Infection Disease & Health最新文献

英文中文

An evaluation of influenza, pneumococcal and herpes zoster vaccination coverage in Australian aged care residents, 2018 to 2022 2018年至2022年澳大利亚老年护理居民流感、肺炎球菌和带状疱疹疫苗接种覆盖率评估。

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-11-01 DOI: 10.1016/j.idh.2023.03.005

Noleen Bennett , Brett Morris , Michael J. Malloy , Lyn-li Lim , Eliza Watson , Ann Bull , Janet Sluggett , Leon J. Worth , NISPAC Advisory Group

Background

For older persons, vaccination mitigates the harmful impact of vaccine preventable infections. Our study objectives were to evaluate in the Victorian public sector residential aged care services (PSRACS) (1) the existence of local vaccination policies and admission assessment practices, (2) the current documented status of resident influenza, pneumococcal and herpes zoster vaccination uptake and (3) changes in documented resident vaccination uptake over time.

Methods

Standardised data were annually reported by all PSRACS between 2018 and 2022. The influenza, pneumococcal and herpes zoster vaccination status of each resident was classified as vaccinated, declined, contraindicated or unknown. Annual trends in vaccination status were assessed using Spearman's correlation.

Results

In 2022, most PSRACS reported an influenza immunisation policy existed (87.1%) and new residents were assessed for their influenza vaccination status (97.2%); fewer PSRACS reported the same for pneumococcal disease (73.1% and 78.9%) and herpes zoster (69.3% and 75.6%). The median resident influenza, pneumococcal and herpes zoster (70–79 years old) vaccination uptake was 86.8%, 32.8% and 19.3% respectively. The median unknown status was 6.9%, 63.0% and 76.0% respectively. Statistical evidence of an increase in annual uptake was observed for the herpes zoster (all resident) surveillance module (r_s = 0.900, p = 0.037).

Conclusions

Our study showed local influenza vaccination policies and practices exist and influenza vaccination uptake was consistently high. Pneumococcal and herpes zoster vaccination uptake were lower. Quality improvement strategies that at least determine the status of those residents classified as unknown are required.

背景：对于老年人来说，接种疫苗可以减轻疫苗可预防感染的有害影响。我们的研究目的是评估维多利亚州公共部门养老院服务（PSRAC）（1）当地疫苗接种政策和入院评估实践的存在，（2）居民流感、肺炎球菌和带状疱疹疫苗接种的当前记录状态，以及（3）随时间推移居民疫苗接种记录的变化。方法：2018年至2022年间，所有PSRAC每年报告标准化数据。每位居民的流感、肺炎球菌和带状疱疹疫苗接种情况分为已接种、拒绝接种、禁忌症或未知。使用Spearman相关性对疫苗接种状况的年度趋势进行评估。结果：2022年，大多数PSRAC报告存在流感免疫政策（87.1%），并对新居民的流感疫苗接种状况进行了评估（97.2%）；较少的PSRAC报告了肺炎球菌疾病（73.1%和78.9%）和带状疱疹（69.3%和75.6%）的相同情况。居民流感、肺炎球菌和带状疱疹疫苗接种率（70-79岁）的中位数分别为86.8%、32.8%和19.3%。中位未知状态分别为6.9%、63.0%和76.0%。观察到带状疱疹（所有居民）监测模块的年接种率增加的统计证据（rs=0.900，p=0.037）。结论：我们的研究表明，当地存在流感疫苗接种政策和做法，流感疫苗接种率一直很高。肺炎球菌和带状疱疹疫苗接种率较低。需要至少确定被归类为未知居民的状况的质量改进策略。

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引用次数: 0

Peripheral intravenous catheter material and design to reduce device failure: A systematic review and meta-analysis 减少装置故障的外周静脉导管材料和设计：系统综述和荟萃分析。

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-11-01 DOI: 10.1016/j.idh.2023.05.005

Robyn Matthews , Nicole C. Gavin , Nicole Marsh , Louise Marquart-Wilson , Samantha Keogh

Background

Patients require vascular access for medical treatments, diagnostic procedures and symptom management. Current failure rates of peripheral intravascular catheters (PIVCs) are unacceptably high (40–50%). This systematic review aimed to determine the effect of different PIVC materials and designs on the incidence of PIVC failure.

Methods

A systematic search was conducted in November 2022 using CINAHL, PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Randomised controlled trials that compared PIVC novel PIVC material/design and standard material/design were included. The primary outcome was all causes of PIVC failure, any reason for device removal due to cessation of device function; and secondary outcomes included individual PIVC complications and infection (local or systemic), and dwell times. Quality appraisal was conducted using the Cochrane risk of bias tool. A meta-analysis was performed using random effects model.

Results

Seven randomised controlled trials were eligible for inclusion. In meta-analysis, the impact of material and design on PIVC failure in the studies favoured the intervention arms (RR 0.71, 95% CI 0.57–0.89), however there was substantial heterogeneity (I² = 81%, 95% CI 61–91%). Through subgroup analyses, a significant difference on PIVC failure favoured the closed system over the open system (RR 0.85, 95% CI 0.73 to 0.99; I² = 23%, 95% CI 0–90%).

Conclusion

Catheter material and design can impact PIVC outcome. Conclusive recommendations are limited due to the small number of studies and inconsistent reporting of clinical outcomes. Further rigorous research of PIVC types is necessary to improve clinical practice and device selection pathways should reflect the resulting evidence.

背景：患者需要血管通路进行医疗、诊断程序和症状管理。目前外周血管内导管（PIVC）的故障率高得令人无法接受（40-50%）。本系统综述旨在确定不同PIVC材料和设计对PIVC失效发生率的影响。方法：于2022年11月使用CINAHL、PubMed、EMBASE和Cochrane对照试验中央注册数据库进行系统检索。包括比较PIVC新型PIVC材料/设计和标准材料/设计的随机对照试验。主要结果是PIVC失败的所有原因，任何因设备功能停止而移除设备的原因；次要结果包括个体PIVC并发症和感染（局部或全身）以及停留时间。使用Cochrane偏倚风险工具进行质量评估。采用随机效应模型进行荟萃分析。结果：7项随机对照试验符合入选条件。在荟萃分析中，研究中材料和设计对PIVC失败的影响有利于干预组（RR 0.71，95%CI 0.57-0.89），但存在显著的异质性（I2=81%，95%CI 61-91%）。通过亚组分析，与开放系统相比，封闭系统的PIVC失败有显著差异（RR 0.85，95%CI 0.73至0.99；I2=23%，95%CI 0-90%）。结论：导管材料和设计会影响PIVC的结果。由于研究数量少，临床结果报告不一致，结论性建议有限。有必要对PIVC类型进行进一步严格的研究，以改进临床实践，设备选择途径应反映由此产生的证据。

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引用次数: 0

Time-to-first-isolation of methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF): An underutilised metric in infection control? 囊性纤维化（CF）中耐甲氧西林金黄色葡萄球菌（MRSA）的首次分离时间：感染控制中一个未充分利用的指标？

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-11-01 DOI: 10.1016/j.idh.2023.05.002

John E. Moore , Jacqueline C. Rendall , Beverley C. Millar

Background

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant pathogen in people with cystic fibrosis (PwCF). There is a paucity of reports on MRSA infection dynamics within CF. It was the aim to examine the utility of Time- To-First Isolation (TTFI) metric and to correlate this with patient gender and CF transmembrane conductance regulator (CFTR) mutation type.

Methods

The microbiology of respiratory specimens from 100 adult (≥18 years) PwCF was examined (50 females; 50 males; mean age 24.6 years ±6.25 (SD)) from birth to present, equating to 2455 patient years. TTFI was determined in relation to (i) presence/absence of MRSA, (ii) CFTR mutation type and (iii) PwCF gender.

Results

MRSA was noted in 23% patients (10 female/13 males); (i) F508del/F508del homozygous (43.5%) and (ii) F508del/other heterozygous (56.5%). No non-F508del CFTR mutations types were noted. The median and mean TTFI was 137 months and 127.4 months respectively, shortest time was 23 months, longest time 211 months. There was no statistical significance in TTFI in relation to CFTR mutation group (p = 0.39) or gender (p = 0.71).

Conclusions

TTFI is useful and applicable to the chronic infection model, where patients with a specific underlying disease are predisposed to acquire infections and where these infections are likely to become chronic. Intelligence offered by TTFI provides a window of opportunity to target IPC interventions, to help prevent MRSA acquisition. CF multidisciplinary teams, microbiologists and infection prevention specialists should utilise such TTFI data from their respective centres to help inform and plan intervention strategies to help prevent MRSA acquisition.

背景：耐甲氧西林金黄色葡萄球菌（MRSA）已成为囊性纤维化患者的重要病原体。关于CF中MRSA感染动力学的报道很少。目的是检查首次分离时间（TTFI）指标的实用性，并将其与患者性别和CF跨膜电导调节因子（CFTR）突变类型相关联。方法：对100例成人（≥18岁）PwCF（女性50例，男性50例，平均年龄24.6岁±6.25（SD））从出生到现在的呼吸道标本进行微生物学检查，相当于2455例患者年。TTFI与（i）MRSA的存在/不存在、（ii）CFTR突变类型和（iii）PwCF性别有关。结果：23%的患者（10名女性/13名男性）出现MRSA；（i） F508del/F508del纯合子（43.5%）和（ii）F508del/其他杂合子（56.5%）。未发现非F508delCFTR突变类型。TTFI中位数和平均值分别为137个月和127.4个月，最短时间为23个月，最大时间为211个月。TTFI与CFTR突变组（p=0.39）或性别（p=0.71）之间没有统计学意义。结论：TTFI适用于慢性感染模型，在慢性感染模型中，患有特定基础疾病的患者容易感染，并且这些感染可能成为慢性感染。TTFI提供的情报为靶向IPC干预提供了机会之窗，有助于预防MRSA的获得。CF多学科团队、微生物学家和感染预防专家应利用各自中心的TTFI数据，帮助告知和规划干预策略，以帮助预防MRSA的获得。

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引用次数: 1

An educational intervention in the emergency department seeking to improve COVID-19 vaccination rates among unvaccinated patients aged 20-64 急诊科的一项教育干预措施，旨在提高20-64岁未接种疫苗患者的新冠肺炎疫苗接种率。

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-11-01 DOI: 10.1016/j.idh.2023.07.001

Shelby DeWaard , Zachary Dewyer , Talal Al Assil , Rachael Gallap , Lauren Patrick , Noelle Fukuda , Maureen Ford

Background

The COVID-19 vaccination rate in the US has plateaued, especially among minorities and young populations. Previous efforts within the Emergency Department (ED) setting to address this disparity have shown positive results. The ED can play a crucial role in engaging vaccine-hesitant individuals, particularly those with limited access to healthcare. By providing education, addressing concerns, and using positive framing, vaccination rates can be improved in the ED. This quality improvement project aimed to increase vaccination rates through one-on-one educational interventions and open discussions with patients.

Methods

Between November 2021 and June 2022, unvaccinated adult patients aged 20 to 64 visiting a local ED in Kalamazoo, MI were approached for a discussion on COVID vaccines. A research team, trained in motivational interviewing techniques, provided an educational intervention, offering evidence-based information and resources to unvaccinated participants.

Results

A total of 37 participants were enrolled, and their demographics were recorded. The participants expressed various concerns about the vaccine, including potential side effects, speed of testing and production, perceived ineffectiveness, mistrust, and low personal risk. At the four-week follow-up, three participants (8%) had received their first dose of the COVID-19 vaccine.

Conclusion

The study fell short of its desired sample size and the intervention failed to raise vaccination rates among ED patients. Factors like low perceived risk, vaccine hesitancy, and limited resources may have influenced these outcomes. Future research should focus on staffing, operational hours, repeated educational interventions, and targeted approaches for different populations. Improving participant recruitment through institutional engagement and involvement of multiple EDs should be explored. Addressing these factors can help inform effective interventions to increase COVID-19 vaccination rates in the ED.

背景：美国新冠肺炎疫苗接种率已趋于平稳，尤其是在少数民族和年轻人口中。此前，急诊科为解决这一差距所做的努力取得了积极成果。ED可以在吸引对疫苗犹豫不决的个人，特别是那些获得医疗保健机会有限的人方面发挥关键作用。通过提供教育、解决问题和使用积极的框架，可以提高ED的疫苗接种率。这一质量改进项目旨在通过一对一的教育干预和与患者的公开讨论来提高疫苗接种率。方法：在2021年11月至2022年6月期间，访问密歇根州卡拉马祖当地急诊室的20至64岁未接种疫苗的成年患者被邀请讨论新冠疫苗。一个接受过动机访谈技术培训的研究团队提供了教育干预，为未接种疫苗的参与者提供了循证信息和资源。结果：共有37名参与者被纳入，并记录了他们的人口统计数据。参与者表达了对疫苗的各种担忧，包括潜在副作用、测试和生产速度、无效性、不信任和低个人风险。在为期四周的随访中，三名参与者（8%）接种了第一剂新冠肺炎疫苗。结论：该研究没有达到预期的样本量，干预措施未能提高ED患者的疫苗接种率。低感知风险、疫苗犹豫和资源有限等因素可能影响了这些结果。未来的研究应侧重于人员配备、手术时间、重复的教育干预措施以及针对不同人群的有针对性的方法。应探索通过机构参与和多个ED的参与来改善参与者的招聘。解决这些因素有助于为提高ED新冠肺炎疫苗接种率的有效干预措施提供信息。

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引用次数: 0

Response to the letter: Comment on “Care bundle for the prevention of peripheral venous catheter blood stream infections at a secondary care university hospital: Implementation and results” 对这封信的回应：对“二级护理大学医院预防外周静脉导管血流感染的护理包：实施和结果”的评论。

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-11-01 DOI: 10.1016/j.idh.2023.07.003

Yolanda Lladó Maura, Magdalena Lucía Berga Figuerola, M José Rodríguez Moreno, Verónica Lluch Garvi, Elisabet E Soler Felsner, Adrián Rodríguez-Rodríguez, Alexander Almendral, Enric Limón, Ester Fusté

引用次数: 0

The impact of rapid diagnostic testing on hospital administrative coding accuracy for influenza 快速诊断检测对流感医院管理编码准确性的影响。

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-11-01 DOI: 10.1016/j.idh.2023.05.003

Hugh C. Murray , Benjamin J. Smith , Mark Putland , Lou Irving , Douglas Johnson , Deborah A. Williamson , Steven Y.C. Tong

Background

Hospital administrative coding may underestimate the true incidence of influenza-associated hospitalisation. Earlier availability of test results could lead to improved accuracy of administrative coding.

Methods

In this study we evaluated International Classification of Diseases 10 (ICD-10) coding for influenza (with [J09-J10] or without [J11] virus identified) in adult inpatients who underwent testing in the year prior, compared to those in the 2.5 years after, the introduction of rapid PCR testing in 2017. Other factors associated with influenza coding were evaluated using logistic regression. Discharge summaries were audited to assess the impact of documentation and result availability on coding accuracy.

Results

Influenza was confirmed by laboratory testing in 862 of 5755 (15%) patients tested after rapid PCR introduction compared with 170 of 926 (18%) prior. Following the introduction of rapid testing there was a significant increase in patients allocated J09 or J10 ICD-10 codes (768 of 860 [89%] vs 107 of 140 [79%], P = 0.001). On multivariable analysis, factors independently associated with correct coding were rapid PCR testing (aOR 4.36 95% CI [2.75–6.90]) and increasing length of stay (aOR 1.01, 95% CI [1.00–1.01]). Correctly coded patients were more likely to have documentation of influenza in their discharge summaries (95 of 101 [89%] vs 11 of 101 [10%], P < 0.001) and less likely to have pending results at discharge (8 of 101 [8%] vs 65 of 101 [61%], P < 0.001).

Conclusion

The introduction of rapid PCR testing for influenza was associated with more accurate hospital coding. One possible explanation is faster test turnaround leading to improvement in clinical documentation.

背景：医院行政编码可能低估了流感相关住院的真实发生率。尽早获得测试结果可以提高管理编码的准确性。方法：在本研究中，我们评估了在前一年接受检测的成年住院患者中编码流感（已识别[J09-J10]或未识别[J11]病毒）的国际疾病分类10（ICD-10），与2017年引入快速PCR检测后2.5年的住院患者进行了比较。其他与流感编码相关的因素使用逻辑回归进行评估。对出院总结进行了审计，以评估文件和结果可用性对编码准确性的影响。结果：在5755名患者中，862名（15%）在快速PCR引入后接受检测，而926名患者中有170名（18%）在实验室检测中确诊为流感。在引入快速检测后，分配J09或J10 ICD-10代码的患者显著增加（768/860[89%]vs 107/140[79%]，P=0.001）。在多变量分析中，与正确编码独立相关的因素是快速PCR检测（aOR 4.36 95%CI[2.75-6.90]）和住院时间增加（aOR 1.01，95%CI[1.00-1.01]）。正确编码的患者更有可能在出院总结中记录流感（101例中有95例[89%]，而101例中只有11例[10%]结论：流感快速PCR检测的引入与更准确的医院编码有关。一种可能的解释是更快的测试周转，从而改善临床文档。

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引用次数: 0

COVID-19 Outbreak Management Response for Residential Aged Care Facilities in Western Sydney: A Donabedian Health Evaluation 西悉尼养老院新冠肺炎疫情管理应对：多纳贝迪亚健康评估

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-10-27 DOI: 10.1016/j.idh.2023.09.025

Dr Catherine Viengkham , Mr Vincent Villanueva Vicencio , Mr Heonsu Shin , Dr Shopna Bag , Dr Conrad Moreira , Richard Lindley (Professor) , Mr Nicholas Grange , Ms Sophie Norton , Ms Jenny Watts , Ms Claire Thomas , Ms Bronnie Anderson-Smith , Ms Jasmin Ellis , Ramon Shaban (Professor)

引用次数: 0

P2-N95 Mask Use During the COVID- 19 Pandemic - Experiences and Perceptions of Nurses Who Suffered Adverse Effects P2-N95 COVID-19大流行期间口罩的使用-遭受不良影响的护士的经验和看法

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-10-27 DOI: 10.1016/j.idh.2023.09.018

Mrs Anie Edward , Dr Bodil Rasmussen , Dr Sara Holton , Stephane Bouchoucha (A/Prof)

引用次数: 0

A new reliable method for testing the performance of pre-moistened cleaning wipes against bacteria and bacterial biofilms 一种新的可靠方法来测试预润湿清洁湿巾对细菌和细菌生物膜的性能

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-10-27 DOI: 10.1016/j.idh.2023.09.023

Greg Whiteley (A/Prof.) , Dr Trevor Glasbey , Dr Theerthankar Das

引用次数: 0

Does longer peripheral intravenous catheter length optimise antimicrobial delivery? A randomised controlled trial 较长的外周静脉导管长度是否能优化抗菌药物的输送？一项随机对照试验

IF 3.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2023-10-27 DOI: 10.1016/j.idh.2023.09.032

Dr Amanda Corley , Ms Catherine O'Brien , Mrs Elizabeth Wignall , Ms Hannah Peach , Mrs Emily Larsen , Claire Rickard (Prof) , Ms Barbara Hewer , Nicole Marsh (Prof)

引用次数: 0

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