American journal of infection control最新文献_第10页

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-19 DOI: 10.1016/S0196-6553(24)00571-6

引用次数: 0

Antibiotic prescription prevalence in Iranian outpatients: A focus on defined daily doses and the AWaRe classification system. 伊朗门诊患者的抗生素处方流行率：伊朗门诊病人的抗生素处方流行率：关注定义的每日剂量和 AWaRe 分类系统。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-18 DOI: 10.1016/j.ajic.2024.07.007

Mohammad Mahdi Nasehi, Mohammad Effatpanah, Mohammad Gholamnezhad, Hossein Karami, Maryam Ghamkhar, Nezam Armand, Yasmin Heydarzadeh Sohi, Reza Mehrizi, Leila Ghamkhar

{"title":"Antibiotic prescription prevalence in Iranian outpatients: A focus on defined daily doses and the AWaRe classification system.","authors":"Mohammad Mahdi Nasehi, Mohammad Effatpanah, Mohammad Gholamnezhad, Hossein Karami, Maryam Ghamkhar, Nezam Armand, Yasmin Heydarzadeh Sohi, Reza Mehrizi, Leila Ghamkhar","doi":"10.1016/j.ajic.2024.07.007","DOIUrl":"10.1016/j.ajic.2024.07.007","url":null,"abstract":"<p><strong>Background: </strong>The inappropriate use and overprescription of antibiotics pose a global health threat, particularly contributing to antimicrobial resistance. This study aims to evaluate antibiotic prescription prevalence in Iranian outpatients using the defined daily doses (DDD) and Access, Watch, and Reserve classification systems.</p><p><strong>Methods: </strong>This retrospective study analyzed electronic prescriptions for systemic antibiotics in Tehran, Iran, from March 2022 to March 2023. The data were obtained from the Iranian Health Insurance Organization and processed using the Cross-Industry Standard Process. Descriptive statistics and DDD per 1,000 inhabitants per day were calculated.</p><p><strong>Results: </strong>A total of 817,178 antibiotic prescriptions were analyzed, with a sex distribution of 57.43% female and a median age of 48 years. On average, each patient received 1.89 antibiotics per prescription. Over 63% of antibiotics were classified in the \"Watch\" category, with Azithromycin being the most commonly prescribed (27.56%). The total DDD per 1,000 inhabitants per day was 4.99, with general practitioners accounting for 58.02% of the prescriptions, primarily prescribing Azithromycin.</p><p><strong>Conclusions: </strong>The study emphasizes the high use of Watch group antibiotics, indicating a need for improved prescribing practices. Education on antibiotic stewardship and stricter guidelines are necessary to combat antimicrobial resistance. Continuous monitoring is crucial to optimize antibiotic use in outpatient settings in Iran.</p>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733310","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}

引用次数: 0

Successful practices to reduce central line–associated bloodstream infections post pandemic: A qualitative study 减少大流行后中心静脉相关血流感染的成功实践：定性研究

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-16 DOI: 10.1016/j.ajic.2024.07.005

Jamie Patrianakos PhD, Beth A. Longo DrPH, RN, MSN, Scott C. Williams PsyD

{"title":"Successful practices to reduce central line–associated bloodstream infections post pandemic: A qualitative study","authors":"Jamie Patrianakos PhD, Beth A. Longo DrPH, RN, MSN, Scott C. Williams PsyD","doi":"10.1016/j.ajic.2024.07.005","DOIUrl":"10.1016/j.ajic.2024.07.005","url":null,"abstract":"<div><h3>Background</h3><div>Central Line-Associated Bloodstream Infections (CLABSIs) decreased in U.S. hospitals over the last decade, but CLABSI rates increased during the COVID-19 pandemic disrupting the downward trend. This study explored factors contributing to the reduction of CLABSI, identifying deviations in infection prevention and control protocol during the pandemic, actions taken to address the increase in CLABSI, and factors promoting sustained progress.</div></div><div><h3>Methods</h3><div>This qualitative study used the National Healthcare Safety Network data. The Centers for Disease Control and Prevention identified hospitals with elevated CLABSI standardized infection ratios (SIR) >1 between Q1 2019 – Q4 2021 followed by four quarters of sustained reduction (CLABSI SIR <1). Joint Commission researchers conducted semi-structured phone interviews with infection preventionist professionals from six hospitals representing these performance patterns.</div></div><div><h3>Results</h3><div>Interview themes suggested that staffing shortages (83%) and less vigilant central line practices (100%) contributed to increased CLABSI SIR during the pandemic. Organizations described evidence-based interventions, such as using chlorhexidine gluconate for skin preparation, along with other innovative strategies they used to establish reduced CLABSI rates.</div></div><div><h3>Conclusions</h3><div>Despite challenges faced during the COVID-19 pandemic, some health care organizations have excelled in their efforts to reduce and sustain low rates of CLABSI by implementing evidence-based practices, innovative solutions, and education.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713699","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}

引用次数: 0

Evaluation of the adherence to surgical antibiotic prophylaxis recommendations and associated factors in a University Hospital: A cross-sectional study 评估一家大学医院对手术抗生素预防建议的遵守情况及相关因素：一项横断面研究。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-10 DOI: 10.1016/j.ajic.2024.07.004

{"title":"Evaluation of the adherence to surgical antibiotic prophylaxis recommendations and associated factors in a University Hospital: A cross-sectional study","authors":"","doi":"10.1016/j.ajic.2024.07.004","DOIUrl":"10.1016/j.ajic.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Surgical antibiotic prophylaxis (SAP) is an important preventive measure, aiming to minimize surgical site infections. However, despite evidence-based guidelines, adherence to SAP protocols remains suboptimal in clinical practice. The aim of this study was to assess the adequacy of SAP in a high-complexity hospital and investigate associated factors.</div></div><div><h3>Methods</h3><div>A cross-sectional design was conducted, involving surgeries performed by expert teams in cardiology, urology, neurology, and gastrointestinal. SAP prescriptions were evaluated based on indication, antibiotic choice, dosage, and duration, according to the hospital protocol. Data analysis included descriptive statistics and association tests between protocol adherence and patient demographics, clinical variables, surgical teams, and types of surgeries.</div></div><div><h3>Results</h3><div>Out of 1,864 surgeries, only 20.7% adhered to SAP protocols. Lower adherence rates were observed for antibiotic choice and duration of prophylaxis. Neurological surgeries exhibited significantly lower adherence, particularly concerning antibiotic choice and duration. Factors associated with nonadherence included elevated preoperative blood glucose levels, prolonged hospitalization, and extended surgical duration. Logistic regression analysis identified surgical teams as significant factors influencing protocol adherence.</div></div><div><h3>Conclusions</h3><div>Despite the relatively high adherence to antibiotic dosage, challenges persist in antibiotic choice and duration adjustment. Poor glycemic control, prolonged surgery, and surgical teams were variables associated with inappropriate practice.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598096","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}

引用次数: 0

The efficacy of an alcohol-based nasal antiseptic versus mupirocin or iodophor for preventing surgical site infections: A meta-analysis 酒精鼻腔消毒剂与莫匹罗星或碘伏在预防手术部位感染方面的功效 - 一项 Meta 分析。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-08 DOI: 10.1016/j.ajic.2024.07.003

{"title":"The efficacy of an alcohol-based nasal antiseptic versus mupirocin or iodophor for preventing surgical site infections: A meta-analysis","authors":"","doi":"10.1016/j.ajic.2024.07.003","DOIUrl":"10.1016/j.ajic.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><p>Nasal decolonization of <em>Staphylococcus aureus</em> is a proven strategy to reduce surgical site infections (SSI). Recently updated guidelines expanded nasal decolonization beyond traditionally high-risk populations to include the option for alcohol-based antiseptics (ABAs). We assessed the efficacy of a novel ABA for reducing SSI compared to mupirocin and iodophor.</p></div><div><h3>Methods</h3><p>A literature search in Google Scholar, PubMed, MEDLINE, and Cochrane databases was completed of studies reporting SSI outcomes in hospitals using an ABA. Primary meta-analyses were conducted to analyze ABA clinical efficacy versus no intervention (7 studies); subanalyses compared the ABA to mupirocin (3 studies) or iodophor (2 studies).</p></div><div><h3>Results</h3><p>One hundred forty-seven nasal decolonization titles for SSI prevention were identified, of which 7 were accepted. In the studies selected, 16,212 patients were included: 7,983 (49.24%) control group, and 8,129 (50.14%) intervention group. Significant effect sizes (measured as odds ratios [ORs]) and <em>z</em>-scores were found in all 3 meta-analyses: (OR = 3.178, <em>z</em> = 4.743, <em>P</em> < .001) in ABA clinical efficacy, (OR = 4.110, <em>z</em> = 3.167, <em>P</em> < .01) in ABA versus mupirocin, and (OR = 3.043, <em>z</em> = 3.155, <em>P</em> < .01) in ABA versus iodophor. Funnel plots for each demonstrated a lack of bias.</p></div><div><h3>Conclusions</h3><p>Statistically significant positive effects were identified in all 3 meta-analyses. An ABA appears to be a viable alternative to mupirocin or iodophors to reduce SSIs.</p></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S019665532400590X/pdfft?md5=d03d444956b9b4b95508bca7f1ff4f93&pid=1-s2.0-S019665532400590X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578749","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}

引用次数: 0

Steam quality monitoring as a strategy to reduce wet packs and sterilization failure 将蒸汽质量监测作为减少湿包和灭菌失败的策略。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-06 DOI: 10.1016/j.ajic.2024.07.002

{"title":"Steam quality monitoring as a strategy to reduce wet packs and sterilization failure","authors":"","doi":"10.1016/j.ajic.2024.07.002","DOIUrl":"10.1016/j.ajic.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><div><span>Hospital articles processed by steam are widely used in the Central Sterile Supply Department (CSSD), responsible for due sterilization. Steam sterilization is discussed worldwide, aiming to protect patients. If steam is outside the specified requirements, the </span>sterilization process<span> may fail, resulting in the wet packs at the end of the sterilization cycle.</span></div></div><div><h3>Methods</h3><div>The present study evaluated the steam quality at Santa Catarina Hospital (São Paulo, SP, Brazil) from 2016 to 2022. Saturated steam containing noncondensable gases, excess condensate, or even superheat was characterized using the methodology indicated in the European Standard EN 285:2015.</div></div><div><h3>Results</h3><div>From 2016 to 2020, qualification tests showed that the saturated steam quality does not achieve standard limit parameters. Infrastructural maintenance actions were taken to adjust the saturated steam quality. In 2021, the steam quality followed technical standards, and its adequacy was confirmed in 2022.</div></div><div><h3>Conclusions</h3><div>The points developed by the hospital's maintenance department, the adoption of appropriate devices for this purpose, and the correct preventive maintenance in the autoclaves, together with the correct qualification of the equipment and proof of the steam quality, contributed to improve the safety of the hospital sterilization process and reduce the incidence of wet packages.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554036","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}

引用次数: 0

Building a biocontainment unit: Infrastructure and organizational experiences of the 13 regional biocontainment units in the United States. 建立生物安全单位：美国 13 个地区生物安全单位的基础设施和组织经验。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-03 DOI: 10.1016/j.ajic.2024.06.021

Caroline Persson, Corri B Levine, Kara Marshall, Sophia Shea, Christa Arguinchona, Sharon Vanairsdale Carrasco, Lauren M Sauer, Jocelyn J Herstein

引用次数: 0

Effectiveness of a multimodal strategy to reduce external ventricular drain–associated infection: A quasi-experimental study 减少室外引流相关感染的多模式策略的有效性：准实验研究

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-03 DOI: 10.1016/j.ajic.2024.06.026

{"title":"Effectiveness of a multimodal strategy to reduce external ventricular drain–associated infection: A quasi-experimental study","authors":"","doi":"10.1016/j.ajic.2024.06.026","DOIUrl":"10.1016/j.ajic.2024.06.026","url":null,"abstract":"<div><h3>Background</h3><div>Infection is a serious complication in neurosurgical patients who undergo external ventricular drain (EVD) insertion.</div></div><div><h3>Methods</h3><div>We conducted a quasi-experimental study in patients who underwent EVD insertion to evaluate the impact of a multi-modal strategy to reduce the incidence of external ventricular drain associated infections (EVDAIs). The study was divided into 2 periods; (1) the pre-intervention period when techniques for EVD insertion and maintenance were up to the discretion of the neurosurgeons and (2) the post-intervention after implementation of a multi-modal strategy (cefazolin antibiotic prophylaxis, preoperative chlorhexidine showers, application of postoperative chlorhexidine-impregnated dressing, limited manipulation of the EVD, and meticulous EVD management). The primary outcome was the incidence rate of EVDAIs; secondary outcomes included in-hospital mortality rate, the hospital length of stay.</div></div><div><h3>Results</h3><div>In total, 135 patients were included. The incidence rate of EVDAIs was significantly reduced in the post-intervention period (5.6 cases/1,000 EVD-days) compared with the pre-intervention period (18.2 cases/1,000 EVD-days; <em>P</em>=0.026). There were no differences in all secondary outcomes analyzed. This multi-modal strategy was associated with high satisfaction among health care personnel.</div></div><div><h3>Conclusions</h3><div>Implementation of a multi-modal strategy was associated with a reduction in the incidence of EVDAIs. This was in line with our goal of promoting a new culture of safety despite being in a resource-limited setting.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537432","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}

引用次数: 0

Harnessing the power of infection prevention and public health data systems to support health care in Washington State during the COVID-19 pandemic 利用感染预防和公共卫生数据系统的力量，在 COVID-19 大流行期间为华盛顿州的医疗保健提供支持。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-03 DOI: 10.1016/j.ajic.2024.06.025

{"title":"Harnessing the power of infection prevention and public health data systems to support health care in Washington State during the COVID-19 pandemic","authors":"","doi":"10.1016/j.ajic.2024.06.025","DOIUrl":"10.1016/j.ajic.2024.06.025","url":null,"abstract":"<div><h3>Background</h3><div><span>State health<span> departments’ (SHD) role in infection prevention and control (IPC) includes robust educational and consultative services for various health care settings. During the COVID-19 pandemic, Washington-SHD (W-SHD) IPC staff conducted remote and on-site Infection Control Assessment and Response (ICAR) consultations for long-term care (LTC) and non-LTC </span></span>health care facilities.</div></div><div><h3>Methods</h3><div>ICAR consultations were classified as “reactive” in response to a COVID-19 outbreak or “proactive” to help facilities improve IPC protocols. Facility addresses were geocoded to census tracks, classifying urban or rural areas. Facility types and characteristics were analyzed, assessing the impacts of repeat visits. All descriptive statistics, Pearson’s χ<sup>2</sup> tests, and odds ratios were calculated.</div></div><div><h3>Results</h3><div>Between March 2020 and December 2022, W-SHD conducted 3,093 ICARs at 1,703 health care facilities in 94.9% (37/39) of Washington counties. Of the total visits, most were in LTC (90.5%) and 48.9% were reactive. Facilities with initial on-site ICARs had 1.5 times the odds of having a repeat visit than facilities with initial remote visit (95% CI: 1.21, 1.87).</div></div><div><h3>Discussion</h3><div>Maintaining strong connections with health care facilities can help bolster infection prevention practices and minimize loss of information at the facility level.</div></div><div><h3>Conclusions</h3><div>Evidence-based findings on the sustainability of the W-SHD’s ICAR services during the COVID-19 pandemic illustrated the value of public health IPC programs.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537433","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}

引用次数: 0

COVID-19 infections among health care workers at a university hospital in Jeddah, Saudi Arabia 沙特阿拉伯吉达一所大学医院的医护人员感染 COVID-19。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-07-03 DOI: 10.1016/j.ajic.2024.06.022

{"title":"COVID-19 infections among health care workers at a university hospital in Jeddah, Saudi Arabia","authors":"","doi":"10.1016/j.ajic.2024.06.022","DOIUrl":"10.1016/j.ajic.2024.06.022","url":null,"abstract":"<div><h3>Background</h3><div><span>The objective of this study was to describe the prevalence, characteristics, and risk factors of coronavirus disease-2019 (COVID-19) infection among </span>health care workers (HCWs) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional study of HCWs confirmed to have COVID-19 infection from March 1, 2020 to December 31, 2022.</div></div><div><h3>Results</h3><div><span>A total of 746 HCWs were diagnosed with COVID-19. Patients’ age ranged from 22 to 60 years with a mean ± standard deviation of 37.4 ± 8.7 years. The infection was community-acquired in 584 (78.3%) HCWs. The vast majority (82.6%) of the infected HCWs had no comorbidities. Nurses (400/746 or 53.6%) represented the largest professional group, followed by physicians (128/746 or 17.2%), administrative staff (125/746 or 16.8%), respiratory therapists (54/746 or 7.2%), and physiotherapists (39/746 or 5.2%). Symptoms included fever (64.1%), cough<span> (55.6%), sore throat (44.6%), headache (22.9%), </span></span>runny nose (19.6%), shortness of breath (19.0%), fatigue (12.7%), body aches (11.4%), diarrhea (10.9%), vomiting (4.4%), and abdominal pain (2.8%). Most (647 or 86.7%) patients were managed as outpatients. Four (0.5%) HCWs died.</div></div><div><h3>Conclusions</h3><div>HCWs face a dual risk of SARS-CoV-2 infection, both from community exposure and within the hospital setting. Comprehensive infection control strategies are needed to protect HCWs both inside and outside the hospital environment.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537424","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}

引用次数: 0