American journal of infection control最新文献

Background: There are many infectious factors causing the outbreak of hemodialysis infection, which may easily lead to the delay of investigation and treatment. This study aimed to develop an investigation form for hemodialysis infection outbreak (HIO), and to identify sources of outbreak in early stage.

Methods: After an exhaustive literature review, we used the Delphi method to determine the indicators and relative risk scores of the assessment tools through 2 rounds of specialist consultation and overall consideration of the opinions and suggestions of 18 specialists.

Results: A total of 87 studies of HIOs were eligible for inclusion. The mean authority coefficient (Cr) was 0.89. Kendall's W coefficient of the specialist consultation was 0.359 after 2 rounds of consultation (P < .005), suggesting that the specialists had similar opinions. Based on 4 primary items and 13 secondary items of the source of HIO, and tripartite distribution characteristics of infected patients, we constructed the investigation form.

Conclusions: The investigation form may be implemented during the initial phase of an outbreak investigation, it is a prerequisite for taking effective control measures, avoiding HIO occurrence. However, the efficacy of the investigation form needs to be further evaluated.

Background: Chronic obstructive pulmonary disease (COPD) is a risk factor for herpes zoster. Vaccination can prevent or attenuate herpes zoster and its related complications. However, evidence regarding vaccine uptake among patients with COPD is limited. Therefore, this study aimed to evaluate trends in herpes zoster vaccination and characteristics associated with vaccination among US older adults with COPD.

Methods: Data from the 2008 to 2022 National Health Interview Survey were used. Participants aged ≥50 years were included. Joinpoint regression analysis was performed to analyze trends in herpes zoster vaccination. A multivariable logistic regression model was used to identify factors associated with vaccination.

Results: From 2008 to 2022, an increasing trend in herpes zoster vaccination was observed (average annual percent change = 15.10, P < .01). This increasing trend was also observed when stratified by age groups. Disparities in vaccination were found across several factors, including age, sex, race or ethnicity, region, educational level, health insurance, income, smoking status, perceived health status, and flu and pneumococcal vaccination.

Conclusions: There has been an upward trend in herpes zoster vaccination over the past 15 years among older adults with COPD. Disparities across several characteristics existed, underscoring the necessity for targeted policies and interventions to promote equity in vaccination.

Background: This study explores the infrastructural and organizational risk factors for health care-associated (HCA) Clostridioides difficile infections (CDIs) and methicillin-resistant Staphylococcus aureus (MRSA) in hospitals.

Methods: This is a retrospective observational study involving all eligible inpatient units from 12 hospitals in British Columbia, Canada, from April 1, 2020 to September 16, 2021. The outcomes were the average HCA CDI or MRSA rates. Covariates included, but were not limited to, infection control factors (eg, hand hygiene rate), infrastructural factors (eg, unit age), and organizational factors (eg, hallway bed utilization). Multivariable regression was performed to identify statistically significant risk factors.

Results: Older units were associated with higher HCA CDI rates (adjusted relative risk [aRR]: 0.012; 95% confidence interval (CI) [0.004, 0.020]). Higher HCA MRSA rates were associated with decreased hand hygiene rate (aRR: -0.035; 95% CI [-0.063, -0.008]), higher MRSA bioburden (aRR: 9.008; 95% CI [5.586, 12.429]), increased utilization of hallway beds (aRR: 0.680; 95% CI [0.094, 1.267]), increased nursing overtime rate (aRR: 5.018; 95% CI [1.210, 8.826]), and not keeping the clean supply room door closed (aRR: -0.283; 95% CI [-0.536, -0.03]).

Conclusions: The study confirmed the multifaceted nature of infection prevention and emphasized the importance of interdepartmental collaboration to improve patient safety.

Background: To analyze the epidemiological characteristics of the SARS-CoV-2 infection and reinfection associated with the emergence of Omicron variant in Healthcare workers (HCWs).

Methods: We enrolled 760 HCWs who received 2-4 vaccination doses of COVID-19 and followed by BA.5/BF.7 and/or XBB.1.5 breakthrough infections between December 2022 and July 2023. Serum sample from each individual were collected approximately 1,3 and 6 months after last exposure. IgM, IgG and Total antibodies against SARS-CoV-2 were measured by chemiluminescent immunoassay. Meanwhile, we created an Enterprise WeChat link for HCWs to self-report SARS-CoV-2 infections, symptoms and post COVID-19 conditions.

Results: Our study revealed that the reinfection rate among HCWs reached 26.1%. The main symptoms were fever (91.2% vs 60.1%), cough (78.8% vs 58.0%), and sore throat (75.4% vs 59.6%) during infection and reinfection in Omicron BA.5/BF.7 and XBB.1.5 wave, and the interval for reinfection ranged from 91 to 210 days (median 152). Fatigue (23.6%), memory loss (18.8%) and coughing (18.6%) were the most prevalent long COVID symptoms, with a higher prevalence among female HCWs.

Conclusions: HCWs reinfection with SARS-CoV-2 causes milder symptoms, but high reinfection rate and short intervals. Strengthen infection prevention and control is crucial to mitigating infection risk and improving health services.