Glove Change Research Articles

Implementation of enhanced recovery after cesarean section reduces surgical site infection

The cesarean section surgical site infection (SSI) rate for Barnes Jewish Hospital in 2019 rose to 2.2 infections per 100 procedures, the highest since achieving an average rate of 1.1 infections per 100. A multidisciplinary team was convened to create a cesarean section SSI bundle. Several studies demonstrated that implementing an Enhanced recovery after surgery, an evidenced-based protocol, could improve maternal outcomes and decrease SSI rates. This group implemented the Enhanced recovery after cesarean section with closure tray and glove change at the fascia closure to decrease the SSI rate.

Factors affecting infection control measures performed by dental workers

Background/purposeAn understanding of self-protection related factors is important for dental infection control. This study aimed to investigate factors associated with personal self-protection in infection control among dental care workers. Materials and methodsA cross-sectional survey with self-report questionnaire was conducted between Jan and Dec, 2018.275 dentists and 298 dental assistants were enrolled from randomly selected dental care settings. ResultsCompliance with wearing hair caps, facial masks, and hand washing is not as high as oral masks and gloves (over 90%). For dentists, the level of clinical setting (aOR = 3.1, P < 0.001) and the correct use of disinfectants for impression materials (aOR = 2.0, P < 0.05) were associated with hair cap wearing. Gender (aOR = 0.15, P < 0.05) and correct use of indicator during sterilization (aOR = 2.9, P < 0.05) were associated with facial mask wearing. The correct use of indicator during sterilization (aOR = 2.4, P < 0.05) and disinfection for impression materials (aOR = 2.2, P < 0.05) were associated with hand washing. For dental assistants, longer work experience (aOR = 1.05, P < 0.05), working days (aOR = 1.82, P < 0.05), the correct use of disinfectants for impression materials (aOR = 2.4, P < 0.001), and the frequent use of gloves (aOR = 8.0, P < 0.05) were associated with facial mask wearing. The surface disinfection of working tables (aOR = 2.8, P < 0.001) and the frequent changing of gloves (aOR = 5.96, P < 0.05) were associated with hand washing. ConclusionGender, the length of work practice, and correct techniques for sterilization use were identified as major factors associated with compliance with self-protection in infection control among dental care workers.

Surgical Infection Reduction Program of the Observatory of Surgical Infection (PRIQ-O): Delphi prioritization and consensus document on recommendations for the prevention of surgical site infection

Surgical site infection is the most frequent and avoidable complication of surgery, but clinical guidelines for its prevention are insufficiently followed. We present the results of a Delphi consensus carried out by a panel of experts from 17 Scientific Societies with a critical review of the scientific evidence and international guidelines, to select the measures with the highest degree of evidence and facilitate their implementation. Forty measures were reviewed and 53 recommendations were issued. Ten main measures were prioritized for inclusion in prevention bundles: preoperative shower; correct surgical hand hygiene; no hair removal from the surgical field or removal with electric razors; adequate systemic antibiotic prophylaxis; use of minimally invasive approaches; skin decontamination with alcoholic solutions; maintenance of normothermia; plastic wound protectors-retractors; intraoperative glove change; and change of surgical and auxiliary material before wound closure.

Programa de Reducción de la Infección Quirúrgica del Observatorio de Infección en Cirugía (PRIQ-O). Documento de priorización y consenso Delphi de recomendaciones para la prevención de la infección de localización quirúrgica

Surgical site infection is the most frequent and avoidable complication of surgery, but clinical guidelines for its prevention are insufficiently followed. We present the results of a Delphi consensus carried out by a panel of experts from 17 Scientific Societies with a critical review of the scientific evidence and international guidelines, to select the measures with the highest degree of evidence and facilitate their implementation. Forty measures were reviewed and 53 recommendations were issued. Ten main measures were prioritized for inclusion in prevention bundles: preoperative shower; correct surgical hand hygiene; no hair removal from the surgical field or removal with electric razors; adequate systemic antibiotic prophylaxis; use of minimally invasive approaches; skin decontamination with alcoholic solutions; maintenance of normothermia; plastic wound protectors-retractors; intraoperative glove change; and change of surgical and auxiliary material before wound closure.

Factors Affecting Awareness of Infection Control Measures among Dental Practitioners of Karachi

OBJECTIVES: To determine the factors affecting awareness of infection control measures among dental practitioners working in universities and teaching hospitals of Karachi. METHODOLOGY: A cross-sectional study was conducted from May 2017 to January 2018 among 190 conveniently sampled practitioners from four dental clinics of tertiary care hospitals of Karachi. The study population consisted of dental practitioners that included graduates and post graduates of either gender with an experience of two years and above while practitioners refusing to give written informed consent were excluded from the study. The questionnaires were distributed and collected on same day by the principal investigator. All the collected data were analyzed on Statistical Package for Social Sciences version 20. RESULTS: A majority of dental practitioners (&gt;90%) were aware that contact with blood may transmit pathogenic microorganisms; goal of infection control is to eliminate the transfer of microorganisms; steam autoclave sterilizes by using steam under pressure; disinfection of dental chair, clinic, and dental office; wearing gloves, face masks and having protective eye wear on while checking patients; changing gloves, extraction instrument, saliva ejectors and burs in operative dentistry after checking each patient is necessary for a dental practitioner. Moreover, the awareness scores of dental practitioners were found to be significantly different across categories of experience (p=0.008). CONCLUSION: A majority of dental practitioners was aware about most measures of infection control. Further confirmation of study results by studies with larger sample sizes is recommended. KEYWORDS: Risk Factors, Awareness, Infection Control, Dentists

Variation in the use of infection control measures and infection-related revision incidence after breast implant surgery in the Netherlands

The use and effect of most infection control measures (ICMs) in breast implant surgery are still debated, likely resulting in undesired variation in current practices. This study investigated the relationship between the number and combinations of ICMs used and the infection-related revision incidence after breast implant surgery. Additionally, national variation between Dutch healthcare institutions in ICM use was evaluated. For this multicentre, population-based study, all patients who received a primary breast implant or tissue expander for breast augmentation or reconstruction between 2015 and 2019 were identified from the Dutch Breast Implant Registry. Seven prospectively collected ICMs were investigated: preoperative antibiotics, implant and/or pocket irrigation, glove change, nipple guards, insertion sleeve, postoperative drains, and postoperative antibiotics. This study included 52,415 implants (85% augmentation, 15% reconstruction).The median (IQR) number of ICMs used was 3 (3-4) for augmentation and 4 (4-5) for reconstruction. Median follow-up was 30 months for augmentation and 34 months for reconstruction. Infection-related revision incidence was 0.1% for augmentation and 2.1% for reconstruction. Most infection-related revisions occurred within 2 months for augmentation and 2.5 months for reconstruction. The impact of ICM use on infection-related revision incidence remained unclear, given its low incidence. A significant variation was observed between institutions in the use of postoperative antibiotics and drains. Although the use of different ICMs varied considerably between institutions, the infection-related revision incidence after breast implant surgery was generally low. Most surgeons used four ICMs for breast reconstruction and three ICMs for breast augmentation. Further studies on the causes and effects of the observed variation are needed.

The outcome of endodontic treatment using an enhanced infection protocol in specialist practice.

Objectives This study aims to determine the outcome of primary root canal treatment with specific enhanced infection control protocol. The secondary aim was to compare percentages of successful outcomes in this study with a previous study undertaken by the same operator using both periapical radiograph (PR) and cone beam computed tomography (CBCT).Materials and methods Root canal treatment of 110 teeth in 95 patients carried out by a single operator using an enhanced infection control procedure (disinfection of gutta percha before obturation, changing of gloves after each intraoperative radiograph and also before the start of the root canal obturation). PR and CBCT scans of 94 teeth in 87 patients were assessed 12 months after completion of primary root canal treatment and compared with their respective pre-treatment (diagnostic) PR and CBCT scans. Healing was assessed by a consensus panel consisting of two calibrated examiners. Comparison of the PR and CBCT images for 'healed' and/or 'healing' outcomes was performed using McNemar's test.Results The 'healed' rate (absence of periapical radiolucency) was 89.4% using PR and 78.7% for CBCT (p <0.046). This rate increased to 95.7% for PR and 92.6% for CBCT when the 'healing' group (reduced size of periapical radiolucency) was included (p <0.046).Conclusion The frequent changing of gloves during the course of endodontic treatment and disinfection of gutta percha points before obturation, together with the use of contemporary rotary files, resulted in a high success rate of primary root canal treatment compared to similar clinical studies conducted previously.

Compliance to infection-preventing measures in colorectal surgery – a word of caution

Abstract Objective The success of a colorectal surgical site infection (SSI) preventing bundle is dependent on compliance to individual infection-preventing measures. The present study aimed to assess whether challenging circumstances may affect bundle compliance. Methods Retrospective analysis including consecutive patients undergoing colorectal surgery and appendectomy between November 2018 and October 2020, after implementation of an evidence-based SSI-preventing care bundle. Bundle items were antibiotic administration, disinfection, core temperature control, glove change, intra-abdominal lavage and drain placement according to pre-defined standards. Compliance to each item was assessed according to surgical duration, patient age and time of surgery. Results Over the study period, 463 patients underwent appendectomy, 458 patients colonic surgery and 98 patients rectal resections. Compliance to intraabdominal lavage standards decreased significantly with surgical duration of colonic resections (88% for surgeries lasting &amp;lt;90 minutes vs. 56% for surgeries lasting &amp;gt; 180 minutes), while similar decreasing compliance patterns were observed regarding intraabdominal drain placement (86% vs. 68%) and core temperature control (64% vs. 57%, all p&amp;gt;0.05) with long lasting procedures. Compliance to antibiotic timing and glove change recommendations was higher in patients undergoing day-time colectomies (08 h and 16 h) compared to patients operated on during night shifts (0h-08 h, 93% vs. 69% and 87% vs. 58%, respectively, both p&amp;lt;0.05). Specific compliance patterns were not observed in patients undergoing appendectomy or rectal surgery. Furthermore, patient age had no impact on bundle compliance. Conclusion The present study revealed decreasing compliance to several infection-preventing bundle items with increasing surgical duration and during night shifts. This may contribute to worse outcomes in these challenging settings but may be a point of attention that can be corrected.

The Bad Bug is Back: Acinetobacter Baumannii Bacteremia Outbreak during the COVID-19 Pandemic in an Intensive Care Unit.

Epidemiology of nosocomial infections may show variability because of under-estimation of infection control measures (ICMs) in coronavirus disease 19 (COVID-19) outbreak. To investigate the Acinetobacter bacteremia outbreak developed in an intensive care unit (ICU) between March 20 to May 15, 2020, examine the risk factors, and re-evaluate ICM retrospectively. A retrospective cohort analysis was conducted to determine the risk factors, pulsed field gel electrophoresis (PFGE) was performed for analysis of the outbreak, ICM practices were observed by a team, and infection control interventions were undertaken. Acinetobacter bacteremia developed in 17 patients (21.5%) within 79 COVID-19 patients included in the study. The mean age of the bacteremic patients was 67.3 (SD = 14.82) years, and 82.4% of them were male; of these, 15 died, leading to 88.2% mortality. The bacteremia rate was higher compared with a 14-month period preceding the COVID-19 pandemic (17/79 versus 12/580 patients, respectively). PFGE revealed that the outbreak was polyclonal. On multi-variate analysis, the bacteremia development rate was 13.7 and 5.06 times higher with central venous catheter (CVC) use and in patients with chronic obstructive pulmonary disease (COPD), respectively. The mortality rate was higher in bacteremic patients (p = 0.0016). It was observed that ICMs were not followed completely, especially change of gloves and hand hygiene. Contamination of A. baumannii was observed in 38% of the gloves. COPD and CVC use were determined as risk factors for Acinetobacter bacteremia development, and failures in ICM may have led to cross-contamination of endemic A. baumannii. The outbreak could be controlled within 3 weeks of interventions.

MP25-18 SEPARATE ABDOMINAL CLOSURE TRAYS SIGNIFICANTLY IMPROVE CYSTECTOMY SURGICAL SITE INFECTION; OUTCOMES FROM A PRE-POST IMPLEMENTATION NATIONAL SURGICAL QUALITY INPATIENT PROGRAM (NSQIP) PROJECT

You have accessJournal of UrologyCME1 May 2022MP25-18 SEPARATE ABDOMINAL CLOSURE TRAYS SIGNIFICANTLY IMPROVE CYSTECTOMY SURGICAL SITE INFECTION; OUTCOMES FROM A PRE-POST IMPLEMENTATION NATIONAL SURGICAL QUALITY INPATIENT PROGRAM (NSQIP) PROJECT Kevin Krughoff, Christopher Mantyh, Charles D. Scales, and Andrew C. Peterson Kevin KrughoffKevin Krughoff More articles by this author , Christopher MantyhChristopher Mantyh More articles by this author , Charles D. ScalesCharles D. Scales More articles by this author , and Andrew C. PetersonAndrew C. Peterson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002568.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While surgical site infection (SSI) prevention bundles have gained popularity across many disciplines, the urologic experience remains underreported. Our goal was to assess the impact of an abdominal closure protocol (ACP) on the incidence of SSI, UTI and procedure duration for cystectomy with urinary diversion. METHODS: A standardized abdominal closure protocol (ACP) was adopted at our institution in 2021 which included re-prep and re-drape of the abdomen, change of surgeon gowns and gloves and utilization of a separate abdominal closure tray. Utilizing the National Surgical Quality Inpatient Program (NSQIP) database, patients who underwent cystectomy and urinary diversion between 2016-2021 were identified for assessment. Cases incorporating the ACP were matched to cases pre-dating the incorporation of the ACP through propensity score matching based on 16 NSQIP-derived predictor variables. The optimal matching algorithm was determined based on greatest resulting reductions in standardized mean differences and variance ratios between groups. Counterfactual outcomes were generated using logistic regression to determine the average treatment effect of ACP incorporation. Standard errors and the 95% confidence intervals were calculated from 1,000 bootstrap samples. RESULTS: A total of 327 cases at our facility were reviewed. Twenty-three of 24 ACP cases were successfully matched to 245 of 303 non-ACP cases using a kernel-matching algorithm (Figure 1). Matching resulted in standardized mean differences below 0.1 for 14 of 16 NSQIP predictor variables and variance ratios of less than 2.0 for all NSQIP predictor variables. Following ACP incorporation, there was a raw SSI reduction of 5.7%, a raw UTI reduction of 5.6% and a raw increase in procedure duration of 38.4 minutes. The estimated treatment effect after modeling was a 4.1% reduction in SSI (p<0.02, CI 0.6% to 7.5%), with no significant effect on UTI incidence or procedure duration. CONCLUSIONS: Using a treatment effects model, the incorporation of an abdominal closure protocol was associated with a significant reduction in surgical site infection with minimal increase in surgical time. Source of Funding: Boston Scientific Fellowship Grant © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e435 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Krughoff More articles by this author Christopher Mantyh More articles by this author Charles D. Scales More articles by this author Andrew C. Peterson More articles by this author Expand All Advertisement PDF DownloadLoading ...

Infection prevention and control awareness, attitudes, and practices among healthcare professionals in South India

Infection is a key challenge in healthcare settings around the world. Healthcare professionals (HCPs), including medical laboratory technologists (MLTs) and nurses, are at risk of infection because they are in close contact with infected patients. This investigation was conducted to evaluate the awareness, attitude, and practices of Infection Prevention Control (IPC) among HCPs working in private tertiary hospitals in two states in South India. This quantitative study surveyed 571 HCPs in southern India. In September 2021, an online survey was used to collect data on the respondents' demographic and IPC-related variables, as well as their awareness, attitudes, and practices of IPC. The survey revealed high level of awareness, positive attitudes, and good IPC practices. Among the IPC practices, "changing gloves between contacts with different patients" was the most often practiced and "washing hands after removal of gloves" was the least practiced. Being a nurse, being older, finishing a graduate program, attending a risk assessment training, having sufficient Personal Protective Equipment (PPE) at work, and being aware of the safety guidelines were associated with better awareness. Being a nurse, being older, and holding a diploma were associated with more positive attitudes. Being MLT, attending risk assessment training, having sufficient PPE at work, and being aware of the safety guidelines were associated with better IPC practices. Measures to sustain the high awareness, positive attitudes, and good IPC practices by dealing with the factors associated with these variables identified in this study must be planned and implemented.

Association of an Obstetric Surgical Closing Protocol With Infection After Cesarean Delivery.

To examine surgical site infection rates before and after the addition of a closing protocol to an existing surgical site infection risk-reduction bundle used during cesarean delivery. We conducted a single-center retrospective cohort study to review the association of a closing protocol with rates of surgical site infection after cesarean delivery. The closing protocol included fresh surgical instruments and physician and scrub nurse glove change before fascia closure. Surgical site infections were defined using Centers for Disease Control and Prevention criteria. Eligible patients underwent cesarean delivery at our institution from July 1, 2013, through December 31, 2015 (n=1,708; preimplementation group), or from June 1, 2016, through April 30, 2018 (n=1,228; postimplementation group). The surgical site infection rate was 2.3% preimplementation and 2.7% postimplementation (difference 0.4%, 95% CI -1.6 to 0.7%]. The mean [SD] duration of the surgical procedure was longer postimplementation (59.6 [23.7] vs 55.6 [21.5] minutes; P<.001). Addition of a closing tray and glove change to our existing surgical site infection risk-reduction bundle was not associated with a reduction in the frequency of postcesarean surgical site infection but was associated with longer operating times.

Occupational Risk Factors and Preventive Measures for Covid 19 in Prosthodontics

Objective: The Aim of this study is to determine the occupational risk factors and preventive measure for Covid-19 in prosthodontics. Study Design:Cross-sectional study Place and Duration: Conducted at Nishtar institute of dentistry Multan during from the period 01 July, 2021 to 31 Dec, 2021 Methods: There were one hundred and thirteen professionals working in prosthodontics were presented in this study. Enrolled cases were aged between 22- 55 years. After obtaining informed written permission, the demographics of enrolled professionals were recorded, including age, sex, residence, occupation, and marital status.Association of risk factors in their occupation related to Covid-19 and its preventive measures were measured and calculated. Awareness of vaccine and vaccination status was also recorded. SPSS 24.0 was used to analyze all data. Results:Among 113 cases, majority of the cases were females 73 (61.3%) and rest were males 40 (38.7%). 45 (39.8%) cases were aged between 22-28 years, 40 (35.4%) were aged between 29-34 years and 28 (24.7%) had ages &gt; 35 years. 63 (55.8%) were married and 78 (69.02%) had urban residency. Majority were dentist 85 (75.2%) and 20 (17.7%) were dental assistants and 8 (7.1%)are dental technicians .64 (56.6%) were vaccinated and 40 (35.4%) were partially vaccinated.Most common symptoms were fever, cough, fatigue and shortness of breath. Risk factors were direct contact, not used of personal protective equipment (PPE) or lack of PPE i.e. gloves, hand wash, sanitizer and mask. Instantly change of gloves, hygienic cleaning, change of dress after job hours and social distance were the preventive measures. Conclusion: Given the pathways of COVID-19 transmission, even dental practitioners must adjust usual methods to avoid infection. In clinical conditions, dentists must recognize the signs and symptoms and perform stringent infection control. Keywords: Infectious Disease, Prosthodontics, Risk Factors, Symptoms

Study protocol for a cluster randomised trial of sterile glove and instrument change at the time of wound closure to reduce surgical site infection in low- and middle-income countries (CHEETAH)

BackgroundSurgical site infection (SSI) represents a major burden for patients, doctors, and health systems around the world. The aim of this trial is to assess whether the practice of using separate sterile gloves and instruments to close wounds at the end of surgery compared to current routine hospital practice can reduce surgical site infection at 30-days post-surgery for patients undergoing clean-contaminated, contaminated, or dirty abdominal surgery.MethodsThis study protocol describes a pragmatic, international, multi-centre, 2-arm, cluster randomised controlled trial, with an internal pilot. Clusters are defined as hospitals within low- and middle-income countries (LMICs) defined by the Development Assistance Committee (DAC) Official Development Assistance (ODA) list, where there are at least 4 eligible hospitals per country. Hospitals (clusters) must be in LMICs where glove and instrument change are not currently routine practice. Patients (adults and children) undergoing emergency or elective abdominal surgery for a clean-contaminated, contaminated, or dirty operation are eligible for inclusion. Before closing the abdominal wall, surgeons and the scrub nurse will change gloves and use separate, sterile instruments (intervention), versus no changing gloves or using separate, sterile instruments (standard practice, control). The primary outcome is SSI within 30 days after surgery, using the Centre for Disease Control (CDC) criteria. Secondary outcomes are SSI before point of hospital discharge, and readmission, reoperation, length of hospital stay, return to normal activities, and death up to 30-days after surgery. A 12-month internal pilot, including 12 clusters and approximately 600 participants, aims to assess adherence to allocation and follow-up of patients. The main trial is powered to detect a minimum reduction in the primary outcome from 16 to 12%. A total of 12,800 participants will be recruited from 64 clusters (hospitals) each including at least 200 participants.DiscussionChange of gloves and sterile instruments prior to fascial closure in abdominal surgery is a low-cost, simple, intraoperative intervention which involves all members of the surgical and scrub team. If effective at reducing SSI, this practice could be readily implemented across all contexts. The findings of this trial will inform future guideline updates from international healthcare organisations, including the World Health Organization.Trial registrationClinicalTrials.gov NCT03980652. Registered on 9 July 2019

Delphi Consensus on Intraoperative Technical/Surgical Aspects to Prevent Surgical Site Infection after Colorectal Surgery.

BACKGROUND:Previous studies have focused on the development and evaluation of care bundles to reduce the risk of surgical site infection (SSI) throughout the perioperative period. A focused examination of the technical/surgical aspects of SSI reduction during CRS has not been conducted. This study aimed to develop an expert consensus on intraoperative technical/surgical aspects of SSI prevention by the surgical team during colorectal surgery (CRS).STUDY DESIGN:In a modified Delphi process, a panel of 15 colorectal surgeons developed a consensus on intraoperative technical/surgical aspects of SSI prevention undertaken by surgical personnel during CRS using information from a targeted literature review and expert opinion. Consensus was developed with up to three rounds per topic, with a prespecified threshold of ≥70% agreement.RESULTS:In 3 Delphi rounds, the 15 panelists achieved consensus on 16 evidence-based statements. The consensus panel supported the use of wound protectors/retractors, sterile incision closure tray, preclosure glove change, and antimicrobial sutures in reducing SSI along with wound irrigation with aqueous iodine and closed-incision negative pressure wound therapy in high-risk, contaminated wounds.CONCLUSIONS:Using a modified Delphi method, consensus has been achieved on a tailored set of recommendations on technical/surgical aspects that should be considered by surgical personnel during CRS to reduce the risk of SSI, particularly in areas where the evidence base is controversial or lacking. This document forms the basis for ongoing evidence for the topics discussed in this article or new topics based on newly emerging technologies in CRS.

Assessment of the invisible blood contamination on nurses’ gloved hands during vascular access procedures in a hemodialysis unit

A prospective study was conducted to assess potential invisible blood contamination on nurses' gloved hands during vascular access procedures using the occult blood detection method in a hemodialysis unit. 60.13% (273/454) of samples tested positive for hemoglobin. These results highlighted the importance of hand hygiene and glove change during hemodialysis access care.

Intraoperative Glove Change During Cesarean Birth: A Pre- and Post-Interventional Trial

Intraoperative Glove Change During Cesarean Birth: A Pre- and Post-Interventional Trial

802. Corynebacterium striatum Outbreak Among Ventilated COVID-19 Patients in an Acute Care Hospital – California, 2021

Background Corynebacterium striatum (CS), a common human commensal colonizing the skin and nasopharynx, has been associated with nosocomial infections in immunocompromised and chronically ill patients. During the winter 2020-2021 COVID-19 surge, a 420-bed California hospital reported a marked increase in CS respiratory cultures among ventilated COVID-19 patients. We conducted a public health investigation to assess and mitigate nosocomial transmission and contributing infection prevention and control (IPC) practices. MethodsA case was defined as a patient with CS in respiratory cultures from January 1, 2020 - February 28, 2021. We reviewed clinical characteristics on a subset of cases in 2021 and IPC practices in affected hospital locations. CS respiratory isolates collected on different dates and locations were assessed for relatedness by whole genome sequencing (WGS) on MiSeq.ResultsEighty-three cases were identified, including 75 among COVID-19 patients (Figure 1). Among 62 patients identified in 2021, all were ventilated; 58 also had COVID-19, including 4 cases identified on point prevalence survey (PPS). The median time from admission to CS culture was 19 days (range, 0-60). Patients were critically ill; often it was unclear whether CS cultures represented colonization or infection. During the COVID-19 surge, two hospital wings (7W and 7S) were converted to negative-pressure COVID-19 units. Staff donned and doffed personal protective equipment in anterooms outside the units; extended use of gowns was practiced, and lapses in glove changes and hand hygiene (HH) between patients likely occurred. In response to the CS outbreak, patients were placed in Contact precautions and cohorted. Staff were re-educated on IPC for COVID-19 patients. Gowns were changed between CS patients. Subsequent PPS were negative. Two CS clusters were identified by WGS: cluster 1 (5 cases) in unit 7W, and cluster 2 (2 cases) in unit 7S (Figure 2). Figure 1. Corynebacterium striatum Respiratory Cultures January 2020-February 2021 Figure 2. Phylogenetic Tree Corynebacterium striatum Isolates ConclusionA surge in patients, extended use of gowns and lapses in core IPC practices including HH and environmental cleaning and disinfection during the winter 2020-2021 COVID-19 surge likely contributed to this CS outbreak. WGS provides supportive evidence for nosocomial CS transmission among critically ill COVID-19 patients. Disclosures All Authors: No reported disclosures

Association of gloves change and surgical site complications in elective cesarean sections of low-risk pregnancies.

The aim of this study was to assess whether the change of gloves is associated with reduced surgical site complications of elective cesarean sections in low-risk pregnancies. A prospective and observational study was conducted, with 169 patients selected for elective cesarean sections, and divided into two groups: group 1 (N.=100) (no change of gloves); and group 2 (N.=94) (gloves changed during surgery). Fisher's Exact Test was used to test hypotheses and existence of associations between variables. The receiver operating characteristic curve (ROC) was used to determine the best value of surgical time to identify complications in the surgical site. There was significant effect on surgical time (group 1: 72.6 vs. group 2: 65.1 min, P=0.006). There was no association between changing gloves and the presence of complications of the surgical site. Approximately 22.5% of patients had at least one complication up to 60 days after cesarean section, with no association between the change of gloves and the presence of comorbidities during prenatal follow-up (P>0.999). Surgical time >70 min was able to correctly identify 59.1% of cases of surgical site complications up to 60 days after cesarean section with a false positive rate of 34% (area under ROC curve: 0.627, P=0.0126, 95% CI: 0.554-0.695). In low-risk patients submitted to elective cesarean sections, change of gloves did not reduce the incidence of complications of the surgical site. Surgical time was an independent predictor for the presence of complications of the surgical site up to 60 days after cesarean section.

Effects of The Long-Time Wearing of Gloves by Health Care Workers Managing Covid-19 Assessed by Electrodermal Activity: A Pilot Study

Continues wearing gloves is a crucial problem among health care workers treating patients with coronavirus (COVID-19) infection that may cause skin complications. In the present study, the skin conductance (SC), skin potential (SP) and skin susceptance (SS) were used to identify the effects of long-term wearing gloves among health care workers managing COVID-19. The experimental procedure was repeated 30 times on three subjects recruited as volunteers to wear gloves for 4 hours. The baseline of parameters SC, SP, and SS were recorded at normal conditions without wearing the glove at zero time (To). The parameters were again recorded in the cases of glove-wearing with and without zinc oxide ointment (ZnO) for the same period. Noticeable differences were found in each of SC, SP and SS for subjects who wore gloves when compared to the baseline for 4 h. Results also showed significant differences in each of SP and SS during the same period with applying ZnO comparing to wearing gloves without applying ZnO. The results show that skin hydration is significantly improved by using ZnO. However, changing gloves at least every four hours of continuous wearing is recommended.