Pub Date : 2024-07-18DOI: 10.1016/j.ajic.2024.07.007
Mohammad Mahdi Nasehi, Mohammad Effatpanah, Mohammad Gholamnezhad, Hossein Karami, Maryam Ghamkhar, Nezam Armand, Yasmin Heydarzadeh Sohi, Reza Mehrizi, Leila Ghamkhar
Background: The inappropriate use and overprescription of antibiotics pose a global health threat, particularly contributing to antimicrobial resistance. This study aims to evaluate antibiotic prescription prevalence in Iranian outpatients using the defined daily doses (DDD) and Access, Watch, and Reserve classification systems.
Methods: This retrospective study analyzed electronic prescriptions for systemic antibiotics in Tehran, Iran, from March 2022 to March 2023. The data were obtained from the Iranian Health Insurance Organization and processed using the Cross-Industry Standard Process. Descriptive statistics and DDD per 1,000 inhabitants per day were calculated.
Results: A total of 817,178 antibiotic prescriptions were analyzed, with a sex distribution of 57.43% female and a median age of 48 years. On average, each patient received 1.89 antibiotics per prescription. Over 63% of antibiotics were classified in the "Watch" category, with Azithromycin being the most commonly prescribed (27.56%). The total DDD per 1,000 inhabitants per day was 4.99, with general practitioners accounting for 58.02% of the prescriptions, primarily prescribing Azithromycin.
Conclusions: The study emphasizes the high use of Watch group antibiotics, indicating a need for improved prescribing practices. Education on antibiotic stewardship and stricter guidelines are necessary to combat antimicrobial resistance. Continuous monitoring is crucial to optimize antibiotic use in outpatient settings in Iran.
{"title":"Antibiotic prescription prevalence in Iranian outpatients: A focus on defined daily doses and the AWaRe classification system.","authors":"Mohammad Mahdi Nasehi, Mohammad Effatpanah, Mohammad Gholamnezhad, Hossein Karami, Maryam Ghamkhar, Nezam Armand, Yasmin Heydarzadeh Sohi, Reza Mehrizi, Leila Ghamkhar","doi":"10.1016/j.ajic.2024.07.007","DOIUrl":"10.1016/j.ajic.2024.07.007","url":null,"abstract":"<p><strong>Background: </strong>The inappropriate use and overprescription of antibiotics pose a global health threat, particularly contributing to antimicrobial resistance. This study aims to evaluate antibiotic prescription prevalence in Iranian outpatients using the defined daily doses (DDD) and Access, Watch, and Reserve classification systems.</p><p><strong>Methods: </strong>This retrospective study analyzed electronic prescriptions for systemic antibiotics in Tehran, Iran, from March 2022 to March 2023. The data were obtained from the Iranian Health Insurance Organization and processed using the Cross-Industry Standard Process. Descriptive statistics and DDD per 1,000 inhabitants per day were calculated.</p><p><strong>Results: </strong>A total of 817,178 antibiotic prescriptions were analyzed, with a sex distribution of 57.43% female and a median age of 48 years. On average, each patient received 1.89 antibiotics per prescription. Over 63% of antibiotics were classified in the \"Watch\" category, with Azithromycin being the most commonly prescribed (27.56%). The total DDD per 1,000 inhabitants per day was 4.99, with general practitioners accounting for 58.02% of the prescriptions, primarily prescribing Azithromycin.</p><p><strong>Conclusions: </strong>The study emphasizes the high use of Watch group antibiotics, indicating a need for improved prescribing practices. Education on antibiotic stewardship and stricter guidelines are necessary to combat antimicrobial resistance. Continuous monitoring is crucial to optimize antibiotic use in outpatient settings in Iran.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733310","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}
Pub Date : 2024-07-10DOI: 10.1016/j.ajic.2024.07.004
Lucas Borges Pereira, Cinara Silva Feliciano, Fernando Bellissimo-Rodrigues, Leonardo Régis Leira Pereira
Background: Surgical antibiotic prophylaxis (SAP) is an important preventive measure, aiming to minimize surgical site infections. However, despite evidence-based guidelines, adherence to SAP protocols remains suboptimal in clinical practice. The aim of this study was to assess the adequacy of SAP in a high-complexity hospital and investigate associated factors.
Methods: A cross-sectional design was conducted, involving surgeries performed by expert teams in cardiology, urology, neurology, and gastrointestinal. SAP prescriptions were evaluated based on indication, antibiotic choice, dosage, and duration, according to the hospital protocol. Data analysis included descriptive statistics and association tests between protocol adherence and patient demographics, clinical variables, surgical teams, and types of surgeries.
Results: Out of 1,864 surgeries, only 20.7% adhered to SAP protocols. Lower adherence rates were observed for antibiotic choice and duration of prophylaxis. Neurological surgeries exhibited significantly lower adherence, particularly concerning antibiotic choice and duration. Factors associated with nonadherence included elevated preoperative blood glucose levels, prolonged hospitalization, and extended surgical duration. Logistic regression analysis identified surgical teams as significant factors influencing protocol adherence.
Conclusions: Despite the relatively high adherence to antibiotic dosage, challenges persist in antibiotic choice and duration adjustment. Poor glycemic control, prolonged surgery, and surgical teams were variables associated with inappropriate practice.
背景:手术抗生素预防(SAP)是一项重要的预防措施,旨在最大限度地减少手术部位感染。然而,尽管有循证指南的指导,临床实践中对 SAP 方案的遵守情况仍然不尽如人意。本研究旨在评估一家高复杂性医院的 SAP 是否充分,并调查相关因素:研究采用横断面设计,涉及心脏科、泌尿科、神经科和胃肠科专家团队实施的手术。根据医院规程,根据适应症、抗生素选择、剂量和持续时间对 SAP 处方进行评估。数据分析包括描述性统计和方案遵守情况与患者人口统计学、临床变量、手术团队和手术类型之间的关联测试:在1864例手术中,只有20.7%的手术遵守了SAP方案。抗生素选择和预防时间的遵守率较低。神经外科手术的依从性明显较低,尤其是在抗生素选择和持续时间方面。与不依从性相关的因素包括术前血糖水平升高、住院时间延长和手术时间延长。逻辑回归分析发现,手术团队是影响方案依从性的重要因素:结论:尽管抗生素剂量的依从性相对较高,但在抗生素选择和疗程调整方面仍存在挑战。血糖控制不佳、手术时间过长和手术团队是与不当操作相关的变量。
{"title":"Evaluation of the adherence to surgical antibiotic prophylaxis recommendations and associated factors in a University Hospital: A cross-sectional study.","authors":"Lucas Borges Pereira, Cinara Silva Feliciano, Fernando Bellissimo-Rodrigues, Leonardo Régis Leira Pereira","doi":"10.1016/j.ajic.2024.07.004","DOIUrl":"10.1016/j.ajic.2024.07.004","url":null,"abstract":"<p><strong>Background: </strong>Surgical antibiotic prophylaxis (SAP) is an important preventive measure, aiming to minimize surgical site infections. However, despite evidence-based guidelines, adherence to SAP protocols remains suboptimal in clinical practice. The aim of this study was to assess the adequacy of SAP in a high-complexity hospital and investigate associated factors.</p><p><strong>Methods: </strong>A cross-sectional design was conducted, involving surgeries performed by expert teams in cardiology, urology, neurology, and gastrointestinal. SAP prescriptions were evaluated based on indication, antibiotic choice, dosage, and duration, according to the hospital protocol. Data analysis included descriptive statistics and association tests between protocol adherence and patient demographics, clinical variables, surgical teams, and types of surgeries.</p><p><strong>Results: </strong>Out of 1,864 surgeries, only 20.7% adhered to SAP protocols. Lower adherence rates were observed for antibiotic choice and duration of prophylaxis. Neurological surgeries exhibited significantly lower adherence, particularly concerning antibiotic choice and duration. Factors associated with nonadherence included elevated preoperative blood glucose levels, prolonged hospitalization, and extended surgical duration. Logistic regression analysis identified surgical teams as significant factors influencing protocol adherence.</p><p><strong>Conclusions: </strong>Despite the relatively high adherence to antibiotic dosage, challenges persist in antibiotic choice and duration adjustment. Poor glycemic control, prolonged surgery, and surgical teams were variables associated with inappropriate practice.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598096","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}
Pub Date : 2024-07-08DOI: 10.1016/j.ajic.2024.07.003
Background
Nasal decolonization of Staphylococcus aureus is a proven strategy to reduce surgical site infections (SSI). Recently updated guidelines expanded nasal decolonization beyond traditionally high-risk populations to include the option for alcohol-based antiseptics (ABAs). We assessed the efficacy of a novel ABA for reducing SSI compared to mupirocin and iodophor.
Methods
A literature search in Google Scholar, PubMed, MEDLINE, and Cochrane databases was completed of studies reporting SSI outcomes in hospitals using an ABA. Primary meta-analyses were conducted to analyze ABA clinical efficacy versus no intervention (7 studies); subanalyses compared the ABA to mupirocin (3 studies) or iodophor (2 studies).
Results
One hundred forty-seven nasal decolonization titles for SSI prevention were identified, of which 7 were accepted. In the studies selected, 16,212 patients were included: 7,983 (49.24%) control group, and 8,129 (50.14%) intervention group. Significant effect sizes (measured as odds ratios [ORs]) and z-scores were found in all 3 meta-analyses: (OR = 3.178, z = 4.743, P < .001) in ABA clinical efficacy, (OR = 4.110, z = 3.167, P < .01) in ABA versus mupirocin, and (OR = 3.043, z = 3.155, P < .01) in ABA versus iodophor. Funnel plots for each demonstrated a lack of bias.
Conclusions
Statistically significant positive effects were identified in all 3 meta-analyses. An ABA appears to be a viable alternative to mupirocin or iodophors to reduce SSIs.
{"title":"The efficacy of an alcohol-based nasal antiseptic versus mupirocin or iodophor for preventing surgical site infections: A meta-analysis","authors":"","doi":"10.1016/j.ajic.2024.07.003","DOIUrl":"10.1016/j.ajic.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><p>Nasal decolonization of <em>Staphylococcus aureus</em> is a proven strategy to reduce surgical site infections (SSI). Recently updated guidelines expanded nasal decolonization beyond traditionally high-risk populations to include the option for alcohol-based antiseptics (ABAs). We assessed the efficacy of a novel ABA for reducing SSI compared to mupirocin and iodophor.</p></div><div><h3>Methods</h3><p>A literature search in Google Scholar, PubMed, MEDLINE, and Cochrane databases was completed of studies reporting SSI outcomes in hospitals using an ABA. Primary meta-analyses were conducted to analyze ABA clinical efficacy versus no intervention (7 studies); subanalyses compared the ABA to mupirocin (3 studies) or iodophor (2 studies).</p></div><div><h3>Results</h3><p>One hundred forty-seven nasal decolonization titles for SSI prevention were identified, of which 7 were accepted. In the studies selected, 16,212 patients were included: 7,983 (49.24%) control group, and 8,129 (50.14%) intervention group. Significant effect sizes (measured as odds ratios [ORs]) and <em>z</em>-scores were found in all 3 meta-analyses: (OR = 3.178, <em>z</em> = 4.743, <em>P</em> < .001) in ABA clinical efficacy, (OR = 4.110, <em>z</em> = 3.167, <em>P</em> < .01) in ABA versus mupirocin, and (OR = 3.043, <em>z</em> = 3.155, <em>P</em> < .01) in ABA versus iodophor. Funnel plots for each demonstrated a lack of bias.</p></div><div><h3>Conclusions</h3><p>Statistically significant positive effects were identified in all 3 meta-analyses. An ABA appears to be a viable alternative to mupirocin or iodophors to reduce SSIs.</p></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S019665532400590X/pdfft?md5=d03d444956b9b4b95508bca7f1ff4f93&pid=1-s2.0-S019665532400590X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1016/j.ajic.2024.07.002
Emerson Aparecido Miguel, Fernanda Patrícia Dos Santos, Paulo Roberto Laranjeira, Marina Ishii, Terezinha de Jesus Andreoli Pinto
Background: Hospital articles processed by steam are widely used in the Central Sterile Supply Department (CSSD), responsible for due sterilization. Steam sterilization is discussed worldwide, aiming to protect patients. If steam is outside the specified requirements, the sterilization process may fail, resulting in the wet packs at the end of the sterilization cycle.
Methods: The present study evaluated the steam quality at Santa Catarina Hospital (São Paulo, SP, Brazil) from 2016 to 2022. Saturated steam containing noncondensable gases, excess condensate, or even superheat was characterized using the methodology indicated in the European Standard EN 285:2015.
Results: From 2016 to 2020, qualification tests showed that the saturated steam quality does not achieve standard limit parameters. Infrastructural maintenance actions were taken to adjust the saturated steam quality. In 2021, the steam quality followed technical standards, and its adequacy was confirmed in 2022.
Conclusions: The points developed by the hospital's maintenance department, the adoption of appropriate devices for this purpose, and the correct preventive maintenance in the autoclaves, together with the correct qualification of the equipment and proof of the steam quality, contributed to improve the safety of the hospital sterilization process and reduce the incidence of wet packages.
{"title":"Steam quality monitoring as a strategy to reduce wet packs and sterilization failure.","authors":"Emerson Aparecido Miguel, Fernanda Patrícia Dos Santos, Paulo Roberto Laranjeira, Marina Ishii, Terezinha de Jesus Andreoli Pinto","doi":"10.1016/j.ajic.2024.07.002","DOIUrl":"10.1016/j.ajic.2024.07.002","url":null,"abstract":"<p><strong>Background: </strong>Hospital articles processed by steam are widely used in the Central Sterile Supply Department (CSSD), responsible for due sterilization. Steam sterilization is discussed worldwide, aiming to protect patients. If steam is outside the specified requirements, the sterilization process may fail, resulting in the wet packs at the end of the sterilization cycle.</p><p><strong>Methods: </strong>The present study evaluated the steam quality at Santa Catarina Hospital (São Paulo, SP, Brazil) from 2016 to 2022. Saturated steam containing noncondensable gases, excess condensate, or even superheat was characterized using the methodology indicated in the European Standard EN 285:2015.</p><p><strong>Results: </strong>From 2016 to 2020, qualification tests showed that the saturated steam quality does not achieve standard limit parameters. Infrastructural maintenance actions were taken to adjust the saturated steam quality. In 2021, the steam quality followed technical standards, and its adequacy was confirmed in 2022.</p><p><strong>Conclusions: </strong>The points developed by the hospital's maintenance department, the adoption of appropriate devices for this purpose, and the correct preventive maintenance in the autoclaves, together with the correct qualification of the equipment and proof of the steam quality, contributed to improve the safety of the hospital sterilization process and reduce the incidence of wet packages.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554036","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}
Background: Infection is a serious complication in neurosurgical patients who undergo external ventricular drain (EVD) insertion.
Methods: We conducted a quasi-experimental study in patients who underwent EVD insertion to evaluate the impact of a multi-modal strategy to reduce the incidence of external ventricular drain associated infections (EVDAIs). The study was divided into 2 periods; (1) the pre-intervention period when techniques for EVD insertion and maintenance were up to the discretion of the neurosurgeons and (2) the post-intervention after implementation of a multi-modal strategy (cefazolin antibiotic prophylaxis, preoperative chlorhexidine showers, application of postoperative chlorhexidine-impregnated dressing, limited manipulation of the EVD, and meticulous EVD management). The primary outcome was the incidence rate of EVDAIs; secondary outcomes included in-hospital mortality rate, the hospital length of stay.
Results: In total, 135 patients were included. The incidence rate of EVDAIs was significantly reduced in the post-intervention period (5.6 cases/1,000 EVD-days) compared with the pre-intervention period (18.2 cases/1,000 EVD-days; P=0.026). There were no differences in all secondary outcomes analyzed. This multi-modal strategy was associated with high satisfaction among health care personnel.
Conclusions: Implementation of a multi-modal strategy was associated with a reduction in the incidence of EVDAIs. This was in line with our goal of promoting a new culture of safety despite being in a resource-limited setting.
{"title":"Effectiveness of a multimodal strategy to reduce external ventricular drain-associated infection: A quasi-experimental study.","authors":"Chaiwat Pongkaew, Raywat Noiphithak, Pataravit Rukskul, Pornchai Yodwisithsak, Dilok Tantongtip, Pree Nimmannitya, Prachya Punyarat, Gahn Duangprasert, Wadrawee Kaewwichai, Sirada Songphul, Watcharee Chancharoenrat, Kittiya Jantarathaneewat, Chattrabongkot Chokaouychai, Sasikan Sukhor, Piyaporn Apisarnthanarak, Bernard C Camins, David J Weber, Anucha Apisarnthanarak","doi":"10.1016/j.ajic.2024.06.026","DOIUrl":"10.1016/j.ajic.2024.06.026","url":null,"abstract":"<p><strong>Background: </strong>Infection is a serious complication in neurosurgical patients who undergo external ventricular drain (EVD) insertion.</p><p><strong>Methods: </strong>We conducted a quasi-experimental study in patients who underwent EVD insertion to evaluate the impact of a multi-modal strategy to reduce the incidence of external ventricular drain associated infections (EVDAIs). The study was divided into 2 periods; (1) the pre-intervention period when techniques for EVD insertion and maintenance were up to the discretion of the neurosurgeons and (2) the post-intervention after implementation of a multi-modal strategy (cefazolin antibiotic prophylaxis, preoperative chlorhexidine showers, application of postoperative chlorhexidine-impregnated dressing, limited manipulation of the EVD, and meticulous EVD management). The primary outcome was the incidence rate of EVDAIs; secondary outcomes included in-hospital mortality rate, the hospital length of stay.</p><p><strong>Results: </strong>In total, 135 patients were included. The incidence rate of EVDAIs was significantly reduced in the post-intervention period (5.6 cases/1,000 EVD-days) compared with the pre-intervention period (18.2 cases/1,000 EVD-days; P=0.026). There were no differences in all secondary outcomes analyzed. This multi-modal strategy was associated with high satisfaction among health care personnel.</p><p><strong>Conclusions: </strong>Implementation of a multi-modal strategy was associated with a reduction in the incidence of EVDAIs. This was in line with our goal of promoting a new culture of safety despite being in a resource-limited setting.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537432","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}
Pub Date : 2024-07-03DOI: 10.1016/j.ajic.2024.06.021
Caroline Persson, Corri B Levine, Kara Marshall, Sophia Shea, Christa Arguinchona, Sharon Vanairsdale Carrasco, Lauren M Sauer, Jocelyn J Herstein
In the United States, the system for special pathogen patient care incorporates a network of federally funded US biocontainment units that maintain operational readiness to care for patients afflicted by high-consequence infectious diseases (HCIDs). This network has expanded in number of facilities and in scope, serving as a regional resource for special pathogen preparedness. Lessons learned for maintaining these units are shared with the intent of informing new and existing biocontainment units.
{"title":"Building a biocontainment unit: Infrastructure and organizational experiences of the 13 regional biocontainment units in the United States.","authors":"Caroline Persson, Corri B Levine, Kara Marshall, Sophia Shea, Christa Arguinchona, Sharon Vanairsdale Carrasco, Lauren M Sauer, Jocelyn J Herstein","doi":"10.1016/j.ajic.2024.06.021","DOIUrl":"10.1016/j.ajic.2024.06.021","url":null,"abstract":"<p><p>In the United States, the system for special pathogen patient care incorporates a network of federally funded US biocontainment units that maintain operational readiness to care for patients afflicted by high-consequence infectious diseases (HCIDs). This network has expanded in number of facilities and in scope, serving as a regional resource for special pathogen preparedness. Lessons learned for maintaining these units are shared with the intent of informing new and existing biocontainment units.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537423","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}
Pub Date : 2024-07-03DOI: 10.1016/j.ajic.2024.06.025
Melissa Feskin, Trenton MacAllister, Elli Moon, Lisa Hannah, Sabine Meuse, Melissa Polomis, Sara Podczervinski
Background: State health departments' (SHD) role in infection prevention and control (IPC) includes robust educational and consultative services for various health care settings. During the COVID-19 pandemic, Washington-SHD (W-SHD) IPC staff conducted remote and on-site Infection Control Assessment and Response (ICAR) consultations for long-term care (LTC) and non-LTC health care facilities.
Methods: ICAR consultations were classified as "reactive" in response to a COVID-19 outbreak or "proactive" to help facilities improve IPC protocols. Facility addresses were geocoded to census tracks, classifying urban or rural areas. Facility types and characteristics were analyzed, assessing the impacts of repeat visits. All descriptive statistics, Pearson's χ2 tests, and odds ratios were calculated.
Results: Between March 2020 and December 2022, W-SHD conducted 3,093 ICARs at 1,703 health care facilities in 94.9% (37/39) of Washington counties. Of the total visits, most were in LTC (90.5%) and 48.9% were reactive. Facilities with initial on-site ICARs had 1.5 times the odds of having a repeat visit than facilities with initial remote visit (95% CI: 1.21, 1.87).
Discussion: Maintaining strong connections with health care facilities can help bolster infection prevention practices and minimize loss of information at the facility level.
Conclusions: Evidence-based findings on the sustainability of the W-SHD's ICAR services during the COVID-19 pandemic illustrated the value of public health IPC programs.
{"title":"Harnessing the power of infection prevention and public health data systems to support health care in Washington State during the COVID-19 pandemic.","authors":"Melissa Feskin, Trenton MacAllister, Elli Moon, Lisa Hannah, Sabine Meuse, Melissa Polomis, Sara Podczervinski","doi":"10.1016/j.ajic.2024.06.025","DOIUrl":"10.1016/j.ajic.2024.06.025","url":null,"abstract":"<p><strong>Background: </strong>State health departments' (SHD) role in infection prevention and control (IPC) includes robust educational and consultative services for various health care settings. During the COVID-19 pandemic, Washington-SHD (W-SHD) IPC staff conducted remote and on-site Infection Control Assessment and Response (ICAR) consultations for long-term care (LTC) and non-LTC health care facilities.</p><p><strong>Methods: </strong>ICAR consultations were classified as \"reactive\" in response to a COVID-19 outbreak or \"proactive\" to help facilities improve IPC protocols. Facility addresses were geocoded to census tracks, classifying urban or rural areas. Facility types and characteristics were analyzed, assessing the impacts of repeat visits. All descriptive statistics, Pearson's χ<sup>2</sup> tests, and odds ratios were calculated.</p><p><strong>Results: </strong>Between March 2020 and December 2022, W-SHD conducted 3,093 ICARs at 1,703 health care facilities in 94.9% (37/39) of Washington counties. Of the total visits, most were in LTC (90.5%) and 48.9% were reactive. Facilities with initial on-site ICARs had 1.5 times the odds of having a repeat visit than facilities with initial remote visit (95% CI: 1.21, 1.87).</p><p><strong>Discussion: </strong>Maintaining strong connections with health care facilities can help bolster infection prevention practices and minimize loss of information at the facility level.</p><p><strong>Conclusions: </strong>Evidence-based findings on the sustainability of the W-SHD's ICAR services during the COVID-19 pandemic illustrated the value of public health IPC programs.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537433","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}
Pub Date : 2024-07-03DOI: 10.1016/j.ajic.2024.06.022
Tariq A Madani, Nabeela A Al-Abdullah, Saleh M Binmahfooz, Amir Y Neyazi, Salman T Madani, Rayan A Alshehri, Jawad A Alnajjar, Badran S Alqurashi, Ibrahim S Aladni, Shaker A Alsharif
Background: The objective of this study was to describe the prevalence, characteristics, and risk factors of coronavirus disease-2019 (COVID-19) infection among health care workers (HCWs) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Methods: A prospective cross-sectional study of HCWs confirmed to have COVID-19 infection from March 1, 2020 to December 31, 2022.
Results: A total of 746 HCWs were diagnosed with COVID-19. Patients' age ranged from 22 to 60 years with a mean ± standard deviation of 37.4 ± 8.7 years. The infection was community-acquired in 584 (78.3%) HCWs. The vast majority (82.6%) of the infected HCWs had no comorbidities. Nurses (400/746 or 53.6%) represented the largest professional group, followed by physicians (128/746 or 17.2%), administrative staff (125/746 or 16.8%), respiratory therapists (54/746 or 7.2%), and physiotherapists (39/746 or 5.2%). Symptoms included fever (64.1%), cough (55.6%), sore throat (44.6%), headache (22.9%), runny nose (19.6%), shortness of breath (19.0%), fatigue (12.7%), body aches (11.4%), diarrhea (10.9%), vomiting (4.4%), and abdominal pain (2.8%). Most (647 or 86.7%) patients were managed as outpatients. Four (0.5%) HCWs died.
Conclusions: HCWs face a dual risk of SARS-CoV-2 infection, both from community exposure and within the hospital setting. Comprehensive infection control strategies are needed to protect HCWs both inside and outside the hospital environment.
{"title":"COVID-19 infections among health care workers at a university hospital in Jeddah, Saudi Arabia.","authors":"Tariq A Madani, Nabeela A Al-Abdullah, Saleh M Binmahfooz, Amir Y Neyazi, Salman T Madani, Rayan A Alshehri, Jawad A Alnajjar, Badran S Alqurashi, Ibrahim S Aladni, Shaker A Alsharif","doi":"10.1016/j.ajic.2024.06.022","DOIUrl":"10.1016/j.ajic.2024.06.022","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to describe the prevalence, characteristics, and risk factors of coronavirus disease-2019 (COVID-19) infection among health care workers (HCWs) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.</p><p><strong>Methods: </strong>A prospective cross-sectional study of HCWs confirmed to have COVID-19 infection from March 1, 2020 to December 31, 2022.</p><p><strong>Results: </strong>A total of 746 HCWs were diagnosed with COVID-19. Patients' age ranged from 22 to 60 years with a mean ± standard deviation of 37.4 ± 8.7 years. The infection was community-acquired in 584 (78.3%) HCWs. The vast majority (82.6%) of the infected HCWs had no comorbidities. Nurses (400/746 or 53.6%) represented the largest professional group, followed by physicians (128/746 or 17.2%), administrative staff (125/746 or 16.8%), respiratory therapists (54/746 or 7.2%), and physiotherapists (39/746 or 5.2%). Symptoms included fever (64.1%), cough (55.6%), sore throat (44.6%), headache (22.9%), runny nose (19.6%), shortness of breath (19.0%), fatigue (12.7%), body aches (11.4%), diarrhea (10.9%), vomiting (4.4%), and abdominal pain (2.8%). Most (647 or 86.7%) patients were managed as outpatients. Four (0.5%) HCWs died.</p><p><strong>Conclusions: </strong>HCWs face a dual risk of SARS-CoV-2 infection, both from community exposure and within the hospital setting. Comprehensive infection control strategies are needed to protect HCWs both inside and outside the hospital environment.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537424","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}
Pub Date : 2024-07-03DOI: 10.1016/j.ajic.2024.07.001
We report a large outbreak of severe acute respiratory syndrome coronavirus 2 in a residential living facility. Measurements of carbon dioxide levels, aerosol particle clearance, and airflow were used to identify and remediate areas with suboptimal ventilation. A simple intervention involving continuous operation of bathroom fans was effective in significantly improving ventilation in resident rooms.
{"title":"A coronavirus disease 2019 outbreak in a residential living facility with suboptimal ventilation in resident rooms","authors":"","doi":"10.1016/j.ajic.2024.07.001","DOIUrl":"10.1016/j.ajic.2024.07.001","url":null,"abstract":"<div><p>We report a large outbreak of severe acute respiratory syndrome coronavirus 2 in a residential living facility. Measurements of carbon dioxide levels, aerosol particle clearance, and airflow were used to identify and remediate areas with suboptimal ventilation. A simple intervention involving continuous operation of bathroom fans was effective in significantly improving ventilation in resident rooms.</p></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537422","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}
Pub Date : 2024-07-02DOI: 10.1016/j.ajic.2024.06.024
Michael A Ben-Aderet, Souci Louis, Jonathan D Grein, Susan E Beekmann, Philip M Polgreen, Daniel Z Uslan
In a survey of 104 US infectious disease specialists, 88% reported working in facilities that allow animal-assisted activities or pet visitation. Variability existed in the species of animals allowed, restricted areas, and veterinary assessments, demonstrating a need to standardize infection prevention approaches across health care facilities to mitigate potential risks.
{"title":"A survey of infection prevention and animal-assisted activity policies in health care facilities-United States, 2023.","authors":"Michael A Ben-Aderet, Souci Louis, Jonathan D Grein, Susan E Beekmann, Philip M Polgreen, Daniel Z Uslan","doi":"10.1016/j.ajic.2024.06.024","DOIUrl":"10.1016/j.ajic.2024.06.024","url":null,"abstract":"<p><p>In a survey of 104 US infectious disease specialists, 88% reported working in facilities that allow animal-assisted activities or pet visitation. Variability existed in the species of animals allowed, restricted areas, and veterinary assessments, demonstrating a need to standardize infection prevention approaches across health care facilities to mitigate potential risks.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533353","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}