Infection Disease & Health最新文献

{"title":"SARS-CoV-2 self-testing: Handle with care","authors":"Giuseppe Lippi","doi":"10.1016/j.idh.2023.12.002","DOIUrl":"10.1016/j.idh.2023.12.002","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulating antimicrobial use within hospitals: A qualitative study","authors":"Jennifer Broom ,&nbsp;Alex Broom ,&nbsp;Katherine Kenny ,&nbsp;Pamela Konecny ,&nbsp;Jeffrey J. Post","doi":"10.1016/j.idh.2023.12.001","DOIUrl":"10.1016/j.idh.2023.12.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To examine how regulatory structures and processes focused on antimicrobial stewardship and antimicrobial resistance are experienced by hospital managers and clinicians.</p></div><div><h3>Methods</h3><p>Forty-two hospital managers and clinicians working within accreditation and antimicrobial stewardship teams in three Australian hospitals participated in individual in-depth interviews. Thematic analysis was performed.</p></div><div><h3>Results</h3><p>Thematic analysis revealed participants’ experiences of hospital antimicrobial regulation and their perceptions of what would be required for meaningful antimicrobial optimisation.</p><p><strong>Theme 1: Experience of regulation of antimicrobials within hospitals:</strong> Participants described an increased profile of antimicrobial resistance with inclusion in regulatory requirements, but also the risks of bureaucratic manoeuvring to meet standards rather than governance-inducing systemic changes.</p><p><strong>Theme 2: Growth of accreditation processes and hospitals over time:</strong> Both regulatory requirements and hospitals were described as evolving over time, each manoeuvring in response to each other (e.g. development of short notice accreditation).</p><p><strong>Theme 3: Perceived requirements for change:</strong> Participants perceived a need for top-down buy-in, resource prioritisation, complex understanding of power and influence on clinician behaviour, and a critical need for medical engagement.</p></div><div><h3>Conclusions</h3><p>This study around antimicrobials shows the tension and dynamic relationship between regulatory processes and hospital responses, bringing to light the enduring balance of a system that positions itself to meet regulatory requirements and emerging “demands”, without necessarily addressing the key underlying concerns. Antimicrobial resistance-related solutions are perceived as likely to require further resourcing and buy-in across multiple levels, engagement across professional streams and require strategies that consider complex systems change in order for regulatory structures to have potency.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045123001128/pdfft?md5=aee2bfbb28291422ffebf148af8d687c&pid=1-s2.0-S2468045123001128-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433197","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":"Are self-test kits still relevant post COVID-19 pandemic? Qualitative study on working adults' perceptions","authors":"Gladys Yu Lin Lee ,&nbsp;Raymond Boon Tar Lim","doi":"10.1016/j.idh.2023.11.001","DOIUrl":"10.1016/j.idh.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Other than self-isolation measures, self-testing is likely to reduce the transmission of COVID-19 and may become a valuable approach in future outbreaks of infectious diseases. This study delves into the perceptions and experiences of working adults who utilised COVID-19 self-test kits in Singapore during the post-pandemic period.</p></div><div><h3>Methods</h3><p>Employing a qualitative descriptive design, in-depth interviews were conducted with 40 working adults from diverse occupations, with a median age of 35 years. Thematic analysis of transcribed interviews was carried out by two independent qualitative research-trained researchers.</p></div><div><h3>Results</h3><p><span>Facilitators included personal motivations like safeguarding vulnerable individuals and the convenience of user-friendly self-test kits. Proximal environmental factors encompassed situations involving close contacts and large gatherings, while distal factors involved workplace regulations, </span>public health campaigns, mass media influence, and trust in authorised kits. Nonetheless, barriers include discomfort, cost, uncertainty about proper technique, and evolving testing requirements. Positive test results prompted participants to notify contacts and self-isolate, whereas negative results encouraged a return to normalcy. Participants recommend sustained testing for new variants and vulnerable groups, though some view it as unnecessary due to pandemic normalisation.</p></div><div><h3>Conclusions</h3><p>Self-testing emerged as a social phenomenon influenced by societal obligations and relationships across multiple levels. Effective communication strategies may play a role in fostering trust and ensuring that working adults sustain the practice of self-testing; therefore, further research is needed to explore their potential impact. Such efforts could be valuable for maintaining vigilance and achieving effective disease control in the post-COVID-19 pandemic landscape.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To swab or not to swab? A qualitative study of pathology testing, interpretation, and value in diabetes-related foot ulceration","authors":"Jennifer Broom ,&nbsp;Leah Williams Veazey ,&nbsp;Alex Broom ,&nbsp;Lijie Kee ,&nbsp;Keat Choong","doi":"10.1016/j.idh.2023.10.002","DOIUrl":"10.1016/j.idh.2023.10.002","url":null,"abstract":"<div><h3>Background</h3><p>Diagnostic testing has been proposed as a key strategy to tackle escalating antimicrobial resistance (AMR). However, effectiveness of testing is limited by the complexities of the hospital environment, including human factors.</p></div><div><h3>Objectives</h3><p>To examine swab-testing in diabetes-related foot infections as a case study of the factors impacting microbiology testing use, efficacy, and antimicrobial resistance.</p></div><div><h3>Methods</h3><p>Seventeen clinicians involved in the management of diabetes-related foot infections, including podiatrists, nurses, and doctors, participated in in-depth individual interviews conducted by a qualitative researcher on the investigation and management of diabetes-related foot infections. Thematic analysis was performed.</p></div><div><h3>Results</h3><p>The multilayered and evolving features of the human-diagnostic interface were described by participants as potential barriers to effective swab-testing in clinical care, including diagnostic training and interpretation deficits; communication difficulties; interpretation deficits and diagnostic assumptions; the influence of inter-professional dynamics; and flow-on consequences for patient decisions and care.</p></div><div><h3>Conclusions</h3><p>Swab-testing has been used for over 100 years, and yet there remain substantial factors that limit their effective use in clinical practice as demonstrated by this study. A focus on upscaling diagnostic testing, particularly with escalating AMR, without considering complex implementation and human factors is likely to have limited impact on practice improvement. This study identified vulnerability points in the human-diagnostic interaction which should be considered in the implementation of other microbiological tests. This study on the simple wound swab has implications for future diagnostic upscaling and investment, including its role in address antimicrobial resistance.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045123001098/pdfft?md5=b8f82616f88bbe74f25e2706c7f2075a&pid=1-s2.0-S2468045123001098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453318","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 plain ring is not associated with increased bacterial load on hands: An experimental study among healthcare worker students undertaking mock surgery","authors":"Eva María Aguiar Cabrera ,&nbsp;Sergio Barroso Rosa ,&nbsp;María del Mar Ojeda Vargas ,&nbsp;Carmen Nieves Hernández Flores ,&nbsp;Elena María Hernández Costa","doi":"10.1016/j.idh.2023.10.003","DOIUrl":"10.1016/j.idh.2023.10.003","url":null,"abstract":"<div><h3>Background</h3><p>Adequate hand hygiene is considered as one of the most effective strategies in healthcare-related infection prevention. The potential negative effect of rings in hand disinfection and thus, in increased nosocomial infections rates is still controversial. Therefore, the present study was designed with the purpose of examining if rings frequently exposed to surgical scrubbing were associated or not with increased bacterial counts.</p></div><div><h3>Methods</h3><p>32 volunteers were randomized into 4 groups: A (no rings), B (participants wore a ring), C (no rings and performed surgical scrubbing with chlorhexidine every 48 h) and D (participants wore a ring and performed surgical scrubbing every 48 h). Glove juice samples were obtained at day 0 (T0) and after a 90-min mock-surgery on day 14 (T1). Quantitative (number of UFC/mL) and qualitative data (microorganism type) were collected as study variables.</p></div><div><h3>Results</h3><p>All groups were comparable at T0. All ring carriers obtained negative cultures at T1. Ring presence was not associated with higher bacterial counts; comparisons between A vs B groups and C vs D groups showed no statistically significant differences (p = 0.076 and 1.000). T1 negative cultures were more frequent in participants performing surgical scrubbing every second day (93.8 % vs 75 %), although this difference did not reach statistical significance (p = 0.332).</p></div><div><h3>Conclusions</h3><p>The presence of single plain ring does not seem to be associated with an increased hand bacterial load. Regular surgical scrubbing with chlorhexidine impregnated sponges reduces bacterial contamination of hands, even in the presence of plain rings.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045123001104/pdfft?md5=84306e1eb755ba10de556991af6ed1b6&pid=1-s2.0-S2468045123001104-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296865","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":"Applicability of the ATP assay in monitoring the cleanliness of hospital environments","authors":"Naoaki Ishino ,&nbsp;Chiharu Miyaji ,&nbsp;Megumi Ogata ,&nbsp;Miki Inada ,&nbsp;Mayu Nagata ,&nbsp;Mayumi Shimamoto","doi":"10.1016/j.idh.2023.09.034","DOIUrl":"10.1016/j.idh.2023.09.034","url":null,"abstract":"<div><h3>Background</h3><p>The adenosine triphosphate (ATP) assay is widely used for simple and rapid evaluation of the cleanliness of environmental surfaces. However, there remain concerns regarding the reliability of the ATP assay in hospital settings. This study aimed to assess whether the ATP assay could detect inadequate cleaning within hospital environments as well as monitor the effectiveness of routine cleaning.</p></div><div><h3>Methods</h3><p>The cleanliness of seven types of high-touch surfaces in operating rooms that were routinely cleaned was evaluated by testing the ATP assay and aerobic colony counts (ACC). For pressure redistribution mattresses (Soft-nurse®) that were found to be particularly at risk of infection, cleaning methods were improved, and the effectiveness of these improvements was monitored using the same two methods.</p></div><div><h3>Results</h3><p>The ATP assay quantitatively detected contamination on seven high-touch surfaces but showed no correlation with ACC. However, a significant positive correlation between luminescence and ACC was found on one specific surface, allowing for determining a theoretical cutoff value. Additionally, the ATP assay effectively identified the risk of future infection, which the ACC test could not assess.</p></div><div><h3>Conclusions</h3><p>The ATP assay can monitor the effectiveness of routine cleaning by setting a theoretical cutoff value for each subject. The method provides quantitative and meaningful values when used with an understanding of its limitations.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A commentary on “Care bundle for the prevention of peripheral venous catheter blood stream infections at a secondary care university hospital: Implementation and results” (Lladó Maura et al., 2023)","authors":"Ema Mata,&nbsp;Gisela Silva,&nbsp;Teresa Peralta","doi":"10.1016/j.idh.2023.08.001","DOIUrl":"10.1016/j.idh.2023.08.001","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10192041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of organism acquisition from prior room occupants: An updated systematic review","authors":"Brett G. Mitchell ,&nbsp;Julee McDonagh ,&nbsp;Stephanie J. Dancer ,&nbsp;Sindi Ford ,&nbsp;Jenny Sim ,&nbsp;Bismi Thottiyil Sultanmuhammed Abdul Khadar ,&nbsp;Philip L. Russo ,&nbsp;Jean-Yves Maillard ,&nbsp;Helen Rawson ,&nbsp;Katrina Browne ,&nbsp;Martin Kiernan","doi":"10.1016/j.idh.2023.06.001","DOIUrl":"10.1016/j.idh.2023.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Evidence from a previous systematic review indicates that patients admitted to a room where the previous occupant had a multidrug-resistant bacterial infection resulted in an increased risk of subsequent colonisation and infection with the same organism for the next room occupant. In this paper, we have sought to expand and update this review.</p></div><div><h3>Methods</h3><p>A systematic review and meta-analysis was undertaken. A search using Medline/PubMed, Cochrane and CINHAL databases was conducted. Risk of bias was assessed by the ROB-2 tool for randomised control studies and ROBIN-I for non-randomised studies.</p></div><div><h3>Results</h3><p>From 5175 identified, 12 papers from 11 studies were included in the review for analysis. From 28,299 patients who were admitted into a room where the prior room occupant had any of the organisms of interest, 651 (2.3%) were shown to acquire the same species of organism. In contrast, 981,865 patients were admitted to a room where the prior occupant did not have an organism of interest, 3818 (0.39%) acquired an organism(s). The pooled acquisition odds ratio (OR) for all the organisms across all studies was 2.45 (95% CI: 1.53–3.93]. There was heterogeneity between the studies (I² 89%, P &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>The pooled OR for all the pathogens in this latest review has increased since the original review. Findings from our review provide some evidence to help inform a risk management approach when determining patient room allocation. The risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10055040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomic insights into microbial contamination in critical healthcare environments and the efficacy of a novel “HLE” disinfectant","authors":"Hikmate Abriouel ,&nbsp;Julia Manetsberger ,&nbsp;Leyre Lavilla Lerma ,&nbsp;María Dolores Pestaña Blanco ,&nbsp;Rafael Martínez Nogueras ,&nbsp;Natacha Caballero Gómez ,&nbsp;Nabil Benomar","doi":"10.1016/j.idh.2023.07.002","DOIUrl":"10.1016/j.idh.2023.07.002","url":null,"abstract":"<div><h3>Background</h3><p>Bacterial contamination on inanimate clinical surfaces is directly linked to severe health problems, especially those caused by multidrug resistant (MDR) pathogens. Here, we evaluated the microbial burden in these environments and tested the efficacy of a novel HLE disinfectant solution.</p></div><div><h3>Methods</h3><p>Microbial contamination of healthcare surfaces [Intensive Care Unit (ICU), Long Period Hospitalization Room (LPHR) and Otolaryngology Consultation (OC)] and the efficacy of HLE disinfectant solution were determined analyzing the viable counts on general and selective media, and also by molecular studies focused on metagenomic and specific qPCR.</p></div><div><h3>Results</h3><p>Different contamination loads were detected with LPHR showing the highest contamination. Treatment with the HLE disinfectant solution curbed the spread of well-adapted pathogens on touched surfaces (ICU, LPHR and OC). Metagenomic analysis of microbial diversity of the Patient Table (most contaminated surface in LPHR) revealed the presence of mainly <em>A. johnsonii</em> and <em>P. putida</em>. Furthermore, functional annotation of toxin, virulence and antibiotic resistance sequences showed a high diversity of <em>Acinetobacter</em> spp. and <em>Pseudomonas</em> spp. In this context, specific qPCR analysis confirmed the efficacy of HLE disinfectant solution against the most prevalent and critical pathogens <em>Pseudomonas</em> sp. and <em>Acinetobacter</em> sp. achieving their complete eradication.</p></div><div><h3>Conclusion</h3><p>Given the persistence of detrimental resistant pathogens, the application of HLE disinfection solution could be a highly beneficial and effective option -used either alone or in combination-for infection prevention and control with the aim to eliminate microbial pathogens and their genes from contaminated contact-surfaces and thus limit the spread to humans and other ecological niches.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9969240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the use of midline catheters versus peripherally inserted central catheters for patients requiring peripherally compatible therapies: A pilot randomised controlled trial (the compact trial)","authors":"Nicole Marsh ,&nbsp;Emily N. Larsen ,&nbsp;Catherine O'Brien ,&nbsp;Peter Groom ,&nbsp;Tricia M. Kleidon ,&nbsp;Evan Alexandrou ,&nbsp;Emily Young ,&nbsp;Kate McCarthy ,&nbsp;Claire M. Rickard","doi":"10.1016/j.idh.2023.03.007","DOIUrl":"10.1016/j.idh.2023.03.007","url":null,"abstract":"<div><h3>Background</h3><p><span>Midline catheter<span> (MC) use has increased in acute-care settings, particularly for patients with difficult venous access or requiring peripherally compatible intravenous therapy for up-to 14 days. Our aim was to assess feasibility and generate clinical data comparing MCs with </span></span>Peripherally Inserted Central Catheters (PICCs).</p></div><div><h3>Methods</h3><p>A two-arm parallel group pilot randomised controlled trial<span> (RCT), comparing MCs with PICCs, was conducted in a large tertiary hospital in Queensland between September 2020 and January 2021. The primary outcome was study feasibility, measured against rates of eligibility (&gt;75%), consent (&gt;90%), attrition (&lt;5%); protocol adherence (&gt;90%) and missing data (&lt;5%). The primary clinical outcome was all-cause device failure.</span></p></div><div><h3>Results</h3><p>In total, 25 patients were recruited. The median patient age was 59–62 years; most patients were overweight/obese, with ≥2 co-morbidities. Primary outcomes: The eligibility and protocol adherence criteria were not met; of 159 screened patients, only 25 (16%) were eligible, and three patients did not receive their allocated intervention post-randomisation (88% adherence). All-cause failure occurred in two patients allocated to MC (20%) and one PICC (8.3%).</p></div><div><h3>Conclusions</h3><p>Our study found that a fully powered RCT testing MCs compared with PICCs is not currently feasible in our setting. We recommend a robust process evaluation before the introduction of MCs into clinical practice.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9763543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}