Journal of Infection Prevention最新文献

{"title":"Single centre experience: Managing seasonal influenza without a point-of-care test.","authors":"Pei Sen Tee","doi":"10.1177/17571774231159581","DOIUrl":"10.1177/17571774231159581","url":null,"abstract":"<p><strong>Background: </strong>The use of point-of-care testing (POCT) for influenza is not routine in many hospitals in the United Kngdom and testing is currently by laboratory-based polymerase chain reaction (PCR) tests. This review aims to evaluate patients who were tested positive for influenza in the last winter season and project if future POCT usage at initial point of patient assessment could assist in better utilisation of healthcare resources.</p><p><strong>Methods: </strong>Retrospective review in a district general hospital without POCT facility for influenza. Medical records of patients who tested positive for influenza during a 4-month period from 1 October 2019 to 31 January 2020 in the paediatric department were reviewed and analysed.</p><p><strong>Results: </strong>Thirty patients had laboratory-confirmed cases of influenza of which 63% (<i>n</i> = 19) were admitted to the ward. 56% of patients were not isolated at first instance on admission and 50% (<i>n</i> = 9) of admitted patients did not require inpatient management which totalled up to 224 h length of stay in ward.</p><p><strong>Conclusions: </strong>Routine POCT for influenza can potentially improve management of patients presenting with respiratory symptoms and allocation of healthcare resources. We recommend its use to be introduced in diagnostic pathways for acute respiratory illness in the paediatric population in the next winter season in all hospitals.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9322378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-contamination rate of reusable flexible bronchoscopes: A systematic literature review and meta-analysis.","authors":"Helena S Travis,&nbsp;Rasmus V Russell,&nbsp;Julia Kovaleva","doi":"10.1177/17571774231158203","DOIUrl":"https://doi.org/10.1177/17571774231158203","url":null,"abstract":"<p><strong>Background: </strong>Bronchoscopy is generally a safe and efficient procedure. However, the risk of cross-contamination with reusable flexible bronchoscopes (RFB) has been detected in several outbreaks worldwide.</p><p><strong>Aim: </strong>To estimate the average cross-contamination rate of patient-ready RFBs based on available published data.</p><p><strong>Methods: </strong>We performed a systematic literature review in PubMed and Embase to investigate the cross-contamination rate of RFB. Included studies identified indicator organisms or colony forming units (CFU) levels, and total number of samples >10. The Contamination threshold was defined according to the European Society of Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy Nurse and Associates (ESGE-ESGENA) guidelines. To calculate the total contamination rate, a random effects model was applied. Heterogeneity was analysed via a Q-test and illustrated in a forest plot. Publication bias was analysed via the Egger's regression test and illustrated in a funnel plot.</p><p><strong>Results: </strong>Eight studies fulfilled our inclusion criteria. The random effects model included 2169 samples and 149 events (positive tests). The total RFB cross-contamination rate was 8.69% ± 1.86 (standard division [SD]) (95% confidence interval [CI]: 5.06-12.33%). The result showed significant heterogeneity of 90% and publication bias.</p><p><strong>Discussion: </strong>Significant heterogeneity and publication bias is likely associated with varying methodology and aversion towards publishing negative findings, respectively. Based on the cross-contamination rate an infection control paradigm shift is needed to ensure patient safety. We recommend to follow the Spaulding classification and classify RFBs as critical items. Accordingly, infection control measures such as obligatory surveillance, and implementing single-use alternatives must be considered where feasible.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/d9/10.1177_17571774231158203.PMC10090576.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9317928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diary.","authors":"","doi":"10.1177/17571774231166867","DOIUrl":"10.1177/17571774231166867","url":null,"abstract":"","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9364762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence of healthcare workers to COVID-19 infection prevention practices and its relationship with SARS-CoV-2 seropositivity.","authors":"Engy Mohamed El-Ghitany, Ayat Ashour, Hala Elmorshedy, Azza Galal Farghaly, Mona H Hashish, Eman A Omran","doi":"10.1177/17571774231158782","DOIUrl":"10.1177/17571774231158782","url":null,"abstract":"<p><strong>Background: </strong>Infection prevention and control (IPC) practices against COVID-19 should be adopted by healthcare workers (HCWs) at their workplaces to protect themselves, their patients, and their families from infection.</p><p><strong>Purpose: </strong>This study aimed to describe the relationship between the healthcare-related COVID-19 infection prevention measures adopted by HCWs and their SARS-CoV-2 seropositivity.</p><p><strong>Research design: </strong>This cross-sectional study was conducted during the second and third COVID-19 waves in Egypt.</p><p><strong>Study sample: </strong>The study included 416 unvaccinated HCWs from 39 hospitals in Egypt.</p><p><strong>Data collection: </strong>Sociodemographic data, as well as COVID-19 IPC measures done at work, and protective measures performed by their healthcare facilities were collected. SARS-CoV-2 spike protein antibodies were measured by ELISA.</p><p><strong>Results: </strong>58.2% of participants were seropositive for SARS-CoV-2. Among the previously undiagnosed HCWs, 125/271 (46.1%) were seropositive. Predictors of seropositivity were rural residence (aOR = 5.096; 95% CI: 1.583-16.403, <i>p</i> = 0.006), previous COVID-19 infection (aOR = 4.848, 95% CI: 2.933-8.015, <i>p</i> = 0.000), and examining 10-20 suspected COVID-19 patients daily (aOR = 2.329; 95% CI: 1.331-4.077, <i>p</i> = 0.003. Reporting low satisfaction (25-50%) with infection control implementation, working more than 40 h per week, reporting to \"sometimes abiding by hand hygiene\" compared to those who reported to \"always\" adhere to hand hygiene and shorter duration of hand washing (<20 s) were associated with significantly higher odds of seropositivity.</p><p><strong>Conclusions: </strong>Poor infection control measures and the high workload of HCWs (longer working hours and examining more patients) were modifiable risk factors for SARS-CoV-2 seropositivity among HCWs. Hand hygiene was better among HCWs working in urban <i>versus</i> rural areas.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9988594/pdf/10.1177_17571774231158782.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9673804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diary.","authors":"","doi":"10.1177/17571774231152095","DOIUrl":"10.1177/17571774231152095","url":null,"abstract":"","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10758430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors to consider in the safe design of intensive care units - Part 1: historical aspects and ventilation systems.","authors":"Teresa Inkster, Michael Weinbren, Jimmy Walker","doi":"10.1177/17571774231152724","DOIUrl":"10.1177/17571774231152724","url":null,"abstract":"<p><strong>Background: </strong>Evidence linking the role of ventilation systems in transmission of infection to patients in intensive care units has increased in recent years.</p><p><strong>Aims: </strong>This research-based commentary set out to identify the historical aspect of intensive care unit design, current problems and some potential solutions with respect to ventilation systems.</p><p><strong>Methods: </strong>Databases and open source information was used to obtain data on the historical aspects and current guidance in ICU, and the authors experiences have been used to suggest potential solutions to ventilation problems in ICU.</p><p><strong>Findings: </strong>The authors found a number of problems with ventilation in ICU to which there has not been a cohesive response in terms of guidance to support users and designers. The resultant void permits new projects to proceed with suboptimal and designs which place patients and staff at risk.</p><p><strong>Discussion: </strong>The NHS is now at the start of major new investments in healthcare facilities in England and this together with the end of the antibiotic era mandates new guidance to address these major concerns.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pseudo-outbreak of COVID-19 associated pulmonary aspergillosis: a microbiological investigation of both the patients and the environment.","authors":"Kohei Hasegawa,&nbsp;Asako Doi,&nbsp;Hirokazu Kuroda,&nbsp;Toshikazu Hasuike,&nbsp;Akiko Ogura,&nbsp;Seiko Nasu,&nbsp;Hiroaki Nishioka,&nbsp;Keisuke Tomii","doi":"10.1177/17571774231152721","DOIUrl":"https://doi.org/10.1177/17571774231152721","url":null,"abstract":"<p><strong>Background: </strong>We experienced a pseudo-outbreak of aspergillosis in a newly constructed COVID-19 ward. Within the first 3 months from the commencement of the ward, six intubated patients of COVID-19 developed probable or possible pulmonary aspergillosis. We suspected an outbreak of pulmonary aspergillosis associated with ward construction and launched air sampling for the investigation of the relationship between these.</p><p><strong>Methods: </strong>The samples were collected at 13 locations in the prefabricated ward and three in the general wards, not under construction, as a control.</p><p><strong>Results: </strong>The results from samples revealed different species of <i>Aspergillus</i> from those detected by the patients. <i>Aspergillus</i> sp. was detected not only from the air samples in the prefabricated ward but also in the general ward.</p><p><strong>Discussion: </strong>In this investigation, we could not find evidence of the outbreak that links the construction of the prefabricated ward with the occurrence of pulmonary aspergillosis. It might suggest that this series of aspergillosis was more likely occurred from fungi that inherently colonized patients, and was associated with patient factors such as severe COVID-19 rather than environmental factors. Once an outbreak originating from building construction is suspected, it is important to conduct an environmental investigation including an air sampling.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10765432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing changes to reduce infections in ICU patients. Water services and waste systems.","authors":"Michael Weinbren, Teresa Inkster, Jimmy Walker","doi":"10.1177/17571774231152715","DOIUrl":"10.1177/17571774231152715","url":null,"abstract":"<p><strong>Background: </strong>Evidence linking the role of water services in transmission of infection to patients in ICUs has increased in recent years.</p><p><strong>Aims: </strong>This research based commentary set out to identify potential solutions for water and wastewater systems in ICU settings.</p><p><strong>Methods: </strong>Databases and open source information was used to obtain data on approaches to water and wastewater-related issues in ICU settings. This and the authors experiences have been used to describe approaches to these problems.</p><p><strong>Findings: </strong>The lack of updated guidance has required some ICUs to develop unique responses, including 'water free' patient care combined with reduction in water services. The options consider guidance, compliance, training and education as key factors to successful outcomes and protecting vulnerable patients in ICU.</p><p><strong>Discussion: </strong>The authors found a number of problems with water and wastewater systems in ICU to which there has not been a cohesive response in terms of guidance to support users and designers. The resultant void permits new projects to proceed with suboptimal and designs which place patients and staff at risk. As an interim measure a series of solutions suitable for existing units and new builds need to be considered.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspects and problems associated with the water services to be considered in intensive care units.","authors":"Jimmy Walker, Teresa Inkster, Michael Weinbren","doi":"10.1177/17571774231152716","DOIUrl":"10.1177/17571774231152716","url":null,"abstract":"<p><strong>Background: </strong>Water is a product taken for granted and assumed to be a safe commodity in intensive care units (ICU). Biofilm readily becomes established in complex water services presenting a risk to vulnerable patients. Harboured within biofilms are opportunistic pathogens which can be transmitted via hand contact, splashing, aerosol and indirect contact through medical equipment. Evidence linking the role of water services in transmission of infection to patients in ICUs has increased in recent years.</p><p><strong>Aims: </strong>This research based commentary set out to identify current problems with water and wastewater systems in ICU settings.</p><p><strong>Methods: </strong>Databases and open source information was used to obtain data on current water and wastewater-related issues in ICU settings. This and the authors experiences have been used to describe current challenges.</p><p><strong>Findings: </strong>the authors found a number of problems with water systems in ICU to which there has not been a cohesive response in terms of guidance to support users and designers. The resultant void permits new projects to proceed with suboptimal and designs which place patients and staff at risk.</p><p><strong>Discussion: </strong>Hand hygiene stations are frequently misused or close enough to patients such that splashing poses a transmission risk. The wastewater system (drain) also presents a risk, from where Gram-negative antibiotic resistant organisms may be dispersed resulting in untreatable patient infections. The water and wastewater system provide a superhighway for the movement of pathogenic microorganisms and these risks need to be addressed if we are to safeguard vulnerable users in ICU.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial use among paediatric inpatients in a Nigerian tertiary hospital: A three-year point prevalence survey.","authors":"Chukwuma D Umeokonkwo, Cosmas K Onah, Azuka S Adeke, Dorothy O Igwe-Okomiso, Adanna A Umeokonkwo, Ugochukwu C Madubueze, Saheed O Dauda, Kingsley C Okeke, Ann Versporten, Oyinlola O Oduyebo, Herman Goossens, Adaoha P Agu","doi":"10.1177/17571774231152719","DOIUrl":"10.1177/17571774231152719","url":null,"abstract":"<p><strong>Aim: </strong>Antimicrobials are among the most widely prescribed therapeutic agents among paediatric population. Irrational use of these agents increases the risk of antimicrobial resistance. We described the prevalence and pattern of antimicrobial use among paediatric inpatients from 2017 to 2019.</p><p><strong>Subject and method: </strong>The study was a repeated point prevalence survey over a 3-year period using the global point prevalence standardized tools among all paediatric inpatients. The prevalence of antimicrobial use, the prescription indicators and patterns of antimicrobial use were estimated.</p><p><strong>Result: </strong>Among 191 paediatric inpatients assessed, the 3-year period prevalence antimicrobial use was 85.9% (164/191) with prevalence of 80.6% in 2017, 94.6% in 2018, and 83.6% in 2019. Antimicrobial agents used ranged from one agent (20.1%) to five different agents (5.5%). Parenteral route (66.6%) was the preferred route of administration. The reason for the use of antimicrobial agents (92.6%) and the stop/review date (99.5%) were mostly well documented. Only 4.5% of the antimicrobial use were targeted. There were no antimicrobial guidelines or policy guiding the use of antimicrobial agents, except the national guideline on the treatment of malaria and tuberculosis. Ceftriaxone, a third generation cephalosporin was the most commonly used agent across the period under review. Community-acquired infection was the commonest indication for antimicrobial use.</p><p><strong>Conclusion: </strong>Our findings of high antimicrobial prevalence has raised the attention for the need to develop hospital-based antimicrobial guideline and antimicrobial stewardship program to protect the vulnerable children, their contacts and the environment from the impact of antimicrobial resistance.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}