M. Ando, Yoko Sakaime, K. Maruyama, Mikoto Moriguchi, Tomohiro Hamashima
In-hospital isolation for patients with seasonal influenza is currently dependent on the facilities. In this study, we validated in-hospital isolation for patients who were diagnosed with seasonal influenza and admitted to our hospital from December 2018 to March 2020 using both viral copy numbers calculated by real-time RT-PCR method and viral culture. We collected each nasopharyngeal swab sample at the date of admission, and at three and seven days from admission, respectively, and determined viral copy numbers and cultivated viruses collected from each patient. Four patients were evaluated (73―90 years old; male: female, 3:1). The viral copy numbers decreased with time in three of the four patients (increased again at seven days from admission in the other patient). As for the viral culture, three of the four patients were positive both at the date of admission and three days from admission and negative at seven days from admission. The remaining patient was positive only at the date of admission. Thus, both viral shedding and infectiousness decrease with time in patients with seasonal influenza. The longest fever duration was six days in two patients, both of whom were complicated by pneumonia. On the basis of our findings, the longest indicated in-hospital isolation for inpatients with seasonal influenza is seven days after symptom onset or 24 hours after defervescence.
{"title":"Validation of In-hospital Isolation Based on Viral Shedding of Seasonal Influenza","authors":"M. Ando, Yoko Sakaime, K. Maruyama, Mikoto Moriguchi, Tomohiro Hamashima","doi":"10.4058/jsei.36.60","DOIUrl":"https://doi.org/10.4058/jsei.36.60","url":null,"abstract":"In-hospital isolation for patients with seasonal influenza is currently dependent on the facilities. In this study, we validated in-hospital isolation for patients who were diagnosed with seasonal influenza and admitted to our hospital from December 2018 to March 2020 using both viral copy numbers calculated by real-time RT-PCR method and viral culture. We collected each nasopharyngeal swab sample at the date of admission, and at three and seven days from admission, respectively, and determined viral copy numbers and cultivated viruses collected from each patient. Four patients were evaluated (73―90 years old; male: female, 3:1). The viral copy numbers decreased with time in three of the four patients (increased again at seven days from admission in the other patient). As for the viral culture, three of the four patients were positive both at the date of admission and three days from admission and negative at seven days from admission. The remaining patient was positive only at the date of admission. Thus, both viral shedding and infectiousness decrease with time in patients with seasonal influenza. The longest fever duration was six days in two patients, both of whom were complicated by pneumonia. On the basis of our findings, the longest indicated in-hospital isolation for inpatients with seasonal influenza is seven days after symptom onset or 24 hours after defervescence.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"84 18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130748354","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}
The objective of this study was to examine the nature of antimicrobial resistance (AMR) measures by clarifying the actual state of such measures at private nursing homes and long-term care insurance facilities. Infection control staff at a total of 2,800 randomly sampled facilities for the elderly (private nursing homes, designated facilities covered by public aid providing long-term care to the elderly, long-term care health facilities, and medical long-term care sanatoriums) were surveyed using a self-administered questionnaire. The responses of 254 (9.1%) facilities were tabulated. The conditions for hindering the spread of antimicrobial-resistant bacteria were being met at private nursing homes, but outbreaks of methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-Lactamase-producing bacteria, carbapenem-resistant Enterobacteriaceae, multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant Acinetobacter, and vancomycin-resistant enterococci infections had occurred like at other types of facilities. AMR measures at facilities for the elderly, such as availability of manuals, training, and measures upon admission, were insufficient. Screening upon admission was only implemented at 22% ― 33% of the facilities, and the target bacterium in screening was almost always limited to MRSA. There were also issues with care that facilitates the spread of antimicrobial-resistant bacteria (such as urethral indwelling catheter management and diaper care). Accordingly, this demonstrated the risk of the spread of antimicrobial-resistant bacteria from overlooked carriers. These findings suggest that because AMR measures at facilities for the elderly do not require screening upon admission, it may be effective to strengthen contact precautions in addition to standard precautions during provision of care that facilitates the spread of antimicrobial-resistant bacteria to all residents. Medical care and long-term care fee incentives are also needed to pro-mote support from public health centers and regional core hospitals.
{"title":"Antimicrobial Resistance Measures at Facilities for the Elderly: A Fact-finding Survey on Infection Control Measures at Private Nursing Homes and Long-term Care Insurance Facilities","authors":"Ye-Seul Oh, M. Aminaka, Namiko Mori, M. Nishioka","doi":"10.4058/jsei.36.10","DOIUrl":"https://doi.org/10.4058/jsei.36.10","url":null,"abstract":"The objective of this study was to examine the nature of antimicrobial resistance (AMR) measures by clarifying the actual state of such measures at private nursing homes and long-term care insurance facilities. Infection control staff at a total of 2,800 randomly sampled facilities for the elderly (private nursing homes, designated facilities covered by public aid providing long-term care to the elderly, long-term care health facilities, and medical long-term care sanatoriums) were surveyed using a self-administered questionnaire. The responses of 254 (9.1%) facilities were tabulated. The conditions for hindering the spread of antimicrobial-resistant bacteria were being met at private nursing homes, but outbreaks of methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-Lactamase-producing bacteria, carbapenem-resistant Enterobacteriaceae, multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant Acinetobacter, and vancomycin-resistant enterococci infections had occurred like at other types of facilities. AMR measures at facilities for the elderly, such as availability of manuals, training, and measures upon admission, were insufficient. Screening upon admission was only implemented at 22% ― 33% of the facilities, and the target bacterium in screening was almost always limited to MRSA. There were also issues with care that facilitates the spread of antimicrobial-resistant bacteria (such as urethral indwelling catheter management and diaper care). Accordingly, this demonstrated the risk of the spread of antimicrobial-resistant bacteria from overlooked carriers. These findings suggest that because AMR measures at facilities for the elderly do not require screening upon admission, it may be effective to strengthen contact precautions in addition to standard precautions during provision of care that facilitates the spread of antimicrobial-resistant bacteria to all residents. Medical care and long-term care fee incentives are also needed to pro-mote support from public health centers and regional core hospitals.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125766891","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}
Of nine samples from high-grade ethanol products sold by sake breweries, seven (77.8%) were contaminated with 5―44 colony forming units (cfu) of bacteria per 100 mL. The most common bacteria detected were Bacillus species and Paenibacillus species. No microbial contamination was observed in two samples (22.2%) from high-grade ethanol products nor in all three (100%) hospital-grade disinfectants (76.9―81.4 vol% ethanol). We conclude that although high-grade ethanol produced by sake breweries poses no problem as a hand sanitizer, it is unadvisable to use it for other purposes such as for sanitizing vials and infusion apparatus.
{"title":"Microbial Evaluation of High-grade Ethanol from Sake Breweries","authors":"S. Oie, Kyoko Shikichi","doi":"10.4058/jsei.36.72","DOIUrl":"https://doi.org/10.4058/jsei.36.72","url":null,"abstract":"Of nine samples from high-grade ethanol products sold by sake breweries, seven (77.8%) were contaminated with 5―44 colony forming units (cfu) of bacteria per 100 mL. The most common bacteria detected were Bacillus species and Paenibacillus species. No microbial contamination was observed in two samples (22.2%) from high-grade ethanol products nor in all three (100%) hospital-grade disinfectants (76.9―81.4 vol% ethanol). We conclude that although high-grade ethanol produced by sake breweries poses no problem as a hand sanitizer, it is unadvisable to use it for other purposes such as for sanitizing vials and infusion apparatus.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130946641","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}
Y. Tsuchida, Ryota Ochiai, Yuri Tokunaga, Fumie Fukase, S. Watabe
Background: Infection control is important in in-hospital nurseries. There is a concern that healthcare workers who are parents may become carriers and transmit infectious diseases to infants and patients. Study objective: The purpose of this study was to evaluate the effectiveness of a hygienic intervention to prevent infectious diseases from spreading among infants and nursery teachers at an in-hospital nursery. Methodology: A hygienic intervention consisting of education on hand hygiene, cough eti-quette, and environmental cleaning was implemented for infants and nursery teachers at the in-hospital nursery. Hand hygiene adherence of infants and nursery teachers, before and after the intervention, were compared using the χ 2 test. The relative risk of contracting an infectious dis-ease and the percentage of infection-related absence among infants, before and after the intervention, were also assessed. Results: Consent was obtained for 29 infants (100% consent rate) and from 22 nursery teachers (92% consent rate). The hand hygiene adherence of the infants significantly improved from 78.2%, before the intervention, to 97.4%, after the intervention (p ＜ 0.001). Hand hygiene adherence of the nursery teachers also significantly improved from 37.6%, before the intervention, to 78.2%, after the intervention (p ＜ 0.001). On the other hand, the incidence of infectious diseases among the infants was 11.47/1,000 person-days, before the intervention, and 11.31/1,000 person-days, after the intervention, and the relative risk with its 95% confidence interval was 0.99 (0.53-1.83). The percentage of absenteeism due to infection was 2.17% before, and 2.75% after the intervention, and the relative risk with its 95% confidence interval was 1.26 (0.24-6.68). Conclusions: The hygienic interventions implemented in this study did not change the incidence of infectious diseases and absenteeism among the infants, but improved hand hygiene adherence among infants and nursery teachers in an in-hospital nursery.
{"title":"Effectiveness of Hygienic Intervention in the Prevention of Infectious Diseases in Infants Attending an In-hospital Nursery","authors":"Y. Tsuchida, Ryota Ochiai, Yuri Tokunaga, Fumie Fukase, S. Watabe","doi":"10.4058/jsei.36.28","DOIUrl":"https://doi.org/10.4058/jsei.36.28","url":null,"abstract":"Background: Infection control is important in in-hospital nurseries. There is a concern that healthcare workers who are parents may become carriers and transmit infectious diseases to infants and patients. Study objective: The purpose of this study was to evaluate the effectiveness of a hygienic intervention to prevent infectious diseases from spreading among infants and nursery teachers at an in-hospital nursery. Methodology: A hygienic intervention consisting of education on hand hygiene, cough eti-quette, and environmental cleaning was implemented for infants and nursery teachers at the in-hospital nursery. Hand hygiene adherence of infants and nursery teachers, before and after the intervention, were compared using the χ 2 test. The relative risk of contracting an infectious dis-ease and the percentage of infection-related absence among infants, before and after the intervention, were also assessed. Results: Consent was obtained for 29 infants (100% consent rate) and from 22 nursery teachers (92% consent rate). The hand hygiene adherence of the infants significantly improved from 78.2%, before the intervention, to 97.4%, after the intervention (p ＜ 0.001). Hand hygiene adherence of the nursery teachers also significantly improved from 37.6%, before the intervention, to 78.2%, after the intervention (p ＜ 0.001). On the other hand, the incidence of infectious diseases among the infants was 11.47/1,000 person-days, before the intervention, and 11.31/1,000 person-days, after the intervention, and the relative risk with its 95% confidence interval was 0.99 (0.53-1.83). The percentage of absenteeism due to infection was 2.17% before, and 2.75% after the intervention, and the relative risk with its 95% confidence interval was 1.26 (0.24-6.68). Conclusions: The hygienic interventions implemented in this study did not change the incidence of infectious diseases and absenteeism among the infants, but improved hand hygiene adherence among infants and nursery teachers in an in-hospital nursery.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128679584","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}
The trends and problems of sexually transmitted infections in Japan are identified from the following four viewpoints: 1) epidemiology, 2) increase in syphilis incidence and Stop! syphilis project, 3) drug resistance of Neisseria gonorrhoeae , and 4) emergence of Mycoplasma genitalium . The epidemiological information obtained using surveillance data for the following five diseases under Category V of the Infectious Disease Law: syphilis from notifiable disease surveillance, genital chlamydial infection, genital herpes, condyloma acuminatum, and gonococcal infection from the sentinel surveillance. On the other hand, data from welfare science research are also introduced. Syphilis incidence rapidly increased from 2012 to 2018; however, in 2019 and 2020 the reported number decreased. This might be due to the Stop! syphilis project and the COVID-19 pandemic. Ceftriaxone resistant strains of N. gonorrhoeae with MIC of 0.5 μg/mL are scattered around the world. Mycoplasma genitalium , which is the third most common sexually transmitted cause of male urethritis after gonococcus and chlamydia, is also becoming an issue regarding multi-drug resistance.
{"title":"Trends and Problems of Sexually Transmitted Infections","authors":"Soichi Arakawa","doi":"10.4058/jsei.36.1","DOIUrl":"https://doi.org/10.4058/jsei.36.1","url":null,"abstract":"The trends and problems of sexually transmitted infections in Japan are identified from the following four viewpoints: 1) epidemiology, 2) increase in syphilis incidence and Stop! syphilis project, 3) drug resistance of Neisseria gonorrhoeae , and 4) emergence of Mycoplasma genitalium . The epidemiological information obtained using surveillance data for the following five diseases under Category V of the Infectious Disease Law: syphilis from notifiable disease surveillance, genital chlamydial infection, genital herpes, condyloma acuminatum, and gonococcal infection from the sentinel surveillance. On the other hand, data from welfare science research are also introduced. Syphilis incidence rapidly increased from 2012 to 2018; however, in 2019 and 2020 the reported number decreased. This might be due to the Stop! syphilis project and the COVID-19 pandemic. Ceftriaxone resistant strains of N. gonorrhoeae with MIC of 0.5 μg/mL are scattered around the world. Mycoplasma genitalium , which is the third most common sexually transmitted cause of male urethritis after gonococcus and chlamydia, is also becoming an issue regarding multi-drug resistance.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133641772","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}
Purpose: Blood culture guidelines suggest that a positive rate of 5% to 15% and a contamination rate of 2% to 3% or less are appropriate. It is said that blood collection from the groin area increases contamination; however, in our hospital, blood collection from the groin area is pre-dominantly performed. From 2016, we followed the disinfection method according to the guideline and determined whether the contamination from the groin area can be reduced. In order to eliminate the difference in procedures between individuals, only the samples collected by one physician were taken for verification. Method: From 2014 to 2019, we conducted descriptive statistics and past-origin cohort studies on blood culture conducted by one doctor among blood cultures submitted at the Izumo-Shimin Hospital. Results: Eight hundred sets were analyzed. The blood collection was done 94.4% in the groin area, 5.6% in the upper limbs, and the collection rate for multiple sets was 99.0%. From 2016, when the disinfection method was changed according to the guidelines, both the positive rate and the contamination rate of blood collection from the groin area decreased, and the contamination rate of blood collection from the groin area from 2016 to 2018 was 1.7%. The contamination rate of blood collection from the upper limb was 0%, but no significant difference was observed. Discussion: Although blood culture blood collection from the groin area tends to increase contamination, it is considered that a contamination rate within the appropriate range is possible if proper skin disinfection according to the guidelines is performed.
{"title":"The Disinfection Method Recommended in the Guideline Reduced Contamination Rate in Blood Cultures from the Groin Area - Evaluation using Blood Culture Performed by One Skillful Physician","authors":"S. Takahashi","doi":"10.4058/jsei.36.53","DOIUrl":"https://doi.org/10.4058/jsei.36.53","url":null,"abstract":"Purpose: Blood culture guidelines suggest that a positive rate of 5% to 15% and a contamination rate of 2% to 3% or less are appropriate. It is said that blood collection from the groin area increases contamination; however, in our hospital, blood collection from the groin area is pre-dominantly performed. From 2016, we followed the disinfection method according to the guideline and determined whether the contamination from the groin area can be reduced. In order to eliminate the difference in procedures between individuals, only the samples collected by one physician were taken for verification. Method: From 2014 to 2019, we conducted descriptive statistics and past-origin cohort studies on blood culture conducted by one doctor among blood cultures submitted at the Izumo-Shimin Hospital. Results: Eight hundred sets were analyzed. The blood collection was done 94.4% in the groin area, 5.6% in the upper limbs, and the collection rate for multiple sets was 99.0%. From 2016, when the disinfection method was changed according to the guidelines, both the positive rate and the contamination rate of blood collection from the groin area decreased, and the contamination rate of blood collection from the groin area from 2016 to 2018 was 1.7%. The contamination rate of blood collection from the upper limb was 0%, but no significant difference was observed. Discussion: Although blood culture blood collection from the groin area tends to increase contamination, it is considered that a contamination rate within the appropriate range is possible if proper skin disinfection according to the guidelines is performed.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"56 2-3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134282947","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}
One of the problems of cover-up type protective clothing (protective clothes) is to make heat stress on health care workers. Thus, the purpose of this research is to survey the effects of local torso cooling with cooling devices on the human body. The design of this study is an “intervention design.” So when nurses simulate 120 minutesʼ nursing procedures, 16 link nurses were divided randomly into two groups; one using cooling devices (intervention group) and the other using conventional clothes (control group). The indica-tors of heat stress (thermal sensation, comfort index, temperature in-and-out of the clothes, tympanic temperature, forehead temperature, and fogging of goggles) were measured every 30 min-utes. The results showed that torso cooling is more effective in thermal sensation immediately after wearing and in comfort index from after wearing 30 to 120 minutes, i.e., every 30 minutes, (p ＜ 0.05 p ＜ 0.001, respectively) respectively. Between tympanic temperature and forehead temperature, there was no significant difference. In the intervention group, the grade of fogging of goggles was relatively weak as compared with the control group. Results indicated that local torso cooling increased the “comfort index” by controlling skin sur-face temperature. Furthermore, the fact that the temperatures in both groups were not signifi-cantly different indicated that thermoregulation mechanisms made possible to control the temperature by vasodilation associated with sweating. Thus, the temperature of the intervention group was relatively low. The results for fogging of goggles had been strengthened in the control group might be explained also by the effect of gradual rise of temperature. This study indicated that “local torso cooling” effectively improved heat stress.
遮盖式防护服(防护服)的问题之一是使医护人员产生热应激。因此，本研究的目的是调查局部躯干冷却装置对人体的影响。本研究的设计为“干预设计”。因此，当护士模拟120分钟的护理过程时，16名环节护士随机分为两组;一组使用冷却装置(干预组)，另一组使用传统衣服(对照组)。每隔30 min测量热应激指标(热感觉、舒适指数、衣服内外温度、鼓室温度、前额温度、护目镜起雾)。结果表明，躯干降温对穿着后即刻热感觉和穿着后30 ~ 120分钟(即每30分钟)舒适度的影响更显著(p < 0.05 p < 0.001)。鼓室温度与前额温度之间无显著差异。干预组的护目镜起雾程度较对照组较弱。结果表明，躯干局部降温通过控制皮肤表面温度来提高“舒适度”。此外，两组的温度没有显著差异这一事实表明，温度调节机制可能通过与出汗相关的血管舒张来控制温度。因此，干预组的体温相对较低。对照组护目镜起雾效果明显增强，也可能是温度逐渐升高的影响所致。该研究表明，“局部躯干冷却”有效地改善了热应激。
{"title":"Research about How to Improve Heat Stress in Health Care Workers with Cover-up Type Protective Clothing-Effects of Local Torso Cooling on Human Body-","authors":"Setuko Watabe, M. Ohgama, Midori Tsukakosi","doi":"10.4058/jsei.36.35","DOIUrl":"https://doi.org/10.4058/jsei.36.35","url":null,"abstract":"One of the problems of cover-up type protective clothing (protective clothes) is to make heat stress on health care workers. Thus, the purpose of this research is to survey the effects of local torso cooling with cooling devices on the human body. The design of this study is an “intervention design.” So when nurses simulate 120 minutesʼ nursing procedures, 16 link nurses were divided randomly into two groups; one using cooling devices (intervention group) and the other using conventional clothes (control group). The indica-tors of heat stress (thermal sensation, comfort index, temperature in-and-out of the clothes, tympanic temperature, forehead temperature, and fogging of goggles) were measured every 30 min-utes. The results showed that torso cooling is more effective in thermal sensation immediately after wearing and in comfort index from after wearing 30 to 120 minutes, i.e., every 30 minutes, (p ＜ 0.05 p ＜ 0.001, respectively) respectively. Between tympanic temperature and forehead temperature, there was no significant difference. In the intervention group, the grade of fogging of goggles was relatively weak as compared with the control group. Results indicated that local torso cooling increased the “comfort index” by controlling skin sur-face temperature. Furthermore, the fact that the temperatures in both groups were not signifi-cantly different indicated that thermoregulation mechanisms made possible to control the temperature by vasodilation associated with sweating. Thus, the temperature of the intervention group was relatively low. The results for fogging of goggles had been strengthened in the control group might be explained also by the effect of gradual rise of temperature. This study indicated that “local torso cooling” effectively improved heat stress.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116436304","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}
{"title":"Ethical Behavior of Healthcare Providers as Experienced by Hepatitis B Virus Carriers at Diagnosis: An Examination of the Effects of Standard Precautions","authors":"Sachiko Fukui, H. Yano, S. Yasuoka, K. Ohnishi","doi":"10.4058/jsei.36.66","DOIUrl":"https://doi.org/10.4058/jsei.36.66","url":null,"abstract":"","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129564296","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}
In Japan, seasonal influenza vaccine is routinely administered subcutaneously. In contrast, intramuscular administration is recommended overseas because of the mild local adverse reaction and appropriate increase in the influenza antibody titer. Thus far, the difference in the preventive effect of the vaccine on influenza incidence and the level of pain experienced during the injection between the subcutaneous and intramuscular routes of administration have not been elucidated. Regarding the influenza vaccination at our hospital, staff and nursing students choose either a subcutaneous or an intramuscular route of administration. Therefore, in this prospective observational cohort study, we investigated the difference between the two routes of vaccine administration by comparing influenza incidence, level of pain during the injection, and postadministration adverse reaction. By law, influenza cases must be reported to the workplace or school. Hence, the incidence rate of influenza is calculated according to the number of reported cases. The incidence of influenza was 11.3% (65/574) and 8.2% (258/3147) among individuals who received the vaccine subcutaneously and intramuscularly, respectively. Furthermore, a univariate analysis showed a significantly lower incidence of influenza among individuals who received the intramuscular injection than among those who received the subcutaneous injection (P=0.02). Based on logistic regression adjusted for sex, age, cohabitation with people under 15 years of age, and measures to prevent infection, influenza incidence was significantly lower in the intramuscular injection group (odds ratio 0.73, P=0.04). Additionally, the level of pain during the injection and post-administration adverse reactions were assessed among 320 nursing students (subcutaneous administration, 77; intramuscular administration, 243). The median score of pain experienced during the injection (where 0 was defined as painless and 10 was defined as very painful)was 4 in the subcutaneous injection group and 2 in the intramuscular injection group. The intramuscular injection group experienced significantly less pain (P<0.001). Based on a multivariate regression analysis adjusted for fear of injection, the level of pain due to the injection was significantly lower in the intramuscular group (regression coefficient of -1.26, P<0.001). Postadministration pain and swelling were also milder in the intramuscular group. In conclusion, intramuscular administration of the influenza vaccine resulted in lower influenza incidence, less pain during injection, and less severe post-administration adverse reaction than the subcutaneous administration of the vaccine. As intramuscular administration of the influenza vaccine is generally considered an excellent method of administration, we hope that this method will become widely accepted in Japan.
{"title":"Differences in the Preventive Effect of Subcutaneous Versus Intramuscular Administration of Seasonal Influenza Vaccine: A Prospective Cohort Observational Study on Influenza Incidence, Injection Pain Level, and Adverse Reaction","authors":"K. Majima, N. Furuya, N. Hosokawa","doi":"10.4058/jsei.36.44","DOIUrl":"https://doi.org/10.4058/jsei.36.44","url":null,"abstract":"In Japan, seasonal influenza vaccine is routinely administered subcutaneously. In contrast, intramuscular administration is recommended overseas because of the mild local adverse reaction and appropriate increase in the influenza antibody titer. Thus far, the difference in the preventive effect of the vaccine on influenza incidence and the level of pain experienced during the injection between the subcutaneous and intramuscular routes of administration have not been elucidated. Regarding the influenza vaccination at our hospital, staff and nursing students choose either a subcutaneous or an intramuscular route of administration. Therefore, in this prospective observational cohort study, we investigated the difference between the two routes of vaccine administration by comparing influenza incidence, level of pain during the injection, and postadministration adverse reaction. By law, influenza cases must be reported to the workplace or school. Hence, the incidence rate of influenza is calculated according to the number of reported cases. The incidence of influenza was 11.3% (65/574) and 8.2% (258/3147) among individuals who received the vaccine subcutaneously and intramuscularly, respectively. Furthermore, a univariate analysis showed a significantly lower incidence of influenza among individuals who received the intramuscular injection than among those who received the subcutaneous injection (P=0.02). Based on logistic regression adjusted for sex, age, cohabitation with people under 15 years of age, and measures to prevent infection, influenza incidence was significantly lower in the intramuscular injection group (odds ratio 0.73, P=0.04). Additionally, the level of pain during the injection and post-administration adverse reactions were assessed among 320 nursing students (subcutaneous administration, 77; intramuscular administration, 243). The median score of pain experienced during the injection (where 0 was defined as painless and 10 was defined as very painful)was 4 in the subcutaneous injection group and 2 in the intramuscular injection group. The intramuscular injection group experienced significantly less pain (P<0.001). Based on a multivariate regression analysis adjusted for fear of injection, the level of pain due to the injection was significantly lower in the intramuscular group (regression coefficient of -1.26, P<0.001). Postadministration pain and swelling were also milder in the intramuscular group. In conclusion, intramuscular administration of the influenza vaccine resulted in lower influenza incidence, less pain during injection, and less severe post-administration adverse reaction than the subcutaneous administration of the vaccine. As intramuscular administration of the influenza vaccine is generally considered an excellent method of administration, we hope that this method will become widely accepted in Japan.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132934806","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}
Yoshihiko Matsuki, Haruna Matsumoto, K. Sako, M. Yajima, Tamaki Watanabe, Shigekazu Watanabe
The Geriatric Nutritional Risk Index (GNRI) is used to assess nutritional risk in the elderly population based on the percent ideal body weight (IBW) and albumin (Alb) level, while severe infections are associated with hypoproteinemia and hypoalbuminemia, which can make the treatment of infections challenging. Although GNRI is an effective index to assess disease severity, its association with vancomycin (VCM)-induced renal dysfunction has not yet been clarified. In the present study, classification and regression tree (CART) analysis and receiver operating charac-teristic (ROC) curve were used to determine the GNRI threshold level that discriminates patients with and without renal dysfunction, with a total of 293 patients who were administered VCM be-ing included. We examined the association between GNRI and the incidence of VCM-induced renal dysfunction to explore ways in which GNRI may be used to determine the target VCM trough levels for individual patients. Based on the threshold level, patients were further divided into high and low GNRI groups, and survival analysis was performed based on trough levels ( ＜ 20, 20-25, (cid:2) 25 μ g/mL). Bearing in mind that, due to safety concerns, guidelines do not recom-mend the trough level of ＞ 20 μ g/mL, in the high GNRI group ( (cid:2) 68, n = 163), there was no sig-nificant difference in the rate of renal dysfunction between those with trough levels of ＜ 20 and 20-25 μ g/mL (p = 0.66), while in the low GNRI group ( ＜ 68, n = 130), patients with the trough level of 20-25 μ g/mL were at a higher risk of developing renal dysfunction than those with trough level of ＜ 20 μ g/mL (p ＜ 0.01). While this was in agreement with our low GNRI group, our findings suggest that the trough level may be increased to 25 μ g/mL in patients who are in the high GNRI group.
{"title":"Association between Serum Trough Concentration of Vancomycin and Vancomycin-induced Renal Dysfunction Based on the Geriatric Nutritional Risk Index","authors":"Yoshihiko Matsuki, Haruna Matsumoto, K. Sako, M. Yajima, Tamaki Watanabe, Shigekazu Watanabe","doi":"10.4058/JSEI.35.223","DOIUrl":"https://doi.org/10.4058/JSEI.35.223","url":null,"abstract":"The Geriatric Nutritional Risk Index (GNRI) is used to assess nutritional risk in the elderly population based on the percent ideal body weight (IBW) and albumin (Alb) level, while severe infections are associated with hypoproteinemia and hypoalbuminemia, which can make the treatment of infections challenging. Although GNRI is an effective index to assess disease severity, its association with vancomycin (VCM)-induced renal dysfunction has not yet been clarified. In the present study, classification and regression tree (CART) analysis and receiver operating charac-teristic (ROC) curve were used to determine the GNRI threshold level that discriminates patients with and without renal dysfunction, with a total of 293 patients who were administered VCM be-ing included. We examined the association between GNRI and the incidence of VCM-induced renal dysfunction to explore ways in which GNRI may be used to determine the target VCM trough levels for individual patients. Based on the threshold level, patients were further divided into high and low GNRI groups, and survival analysis was performed based on trough levels ( ＜ 20, 20-25, (cid:2) 25 μ g/mL). Bearing in mind that, due to safety concerns, guidelines do not recom-mend the trough level of ＞ 20 μ g/mL, in the high GNRI group ( (cid:2) 68, n = 163), there was no sig-nificant difference in the rate of renal dysfunction between those with trough levels of ＜ 20 and 20-25 μ g/mL (p = 0.66), while in the low GNRI group ( ＜ 68, n = 130), patients with the trough level of 20-25 μ g/mL were at a higher risk of developing renal dysfunction than those with trough level of ＜ 20 μ g/mL (p ＜ 0.01). While this was in agreement with our low GNRI group, our findings suggest that the trough level may be increased to 25 μ g/mL in patients who are in the high GNRI group.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130984367","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}
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