Efficient Infection Control Research Articles

Prevalence of Enterococcus Species in Various Clinical Samples and Their Antimicrobial Susceptibility Pattern.

Background and aim Gram-positive enterococci, which are normally prevalent in the intestine as commensals, have become important pathogens that cause serious illnesses such as meningitis, bacteremia, and endocarditis, especially in people with impaired immune systems. Due to the presence of resistance genes such as van A, B, and C, which lead to multidrug resistance, the two prevalent species, Enterococcus faecalis and Enterococcus faecium, are causing increasing concerns. In order to effectively combat these dangerous infections, there is an urgent need for improved surveillance, infection control measures, and antimicrobial stewardship. Research on the genetic features of enterococci is still lacking in India. The purpose of this work is to assess the frequency of Enterococcus isolates from different clinical samples and to examine the patterns of antibiotic resistance in these isolates. Materials and methods The purpose of this cross-sectional observational study was to assess the prevalence of Enterococcus isolates from various clinical specimens. Based on information from previous studies, a sample size of 114 was chosen. Urine, blood, sputum, wound swabs, and sterile body fluids were all used for theisolation of bacteria. Through the use of biochemical tests such as bile esculin hydrolysis and salt tolerance, gram staining, and cultural traits, enterococci were identified. The Kirby-Bauer disc diffusion method was utilized to evaluate antibiotic susceptibility, with a specific focus on resistance patterns. The findings show that in order to address the increasing problems that these pathogens are posing in hospital settings, there is an urgent need for improved surveillance and efficient infection control strategies. Results The results of the investigation showed that different clinical specimens had different distributions of Enterococcus species. The majority of isolates (69.16%) came from urine samples, with blood samples making up the remaining 12.5%. The age group between 41 and 50 years old had the highest occurrence, with a notable male predominance. The majority of Enterococcus isolates (96.66%) came from inpatient settings, specifically from the critical care units (CCU) and intensive care units (ICU). Teicoplanin sensitivity was highest among the isolates (79.16%). Conclusion In our study, 120 Enterococcus isolates in all, mostly of Enterococcus faecium and Enterococcus faecalis, were isolated from different clinical specimens for our investigation. Teicoplanin showed the highest sensitivityamong the isolates.The study of Enterococcus species prevalence and antimicrobial susceptibility is vital for informing infection control and treatment strategies, enhancing antibiotic stewardship, and guiding public health policies.

Prevalence of ANA and Anti-GBM Antibodies among Patients with Renal Failure in Tikrit City

Background: End-stage renal disease (ESRD) people need regular hemodialysis because they have chronic renal disease, which is a major health issue. Aim: This study aimed to evaluate the prevalence and characteristics of ANA and Anti-GBM antibodies, associated infections, and bacterial isolates in hemodialysis patients, comparing the findings with a healthy control group. Materials and Methods: A cross-sectional hospital-based study was conducted from December 1, 2023, to May 31, 2024, at Tikrit Teaching Hospital. The study comprised a cohort of 240 patients, aged 15-75 years, who were diagnosed with chronic renal disease and were receiving hemodialysis. Additionally, a control group of 40 healthy persons was included. Enzyme-linked immunosorbent assay (ELISA) technology was utilized to collect blood samples for the purpose of detecting ANA and Anti-GBM antibodies. Results: There was a modest preponderance of men in the sex distribution of hemodialysis patients. The age distribution was adequately represented throughout several decades. The investigation revealed notable disparities in the occurrence of ANA and Anti-GBM antibodies between hemodialysis patients and the control group. Out of the patients undergoing hemodialysis, 32.29% were found to have ANA antibodies, and 29.17% were found to have Anti-GBM antibodies. In contrast, none of the individuals in the control group tested positive for either type of antibody. The prevalence of Hepatitis C and B viruses among hemodialysis patients was 8.33% and 5.21% respectively. 52.08% of the patients had diabetes, whereas 57.29% had hypertension. In addition, the bacteria obtained from the mouth exhibited a varied microbial composition, with the most common species being Staphylococcus epidermidis and Streptococcus viridans. Conclusion: This study emphasizes the notable occurrence of ANA and Anti-GBM antibodies in hemodialysis patients, which is associated with a heightened susceptibility to urinary tract infections (UTIs). Implementing efficient infection control techniques and enhancing oral hygiene practices are crucial for effectively controlling infections in hemodialysis patients. Additional investigation is required to examine the intricacies of the microbial composition in this particular group and to formulate thorough measures for preventing infections.

Saudi Arabia's Middle East respiratory syndrome Coronavirus (MERS-CoV) outbreak: consequences, reactions, and takeaways.

Middle East respiratory syndrome (MERS) is a viral illness caused by the MERS-Coronavirus (MERS-CoV) that was first identified in Saudi Arabia in 2012. Saudi Arabia has reported most global MERS-CoV cases and deaths, with periodic outbreaks in other countries. This review aims to provide a comprehensive overview of the 2023 MERS-CoV outbreak in Saudi Arabia, including its epidemiology, public health response, impact, and lessons learned. This study utilized a narrative review approach, drawing on published literature and data from sources such as the WHO and the Centers for Disease Control and Prevention. The 2023 outbreak was centered in the Riyadh region, with 312 confirmed cases and 97 deaths reported. MERS-CoV primarily spreads from dromedary camels to humans, with human-to-human transmission, especially in healthcare settings. The outbreak exhibited seasonal and spatial trends, with most cases during camel calving season and in rural areas with high camel populations. The Saudi Ministry of Health implemented a multi-faceted response, including enhancing surveillance, improving infection prevention, providing clinical support, and conducting risk communication. Over time, the response showed a decline in the number of cases and deaths, indicating its effectiveness. The outbreak has significant public health, economic, and social impacts, underscoring the ongoing threat of emerging zoonotic diseases. Key lessons include early case detection, efficient infection control, vaccine and treatment development, public engagement, and strengthening of regional and global collaboration to mitigate future outbreaks and safeguard public health.

Tissue Regeneration in Infected Wounds of Albino Rats Using Ciprofloxacin-Loaded Gelatin Microspheres Incorporated Collagen Scaffold: A Histological Approach with H&E Staining

A wound care system consisting of ciprofloxacin-loaded gelatin microspheres impregnated in a macroporous collagen scaffold was created to effectively control wound infection and regenerate soft tissue at the wound site. Histological and biochemical alterations were observed in infected wounds treated with these scaffolds in Albino Wistar rats. Furthermore, the study examined the immediate and prolonged release of ciprofloxacin from the scaffolds, as well as their function in eliminating bacterial infections and expediting the process of skin healing and regeneration. The developed technique was followed in the streamlined process of creating these collagen scaffolds. Compared to untreated wounds, the group receiving scaffold treatment experienced a faster rate of wound closure. It was noted that the rate of infections was considerably reduced and that full soft tissue regeneration occurred within 12 days. The development of well-deposited collagen bundles in the treated groups was demonstrated by H&E staining, which verified the flawless regeneration of the dermis and epidermis. The antimicrobial agent-loaded gelatin microspheres impregnated into the porous collagen scaffold demonstrated remarkable soft tissue regeneration and efficient infection control at the wound site.

Detection of Metallo β-Lactamase in Acinetobacter Species Using Phenotypic Methods with their Antibiotic Resistance Profile in Tertiary Care Hospital

Background: Acinetobacter species are commonly found in nature, in water, and in soil, and also, and they have been isolated from humans and animals. In the hospital setting, Acinetobacter species has emerged as a major opportunistic pathogen, being able to colonize and develop infections in patients. In Acinetobacter species, β-lactamases and outer membrane alterations are likely to function together to impart resistance. Understanding the epidemiology, and resistance mechanism, and for infection management and preventing a potential global health crisis, techniques for identifying Carbapenem-Resistant-Acinetobacter species are essential. Aim: To detect Metallo β-Lactamase (MBL) in Acinetobacter species with their antimicrobial susceptibility pattern. Material and Methods: 100 Acinetobacter species isolates from various clinical samples such as blood, cerebrospinal fluid, sputum, bronchoalveolar lavage, pus, urine, wound swab, and body fluids were included in the study. Phenotypic tests such as, Disc Potentiation test & Modified Hodge test were used to detect the presence of Metallo β-lactamase in imipenem & meropenem-resistant isolates. Results: The highest prevalence of Acinetobacter was found in blood (37%), followed by sputum (31%) and others [pus, urine, ascitic fluid, cerebrospinal fluid (CSF), bronchoalveolar Lavage (BAL), and pleural fluid]. A maximum number of Acinetobacter were isolated from MICU followed by medicine and surgery. The Modified Hodge test yielded the largest percentage of MBL-positive Acinetobacter isolates (67.26%) when compared to the Disc Potentiation test method (50.45%). Conclusion: Early detection of Metallo β-lactamase production is essential for planning appropriate treatment according to the resistance mechanisms of the multi-drug resistant strains, as well as for efficient infection control procedures to prevent the spread of infection.

Efficiency of Commonly Used Disinfectants and Antiseptics against Pathogenic Bacteria Isolated from Tripoli University Hospital, Libya

Background and objectives: Disinfectants and antiseptics are widely used in hospitals and other healthcare centers to ensure the prevention of nosocomial infections and provide efficient infection control. Numerous studies have recently shown that hospital-acquired bacteria are developing resistance against such compounds. The purpose of this study is to examine the effectiveness of the commonly used disinfectants and antiseptics against a group of nosocomial bacteria isolated from Tripoli University Hospital, Libya. Material and Methods: Five bacterial pathogens isolated from different hospital departments are klebsiella spp., Proteus spp., Escherichia coli (E. coli), Acinetobacter spp., Staphylococcus aureus (S. aureus). These isolated bacterial species were subjected to disinfectants and antiseptics impregnated with filter paper discs (disk diffusion assay). The disinfectants and antiseptics used were; Hydrogen peroxide (H2O2), OROLIN® Multisept plus (Orolin), Chlorhexidine (CHX), 84 Disinfectant, ACTOSAL® Flache AF (Actosal) and Ethyl alcohol. Results: In the present study found that the most effective was H2O2 antiseptic against the tested bacterial pathogens with inhibition diameters of 10 to 26mm, except for Proteus bacteria which illustrated resistance at high concentrations. Similarly, Orolin disinfectant shows very excellent efficacy against tested bacteria, and even with low concentrations. Good efficacy was observed for Actosal disinfectant on all species with diameters of inhibition ranging from 10 to 15mm. S. aureus in particular was very sensitive to 70% Ethyl alcohol (20mm), while all tested species were slightly insensitive to both Ethyl alcohol and CHX. In contrast, no effect of the 84 disinfectant was observed on most of isolates. Conclusion: The results of this study indicated that Orolin disinfectant had comparable effects to H2O2 atiseptic but less than to Actosal, 70% Ethyl alcohol and CHX, whereas 84 disinfectant was the weakest one. This study suggests the necessity of applying continuous monitoring to determine the antimicrobial efficacy of these antimicrobial agents regularly.

Thoughts on and Proposal for the Education, Training, and Recruitment of Infectious Disease Specialists.

The global pandemic of COVID-19 has underscored the significance of establishing and sustaining a practical and efficient infection control system for the benefit and welfare of society. Infectious disease (ID) specialists are expected to take on leadership roles in enhancing organizational infrastructures for infection prevention and control (IPC) at the hospital, community, and national levels. However, due to an absolute shortage and an uneven distribution, many core hospitals currently lack the ID specialists. Given the escalating global risk of emerging and re-emerging infectious diseases as well as antimicrobial resistance pathogens, the education and training of ID specialists constitutes an imperative concern. As demonstrated by historical changes in the healthcare reimbursement system, the establishment and enhancement of IPC measures is pivotal to ensuring medical safety. The existing structure of academic society-driven certification and training initiatives for ID specialists, contingent upon the discretionary decisions of individual physicians, possesses both quantitative and qualitative shortcomings. In this article, I first address the present situations and challenges related to ID specialists and then introduce my idea of securing ID specialists based on the new concepts and platforms; (i) ID Specialists as National Credentials, (ii) Establishment of the Department of Infectious Diseases in Medical and Graduate Schools, (iii) Endowed ID Educative Courses Funded by Local Government and Pharmaceutical Companies, and (iv) Recruitment of Young Physicians Engaged in Healthcare Services in Remote Areas. As clarified by the COVID-19 pandemic, ID specialists play a crucial role in safeguarding public health. Hopefully, this article will advance the discussion and organizational reform for the education and training of ID specialists.

Evaluation of Antimicrobial Resistancein Clinical Isolates of Enterococcus spp. Obtained from Hospital Patients in Latvia.

Background and Objective: Enterococci are typically found in a healthy human gastrointestinal tract but can cause severe infections in immunocompromised patients. Such infections are treated with antibiotics. This study addresses the rising concern of antimicrobial resistance (AMR) in Enterococci, focusing on the prevalence of vancomycin-resistant enterococcus (VRE) strains. Materials and Methods: The pilot study involved 140 Enterococci isolates collected between 2021 and 2022 from two multidisciplinary hospitals (with and without local therapeutic drug monitoring protocol of vancomycin) in Latvia. Microbiological assays and whole genome sequencing were used. AMR gene prevalence with resistance profiles were determined and the genetic relationship and outbreak evaluation were made by applying core genome multi-locus sequence typing (cgMLST). Results: The acquired genes and mutations were responsible for resistance against 10 antimicrobial classes, including 25.0% of isolates expressing resistance to vancomycin, predominantly of the vanB type. Genetic diversity among E. faecalis and E. faecium isolates was observed and seven potential outbreak clusters were identified, three of them containing sequence types ST6, ST78 and ST80. The prevalence of vancomycin resistance was highest in the hospital without a therapeutic drug-monitoring protocol and in E. faecium. Notably, a case of linezolid resistance due to a mutation was documented. Conclusions: The study illustrates the concerning prevalence of multidrug-resistant Enterococci in Latvian hospitals, showcasing the rather widespread occurrence of vancomycin-resistant strains. This highlights the urgency of implementing efficient infection control mechanisms and the need for continuous VRE surveillance in Latvia to define the scope and pattern of the problem, influencing clinical decision making and planning further preventative measures.

Modeling and stability analysis of the transmission dynamics of Monkeypox with control intervention

Modeling and stability analysis of the transmission dynamics of Monkeypox with control intervention

Research on Strategies for Wound Healing and Infection Control in Skin Disease Nursing

The skin, as the largest organ in the human body, plays multiple roles such as protecting, sensing, and regulating body temperature. Wound healing and infection control are two extremely important links, in the treatment and care of skin diseases. Efficient wound healing and infection control strategies affect the speed and quality of patient recovery and can reduce medical costs and alleviate social burdens. This study adopts the method of literature review to systematically sort out the basic theory of skin wound healing, analyze the particularity of skin disease wound care, and summarize the key technologies of wound healing and infection control. Research has found that skin wound healing is a complex physiological process involving multiple stages such as inflammatory response, cell proliferation, and tissue remodeling. Therefore, wound care for skin diseases requires personalized nursing measures based on the characteristics of different types of skin diseases. The research results indicate that effective wound healing and infection control strategies include: cleaning the wound, rational use of dressings, maintaining a moist environment for the wound, and timely treatment of infections. These strategies provide a scientific theoretical basis and practical guidance for wound healing and infection control in skin disease care, which helps to improve the quality of clinical nursing and promote patient recovery.

Pathogenicity and Antibiotic Resistance of Pseudomonas aeruginosa: A Comprehensive Review

Pseudomonas aeruginosa (P. aeruginosa) presents a complex challenge in terms of pathogenicity and antibiotic resistance. This versatile pathogen adeptly colonises various host tissues and evades the immune system through its intricate virulence factors. The review delves into the antimicrobial resistance mechanisms at play, which encompass inherent resistance characteristics and those acquired through genetic mutations and horizontal gene transfer. Notably, efflux pump systems and limited membrane permeability underpin its inherent resistance, rendering many conventional antibiotics ineffective. Multidrug Resistant (MDR) strains are on the rise, posing a substantial threat to patient care and infection control. In response, innovative strategies are being explored, including combination therapies to enhance the effectiveness of existing antibiotics and drug repurposing, redirecting existing medications to target P. aeruginosa. Phage therapy, which leverages bacteriophages to combat P. aeruginosa infections, is gaining attention as a promising solution. Infection prevention and control are pivotal, particularly in healthcare settings, to curtail the spread of P. aeruginosa. Surveillance programs are crucial for monitoring the prevalence and dissemination of antibiotic-resistant strains and guiding response strategies during outbreaks. Comprehending P. aeruginosa’s complex virulence and resistance mechanisms is paramount for developing efficient treatments and effective infection control measures. Ongoing research and collaborative efforts are instrumental in mitigating the substantial impact of P. aeruginosa infections on public health, underscoring the need for sustained vigilance and innovation in infectious disease management.

Nosocomial infections in patients admitted in medical intensive care units in a tertiary health center in Western part of India and their hematological correlation

Background and Aim: Acquired infections (AIs) in medical intensive care units (MICUs) have become serious threats with increasing mortality and morbidity more so in the developing countries. The most common reason is lack of efficient infection control protocols. The national nosocomial infections surveillance system defines a nosocomial infection as a localized or systemic condition that results from adverse reaction to the presence of infectious agents or their toxins that were not present or incubating at the time of admission to the hospital. Critically ill patients are at increased risk of acquiring nosocomial infections because of their lower immune status. These infections being opportunistic, microbes of low virulence cause also cause disease in hospital patients whose immune systems are impaired. This study was conducted to study the association of leukocytosis in relation to nosocomial infections in MICU. Methods: A retrospective study was conducted at the MICU under the Department of Anesthesiology in collaboration with the Department of Microbiology and Department of Pathology of Mahatma Gandhi Medical College and Hospital, Navi Mumbai over six months. All the patients who were admitted in MICU and stayed for more than 48 hours were included in the present study. Results: A total of 805 patients were admitted in the MICU from January 1st to June 30th, 2017, for a period of 6 months. Out of 805 cases, 27 patients developed nosocomial infections amounting to 3.3% with male-to-female ratio of 2.8:1. The age of the patient ranged from 15 to 85 years with the mean age of 50 years. Male predominance was seen with 74% cases with mean age of 48.5 years. Maximum cases were seen in the geriatric age group mainly 6th to 7th decade comprising of 40.7% of all cases. In our study, bloodstream infection was the most common finding constituting 100% of the cases, followed by urinary tract infections. All the cases of nosocomial infections showed polymorphonuclear leukocytosis with shift to left. In our study, diabetes mellitus followed by hypertension and chronic kidney disease was the major contributory comorbidities comprising of 29.6%, 29.6%, and 22.2%, respectively. In our study, the invasive devices contributed to the overall outcome of the patients. Urinary catheters (all cases) were the most prevalent invasive device followed closely by Ryle’s tube (90%) and endotracheal tube (60%). Conclusions: Intensive care units (ICUs) comprise of less than 10% of the total hospital beds but contribute >20% of all the nosocomial infections acquired in the hospital. World Health Organization (WHO) estimates the burden of nosocomial infections in hospitalized patients to be 7–12% globally, in contrast to the figures from India being alarmingly high varying from 11–83%.

Interventional knowledge, attitude and practice study of standard precautions among health care workers at a tertiary care hospital in Western India

Standard precautions are the backbone of any efficient infection control program. Compliance with standard precautions has been a major challenge for health care workers, especially in developing countries. To access the impact of the training program on health care workers (HCW) knowledge, attitude, and practice towards standard precautions. We conducted an interventional Knowledge, Attitude, and Practice (KAP) study among 150 HCW (50 Doctors, 50 Nurses, and 50 Technicians) in a tertiary care hospital from June 2019 to December 2019. We carried out educational interventions through training sessions with pre- and post-test questionnaires. We compared pre and post questionnaire mean scores to access the impact of short educational videos and seminars on HCWs using unpaired t-tests.HCWs have poor KAP on important aspects of standard precautions. Pre-intervention KAP mean scores were highest among doctors, followed by lab technicians and nurses. After training intervention, improvement in knowledge, attitude, and practice among all 3 types of HCWs were statistically significant (P-value <0.005, unpaired t-test). Low pre-intervention knowledge and attitude practice scores regarding standard precautions among doctors, nurses, and lab technicians were improved after training significantly. Hence, we recommend training programs regarding standard precautions should be regularly conducted in health-care facilities to promote good infection control practices and mitigate the risk of hospital-acquired infection. This has future implications in terms of reduced morbidity and mortality in resource limited settings.

Prevalence and molecular characteristics of polymyxin-resistant Enterobacterales in a Chinese tertiary teaching hospital.

Polymyxin-resistant Enterobacterales poses a significant threat to public health globally, but its prevalence and genomic diversity within a sole hospital is less well known. In this study, the prevalence of polymyxin-resistant Enterobacterales in a Chinese teaching hospital was investigated with deciphering of their genetic determinants of drug resistance. Polymyxin-resistant Enterobacterales isolates identified by matrix-assisted laser desorption were collected in Ruijin Hospital from May to December in 2021. Both the VITEK 2 Compact and broth dilution methods were used to determine polymyxin B (PMB) susceptibility. Polymyxin-resistant isolates were further characterized by molecular typing using PCR, multi-locus sequence typing, and sequencing of the whole genome. Of the 1,216 isolates collected, 32 (2.6%) across 12 wards were polymyxin-resistant (minimum inhibitory concentration (MIC) range, PMB 4-256 mg/ml, and colistin 4 ≥ 16 mg/ ml). A total of 28 (87.5%) of the polymyxin-resistant isolates had reduced susceptibility to imipenem and meropenem (MIC ≥ 16 mg/ml). Of the 32 patients, 15 patients received PMB treatment and 20 survived before discharge. The phylogenetic tree of these isolates showed they belonged to different clones and had multiple origins. The polymyxin-resistant Klebsiella pneumoniae isolates belonged to ST-11 (85.72%), ST-15 (10.71%), and ST-65 (3.57%), and the polymyxin-resistant Escherichia coli belonged to four different sequence types, namely, ST-69 (25.00%), ST-38 (25.00%), ST-648 (25.00%), and ST-1193 (25.00%). In addition, six mgrB specific mutations (snp_ALT c.323T>C and amino acid change p.Val8Ala) were identified in 15.6% (5/32) of the isolates. mcr-1, a plasmid-mediated polymyxin-resistant gene, was found in three isolates, and non-synonymous mutations including T157P, A246T, G53V, and I44L were also observed. In our study, a low prevalence of polymyxin-resistant Enterobacterales was observed, but these isolates were also identified as multidrug resistant. Therefore, efficient infection control measures should be implemented to prevent the further spread of resistance to last-line polymyxin therapy.

The Many Mutations of the COVID-19 Variant: Current Perspectives on EG.5/Eris

Viral diseases pose a significant threat to public health around the world. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was originally identified in Wuhan, China, in 2019. Throughout the epidemic, SARS-CoV-2 has continually changed genetically, giving rise to variants that are distinct from the original virus. SARS-CoV-2 has a high-frequency mutation rate, resulting in more genetic diversity. EG.5/Eris is a subvariant and descendant of Omicron, which remains the world’s most prevalent coronavirus strain of current concern. The percentage of EG.5 recorded has steadily increased across the board. Epidemiological week 29 (17-23 July 2023) saw a 17.4% global prevalence of EG.5. Mutations in the virus’s genome can cause false-negative results in molecular detection and cause increased transmissibility, morbidity, and mortality due to a reduction in vaccine efficiency. Furthermore, these changes in S-protein structure alter the neutralising ability of neutralising antibodies (Nabs), resulting in a reduction in vaccine efficiency. Therefore, all countries should take efficient infection prevention and control measures as per the guidelines of the world, continental, and their country’s health organisations, along with vaccine and treatment investigations.

Healthcare-associated infections in patients who are immunosuppressed due to chemotherapy treatment: a narrative review.

Chemotherapy is one of the best methods to cure oncologic patients. However, it leads to adverse effects that contribute to the establishment of infections. Up-to-date knowledge is needed to offer the best care to patients. This is a narrative review based on searching articles in five databases (PubMed, LILACS, Research Gate, Google Scholar, and SciELO) using "cancer treatments", "chemotherapy", "febrile neutropenia", "cancer opportunistic infections", "chemotherapy AND febrile neutropenia", "cancer AND hospital infections", and "immunosuppression AND cancer patients" as keywords. No filter was applied, however, articles published in the last five years were preferentially selected to compose this article. Almost all microorganisms can cause infection in cancer patients, including colonizing and normal microbiota. However, Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp., Staphylococcus spp., and Streptococcus spp. are the most reported agents. Viruses may be underrepresented because molecular techniques are needed to identify them. Bloodstream and associated infections are among the highest occurrences because of the devices that are constantly introduced. Antibiotic administration selects for resistant microorganisms, which leads to delay or even failure in the treatment. Protocols for efficient infection prevention and control measures must involve staff from the kitchen, janitors, nurses, and physicians, in addition to patients and relatives. Bloodstream infections caused by the bacteria and which have the most resistance to several antimicrobials are the main concern for oncologic patients. Preventive and educative actions must be taken by a multidisciplinary team in order to achieve the best care for the vulnerable patients.

Outbreaks of Human Metapneumovirus in Western Sydney Aged-Care Facilities in 2018.

Human metapneumovirus (hMPV), first described in 2001, is a cause of acute respiratory tract infection in the elderly, with symptoms ranging from mild to severe, including pneumonia, but outbreaks are rarely described. Between 1 July and 31 December 2018, there were three outbreaks of Influenza-like Illness (ILI) where hMPV was the primary pathogen observed, among 64 aged-care facilities (ACFs) in Western Sydney. These outbreaks were investigated by the Western Sydney Local Health District (WSLHD) Public Health Unit (PHU); multiplex polymerase chain reaction (PCR) testing was performed on nasopharyngeal swabs collected by the ACF. hMPV was the main causative pathogen in three outbreaks (27, 28, and 15 symptomatic cases, respectively) in late winter and early spring. Fifty-five residents and 15 staff cases (70 total cases) were identified; hMPV was detected in 12 of 63 specimens submitted. Of the cases in residents, eight were hospitalised (8/63; 15%), including five with confirmed hMPV and a further one epidemiologically linked to a positive case. Six residents died (6/63; 11%) during the hMPV outbreaks; four of these had laboratory-confirmed hMPV, with a further case epidemiologically linked to a hMPV case, with a primary diagnosis of pneumonia/viral pneumonia. The sixth death was not epidemiologically linked, nor did this case exhibit any respiratory symptoms during the outbreak; however, it was reported in line with public health guidelines. A major challenge in 2018 was the incompleteness of testing for, and awareness of, hMPV as a viral cause of ILI by facilities, laboratories, and emergency departments, which generally opted for rapid testing for influenza and RSV only. There is no licensed vaccine or approved treatment for hMPV, so efficient infection control measures are most important.

What is the Fee for Infection Prevention and Control? Current Status and Prospect

Infection control is an essential factor for improving the quality of acute and long-term care facilities, including patient safety. Infection control should be implemented in all medical facility sectors, and participation of all healthcare workers is required. For efficient infection control, securing and maintaining professionals with sufficient experience and training to establish and implement infection control plans focusing the infection control unit is imperative. Moreover, there should be no shortage of infection control supplies, including consumables and disposables necessary for hand hygiene, personal protective equipment, and isolation. The fee for infection prevention and control should be resourced as necessary funding to establish such infection control infrastructure. Moreover, re-evaluating whether the standard for the fee for infection prevention and control is appropriate, improving the current payment mode, and monitoring whether the fee used is executed as infection control costs are necessary.

Efficient and Privacy-Preserving Infection Control System for Covid-19-Like Pandemics Using Blockchain

Contact tracing is a very effective way to control the COVID-19-like pandemics. It aims to identify individuals who closely contacted an infected person during the incubation period of the virus and notify them to quarantine. However, the existing systems suffer from privacy, security, and efficiency issues. To address these limitations, in this article, we propose an efficient and privacy-preserving Blockchain-based infection control system. Instead of depending on a single authority to run the system, a group of health authorities, that form a consortium Blockchain, run our system. Using Blockchain technology not only secures our system against single point of failure and denial of service attacks, but also brings transparency because all transactions can be validated by different parties. Although contact tracing is important, it is not enough to effectively control an infection. Thus, unlike most of the existing systems that focus only on contact tracing, our system consists of three integrated subsystems, including contact tracing, public places access control, and safe-places recommendation. The access control subsystem prevents infected people from visiting public places to prevent spreading the virus, and the recommendation subsystem categorizes zones based on the infection level so that people can avoid visiting contaminated zones. Our analysis demonstrates that our system is secure and preserves the privacy of the users against identification, social graph disclosure, and tracking attacks, while thwarting false reporting (or panic) attacks. Moreover, our extensive performance evaluations demonstrate the scalability of our system (which is desirable in pandemics) due to its low communication, computation, and storage overheads.

Prevalence of intestinal parasites, Salmonella and Shigella species among food handlers working in a tertiary care hospital of South India

Background: Infected food handlers act as potential sources of food borne illnesses. Consequences of such outbreaks in healthcare settings are more severe affecting their vulnerable sick patients. We aimed to determine the prevalence of intestinal parasites, Salmonella and Shigella species, and associated risk factors in our hospital food handlers in this cross-sectional study. Materials and Methods: Data on sociodemographic details, past medical illness, hygiene awareness practices, occupational prophylaxis undertaken were collected from 110 food handlers in hospital kitchen area. Their stool samples were collected for microbiological analyses of common intestinal parasites using saline and Lugol’s iodine wet mount preparations. Stool samples were inoculated onto Selenite F broth and subcultured onto Nutrient agar, MacConkey’s agar, Salmonella Shigella agar for isolation of Salmonella, Shigella species. Chi-square test and Odds ratio were used to determine risk factors in infected food handlers. Results: Only 4 (3.6%) food handlers were positive for intestinal parasites of Entamoeba histolytica (1.8%), Ascaris lumbricoides (0.9%) and Giardia lamblia (0.9%). None had Salmonella or Shigella species isolated from stool culture. All infected food handlers were aged over 50 years. Noncompliance to hand hygiene standards and illiteracy rates raised above 50 years. Conclusion: The negligible prevalence of intestinal parasites, Salmonella and Shigella species in food handlers testify our efficient hospital infection control program. Age over 50 years, uneducated and incompetent in hand hygiene practices were predominant risk factors for IPI. Scrupulous occupational health screening and trainings targeting high risk food handlers above 50 years of age, could prevent enteric pathogen spread in healthcare settings.