American journal of infection control最新文献_第3页

Clusters of emerging multidrug-resistant organisms in US health care facilities during the initial months of the SARS-CoV-2 pandemic. SARS-CoV-2 大流行最初几个月美国医疗机构中新出现的耐多药生物群。

IF 4.3 3区医学

American journal of infection control Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI: 10.1016/j.ajic.2024.07.013

D Cal Ham, Ruoran Li, Tisha Mitsunaga, Christopher Czaja, Christopher Prestel, Sandeep Bhaurla, Melissa Cumming, Brenda Brennan, Gabriel Innes, Savannah Carrico, Allison Chan, Enyinnaya Merengwa, Anna Stahl, Belinda Ostrowsky, Marie A de Perio, Maroya Spalding Walters

{"title":"Clusters of emerging multidrug-resistant organisms in US health care facilities during the initial months of the SARS-CoV-2 pandemic.","authors":"D Cal Ham, Ruoran Li, Tisha Mitsunaga, Christopher Czaja, Christopher Prestel, Sandeep Bhaurla, Melissa Cumming, Brenda Brennan, Gabriel Innes, Savannah Carrico, Allison Chan, Enyinnaya Merengwa, Anna Stahl, Belinda Ostrowsky, Marie A de Perio, Maroya Spalding Walters","doi":"10.1016/j.ajic.2024.07.013","DOIUrl":"10.1016/j.ajic.2024.07.013","url":null,"abstract":"Background: Outbreaks of emerging multidrug-resistant organisms (eMDROs), including carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, and Candida auris, have been reported among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. We describe eMDRO clusters in SARS-CoV-2 units and associated infection control (IC) practices early in the SARS-CoV-2 pandemic.Methods: We conducted a retrospective survey of a convenience sample of health departments in 11 states to describe clusters of eMDROs that began before November 1, 2020 and involved SARS-CoV-2 units. Cluster characteristics and IC practices during the cluster period were assessed using a standardized outbreak report form, and descriptive analyses were performed.Results: Overall, 18 eMDRO clusters (10 carbapenem-resistant Enterobacterales, 6 C auris, 1 carbapenem-resistant Pseudomonas aeruginosa, and 1 carbapenem-resistant A baumannii) in 18 health care facilities involving 397 patients were reported from 10 states. During the cluster period, 60% of facilities reported a shortage of isolation gowns, 69% extended use of gowns, and 67% reported difficulty obtaining preferred disinfectants. Reduced frequency of hand hygiene audits was reported in 85% of acute care hospitals during the cluster period compared with before the pandemic.Conclusions: Changes in IC practices and supply shortages were identified in facilities with eMDRO outbreaks during the SARS-CoV-2 pandemic and might have contributed to eMDRO transmission.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":"1390-1396"},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141873873","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

Effect of the COVID-19 Pandemic on Occupational Risk for Bloodborne Pathogen Exposure Among Healthcare Providers. COVID-19 大流行对医护人员接触血源性病原体职业风险的影响。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-15 DOI: 10.1016/j.ajic.2024.11.007

Subhadra Mandadi, Mark E Rupp, Barbara Wolford, Elizabeth Lyden, Rick Starlin

{"title":"Effect of the COVID-19 Pandemic on Occupational Risk for Bloodborne Pathogen Exposure Among Healthcare Providers.","authors":"Subhadra Mandadi, Mark E Rupp, Barbara Wolford, Elizabeth Lyden, Rick Starlin","doi":"10.1016/j.ajic.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.11.007","url":null,"abstract":"Background: The effect of COVID-19 pandemic on the rates and trends of Needlestick and sharp injuries (NSSIs) and splash injuries (SIs) among healthcare providers (HCPs) is not well defined.Methods: A retrospective study analyzed the rates of injuries among HCPs during the pre-pandemic (38 months) and pandemic (37 months) periods. Single interrupted time-series analysis (SITSA) was employed to assess the impact of the pandemic on injury rates.Results: During the pre-pandemic and pandemic periods, 608 and 637 NSSIs and 137 and 120 SIs were reported, respectively. No statistically significant difference was identified in the median monthly rates of NSSIs (0.34 vs. 0.37; p=0.622) and SIs (0.075 vs. 0.047; p=0.094) per 1000 inpatient days, nor their combined risk (0.439 vs. 0.434; p=0.449). The SITSA indicated a marginally significant trend during the pandemic, with a monthly 0.0028% decrease in NSSI/SI rates (p = 0.059). Subsequent SITSA revealed significant changes in rates of NSSI during the pandemic, with rates rising early (p = 0.016) and falling marginally later (p = 0.051).Conclusions: We report no statistically significant difference in the rates of NSSIs/SIs between the pre-pandemic and pandemic periods. HCPs remain at risk for occupational injuries, emphasizing targeted training and well-designed infection control policies.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646688","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

No detrimental effect on the hand microbiome of health care staff by frequent alcohol-based antisepsis. 经常用酒精消毒不会对医护人员的手部微生物群产生不利影响。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-15 DOI: 10.1016/j.ajic.2024.11.006

Axel Kramer, Mathilde Borg Dahl, Mia M Bengtsson, John M Boyce, Matthias Heckmann, Mareike Meister, Roald Papke, Didier Pittet, Anne Reinhard, Hortense Slevogt, Haitao Wang, Paula Zwicker, Tim Urich, Ulrike Seifert

{"title":"No detrimental effect on the hand microbiome of health care staff by frequent alcohol-based antisepsis.","authors":"Axel Kramer, Mathilde Borg Dahl, Mia M Bengtsson, John M Boyce, Matthias Heckmann, Mareike Meister, Roald Papke, Didier Pittet, Anne Reinhard, Hortense Slevogt, Haitao Wang, Paula Zwicker, Tim Urich, Ulrike Seifert","doi":"10.1016/j.ajic.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.11.006","url":null,"abstract":"Background: The importance of ethanol-based hand rubs (EBHR) to prevent health care-associated infections is undisputed. However, there is a lack of meaningful data regarding the influence of EBHRs on skin microbiome.Methods: Four nurses in a neonatal intensive care unit were included. After a leave of 14 days, samples were taken before the first hand rubbing action and at the end of shift, with continued sampling on days 1, 7 and 28. To analyze the hand microbiome, microbial cells were collected using the glove-juice technique. Pro- and eukaryotic community profiles were created using amplicon sequencing of 16S and 18S rRNA gene markers.Results: On average, hand antisepsis was performed 108 times per 8-hour work shift. Microbial communities were dominated by typical taxa found on human skin. In addition, a clear nurse-specific (i.e. individual) microbiome signature could be observed. For Prokaryota, daily exposure led to the end-of-the-day microbiomes being more similar to each other across nurses. In contrast, longitudinal effect of 28 day-application revealed more similarity of the Eukaryotic community.Conclusions: Frequent occupational use of EBHR did not adversely affect the composition of the human hand microbiome. Thus, daily hand antisepsis retains its significance as the most important procedure for infection control.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646689","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

Threshold Modeling for Antibiotic Stewardship in Oman. 阿曼抗生素管理的阈值模型。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-14 DOI: 10.1016/j.ajic.2024.11.005

Zainab Said Al-Hashimy, Mubarak Al-Yaqoobi, Amal Al Jabari, Nawal Al Kindi, Ahmed Saleh Al Kazrooni, Barbara R Conway, Feras Darwish Elhajji, Stuart E Bond, William J Lattyak, Mamoon A Aldeyab

{"title":"Threshold Modeling for Antibiotic Stewardship in Oman.","authors":"Zainab Said Al-Hashimy, Mubarak Al-Yaqoobi, Amal Al Jabari, Nawal Al Kindi, Ahmed Saleh Al Kazrooni, Barbara R Conway, Feras Darwish Elhajji, Stuart E Bond, William J Lattyak, Mamoon A Aldeyab","doi":"10.1016/j.ajic.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.11.005","url":null,"abstract":"Background: Antimicrobial stewardship supports rational antibiotic use. However, balancing access to antibiotic treatment while controlling resistance is challenging. This research used a threshold logistic modelling approach to identify targets for antibiotic usage associated with carbapenem-resistant Acinetobacter baumannii (CRAb), carbapenem-resistant Klebsiella pneumonia (CRKP), and extended-spectrum β-lactamases- producing Escherichia coli (ESBL-producing E. coli) incidence in hospitals.Methods: This study utilises an ecological population-level design. Monthly pathogen cases and antibiotic use were retrospectively determined for inpatients between January 2015 and December 2023. The hospital pharmacy and microbiology information systems were used to obtain this data. Thresholds were identified by applying nonlinear modelling and logistic regression.Results: Incidence rates of 0.199, 0.175, and 0.146 cases/100 occupied bed-days (OBD) for CRAb, CRKP, and ESBL-producing E. coli, respectively, were determined as the cutoff values for high (critical) incidence rates. Thresholds for aminoglycosides (0.59 defined daily dose (DDD)/100 OBD), carbapenems (6.31 DDD/100 OBD), piperacillin-tazobactam (3.71 DDD/100 OBD), third-generation cephalosporins (3.71 DDD/100 OBD), and fluoroquinolones (1.91 DDD/100 OBD), were identified. Exceeding these thresholds would accelerate the gram-negative pathogens' incidence rate above the critical incidence levels. Employing the threshold logistic approach enabled near real-time performance monitoring feedback, risk scores and alert signals for when the incidence of the selected pathogens are entering critical levels.Conclusion: Threshold logistic models can help inform and implement effective antimicrobial stewardship interventions to manage resistance within hospital settings.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643241","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

Prevention of possible vancomycin resistant enterococcus outbreak caused by infants transferred due to earthquake-trauma. 预防因地震创伤而转院的婴儿可能引起的耐万古霉素肠球菌爆发。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-08 DOI: 10.1016/j.ajic.2024.11.001

Esma Eryilmaz Eren, Hüsniye Şimşek, Esma Saatçi, Ahmet Özdemir, Gülden Şengül, İlhami Çelik

引用次数: 0

Infection Prevention and Control Response and Escalation Framework - evaluation and application beyond a pandemic. 感染预防与控制响应和升级框架--大流行后的评估和应用。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-07 DOI: 10.1016/j.ajic.2024.10.036

Kathy Dempsey, Susan Jain, Patricia Bradd, Kate Clezy, David Greenfield

{"title":"Infection Prevention and Control Response and Escalation Framework - evaluation and application beyond a pandemic.","authors":"Kathy Dempsey, Susan Jain, Patricia Bradd, Kate Clezy, David Greenfield","doi":"10.1016/j.ajic.2024.10.036","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.10.036","url":null,"abstract":"Background: The COVID-19 pandemic brought rapid and frequent changes to Infection Prevention and Control (IPAC) recommendations making it difficult for clinicians to stay informed of the most recent requirements and guidelines. The COVID-19 IPAC Response and Escalation Framework (IPAC Framework) was developed to provide scalable IPAC guidance during the pandemic to healthcare in New South Wales, Australia. The use of such frameworks during or outside of a pandemic has rarely been reported and evaluated here.Methods: Using a thematic analysis approach, a qualitative study using an online, cross-sectional survey comprising 27 questions was sent to 248 key stakeholders. Participants were health workers with broad clinical and system representation with responsibilities for risk assessment, communicating, implementing and/or monitoring the IPAC Framework.Results: The IPAC Framework provided a useful IPAC tool for the management of COVID-19 as perceived by 93% of respondents. The overwhelming majority (91%) reported the Framework provided enough information on IPAC strategies needed for COVID-19 that were aligned with transmission risk. Resources supporting the IPAC Framework were reported by most respondents (84%) as being widely accepted as the authoritative guidance.Conclusion: An IPAC response and escalation framework is perceived as highly useful by clinicians and administrators to manage IPAC requirements in health care during a pandemic. The IPAC Framework can be applied more generally to support ongoing IPAC requirements.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611679","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

Tracking SARS-CoV-2 RNA in the Air: Lessons from a COVID-19 Outbreak in an Infirmary Unit. 追踪空气中的 SARS-CoV-2 RNA：从医务室爆发的 COVID-19 事件中汲取的教训。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-07 DOI: 10.1016/j.ajic.2024.10.035

Shuk-Ching Wong, Jonathan Hon-Kwan Chen, Pui-Hing Chau, Wai-On Tam, Germaine Kit-Ming Lam, Lithia Lai-Ha Yuen, Wan-Mui Chan, Allen Wing-Ho Chu, Jonathan Daniel Ip, Hoi-Wah Tsoi, Simon Yung-Chun So, Kelvin Hei-Yeung Chiu, Kwok-Yung Yuen, Kelvin Kai-Wang To, Vincent Chi-Chung Cheng

{"title":"Tracking SARS-CoV-2 RNA in the Air: Lessons from a COVID-19 Outbreak in an Infirmary Unit.","authors":"Shuk-Ching Wong, Jonathan Hon-Kwan Chen, Pui-Hing Chau, Wai-On Tam, Germaine Kit-Ming Lam, Lithia Lai-Ha Yuen, Wan-Mui Chan, Allen Wing-Ho Chu, Jonathan Daniel Ip, Hoi-Wah Tsoi, Simon Yung-Chun So, Kelvin Hei-Yeung Chiu, Kwok-Yung Yuen, Kelvin Kai-Wang To, Vincent Chi-Chung Cheng","doi":"10.1016/j.ajic.2024.10.035","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.10.035","url":null,"abstract":"Background: The duration and magnitude of SARS-CoV-2 air dispersal during nosocomial outbreaks remain uncertain. This study evaluates the impact of mobile modular high-efficiency-particulate-air filter units (MMHUs) on SARS-CoV-2 air dispersal.Methods: We investigated a nosocomial COVID-19 outbreak in an infirmary unit. The viral load (VL) of SARS-CoV-2 in air samples was correlated with the VL in nasopharyngeal swabs (NPS) with or without MMHU. These samples underwent whole genome sequencing (WGS) and phylogenetic analysis.Results: Upon outbreak declaration (2 August 2024, Day 0), 44 (69.8%) of 63 patients acquired COVID-19 in Ward 2B (19 male) and 2C (25 female) by Day 4. The VL of SARS-CoV-2 remained detectable in air until Day 11 (2B) and Day 20 (2C). The VL of air samples was significantly correlated with the VL in NPS collected on Days 5,7,10, and 13 in 2C (r= -0.975, p=0.004). Using MMHU, the mean daily ratio of SARS-CoV-2 RNA (copies/1,000L of air/patient) in 2B was five times lower than in 2C from Days 5 to 10. WGS revealed all 41 tested strains belonged to the Omicron variant, KP.3.1.1, phylogenetically related to the prevailing community strains.Conclusion: Using MMHU mitigates the duration and magnitude of SARS-CoV-2 air dispersal during nosocomial outbreak.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611780","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 Epidemiology of Midline-Associated Bloodstream Infections in an Urban Healthcare System. 城市医疗系统中线相关血流感染的流行病学。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-06 DOI: 10.1016/j.ajic.2024.10.037

Rebecca Choudhury, Jordan Ehni, Waleed Javaid, Mateen Jangda, Itay Rabinovitz, Nikita Ekhelikar, Bernard C Camins

引用次数: 0

Identifying high-risk central lines in critically ill children: a novel nurse-driven screening and mitigation intervention to reduce CLABSI. 识别重症患儿的高风险中心静脉置管：以护士为主导的新型筛查和缓解干预措施，以减少 CLABSI。

IF 3.8 3区医学

American journal of infection control Pub Date : 2024-11-04 DOI: 10.1016/j.ajic.2024.10.029

Stephanie Morgenstern, Katie Thompson, Stephanie Panton, Vivian Donnelly, Sara Pau, Kat Nelson, Lauren Booth, Taylor McIlquham, Jessica Kitlas, Christina Schumacher, Aaron M Milstone, Meghan Bernier, Anna C Sick-Samuels

{"title":"Identifying high-risk central lines in critically ill children: a novel nurse-driven screening and mitigation intervention to reduce CLABSI.","authors":"Stephanie Morgenstern, Katie Thompson, Stephanie Panton, Vivian Donnelly, Sara Pau, Kat Nelson, Lauren Booth, Taylor McIlquham, Jessica Kitlas, Christina Schumacher, Aaron M Milstone, Meghan Bernier, Anna C Sick-Samuels","doi":"10.1016/j.ajic.2024.10.029","DOIUrl":"https://doi.org/10.1016/j.ajic.2024.10.029","url":null,"abstract":"Background: Despite strong adherence to central line associated bloodstream infection (CLABSI) infection prevention bundles, the CLABSI rate in our academic pediatric intensive care unit (PICU) and pediatric cardiac intensive unit (PCICU) remained high.Methods: We developed a novel screening tool that stratified patients' risk for CLABSI and considered risk-mitigation strategies.Results: Of 1583 screenings, 30% were classified as high-risk, 27% as moderate-risk, and 43% as low-risk. With accurate screening, the tool was 100% sensitive to patients who developed CLABSI, with a negative predictive value of 100% for low-risk screens. The CLABSI rate declined from 1.83 per 1000 catheter-days to 0.98 and 1.02 in 2021 and 2022, respectively, with unprecedented consecutive months CLABSI free. Device utilization was stable across both units, declining by 22% in the PICU and rising in the PCICU with increased cardiac surgeries. Clinicians expressed increased awareness of patient CLABSI risk factors and mitigation strategies in surveys.Discussions: This novel screening tool effectively identified high-risk patients to target resources and promoted improvements in CLABSI-prevention processes in the PICU and PCICU.Conclusions: A novel nurse-driven CLABSI risk factor screening tool identified and focused resources on patients at high-risk for CLABSI, and increased awareness and proactive risk mitigation by clinicians.","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589850","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

A framework for defining and documenting infection preventionist competency. 定义和记录感染预防人员能力的框架。

IF 4.3 3区医学

American journal of infection control Pub Date : 2024-11-02 DOI: 10.1016/j.ajic.2024.10.034

Christine C Zirges, Eileen R Sherman, Julietta Davidson, Kelly Holmes, Holly Taylor, Renee Brum, Letty Kluttz, Stephanie Holley

引用次数: 0