Journal of Hospital Infection最新文献

{"title":"Development and evaluation of a high-fidelity, multi-disciplinary simulation training course for high-consequence infectious diseases using fluorescence visualization","authors":"L. Hunt ,&nbsp;J. Cole ,&nbsp;C. Evans ,&nbsp;S. Farrow ,&nbsp;P. Johnson ,&nbsp;C. Bailey ,&nbsp;P. Lewthwaite ,&nbsp;P. Lillie ,&nbsp;S. Lukins ,&nbsp;C. Mace ,&nbsp;G. Mountford ,&nbsp;M. Rumbold ,&nbsp;M. Ankcorn ,&nbsp;N. Easom ,&nbsp;A. Tunbridge ,&nbsp;B. Crook ,&nbsp;the UK High Consequence Infectious Disease Network","doi":"10.1016/j.jhin.2024.12.008","DOIUrl":"10.1016/j.jhin.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>High-consequence infectious diseases (HCIDs) include contact-transmissible viral haemorrhagic fevers and airborne-transmissible infections such as Middle Eastern Respiratory Syndrome. Assessing suspected HCID cases requires specialized infection control measures including patient isolation, personal protective equipment (PPE), and decontamination. There is need for an accessible course for NHS staff to improve confidence and competence in using HCID PPE outside specialist HCID centres.</div></div><div><h3>Aim</h3><div>To produce and evaluate a training course for National Health Service (NHS) staff on recognition and assessment of patients with suspected HCID infection.</div></div><div><h3>Methods</h3><div>We developed a multi-disciplinary course blending online learning with in-person, high-fidelity simulation using a manikin which employs fluorescent tracers to simulate airborne, contact, and fomite transmission. This facilitates visualization of contamination pre- and post-PPE removal and supports team-based debrief of performance. Training culminated in competency-based assessment. Educational effectiveness was evaluated through curriculum-linked pre- and post-course tests, and self-rated confidence using Likert scales.</div></div><div><h3>Findings</h3><div>Between December 2022 and April 2024 180 nurses, specialty registrars and consultants were trained. Educational effectiveness was evaluated in 60 consecutive participants between December 2022 and April 2023. Pre- and post-course assessments revealed significant improvements in knowledge (mean score 61% vs 83%, <em>P</em>&lt;0.0001). Pre-course, 36% of learners reported feeling confident in HCID PPE donning and doffing, rising to 97% post-course. Participants unanimously rated the learning experience as high- or very-high quality.</div></div><div><h3>Conclusion</h3><div>This course, incorporating ultraviolet markers for contamination visualization, represents a novel approach outside military settings. The results demonstrate its effectiveness as an educational intervention, improving staff confidence and competence in PPE use.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 1-9"},"PeriodicalIF":3.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of an antimicrobial coating on comfort: a comparative trial of an extended-use disposable isolation gown","authors":"N. Angelopoulos ,&nbsp;M. Chamberlin ,&nbsp;T. Botha ,&nbsp;J. Staines ,&nbsp;S. Bates ,&nbsp;F. McGain","doi":"10.1016/j.jhin.2024.12.009","DOIUrl":"10.1016/j.jhin.2024.12.009","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 56-58"},"PeriodicalIF":3.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large, protracted, multi-species and multi-clonal spread of VIM-type metallo-β-lactamase-producing Enterobacterales in an Italian hospital","authors":"R. Olivieri ,&nbsp;E. Riccobono ,&nbsp;S. Gonnelli ,&nbsp;C. Basagni ,&nbsp;M. Tumbarello ,&nbsp;M.G. Cusi ,&nbsp;G.M. Rossolini","doi":"10.1016/j.jhin.2024.12.003","DOIUrl":"10.1016/j.jhin.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant Enterobacterales, particularly those producing carbapenemase (CPE), pose a major threat to human health, being listed among critical-priority resistant pathogens by the World Health Organization.</div></div><div><h3>Aim</h3><div>To report on a large nosocomial spread of CPE of different species producing Verona integron-encoded metallo-β-lactamase (VIM)-type carbapenemases, and on the infection prevention and control measures that were adopted to combat the spread.</div></div><div><h3>Methods</h3><div>Conventional culture and molecular methods were used for detection and identification of VIM-positive CPE (VIM-CPE) causing infections or colonizing patients or present in environmental specimens. Whole-genome sequencing analysis of selected isolates was performed to investigate clonal relatedness. Basic (active surveillance, contact precautions, close contact screening, cohorting of patients, surface cleaning, hand hygiene) and advanced (weekly point-prevalence surveys for rectal colonization, additional training of healthcare workers, extraordinary ward sanitization, extraordinary maintenance interventions, and environmental microbiological screening, single-use equipment, ward relocation) infection prevention and control (IPC) measures were implemented to combat the spread.</div></div><div><h3>Findings</h3><div>Spread of VIM-CPE involving 151 patients (mostly colonizations) was documented in a single hospital ward from November 2021 to December 2023. The spread involved several different species of Enterobacterales, with clonal expansion documented in some cases. Implementation of basic and advanced IPC measures was temporarily successful at mitigating the spread, but multiple relapses were observed, suggesting the presence of an unidentified environmental reservoir.</div></div><div><h3>Conclusion</h3><div>VIM-CPE has the potential to cause large and complex nosocomial outbreaks in hospital environments, underscoring the challenges to their control by IPC practices.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 10-18"},"PeriodicalIF":3.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gel nail polish does not have a negative impact on the nail bacterial burden nor on the quality of hand hygiene with an alcohol-based hand rub","authors":"P. Arreba ,&nbsp;J. Iglesias ,&nbsp;J. Ríos ,&nbsp;S. Herrera ,&nbsp;D.N. Marco ,&nbsp;M. Montoya ,&nbsp;M. Brey ,&nbsp;C. Pitart ,&nbsp;M. Hernández-Meneses ,&nbsp;C. Cardozo ,&nbsp;N. García ,&nbsp;A. Sempere ,&nbsp;M. Verdejo ,&nbsp;L. Morata ,&nbsp;M. Bodro ,&nbsp;C. García-Vidal ,&nbsp;F. García ,&nbsp;A. Soriano ,&nbsp;J.A. Martínez ,&nbsp;A. del Río","doi":"10.1016/j.jhin.2024.12.006","DOIUrl":"10.1016/j.jhin.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The bacterial burden on gel polished (GP) nails, standard polished (SP) nails and unpolished (UP) nails was evaluated before and after hand hygiene (HH) with alcohol-based hand rub.</div></div><div><h3>Methods</h3><div>Three GP nails, two SP nails and five UP nails on both hands were analysed in 46 healthcare workers. Nail length was maintained at ≤2 mm during the study. Nail surface cultures were performed on blood agar plates before and after HH on days 1, 4, 7, 14 and 21 after application. Nail bacterial counts were estimated using a Poisson regression procedure, with nail polish group, participant, hand side, finger, evaluation day, and interaction between nail polish group and evaluation day as independent factors.</div></div><div><h3>Results</h3><div>In total, 460 nails were evaluated: 92 SP nails (20%), 138 GP nails (30%) and 230 UP nails (50%). Before HH, SP nails were associated with a higher bacterial burden than GP nails on day 4, and with a higher bacterial burden than GP nails and UP nails on day 21 (with counts for UP nails higher than those for GP nails). After HH, SP nails had a higher bacterial burden than UP nails and GP nails on day 4, a higher bacterial burden than UP nails on day 14, and a higher bacterial burden than UP nails and GP nails on day 21.</div></div><div><h3>Conclusions</h3><div>Compared with UP nails, GP nails were not associated with a higher bacterial burden within 3 weeks of application, and even had a significantly lower bacterial burden before HH on day 21.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 40-44"},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying potential predictors of the risk of surgical site infection following cardiac surgery: a scoping review","authors":"K.V. Charlwood ,&nbsp;J. Jackson ,&nbsp;R. Vaja ,&nbsp;L.J. Rogers ,&nbsp;S. Dawson ,&nbsp;K.R. Moawad ,&nbsp;J. Brown ,&nbsp;J. Trevis ,&nbsp;I. Vokshi ,&nbsp;G.R. Layton ,&nbsp;R. Magboo ,&nbsp;J. Tanner ,&nbsp;M. Rochon ,&nbsp;G.J. Murphy ,&nbsp;P. Whiting","doi":"10.1016/j.jhin.2024.12.002","DOIUrl":"10.1016/j.jhin.2024.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This scoping review was undertaken to identify risk prediction models and pre-operative predictors of surgical site infection (SSI) in adult cardiac surgery. A particular focus was on the identification of novel predictors that could underpin the future development of a risk prediction model to identify individuals at high risk of SSI, and therefore guide a national SSI prevention strategy.</div></div><div><h3>Methods</h3><div>A scoping review to systematically identify and map out existing research evidence on pre-operative predictors of SSI was conducted in two stages. Stage 1 reviewed prediction modelling studies of SSI in cardiac surgery. Stage 2 identified primary studies and systematic reviews of novel cardiac SSI predictors.</div></div><div><h3>Results</h3><div>The search identified 7887 unique reports; 7154 were excluded at abstract screening and 733 were selected for full-text assessment. Twenty-nine studies (across 30 reports) were included in Stage 1 and reported the development (<em>N</em>=14), validation (<em>N</em>=13), or both development and validation (<em>N</em>=2) of 52 SSI risk prediction models including 67 different pre-operative predictors. The remaining 703 reports were re-assessed in Stage 2; 49 studies met the inclusion criteria, and 56 novel pre-operative predictors that have not been assessed previously in models were identified.</div></div><div><h3>Conclusions</h3><div>This review identified 123 pre-operative predictors of the risk of SSI following cardiac surgery, 56 of which have not been included previously in the development of cardiac SSI risk prediction models. These candidate predictors will be a valuable resource in the future development of risk prediction scores, and may be relevant to prediction of the risk of SSI in other surgical specialities.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 29-39"},"PeriodicalIF":3.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can screening and decontamination procedures performed on an outpatient basis reduce colonization with Staphylococcus aureus and mitigate associated complications in patients undergoing elective hospital procedures? A controlled intervention study (STAUfrei)","authors":"A. Bauer ,&nbsp;H. Sturm ,&nbsp;P. Martus ,&nbsp;B. Brüggenjürgen ,&nbsp;H. Eberhardt ,&nbsp;E. Mayer ,&nbsp;R. Schulz ,&nbsp;J. Bernhold ,&nbsp;T. Krause ,&nbsp;P. Höllein ,&nbsp;J. Liese ,&nbsp;S. Wolf ,&nbsp;S. Joos ,&nbsp;M. Grünewald ,&nbsp;STAUfrei Consortium","doi":"10.1016/j.jhin.2024.12.001","DOIUrl":"10.1016/j.jhin.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div><em>Staphylococcus aureus</em> colonization increases the risk of wound infection in surgical procedures. Prevention strategies to date have focused primarily on the hospital setting, although there are recommendations for pre-hospital decontamination at home, which can be performed by patients themselves. This study aimed to shift the process of screening and decontamination of <em>S</em>. <em>aureus</em> [meticillin-resistant <em>S. aureus</em> (MRSA) and meticillin-susceptible <em>S. aureus</em> (MSSA)] out of the hospital setting.</div></div><div><h3>Methods</h3><div>Between April 2019 and March 2022, 8054 (intervention group <em>N</em>=3390, control group 4664) patients (age &gt;18 years) undergoing elective procedures in a hospital in Baden-Württemberg (Germany) were recruited for the study. The intervention consisted of 5 days of decontamination carried out by patients (or their caregivers) in their domestic environment. The analysis comprised a simple arm comparison of colonization rates at admission between study groups, as well as adjusted logistic regressions.</div></div><div><h3>Results</h3><div>After adjustment for relevant risk factors, the intervention reduced the risk of <em>S</em>. <em>aureus</em> colonization at admission by 14%; this difference was significant (odds ratio 0.86, 95% confidence interval 0.74–0.10; <em>P</em>=0.046). Re-admission was significantly less common in the intervention group. Signs of wound infection and recolonization after invasive procedures did not differ significantly between the study groups.</div></div><div><h3>Conclusions</h3><div>Outpatient decontamination measures appear to be more effective compared with routine care. As the results from logistic regressions are based on MSSA, its consideration in clinical hygiene management should be discussed. Strict adherence during the coronavirus disease 2019 pandemic was challenging, potentially underestimating the overall impact of the intervention.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 19-28"},"PeriodicalIF":3.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of faecal microbiota transplantation compared with vancomycin monotherapy for early Clostridioides difficile infection: economic evaluation alongside a randomized controlled trial","authors":"C.R. Birch ,&nbsp;S.E. Paaske ,&nbsp;M.B. Jensen ,&nbsp;S.M.D. Baunwall ,&nbsp;L.H. Ehlers ,&nbsp;C.L. Hvas","doi":"10.1016/j.jhin.2024.11.003","DOIUrl":"10.1016/j.jhin.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>For <em>Clostridioides difficile</em> infection (CDI), faecal microbiota transplantation (FMT) is currently recommended for patients with three or more CDI episodes. A recent randomised controlled trial (RCT) show that FMT may be considered early, defined as intervention during the first or second CDI episode.</div></div><div><h3>Aim</h3><div>The aim was to investigate hospital costs of FMT as a complementary treatment compared with current standard care in patients with first or second CDI.</div></div><div><h3>Findings</h3><div>Compared with standard care for first or second CDI, patients randomised to FMT had €1,645 lower hospital costs over 26 weeks owing to fewer admissions and hospital contacts and less medication use. In the sensitivity analyses, FMT remained cost-effective as long as the treatment cost of FMT stayed below approximately €1,572 per component, corresponding to a total cost of FMT treatment (two components) of €3,144.</div></div><div><h3>Conclusion</h3><div>FMT was cost-effective with both lower costs and greater effectiveness than current standard care involving vancomycin monotherapy. The findings were robust to sensivity analyses, with a threshold cost for one FMT treatment consisting of two components of €3,144.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":"Pages 145-149"},"PeriodicalIF":3.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycobacteroides abscessus outbreak and mitigation in a cardiothoracic transplant population: the problem with tap water","authors":"S.N. Rathod ,&nbsp;R.T. Weber ,&nbsp;A.A. Salim ,&nbsp;S.D. Tanna ,&nbsp;V. Stosor ,&nbsp;M. Malczynski ,&nbsp;A. O'Boye ,&nbsp;K. Hoke ,&nbsp;J. Landon ,&nbsp;S. McCarthy ,&nbsp;C. Qi ,&nbsp;M.P. Angarone ,&nbsp;M.G. Ison ,&nbsp;J.L. Williams ,&nbsp;T.R. Zembower ,&nbsp;M.K. Bolon","doi":"10.1016/j.jhin.2024.10.016","DOIUrl":"10.1016/j.jhin.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Hospital outbreaks caused by <em>Mycobacteroides abscessus</em> complex are a major cause for concern in vulnerable patients such as the cardiothoracic transplant population.</div></div><div><h3>Aim</h3><div>To describe the outbreak investigation and mitigation steps undertaken to address an increase in healthcare-associated <em>M. abscessus</em> complex cases in an inpatient cardiothoracic transplant population.</div></div><div><h3>Methods</h3><div>We extracted clinical characteristics from patients with <em>M. abscessus</em> pre-outbreak (March 2018 to December 2020) and during the outbreak (January 2021 to June 2022) from the electronic medical record. A multi-disciplinary team conducted the outbreak investigation and devised a mitigation strategy to implement at our institution.</div></div><div><h3>Findings</h3><div>The baseline incidence of healthcare-associated <em>M. abscessus</em> was 0.11 cases per 10,000 patient-days; this increased to 0.24 cases per 10,000 patient-days during the outbreak. There were 1/9 (11%) cardiothoracic transplant patients in the pre-outbreak group compared with 7/12 (58%) during the outbreak, and respiratory specimen types compromised 6/9 (67%) of <em>M. abscessus</em> results in the pre-outbreak group compared with 10/12 (83%) during the outbreak. Among the clinical care activities involving water, a variety of water sources were utilized, including filtered and tap water. The incidence of healthcare-associated <em>M. abscessus</em> subsequently decreased to 0.06 cases per 10,000 patient-days after implementing an outbreak-mitigation strategy of sterile water precautions.</div></div><div><h3>Conclusions</h3><div>Robust educational efforts from a multi-disciplinary team on eliminating exposure to tap water were effective measures to reduce healthcare-associated <em>M. abscessus</em> incidence at our institution. Non-tuberculous mycobacteria infection surveillance, targeted education, and water mitigation strategies may be beneficial preventative strategies for other lung transplant centres facing similar issues.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":"Pages 150-157"},"PeriodicalIF":3.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed Infection Prevention and Control Activities and Their Predictors: Insights from a Pre- and Post-Pandemic Study","authors":"Chiara Moreal ,&nbsp;Stefania Chiappinotto ,&nbsp;Ian Blackman ,&nbsp;Luca Grassetti ,&nbsp;Sara Scarsini ,&nbsp;Barbara Narduzzi ,&nbsp;Maura Mesaglio ,&nbsp;Carlo Tascini ,&nbsp;Alvisa Palese","doi":"10.1016/j.jhin.2024.10.015","DOIUrl":"10.1016/j.jhin.2024.10.015","url":null,"abstract":"<div><h3>Aim</h3><div>The primary aim was to compare differences, if any, in missed infection prevention and control (IPC) activities before and after the pandemic, along with the related predictors. The secondary aim was to identify relationships between missed IPC activities and unfinished nursing care.</div></div><div><h3>Methods</h3><div>A repeated cross-sectional design was conducted in 2019 (pre-pandemic, 184 nurses) and 2024 (post-pandemic, 240 nurses) in a large academic hospital following the Checklist for Reporting of Survey Studies guidelines. The Missed Nursing Care in Infection Prevention and Control Survey (MNC-IPC) (Part A: missed activities, Part B: reasons), the Unfinished Nursing Care Survey (UNCS), and professional data were collected homogeneously across both periods.</div></div><div><h3>Findings</h3><div>Self-reported missed IPC activities decreased from 2.15 out of 5 (95% CI, 2.05–2.25) to 1.51 (95% CI, 1.45–1.58) (p &lt; 0.0005), as did the related reasons, which decreased from 2.35 out of 4 (95% CI, 2.24–2.46) to 2.20 (95% CI, 2.11–2.30) (p = 0.046). The total variance in the MNC-IPC overall scores was explained by 22.8% (pre-) and 20.7% (post-pandemic) by different predictors: system-level issues (estimated value 0.409, p = 0.008) and nurses’ intention to leave (0.107, p = 0.023) in the pre-pandemic and by the number of patients admitted in the last shift (0.015, p = 0.053), organisational issues (0.186, p &lt; 0.0005) and priority-setting issues (0.092, p = 0.053) in the post-pandemic period. MNC-IPC and UNCS scores have reported significant correlations in both periods.</div></div><div><h3>Conclusion</h3><div>Missed IPC activities were less likely in the post-pandemic period possibly due to system efforts and lessons learned during the pandemic, which may have routinised IPC practices among nurses. Overall, predictors of missed IPC care changed after the pandemic, suggesting new patterns and the need for innovative interventions, particularly at the unit level and targeting younger nurses. The correlations between UNCS and MNC-IPC suggest that targeted improvements in one area are likely to yield positive outcomes in the other. However, despite their commonalities, these represent two distinct phenomena.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A ‘Tuba Drain’ incorporated in sink drains reduces counts of antibiotic-resistant bacterial species at the plughole: a blinded, randomized trial in 36 sinks in a hospital outpatient department with a low prevalence of sink colonization by antibiotic-resistant species","authors":"S. Harris ,&nbsp;G. Njogu ,&nbsp;R. Galbraith ,&nbsp;J. Galbraith ,&nbsp;S. Hastick ,&nbsp;N. Storey ,&nbsp;D. Chapman-Jones ,&nbsp;J. Soothill","doi":"10.1016/j.jhin.2024.10.014","DOIUrl":"10.1016/j.jhin.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Multi-resistant Gram-negative bacteria (GNB) survive in hospital drains in traps that contain water and may ascend into the sink because of splashes, or biofilm growth.</div></div><div><h3>Aim</h3><div>To investigate whether the ‘Tuba Drain’ (TD) a long, bent, continually descending copper tube between the sink outlet and the trap prevents the ascent of bacteria.</div></div><div><h3>Methods</h3><div>After initial laboratory tests confirmed that the TD prevented bacteria in the U-bend from splashing upwards into the sink outlet, TDs were assessed in a randomized, blinded trial in a hospital outpatient department built in 2019. Sinks were paired into those with a similar clinical exposure and each member of each pair was randomized to receive either new, standard plumbing up to and including the trap (18 sinks) or the same new standard plumbing but including the TD inserted between the sink outlet and trap. Bacterial counts in swabs from the sink outlets were determined blindly before and monthly after the plumbing change for a year. GNB that are associated with clinical infection and carriage of resistance genes, <em>Pseudomonas aeruginosa</em>, <em>Acinetobacter baumanii</em>, <em>Stenotrophomonas maltophilia</em> and all Enterobacterales were the organisms of primary interest and termed target bacteria.</div></div><div><h3>Findings</h3><div>The TDs fitted into the required spaces and functioned without problems. The geometric means (over months) of the counts of target bacteria in TD-plumbed sinks was lower than those in their paired controls, <em>P</em>=0.012 (sign test, two-tailed). Prevalence of target bacteria in sinks was low.</div></div><div><h3>Conclusion</h3><div>TDs were effective for reducing target bacteria in sinks.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":"Pages 123-129"},"PeriodicalIF":3.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}