American journal of infection control最新文献

Background: Coagulase-negative staphylococci (CoNS) are frequently cited as the most common cause of bacteremia in patients receiving extracorporeal membrane oxygenation (ECMO), yet there is significant variability in reporting rates between centers.

Methods: All patients who received ECMO with CoNS isolated from blood cultures between January 2022 and March 2024 were included in this retrospective cohort study. Previously reported bacteremia definitions were applied to determine the variability in rates by definition.

Results: In 68 patients who received ECMO during the study period, 424 blood culture sets were obtained, of which 20 (4%) yielded CoNS in 13 (19%) patients. Only 5 (38%) patients had repeat isolation. Clinical variables, such as fever and leukocytosis, did not predict repeat positivity. Rates of CoNS varied from 0-15 infections per 1000 ECMO days depending on the definition utilized.

Conclusion: CoNS were frequently isolated in blood cultures from patients receiving ECMO. Despite the concern for biofilm formation, most CoNS were only isolated in a single culture. With the limited utility of clinical markers and frequent false positives, clinicians should order repeat blood cultures on those with CoNS isolated from blood cultures. We propose a standardized definition for CoNS bacteremia which entails isolations of CoNS from two subsequent blood cultures.

Background: Aerosol generation in dental practice is a significant concern in infection control. This study aimed to investigate the strategies for controlling and preventing aerosol-generated microbes during dental procedures.

Methods: A systematic search was performed using PRISMA guidelines through electronic databases (PubMed, ScienceDirect, Cochrane Library, Google Scholar, and Scopus) using specific keywords, like "aerosol generation" AND "dental procedures" AND "prevention" for studies reporting interventions, including mouthwash and suction devices, that were effective against pathogens generated during dental procedures. Eligible studies were included based on predefined criteria. Pooled effectiveness was calculated using a random-effects model in RevMan 5.4 software. Quality assessments were performed using RoB-2.0 and the Robvis web application.

Results: Nineteen studies were included in this systematic review and meta-analysis. Different interventions, including cetylpyridinium chloride, chlorhexidine, chlorine dioxide, hydrogen peroxide, herbal formulated products, and suction devices, have been identified as the most utilized interventions to reduce microbial contamination during dental procedures. Overall, these interventions were found to be effective, with a pooled effectiveness of -46.64 (95% CI: -60.89 to -32.38, I²=100%, p<0.00001).

Conclusions: This study underscores the importance of a multifaceted approach that integrates antiseptic mouthwash and suction devices to minimize the risk of cross-contamination and infection transmission during aerosol-generated dental procedures, thereby safeguarding the health and safety of both patients and dental healthcare workers.

Data availability statement: The data presented in this study are available on request from the corresponding author.

A staff-initiated outbreak of COVID-19 among residents in a long-term care facility was notable for differences in attack rates between units and the association with dry hydrogen peroxide (DHP) deployment for continuous microbial reduction. DHP had previously been shown to significantly reduce environmental bioburden in the facility, but the association with infection had not been monitored. This outbreak highlights the potential for DHP to reduce infection transmission without requiring additional staff intervention.

We developed a tool to evaluate antibiotic stewardship (AS) in outpatient hemodialysis (HD) infection prevention and control assessments, based on the CDC's Core Elements of Outpatient AS. Of facilities assessed (n=12), the average score was 79% (range 44-100%) for implementation of the Core Elements. Tracking and reporting had the highest engagement (94.1%) and education had the lowest (58.3%). By leveraging HD-specific tools, infection preventionists can assess antibiotic use and provide actionable feedback.

Background: Healthcare-associated infections pose a significant risk for the patients in intensive care due to the use of medical instrumentation required for care.

Methods: We conducted a cross-sectional, nationwide survey on awareness of recommended infection prevention practices involving central venous catheters and invasive ventilators in intensive care units.

Results: A total of 810 (50% of those surveyed) nurses and physicians participated in the survey. We found that 8% of the respondents had good knowledge of infection prevention in central venous care, while 24% had good knowledge of ventilator-associated pneumonia prevention practices.

Discussion: The overall level of knowledge measured with this nationwide survey was suboptimal. The level varied between units, and depending on individual questions for particular professions. The displayed knowledge may have partially been based on tradition rather than on up-to-date evidence-based guidelines.

Conclusion: Educational training in evidence-based infection prevention is needed for practical implementation to be improved.