Biomaterials for bacterial recruitment function: A review.

This article is a theoretical-reflexive study that aims to discuss the development and changes in the quality of healthcare assistance to the patient over the years in Brazil, in light of the policies of control and prevention of Healthcare-associated Infection (HAI). Aspects of HAI and the process of change in health policy in Brazil, as well as the quality of assistance associated with its control, are approached in relation to policies of patient safety. There are various new theoretical and practical proposals created in Brazil. In spite of the difficulty of measuring patient safety, directed to the prevention and control of HAI, we emphasize that to only create policies and establish norms, guidelines, and indicators is not sufficient. If no structural support or conditions exist for interventions in the practices of healthcare professionals, aiming at results in acceptable levels, the control of HAI will not be achieved. Resumo Trata-se um estudo teórico-reflexivo, que objetiva discutir a evolução e as mudanças na qualidade da assistência ao paciente, ao longo dos anos no Brasil, à luz das políticas de controle e prevenção da Infecção Relacionada à Assistência à Saúde (IRAS). Aspectos sobre IRAS e o processo de mudança nas políticas de saúde no Brasil, bem como a qualidade da assistência associada ao seu controle, são abordados em relação às políticas de segurança do paciente. Há novas e várias propostas teóricas e práticas criadas no Brasil. Apesar da dificuldade de medir a segurança do paciente, direcionada à prevenção e controle das IRAS, enfatiza-se que somente criar políticas, estabelecer normas, diretrizes e indicadores não são suficientes. Se não houver suporte de estrutura e condições para as intervenções nas práticas dos profissionais na assistência prestada ao paciente, visando resultados em níveis aceitáveis, o controle das IRAS não será alcançado.

Background and purpose: The implementation of healthcareassociated infections (HAIs) prevention and control program in hospitals remains sub-optimal. The present study aims to determine the relationships between nurse’s self-efficacy, hospital’s occupational safety environment, and the availability of facilities, with the compliance on HAIs prevention and control in hospital inpatient care units. Methods: Cross-sectional survey was conducted with 128 nurses selected using systematic random sampling at Buleleng District Hospital’s inpatient care units. Data collection was conducted in March 2018 using self-administered questionnaires. The questionnaire consisted of five sections including characteristics of respondents, HAIs prevention and control practices, self-efficacy, occupational safety environment and the availability of facilities. Bivariate analysis was conducted to calculate the Pearson correlation coefficients between variables. Multivariate analysis was performed with multiple linear regressions to examine self-efficacy, occupational safety environment and availability of facilities as predictors of the compliance on HAIs prevention and control. Results: The study shows that 56.2% of nurses reported good compliance on HAIs prevention and control practices. Bivariate analysis shows a significant correlation between HAIs prevention and control compliance scores and self-efficacy (r=0.45; p=0.00), occupational safety environment (r=0.53; p=0.00), and the availability of facilities (r=0.65; p=0.00). Multivariate analysis shows that the availability of facilities is a significant predictor of HAIs prevention and control compliance (β=0.49; p<0.01) while self-efficacy and the occupational safety environment are also found to be significant predictors, although with lower standardized coefficients: β=0.16 (p=0.03) and β=0.17 (p=0.04), respectively. Conclusion: The significant predictors of compliance on HAIs prevention and control are availability of facilities, self efficacy and hospital’s occupational safety environment. This study highlights the importance of optimizing the availability of facilities, improving the occupational safety environment, and enhancing nurses’ self-efficacy in order to reduce the incidence of HAIs in hospitals.

Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.

Background: There is an insufficient understanding of factors that impede nursing students' learning of healthcare-associated infection prevention and control in developing countries. This study aimed to explore current challenges in healthcare-associated infection control and prevention education in the nursing curriculum in two Vietnamese and two Cambodian universities. Methods: Exploratory research was conducted through consultation of education programs and a qualitative study design utilizing interviews and focus group discussions. Data collection was conducted through interviews with university board members and focus group discussions with lecturers and tutors. The data were analyzed by using content analysis methods. Results: The research results indicated that there were three generic themes of challenges in teaching HAIs-PC in nursing education in Vietnam and Cambodia. They were Implementation of healthcare associated infections prevention and control education into nursing curriculum, Positive aspects fostering healthcare associated infections prevention and control learning, Negative aspects hindering healthcare associated infections prevention and control learning. Conclusions: The study results provided evidence of challenges in healthcare associated infections prevention and control education in some Asia higher education institutions. To improve professional safety, universities should pay more attention to developing appropriate teaching methods for healthcare-associated infections prevention and control education to improve students' practice outcomes.

8 - Infection control in Europe

4 - Infection control in Europe

Introduction: Healthcare-Associated Infections (HAIs) are infections acquired during hospital care, which may occur during hospitalization or after discharge. Factors such as age, comorbidities, and inadequate procedures increase the risk of infection. Active surveillance is essential to minimize the consequences of this issue and ensure the safety of both patients and healthcare professionals. In Brazil, this control is carried out through the Healthcare-Associated Infections Control Program (PCIRAS), in an effort to monitor the technological evolution and scientific evidence of healthcare practices. Objective: To analyze the importance of a surveillance culture in the prevention and control of HAI, aiming at improving the quality of health. Methodology: This is a literature review, referring to the importance of surveillance cultures in the control and prevention of HAI. Articles indexed in Google Scholar and in the Scientific Electronic Library Online (SciELO), Nature and Science Direct databases were used, in addition to dissertations/thesis and specialized literary works on the subject. Conclusion: With this study it is possible to observe not only the consequences and the high incidence of HAI in public health, but also the growing increase in the rate of multidrug-resistant microorganisms in the hospital environment, which shows the need for preventive measures to reduce this incidence, such as, for example, the surveillance culture.

Technetium-99m dimercaptosuccinic acid (DMSA) study has been advocated as a method for the assessment of renal sequelae after acute febrile urinary tract infection (UTI). However, it is not known whether DMSA scintigraphy performed during acute UTI has any prognostic value for outcome assessment. The objective of this study was to evaluate the usefulness of DMSA scintigraphy performed during UTI as a predictor of patient outcome, to identify children at risk of events [vesico-ureteral reflux (VUR) or recurrent UTI] that may lead to the development of progressive renal damage. One hundred and fifty-two children (including 78 girls) with a mean age of 20 months (range 1 month to 12 years) with first febrile UTI were evaluated by DMSA scintigraphy during acute UTI. After acute UTI, children were explored by voiding cysto-urethrography. Children who presented an abnormal DMSA study, or a normal DMSA study but VUR or recurrent UTI, underwent a DMSA control study 6 months after UTI. Children with VUR were followed up by direct radionuclide cystography. DMSA scintigraphy performed during acute UTI was normal in 112 children (74%). In 95 of these children, follow-up DMSA scintigraphy was not performed owing to a good clinical outcome. In the remaining 17 children, follow-up scintigraphy was normal. Forty children (26%) presented abnormal DMSA study during acute UTI. Twenty-five of them presented a normal follow-up DMSA, and 15 presented cortical lesions. Children with abnormal DMSA had a higher frequency of VUR than children with normal DMSA (48% vs 12%). It is concluded that children with normal DMSA during acute UTI have a low risk of renal damage. Children with normal follow-up DMSA and low-grade VUR have more frequent spontaneous resolution of VUR.

Background: There is an insufficient understanding of factors that impede nursing students’ learning of healthcare-associated infection prevention and control in developing countries. This study aimed to explore current challenges in healthcare-associated infection control and prevention education in the nursing curriculum in two Vietnamese and two Cambodian universities. Methods: Exploratory research was conducted through consultation of education programs and a qualitative study design utilizing interviews and focus group discussions. Data collection was conducted through interviews with university board members and focus group discussions with lecturers and tutors. The data were analyzed by using content analysis methods. Results: The research results indicated that there were three generic themes of challenges in teaching HAIs-PC in nursing education in Vietnam and Cambodia. They were Implementation of healthcare associated infections prevention and control education into nursing curriculum, Positive aspects fostering healthcare associated infections prevention and control learning, Negative aspects hindering healthcare associated infections prevention and control learning. Conclusions: The study results provided evidence of challenges in healthcare associated infections prevention and control education in some Asia higher education institutions. To improve professional safety, universities should pay more attention to developing appropriate teaching methods for healthcare-associated infections prevention and control education to improve students’ practice outcomes.

During the university period, student wellbeing is exposed to the negative effects of many stressful factors, including the use and abuse of alcoholic beverages. The aim of this study is to estimate the risky alcohol consumption within the student population of the University of Palermo. An anonymous online questionnaire was provided to students enrolled in the mailing list of the Regional Agency for the Right to University Study (ERSU) of the University of Palermo. the first section investigated demographic and social data, while in the second section the A.U.D.I.T. C (Alcohol Use Disorders Identification Test-Consumption) test was administered. 539 subjects agreed to the informed consent and completed the questionnaire. The average age of the sample is 22.65 years (SD ± 2.95). Considering as dependent variable "students with risky consumption of alcohol", the statistically significant independent variables associated were: "age class ≤22 years old" (aOR 2.02, 95% CI 1.18-3.44, p=0.019), "don't live with own family" (aOR 3.21, 95% CI 1.81-5.69, p&0.001) and "I currently smoke" (aOR 6.44, 95% CI 3.85-10.79, p&0.001). The results of the study show that about 19% of students experience risky alcohol consumption. This percentage seems not to be gender related. Information and training campaigns focused on alcoholism and related risks are of great importance in order to educate students on the socio-economic costs of alcohol related diseases to public health; parents can play a crucial role in minimising the use of alcohol in their sons/children through dialogue if properly trained to address these issues. In fact, our study seems to show that those who no longer live in the household have a higher risk of alcohol consumption.

Individuals with diabetes mellitus frequently develop severe skin and soft tissue infections (SSTIs) that are recalcitrant to antibiotic treatment. We examined how diabetes affects the emergence of antibiotic resistance in a Staphylococcus aureus SSTI. We determined that S. aureus evolves antibiotic resistance rapidly in diabetic mice, while resistance did not occur in nondiabetic mice over the course of infection. Diabetes-associated immune cell dysfunction plays a minor role in the emergence of resistance, while hyperglycemia plays a dominant role facilitating the expansion and takeover of resistant mutants in diabetic infections. Furthermore, vancomycin intermediate resistant isolates display a pronounced fitness defect in nondiabetic mice but not in diabetic mice. Together, these data suggest that the diabetic infection environment represents an ideal reservoir for the emergence and proliferation of antibiotic resistance. Controlling the blood sugar of diabetic mice with insulin resulted in significantly decreased incidence of antibiotic-resistant S. aureus.

Background: Acute, recurrent and chronic urinary tract infections are a major public health concern and occur in all age groups of males and females. They are a major and serious health problem that may lead to the subsequent development of serious symptoms with increased resistance to antibiotics.Aim: This study aimed to identify the most vulnerable ages in acute, recurrent and chronic urinary tract infections and the most common age groups for infection in Kirkuk cityMaterials and Methods: 151 urine samples were collected from patients with urinary tract infections who visited private clinics in Kirkuk Governorate. They were diagnosed by a urologist for the period from December 2022 to October 2023. The patients' ages ranged from 21-76 years. Microscopic examination, laboratory tests, culture and isolation of pathogens were performed to confirm the patients' cases.Results: In the current study, the number of male patients with urinary tract infections was 62, representing 41.1%, while the number of females was 89, representing 58.9%. The condition was diagnosed as acute, recurrent, or chronic. The results of the current study showed, that the number of samples for patients with acute urinary tract infections was 91 samples, representing 60.3% for both males and females. The number of males was 37, representing 40.7%, and the number of females was 54, representing 3.59%. As for the cases of patients with recurrent urinary tract infections, the percentage of males was 42.6%, with 23, while the percentage of females was 57.4%, with 31 samples. As for patients with chronic urinary tract infections, the percentage of males was 33.3%, with 2, while the percentage of females was 66.7%, with 4 samples. As for the age groups most affected by these cases, the ages ranged between 42-51, where the numbers were 62, with a percentage of 41.1%, followed by the age group 21-32 years, where the numbers were 42, with a percentage of 28.8%. In general, female infections were higher than males.Conclusion: This study, which was conducted on urinary tract patients in Kirkuk Governorate, showed that ages 42-51 years and ages 21-32 years are the most vulnerable groups to acute, chronic and recurrent urinary tract infections.

Results from the Scottish National HAI Prevalence Survey

BackgroundThe Italian National action plan to contrast antimicrobial resistance (PNCAR) was adopted in Italy with the aim of reducing antimicrobial resistance (AMR) rates through a “One Health” approach. The project “Support for the National Plan to Combat Antimicrobial Resistance (SPiNCAR)” was developed to evaluate the level of implementation of actions outlined by the PNCAR, through a self-assessment tool, addressed to regional and local health authorities. This study presents the findings of the first use of the SPiNCAR tool in the Region of Piedmont, detailing the level of implementation as of 31 December 2022.MethodsThe self-assessment questionnaire is divided into 7 central "areas" representing the main actions against AMR: governance, surveillance and monitoring, appropriate use of antimicrobials, healthcare-associated infection (HAI) control and prevention, education and training, alliance among stakeholders, evaluation of the impact and implementation of the program. Areas are structured into two or more items called "standards", subdivided into "criteria”. Different questionnaires were developed for Regional and Local Authorities. Scores were calculated as the percentage of criteria met within each area, aggregated at both regional and local levels.ResultsBy analysing results at the regional level, it was possible to identify domains of strength in the areas of Governance (79%), Appropriate use of antimicrobials (70%), HAI Control and Prevention (68%) and areas for improvement in Alliance among Stakeholders (18%), Training (33%) and Surveillance (41%). Local authorities showed encouraging median results in Surveillance (37%), Appropriate Use of Antimicrobials (22,5%), and HAI Control and Prevention (21,5%), whereas Implementation (10,5%), Education and Training (8%) and Alliance among Stakeholders (2,5%) need to be improved.ConclusionsThe first SPiNCAR assessment offered valuable insights to enhance healthcare quality; the evaluation identified stakeholder engagement and training as priority areas for improvement and targeted interventions for AMR containment.

To understand the management actions for prevention and control of health care-associated infections (HAIs) performed by health professionals. Prevention of nosocomial infections has evidence-based practice at its essence, but not all institutions are successful in implementing prevention methodology. Qualitative research with Grounded Theory methodological framework. The research was carried out in two southern Brazilian hospitals. Data collected were employed through open interviews with 21 health professionals and managers. This process occurred concurrently with the data analysis, through constant comparative analysis. The understanding of the co-responsibility of managerial actions emerged as a central phenomenon of the theoretical model. Management actions for the prevention and control of HAIs are a collective phenomenon, in which co-responsibility sustains the effectiveness of the offered assistance. The behaviours of health teams in the face of structural and human weaknesses influence the construction of a supportive relationship in the effectiveness of patient safety actions. The sharing of responsibilities between professionals and the actions of prevention and control of HAIs arising from this conduct positively influence the promotion of safer and improved quality care. Nursing managers should consider applying the tools to prevent and control HAIs and generate in-depth discussion to promote institution's cultural changes.