Infection Prevention in Practice最新文献

{"title":"A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study","authors":"Sunil Kumar Bijarania ,&nbsp;Rupinder Kaur ,&nbsp;Manisha Biswal ,&nbsp;Sangeeta Maheshwar ,&nbsp;Rajarajan Ganesan ,&nbsp;Goverdhan D. Puri ,&nbsp;Sushant Konar ,&nbsp;Shyam Thingnam","doi":"10.1016/j.infpip.2024.100423","DOIUrl":"10.1016/j.infpip.2024.100423","url":null,"abstract":"<div><h3>Background</h3><div>Infection prevention and control (IPC) practices by critical care nurses are crucial in preventing ventilator-associated pneumonia (VAP) and central-line-associated bloodstream infection (CLABSI).</div></div><div><h3>Aim</h3><div>To implement an integrative approach to developing a set of IPC practices and disseminating information on the IPC practices through an educational multimedia tool to improve compliance with the practices.</div></div><div><h3>Methods</h3><div>This participatory interventional before–after study was conducted in a single tertiary care centre's cardiac surgical intensive care unit (ICU) from May 2022 to March 2023. Thirty-seven nursing IPC practices related to VAP and eight for CLABSI were finalized through a three-step process: systematized review, focused group discussions (five rounds), and Delphi rounds (three rounds). The IPC practices were disseminated through a multimedia tool, displayed continuously in the ICU. Nurses' compliance with the IPC practices observed directly was compared before and after implementing the multimedia tool.</div></div><div><h3>Results</h3><div>A total of 6043 observations for practices related to VAP and 1957 observations for those of CLABSI were performed. There was an increase in compliance post implementation for 11 IPC practices related to VAP and two IPC for those of CLABSI. There was an increase in compliance with practices relevant to chlorhexidine baths, oral care, cuff pressure maintenance, hypertonic saline nebulization, endotracheal suctioning, scrubbing the hub for central line access, and assessment of the central line for removal.</div></div><div><h3>Conclusion</h3><div>Through a participatory approach, we developed a set of IPC nursing practices for VAP and CLABSI. Implementing a multimedia tool, which encompasses the newly implemented IPC practices, improved compliance with many practices.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100423"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980200","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":"Healthcare professionals' knowledge, attitudes, and practices in preventing catheter-associated urinary tract infections: a cross-sectional study in a rehabilitation facility","authors":"D.C. Muscat ,&nbsp;M. Sciortino ,&nbsp;E. Tartari","doi":"10.1016/j.infpip.2025.100438","DOIUrl":"10.1016/j.infpip.2025.100438","url":null,"abstract":"<div><h3>Background</h3><div>Catheter-associated urinary tract infections (CAUTIs) are prevalent yet preventable healthcare-associated infections. Effective prevention requires healthcare professionals (HCPs) to possess adequate knowledge, positive attitudes, and adherence to best practices.</div></div><div><h3>Objective</h3><div>To evaluate the knowledge, attitudes, and practices (KAPs) of HCPs regarding the prevention and management of CAUTI in a Maltese rehabilitation facility.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted with a self-administered online questionnaire from January to March 2023, using total population sampling of doctors, nurses, and nursing assistants (<em>N</em> = 315). Descriptive and inferential analyses were conducted using SPSS.</div></div><div><h3>Results</h3><div>Of the 315 HCPs invited, 215 responded (68.3%). KAP levels towards CAUTI prevention were moderate to adequate. The attitude scores of doctors and nurses varied significantly based on nationality (<em>P</em> = 0.011), professional designation (<em>P</em> = 0.010), and educational level (<em>P</em>&lt;0.001). Positive correlations were identified between CAUTI knowledge and practices among doctors' and nurses' (<em>P</em>=0.002, r = 0.309). For nursing assistants, significant differences were observed across knowledge (<em>P</em>&lt;0.001), attitude (<em>P</em>&lt;0.001), and practice scores (<em>P</em>&lt;0.001), based on age, educational level, job experience, and timing of their last infection prevention and control training. Positive correlations were observed between knowledge and attitudes (<em>P</em>&lt;0.001, r = 0.471), knowledge and practice (<em>P</em>&lt;0.001, r = 0.383), and attitudes and practice (<em>P</em>&lt;0.001, r = 0.403) for nursing assistants.</div></div><div><h3>Conclusions</h3><div>HCP knowledge and attitudes directly influence CAUTI prevention practices. Continuous education and targeted training programmes are critical to improving practices and reducing CAUTI-related patient harm.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100438"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104738","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":"Effects of disposable pull-through brush types for reprocessing of flexible endoscopes in clinical environment","authors":"Remus O. Anders ,&nbsp;Adriana M. Airo ,&nbsp;Eve Capistran ,&nbsp;Anita Chin ,&nbsp;Garry Bassi ,&nbsp;Tony Mazzulli","doi":"10.1016/j.infpip.2025.100445","DOIUrl":"10.1016/j.infpip.2025.100445","url":null,"abstract":"<div><div>Evaluating the effectiveness of different brush types used during the cleaning and reprocessing of flexible endoscopes is challenging. This study compared the yield of microbial growth from endoscopes that had been used clinically before and after cleaning with different brush types (bristle, squeegee, and hybrid). Endoscopes used to perform a total of 91 medical procedures on 82 patients were included. Quantitative bacterial cultures yielded no statistical differences between the different brushes used. Colonoscopes and gastroscopes surveyed after rigorous cleaning steps resulted in a drop in colony counts between pre- and post-cleaning from 1.45E+8 (±5.21E+07) to 2.5 (±0.13) individual colonies suggesting that the overall cleaning process was effective regardless of the brush type used.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100445"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143200033","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 toilets and drainage systems as a reservoir for a long-term polyclonal outbreak of clinical infections with multidrug-resistant Klebsiella oxytoca species complex","authors":"Astri Lervik Larsen ,&nbsp;Torunn Pedersen ,&nbsp;Arnfinn Sundsfjord ,&nbsp;Theodor A. Ross ,&nbsp;Anja Dyresen Guleng ,&nbsp;Jon Birger Haug ,&nbsp;Anna K. Pöntinen ,&nbsp;Ørjan Samuelsen","doi":"10.1016/j.infpip.2024.100430","DOIUrl":"10.1016/j.infpip.2024.100430","url":null,"abstract":"<div><h3>Background</h3><div>Nosocomial outbreaks with multidrug-resistant bacteria with a probable reservoir in hospital toilets and drainage systems have been increasingly reported.</div></div><div><h3>Aim</h3><div>To investigate an increase in bacteraemia with extended-spectrum β-lactamase (ESBL)-producing <em>Klebsiella oxytoca</em> at our hospital in 2021; the epidemiology of the outbreak suggested an environmental source.</div></div><div><h3>Methods</h3><div>Available clinical <em>K. oxytoca</em> isolates from patient with infection or rectal carriage from 2019 to 2022 were collected. Clinical information was gathered from included patients and sampled sinks, shower drains, and toilet water. Short- and long-read whole-genome sequencing (WGS) was performed on patient and environmental isolates to assess phylogenetic relationships, antibiotic resistance genes/mutations, and plasmid profiles.</div></div><div><h3>Results</h3><div>WGS revealed four clusters and a polyclonal population consisting of ESBL-producing <em>K. oxytoca</em> and <em>Klebsiella michiganensis</em>. All clusters contained both clinical and environmental isolates. The environmental sampling revealed widespread contamination of the outbreak strains in the outbreak ward, and plasmid analyses indicated possible transfer of plasmids between species and clones. Most environmental findings in the outbreak ward were from toilet water, and enhanced cleaning of bathrooms and toilets was introduced. The following year, a decrease in outbreak strains in systemic infections was observed.</div></div><div><h3>Conclusion</h3><div>This investigation uncovered a polyclonal outbreak of multidrug-resistant <em>K. oxytoca</em> and <em>K. michiganensis</em> and unveiled a persistent reservoir of outbreak clones in the drainage system and toilet water, facilitating exchange of resistance genes. The risk of toilet water as a source of clinical infections warrants further investigation.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100430"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048050","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":"Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey","authors":"T.J. Schrama ,&nbsp;K.J. Vliegenthart-Jongbloed ,&nbsp;M. Gemuwang ,&nbsp;E.Q. Nuwass","doi":"10.1016/j.infpip.2024.100429","DOIUrl":"10.1016/j.infpip.2024.100429","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance (AMR) is a significant global health concern, with improper antibiotic use contributing to its rise. Tanzania initiated an AMR action plan in 2017, but comprehensive surveillance and stewardship efforts remain limited. This study focused on evaluating antibiotic use, particularly surgical prophylaxis, in a rural Tanzanian hospital.</div></div><div><h3>Methods</h3><div>The study was conducted at Haydom Lutheran Hospital in Tanzania in May 2023, using a cross-sectional point prevalence survey. Antibiotic use in all patients admitted for &gt;24 h and those undergoing surgery was recorded, including type, dose, indication and duration. Quality indicators for surgical prophylaxis were assessed.</div></div><div><h3>Results</h3><div>Among 199 inpatients, 55% received antibiotics, with surgical prophylaxis accounting for 23% of prescriptions. Notably, none of the patients who received surgical prophylaxis received a single-dose regimen, and 67% exceeded the recommended 24-h duration. A combination of ampicillin-cloxacillin plus metronidazole was the most commonly prescribed combination for surgical prophylaxis (41% of prescriptions). Thirty-three percent of the antibiotics prescribed for surgical prophylaxis were classified as ‘Not recommended’ by the World Health Organization. Furthermore, 90% of surgical prophylaxis prescriptions lacked documented rationale, and 83% of prescriptions lacked stop/review dates in medical records.</div></div><div><h3>Conclusion</h3><div>This study reveals a high prevalence of prolonged antibiotic use for surgical prophylaxis, frequent use of antibiotics classified as ‘Not recommended’, and a lack of adequate documentation, which deviates from international standards. These practices highlight the urgent need for contextualized national guidelines, large-scale implementation projects of evidence-based interventions, and local initiatives in antibiotic stewardship, particularly in low-resource settings.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100429"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135749","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":"Sodium dichloroisocyanurate: a promising candidate for the disinfection of resilient drain biofilm","authors":"Abbie Martin ,&nbsp;Natasha Doyle ,&nbsp;Tom F. O'Mahony","doi":"10.1016/j.infpip.2025.100446","DOIUrl":"10.1016/j.infpip.2025.100446","url":null,"abstract":"<div><h3>Background</h3><div>Biofilms are complex multicellular communities of microorganisms embedded within a protective matrix which confers resistance to various antimicrobials, including biocides. Biofilms can cause a range of human diseases and are responsible for 1.7 million hospital-acquired infections in the US annually, providing an economic burden of $11.5 billion in treatment costs. Biofilm contained within drain and plumbing systems may contain pathogenic viruses and bacteria which pose a significant risk to patient safety within healthcare environments.</div></div><div><h3>Aim</h3><div>The aim of this study was to determine if three hospital-grade disinfectants (sodium dichloroisocyanurate, peracetic acid and sodium hypochlorite) were capable of killing microorganisms within biofilm, and thus, determining their potential as candidates for drain biofilm disinfection.</div></div><div><h3>Methods</h3><div><em>Pseudomonas aeruginosa</em> biofilms were cultivated using the CDC biofilm reactor, a standardised method for determining disinfectant efficacy against biofilm within the United States of America. Each disinfectant was tested using a one-minute contact time, using the highest concentration available on the product label.</div></div><div><h3>Findings</h3><div>The sodium dichloroisocyanurate product was successful in killing biofilm microorganisms, resulting in a log reduction of ≥ 8.70. Peracetic acid reduced biofilm by 3.82 log₁₀ units, followed by sodium hypochlorite, which produced a reduction of 3.78 log₁₀ units.</div></div><div><h3>Conclusions</h3><div>The use of a highly effective disinfectant with proven biofilm efficacy can help ensure patient safety and reduce infection levels. Drains and plumbing systems provide a reservoir for potential pathogens and biofilm; thus, drain disinfection is critical in reducing the instance of hospital-acquired infections. Sodium dichloroisocyanurate may provide a reliable solution for drain applications and subsequently, patient wellbeing and safety.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100446"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348434","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":"The correlation between subcutaneous fat thickness and the incidence of chemoport-related infection","authors":"Thanaphon Khongyut,&nbsp;Tanapong Panpikoon,&nbsp;Chinnarat Buangam,&nbsp;Kaewpitcha Pichitpichatkul,&nbsp;Tharinton Treesit,&nbsp;Sasikorn Feinggumloon","doi":"10.1016/j.infpip.2024.100433","DOIUrl":"10.1016/j.infpip.2024.100433","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to examine the correlation between subcutaneous fat thickness and chemoport-related infection and to determine the risk factors that lead to complications associated with chemoport.</div></div><div><h3>Methods</h3><div>This study retrospectively reviewed 363 patients with chemoport insertion between May 2018 and May 2022. The patients were classified into three groups, with 121 patients in each group, based on the tertiles of subcutaneous fat thickness measured in the computed tomography (CT) scan. The incidence of short-term and long-term complications, including dislocation, infection, and malfunction, were obtained and compared between the three groups. The risk factors of chemoport-related complications were analysed in multivariate analysis.</div></div><div><h3>Results</h3><div>The incidence of infection in the low, middle, and high subcutaneous fat thickness groups were 1.7%, 3.3%, and 0%, respectively (<em>P</em> = 0.131). No short-term complications occurred in this study group. After one year of follow-up, 11 patients (3.0%) had long-term complications; 6 patients (1.7%) developed chemoport infection, while five patients (1.4%) had chemoport dislocation. In multivariate analysis, the risk of dislocation was significantly higher when insertion was performed via the left internal jugular vein (OR = 9.87, <em>P</em>=0.033).</div></div><div><h3>Conclusions</h3><div>The thickness of subcutaneous fat does not significantly correlate with the incidence of chemoport infection, and placement of the port on the left side of the chest wall via the left internal jugular vein is the risk factor for chemoport dislocation.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100433"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932855","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":"Reducing waste and improving provider safety: a retrospective analysis with lessons from the COVID-19 Pandemic","authors":"Johannes Heymer,&nbsp;Stefani Fruchi,&nbsp;Anna Hein,&nbsp;Matthias Ott,&nbsp;Daniel Räpple","doi":"10.1016/j.infpip.2025.100437","DOIUrl":"10.1016/j.infpip.2025.100437","url":null,"abstract":"<div><h3>Background</h3><div>Reducing waste is an important component in comprehensive efforts to create greener intensive care units (ICU). Personal protective equipment (PPE) constitutes a significant share of the waste produced during ICU care. During the COVID-19 pandemic, the availability and supply of PPE posed substantial challenges globally. We aimed to investigate the lessons learned from the use of PPE during the pandemic (regarding the reduction of PPE consumption) and impact on hospital-acquired infections in healthcare workers.</div></div><div><h3>Methods</h3><div>Conducting a retrospective analysis, we examined all newly issued standard operating procedures for the ICU related to the pandemic. We observed for a potential effect on the use of PPE and scrutinized PPE consumption and patient day data focusing on potential differences between 2020 and the following years until 2023. The primary objective was to evaluate the impact of the protocols and measures on PPE consumption.</div></div><div><h3>Results</h3><div>Our analysis revealed that the implementation of four key infection control measures (cohorting, limitation of visits, institutional protocols for PPE use, staff training) lead to a substantial reduction in the use of masks and isolation gowns during the initial stages of the COVID-19 pandemic with no recorded hospital-acquired infections among healthcare workers.</div></div><div><h3>Conclusion</h3><div>It is possible to reduce PPE consumption without compromising the safety of our healthcare professionals. Our observations may guide future policies to reduce PPE consumption with the intent of reducing the environmental impact.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100437"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095954","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 burden and drug-resistant bacteria in healthcare workers' mobile phones: a study in Puerto Rican outpatient clinics","authors":"R. Scharbaai–Vázquez,&nbsp;A.N. García–Aponte,&nbsp;C. Huertas–Ayala,&nbsp;E.Y. Martínez–Monegro,&nbsp;G.M. Guadalupe–Ríos,&nbsp;J. Díaz–Portorreal,&nbsp;M.I. González–Torres,&nbsp;N.M. Fernández","doi":"10.1016/j.infpip.2024.100432","DOIUrl":"10.1016/j.infpip.2024.100432","url":null,"abstract":"<div><h3>Background</h3><div>Mobile phones used by healthcare workers (HCWs) in hospitals are significant reservoirs of drug-resistant bacteria responsible for hospital-acquired infections (HAIs).</div></div><div><h3>Aim</h3><div>The objective of this study was to assess the level of contamination with such bacteria in outpatient clinics.</div></div><div><h3>Methods</h3><div>Swabs from 83 HCWs' mobile phones were processed using standard biochemical and enzymatic procedures to identify pathogenic bacteria. β-Lactamase tests, antimicrobial susceptibility tests, screening for extended-spectrum β-lactamase (ESBL), and carbapenemase production were performed according to CLSI guidelines. Molecular detection of multi-drug-resistant genes (<em>mecA</em> in <em>Staphylococcus aureus</em> and <em>kpc</em>/<em>ndm</em> carbapenemases in <em>Klebsiella pneumoniae</em> and <em>Acinetobacter</em> spp.) was performed using multiplex real-time polymerase chain reaction.</div></div><div><h3>Findings</h3><div>The overall prevalence of mobile phone contamination with one or more bacteria was 100%. A total of 51 Gram-positive and 44 Gram-negative isolates, including 20 coagulase-negative staphylococci (CoNS), 20 <em>S. aureus</em> (0 meticillin-resistant <em>S. aureus</em>), 11 <em>Acinetobacter</em> spp. and 10 <em>K. pneumoniae</em> were isolated. β-Lactamase production was detected in 45% of CoNS and 30% of <em>S. aureus</em>. Panton–Valentine Leukocidin (PVL) toxin gene in <em>S. aureus</em> was found in 20% (4/20) of the isolates. Twenty (20%) and 13% of the <em>Acinetobacter</em> spp. and <em>K. pneumoniae</em> isolates, respectively, were ESBL but not carbapenemase producers.</div></div><div><h3>Conclusions</h3><div>The presence of HAI-causing organisms on mobile phones used by HCWs in outpatient clinics necessitates the implementation of infection control measures to mitigate the risk of cross-contamination in critical healthcare settings.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100432"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012992","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":"Optimizing epidemic prevention in nursing homes using clinical surveillance of respiratory infections","authors":"Philippe Gaspard ,&nbsp;Martin Martinot","doi":"10.1016/j.infpip.2025.100444","DOIUrl":"10.1016/j.infpip.2025.100444","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory tract infections (RTIs) pose a significant risk in nursing homes (NHs), which makes surveillance crucial for timely intervention.</div></div><div><h3>Aim</h3><div>To monitor the impacts of seasonal RTIs in NHs, which include frequency, the use of rapid diagnostic tests and antibiotics, mortality, and cluster dynamics, with the use of clinical surveillance.</div></div><div><h3>Methods</h3><div>During the winter periods from 2015 to 2019 (22 weeks), data on general signs (GSs), and respiratory signs (RSs) were collected to define three respiratory clinical sign patterns (CSPs): GS+/RS+, GS−/RS+, and GS+/RS−. Clusters (≥2 cases) were identified and classified into three intensity levels, namely, L1, L2, and L3 (2, 3–5, and ≥6 GS+/RS+/4 days, respectively). CSP frequencies and the 28-day all-cause mortality were calculated.</div></div><div><h3>Findings</h3><div>In 13 NHs (N = 3,628 resident inclusions, median age: 87.2 years), 1,538 GS+/RS+, 1,482 GS−/RS+, and 233 GS+/RS− cases were observed, with mortality rates of 8.5%, 2.8%, and 6%, respectively. Among the GS+/RS+ cases, 63% received an antimicrobials. GS+/RS+ cluster analysis identified 141 clusters with L1, 100 with L2, and 26 with L3.</div><div>A total of 209 rapid diagnostic tests for influenza were carried out, with 72.2% conducted in L2 or L3 clusters. Within clusters, the first case must be identified promptly with rapid outbreak development taking place within the first 2–3 days, and potentially less effective containment efforts following delayed detection.</div></div><div><h3>Conclusion</h3><div>Clinical surveillance is a comprehensive method that can be utilized for the rapid implementation of preventive measures and appropriate use of antibiotics.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100444"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402680","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}