Journal of Infection Prevention最新文献

{"title":"Staff views need to be at the centre of electronic hand hygiene monitoring system development.","authors":"Katie-Rose Cawthorne, Richard P D Cooke","doi":"10.1177/17571774221092530","DOIUrl":"https://doi.org/10.1177/17571774221092530","url":null,"abstract":"We read with great interest Kelly et al.’s qualitative study of healthcare worker (HCW) perceptions of an electronic hand hygiene monitoring system (EMS) (2021). It is excellent to read of a successful implementation of a new innovative approach to hand hygiene (HH) monitoring in a busy NHS hospital. Though the qualitative analysis (from the 11 frontline HCWs interviewed) demonstrated mixed opinions, this study does provide cautious optimism about the longterm adoption of EMS technology by NHS staff. This should encourage other Infection Prevention and Control (IPC) teams to evaluate the impact of EMS technology in their own clinical practice. As demonstrated in this study, staff members recognise the importance of embracing change and the opportunities that EMS technology can bring in improving HH compliance and reducing healthcare-associated infections (HCAI). We therefore commend the authors’ initiative in wishing to seek HCW views of an implemented EMS. For any HH initiative to be effective, staff must be at the centre of the innovation process, and must be assured that they have ownership and control of the process. However, a limitation of this study is that interviews were restricted to a small group of nursing staff and healthcare assistants. As medical staff are well recognised to have low rates of HH compliance, (Pittet et al., 2000) it would have been useful to explore the perspectives of this staff group. A large staff survey which analysed 1200 responses across two acute NHS trusts (Cawthorne and Cooke, 2020) indicates that all staff groups take HH seriously, have concerns about direct observation (DO) audits and are generally supportive of new technological innovations. As part of a team of innovators working in an acute specialist NHS trust, we are taking a very different approach to EMS development compared to the system used by Kelly et al. and other current commercial applications. Our approach, Hy-genie (Cawthorne et al., 2022), has been underpinned by extensive staff consultations which is why the theme of exploring staff acceptability of how feedback is delivered is so critically important. As highlighted by Kelly et al., their chosen EMS may ‘monitor how effective we are but doesn’t make us more effective’. Many EMS, including the one used in their study, measure HH compliance, that is, HH opportunities taken against total HH opportunities available (HHOA). This means that EMSmust accurately be able to capture all HHOA. A concern raised in this study was that HCWsmay disagree with the EMSwhen recognising an HHOA. Thus, some HCWs found the EMS to undermine their own clinical judgement on when HH should be performed (‘I haven’t touched any patients but I have been in their bed space which says I should gel but I haven’t touched anyone’). In the development of our own EMS, we have sought an alternative approach to overcome this technical challenge. Rather than measuring HH compliance, our EMS simply measures HH frequency. It is","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"248-249"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393604/pdf/10.1177_17571774221092530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132908","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":"Medical interns' views on the strategies for reducing antibiotic misuse in the hospitals-what guidelines do they follow?","authors":"Kai Sing Sun, Tai Pong Lam, Tak Hon Chan, Kwok Fai Lam, Kit Wing Kwok, Hoi Yan Chan, Pak Leung Ho","doi":"10.1177/17571774221094154","DOIUrl":"10.1177/17571774221094154","url":null,"abstract":"<p><strong>Objectives: </strong>Although the topic of antibiotic misuse is taught in medical schools, interns (fresh medical graduates) still encounter barriers to appropriate antibiotic prescription when they practice in hospitals under supervision. The impact of teaching in medical school, antibiotics stewardship program (ASP), and prescription guidelines was uncertain. This study explored the medical interns' views on antibiotic use and resistance, and their perceived enablers to appropriate antibiotic prescription.</p><p><strong>Methods: </strong>Two focus groups were conducted among medical interns with rotation experiences in different public hospitals of Hong Kong. The identified themes about attitudes to antibiotic resistance and enablers to appropriate antibiotic prescription were further examined by a questionnaire survey with 77 respondents.</p><p><strong>Results: </strong>The interns had lower preferences for tackling antibiotic resistance as they feared of delayed prescriptions. Guidelines provided by international evidence-based clinical resources and the interns' working hospitals were stronger enablers to appropriate antibiotic use than education materials from schools and the government. Qualitative findings revealed that the interns were aware of the existing ASP but doubted its effectiveness as it failed to get the prescribers' attention. They followed guidelines in their wards but perceived guidelines from local health authorities user-unfriendly. Knowledge from medical school was not very applicable. Varying prescribing practices between hospitals and the densely placed hospital beds made it difficult to prevent the spread of antimicrobial resistance.</p><p><strong>Conclusions: </strong>Minimizing delayed prescription is of a higher priority than tackling antibiotic resistance in medical interns' perspective. Interventions should target guidelines in hospitals and simplify the interface of local guidelines.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"214-221"},"PeriodicalIF":0.9,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393602/pdf/10.1177_17571774221094154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132910","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":"Knowledge and compliance to prevention of central line-associated blood stream infections among registered nurses in Jordan.","authors":"Abd Alrahman Matlab,&nbsp;Mahmoud Ogla Al-Hussami,&nbsp;Maha Alkaid Albqoor","doi":"10.1177/17571774211066778","DOIUrl":"https://doi.org/10.1177/17571774211066778","url":null,"abstract":"<p><strong>Background: </strong>Central line-associated bloods tream infections (CLABSIs) are among the most common healthcare-associated infections (HAIs).</p><p><strong>Aims: </strong>To assess the rates of CLABSIs and to investigate predictors of knowledge and compliance of registered nurses to central venous catheters (CVCs) maintenance care bundle in intensive care units (ICUs).</p><p><strong>Methods: </strong>A cross-sectional correlational design was used. A convenient sample of 114 registered nurses was selected from three hospitals in Jordan. Nurses' knowledge and compliance were measured by previously established measures and an observational checklist developed according to the Center for Disease Control and Prevention (CDC).</p><p><strong>Findings: </strong>The rate of CLABSI was the lowest in the hospital that applies the CVC bundle of care. Nurses' knowledge about CLABSI prevention practices was significantly correlated with their compliance to CVCs maintenance care bundle. Nurses' knowledge differed bytheirage, income, experience in ICU, and nurse-to-patient ratio, and in multiple regressions, age was the single predictor of knowledge of CLABSI prevention. Significant differences were also found in nurses' compliance to the CVC care bundle according to the hospital and nurse-to-patient ratio. The nurse-to-patient ratio was the single significant predictor, and it attenuated the effect of age and income on nurse's compliance to the CVC care bundle.</p><p><strong>Conclusion: </strong>This study indicated the need to expand the application of the CVC maintenance care bundle in hospitals. Programs that target promoting nurses' knowledge about CLABSI prevention and compliance to CVC care need to consider some factors, such as nurses' age and the circumstances of their work (nurse-to-patient ratio).</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"133-141"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226055/pdf/10.1177_17571774211066778.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298415","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":"Beware what lurks on the surface - persistent contamination of high-touch surfaces on slit lamps despite regular cleaning.","authors":"Cassandra Xc Chan,&nbsp;Berdjette Yy Lau,&nbsp;Xin Le Ng,&nbsp;Dawn Ka Lim,&nbsp;Blanche Xh Lim,&nbsp;Chris Hl Lim","doi":"10.1177/17571774211066790","DOIUrl":"https://doi.org/10.1177/17571774211066790","url":null,"abstract":"<p><p>High-touch surfaces contributing to infection transmission are particularly concerning in the ophthalmology clinic where frequent contact exists between ophthalmologists and various ophthalmic instruments. Areas of surface contamination from an ophthalmologist's contact with the slit lamp environment were identified using ultraviolet fluorescence as a surrogate for pathogen contamination. Ultraviolet fluorescent product was applied on the ophthalmologist's hands after thorough hand washing to indicate the contamination that may be derived from multiple sources in the ophthalmology clinic, such as touching the patient or the patient's folder during eye examinations and transfers. The ophthalmology clinic was run normally, with the ophthalmologist wiping down patient-contact surfaces on the slit lamp and performing thorough hand hygiene after every patient. Using ultraviolet black light, persistence of surface contamination in the slit lamp environment was identified and evaluated across five days. High-touch surfaces of suboptimal disinfection were inclined towards those touched only by the ophthalmologist, for example: joystick and chin-rest adjustment knob, as compared to patient-contact surfaces. Persistent contamination on the same surfaces revealed inefficacy of current hand hygiene and clinical disinfection practices. This poses a significant risk for pathogen transmission and underscores the importance of including these specific clinician high-touch surfaces in existing cleaning protocols.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"186-189"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226059/pdf/10.1177_17571774211066790.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290680","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 single institution pre-/post-comparison after introduction of an external urinary collection device for female medical patients.","authors":"Nathan Jasperse,&nbsp;Oscar Hernandez-Dominguez,&nbsp;Jacob S Deyell,&nbsp;Janani P Prasad,&nbsp;Charlene Yuan,&nbsp;Meril Tomy,&nbsp;Catherine M Kuza,&nbsp;Areg Grigorian,&nbsp;Jeffry Nahmias","doi":"10.1177/17571774211060423","DOIUrl":"https://doi.org/10.1177/17571774211060423","url":null,"abstract":"<p><strong>Background: </strong>External urinary collection devices (EUCDs) may serve as an alternative to indwelling urinary catheters (IUCs) and decrease the rate of catheter associated urinary tract infections (CAUTIs). <i>PureWick®</i> is a novel female EUCD; however, no study has definitively proven benefit regarding reduction of CAUTIs.</p><p><strong>Aim: </strong>We sought to compare the CAUTI rate and IUC days before and after availability of the <i>PureWick®</i> EUCD at a single institution. We provide a descriptive analysis of female medical patients receiving an EUCD.</p><p><strong>Methods: </strong>A retrospective review of adult female patients admitted to a single institution on a medical service who received an IUC and/or an EUCD was performed. Patients who received an IUC in the 3 months before EUCD availability (PRE) were compared to patients who received an IUC and/or EUCD in the 12 months after (POST).</p><p><strong>Results: </strong>Out of 848 female patients, 292 received an EUCD in the POST cohort and overall, 656 received an IUC (259 (100%) PRE vs. 397 (67.4%) POST). Compared to the PRE cohort, the POST cohort had a higher number of IUC days (median, 3 vs 2 days, <i>p</i> = 0.001) and a higher rate of CAUTI (infections per 1000 catheter days, 9.3 vs 2.3, <i>p</i> = 0.001). The rate of UTI associated with EUCD use was 9.8 infections per 1000 device days.</p><p><strong>Discussion: </strong>While EUCDs might appear to be a promising alternative to IUCs for female patients, this single center pre-/post-analysis found that both the number of IUC days and the CAUTI rate increased after introduction of a female EUCD.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"149-154"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226054/pdf/10.1177_17571774211060423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290681","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":"Carbapenems consumption and <i>Klebsiella</i> resistance in intensive care units in Egypt: A study to evaluate the effect of an antimicrobial stewardship program.","authors":"Hozaifa Elsawah,&nbsp;Ahmed Samir,&nbsp;Mahmoud Elrazzaz,&nbsp;Abdallah Ramadan,&nbsp;Amr Elnaggar,&nbsp;Khaled Taema","doi":"10.1177/17571774211060436","DOIUrl":"https://doi.org/10.1177/17571774211060436","url":null,"abstract":"<p><strong>Background: </strong>The high prevalence of carbapenem-resistant <i>Klebsiella</i> imposes optimizing antibiotic consumption. We aimed to evaluate the impact of antibiotic stewardship program on carbapenem consumption and the <i>Klebsiella</i> resistance.</p><p><strong>Method: </strong>We retrospectively evaluated critically ill patients with isolated <i>Klebsiella</i> species from Elaraby hospital, Egypt during the period from April 2017 to January 2019. We collected data related to carbapenems consumption and <i>Klebsiella</i> clinical isolates with their antimicrobial susceptibility. Based on susceptibility, <i>Klebsiella</i> isolates were classified into sensitive, extended spectrum beta-lactamase (ESBL) producer, and carbapenem-resistant <i>Klebsiella</i> (CRK), respectively. Our primary outcome was the change in carbapenems consumption after implementing the program, while the secondary outcomes were the changes in the incidence of CRK.</p><p><strong>Results: </strong>The study included 205 patients with isolated <i>Klebsiella</i> species during the study period. The antibiotic stewardship program started in March 2018. Out of the 205 patients, 61 patients (29.8%) represented the pre-intervention sample, and 144 patients (70.2%) represented the post-intervention sample. Applying the antibiotic stewardship program was associated with a significant decrease in the carbapenems consumption from 38.9 to 26.6 defined daily dose/1000 patient-days (<i>p</i> = 0.02). The incidence of CRK was decreased from 85.25% of total <i>Klebsiella</i> isolates to 48.6% (<i>p</i> < 0.001). <i>Klebsiella</i> species were more likely to be in a lower category of resistance after applying the program with an odds ratio of 6.3 (2.88-13.73) using ordinal logistic regression.</p><p><strong>Conclusion: </strong>Applying the antibiotic stewardship program could reduce the unnecessary carbapenems use in the ICU with a subsequent decrease in the emergence of the <i>Klebsiella-</i>resistant strains.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"142-148"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226057/pdf/10.1177_17571774211060436.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298413","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":"10.1177/17571774221101090","DOIUrl":"https://doi.org/10.1177/17571774221101090","url":null,"abstract":"","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"192"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226058/pdf/10.1177_17571774221101090.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10094426","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":"<i>Mycobacterium tuberculosis</i> infection and disease in healthcare workers in a tertiary referral hospital in Bandung, Indonesia.","authors":"Lika Apriani,&nbsp;Susan McAllister,&nbsp;Katrina Sharples,&nbsp;Isni Nurul Aini,&nbsp;Hanifah Nurhasanah,&nbsp;Rovina Ruslami,&nbsp;Dick Menzies,&nbsp;Philip C Hill,&nbsp;Bachti Alisjahbana","doi":"10.1177/17571774211046887","DOIUrl":"https://doi.org/10.1177/17571774211046887","url":null,"abstract":"<p><strong>Background: </strong>Healthcare workers (HCWs), especially in high tuberculosis (TB) incidence countries, are at risk of <i>Mycobacterium tuberculosis</i> infection and TB disease, likely due to greater exposure to TB cases and variable implementation of infection control measures.</p><p><strong>Aim: </strong>We aimed to estimate the prevalence of tuberculin skin test (TST) positivity, history of TB and to identify associated risk factors in HCWs employed at a tertiary referral hospital in Bandung, Indonesia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from April to August 2018. A stratified sample of the HCWs were recruited, screened by TST, assessed for TB symptoms, history of TB disease and possible risk factors. Prevalence of positive TST included diagnosis with TB after starting work. HCWs with TB disease diagnosed earlier were excluded. Survey weights were used for all analyses. Possible risk factors were examined using logistic regression; adjusted odds ratios and 95% confidence intervals (CI) are presented.</p><p><strong>Results: </strong>Of 455 HCWs recruited, 42 reported a history of TB disease (25 after starting work) and 395 had a TST result. The prevalence of positive TST was 76.9% (95% CI 72.6-80.8%). The odds increased by 7% per year at work (95% CI 3-11%) on average, with a rapid rise in TST positivity up to 10 years of work and then a plateau with around 80% positive.</p><p><strong>Discussion: </strong>A high proportion of HCWs had a history of TB or were TST positive, increasing with longer duration of work. A package of TB infection control measures is needed to protect HCWs from <i>Mycobacterium tuberculosis</i> infection.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"155-166"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/62/10.1177_17571774211046887.PMC10226060.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298409","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":"Feasibility of hygienic clinical attire for doctors during COVID-19: A university hospital experience.","authors":"Hannah James,&nbsp;Andrew Phillips","doi":"10.1177/17571774211046989","DOIUrl":"https://doi.org/10.1177/17571774211046989","url":null,"abstract":"Personal protective equipment (PPE) for healthcare staff has been central to reducing nosocomial transmission of COVID-19 (Public Health England, 2020: p6–36). The role of doctors’ clinical attire in transmitting the virus in hospital settings has not been reported in the literature. The survival of SARS-CoV-2 on clothing is currently unknown, but the virus has been shown to remain viable and infectious on surfaces for several days, depending on inoculum shed (Doremalen et al., 2020). Fomite transmission was associated with nosocomial spread and super-spreading events with SARS-CoV-1, and the stability of the two viruses has been demonstrated to be similar (Chen et al., 2004). In contrast to nursing and allied healthcare staff who have an established uniform policy with evidence-based hygiene measures (NHS England and NHS Improvement, 2020:p2– 6), doctors habitually commute to the hospital in work clothing and visit public places en route (Oxtoby, 2015). This is poor infection control practice in ordinary times, but in the context of a pandemic may represent an underappreciated route of viral transmission. We report the experience of piloting hygienic ‘ward wear’ scrubs for doctors at a large 1000-bed National Health Service University teaching hospital. The hospital employs 1022 doctors, all of whom were offered use of the new scrubs on a loan basis during the first wave of the UK COVID-19 pandemic in March 2020. The provision consisted of three sets of a unisex navy blue poly-cotton scrub suit of standard design, with the hospital logo and ‘doctor’ embroidered on the chest. Doctors were responsible for laundering their own scrubs, as evidence shows that domestic laundering at 60°C is as effective as commercial washing for decontaminating healthcare clothing (NHS England and NHS Improvement, 2020:p2–6). Doctors using the scrubs were instructed to change into and out of them on hospital premises using existing changing room facilities and store their clothing with their personal belongings. Data was obtained by a web survey with 10 questions in October 2020. Questions included multiple choice, Likert scale questions and free-text. All doctors employed at the hospital (n = 1022) were invited by email to take part. The objectives were to map the demographics of uptake of the ward wear initiative; to obtain feedback on users’ perceptions of hygiene, comfort and professionalism; and to understand the barriers to use among doctors who chose not to take part in the pilot. Of 1022 doctors, 504 (49%) opted to use the new scrubs. 169 doctors completed the survey (14%). 135 (80%) of respondents were using the new scrubs at the time of the survey, 6 months after the start of the initiative. There was an equal gender split amongst respondents who had tried the scrubs (the ‘uptake’ group) and those who chose not to (the ‘decline’ group). The grade of respondents was comparable between the uptake and decline groups and broadly representative of the proportions","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"190-191"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006087/pdf/10.1177_17571774211046989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9540229","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":"Infection prevention and control strategies against carbapenem resistant Enterobacteriaceae - a systematic review.","authors":"Catarina Santos-Marques,&nbsp;Helena Ferreira,&nbsp;Sónia Gonçalves Pereira","doi":"10.1177/17571774211066762","DOIUrl":"https://doi.org/10.1177/17571774211066762","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance is exponentially worsening, and the spread of prevalent carbapenem resistant Enterobacteriaceae (CRE) is a major contributor to this global concern. Infection prevention and control strategies are increasingly consolidated key tools to control this worldwide problem.</p><p><strong>Aim: </strong>To identify, collect and analyse available evidence regarding the impact of infection prevention and control strategies on prevalent CRE dissemination.</p><p><strong>Methods: </strong>Pubmed®, Scopus® and Web of Science® were searched systematically for articles published between 1th January 2017 and 30th June 2020, guided by the research question 'What are the most effective and efficient strategies to prevent and control infection/colonisation caused by Carbapenem resistant <i>Escherichia coli</i> and Carbapenem resistant <i>Klebsiella pneumoniae</i>?'.</p><p><strong>Findings: </strong>Eleven thousand six hundred and thirty-five publications were found, but after applying the inclusion and exclusion criteria, only 30 were selected. The majority of reviewed studies (<i>n</i> = 24) were performed in outbreak situations, 26 studies occurred in acute care units and of those, 17 in intensive care units . From the set of implemented infection prevention and control measures, in 29 studies surveillance cultures were applied, in 23 studies patients were isolated or cohorted and, in general, all described the implementation of standard and contact precaution measures.</p><p><strong>Conclusion: </strong>This systematic review underlines the importance of infection prevention and control strategies in CRE dissemination, standing out the need of further studies outside outbreak and intensive care units contexts. Investment increments and training and educating of all involved are also important contributors to shift this problem, but still with relevant gaps in their implementation, in all types of care units, that need to be addressed.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"167-185"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226056/pdf/10.1177_17571774211066762.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298411","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}