Control Of Hospital-acquired Infections Research Articles

Intelligent Forest Hospital as a New Management System for Hospital-Acquired Infection Control.

Hospital-acquired infection (HAI) is a significant global health concern, elevating the risks of morbidity and imposing a substantial socioeconomic burden. To enhance the management of HAI, particularly in the aftermath of the coronavirus disease 2019 (COVID-19) pandemic, the Guangdong Second Provincial General Hospital (GD2H) has launched a new system called Intelligent Forest Hospital (IFH). Leveraging advancements in artificial intelligence, 5G technology, and cloud networking, the IFH implements customized indoor air quality (IAQ) control strategies tailored to different medical settings. It utilizes various intelligent disinfection devices and air purification systems. The IFH features a dynamic 3D hospital model with real-time monitoring of crucial IAQ parameters and a risk assessment ranking for clinical departments, providing timely risk alerts, communication prompts, and automatic disinfection processes. The IFH aims to effectively mitigate HAI post-COVID-19 and other future pandemics, ensuring a safe and pleasant environment for patients, hospital staff, and visitors.

Knowledge and Practice on Hospital Acquired Infections of Tertiary Care Hospital at Dhaka City; Staff Nurse’s Perspective

Introduction: In hospital patients, infections continue to develop and may also be affected by hospital personnel despite progress in the field of public health and hospital care. Infection among hospitable patients is encouraged by many factors: reduced immunity among patients; increasing variety of medical procedures and invasive techniques that lead to potential routes for infection; and transmission among crowded hospital populations of drug-resistant bacteria, where low infect control practices can facilitate transmission. Nosocomial infections occur globally and affect developing countries as well as poor- resource countries. The major causes of death and increased morbidity include infections acquired in health care.  Objective: To find out the Knowledge, Attitude and Practice of Staff nurses on Hospital Acquired Infections in tertiary care Hospital of Dhaka city.  Method: The study was conducted by Cross sectional, descriptive quantitative research study design with 133 samples included with the inclusion criteria. Data were collected by face to face interviewed method.  Results: Among of the participants, the majority of the nurses were Diploma in Nursing 64.4%, B.Sc. in Nursing 23.7% and MPH/M.Sc. were 11.9%. Distribution of the participants by level of knowledge on hospital acquired infections (n=133), Here the most of the participants had moderate 46% (n=61) knowledge about hospital acquired infections.  Conclusion: Most of the nurses do not have a perfect knowledge about hospital acquired infection control. Therefore, it must be necessary that to learn the knowledge, control and prevention of hospital acquired infections. We also must be known how can use medical personnel about the prevention and control of HAIs according to world standards. Another way of gain knowledge from training, Presentation, academic courses, posters, and conferences.

Research Progress in the Prevention and Control of Hospital-acquired Infections in Neonatal Units

Neonatal hospital-acquired infections are an important problem affecting the health and life safety of newborns. This paper reviews the research progress on the prevention and control of hospital-acquired infections in neonatology, discusses the risk factors of hospital-acquired infections in neonatology, summarizes the effective preventive and control measures such as strengthening the training and education on hospital-acquired infections, reducing invasive diagnostic and therapeutic operations, implementing disinfecting and isolating measures, rationally using antibiotics, and improving immunity for newborns, etc., and introduces common monitoring and detection techniques such as bacterial culture and drug susceptibility testing, molecular biology testing techniques, and biomarker detection and application. marker detection and application, and other commonly used surveillance and detection techniques. Future research should focus on strengthening the monitoring and study of pathogen resistance, optimizing the diagnosis and treatment process, strengthening the infection prevention and control training for healthcare workers, improving the infection prevention and control system in neonatal hospitals, and carrying out multidisciplinary collaborative research, so as to effectively reduce the incidence of infections and safeguard the health and safety of neonates.

Clinical study of antibacterial medical textiles containing polyhydroxyalkanoate oligomers for reduction of hospital-acquired infections

The prevention and control of hospital-acquired infections remain a significantchallenge worldwide, as textiles used in hospital wards are highly involved in transmission processes. This paper reports a new antibacterial medical fabric used to prepare hospital pillowcases, bottom sheets and quilt covers for controlling and reducing hospital-acquired infections. The medical fabric was composed of blended yarns of staple polyester (PET) and degradable poly(3-hydroxybutyrate co-3-hydroxyvalerate) (PHBV)/polylactic acid (PLA) fibres, which were coated with polylactide oligomers (PLAO), which are environmentally friendly and safe antimicrobial agents with excellent thermal stability in high-temperature laundry. A clinical trial was conducted, with emphasis on the bacterial species that were closely related to the infection cases in the study hospital. After 7 days of use, 94% of PET/PHBV/PLA-PLAO fabric retained <20colony-forming units/100cm2 of the total bacterial amount, meeting hygiene and cleanliness standards. This study demonstrates the potential of fabrics containing polyhydroxyalkanoate oligomers as highly effective, safe and long-lasting antimicrobial medical textiles that can effectively reduce the incidence of hospital-acquired infections.

A novel extraction-free dual HiFi-LAMP assay for detection of methicillin-sensitive and methicillin-resistant Staphylococcus aureus.

Staphylococcus aureus (S. aureus) is a leading cause of bacteremia and blood stream infections. Methicillin-resistant S. aureus (MRSA) that first appeared in 1961 often caused hospital-acquired infections (HAIs) and community-acquired infections (CAIs) and was associated with high mortality rate. Accurate and rapid point-of-care testing (POCT) of MRSA is crucial for clinical management and treatment of MRSA infections, as well as the prevention and control of HAIs and CAIs. Here, we reported a novel extraction-free dual HiFi-LAMP assay for discriminative detection of methicillin-susceptible S. aureus and MRSA. The dual HiFi-LAMP assay can detect 30 copies/reaction of nuc and mecA genes with detection limits of 147 and 158 copies per 25 µL reaction, respectively. A retrospective clinical evaluation with 107 clinical S. aureus isolates showed both sensitivity and specificity of 100%. A prospective clinical evaluation with 35 clinical samples revealed a specificity of 100% and a sensitivity of 92.3%. The dual HiFi-LAMP assay can detect almost all S. aureus samples (141/142; 99.3%) within 20 min, implying that the entire HiFi-LAMP assay (including sample process) can be completed within 40 min, extremely significantly shorter than 3-5 days by the traditional clinical microbial culture and antibiotic susceptibility testing. The novel extraction-free dual HiFi-LAMP assay can be used as a robust POCT tool to promote precise diagnosis and treatment of MRSA infections in hospitals and to facilitate surveillance of MRSA at hospital and community settings.IMPORTANCEMethicillin-resistant Staphylococcus aureus (MRSA) was associated with high mortality rate and listed as a "priority pathogen" by the World Health Organization. Accurate and rapid point-of-care testing (POCT) of MRSA is critically required for clinical management and treatment of MRSA infections. Some previous LAMP-based POCT assays for MRSA might be questionable due to their low specificity and the lack of appropriate evaluation directly using clinical samples. Furthermore, they are relatively tedious and time-consuming because they require DNA extraction and lack multiplex detection capacity. Here, we reported a novel extraction-free dual HiFi-LAMP assay for discriminative detection of MRSA and methicillin-susceptible S. aureus. The assay has high specificity and sensitivity and can be completed within 40 min. Clinical evaluation with real clinical samples and clinical isolates showed excellent performance with 100% specificity and 92.3%-100% sensitivity. The novel extraction-free assay may be a robust POCT tool to promote precise diagnosis of MRSA infections and facilitate surveillance of MRSA at hospital and community settings.

Uses of a real-time automatic nosocomial infection surveillance system to support prevention and control of hospital-acquired infections in the ICU.

The intensive care unit (ICU) caters to patients with severe illnesses or injuries who require constant medical attention. These patients are susceptible to infections due to their weak immune systems and prolonged hospital stays. This makes the ICU the specialty with the highest hospital-acquired infection (HAI) cases. The core dimension of infection prevention and control for ICUs is infection surveillance, which analyses the risk factors of HAI and implements comprehensive interventions for HAI prevention and control. Hence, this study aimed to investigate the potential risk factors for developing HAI in the ICU using real-time automatic nosocomial infection surveillance systems (RT-NISS) to surveil, and analyze the effectiveness of RT-NISS coupled with comprehensive interventions on HAI prevention and control in the ICU. A retrospective analysis was conducted using data from an RT-NISS for all inpatients in the ICU from January 2021 to December 2022. Univariate and multivariate logistic regression analyses were performed to analyse potential risk factors for HAI in the ICU. Surveillance of the prevalence proportion of HAI, the prevalence proportion of site-specific HAI, the proportion of ICU patients receiving antibiotics, the proportion of ICU patients receiving key antimicrobial combination, the proportion of HAI patients with pathogen detection, the proportion of patients with pathogen detection before antimicrobial treatment and the proportion of patients before receiving key antimicrobial combination, the utilization rate of devices and the rate of device-associated HAIs were monitored monthly by the RT-NISS. Comprehensive interventions were implemented in 2022, and we compared the results of HAIs between 2021 and 2022 to evaluate the effect of the RT-NISS application combined with comprehensive interventions on HAI prevention and control. The relative risk factors, observed as being a significantly higher risk of developing HAI, were hospitalization over 2 weeks, chronic lung diseases, chronic heart diseases, chronic renal diseases, current malignancy, hypohepatia, stroke, cerebrovascular accident, severe trauma, tracheal intubation and tracheostomy and urinary catheter. By implementing comprehensive interventions depending on infection surveillance by the RT-NISS in 2022, the prevalence proportion of HAI was reduced from 12.67% in 2021 to 9.05% in 2022 (χ2 = 15.465, p < 0.001). The prevalence proportion of hospital-acquired multidrug-resistant organisms was reduced from 5.78% in 2021 to 3.21% in 2022 (χ2 = 19.085, p < 0.001). The prevalence proportion of HAI in four sites, including respiratory tract infection, gastrointestinal tract infection, surgical site infection, and bloodstream infection, was also significantly reduced from 2021 to 2022 (both p < 0.05). The incidence of ventilator-associated pneumonia in 2022 was lower than that in 2021 (15.02% vs. 9.19%, χ2 = 17.627, p < 0.001). The adoption of an RT-NISS can adequately and accurately collect HAI case information to analyse the relative high-risk factors for developing HAIs in the ICU. Furthermore, implementing comprehensive interventions derived from real-time automation surveillance of the RT-NISS will reduce the risk and prevalence proportions of HAIs in the ICU.

Knowledge and practices of healthcare workers in prevention and control of hospital-acquired infections in the Maternity Department at Bindura Provincial Hospital, Zimbabwe

Infections acquired in hospitals are the most frequent negative consequences of the healthcare delivery system, which affects both developed and developing nations. Among hospitalized patients and healthcare professionals, they are among the top causes of mortality and morbidity. Therefore, healthcare professionals are crucial in preventing and controlling hospital-acquired illnesses and safeguarding patients. The purpose of this study was to determine the knowledge and practices of healthcare workers (HCWs) in the prevention and control of hospital-acquired infections (HAIs) in the Maternity Department at Bindura Provincial Hospital. A cross-sectional study design was used to collect data from 46 participants using a self-administered questionnaire. Of which, 54.3% had 2 to 5 years of experience. With regard to the knowledge of HAIs, 59% of HCWs did not know what HAIs were, 57% did not know that cleaners and mothers should be engaged in infection prevention and control (IPC) activities, whereas 85% did not know that ventilator-associated infections and COVID-19 (57%) are HAIs. Segregation of waste was shown to be poorly practiced with 56% of HCWs, 65% were unaware of the hospital’s IPC policy, and 7% had never utilize the manuals of standard operating procedures when performing their jobs. This study recommended that every HCW should receive instruction on IPC methods from the facilities’ IPC coordinators, who should also regularly supervise the staff to monitor compliance with IPC. Mothers should receive more education on the prevention of infections when first admitted to the ward.

Epidemiologic characteristics and drug resistance of isolated from blood culture escherichia coli in a hospital in Qinghai Province from 2016 to 2022

Objective: To explore the drug resistance of Isolated From Blood Culture Escherichia coli (E. coli) in a hospital in Qinghai over the past seven years, to evaluate the ability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to analyze the homologous origin of E. coli, and to establish a protein fingerprint library to match with it, adjuvant clinical experience medication so as to provide the basis for the prevention and control of hospital-acquired infections. Methods: Retrospective analysis of blood cultures sent to hospitals from January 2016 to December 2022. Drug resistance and resistance changes in E. coli.A total of 1 841 E. coli strains were isolated from Qinghai Provincial People's Hospital from January 2016 to December 2022; all strains were identified by MALDI-TOF MS, and the VITEK2.0 drug sensitivity analyzer was applied for drug sensitivity analysis of the strains, and the mass spectrometry homology analysis and self-constructed protein fingerprint library were carried out by MALDI-Biotyper software; the protein fingerprint library was built by using WHONET5.6 software was used to statistically analyze the drug sensitivity results, SPSS23.0 software was used to analyze the relationship between fingerprint typing and drug sensitivity, and the χ2 test was used for intergroup comparisons. Results: A total of 1 841 strains of E. coli were detected in 4 582 positive blood culture specimens from January 2016 to December 2022, with a detection rate of 40.17%; the resistance rate of E. coli from blood sources to piperacillin/tazobactam and ceftriaxone was on the rise, and it was slightly decreased to cefepime, amikacin, levofloxacin, and sulfamethoxazole, and there was not much change to the rest of the drugs; After MALDI-Biotyper clustering analysis, the 1841 E. coli strains from Isolated From Blood Culture were classified into two major clusters and five subtypes, of which type Ⅰa1 accounted for about 40%, type Ⅰa2 accounted for about 2.7%, type Ⅰb accounted for about 3.8, type Ⅱa accounted for about 46%, and type Ⅱb accounted for about 7.5%. The detection rate of type Ⅰa1 E. coli was higher in general surgery (50.45%) and emergency surgery (50.92%), and the detection rate of type Ⅰb E. coli was higher in emergency medicine(10.05%)than in other departments. The drug sensitivity results of different subtypes were compared with each other, the resistance rate of type Ⅰa1 E. coli to cefepime was 21.3% higher than that of the remaining four types, and the difference was statistically significant (χ2=37.74,P=0.000); the resistance rate of type Ⅱ E. coli(>60%) to sulfamethoxazole was higher than that of type Ⅰ (<60%) as a whole, and the difference was statistically significant (χ2=15.248,P=0.004); and a preliminary database of homologous protein fingerprints of E. coli has been established E. coli homologous protein fingerprint library and validated. The drug susceptibility results of 1 288 E. coli strains in the validation set were statistically analyzed and compared with those in the training set. There was no significant difference(P>0.05). Conclusion: In recent years, the resistance rate of E. coli isolated from a hospital in Qinghai province to piperacillin/Tazobactam, cefepime, amicacin and other antibiotics has changed greatly. A fingerprint database of E. coli homologous protein was established, and it was found that the drug sensitivity data of E. coli were different among different fingerprint types. According to drug sensitivity, drug use could assist clinical experience and provide evidence for prevention and control of hospital illness.

A joint program of antimicrobial stewardship and hospital-acquired infection control to reduce healthcare-associated infections after kidney transplantation: The Hipomenes study

Infection is a common complication in kidney transplant recipients (KTRs). The usefulness of antimicrobial stewardship programs (ASP) and hospital-acquired infection control (HAIC) initiatives in the general inpatient population is well established. We performed a quasi-experimental study to evaluate a joint ASP/HAIC initiative focused on KTRs. A dedicated ASP team optimized antimicrobial prescriptions in consecutive KTRs during the intervention period (June 2015-March 2016). A multifaceted, evidence-based HAIC program was concurrently implemented. Results were compared with the preceding period (June 2014-March 2015). We included 96 and 100 KTRs in the intervention and preintervention periods, respectively. There was a reduction in the consumption of meropenem (rate ratio [RR]: 0.63; 95% confidence interval [CI]: 0.53-0.75; P <.0001), ceftazidime (RR: 0.31; 95% CI: 0.21-0.45; P <.0001), vancomycin (RR: 0.65; 95% CI: 0.53-0.8; P <.0001), and ciprofloxacin (RR: 0.66; 95% CI: 0.55-0.81; P <.0001) and an increase of fosfomycin (RR: 1.80; 95% CI: 1.17-2.76; P =.008) during the intervention period. The incidence of cystitis (RR: 0.30; 95% CI: 0.28-0.33; P <.001) and upper urinary tract infection (RR: 0.56; 95% CI: 0.33-0.95; P =.04) decreased. A specific ASP/HAIC initiative was effective in optimizing antimicrobial use and reducing the incidence of common bacterial infections among KTRs.

Establishment of a Novel Detection Platform for Clostridioides difficile Toxin Genes Based on Orthogonal CRISPR.

Clostridioides difficile is one of the leading pathogens causing nosocomial infection. The infection can range from mild to severe, and rapid identification is pivotal for early clinical diagnosis and appropriate treatment. Here, a genetic testing platform for toxins, referred to as OC-MAB (orthogonal CRISPR system combined with multiple recombinase polymerase amplification [RPA]), was developed to detect the C. difficile toxin genes tcdA and tcdB. While recognizing the amplified products of the tcdA gene and the tcdB gene, Cas13a and Cas12a could activate their cleavage activities to cut labeled RNA and DNA probes, respectively. The cleaved products were subsequently identified by dual-channel fluorescence using a quantitative PCR (qPCR) instrument. Finally, they could also be combined with labeled antibodies on immunochromatographic test strips to achieve visual detection. The OC-MAB platform exhibited ultrahigh sensitivity in detecting the tcdA and tcdB genes at levels of as low as 102 to 101 copies/mL. When testing 72 clinical stool samples, the sensitivity (95% confidence interval [CI], 0.90, 1) and specificity (95% CI, 0.84, 1) of the single-tube method based on the fluorescence readout was 100%, with a positive predictive value (PPA) value of 100% (95% CI, 0.90, 1) and a negative predictive value (NPA) value of 100% (95% CI, 0.84, 1), compared to the results of qPCR. Likewise, the sensitivity of the 2-step method based on the test strip readout was 100% (95% CI, 0.90, 1), while the specificity was 96.3% (95% CI, 0.79, 0.99), with a PPA of 98% (95% CI, 0.87, 0.99) and an NPA of 100% (95% CI, 0.90, 1). In short, orthogonal CRISPR technology is a promising tool for the detection of C. difficile toxin genes. IMPORTANCE C. difficile is currently the primary causative agent of hospital-acquired antibiotic-induced diarrhea, and timely and accurate diagnosis is crucial for hospital-acquired infection control and epidemiological investigation. Here, a new method for the identification of C. difficile was developed based on the recently popular CRISPR technology, and an orthogonal CRISPR dual system was utilized for the simultaneous detection of toxin genes A and B. It also uses a currently rare CRISPR dual-target lateral flow strip with powerful color-changing capabilities, which is appropriate for point-of-care testing (POCT).

Knowledge, attitude, and practice on prevention and control of Hospital-acquired infections at Macaani hospital in Mogadishu Somalia.

Knowledge, attitude, and practice on prevention and control of Hospital-acquired infections at Macaani hospital in Mogadishu Somalia.

ASSESSING KNOWLEDGE, ATTITUDES, AND PRACTICES OF HEALTHCARE PROFESSIONALS REGARDING HOSPITAL ACQUIRED INFECTION IN TERTIARY CARE TEACHING HOSPITAL AT EASTERN NEPAL: CROSS-SECTIONAL STUDY

Hospital-acquired infections (HAIs) are a common problem and represent significant challenges to the effective delivery of healthcare services faced by hospitals in all countries around the world. Healthcare workers (HCWs) are an important part of the healthcare team that plays a unique role in the control of HAIs. Compliance on the part of healthcare workers (HCWs) with standard precautions has been recognized as being an efficient means to prevent and control HAIs. Objective: The present study was conducted with objective of understanding the level of Knowledge, attitude and practice (KAP) regarding Hospital-acquired infections (HAIs) among health care workers in the Eastern region of Nepal. Method:This descriptive cross-sectional study was conducted among healthcare workers posted in different wards of hospitals of BPKIHS. A self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used for data collection. Simple random sampling method was employed. Statistical package for social sciences (SPSS) was used to analyze the data and presented in frequency tables and graph. Results: Regarding knowledge of the participants: Among the total participants in the study, 97% of the participants had good knowledge regarding Hospital acquired infections (HAIs) but only 72% of the participants had received formal training regarding hand hygiene. 97 % participants agreed on the fact that hand hygiene act should be performed before and after direct patient contact. Highest proportions of the participants (97%) were aware of the fact that washing hands with antiseptic decreases the risk of transmission of hospital acquired pathogens. Large proportion of the respondents ( 95%) were aware of the fact that Gloves should be worn if blood or body fluid exposure is anticipated and still considered that gloves provided complete protection against acquiring/ transmitting infections. Hand hygiene (89%) and Personal protective equipment 68%) were common preventive measures of transmission of hospital acquired infection. The common sources of acquiring infections was uniform (59%) whereas commonly hospital acquired infection (HAIs) were reproductive tract infection (86%) and gastro -intestinal tract (GIT) infection (76%) and most susceptible group to hospital acquired infections (HAIs) were OT assistants (74%), Lab technicians(69%) etc. Regarding attitude of the participants, 91% of the participants felt that they would be less likely to transmit infection to the patient if they performed hand-hygiene. Regarding various hindrances in adoption of hand hygiene, few of the respondents (48%) identified that hand hygiene agents were not readily available in our current settings. 31% of the health care workers reported that they often forgot to perform hand hygiene.42% of health care workers found that Gloves are always available when they wanted. 25% of health workers believed that there was very low risk of acquiring infections from my patients.79 % participants thought that all patients are potentially contagious while 88% transmission of hospital acquired infections occurred through unsterilized use of needles and sharp objects. Regarding practice of the participants , majority of respondents (more than 90%) performed hand hygiene before patient contact, after patient contact and caring for wound.95% of the participants practiced hand hygiene after removal of gloves. Majority of the participants (97%) washed their hands after handling every patient. 74% participants practiced of using reusable instruments while 86% respondents practiced of using pre-sterilized instruments. 82 % of the participants exposed to patients blood. Conclusion: All health workers had good knowledge regarding Hospital-acquired infections (HAIs) that was reflected in their attitude and practice on hand hygiene for the prevention of HAIs. However there is the need of regular training and performance feedback regarding hand hygiene and the hospital environment should be hand-hygiene friendly with easily accessible to sinks and other facilities. Improving sustainable supplies like personal protective equipment, water supply and hand washing facilities at patient care site is vital to reduce nosocomial infection. Therefore health workers should strictly follow hospital acquired infection prevention guidelines to reduce infections.

HAND HYGIENE COMPLIANCE STATUS OF MEDICAL STAFFS AT THE NATIONAL EYES HOSPITAL, IN 2021

Background: Hand hygiene (VST) is the simplest, most effective and most importantmeasure that contributes to reducing hospital-acquired infections, ensuring the safetyof health workers and improving the quality of patient care.Objectives: Describe the knowledge and practice of hand hygiene of medical staff atthe National Eye Hospital and analyze some related factors.Methods: Cross-sectional survey, quantitative research.Results: This study collected information from 323 health workers (NVYT),National Eye Hospital through questionnaires and observation using checklists. Theresearch results show that the knowledge and practice of hand hygiene in the controlof hospital-acquired infections of health workers is quite good.Conclusion: The rate of health workers with knowledge of hand hygiene reached74.9%. The rate of health workers with practices of hand hygiene reached over 85%.There are 4 factors related to knowledge of hand hygiene including: age, workingposition, working time and professional qualifications. Three factors related topractices of hand hygiene including: Gender, working position and time of trainingon infection control (p&lt;0.05).

Factors Associated with Prevention and Control of Hospital Acquired Infections within Nurses in Ngora Fredica Hospital Ngora District Eastern Uganda

Hospital Acquired Infections occur worldwide and affect hundreds and millions of people, and they are related to high rates of morbidity and mortality among patients who are admitted in hospitals or health facilities and are a major problem to patients’ safety and in settings where health care is to be made safe, their close watch and avoidance should be the topmost priority. The purpose of the study was to determine the factors within the nurses that were associated to the prevention and control of Hospital-acquired infections. The study was conducted at Ngora Fredica Hospital Ngora district Eastern Uganda. Results: 63.6% and 77.3% of nurses were found to be knowledgeable on causes and transmission of HAIs, respectively, which reflected good practices on medical waste segregation (85.2%), washing hands (77.3%), and storing sharps in safety boxes (92%). Respondents demonstrated good practice on infection prevention and control. Gender (female with COR = 1.54), experience (less than four years with COR = 1.43), and cadre (COR = 1.41) were significantly associated with nurses’ prevention and control abilities. Based on the key findings, the following were the conclusions: The study has demonstrated that the majority of the nurses who had adequate Knowledge about infection prevention and nearly above one-third of healthcare providers had poor practices towards infection prevention. Individual factors (gender, advanced age, educational status - cadre, serving year-experience, specialty, Knowledge, perceptions, and practice were significantly associated with nurses’ infection prevention and control. Keywords: Control, Hospital acquired infections, Nurses, Prevention.

Determinants of knowledge and precautionary practices about nosocomial infection among fourth graded hospital workers in Bangladesh: A mathematical and statistical approach

The goal of this study was to evaluate the determinants associated with knowledge level and precautionary practices concerning nosocomial infection among the fourth graded hospital workers in Bangladesh. A cross-sectional study based on 343 respondents selected through a convenience sampling method from two hospitals in the Dhaka city was carried out to meet the objective of the study. The outcomes of the chi-square test of association showed that education, types of organization, years of experience and participation in workshop or training on the infection control program had a highly significant association (p-value=0.000) with knowledge level while education, types of organization and participation in workshop or training on the infection control program had a highly significant association (p-value=0.000) with practice level. Besides, employment status had a significant association (p-value=0.033) with practice level as well. Almost analogous outcomes were observed in the binary logistic regression results for knowledge level and multinomial logistic regression results for practice level. The findings of the study also highlight that the fourth graded hospital workers in private hospitals had higher knowledge and performed better precautionary practices than their public hospital counterparts. This translates into the conclusion of paying more attention to the public hospital workers by giving them the opportunity of making themselves trained by engaging them with several workshops or training related to “Hospital Acquired Infection Control”.

Current state of antimicrobial stewardship and organ transplantation in Spain.

Solid-organ transplantation (SOT) remains the best therapeutic option for end-stage organ disease. Regrettably, SOT recipients are disproportionately affected by nosocomial infections produced by multidrug-resistant (MDR) microorganisms and antimicrobial adverse events. Both have a negative impact on the patient´s outcome. Description of data concerning the antimicrobial stewardship program (ASP) in SOT recipients of the University Hospital "12 de Octubre", and review of other Spanish ASPs. From May 2017 to December 2021, the ASP issued 2.785 recommendations. Approximately, 4.9% were aimed at improving the antimicrobial treatment administered to SOT recipients. Treatment discontinuation or change to a better therapeutic regimen was recommended in 51.8% and 26.3% of cases, respectively. The acceptance rate of the recommendations was close to 92%. Between June 2015 and March 2016, a quasi-experimental study consisting of a joint ASP and hospital-acquired infection control (HAIC) initiative, which included kidney transplant recipients, reported a significant reduction in the consumption of meropenem, vancomycin and ciprofloxacin, and a reduction in the incidence of global bacterial infections, upper urinary tract infections, and cystitis. Although Spain has several robust regional ASPs (e.g., VINCat and PIRASOA), data specifically concerning SOT patients is lacking. ASP coupled with HAIC programs have proven to be effective in SOT, and should be implemented in centers that perform transplantation. Since data is scarce, Spanish centers which have ASP should report their experience in SOT. Understanding the efficacy and safety of the Spanish ASP´s intervention in the SOT population is essential and deserves further study.

The Role of Emergency Departments in Cross-Contamination: The Case of VRE

Colonized surfaces, equipment, individuals, and infected patients can be sources for the hospital spread of vancomycin-resistant enterococci (VRE), which is one of the important nosocomial pathogens. The basic epidemiological tools for the prevention and control of hospital-acquired infections are the typing methods. Pulsed-field gel electrophoresis (PFGE) is a highly discriminating method used frequently to detect clonal associations in epidemics and hospital-acquired VRE infections. This study aimed to investigate the presence of cross-contamination, which service or services come to the forefront in case of possible cross-contamination and clonal relationship between VRE strains isolated from rectal swab, clinical and environmental swab samples taken in two different periods in various clinics of Istanbul University Istanbul Medical Faculty Hospital by PFGE method. A total of 125 VREs isolated in two different periods were included in the study. Rectal and environmental swab samples were inoculated on Enterococcosel agar and sodium azide broth, urine samples were inoculated on chromogenic agar, and other clinical samples were inoculated on 5% sheep blood agar and incubated for 18-24 hours. VITEK 2 Compact automation system GP panel (bioMerieux, MarcyL'Etoile, France) was used for the species identification of catalase-negative, gram-positive colonies and disc diffusion and minimum inhibitory concentration (MIC) gradient tests were used to determine vancomycin susceptibility. Multiplex polymerase chain reaction was used to search for vanA and vanB resistance genes in isolates identified as VRE, and PFGE was used to determine clonal association. All isolates were identified as Enterococcus faecium with the vanA resistance gene. It was shown that PFGE clones were divided into six types with 65% similarity (A-F), and in this polyclonal spread, the major type was type A, which contained 108 isolates in 37 subtypes existed in the hospital for years. In patients from whom similar isolates were obtained, the high rate of hospitalizations in the same emergency room or in different emergency services in the same building drew attention. Our results showed that the presence of VRE was established in our hospital, new isolates were added from time to time, and there was a cross-contamination. It was observed that emergency services, where infection control measures were neglected due to working conditions, were among the high-risk areas for VRE contamination. In order to better understand the importance of emergency services in cross-contamination, it would be useful to conduct surveillance studies among patients hospitalized in emergency services and monitor the rate of VRE in the services where positive patients were transferred.

Correction of Dental Malocclusion in Twins: Case Report

Background: Hospital-acquired infections (HAIs) are a major problem and challenge that hospitals around the world encounter. Nurses play a particular role in the prevention and control of HAIs as members of the healthcare team. The goal of this study is to analyze nursing students' understanding of nosocomial infection in Mysuru's selected colleges. Methodology: Due to the nature of the problem and the objectives of the study, the study takes a descriptive approach. 100 samples were selected by non-probability convenience sampling technique. The tool used for data collection consisted of proforma for structured knowledge questionnaire. Reliability of structured knowledge questionnaire was done using split half method and found r= 0.8 and the tools were found reliable. The pilot study was conducted to assess the feasibility of the study design. Based on the objectives and hypothesis of the study, the data were analyzed using descriptive and inferential statistics. Results: The mean score for nosocomial infection was 15.19, and the SD was 4.91. Over half of the students had poor knowledge. The knowledge of nursing students regarding nosocomial infections was correlated with their year of study.

Effect of the \u201cNormalized Epidemic Prevention and Control Requirements\u201d on hospital-acquired and community-acquired infections in China

BackgroundNo studies have yet reported the effect of prevention and control measures, which were implemented to combat COVID-19, on the prevention and control of common HAIs. We aimed to examine the effect of the “Normalized Epidemic Prevention and Control Requirements” (implemented in May 2020) by comparison of hospital-acquired infections (HAIs) and community-acquired infections (CAIs) in China during 2018, 2019, and 2020.MethodsData of inpatients before and after implementation of new requirements were retrospectively analyzed, including infection rate, use of alcohol-based hand cleaner, anatomical sites of infections, pathogen species, infection by multi-drug resistant species, and use of different antibiotics.ResultsThe HAI rate was significantly higher in 2020 than in 2018 and 2019 (P < 0.05), and the CAI rate was significantly higher in 2019 and 2020 than in 2018 (P < 0.001). Lower respiratory tract infections were the most common HAI during all years, with no significant changes over time. Lower respiratory tract infections were also the most common CAI, but were significantly more common in 2018 and 2019 than 2020 (P < 0.001). There were no changes in upper respiratory tract infections among HAIs or CAIs. Most HAIs and CAIs were from Gram-negative bacteria, and the percentages of fungal infections were greater in 2019 and 2020 than 2018. MRSA infections were more common in 2020 than in 2018 and 2019 (P < 0.05). The utilization rate and usage days of antibiotics decreased over time (P < 0.001) and the culture rate of microbial specimens before antibiotic usage increased over time (P < 0.001).ConclusionsThe new prevention and control requirements provided important benefits during the COVID-19 pandemic. However, their effects on HAIs were not obvious.

Knowledge, Attitude and Practice of Standard Infection Control Precautions among Health-Care Workers in a University Hospital in Qassim, Saudi Arabia: A Cross-Sectional Survey.

Hospital-acquired infections (HAIs) contribute to increased length of hospital stay, higher mortality and higher health-care costs. Prevention and control of HAIs is a critical public health concern. This study assessed the knowledge, attitude, and practice (KAP) of standard infection control precautions among health-care workers (HCWs) in Qassim, Saudi Arabia. A cross-sectional online survey among HCWs was conducted using a structured questionnaire. Predictors of KAP were investigated using multivariate logistic regression analyses and independent sample t-tests. A total of 213 HCWs participated in the survey. The prevalence of good (≥80% correct response) knowledge, attitude, and practice were 67.6%, 61.5%, and 73.2%, respectively. The predictors of good knowledge included the age of the HCWs (>34 years) (adjusted odds ratio: 30.5, p < 0.001), and training (13.3, p < 0.001). More than 6 years of work experience was a significant predictor of having a positive attitude (5.5, p < 0.001). While the predictors of good practice were having >6 years of experience (2.9, p < 0.01), previous exposure to HAIs (2.5, p < 0.05), and training (3.5, p < 0.01). However, being female (0.22, p < 0.001) and older (>34 years) (0.34, p < 0.01) were negatively associated with knowledge. Results indicate that arranging training for HCWs might be useful in improving their knowledge of standard infection control precautions and is also expected to facilitate positive attitude and practice.