em> and Enterobacterales. DTR surveillance in healthcare providers should be continuous updating local and regional DTR trends among Gram-negative bacteria.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100426"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932825","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 : 2025-03-01Epub Date: 2024-11-29DOI: 10.1016/j.infpip.2024.100428
Olaa M. Alharbi , Mohammed A. Imam , Ahmad M. Alharbi
Although HH (HH) practices can prevent healthcare related infections, low compliance is a major concern. We evaluated HH using a WHO observational tool and HH self-assessment framework (HHSAF) in 30 individuals in a mix of healthcare professions, before and after the implementation of the framework. In 182 opportunities to demonstrate HH practices, pre-implementation scores were assessed across five different domains including system change, training, and evaluation and feedback. Post-implementation scores obtained after 12 months showed HH compliance of 53%, with highest improvements seen across evaluation and feedback domain. The compliance rates after exposure to body fluids was 100%.
{"title":"Implementation of the Hand hygiene self-assessment framework in a primary healthcare Centre in Saudi Arabia: A follow-up study","authors":"Olaa M. Alharbi , Mohammed A. Imam , Ahmad M. Alharbi","doi":"10.1016/j.infpip.2024.100428","DOIUrl":"10.1016/j.infpip.2024.100428","url":null,"abstract":"<div><div>Although HH (HH) practices can prevent healthcare related infections, low compliance is a major concern. We evaluated HH using a WHO observational tool and HH self-assessment framework (HHSAF) in 30 individuals in a mix of healthcare professions, before and after the implementation of the framework. In 182 opportunities to demonstrate HH practices, pre-implementation scores were assessed across five different domains including system change, training, and evaluation and feedback. Post-implementation scores obtained after 12 months showed HH compliance of 53%, with highest improvements seen across evaluation and feedback domain. The compliance rates after exposure to body fluids was 100%.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100428"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068387","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 : 2025-03-01Epub Date: 2025-01-25DOI: 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.
{"title":"Infection control Surveillance of dialysis events at outpatient hemodialysis centers in Saudi Arabia: A 3-year national data","authors":"Mohammed ALQahtani , Aiman El-Saed , Faisal Alsheddi , Ahlam H. Alamri , Atef M. Shibl , Khalid H. Alanazi","doi":"10.1016/j.infpip.2025.100447","DOIUrl":"10.1016/j.infpip.2025.100447","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>P</em><0.001 for each) and a less extent 27%–55% lower when compared with the published results from Chinese people.</div></div><div><h3>Conclusions</h3><div>The current findings provide benchmarking data for different dialysis events that can promote fair comparisons and interest in dialysis event surveillance.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100447"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Infection prevention and control (IPC) practices by critical care nurses are crucial in preventing ventilator-associated pneumonia (VAP) and central-line-associated bloodstream infection (CLABSI).
Aim
To implement an integrative approach to developing a set of IPC practices and disseminating information on the IPC practices through an educational multimedia tool to improve compliance with the practices.
Methods
This participatory interventional before–after study was conducted in a single tertiary care centre's cardiac surgical intensive care unit (ICU) from May 2022 to March 2023. Thirty-seven nursing IPC practices related to VAP and eight for CLABSI were finalized through a three-step process: systematized review, focused group discussions (five rounds), and Delphi rounds (three rounds). The IPC practices were disseminated through a multimedia tool, displayed continuously in the ICU. Nurses' compliance with the IPC practices observed directly was compared before and after implementing the multimedia tool.
Results
A total of 6043 observations for practices related to VAP and 1957 observations for those of CLABSI were performed. There was an increase in compliance post implementation for 11 IPC practices related to VAP and two IPC for those of CLABSI. There was an increase in compliance with practices relevant to chlorhexidine baths, oral care, cuff pressure maintenance, hypertonic saline nebulization, endotracheal suctioning, scrubbing the hub for central line access, and assessment of the central line for removal.
Conclusion
Through a participatory approach, we developed a set of IPC nursing practices for VAP and CLABSI. Implementing a multimedia tool, which encompasses the newly implemented IPC practices, improved compliance with many practices.
{"title":"A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study","authors":"Sunil Kumar Bijarania , Rupinder Kaur , Manisha Biswal , Sangeeta Maheshwar , Rajarajan Ganesan , Goverdhan D. Puri , Sushant Konar , Shyam Thingnam","doi":"10.1016/j.infpip.2024.100423","DOIUrl":"10.1016/j.infpip.2024.100423","url":null,"abstract":"<div><h3>Background</h3><div>Infection prevention and control (IPC) practices by critical care nurses are crucial in preventing ventilator-associated pneumonia (VAP) and central-line-associated bloodstream infection (CLABSI).</div></div><div><h3>Aim</h3><div>To implement an integrative approach to developing a set of IPC practices and disseminating information on the IPC practices through an educational multimedia tool to improve compliance with the practices.</div></div><div><h3>Methods</h3><div>This participatory interventional before–after study was conducted in a single tertiary care centre's cardiac surgical intensive care unit (ICU) from May 2022 to March 2023. Thirty-seven nursing IPC practices related to VAP and eight for CLABSI were finalized through a three-step process: systematized review, focused group discussions (five rounds), and Delphi rounds (three rounds). The IPC practices were disseminated through a multimedia tool, displayed continuously in the ICU. Nurses' compliance with the IPC practices observed directly was compared before and after implementing the multimedia tool.</div></div><div><h3>Results</h3><div>A total of 6043 observations for practices related to VAP and 1957 observations for those of CLABSI were performed. There was an increase in compliance post implementation for 11 IPC practices related to VAP and two IPC for those of CLABSI. There was an increase in compliance with practices relevant to chlorhexidine baths, oral care, cuff pressure maintenance, hypertonic saline nebulization, endotracheal suctioning, scrubbing the hub for central line access, and assessment of the central line for removal.</div></div><div><h3>Conclusion</h3><div>Through a participatory approach, we developed a set of IPC nursing practices for VAP and CLABSI. Implementing a multimedia tool, which encompasses the newly implemented IPC practices, improved compliance with many practices.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100423"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980200","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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