Infection Prevention in Practice最新文献

{"title":"Performance of an Autonomous Sanitary Sterilisation Ultraviolet Machine (ASSUM) on terminal disinfection of surgical theaters and rooms of an intensive-intermediate care unit","authors":"","doi":"10.1016/j.infpip.2024.100396","DOIUrl":"10.1016/j.infpip.2024.100396","url":null,"abstract":"<div><h3>Background</h3><p>Ultraviolet- C (UV–C) light is effective for reducing environmental bioburden in hospitals, and the use of robots to deliver it may be advantageous.</p></div><div><h3>Aim</h3><p>To evaluate the feasibility and clinical efficacy of an autonomous programmable UV-C robot in surgical and intensive care unit (ICU) rooms of a tertiary hospital.</p></div><div><h3>Method</h3><p>During ten consecutive months, the device was used in six theatres where cardiac, colorectal and orthopaedic surgeries were performed, and in the rooms previously occupied by patients subjected to contact precautions of a 14-bed ICU. Surgical site infection (SSI) rates of procedures performed in the UV-cleaned theatres were compared with those of the previous year. Incidence in clinical samples of ICU-acquired multiple-drug resistant (MDR) microorganisms was compared with that of the same period of the previous year. An UV-C exposure study done by semi-quantitative dosimeters and a survey of the bioburden on surfaces were carried out.</p></div><div><h3>Findings</h3><p>SSI rates in the pre- and post-intervention periods were 8.67% (80/922) and 7.5% (61/813), respectively (p=0.37). Incidence of target microorganisms in clinical samples remained unchanged (38.4 vs. 39.4 per 10,000 patient-days, p=0.94). All the dosimeters exposed to ≤1 meter received ≥500 mJ/cm². The bacterial load on surfaces decreased after the intervention, particularly in ICU rooms (from 4.57±7.4 CFU to 0.27±0.8 CFU, p&lt;0.0001).</p></div><div><h3>Conclusion</h3><p>Deployment of an UV-C robot in surgical and ICU rooms is feasible, ensures adequate delivery of germicidal UV-C light and reduces the environmental bacterial burden. Rates of surgical site infections or acquisition of MDR in clinical samples of critically-ill patients remained unchanged.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259008892400060X/pdfft?md5=024a0d705dc6b17c7c6aa1506801f1f2&pid=1-s2.0-S259008892400060X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164862","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":"An assessment of infection prevention and control implementation in Malawian hospitals using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool","authors":"","doi":"10.1016/j.infpip.2024.100388","DOIUrl":"10.1016/j.infpip.2024.100388","url":null,"abstract":"<div><h3>Background</h3><p>Infection prevention and control (IPC) is important for the reduction of healthcare-associated infections (HAI). The World Health Organization (WHO) developed the IPC Assessment Framework (IPCAF) tool to assess the level of IPC implementation and to identify areas for improvement in healthcare facilities.</p></div><div><h3>Methods</h3><p>A cross -sectional survey was conducted using the WHO IPCAF tool from May to June 2023. The aim was to provide a baseline assessment of the IPC programme and activities within health care facilities in Malawi. Forty healthcare facilities were invited to participate. IPC teams were requested to complete the IPCAF and return the scores. The IPCAF tool scores were assessed as recommended in the WHO IPCAF tool.</p></div><div><h3>Results</h3><p>The response rate was 82.5%. The median IPCAF score was 445 out of 800 corresponding to an intermediate IPC implementation level. The results revealed that 66.7% facilities were at intermediate level, 26.4% at basic level, and 6.9% at advanced level. Most facilities (76%) had an IPC program in place with clear objectives and an IPC focal person. Few had a dedicated budget for IPC. The IPCAF domain “monitoring/audit of IPC practices and feedback” had the lowest median score of 15/100, and in 90% of facilities, no monitoring, audit, and feedback was done. HAI surveillance median score was 40/100, workload, staffing and bed occupancy median score was 45/100.</p></div><div><h3>Conclusions</h3><p>Whilst there has been some degree of implementation of WHO IPC guidelines in Malawi's healthcare system, there is significant room for improvement. The IPCAF tool revealed that monitoring/audit and feedback, HAI surveillance and workload, staffing and bed occupancy need to be strengthened. The IPCAF scoring system may need reconsidering given the centrality of these domains to IPC.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000520/pdfft?md5=8b28b2547fe669741f33b412897af756&pid=1-s2.0-S2590088924000520-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096081","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":"Device associated healthcare associated infection (DA-HAI): a detailed analysis of risk factors and outcomes in a university hospital in Rome, Italy","authors":"","doi":"10.1016/j.infpip.2024.100391","DOIUrl":"10.1016/j.infpip.2024.100391","url":null,"abstract":"<div><h3>Introduction</h3><p>This study investigates the impact of invasive procedures on healthcare-associated infections (HAI) at Policlinico Universitario Tor Vergata in Rome, Italy, aiming to understand their role in device-associated HAI and to inform prevention strategies.</p></div><div><h3>Methods</h3><p>A retrospective cohort analysis was conducted, examining mandatory discharge records and microbiology data from 2018 across all departments. The study focused on adult patients, analysing the correlation between invasive procedures and HAI through univariate and multivariate logistic regression.</p></div><div><h3>Results</h3><p>Of the 12,066 patients reviewed, 1,214 (10.1%) experienced HAI. Univariate analysis indicated an association between invasive procedures and HAI (OR = 1.81, <em>P</em> &lt; 0.001), which was not observed in multivariable analysis. Specific procedures significantly raised HAI risks: temporary tracheostomy (AOR = 22.69, <em>P</em> &lt;0.001), central venous pressure monitoring (AOR = 6.74, <em>P</em> &lt;0.001) prolonged invasive mechanical ventilation (AOR = 4.44, <em>P</em> &lt;0.001), and venous catheterisation (AOR = 1.58, <em>P</em> &lt;0.05). Aggregated high-risk procedures had an increased likelihood of HAI in multivariable analysis (OR = 2.51, <em>P</em> &lt; 0.001). High-risk departments were also notably associated with HAI (OR = 6.13, <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>This study suggests that specific invasive procedures, such as temporary tracheostomy, significantly increase HAI risks. The results highlighting the need for targeted infection prevention and control procedures and supports the need for innovative methods such as record-linkage in policymaking to address HAI. These findings inform clinical practice and healthcare policy to improve patient safety and care quality.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000556/pdfft?md5=43d7c06fec6ad516bbc45fda70374095&pid=1-s2.0-S2590088924000556-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238686","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":"Evaluation of the antimicrobial effect of a far-uv radiation lamp in a real-life environment","authors":"","doi":"10.1016/j.infpip.2024.100390","DOIUrl":"10.1016/j.infpip.2024.100390","url":null,"abstract":"<div><h3>Background</h3><p>Using far-Ultraviolet-C (UVC) radiation with an emission maximum of 222 nm, has the potential to kill bacteria while not being harmful to humans and can be used continuously in public areas. Elevators pose a high risk of infection transmission, as they are small, crowded spaces with poor ventilation. In such a setting continuous decontamination would be very useful. This study aimed to measure the effectiveness of a far-UVC lamp installed in a frequently used elevator by comparing the bacterial load found in that elevator with the bacterial load in a control elevator.</p></div><div><h3>Methods</h3><p>Microbial load was measured by different methods; ATP bioluminescence, surface samples were collected by contact slides, contact plates, and swabbing. Air samples were also collected.</p></div><div><h3>Results</h3><p>No significant differences were found in the microbial content between the control elevator and the UV-lamp elevator, regardless of whether the UV-lamp was always on, or was used with a motion sensor to turn off when someone entered the elevator.</p></div><div><h3>Conclusions</h3><p>The results suggest that the far-UVC requires a longer time to kill the bacteria, while the people traffic were continuously re-contaminating the elevators.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000544/pdfft?md5=29655e69d51ea531cc3d3b154d3c0331&pid=1-s2.0-S2590088924000544-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096080","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":"Airborne SARS-CoV-2 RNA detected during deliveries with unmasked patients","authors":"","doi":"10.1016/j.infpip.2024.100389","DOIUrl":"10.1016/j.infpip.2024.100389","url":null,"abstract":"<div><h3>Background</h3><p>Healthcare workers in obstetric clinics may be exposed to airborne SARS-CoV-2 when treating patients with COVID-19.</p></div><div><h3>Method</h3><p>In this study, performed during the midst of the pandemic, air samples were collected in delivery rooms during childbirth and analysed for SARS-CoV-2 RNA content.</p></div><div><h3>Result</h3><p>Six of 28 samples collected inside delivery rooms were positive for SARS-CoV-2, but none in anterooms or corridors. Five of the six positive samples were from the same occasion.</p></div><div><h3>Discussion</h3><p>This indicates that some patients could be major sources of exhaled virus, although the individual variation is large, and it is thus difficult to predict the risk of infection.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000532/pdfft?md5=ed47fc1c05c49b6fa552d8211d8b0c9d&pid=1-s2.0-S2590088924000532-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135976","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 factors associated with post-cataract surgery endophthalmitis - a review of the literature from 2010 – 2023","authors":"","doi":"10.1016/j.infpip.2024.100387","DOIUrl":"10.1016/j.infpip.2024.100387","url":null,"abstract":"<div><p>Patients undergoing cataract surgery are at risk of post-cataract surgery endophthalmitis (PCSE), a sight-threatening complication. Cataract surgery is a relatively straightforward and quick procedure often performed under local anaesthetic. It is therefore simple to scale up to reduce the currently long waiting times, but it is important to maintain patient safety when considering high throughput surgery. This literature review aimed to identify appropriate infection prevention and control (IPC) measures to support increased throughput of cataract surgery in Scotland. Database searches were conducted using Medline and Embase from 2010 to 2023. Further hand-searching was also performed. The organisms associated with PCSE and IPC factors relevant to PCSE were analyzed. A range of microorganisms was associated with PCSE, where outbreak reports were most associated with Gram-negative bacteria and fungi, whereas retrospective chart reviews were most associated with Gram-positive bacteria. IPC risk factors identified were related to the built environment and issues with sterilization. Specifically, the sources of outbreaks included failures in the ventilation system, as well as contaminated ophthalmic solutions, surgical instruments, and medications. The factors identified in this review should be considered when implementing high throughput cataract surgery to ensure that patient safety is maintained.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000519/pdfft?md5=1777309c5f718f20deed0f7b67065b99&pid=1-s2.0-S2590088924000519-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847374","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":"Hospital-acquired respiratory viral infections while applying droplet precautions on-site (DroPS) - prospective observation during the 2019/20 influenza season, Bern, Switzerland","authors":"","doi":"10.1016/j.infpip.2024.100386","DOIUrl":"10.1016/j.infpip.2024.100386","url":null,"abstract":"<div><p>Single room isolation for respiratory viral infections (RVI), like influenza, puts hospitals under pressure. During the influenza season 2019/20, we implemented <em>Droplet precautions on-site</em> (DroPS) for RVI in two acute care hospitals and prospectively assessed the rate of hospital-acquired RVI (HARVI). 318 patients were admitted with RVI, 85 had Influenza or RSV, 75 stayed in multi-bed rooms with DroPS. From 764 patients <em>at risk</em>, hospitalised ≥ three days in a multi-bed room<em>,</em> 11 (1.4%) developed a clinical HARVI, and three tested positive (3/764, 0.4%; 2x RSV, 1x influenza). DroPS may represent an alternative strategy to deal with respiratory viral infections.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000507/pdfft?md5=080f9af36a9f99f276333294824106dd&pid=1-s2.0-S2590088924000507-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847203","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":"Diagnostic stewardship: establishing the role of the hospital nurse to inform local engagement strategies","authors":"","doi":"10.1016/j.infpip.2024.100381","DOIUrl":"10.1016/j.infpip.2024.100381","url":null,"abstract":"<div><h3>Background</h3><p>Diagnostic stewardship is ‘coordinated guidance and interventions to improve appropriate use of microbiological diagnostics to guide therapeutic decisions’ and a fundamental part of antimicrobial stewardship and the nursing role. The role of the nurse in diagnostic stewardship is relatively unknown and an underused resource. Lack of involvement and training in diagnostic stewardship can lead to inaction or incorrect actions, either of which may be detrimental to patient management, outcomes and care.</p></div><div><h3>Aim</h3><p>To determine the role of the hospital adult nurse in diagnostic stewardship to inform local engagement strategies.</p></div><div><h3>Methods</h3><p>The methodology was informed by Whiffin's (2020) systematic search approach. Electronic databases were searched from 2016 to 2022. The studies included were primary research papers involving adult nurses working in a hospital setting, with findings relevant to a diagnostic stewardship role. Thematic analysis was chosen to understand and compare the results, findings and recommendations of the studies.</p></div><div><h3>Findings</h3><p>Seven studies were included in the review. The identified themes were: (i) nursing role – to recognize infection, aid diagnosis and review results; (ii) nurse challenges – lack of knowledge and confidence to implement diagnostic stewardship; and (iii) Nurse education, empowerment and use of clinical tools.</p></div><div><h3>Conclusion</h3><p>Research studies do not consistently recognize the full scope of the diagnostic stewardship nursing role, signifying that nurses remain an underused resource in promoting diagnostic stewardship. Research-based clarification of the role of the nurse in diagnostic stewardship, outlined in this review, is therefore vital. Further UK-based, nurse-led research is needed to capture the impact of nurse-driven diagnostic stewardship interventions.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000453/pdfft?md5=09a3e76733890c6cc6531202bde91314&pid=1-s2.0-S2590088924000453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843785","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":"How did the COVID-19 pandemic affect antibiotic consumption within humanitarian emergencies? Results from five humanitarian contexts","authors":"","doi":"10.1016/j.infpip.2024.100385","DOIUrl":"10.1016/j.infpip.2024.100385","url":null,"abstract":"<div><h3>Introduction</h3><p>Both high- and low-income countries reported increased antibiotic consumption among COVID-19 patients during the first months of the pandemic. To date, however, no studies have examined changes in antibiotic consumption during the COVID-19 pandemic within humanitarian emergency contexts.</p></div><div><h3>Method</h3><p>Data was collected by Médecins Sans Frontières (MSF) for the years 2018–2021 across the following humanitarian settings: Afghanistan (Lashkar Gah), Bangladesh (Kutupalong), the Democratic Republic of Congo (Mweso and Baraka), and South Sudan (Bentiu). Inpatient and outpatient antibiotic consumption was calculated as Daily Defined Dose (DDD) per 1000 inhabitants per day, as per the World Health Organisation's (WHO) Collaborating Centre for Drug Statistics Methodology. Interrupted time series (ITS) analysis, using an autoregressive integrated moving average (ARIMA) model was used to analyse retrospective monthly antibiotic consumption. The impact of COVID-19 pandemic was evaluated as total antibiotic consumption and according to WHO Access, Watch, Reserve (AWaRe) group classifications within each humanitarian setting.</p></div><div><h3>Results</h3><p>The COVID-19 pandemic had no statistically significant impact on total antibiotic consumption in South Sudan (Bentiu) and Bangladesh (Kutupalong). Similarly, the pandemic had no impact on total antibiotic consumption in DR Congo (Baraka), despite an initial 0.27% (estimate=.274, p-value=0.006) increase in March 2020 driven by Access group antibiotics. Meanwhile, total antibiotic consumption in DR Congo (Mweso) and Afghanistan (Lashkar Gah) declined by 0.74% (estimate = −.744, p = 0.003) and 0.26% (estimate = −.26, p &lt; 0.001), respectively with the COVID-19 pandemic.</p></div><div><h3>Conclusion</h3><p>Further studies are required to investigate what may have contributed to these results.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000490/pdfft?md5=5ad2a6afb432bb553d59c9b69d07fad7&pid=1-s2.0-S2590088924000490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840867","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":"Bacterial Tree of Life: assessing the efficacy of microbiology teaching for foundation year doctors","authors":"","doi":"10.1016/j.infpip.2024.100384","DOIUrl":"10.1016/j.infpip.2024.100384","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000489/pdfft?md5=9626150ecd5b8a44c164d69fd3965071&pid=1-s2.0-S2590088924000489-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703534","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}