American journal of infection control最新文献

Background: Some medical equipment travels across patient rooms. Nursing and environmental services staff may not always communicate cleaning responsibilities. The purpose of this study was to identify if a portable UV-C tent utilized with a UV-C device (Xenex LightStrike Robot) can effectively disinfect high use equipment.

Methods: Health care equipment were pre-swabbed to determine colony forming units (CFUs). Following UV-C disinfection, a post swab was completed. Standard microbiology techniques were utilized to sample, plate, and count CFUs from these sampled items.

Results: Samples (n=134) had a significant reduction in contamination (17.08 CFUs vs 0.45 CFUs, P<.05) following UV-C treatment. This near elimination of CFUs highlights the effectiveness of UV-C to disinfect high touch surfaces.

Discussion: More work is needed to determine optimal cleaning practices. At the same time, current cleaning practices are sometimes ineffective, additional steps such as UV-C can assist in ensuring adequate disinfection of equipment.

Conclusions: It is important that nurses take steps to break the chain of infection while providing patient care. Policies regarding infection control need to address high touch items and include methods such as the UV-C tent utilized in this study to ensure these items are disinfected reducing the risk of health care associated infections.

Background: Neonatal sepsis is a leading cause of newborn mortality, particularly in low- and middle-income countries. This study examines the bacterial etiologies and antibiotic resistance patterns of neonatal sepsis in a tertiary hospital in Vietnam.

Methods: A prospective cross-sectional study was conducted at National Children's Hospital, Hanoi, Vietnam from January 2021 to December 2022. All neonates with a clinical suspicion of sepsis and a confirmed positive blood culture were identified. Isolated pathogens were identified, and antibiotic susceptibility was assessed using standard protocols.

Results: In total, 202 neonates were diagnosed with proven sepsis. Among these, 75.2% of cases referred from other hospitals. Early-onset sepsis accounted for 15.8% of these infections. Gram-negative bacteria were responsible for 75.7% of the cases, with Klebsiella pneumoniae being the most prevalent pathogen (32.2%), followed by Staphylococcus aureus (14.9%), and both Serratia marcescens and Escherichia coli (10.9% each). Gram-negative bacteria showed significant resistance to third-generation cephalosporins, carbapenems, while gram-positive bacteria demonstrated considerable resistance to clindamycin and oxacillin. However, most gram-positive isolates were susceptible to vancomycin, and gram-negative bacteria had lower resistance to colistin and fosfomycin.

Conclusions: These findings highlight the critical importance of continuous surveillance and tailored antibiotic policies to combat neonatal sepsis effectively.

A cross-sectional study was conducted to evaluate the relationship between Infection Prevention and Control Assessment Framework scores and the incidence of health care-associated infections in tertiary hospitals in Eastern China. The results indicate that hospitals with Infection Prevention and Control Assessment Framework scores above 700 have a lower incidence rate of health care-associated infections (1.31%; 95%CI, 1.15%-1.47%) compared to those with scores below 700 (1.90%; 95%CI, 1.60%-2.21%).

Background: Tuberculosis (TB) Building and Strengthening Infection Control Strategies (TB BASICS) aimed to achieve improvements in TB infection prevention and control (IPC) through structured training and mentorship.

Methods: TB BASICS was implemented in six Chinese provinces from 2017-2019. Standardized, facility-based risk assessments tailored to inpatient, laboratory, and outpatient departments were conducted quarterly for 18 months. Knowledge, attitudes, and practices surveys were administered to healthcare workers (HCW) at nine participating facilities during the first and last assessments. Kruskal-Wallis rank sum test assessed score differences between departments (alpha = 0.05).

Results: Fifty-seven departments received risk assessments. IPC policies and practices improved substantially during follow up. Facility-based assessment scores were significantly lower in outpatient departments than other departments (p <0.05). All indicators achieved at least partial implementation by the final assessment. Low scores persisted for implementing isolation protocols, while personal protective equipment use among staff was consistent among all departments. Overall, we observed minimal change in IPC knowledge among HCW. In general, HCW had favorable views of their own IPC capabilities, but reported limited agency to improve institutional IPC.

Conclusions: TB BASICS demonstrated improvements in TB IPC implementation. Structured training and mentorship engaged HCW to maintain confidence and competency for TB prevention.

Background: Clostridioides difficile (C. diff) is a pathogen of concern. Several risk factors are known, but patients without these risk factors continue to develop the disease. Alcohol use disorder (AUD) is known to disrupt the gut similar to antibiotics, which prompted this evaluation of the association between AUD and C. diff infection.

Methods: A retrospective cohort study was conducted within 5 hospitals in a health system in Colorado. Adults 18 years of age or older who were seen in the Emergency Department or directly admitted to the hospital in 2022 and 2023 were included. A logistic regression was used to investigate the association between AUD and C. diff.

Results: Using an adjusted model, patients with AUD had 2.36 times greater odds of C. diff compared with patients without AUD. The odds of C. diff were 1.88 times greater for those with AUD diagnoses alone compared with patients without AUD. The odds were 1.96 times greater for those with AUD and active withdrawal compared with those without.

Conclusions: There is a significant association between AUD and increased risk of C. diff, with that risk increasing in patients actively withdrawing. This information can be used to guide earlier interventions.

Using intravascular catheter dressing audit data, we evaluated factors associated with noncompliant dressing. Male sex and gauze dressing had a higher risk of noncompliant dressing; presence of one or more lumens infusing, central venous catheter, peripherally inserted central catheters line, implantable port and contact precautions were associated with a lower risk of noncompliant dressing.

Contaminated portable equipment may contribute to transmission of health care-associated pathogens. We demonstrated that a wall-mounted far ultraviolet-C light technology that delivers far ultraviolet-C only when people are not present was effective in reducing contamination on in-use patient transport chairs and physical therapy equipment in equipment rooms. The technology could potentially be used as an adjunctive measure for decontamination of portable equipment in clinical areas.

Background: There is limited knowledge regarding how long prepared sterile goods can wait before becoming contaminated. We investigated whether surgical goods could be prepared the day before surgery and kept sterile overnight in the operating room, if protected by sterile covers.

Methods: Sterile surgical goods for open-heart surgeries (n=70) were randomized to preparation on the morning of the operation or on the previous evening. Exposure time was the total time between preparation and use. Primary outcome was bacterial growth reported as colony forming units (cfu), isolated on 840 agar plates. The protocol was registered with ClinicalTrials.gov (NCT05597072).

Results: When the agar plates were protected with sterile covers, exposure time had no impact (intervention group: 7 cfu, control group: 17 cfu). Without protection, longer exposure time was associated with more cfu (P=.016). A total of 499 cfu were isolated, displaying 59 different types of bacteria including 13 resistant Staphylococcus epidermidis, 6 (46%) of which were multidrug resistant.

Conclusions: Sterile goods could wait in the operating room for at least 15 hours before use without increased risk of bacterial air contamination, if protected with sterile covers. However, if the goods were not covered, bacterial air contamination occurred over time.