American journal of infection control最新文献

英文中文

Assessing COVID-19 transmission risk: Roommate and unit mate exposures at an inpatient behavioral health facility 评估 COVID-19 传播风险：住院行为健康机构中的室友和单位配偶接触。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.003

Jennifer Falgione MPH , Graham M. Snyder MD, SM , Catherine Cannon MSN, BSN , Janina-Marie Huss MBA, CIC, LTC-CIP

Background

Inpatient psychiatric facilities have an increased risk of infection transmission. This study evaluated the impact of roommate and unit mate exposures on coronavirus disease-2019 (COVID-19) transmission to inform isolation practices.

Methods

A single-center retrospective study was conducted among patients hospitalized in an inpatient behavioral health hospital from July 2020 through August 2023. We compared the risk of COVID-19 acquisition after exposure among patients with a contagious roommate versus those exposed to a contagious unit mate.

Results

During the study period, the conversion rate was 10.05% overall, 24.4% for roommates, and 9.3% for unit mates; patients exposed to a roommate were at 3.14 times higher odds (95% confidence interval, 1.42-6.92) of acquiring COVID-19 after exposure. On unit-stratified analysis, patients exposed to a roommate on the geropsychiatric unit had the highest risk of postexposure conversion compared with unit mate exposed patients (odds ratio 6.38, 95% confidence interval 1.75-23.22). Logistic regression analysis identified a nonsignificant risk associated with increased time in group therapy.

Conclusions

Exposure to a COVID-19-contagious roommate significantly increases the risk of COVID-19 acquisition among exposed patients receiving inpatient psychiatric care. Cohorting contagious and exposed individuals and avoiding multibedded rooms may mitigate COVID-19 transmission risk during psychiatric care.

背景：精神科住院患者的感染传播风险固然会增加。本研究旨在评估室友和单位伙伴暴露对 COVID-19 传播的影响，为最安全的隔离措施提供参考：2020年7月至2023年8月期间，我们在一家住院行为健康医院的六个病房对住院患者进行了一项单中心回顾性研究。我们比较了患者接触具有传染性的室友与接触具有传染性的单位同事后感染 COVID-19 的风险：在研究期间，总体转换率为 10.05%，室友转换率为 24.4%，单位同事转换率为 9.3%；接触室友的患者在接触后感染 COVID-19 的几率是室友的 3.14 倍（95% 置信区间，1.42-6.92）。根据单位分层分析，与单位室友暴露的患者相比，老年精神科单位室友暴露的患者暴露后转化的风险最高（几率比 6.38，95% 置信区间 1.75-23.22）。逻辑回归分析发现，与集体治疗时间增加相关的风险并不显著：结论：在接受精神科住院治疗的患者中，接触 COVID-19 传染性室友会显著增加感染 COVID-19 的风险。将具有传染性和暴露于COVID-19的患者分组并避免多床位病房可成功降低精神病护理期间的COVID-19传播风险。

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引用次数: 0

Elimination of an outbreak of carbapenem-resistant Acinetobacter baumannii in a burn unit 消除烧伤科爆发的耐碳青霉烯类鲍曼不动杆菌。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.10.002

Nancy L. Havill MT(ASCP), MHA, CIC , Monique Samuels BSN, RN, CIC , Anjali Poudyal RN, MPH, CIC , Vineetha Sujanan RN, MSN, CIC , Christina Murdzek M(ASCP), MHS, CIC , Michael J. Aniskiewicz M(ASCP), CIC , Meghan Maloney MPH, CIC , Jacqueline Laird BSN, RN, CNM , Alisa Savetamal MD, FACS

Carbapenem-resistant Acinetobacter baumannii is an opportunistic pathogen which has caused numerous health care-associated outbreaks particularly in intensive care and burn units. We describe an outbreak in a burn unit where 3 patients were identified as being colonized or infected with carbapenem-resistant Acinetobacter baumannii. A multifaceted approach and rapid implementation of infection prevention measures were effective in identification and removal of potential environmental reservoirs resulting in the prevention of further transmission.

耐碳青霉烯类鲍曼不动杆菌（CRAB）是一种机会性病原体，曾多次引起医疗相关疫情爆发，尤其是在重症监护室和烧伤科。我们描述了一起在烧伤科爆发的疫情，其中有 3 名患者被确认定植或感染了 CRAB。我们采取了多管齐下的方法，并迅速实施了感染预防措施，有效地识别并清除了潜在的环境储库，从而防止了进一步的传播。

引用次数: 0

A multilayered infection control intervention on carbapenem-resistant Acinetobacter baumannii acquisition: An interrupted time series 针对耐碳青霉烯类鲍曼不动杆菌感染的多层次感染控制干预：间断时间序列。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.018

Daniel Grupel MD , Abraham Borer MD , Riki Yosipovich RN , Ronit Nativ RN, MPH , Orli Sagi PhD , Lisa Saidel-Odes MD

Background

Carbapenem-resistant Acinetobacter baumannii (CRAB) causes life-threating hospital-acquired. Due to a limited number of Intensive-Care-Unit (ICU) beds, these patients are often treated in high-dependency (HD) non-ICUs within internal-medicine wards (IMW) in Israel. We aimed to assess the effectiveness of a multilayered infection-control intervention on CRAB infection rate in IMWs, especially in its HD non-ICUs with ongoing CRAB transmission.

Methods

A quasi-experimental, before-and-after, interrupted time-series study with control outcomes. We conducted a multilayered intervention over 3.5 years, which included 4 phases: (1) Pre intervention; (2) Intervention introduction: introduced enhanced environment cleaning; (3) Intervention phase 1: introduced active surveillance; (4) Intervention phase 2: introduced CRAB-positive patient cohorting, in addition to previous ongoing measures taken.

Results

CRAB was isolated from 204 patients aged 69.8y/o ± 15.86y, 59.8% male, 34.3% had CRAB-positive clinical samples. Mean hospital length-of-stay was 30.5 days, with a 30-day postdischarge mortality rate of 55.9%. Mean CRAB clinical cases decreased from 0.89 in preintervention to 0.11 at the end of phase 2, with a change in slope and level after the intervention of P = .02 (CI: − 0.204 to − 0.040) and P = .004 (CI: − 0.013 to − 0.003), respectively.

Conclusions

This intervention, including enhanced environment cleaning, active surveillance, and patient cohorting, successfully reduced CRAB acquisition in IMWs and their HD non-ICUs.

背景：耐碳青霉烯类鲍曼不动杆菌（CRAB）会导致危重病人在医院获得性感染，危及生命。由于重症监护病房（ICU）床位有限，这些患者通常在以色列内科病房（IMW）的高依赖性（HD）非重症监护病房接受治疗。我们的目的是评估多层次感染控制干预措施对内科病房（尤其是存在 CRAB 传播的 HD 非重症监护病房）CRAB 感染率的影响：从 2019 年 1 月到 2022 年 6 月，我们开展了一项带有对照结果的前后间断时间序列准实验研究。我们在 3.5 年的时间里进行了多层次干预，包括 4 个阶段：1) 干预前；2) 干预引入：引入强化环境清洁；3) 干预阶段 1：引入主动监测；4) 干预阶段 2：除先前采取的持续措施外，引入 CRAB 阳性患者队列：从 204 名患者中分离出 CRAB，年龄为 69.8 岁/o ± 15.86 岁，59.8% 为男性。其中 34.3% 的患者临床样本呈 CRAB 阳性。平均住院时间为 30.5 天，出院后 30 天的死亡率为 55.9%。CRAB临床病例平均值从干预前的0.89降至第二阶段结束时的0.11，干预后的斜率和水平变化分别为p= 0.02（CI：-0.204-至-0.040）和p=0.004（CI：-0.013-至-0.003）：这种多层次的干预措施，包括加强环境清洁、主动监测和患者分组，成功地减少了IMW及其HD非ICU中CRAB的获得。

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引用次数: 0

Integrating residents’ rights and infection prevention in nursing homes: Summary of the Infection Control Advocate and Resident Education (ICARE) learning modules pilot for long-term care ombudsmen, residents, and other nursing home advocates 将居民权利与养老院感染预防相结合：针对长期护理监察员、居民和其他养老院倡导者的感染控制倡导者和居民教育（ICARE）学习模块试点总结。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.013

Diana Cervantes MS, DrPH, CIC, LTC-IP, FAPIC , Brittany Krenek MPH , Sarah Ross DO, MS, CMD , Janice A. Knebl DO, MBA, FACP, MACOI, CPPS

The Infection Control Advocate and Resident Education educational modules integrate and promote infection prevention and control (IPC) measures and residents’ rights in nursing homes, targeting long-term care ombudsmen, residents, families, and other resident advocates. Survey respondents (N = 102) reported increased knowledge in understanding IPC and preserving resident rights. Integrating these topics and identifying barriers to promoting IPC is necessary for implementing quality IPC in nursing homes.

感染控制倡导者和居民教育（ICARE）教育模块整合并推广了养老院的感染预防与控制（IPC）措施和居民权利，其目标受众为长期护理监察员、居民、家属和其他居民倡导者。调查对象（102 人）表示，他们在了解 IPC 和维护居民权利方面的知识有所增加。要在养老院实施高质量的 IPC，就必须整合这些主题并找出促进 IPC 的障碍。

引用次数: 0

Determining infection prevention staffing needs for the pediatric ambulatory and procedural care setting 确定儿科门诊和程序性护理环境的感染预防人员需求。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.011

Lindsay K. Weir MPH, CIC, Jennifer A. Ormsby DNP, RN, CPN, CIC, CPNP-PC, Ana M. Vaughan-Malloy MD, MPH, Celeste J Chandonnet MSN, RN, CIC

Background

Recent analyses suggest that existing infection preventionist (IP) staffing ratios do not reflect the scope of institutional needs after accounting for complexity and non-inpatient locations. We sought to determine the current IP staffing level required to address the complexity and scope of our pediatric ambulatory and procedural operations.

Methods

This needs assessment was adapted from previous analyses by Bartles et al (2018). We surveyed IPs covering ambulatory/procedural locations regarding clinical complexity indicators and estimated hours per week spent engaged in IP activities. The reported hours were used to calculate total IP hours per week and associated full-time equivalents (FTEs).

Results

Half (118/237) of surveyed locations/services reported at least 1 complexity indicator, while nearly 9% (21/237) reported 3 or more complexity indicators. IPs spent 181.0 h/wk focused on ambulatory/procedural locations, equating to 4.5 FTEs.

Discussion

Infection prevention and control leadership used these findings to successfully add 4 IP FTEs to the department. These FTEs will allow increased ambulatory/procedural IP support, improved regulatory readiness, and increased quality improvement initiatives.

Conclusions

Assessing the complexity and scope of pediatric ambulatory/procedural locations can be a valuable tool for (1) advocating for overall IP staffing increases at a system level and (2) determining the distribution of IP time and resources in such locations.

背景：最近的分析表明，在考虑到复杂性和非住院地点后，现有的感染预防师（IP）人员配备比例并不能反映机构需求的范围。我们试图确定目前的 IP 人员配备水平，以应对儿科门诊和手术操作的复杂性和范围：该需求评估改编自 Bartles 等人（2018 年）之前的分析。我们对负责门诊/手术地点的 IP 进行了调查，内容涉及临床复杂性指标和每周用于 IP 活动的估计小时数。报告的时数用于计算IP每周的总时数和相关的全职当量（FTE）：一半（118/237）接受调查的地点/服务至少报告了一项复杂性指标，近 9%（21/237）报告了 3 项或更多复杂性指标。感染预防控制人员每周花费 181.0 小时专注于门诊/手术地点，相当于 4.5 个全职员工：讨论：感染预防与控制部门的领导利用这些发现，成功地为该部门增加了 4 个 IP 全职员工。讨论：感染预防和控制部门的领导利用这些发现，成功地为该部门增加了 4 名 IP 全职员工。这些全职员工将增加门诊/手术 IP 支持，改善监管准备，并增加质量改进措施：评估儿科门诊/手术场所的复杂性和范围可以作为一种有价值的工具，用于（1）在系统层面倡导增加整体 IP 人员配备，以及（2）确定 IP 时间和资源在这些场所的分配。

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引用次数: 0

Analysis of an expanded admission screening protocol for Candida auris at a New York City hospital 分析纽约市一家医院的念珠菌入院筛查扩展方案。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.027

Aaron Cheng MPH, CIC , Karen Brody MSN, RN, CIC , Jordan Ehni MPH, CIC , Zachary Gallate MS , Scott Lorin MD, MBA , Bernard Camins MD, MSc , Waleed Javaid MD, MBA, MS

Background

Candida auris (C auris) is an emerging global infectious disease threat, and screening practices for identification of C auris are inconsistent across healthcare facilities. This study describes the utility of expanding a C auris admission screening protocol at an acute care hospital to screen all patients presenting from any skilled nursing facility.

Methods

A retrospective review identified all patients screened on admission for C auris from January 2022 through September 2023. Patients were identified for risk potential, and those deemed high risk were placed on transmission-based precautions while awaiting culture results.

Results

Of the 591 patients screened, 14 cases were identified (2.4%). Nine cases presented with tracheostomies or were ventilator-dependent and classified as high risk. Five cases were considered low risk at the time of screening. Eight of these newly identified cases would not be screened under the prior criteria.

Discussion

This study’s findings support prior studies that patients with tracheostomies or were ventilator-dependent have greater risk for C auris colonization. Adopting an expanded admission screening program has allowed the hospital to detect more cases earlier to prevent nosocomial transmissions.

Conclusions

Healthcare facilities should consider initiating or expanding admission screening programs for C auris based on community prevalence rates of C auris.

背景：白色念珠菌（C auris）是一种新出现的全球性传染病威胁，各医疗机构对白色念珠菌的筛查方法并不一致。本研究介绍了将一家急症医院的念珠菌入院筛查方案扩大到筛查来自任何专业护理机构的所有患者的效用：方法：通过回顾性分析，确定了 2022 年 1 月至 2023 年 9 月期间所有接受 C auris 入院筛查的患者。在等待培养结果期间，对患者进行风险可能性鉴定，并对被视为高风险的患者采取基于传播的预防措施：在接受筛查的 591 名患者中，发现了 14 例病例（2.4%）。其中九例患者使用气管插管或依赖呼吸机，被列为高危患者。五例在筛查时被认为是低风险。在这些新发现的病例中，有 8 例在之前的标准下不会被筛查：讨论：本研究结果支持之前的研究，即气管造口或依赖呼吸机的患者有更高的结肠球菌定植风险。通过扩大入院筛查计划，医院可以更早地发现更多病例，从而防止院内传播：结论：医疗机构应根据社区的 C auris 感染率，考虑启动或扩大 C auris 入院筛查计划。

{"title":"Analysis of an expanded admission screening protocol for Candida auris at a New York City hospital","authors":"Aaron Cheng MPH, CIC , Karen Brody MSN, RN, CIC , Jordan Ehni MPH, CIC , Zachary Gallate MS , Scott Lorin MD, MBA , Bernard Camins MD, MSc , Waleed Javaid MD, MBA, MS","doi":"10.1016/j.ajic.2024.08.027","DOIUrl":"10.1016/j.ajic.2024.08.027","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida auris</em> (<em>C auris</em>) is an emerging global infectious disease threat, and screening practices for identification of <em>C auris</em> are inconsistent across healthcare facilities. This study describes the utility of expanding a <em>C auris</em> admission screening protocol at an acute care hospital to screen all patients presenting from any skilled nursing facility.</div></div><div><h3>Methods</h3><div>A retrospective review identified all patients screened on admission for <em>C auris</em> from January 2022 through September 2023. Patients were identified for risk potential, and those deemed high risk were placed on transmission-based precautions while awaiting culture results.</div></div><div><h3>Results</h3><div>Of the 591 patients screened, 14 cases were identified (2.4%). Nine cases presented with tracheostomies or were ventilator-dependent and classified as high risk. Five cases were considered low risk at the time of screening. Eight of these newly identified cases would not be screened under the prior criteria.</div></div><div><h3>Discussion</h3><div>This study’s findings support prior studies that patients with tracheostomies or were ventilator-dependent have greater risk for <em>C auris</em> colonization. Adopting an expanded admission screening program has allowed the hospital to detect more cases earlier to prevent nosocomial transmissions.</div></div><div><h3>Conclusions</h3><div>Healthcare facilities should consider initiating or expanding admission screening programs for <em>C auris</em> based on community prevalence rates of <em>C auris</em>.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 1","pages":"Pages 70-74"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Topic: Response to “Influenza vaccination and COVID-19 infection risk and disease severity: A systematic review and multilevel meta-analysis of prospective studies” 主题：应对“流感疫苗接种与COVID-19感染风险和疾病严重程度：前瞻性研究的系统回顾和多水平荟萃分析”。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.017

Anas Babar

引用次数: 0

Infection preventionists’ current and preferred training strategies and tools 感染预防专家当前和首选的培训策略和工具。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.015

Terri Rebmann PhD, RN, CIC, FAPIC , Charlesnika Evans MPH, PhD , Ashley M. Hughes PhD, MS , Rachel L. Mazzara MPH , Kaeli A. Lugo MPH , Jessica Waechter MPH, MSW , Shay Drummond MPH, RN, CIC, FAPIC , Amanda Carnes MPH , Abigail L. Carlson MD, MPH , Janet Glowicz MPH, PhD, RN, CIC, FAPIC

Background

Educating health care staff on infection prevention and control (IPC) is an essential role of infection preventionists (IPs), but the COVID-19 pandemic diverted resources away from IPC education.

Methods

Association for Professionals in Infection Control and Epidemiology members were invited to complete an online survey from spring 2023 to assess current and preferred approaches and tools for training health care personnel on IPC. Vendors, retirees, APIC staff, or those not working in health care or public health were excluded.

Results

In all, 2,432 IPs participated. IPs were more likely to report engaging in impromptu health care worker training (ie, just-in-time teaching and team huddles) versus planned educational activities (ie, learning modules, formal presentations, train-the-trainer, or simulation; Kruskal-Wallis = 288, P < .001). IPs’ top preferred teaching methodologies included simulation or interactive activity, and their lowest preferred approach was independent learning modules. IPC training apps were frequently requested technology.

Discussion

IPs ranked simulation as their top preferred teaching method; however, simulation was one of the least frequently used approaches. IP education should include strategies for delivering effective impromptu training and how to develop and implement interactive simulation-based education.

Conclusions

The expressed needs and preferences of IPs should be considered when developing IPC-related teaching and training tools.

背景：对医护人员进行感染预防与控制（IPC）教育是感染预防专家（IP）的一项重要职责，但 COVID-19 大流行分散了 IPC 教育的资源。本研究的目的是对当前的 IPC 培训需求进行评估：方法：邀请感染控制和流行病学专业人员协会会员于 2023 年 5 月至 6 月完成一项在线调查，以评估他们当前和首选的 IPC 医护人员培训方法和工具。供应商、退休人员、APIC 工作人员或不在医疗机构或公共卫生机构工作的人员均被排除在外：结果：共有 2,432 名综合方案参与者参与。与计划中的教育活动（即学习模块、正式演讲、培训师培训或模拟；KW=288，P 讨论）相比，IPs 更倾向于报告他们参与了即兴医护人员培训（即即时教学和团队聚会）：IP将模拟教学列为首选教学方法，但模拟教学是最不常用的方法之一。IP教育应包括提供有效即兴培训的策略，以及如何开发和实施互动模拟教学：结论：在开发 IPC 相关教学和培训工具时，应考虑 IP 人员表达的需求和偏好。

{"title":"Infection preventionists’ current and preferred training strategies and tools","authors":"Terri Rebmann PhD, RN, CIC, FAPIC , Charlesnika Evans MPH, PhD , Ashley M. Hughes PhD, MS , Rachel L. Mazzara MPH , Kaeli A. Lugo MPH , Jessica Waechter MPH, MSW , Shay Drummond MPH, RN, CIC, FAPIC , Amanda Carnes MPH , Abigail L. Carlson MD, MPH , Janet Glowicz MPH, PhD, RN, CIC, FAPIC","doi":"10.1016/j.ajic.2024.08.015","DOIUrl":"10.1016/j.ajic.2024.08.015","url":null,"abstract":"<div><h3>Background</h3><div>Educating health care staff on infection prevention and control (IPC) is an essential role of infection preventionists (IPs), but the COVID-19 pandemic diverted resources away from IPC education.</div></div><div><h3>Methods</h3><div>Association for Professionals in Infection Control and Epidemiology members were invited to complete an online survey from spring 2023 to assess current and preferred approaches and tools for training health care personnel on IPC. Vendors, retirees, APIC staff, or those not working in health care or public health were excluded.</div></div><div><h3>Results</h3><div>In all, 2,432 IPs participated. IPs were more likely to report engaging in impromptu health care worker training (ie, just-in-time teaching and team huddles) versus planned educational activities (ie, learning modules, formal presentations, train-the-trainer, or simulation; Kruskal-Wallis = 288, <em>P</em> < .001). IPs’ top preferred teaching methodologies included simulation or interactive activity, and their lowest preferred approach was independent learning modules. IPC training apps were frequently requested technology.</div></div><div><h3>Discussion</h3><div>IPs ranked simulation as their top preferred teaching method; however, simulation was one of the least frequently used approaches. IP education should include strategies for delivering effective impromptu training and how to develop and implement interactive simulation-based education.</div></div><div><h3>Conclusions</h3><div>The expressed needs and preferences of IPs should be considered when developing IPC-related teaching and training tools.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 1","pages":"Pages 2-7"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Persistent methicillin-resistant Staphylococcus aureus (MRSA) nares test positivity during initial days of systemic antistaphylococcal antimicrobial therapy 耐甲氧西林金黄色葡萄球菌 (MRSA) 纳氏试验在全身性抗葡萄球菌抗菌治疗初期的持续阳性反应。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.014

Maximillian S. Wu BS , Wesley Kufel PharmD, BCPS, BCIDP, AAHIVP , Scott Riddell PhD , Jeff Steele PharmD , Elizabeth Asiago-Reddy MD, MS

The typical duration of positive nucleic acid tests for methicillin-resistant Staphylococcus aureus (MRSA) in the nares of patients receiving systemic anti-MRSA antimicrobials is unknown. In this study, hospitalized adult patients with an initial positive MRSA nares nucleic acid test prescribed systemic anti-MRSA antimicrobials had follow-up testing done 48 to 96 hours later. A positive follow-up test was detected in 100/113 (88.5%), indicating that MRSA nares DNA tests still have utility for screening after patients have initiated anti-MRSA therapy.

接受全身性抗 MRSA 抗菌药物治疗的患者鼻腔内耐甲氧西林金黄色葡萄球菌（MRSA）核酸检测呈阳性的典型持续时间尚不清楚。在这项研究中，对初次 MRSA 鼻腔核酸检测呈阳性的住院成人患者，在处方全身性抗 MRSA 抗菌药物 48-96 小时后进行了随访检测。100/113（88.5%）例患者的后续检测结果呈阳性，这表明 MRSA 鼻腔 DNA 检测在患者开始接受抗 MRSA 治疗后仍有筛查作用。

引用次数: 0

Evaluation of a point-of-use kiosk for improving the fit of N95/P2 respirators in health care settings: A randomized controlled trial 使用点自助终端改善医疗机构 N95/P2 呼吸器密合度的评估：随机对照试验

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.008

Darius Chapman BEng(Hons), Campbell Strong BSci, Prabhpreet Kaur BSci, Anand N. Ganesan PhD, MBBS

Background

Fit of N95/P2 half-face respirators is critical. No objective ways exist to evaluate their implementation at use. Previously, we showed 26% of health care workers achieve appropriate fit at point of use.

Methods

657 quantitative fits were conducted on 166 subjects, using 4 different respirator styles. Randomization was performed; controls employing standard “fit-check” and intervention using a infrared video kiosk. Primary outcome was passing rates of quantitative fit, with secondary outcomes of respirator type, gender, race, and previous experience.

Results

Intervention demonstrated significantly higher pass rate (50.6%) compared with controls (30.8%). Odds of passing with kiosk was 2.3 (odds ratios [OR] 2.3, 95% confidence intervals [CI] 1.8-2.9, P < .001). Duckbill style improved the greatest (OR 4.1, 95% CI 2.1-7.9, P < .001), and Tri-fold also showing substantial benefit (OR 2.66, 95% CI 1.4-5.2, P < .001). Gender and race did not influence outcomes when using the kiosk, nor did previous experience.

Conclusions

A custom point-of-use kiosk improved odds of achieving a satisfactory fit of common respirator styles, independent of participant demographics. These findings open the door to addressing a gap in respiratory protection programs by providing individual assessment and interventions that improve worker safety at the time of highest risk.

简介：验证一次性 N95/P2 半面式呼吸器是否合适至关重要。目前还没有客观的方法来评估使用时的执行情况。方法：使用四种不同款式的呼吸器，对 166 名受试者进行了 657 次密合度定量测试。进行了随机分组；对照组采用标准的 "密合度检查"，干预组采用定制的红外线视频亭。主要结果是定量密合度合格率，次要结果是呼吸器类型、性别、种族和以往经验：结果：与对照组（30.8%）相比，干预组的通过率（50.6%）明显更高。与对照组相比，使用 IR Kiosk 的通过率为 2.3（OR 2.3 95%CI 1.8 至 2.9，p）：与参与者的人口统计学特征无关，定制的使用点自助服务终端提高了常见呼吸机款式的合格几率。这些发现为解决呼吸保护计划中的一个关键缺口打开了大门，即在风险最高的时候提供个体评估和干预措施，从而提高工人的安全：支持本研究结果的数据可向通讯作者索取。由于数据中包含的信息可能会损害研究参与者的隐私，因此不对外公开。

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