Control Of Healthcare-associated Infections Research Articles

Availability of complementary resources and equipment for use in the prevention of healthcare-associated infections

Background and Objectives: Recently, complementary resources and equipment have emerged to improve prevention of healthcare-associated infections (HAIs). Our aim is to verify availability and use of different resources/equipment by infection controllers. Methods: We conducted a survey with infection controllers from the State of Rio de Janeiro, Brazil, by invitation using a social media group, in August 2022. Nine different resources and equipment were evaluated. Categorical and continuous variables were evaluated by the chi-square test and Mann–Whitney U test, respectively. A p value of less than 0.05 was considered statistically significant. Results: One hundred and eight persons answered the questionnaire. The mean age was 42.8 years (SD +/- 8.5 years) and 53 (49.1%) reported most of their workload in public hospitals, 45 (41.7%) in private hospitals and 10 (9.2%) reported the same workload in public and private hospitals. Sixty-there percent reported teaching activities in their institutions. There was no correlation between the existence of teaching activities and hospital profile (p=0.42). The most common resource available was molecular biology (PCR) for microbiological samples research for 73 (67.6%) participants. The second resource most available was applications (Apps) for HAIs prevention and control for 33 (30.6%), 19 (17.6%) reported no availability of resource/equipment technology. Conclusion: Molecular biology (PCR) for microbiological samples research was the most common resource available for infection controllers of an important state of Brazil.

Assessment of the Knowledge and Practice of Infection Control among Radiographers in Saudi Arabia: A Cross-Sectional Survey Study.

A descriptive cross-sectional study was conducted in Saudi Arabia in the period from February to May 2022, with data collected using an online survey in the form of a google forms questionnaire disseminated through social media as an electronic link and including the patient's demographic characteristic such as age, gender, education level, experience, and prior infection control training and multiple closed ended questions to assess knowledge of standard infection control precautions and the practice of infection control. Overall, 113 participants responded to the survey and entered their responses directly, and the data were analyzed using the SPSS (statistical package for social science). The study revealed that the mean score of knowledge and awareness of the practice of infection control among radiographers in Saudi Arabia was (63.0 and 61.9, respectively), which were considered moderate levels. Females were significantly more knowledgeable about infection control and more aware of the practice than males (p-values = 0.019). The participants who previously attended courses of infection control training had a significantly higher score with a mean rank of (60.9) than those who had not (43.4), (p-value = 0.013). The radiographers' level of experience, age, and academic qualification had no significant influence on overall knowledge and practice of infection control (p-values > 0.05). In Saudi Arabia, radiographers have a moderate level of knowledge and practice of infection control. There is a need for an ongoing training and education program for practicing radiographers to ensure they perform better in infection control measures.

Efficacy of disinfectants on control and clinical bacteria strains at a zonal referral hospital in Mwanza, Tanzania: a cross sectional hospital-based study

Contaminated-hospital surfaces are an important source of pathogenic bacteria causing health-care associated infection (HCAIs). Monitoring the performance of disinfectants that are routinely used to clean hospital surfaces is critical for prevention and control of HCAIs. Nevertheless, the evaluation of the performance of disinfectants and their efficacy are not routinely practiced in most resource-limited countries. This study was designed to determine the efficacy of sodium dichloroisocyanurate (NaDCC) and chloroxylenol against American Type Culture Collection (ATCC) and their respective multidrug resistant (MDR) strains causing neonatal sepsis at a zonal referral hospital in Mwanza, Tanzania. Four ATCC (n = 4) and their respective MDR strains of Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were used. The suspension test was used with contact time of 1, 5 and 10 min with starting concentration of 105 bacterial colony forming unit per milliliters (CFU/mL). The log10 reduction value at specified bacteria-disinfectant contact time was used to assess the efficacy of 0.5%NaDCC and 4.8% chloroxylenol in-use and freshly prepared solutions. In-use 0.5%NaDCC demonstrated poor log reduction (˂ 5log) against MDR-clinical isolates. Freshly laboratory prepared 0.5% NaDCC had 100% microbial reduction at 1, 5 and 10 min of both ATCC and MDR strains up to 48 h after preparation when compared with freshly prepared 4.8% chloroxylenol (˂ 5log). Freshly, prepared 0.5% NaDCC should be used in health-care facilities for effective disinfection practices.

Hospital mattresses: Thermal disinfection against bacteria, fungi and virus

Disinfection protocols for medical items play an important role in the prevention and con-trol of healthcare-associated infections. Regarding mattresses, disinfection with chemical products only cleans the surface, leading to failures in the execution of final processes of cleaning. This study aims to evaluate the antimicrobial activity of ECOSTOVE Thermal Chamber for the disinfection of hospital mattresses. Microbiological analyses were carried out under different experimental con-ditions, considering microbial viability, treatment time and position of inoculum on mattress. Staphylococcus aureus, Klebsiella pneumoniae, Candida albicans and Chikungunya virus were in-oculated at five pre-defined positions on the external and internal areas of hospital mattresses. Im-prints were done using RODAC plates, before and after heat treatment to evaluate colony-forming unit and microbial viability. The percentage of microbial inhibition obtained by heat treatment of the ECOSTOVE varied between 83.1 to 100%. The best results were observed for the enveloped Chikungunya (100% inhibition) and C. albicans (between 97.6 and 100%), followed by K. pneu-moniae (85.4-100%) and S. aureus (83.1-99.1%). Due to the significant antimicrobial activity of ECOSTOVE, it can be integrated into standard hospital hygiene and cleaning procedures as a prom-ising strategy in the control of healthcare-associated infections.

Consensus of experts on healthcare-associated infection prevention and control of Mpox

Since May 2022, Mpox has rapidly spread globally and been posing new challenges. There is no specific treatment drug for monkeypox (Mpox), and how to avoid cross infection has become the key to the prevention and control of the Mpox epidemic. However, current guidelines lack systematic recommendations for reducing Mpox transmission risk in medical institutions. Therefore, the National Training Center of Hospital Infection in China collaborated with 64 domestic experts to sort out relevant issues and urgently released the consensus of Chinese experts on Mpox healthcare-associated Infection prevention and control. The main content includes an overview of the Mpox epidemic, pathogenic characteristics, epidemiology, early identification and diagnosis, infection prevention and control strategies in medical institutions, and healthcare-associated infection prevention and control measures, aiming to strengthen healthcare-associated infection prevention and control of Mpox and reduce cross infection.

Barriers to Learning Healthcare-Associated Infections Prevention and Control during Clinical Practicum among Nursing Students in Korea: A Focus Group Study.

Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum.

Designing antimicrobial biomembranes via clustering amino-modified cellulose nanocrystals on silk fibroin β-sheets

The continuous rising of infections caused by multidrug-resistant pathogens is becoming a global healthcare concern. Developing new bio-based materials with unique chemical and structural features that allow efficient interaction with bacteria is thus important for fighting this phenomenon. To address this issue, we report an antimicrobial biomaterial that results from clustering local facial amphiphilicity from amino-modified cellulose on silk fibroin β-sheets, by simply blending the two components through casting technology. A simple but effective method for creating a membrane that is antibacterial and non-cytotoxic. Amino-modified cellulose nanocrystals (CNC-NH2) were mixed with proteinaceous silk fibroin (SF) which resulted in a material with improved crystallinity, higher β-sheet content, and exposed amino-groups at its surface features, proven by Fourier transform infrared (FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS), that does not occur when the components are individually assembled. The resulting material possesses important antibacterial activity inducing >3 CFU log10 reduction of Escherichia coli and Staphylococcus epidermidis, while the pristine membranes show no antibacterial effect. The chemical interactions occurring between SF and CNC-NH2 during casting, exposing the amino moieties at the surface of the material, are proposed as the main reason for this antimicrobial activity. Importantly, the membranes are non-cytotoxic, showing their potential to be used as a new bioinspired material with intrinsic antibacterial activity for biomedical applications. Those may include coatings for medical devices for the control of healthcare-associated infections, with no need for including external antimicrobial agents in the material.

IMPROVING CONTROL STRATEGIES OF INFECTIONS BY RESISTANT PATHOGENS IN A HOSPITAL NETWORK

The efficacy of infection prevention and control on several hospital networks is assessed. We tested two kinds of strategy, a network-topology-based allocation and a [Formula: see text]-based allocation, where [Formula: see text] is the basic reproduction number of the infection. For this, a multi-patch deterministic model simulates the spread of carbapenemase-producing Enterobacteriaceae in several theoretical hospital networks parametrized by data from Brazil. Our results show that: (i) the allocation methods based on the [Formula: see text] of the hospitals may work better than the network-topology-based allocations; (ii) results from control efficacy for a specific hospital network cannot be generalized to other types of networks. Putting together the global network topology with local factors that drive pathogens transmission, the [Formula: see text]-based allocation method seems to be enough to control of healthcare-associated infections. Overall, the obtained results emphasize the importance of data collection on infection transmission and patient transfers.

Do Knowledge, Attitudes, and Barrier Perception Affect the Prevention and Control of Healthcare-Associated Infections? A Structural Equation Modelling Approach.

Healthcare-associated infections (HCAIs) have become a global public health problem, resulting in high mortality, serious morbidity, and heavy healthcare costs. Infection prevention and control (IPC) is a significant priority for healthcare workers (HCWs) to eliminate HCAIs. However, barriers exist in the IPC implementation in daily clinical work. This study aimed to explore the relationship between HCWs' knowledge, attitudes, barrier perception, as well as their effects on IPC practice. A structured questionnaire survey was conducted among HCWs who were responsible for IPC in a large tertiary hospital in China. Cronbach's alpha, average variance extracted (AVE), composite reliability (CR), as well as confirmatory factor analyses (CFA) were performed for reliability and validity. Structural equation modelling (SEM) was applied to establish the relationship between knowledge, attitudes, barrier perception and IPC practice. A Multiple Indicators Multiple Causes (MIMIC) model was conducted to detect the effects of covariates on factor structure. In total, 232 valid questionnaires were eventually collected. The average score of knowledge, attitudes, barrier perception and IPC practice were 2.95±0.75, 4.06±0.70, 3.14±0.86, and 4.38±0.45, respectively. The instrument demonstrated good reliability and validity. The SEM results showed that knowledge was positively associated with attitudes (β=0.151, p=0.039), and attitudes had positive effects on IPC practice (β=0.204, p=0.001), whereas barrier perception was negatively associated with attitudes and IPC practice (β=-0.234, p<0.001; β=-0.288, p<0.001, respectively). Additionally, time proportion spent on IPC was significantly associated with attitudes and practice (β=0.180, p=0.015; β=0.287, p<0.001, respectively), and training on HCAIs was a predicator for barrier perception and practice (β=0.192, p=0.039; β=-0.169, p=0.038, respectively). IPC practice was indirectly affected by knowledge through the mediation of attitudes, whereas barrier perception had a negative impact. Designing deficiency-based training programs, developing sustained IPC habits, and strengthening management support are recommended to optimize IPC practice.

Personal protective equipment wearing in the context of COVID-19 in a hospital in Burkina Faso

Personal protective equipment (PPE) is used by health care workers to protect themselves and patients from various exposures such as infectious agents. However, the wearing of this equipment is not always optimal, especially in an epidemic context of COVID-19 transmission. The aim of this study, in the specific context of COVID-19, is to contribute to the improvement of PPE wearing practices by health workers. This is a descriptive cross-sectional study conducted in 2020 at the Charles De Gaulle Pediatric University Hospital in Burkina Faso. All health workers in the care units and the laboratory were included. Data were collected using an observation grid during the first situation indicating the wearing of PPE. The assessment of the indications for wearing PPE was based on the recommendations of the French Society of Hospital Hygiene and on the technical guide for the prevention and control of healthcare-associated infections in Burkina Faso. Out of 350 targeted agents, 296 were observed. Gowns, masks and gloves were worn in 95.60%, 96.58% and 97.63% of cases respectively. However, PPE such as goggles (1.56%), apron (11.54%), and tunic and pants (46.28%) were poorly used during medical care. The practices of health workers with regard to the wearing of certain PPE are still insufficient. A training and awareness program on PPE should be considered to improve patient and staff safety.

A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model.

Although there are simple and low-cost measures to prevent healthcare-associated infections (HAIs), they remain a major public health problem. Quality issues and a lack of knowledge about HAI control among healthcare professionals may contribute to this scenario. In this study, our aim is to present the implementation of a project to prevent HAIs in intensive care units (ICUs) using the quality improvement (QI) collaborative model Breakthrough Series (BTS). A QI report was conducted to assess the results of a national project in Brazil between January 2018 and February 2020. A 1-year preintervention analysis was conducted to determine the incidence density baseline of the 3 main HAIs: central line-associated bloodstream infections (CLABSIs), ventilation-associated pneumonia (VAP), and catheter-associated urinary tract infections (CA-UTIs). The BTS methodology was applied during the intervention period to coach and empower healthcare professionals providing evidence-based, structured, systematic, and auditable methodologies and QI tools to improve patients' care outcomes. A total of 116 ICUs were included in this study. The 3 HAIs showed a significant decrease of 43.5%, 52.1%, and 65.8% for CLABSI, VAP, and CA-UTI, respectively. A total of 5140 infections were prevented. Adherence to bundles inversely correlated with the HAI incidence densities: CLABSI insertion and maintenance bundle (R = -0.50, P = .010 and R = -0.85, P < .001, respectively), VAP prevention bundle (R = -0.69, P < .001), and CA-UTI insertion and maintenance bundle (R = -0.82, P < .001 and R = -0.54, P = .004, respectively). Descriptive data from the evaluation of this project show that the BTS methodology is a feasible and promising approach to preventing HAIs in critical care settings.

SG-APSIC1117: Healthcare-associated infections among the obstetrics and gynecology patients with confirmed COVID-19 in Hung Vuong Hospital, Vietnam

Objectives: During the COVID-19 surge, our hospital was overloaded due to the increasingly high volume of patients and lack of resources, which resulted in difficulties in complying with infection control and prevention (IPC) practices. In this study, we estimated healthcare-associated infection (HAI) incidence and relevant factors among COVID-19 patients in Hung Vuong hospital. Methods: This study included all SARS-CoV-2–positive adult patients hospitalized between September 1 and October 31, 2021. The Centers for Disease Control and Prevention definition of HAI in the acute-care setting was used. Results: Among 773 patients, 21 (2.72%) developed 26 separate HAIs. The cumulative days of hospitalization were 5,607. The incidence of HAI among COVID-19 patients was 4.64 per 1,000 days of hospitalization. The most frequent HAI was clinically defined pneumonia (46.2%), for which the ventilator-associated pneumonia (VAP) rate was 41.9 per 1,000 ventilator days. Among 21 positive cultures, the most frequently isolated microorganisms were pseudomonas aeruginosa, Klebsiella pneumoniae, and escherichia coli. HAIs were significantly associated with the number of central-line days (OR, 1.74; 95% CI, 1.33–2.78), the number of indwelling urinary catheter days (OR, 1.46; 95% CI, 1.05–2.03), the length of administration days (OR, 1.25; 95% CI, 1.07–1.45), antibiotics use prior to HAIs (OR, 0.01; 95% CI, 0.01–0.21), and the number of nasal cannula days (OR, 0.62; 95% CI, 0.44–0.85). Conclusions: COVID-19 makes patients more vulnerable and may require more invasive procedures, increasing the infection risk by opportunistic pathogens like gram-negative Enterobacteriaceae. Hence, fundamental IPC recommendations should be strongly implemented.

The Development of Technology to Prevent, Diagnose, and Manage Antimicrobial Resistance in Healthcare-Associated Infections.

There is a growing risk of antimicrobial resistance (AMR) having an adverse effect on the healthcare system, which results in higher healthcare costs, failed treatments and a higher death rate. A quick diagnostic test that can spot infections resistant to antibiotics is essential for antimicrobial stewardship so physicians and other healthcare professionals can begin treatment as soon as possible. Since the development of antibiotics in the last two decades, traditional, standard antimicrobial treatments have failed to treat healthcare-associated infections (HAIs). These results have led to the development of a variety of cutting-edge alternative methods to combat multidrug-resistant pathogens in healthcare settings. Here, we provide an overview of AMR as well as the technologies being developed to prevent, diagnose, and control healthcare-associated infections (HAIs). As a result of better cleaning and hygiene practices, resistance to bacteria can be reduced, and new, quick, and accurate instruments for diagnosing HAIs must be developed. In addition, we need to explore new therapeutic approaches to combat diseases caused by resistant bacteria. In conclusion, current infection control technologies will be crucial to managing multidrug-resistant infections effectively. As a result of vaccination, antibiotic usage will decrease and new resistance mechanisms will not develop.

Economic evaluation of healthcare-associated infection prevention and control in long-term care: a systematic review protocol

BackgroundGiven the high risk of contracting a healthcare-associated infection in long-term care facilities, infection prevention and control are essential for the quality of care and safety of residents and staff. To develop more effective infection prevention and control interventions in long-term care facilities, it is important to assess the cost-effectiveness and cost-benefit of existing interventions. There are only a few reviews on this subject, but these are not recent and most do not perform an economic evaluation. Moreover, none uses a discounting approach which limits inter-study comparison. To address these gaps, we will conduct a systematic review of economic evaluations related to healthcare-associated infection prevention and control in long-term care facilities using a discounting approach.MethodsWe will query MEDLINE, Embase, Web of Science, Cochrane, CINAHL, EconLit, JSTOR, and Scopus, as well as the gray literature databases CORDIS and ProQuest. We will include quantitative studies that evaluate four clinical best practices associated with infection prevention and control (hand hygiene, hygiene and sanitation, screening, basic, and additional precautions) and use at least one of five economic analyses (cost-effectiveness, cost-benefit, cost-minimization, cost-utility, cost-consequences). Primary outcomes will include net cost savings, incremental cost-effectiveness ratio, incremental cost per quality-adjusted life year, and incremental cost per disability-adjusted life year. Two co-authors will independently screen and select articles, extract data, and assess the quality of selected articles using the Scottish Intercollegiate Guidelines Network criteria, the Economic Evaluation criteria, and the Cochrane criteria for economic evaluation. Extracted data will be synthesized, and values will be adjusted to 2022 Canadian dollars using the discount rates of 3%, 5%, and 8%.DiscussionInformation obtained through this systematic review may help researchers and policy makers make more efficient use of limited healthcare resources to ensure the safety and quality of long-term care.Systematic review registrationResearch registry ID: reviewregistry1210.

The impacts of self-expectation leadership and organizational commitment on hand hygiene behavior of medical staff based on the theory of implicit leadership.

Hand hygiene behavior (HHB) in healthcare settings remains suboptimal globally. Self-expectation leadership and organizational commitment are emphasized as important factors influencing HHB. However, there are no studies to support any relationship between self-expectation leadership and organizational commitment to HHB. This study will fill the gap by applying implicit leadership theory (ILT) to support the further promote HHB among medical staff. A cross-sectional study of 23,426 medical staff was conducted in all second-level and third-level hospitals in Hubei province, China. Based on ILT, an online self-administered and anonymous questionnaire was designed for measuring the medical staff's self-expectation leadership, organizational commitment, and HHB based on Offermann's 8 dimensions scale, Chang's 3 dimensions scale, and the specification of hand hygiene for healthcare workers, respectively, in which self-expectation leadership was divided into positive traits and negative traits parts. The structural equation model was used to examine the direct, indirect, and mediating effects of the variables. Positive traits of self-expectation leadership had a positive effect on organizational commitment (β = 0.617, p < 0.001) and HHB (β = 0.180, p < 0.001). Negative traits of self-expectation leadership had a negative effect on organizational commitment (β = -0.032, p < 0.001), while a positive effect on HHB (β = 0.048, p < 0.001). The organizational commitment had a positive effect on HHB (β = 0.419, p < 0.001). The mediating effect of the organizational commitment showed positively between positive traits of self-expectation leadership and HHB (β = 0.259, p < 0.001), while negatively between negative traits of self-expectation leadership and HHB (β = -0.013, p < 0.001). Positive traits of self-expectation leadership are important predictors of promoting organizational commitment and HHB, while negative traits of self-expectation leadership have a limited impact on organizational commitment and HHB in the field of healthcare-associated infection prevention and control. These findings suggest the need to focus on positive traits of self-expectation leadership; although negative traits of self-expectation leadership can also promote HHB to a lesser degree among medical staff, it will reduce their organizational commitment.

Structure and antibiotic resistance of bacterial pathogens in high-risk departments of healthcare-associated infections during the COVID-19 pandemic

The article presents the results of the evaluation of epidemiologically significant bacterial pathogens spectrum representative of healthcare-associated infections (HAIs). Antibiotic resistance was determined in patients with a confirmed diagnosis of severe and extremely severe COVID-19 in comparison with these characteristics in patients of the intensive care unit (ICU) of surgical profile. The predominance of gram-negative bacteria producing extended-spectrum beta-lactamases (ESBLs) +: Enterobacteriaceae and nonfermenting gram-negative bacilli (NFGNB) in patients with COVID-19 and NFGNB in surgical patients was established. Gram-positive coccal microflora in the structure of nosocomial bacterial pathogens was present in a smaller number of cases. Multiple antibiotic resistance of isolated pathogens associated with HAIs was revealed in ICU patients, regardless of the profile, especially manifested in relation to beta-lactam antibiotics. It is shown that the most epidemiologically significant carbapenem-resistant pathogens received priority distribution in the ICU for patients with COVID-19, where they accounted for almost half of all microorganisms associated with HAIs. Resistance to carbapenemic antimicrobials is due to the production of extended-spectrum carbapenemase by nosomial bacterial pathogens isolated from ICU patients. The data obtained supports the strategy of adequate selection of antibacterial therapy regimens taking into account the sensitivity of the pathogen, including in patients with COVID-19. The intensive development of high-tech, invasive methods of diagnosis and treatment, combined with the widespread spread of multidrug-resistant microorganisms, determine the need for continuous improvement of the system of supervision and control of HAIs.

Knowledge and Awareness of Health Care Associated Infection Control Measures Among Intensive Care Unit Nurses in Hospitals, Turkey

Aim: In this study, we aimed to determine knowledge and awareness of health care associated infection control measures among intensive care unit (ICU) nurses in Turkish hospitals using case-vignettes. &#x0D; Material and Methods: The questionnaire form used in this study was designed and prepared by the researchers by screening the relevant literature. Informative part of the form consisted of demographic data. The question part included 5 main sections with narrative questions of case vignettes and multiple-choice items related to the vignettes. A total of 285 nurses were accessed through e-mail addresses; the survey link was then sent to the ICU nurses who accepted participation in the questionnaire. &#x0D; Results: A total of 149 out of 285 nurses completed the questionnaire and sent filled the form online. The number of the nurses who consider screening of patients admitted to the ICUs from another health care institutions in terms of MRSA, VRE and carbapenemase-producing Enterobacteriaceae was 111 (74.4%), 118 (79.1%) and 93 (62.4%), respectively. The number of the nurses who thought that the hands should be rubbed with alcohol-based hand sanitizer and for 20-30 seconds was 90 (60.4%) and 95 (63.8%), respectively. In case of patients with Clostridium difficile diarrhea, the number of nurses gave the answer as the hand hygiene must be provided by washing hands with antimicrobial soap and water was twenty-six (17.4%) &#x0D; Conclusion: The result of this study indicated that knowledge and awareness of HCAIs among ICUs nurses were not at a desired level. Our results highlight the need for education and training especially on hand hygiene to raise awareness of control of HCAIs in ICUs.

Small wards in the ICU: a favorable measure for controlling the transmission of carbapenem-resistant Klebsiella pneumoniae

PurposeCarbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the leading causes of healthcare-associated infections (HAIs) and is particularly pervasive in intensive care units (ICUs). This study takes ICU layout as the research object, and integrates clinical data and bacterial genome analysis to clarify the role of separate, small wards within the ICU in controlling the transmission of CRKP.MethodsThis study prospectively observed the carriage and spread of CRKP from a long-term in-hospital patient (hereafter called the Patient) colonized with CRKP in the gut and located in a separate, small ward within the ICU. The study also retrospectively investigated CRKP-HAIs in the same ICU. The relationship and transmission between CRKP isolates from the Patient and HAI events in the ICU were explored with comparative genomics.ResultsIn this study, 65 CRKP-HAI cases occurred during the investigation period. Seven CRKP-HAI outbreaks were also observed. A total of 95 nonrepetitive CRKP isolates were collected, including 32 strains from the Patient in the separate small ward. Phylogenetic analysis based on core genome single-nucleotide polymorphism (cgSNP) showed that there were five possible CRKP clonal transmission events and two clonal outbreaks (A1, A2) during the study. CRKP strains from the Patient did not cause CRKP between-patient transmission or outbreaks in the ICU during the 5-year study period.ConclusionThe presence of a long-term hospitalized patient carrying CRKP and positioned in a separate, small ward did not lead to CRKP transmission or infection outbreaks in the ICU. Combining a small-ward ICU layout with normative HAI control measures for multidrug-resistant pathogen infection was effective in reducing CRKP transmission.

Healthcare-associated infection prevention and control practices in Israel: results of a national survey

BackgroundHealthcare-associated infection (HAI) is a common and largely preventable cause of morbidity and mortality. The COVID-19 pandemic has presented unprecedented challenges to health systems. We conducted a national survey to ascertain hospital characteristics and the use of HAI prevention measures in Israel.MethodsWe e-mailed surveys to infection prevention and control (IPC) leads of acute care hospitals in Israel. The survey included questions about the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). The survey also assessed COVID-19 impact and healthcare worker well-being.ResultsIPC leads from 15 of 24 invited hospitals (63%) completed the survey. Only one-third of respondents reported strong support for IPC from hospital leadership. Although several prevention practices were used by all hospitals (e.g., maximum sterile barrier precautions for CLABSI and real-time assessment of environmental cleaning for CDI), use of other practices was suboptimal—particularly for CAUTI and VAP. COVID-19 had a profound impact on Israeli hospitals, with all hospitals reporting opening of new units to care for COVID patients and most reporting moderate to extreme financial hardship. All hospitals reported highly successful plans to vaccinate all staff and felt confident that the vaccine is safe and effective.ConclusionWe provide a status report of the IPC characteristics and practices Israeli hospitals are currently using to prevent HAIs during the COVID-19 era. While many globally accepted IPC practices are widely implemented, opportunities to increase the use of certain IPC practices in Israeli hospitals exist.

Hyaluronic acid association with bacterial, fungal and viral infections: Can hyaluronic acid be used as an antimicrobial polymer for biomedical and pharmaceutical applications?

The relationships between hyaluronic acid (HA) and pathological microorganisms incite new understandings on microbial infection, tissue penetration, disease progression and lastly, potential treatments. These understandings are important for the advancement of next generation antimicrobial therapeutical strategies for the control of healthcare-associated infections. Herein, this review will focus on the interplay between HA, bacteria, fungi, and viruses. This review will also comprehensively detail and discuss the antimicrobial activity displayed by various HA molecular weights for a variety of biomedical and pharmaceutical applications, including microbiology, pharmaceutics, and tissue engineering.