Infection Control Guidelines Research Articles

Efficacy of Health Surveillance and Polymerase Chain Reaction Testing in Judo During the COVID-19 Pandemic.

Background The COVID-19 pandemic necessitated infection control for all sporting activities. More careful infection control measures are required in judo, where close contact with opponents cannot be avoided. The Medical Science Committee of the All Japan Judo Federation (AJJF) established infection control guidelines for daily practice and competitions. Infection control measures were also implemented at the national tournament organized by the AJJF. Objective and methods This study aimed to examine the effectiveness of pre-tournament health surveys and PCR testing in guidelines for judo tournaments. Participants had to complete a health survey one to two weeks before the tournament. Initially, PCR testing was performed on all athletes; however, the final policy was to conduct PCR testing only on athletes with an infected person (risk team testing method). The effectiveness of these methods was also examined. Results In 16 competitions between October 2020 and March 2023, 6980 contestants were registered, and PCR testing was performed on 3672 athletes; 29 (0.79%) had a positive PCR test. Only two contestants were unable to attend the tournament because of the health survey. No competition-related cluster outbreaks were observed. From May 2022, the competition was held under the guideline that only teams at risk of infection were tested and could only compete when they tested negative. No teams were tested according to this guideline. In the competitions organized within this guideline, only one person could not compete because of the information provided in the health survey. No clusters were observed in any of the competitions. The incidence of COVID-19 infection in the first week after the convention was 20 (0.60%) in testing only at-risk teams and 21 (0.57%) in testing all competitors, which was not significantly different.(p=0.62) Conclusion During the COVID-19 epidemic, health surveillance was necessary to prevent the registration of competitors at risk of infection prior to tournaments. If teams at risk of infection could be identified, PCR testing of all athletes might not be mandatory, and competitions could be organized safely. The Judoinfectious disease control guidelines we have developed might be used for other contact sports in the future when other infectious diseases are prevalent.

A seesaw of equilibrium, midwives' experiences of infection prevention and control guideline adherence: A qualitative descriptive study.

Infection prevention and control guidelines play a key role in preventing infections which can impact mothers and their newborn's quality of life. Despite the presence of evidenced-based infection prevention and control guidelines, midwives' adherence can be suboptimal internationally. The identification of facilitators and barriers to infection prevention and control guidelines can support practice and facilitate midwifery care. To understand midwives' experiences of the barriers and facilitators when adhering to infection prevention and control guidelines. A qualitative descriptive study using semi-structured interviews with 10 midwives from February to March 2022. The interviews were audio recorded, transcribed verbatim, and analysed utilising Braun and Clarke's thematic analysis framework involving the six steps of becoming familiar with the data, generating initial codes, generating themes, reviewing themes, defining and naming the themes, and presenting themes. Two themes developed; seesaw for equilibrium and back to basics: learning on your feet. Midwives experienced conflicting emotional motivators in the need for professional integrity towards infection prevention and control guideline adherence. The work environment impacts on midwives' ability to adhere to guidelines and communication and education have a vital role to play in infection prevention and control guideline adherence. While midwives have a strong sense of protection of professional integrity, work conditions such as environment, organisational structures, and management systems affect midwives' adherence to infection prevention and control guidelines. Effective education, training, and communication are required to promote infection prevention and control guideline adherence.

How effective are monthly departmental tracer surveys? A 5-year retrospective study of 138 surveys in 96 departments

Repeat department-wide surveys are commonly employed for infection control. There remains debate concerning their cost-effectivess. The aim of the study was to measure the impact of repeat department-wide surveys in major in-patient departments (IPDs) and ambulatory facilities (AFs) in a tertiary care hospital. This was a retrospective study of 138 surveys condcuted in 96 departments over a 5-year period. Two itemized questionnaires were designed to assess the most frequently inadequately adhered to infection control measures: one for IPD (with 21 items) and the other for AF (with 17 items). A total of 72 surveys were conducted in 49 IPDs, of which 39 (54%) were repeat surveys, and 66 surveys in 47 AFs, of which 33 (50%) were repeat surveys. The baseline rate of adherence/department was 71%±14 for the IPD, with an increase from the first to the last survey to 82%±13 (P=.037). In 15/21 measured infection control items, adherence improved. Adherence to infection control items was lower at baseline in the AFs than in the IPDs (63±27), with an increase to 76±20 (non significant). Although adherence improved for 9 items, it deteriorated in another 8, producing an overall statistically unchanged outcome. Repeat whole-department surveys contribute moderately to increased adherence to infection control guidelines. AFs demonstrate lower rates of adherence to infection control guidelines and are less receptive to educational measures.

Assessment of Microbial Contamination of Dental Prostheses

Objective: Various dental prostheses, such as crowns and dentures, are crafted in dental laboratories and then applied within the patient's mouth in dental institutions. However, dental workers rarely disinfect them before application. Therefore, we investigated the bacterial contamination of various intraoral prostheses to confirm the importance of infection control. Methods: Bacterial samples were collected from 23 dental prostheses (including six gold crowns, seven zirconia crowns, four porcelain-fused-to-metal crowns, and six dentures) in dental laboratories and dental institutions in Gyeongsangbuk-do, Korea. These samples were inoculated onto 3M Petrifilm for general aerobic bacteria and Staphylococcus aureus, respectively. The colonies that formed after 48 hours of culture were counted. Results: General aerobic bacteria and S. aureus were detected on the majority of dental prostheses, with dentures showing the highest presence (p=0.003). Neither aerobic bacteria nor S. aureus showed statistically significant differences between dental institutions and laboratories. A positive correlation was noted between the denture and the denture in terms of general aerobic bacteria and S. aureus detection (r=0.829, p<0.05). Conclusion: As a result, many bacteria were detected in most dental prostheses. Therefore, there is a need to recognize the risk of crossinfection through dental prosthesis and to establish specific infection control guidelines.

Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria

Hospital surfaces can harbour bacterial pathogens, which may disseminate and cause nosocomial infections, contributing towards mortality in low- and middle-income countries (LMICs). During the BARNARDS study, hospital surfaces from neonatal wards were sampled to assess the degree of environmental surface and patient care equipment colonisation by Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs). Here, we perform PCR screening for extended-spectrum β-lactamases (blaCTX-M-15) and carbapenemases (blaNDM, blaOXA-48-like and blaKPC), MALDI-TOF MS identification of GNB carrying ARGs, and further analysis by whole genome sequencing of bacterial isolates. We determine presence of consistently dominant clones and their relatedness to strains causing neonatal sepsis. Higher prevalence of carbapenemases is observed in Pakistan, Bangladesh, and Ethiopia, compared to other countries, and are mostly found in surfaces near the sink drain. Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens and Leclercia adecarboxylata are dominant; ST15 K. pneumoniae is identified from the same ward on multiple occasions suggesting clonal persistence within the same environment, and is found to be identical to isolates causing neonatal sepsis in Pakistan over similar time periods. Our data suggests persistence of dominant clones across multiple time points, highlighting the need for assessment of Infection Prevention and Control guidelines.

Knowledge, Attitude and Practice of Infection Control Among Dental Students at College of Dentistry - Hawler Medical University.

Background: Infections acquired in healthcare facilities have become an increasingly challenging issue worldwide. The prevention of infectious diseases is a critical issue since healthcare workers develop acquired infections while providing services to patients. However, infection prevention and control are challenging, especially in healthcare facilities. Objective: To assess knowledge, attitude, and practice of cross-infection control among dental students at the College of Dentistry, Hawler Medical University. Material and Method: A survey was conducted to obtain information regarding knowledge, attitude, and practice with recommended infection control guidelines. The questionnaire contained three parts (knowledge, attitude, and practice) and was distributed to the participants. Result: Total number of participants was 135, (73) were 5th-year dental students, and (62) 4th year, the mean age of participants was (20-23) years, 96 % had correct knowledge about infection control, 93 % had a correct practice, but unfortunately 48 % had low attitude. Conclusions: The majority of dental students had good knowledge and correct practice, but less about their attitude in infection control. Therefore, regular training that contains educational programs should be supported to maintain the highest level of attitude. Keywords: Infection control, Cross infection, Dental students, Practice, Knowledge, Attitude.

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum.

Antibiotic resistance (ABR) is a major public health issue, associated with increased patient morbidity and mortality globally, with significantly higher rates in low- and middle-income countries (LMICs). Assessment of contextual factors, such as information, education, infrastructure and regulations are important for developing local solutions against ABR. To determine the knowledge and practices of healthcare workers (HCWs) towards ABR in hospitals in Sudan. A survey was conducted in three different hospitals in Khartoum, Sudan from February to December 2020. HCWs of different specialties and expertise were invited to participate. Data were descriptively analysed using Statistical Package for Social Sciences (SPSS). ABR was identified as a big challenge by 89% of 345 HCWs who participated. The results show that 79% of doctors don't rely on the clinical microbiology laboratory (CML) results for antibiotic prescription or clinical decision-making. Sixty percent of HCWs agreed there are infection prevention and control (IPC) guidelines in their hospital, but 74% of them don't have access to them, and infrequently receive relevant IPC training. Furthermore, HCWs obtain ABR information from other colleagues informally, not through local data or reports. Despite adequate knowledge of ABR locally, there are significant contextual technical challenges facing HCWs in Sudan, such as availability of policies and accurate data from CMLs. The results indicate a poor link between HCWs and the CMLs for infection management and it is essential to improve communication between the different hospital departments with regard to ABR transmission, and ensure the effectiveness of local IPC policies based on locally available data.

Availability of basic infection control items and personal protection equipment in 7948 health facilities in eight low- and middle-income countries: Evidence from national health system surveys.

Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items. In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room). We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them. All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.

Surgical team member's application of personal protective equipment: an observational study.

Personal protective equipment (PPE) is a term used to refer to clothing or equipment that creates a barrier to protect an individual from work-place hazards, thereby protecting the worker against work-related injuries and illnesses. This study was aimed at determining the compliance of application of personal protective equipment against the standards. One hundred surgical personnel were included in this study from 21 March 2023 to 23 April 2023. Data were collected through direct observation. The standards were directly changed into question forms with two integral checking components, "Yes", and "No". Data were entered and analyzed by statistical package of social sciences (SPSS) version 25. A total of 100 surgical personnel involved in surgical procedures were assessed for how they applied PPE. Majority of healthcare workers, 61.2%, were compliant with the communicable disease control standard on the application of PPE. The highest compliance rate was observed for the put-on gloves over the gown, while the lowest compliance rate was observed for wearing eye protection. The practice of PPE usage by surgical personnel was suboptimal. Healthcare facilities can better protect their staff and patients from the spread of infections and other hazards through PPE use protocols. Donning and doffing must always be methodical and supervised by another staff member, especially during surgical emergencies. PPE should be used in accordance with infection prevention and control guidelines and the level of risk involved in the specific procedure.

Antibiotic-Resistant Bacteria in Intensive Care Units in the Kingdom of Saudi Arabia: A Systematic Review

Background: The emergence of bacterial pathogens and their associated resistance to antibiotic therapy is one of the most serious public health concerns threatening today’s society, including Saudi Arabia’s intensive care units (ICUs). Aim: This study used a systematic review to explore the antibiotic-resistant bacteria in the intensive care units (ICUs) in Saudi Arabia. Methods: The review adhered to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 guidelines. The search was limited to studies published within 13 years between 2010 and 2023 through CINAHL, Web of Knowledge, PubMed, Science Direct, and Google Scholar. Results: Fifteen studies were reviewed: 12 were retrospective, 1 was comparative historical, 1 was descriptive epidemiologic and 1 was a surveillance study. Most frequently isolated antibiotic-resistant bacteria were Klebsiella pneumonia, Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Enterobacter. These pathogens were found resistant to various antibiotics including methicillin, tazobactam, cilastatin, meropenem, tigecycline, imipenem, meropenem, piperacillin, colistin, penicillin, ampicillin, oxacillin, vancomycin, carbapenems, amoxicillin, ceftriaxone, amikacin, gentamicin, clindamycin, azithromycin, levofloxacin, nitrofurantoin, trimethoprim, cefuroxime, ciprofloxacin, aztreonam, and cefotaxime. Conclusion: To eradicate future infection outbreaks of K. pneumonia, P. aeruginosa, A. baumannii, and other antibiotic-resistant pathogens in Saudi Arabia’s ICUs, comprehensive surveillance programs, strict infection control and prevention guidelines, and stringent implementation of proactive antimicrobial stewardship program are warranted. Keywords: antibiotic; antibiotic-resistant bacteria; intensive care unit; Saudi Arabia

CDC's Proposed Infection Control Guidelines Cause Concern for Health Care Workers

CDC's Proposed Infection Control Guidelines Cause Concern for Health Care Workers

Staffs' experiences and strategies to maintain care for individuals with intellectual disabilities living in supported living facilities during the Covid‐19 pandemic

AbstractBackgroundWe explored the experiences of staff working in Norwegian community‐based living facilities, caring for people with intellectual disabilities during the Covid‐19 pandemic, and what self‐regulatory strategies staff used to maintain health and care service delivery and contribute to organisational resilience.MethodsA qualitative design was utilized. Data were collected from September 2021 to April 2022 with individual and focus group interviews. In this study, 25 staff members participated. Thematic analysis was conducted.FindingsFive main themes were identified regarding the experiences of staff during the pandemic: Lockdown of facilities, social isolation of residents, lack of health follow‐up, high sick leave rates and communication challenges. Only some of the strategies to mitigate pandemic‐related challenges were based on current Norwegian infection control guidelines. Some strategies were successful while others were not and some were negligent and challenged the delivery of health and care services for the residents.ConclusionsOur study shows that people with intellectual disabilities living in the community‐based living facilities were subjected to human rights violations and violations of the Norwegian infection control law. This was caused by a lack of several important organisational qualities in the facilities.

Advanced theoretical-applied model based on the PD approach in the light of healthcare-associated infections: what have we achieved so far?

Healthcare-associated infections remain a persistent concern despite decades of research and intervention efforts. Adherence to infection prevention and control guidelines by health professionals remains a challenge, necessitating innovative strategies. The Positive Deviance (PD) approach, rooted in harnessing localized solutions, holds promise but lacks comprehensive frameworks and empirical validation to bolster its theoretical underpinnings. This perspective article serves a dual purpose: first, to examine the unique challenges of applying the PD approach in the context of HAIs; and second, to introduce a robust theoretical-applied model developed in response to these challenges. This article addresses these gaps through a multi-faceted model developed in a mixed-methods study across three Israeli governmental hospitals and comprises four essential components that address the identified gaps in existing research. This article enriches the dialog on PD's applicability in HAIs by providing a robust model that not only offers solutions but reshapes the approach to healthcare hygiene and safety. It responds to critical gaps highlighted in the literature, offering tailored interventions by practical, context-specific solutions to improve adherence to IPC guidelines in the long term. Methodological clarity is also a key focus, offering a toolkit for practical implementation. This bottom-up approach empowers HPs to drive change, fostering a culture of innovation and improvement in healthcare settings.

The Making of a Health Profession: How Chinese Medicine Became a Nationally Registered Allied Health Profession in Australia

Abstract In 2012, traditional Chinese medicine (TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd. (AACMA), also developed a framework of professional self-regulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.

Knowledge, attitudes, and practices toward infection control precautions among nurses in Palestinian hospitals.

Healthcare-associated infections (HAIs) are common complications in healthcare services, often caused by unsystematic antibiotic use. Despite advancements in medical care and technologies, the burden of HAIs continues to increase globally. Thus, this study purposed to evaluate the levels of knowledge, attitudes, and practices toward infection control precautions among nurses in Palestinian hospitals and identify the predictors of practices of infection control precautions. A cross‑sectional study was conducted on 285 nurses who work at Palestinian hospitals in the West Bank. A self-reported questionnaire was used to collect data during the period from November 2022 to January 2023. The results revealed that 95.8 % of the participants endorsed good knowledge levels, 83.5 % reported positive attitude levels, and 91.2 % endorsed good practice levels toward infection control precautions. Also, gender as being female, attending a training program on infection control, and having good knowledge of infection control precautions were the main factors influencing practices of infection control precautions. It is necessary tomaintain nurses' knowledge, attitudes, and practices toward infection control precautions by continuously conducting training workshops about infection control updating knowledge, and enhancing the work environment by implementing infection control policies and guidelines and providing sufficient resources and equipment to ensure safe practices.

Knowledge, Attitude and Practice towards Prevention of Tuberculosis amongst Healthcare Workers in Dr. Lawrence Henshaw’s Memorial Hospital, Calabar, Cross River State

Despite the availability of tuberculosis (TB) infection control guidelines, research evidence suggests that its implementation seems to be inadequate in many settings including healthcare facilities. This is particularly due to inadequate knowledge and inappropriate attitude of healthcare workers towards TB prevention and control. This study was conducted as an attempt to investigate knowledge, attitude and practice towards prevention of TB among healthcare workers in Dr. Lawrence Henshaw’s Memorial Hospital, Calabar, Cross River State. Three (3) research questions were raised and two (2) hypotheses formulated to direct the course of this study. A descriptive cross-sectional survey was used to study a total of 87 healthcare workers selected from the Healthcare Facility using stratified random sampling technique. The instrument for data collection was validated and reliable questionnaire constructed in consonance with the objectives of the study. Data collected were described using frequency counts, simple percentage, mean, and standard deviation, while the study hypotheses were tested using Pearson Product Moment Correlation Coefficient significant at p<0.05. Results of the study revealed that majority of the respondents had adequate knowledge, positive attitude, and fairly good practice towards prevention of TB infection. There is a statistically significant and positive relationship between knowledge of TB, attitude towards prevention of TB; and practice towards prevention of TB among healthcare workers in Dr. Lawrence Henshaw’s Memorial Hospital, Calabar (p<0.05). It was therefore recommended that healthcare workers should be trained and re-trained through prompt participation in seminars, workshops, and conferences on TB infection prevention and control as an avenue to improve their knowledge and promote practice towards prevention and control of TB in the Hospital.

Critical Evaluation of Global Infection Prevention and Control Guidelines for Dentistry Published during the First 2 Years of the COVID-19 Pandemic.

The outbreak of the coronavirus disease (COVID-19) encouraged immediate actions by governments and healthcare associations across the world to flatten the curve and prevent health systems from being overburdened. As dentistry comprises aerosol-generating procedures (AGPs), which could increase the risk of infection, various guidelines were issued for dental services which focused on infection prevention and control (IPC) measures for COVID-19. This systematic review focuses on dental IPC guidelines, with the aim of comparing these guidelines against a gold standard. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist was employed. Predefined inclusion and exclusion criteria were constructed. Information sources comprised Google Scholar, PubMed, and a manual search from December 2019 to December 2021. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used. Consensus scoring was applied for all guidelines. A total 61 guidelines were included in the review. The UK national guideline was used as a gold standard as it ranked the highest AGREE score (75 out of 84) and thus was established for comparison with each of the included guidelines. Overall, 40% of the included guidelines had a high consensus score in relation to the UK national guideline. This systematic review highlighted the variability in content and quality of advice given by different organizations in response to the COVID-19 pandemic in their efforts to reduce SARS-CoV-2 transmission in dentistry. Establishing a single worldwide fast-acting dental organization would ensure that high-quality standardized guidance is available, to enhance health equality and worldwide dental clinical standards.

LEVERAGING PROJECT ECHO FOR EVIDENCE-BASED INFECTION CONTROL IN NURSING HOMES: A RANDOMIZED CONTROLLED TRIAL

Abstract Nursing homes were ill-equipped for the pandemic; though facilities are required to have infection control staff, only 3% have taken a basic infection control course. Significant research has focused on infection control in the acute care setting; however, little is known about the implementation of practices and effective interventions. We proposed an intervention utilizing Project ECHO to connect Penn State University experts with remote nursing home staff and administrators to support evidence-based infection control guideline implementation. This study sought to answer the critical research question of how evidence-based infection control guidelines can be implemented effectively in nursing homes. A stratified cluster randomized design was used to randomize nursing homes from the Northeast and Midwest to either: 1) AHRQ-funded COVID-19 ECHO that included 16 weekly tele-mentoring sessions addressing COVID-19 guidelines and best practices plus 9 optional, weekly 60-minute office hour sessions, or 2) AHRQ-funded COVID-19 ECHO+, which included 16 weekly tele-mentoring sessions addressing COVID-19 guidelines and best practices, plus 17 weekly 60-minute sessions with a focus on stakeholder-identified needs and CDC infection control training. A total of 136 nursing homes were recruited. There were no statistically significant differences in COVID-19 infection rate, hospitalization, deaths, or flu-like illness. A multipronged approach to improving infection control and emergency preparedness in nursing homes is important. The ECHO model has significant strengths when compared to traditional training, as it allows for remote learning delivered by a multidisciplinary team of experts and utilizes case discussions that match the context and capacity of nursing homes.

Prospective healthcare-associated links in transmission of nontuberculous mycobacteria among people with cystic fibrosis (pHALT NTM) study: Rationale and study design.

Healthcare-associated acquisition and transmission of nontuberculous mycobacteria (NTM) among people with cystic fibrosis (pwCF) has been described, and remains a concern for both patients and providers. This report describes the design of a prospective observational study utilizing the standardized epidemiologic investigation toolkit for healthcare-associated links in transmission of NTM among pwCF. This is a parallel multi-site study of pwCF who have infections with respiratory NTM isolates and receive healthcare within a common CF Care Center. Participants have a history of one or more NTM positive airway cultures and have been identified as having NTM infections suggestive of a possible outbreak within a single Center, based on NTM isolate genomic analysis. Participants are enrolled in the study over a 3-year period. Primary endpoints are identification of shared healthcare-associated source(s) among pwCF in a Center, identification of healthcare environmental dust and water biofilm NTM isolates that are genetically highly-related to respiratory isolates, and identification of common home of residence watersheds among pwCF infected with clustered isolates. Secondary endpoints include characterization of healthcare-associated transmission and/or acquisition modes and settings as well as description of incidence and prevalence of healthcare-associated environmental NTM species/subspecies by geographical region. We hypothesize that genetically highly-related isolates of NTM among pwCF cared for at the same Center may arise from healthcare sources including patient-to-patient transmission and/or acquisition from health-care environmental dust and/or water biofilms. This study design utilizes a published, standardized, evidence-based epidemiologic toolkit to facilitate confidential, independent healthcare-associated NTM outbreak investigations within CF Care Centers. This study will facilitate real-time, rapid detection and mitigation of healthcare-associated NTM outbreaks to reduce NTM risk, inform infection prevention and control guidelines, and characterize the prevalence and origin of NTM outbreaks from healthcare-associated patient-to-patient transmission and/or environmental acquisition. This study will systematically characterize human disease causing NTM isolates from serial collection of healthcare environmental dust and water biofilms and define the most common healthcare environmental sources harboring NTM biofilms. ClinicalTrials.gov NCT05686837.

Factors Impacting Compliance with Infection Control Guidelines among healthcare providers in Neonatal Intensive Care Unit, referral hospital, Saudi Arabia

Healthcare-associated infections continue to be a major problem that endangers patient safety, especially for critically ill hospitalized patients. Reducing the risk of this infection can be achieved through improving compliance with infection control guidelines and identifying and controlling the associated factors. This study aim to investigate factors impacting compliance with infection control guidelines and increasing the risk of healthcare-associated infections in neonatal intensive care units. A qualitative approach, a one-to-one interview design, was used, between April 15 and May 15, 2021, to interview ten participants who worked in the neonatal intensive care unit at a Saudi Arabian referral hospital. Through data analysis, two major themes and four sub-themes were found, which include a factor related to the workforce (shortage of staff and lack of knowledge) and factors related to the workplace (shortage of supplies and lack of monitoring). In conclusion, healthcare-associated infections in neonatal intensive care units are a serious issue that could lead to an increase in mortality and morbidity rates among patients. Thus, healthcare settings' commitment to improve compliance with the infection control guidelines is essential to lowering the incidence of healthcare-associated infections. This can be achieved through proper staffing, sufficient supplies, and effective monitoring.