Hand Hygiene Research Articles

Specialty-specific hand hygiene compliance: 5-year study from a large public sector teaching hospital, South India

: Hand hygiene (HH) is essential for preventing healthcare-associated infections (HAIs), especially in ICUs and cancer care centers. These settings often involve immunocompromised patients and invasive devices, making HH critical for patient safety. Despite its recognized importance, consistent adherence to HH practices by healthcare workers (HCWs) remains a significant challenge. This study aimed to evaluate HH compliance in a tertiary care hospital in South India using a customized Android application aligned with WHO guidelines. : This observational study was conducted across high-risk areas of a tertiary care hospital from June 2019 to May 2024. The hospital's high-risk units, under medical, surgical, and pediatric alliances, were included. An Android application based on the Ibhar platform and WHO hand hygiene audit guidelines was used for data collection. The study recorded HH opportunities, Complete HH Adherence (HHCAR), Partial HH Adherence (HHPAR), and Total HH Adherence (HHTAR). The data were analyzed for location-specific, profession-specific, and moment-specific compliance rates. : A total of 196,252 HH opportunities were recorded, with the surgical alliance accounting for the highest number. Pediatric units had the highest compliance, with an HHTAR of 89% and an HHCAR of 66%. Nurses demonstrated the highest compliance among professions, with an HHTAR of 82.8%. Compliance was higher after patient care moments compared to before. Statistically significant differences were noted across different specialties and moments. : This large-scale study highlights the variation in HH compliance across different specialties and the need for targeted training sessions. Given the resource constraints in many tertiary care centers, focusing audits on high-risk areas is practical. The use of software-based applications like Ibhar enhances data collection and analysis, making the audit process more efficient. Regular HH audits and behavioral changes are essential to improve and sustain high standards of HH compliance, ultimately contributing to better infection control practices.

Surge of healthcare associated infections in COVID intensive care units

: Healthcare-associated infection played a vital role in determining the patient’s outcome during the COVID pandemic. However, the data on HAI rates is largely unavailable in COVID locations. This is because conducting HAI surveillance inside COVID ICUs is a big challenge. Therefore, we conducted this unique quality improvement study which aims at comparing the trends of HAI rates in COVID and non-COVID ICUs during the ongoing pandemic.: The aim of the study was to compare the HAI rates in COVID and non COVID ICUs with the baseline HAI rates in pre COVID era.: The HAI surveillance was carried out during April 2020-December 2020 in the COVID ICUs (test group) and non-COVID ICUs (control group) and compared with ICUs from January 2019 to March 2020 (pre COVID baseline group). Then HAI data was analysed and the HAI rates were calculated based on national healthcare safety network guidelines. Overall, the HAI rates were higher in COVID time in comparison to pre COVID time. During the COVID period, higher HAI rates were seen in the COVID ICUs than in the non COVID ICUs. CLABSI rate had the highest occurrence followed by VAE, CAUTI, and SSI.: Higher HAI rates in COVID time indicates that there is need of serious infection control intervention thereby reducing the HAIs associated in COVID patients. Strict compliance to hand hygiene and other transmission-based precautions are to be followed in order to enhance the overall safety of patients.

Assessment of bacteriological contamination in coin currency in circulation

: The primary aim of this study was to identify the bacterial contaminants present on Indian currency coins, characterize the different types of bacteria isolated, and assess the antimicrobial resistance patterns of the bacteria within the Nagpur region of Maharashtra, India. Determining the isolation and identification of the various pathogens on coin surfaces is essential for addressing the potential spread of diseases through handling currency.: This cross-sectional study was conducted in the Department of Microbiology at Indira Gandhi Government Medical College & Hospital, Nagpur, spanning from 2015 to 2024. We collected 120 currency coin samples aseptically from individuals across various occupational groups. The culture and antimicrobial susceptibility patterns were analyzed following standard operating procedures.: A total of 50.83% of the coins exhibited bacterial contamination, with . identified as the most frequently isolated organism at 13.33%. The highest levels of contamination were found in lower-value coins. Notably, there was a significant decrease in coin contamination during and after the COVID-19 pandemic, likely due to a rise in online monetary transactions. The isolated bacteria demonstrated strong sensitivity to several antibiotics, including Ampicillin, Amikacin, Gentamicin, Ciprofloxacin, Ceftazidime, Cefotaxime, Doxycycline, and Ceftriaxone.: The present study finds that Indian currency coins often harbor pathogenic bacteria, especially enteropathogens, which play a significant role in the spread of diseases. It is essential to raise public awareness about the importance of maintaining good personal hygiene when handling coins. By practicing proper hand hygiene and adhering to sound sanitary practices, individuals can greatly reduce the risk of infection, particularly those who handle both food and money at the same time.

Knowledge, Practices, and Adherence to Infection Prevention and Control among Health Care Providers in the Labour Ward at Busia County Referral Hospital

Provider's Infection prevention and control (IPC) skills are essential for healthcare (HCPs), particularly in labour wards, where they significantly affect maternal and neonatal outcomes. Hospital-acquired infections (HAIs) are major contributors to maternal and neonatal sepsis, resulting in high morbidity and mortality rates, especially in low- and middle-income countries. This study aimed to assess knowledge, practices, and adherence to IPC among HCPs in the labour ward at Busia County Referral Hospital, focusing on hand hygiene, use of personal protective equipment (PPE), and maintaining a clean environment. A cross-sectional study design was used to collect quantitative data from HCPs directly involved in patient care. The sample size consisted of 11 HCPs, with 10 participants, including 30% nurses, 30% clinical officers, and 40% nursing students. Most participants (40%) were aged 20-25 years, and 60% were male. Data were gathered through self-administered questionnaires and an observational checklist. Analysis was performed using Microsoft Excel, with results presented in tables, graphs, and pie charts. The findings revealed that 90% of HCPs had received formal IPC training. While 60% demonstrated good IPC knowledge, the mean score was 78% for knowledge, 69% for practices, and 50% for adherence. Although HCPs exhibited strong knowledge and practices, their adherence to IPC protocols was only borderline satisfactory. The study suggests that regular IPC training is needed to improve adherence, along with hospital management providing sufficient resources, conducting supervision, and implementing feedback mechanisms for HCPs

Water, Sanitation, and Hygiene Conditions and Health Outcomes: A Comparative Study Between Rohingya Refugees and Local People in Southeastern Bangladesh

Bangladesh is now the home to 1.3 million Rohingya refugees living in the southeastern part of the country, specially following the massive violence in Rakhine state, Myanmar since August 2017. Water, sanitation, and an unhygienic situation have left the entire region the worst affected and most vulnerable, ultimately placing pressure on the health sector. This study assessed water, sanitation, and hygiene (WASH) conditions; and explored associated health outcomes, drawing empirical data from Kutupalong-Balukhali Rohingya refugee camp and its surrounding areas in south-eastern Bangladesh. To determine the WASH condition and associated health outcomes, we conducted 200 structured interviews (with both refugees and local residents), three focus group discussions, and two informal interviews with local physicians. The values of drinking water, sanitation, and hand washing ladders indicate that WASH conditions in both refugee camps and surrounding localities were basic to limited. Respondents believed that due to increasing heat and basic to limited WASH conditions, people suffer from many diseases such as diarrhea, heat rash, dehydration, dysentery, and pneumonia. As reported diseases are related to WASH, it is important to increase awareness among people about the significance of WASH. The Dhaka University Journal of Earth and Environmental Sciences, Vol. 13(1), 2024, P 47-58

The Scientific Basis and The Critiical Importance of Hand Hygiene in Fighting Infection and Preventing the Transmission of Diseases

Introduction. Hand hygiene is one of the most important preventive methods to combat infections and prevent the transmission of harmful germs. It is an easy way to protect oneself from infections and the accumulation of germs. Hands are the primary pathways for the transmission of germs, either through direct contact with other people or by touching contaminated surfaces and objects. Washing hands with soap and water or using hand sanitizers plays a vital role in reducing the spread and transmission of many diseases caused by touching the mouth, eyes, or nose. Methods. To complete this research on hand hygiene, I followed a systematic approach and employed several methods to ensure a comprehensive and accurate output. Here's the process: Searching for Reliable Scientific Sources. I relied on reputable global organizations, such as Centers for Disease Control and Prevention (CDC): To understand the appropriate techniques and health benefits of handwashing. Conclusion: This research was prepared with a rigorous methodology, combining scientific analysis and logical organization to deliver content that effectively meets the reader's needs

Implementation of Environmental Hygiene and Sanitation in Deli Tua Market, Deli Serdang District

The market is a public facility that involves many people and physical interactions that can be a means of spreading disease. Further research is needed because the initial observation results show non- compliance with PERMENKES RI No. 17 of 2022 in terms of the application of personal hygiene, spatial arrangement, drainage, and market buildings. The purpose of this study is to analyze the extent of the application of environmental hygiene and sanitation in the Old Deli Market. This research uses qualitative methods with descriptive type research, and data collection using direct observation, in-depth interviews, and documentation. The selection of key informants in this study used purposive sampling method. The results showed that Deli Tua Market has not met the requirements of a healthy market according to PERMENKES RI No. 17 of 2020. Waste management facilities are still smelly and scattered. Clean water facilities are not available by the market manager. Vector control facilities have never been sprayed every month. Hand washing facilities are not available and are not equipped with soap and running water. The application of personal hygiene of traders is not in accordance with the requirements such as incomplete PPE, smoking, spitting, littering in the market environment and not washing hands while the hygiene of traders meets the requirements and drainage channels also meet the requirements because the drainage channels are cemented and covered with gratings and metal and drainage channels are smooth.

The '5 Moments for Hand Hygiene': casting a critical eye on the implications for practice.

The '5 Moments' approach is a time-space framework that delineates when hand hygiene should be performed and provides a resource for educators and auditors. It has become the dominant paradigm for organisations, practice, policy, and research in relation to hand hygiene. It is a concept that adopts the 'precautionary principle' that if the relative risk of a specific care task is unknown, a safe system must be to treat them on an equal level. However, a literal interpretation will frequently result in an extraordinary, implausible number of hand-hygiene opportunities and if this then becomes the standard to audit practice, within a policy document that espouses zero tolerance, it is likely to generate inauthentic data. If used effectively the 5 Moments concept provides an opportunity to enhance practice and reduce healthcare-associated infections but the healthcare provider organisation must embody a 'just culture' and collect the data in a climate of openness, transparency, and learning.

Enhancing Hygiene Education: Teaching Hand Washing Techniques to Intellectually Impaired Youth at Tomohon Special Needs School

In general, young children with intellectual impairments are not used to washing their hands after playing, and most children do not use soap to wash their hands. Worms and diarrhea are common diseases among schoolchildren. Diarrhea is one of the most common ailments among children. It happens because children do not use soap to wash their hands. Many ailments that regularly afflict young children are commonly related to clean and healthy living choices. Establishing a clean and healthy lifestyle in kindergarten is crucial for maintaining, improving, and protecting young children. This can be accomplished through the 'School's Health Clinic' approach. Washing hands with soap simply means removing dirt and dust from both hands. Hand washing is an important part of an early childhood education program that promotes clean and healthy living habits. It can help prevent a number of infections that can lead to death, such as diarrhea and acute respiratory infections. This activity can improve children's knowledge of clean and healthy lifestyles, such as properly washing hands with soap. It can also be done on a daily basis to reduce the spread of diarrhea and worms, which will ultimately improve children's health. All children were given an explanation about the importance of washing their hands properly with soap with running water, and they were able to practice the proper way to wash their hands so that it could be used in everyday life, such as washing their hands with soap after playing or eating. Keywords: wash your hands, remove germs

Gerenciando riscos em salas de vacina: um estudo de segurança em Unidades Básicas de Saúde de Salvador, BA

Introduction: The risks in vaccination rooms imply not only damage to users, but also to vaccination coverage. Objective: to analyze structural conditions and factors that facilitate and hinder risk management in vaccine rooms. Methods: This cross-sectional study was conducted in the vaccination rooms of the Basic Health Units (UBS) of a health district in Salvador, BA. Data collection: form for interview with the responsible professional and on-site observation of these services. The following were analyzed: physical-structural conditions; care for the refrigeration chamber and thermal boxes; Nursing conduct; and training of professionals. Results: 91.3% vaccination rooms were studied. These services operate in exclusive spaces; immunobiologicals stored in refrigerated chambers. Vaccines are packaged and used according to the expiration date. Professional team: one nurse and two nursing technicians were present in 66.6% of the rooms; the hand hygiene practice of the professionals was 76.1%. Nursing team training was observed in 19%, annual training in 14.2%, and participation in scientific events in 19%. Of the 21 vaccine rooms, 5 (23.8%) had adequate risk management practices, 14 (66.6%) had risk management practices requiring adjustment, and 2 (9.6%) had inadequate risk management. Statistical correlation was identified between risk management practices and individual items from the categories analyzed to ratify the good practices in the vaccination room presented here. Conclusion: This study highlights inadequacies in vaccination rooms and the need to review work processes, as well as to incorporate systematic strategies for managing the numerous risks related to these services, to guarantee user safety.

Nurses’ Perception, Barriers and Associated Factors towards Hand Hygiene Practices for Prevention of Healthcare Acquired Infections in the Intensive Care Units

Introduction: Healthcare-Acquired Infections occur within 72 hours of hospitalization, surgical-related infections, and surgical site infections that develop 30 to 90 days after the procedure. They particularly impact critically ill patients due to their weakened immune systems, with hand washing being the most effective prevention method. Objective of the study: Assessing nurses’ perceptions, barriers, and the impact of socio-demographic factors towards hand hygiene practices in ICUs. Methods: The study included 65 ICU nurses from three referral hospitals, using a quantitative descriptive cross-sectional design and whole population sampling. The data were collected from 05th November 2021 to 11th Feb 2022. Data analysis was conducted with SPSS software version 21. Results: Seventy percent of participants viewed health-acquired infections (HAIs) as serious and susceptible, while 83.1% recognized the benefits of hand hygiene. The most commonly cited barrier to hand hygiene was allergies to products, reported by 32.3% of respondents. Positive perceptions of hand hygiene were significantly associated with the working institution and in-service training, with a P-value of less than 0.05. Conclusion: The study investigated nurses' perceptions, barriers, and factors influencing hand hygiene practices in ICUs. It revealed that allergies to hand hygiene products hinder the hand hygiene adherence, while institutional policies and in service training boost It. Recommendations: There is a need for conducting research using an observational checklist to assess HH adherence among ICU nurses, enhancing nursing education on HH, and improving in-service training for managerial teams in three hospitals.

Optimizing Surgical Site Infection Prevention in Dermatologic Surgery.

We aim to review modifiable risk factors and practices for surgical site infections (SSIs) reduction in cutaneous surgeries. The existing norms are assessed with the latest evidence, with the aim of enhancing and optimizing intra and postoperative strategies. This review seeks to offer an updated summary of the results of evidence for SSI reduction strategies tailored for practicing general dermatologists. Searches were conducted for "cutaneous surgery surgical site infection complications" using PubMed Central® and DynaMed®. Articles with pragmatic guideline recommendations were selected. We found evidence for intraoperative factors such as non-sterile gloves, brushless hand scrubbing/simple hand washing, sterile materials, and chlorhexidine gluconate as a skin antiseptic. For postoperative factors, there is a lack of evidence to support the use of topical antibiotic ointments, dressings, or waiting 48 hours before wetting to prevent SSI. Several intra/postoperative factors not specific to dermatologic procedures are briefly discussed for additional context. Several SSI risk factors are inherent to patients or necessary procedures; however, dermatologists have identified modifiable risk factors and developed protocols to mitigate SSI risks intraoperatively and postoperatively. By questioning established practices in cutaneous surgery aimed at preventing SSIs, we can work towards the optimal utilization of resources. This dual-focused approach not only enhances the efficiency of the healthcare system but also diminishes the risks associated with SSIs. It is important to acknowledge that this review does not encompass all factors essential for consideration in these recommendations. Nonetheless, it will approach these factors with an evidence-based lens, placing SSI prevention at the forefront.

Knowledge of hand hygiene and evaluation of hand washing technique among nurses at the University of Nigeria Teaching Hospital

BackgroundHealthcare worker’s hands are route for cross-transmission of potentially harmful germs between patients in a healthcare facility. As hand washing is an established cost-effective measure for infection control, hand hygiene knowledge and compliance with the recommended steps are essential to control healthcare-associated infections (HCAI). We assessed the knowledge and practice of hand hygiene among nurses at the University of Nigeria Teaching Hospital (UNTH), Enugu.MethodsA cross-sectional study was carried out from 14th September to 24th December 2023 on all consenting nurses in UNTH. A modified World Health Organization (WHO) knowledge questionnaire structured to collect demographics and assess hand hygiene knowledge expressed as good(> 75%), moderately good(50–74%) and poor(< 50%) knowledge. Duration to completion of hand washing was timed while Glo germ gel with ultraviolet lamp were used to assess effectiveness of hand washing. Ineffective hand washing was graded as fair, poor, or very poor. The WHO checklist was used to assess steps in hand washing technique performed.ResultA total of 395 nurses participated in the study (mean age and standard deviation, 41.40 ± 8.82 years). Most were females (93.2%), married (80.8%), and functioned in the surgery department (38.5%). Moderately good knowledge of hand hygiene was demonstrated by 58.2% while effective hand washing occurred in 29.2% of them. Steps of hand washing technique most frequently missed were the use of towel to turn off faucet (94.3%), rubbing backs of fingers to opposing palms with fingers interlocked (89.8%), and wetting hands with water before applying soap(55.9%). Zones of hands not adequately washed were mainly the fingernails and perimeter of fingernails (38.4%), the palm (28.6%), and the dorsum of hand (22.9%). There was no significant difference in hand hygiene knowledge and effective hand washing across the different age groups, sex, nursing cadre, educational qualifications, and departments.ConclusionNurses at the UNTH had fair hand hygiene knowledge with the majority demonstrating ineffective hand washing; a finding suggesting sub-optimal infection prevention and control. Periodic hand hygiene training targeting nurses and other health personnel engaged in patient care while emphasizing frequently missed areas is paramount to improving hand hygiene knowledge and effectiveness.Clinical Trial NumberNot applicable.

Coronavirus disease 2019, hand hygiene, and pets

It is a "Letter to Editor", does not have an abstract

Profile of Bacteria Isolated from the Cell Phones of Health Care Providers in a Hospital Setting in Cameroon

Health care providers are an integral part of the era of mobile phones. During various activities linked to health care services, they come in contact with their cell phones regularly. These cell phones act as a perfect substrate for nosocomial pathogens, especially in hot–humid conditions, and may serve as a vehicle in transmitting nosocomial infections. This study aimed at determining the profile of bacteria isolated from the cell phones of healthcare providers. A descriptive cross-sectional study was carried out from 1 April to 3 June 2023, where 115 swab samples were collected from the cell phones of health care providers (laboratory personnel, nurses/midwives and doctors) at the Regional Hospital Bamenda. These swabs were inoculated on blood, chocolate and Mac Conkey plates, and the bacteria were identified according to standard microbiological methods and biochemical tests to the genus/specie level. Data were statistically analyzed using the Statistical Package for Social Sciences (SPSS) version 23. The results were presented in frequencies and proportions. The chi square test was used to compare proportions between variables, and the results were considered statistically significant when p &lt; 0.05. The bacteria isolated from these cell phones included coagulase-negative Staphylococci (CoNS), Staphylococcus aureus, Streptococcus species, Pseudomonas aeroginosa, Escherichia coli, Bacillus species and Neisseria species. All the cell phones of the laboratory personnel were contaminated, followed by those of the nurses/midwives (38; 33.0%) and, lastly, by those of the medical doctors (24; 20.9%). No statistically significant difference was observed between the three categories of health care providers with respect to the presence or absence of bacteria on their cell phones. This study presented that the mobile phones of health care providers are a risk of nosocomial pathogens. The result implies that there is an urgent need to implement and emphasize strategies such as hand washing and decontamination of mobile phones to limit nosocomial infections in the hospital.

Evaluation of Heath Care Commitment with Prevention and Infectious Control Protocols in Mofid Children Hospital, IRAN

Background: The dedication of healthcare teams to adhering to protocols for the use of personal protective equipment (PPE), maintaining vaccination coverage among healthcare workers (HCWs), and ensuring environmental health are crucial elements in managing hospital-acquired infections. Objectives: This study aimed to evaluate adherence to PPE use, vaccination history, hand hygiene protocols, and environmental health practices in a tertiary children's hospital in Iran. Methods: This cross-sectional study evaluated compliance with PPE use, vaccination history among doctors, nurses, and hospital staff, adherence to strict hygiene practices, patient isolation protocols, and environmental health measures based on an Iranian Health Ministry query. Data collection was conducted over three months, from May to August 2023. Results: During the study, 285 staff members were assessed for compliance with hand hygiene protocols. Nurses demonstrated the highest level of compliance, reaching 51%. The highest compliance with hand hygiene protocols at the five designated moments was approximately 79%, with the transplantation and hemodialysis wards achieving the highest rates. Nurses also showed the most positive vaccination records. Personal protective equipment was used correctly in various wards, with an overall compliance rate of 79%. Conclusions: This study revealed that compliance with health protocols in different parts of the hospital was suboptimal and required significant improvement.

Innovative Solutions for Multidrug-resistant Organisms Infections in ICU: A Joint Efficacy Evaluation of Multi-disciplinary Team and SHEL Model (Software, Hardware, Environment, Liveware)

BackgroundThe escalating threat of Multidrug-resistant organisms (MDROs) in Intensive Care Units (ICU) demands innovative management strategies to curb the rising infection rates and associated clinical challenges. ObjectiveTo assess the effectiveness of integrating the Multi-disciplinary team (MDT) approach with the SHEL model (Software, Hardware, Environment, Liveware) in reducing MDROs infections within ICU settings. MethodsFrom January 2021 to April 2024, a prospective, randomized controlled study was conducted in the ICU of Nantong Fourth People's Hospital, enrolling 411 patients with MDROs infections. These patients were randomly assigned into three groups: the MDT group, the SHEL model group, and a combined group. The intervention lasted for four weeks, during which the effects on the MDROs detection rate, infection rate, healthcare staff's infection control execution scores, and the rationality of antibiotic use were assessed, aiming to determine the efficacy of each approach in managing MDROs in the ICU setting. ResultsThe overall infection rate of MDROs in the ICU of our hospital from 2021 to 2024 was 60.18%, with sputum infection sources accounting for 68.37% of the total sources, making it the primary source of infection. The detection rate of MOROs in the combined group was significantly higher than that in the MDT group and the SHEL group, with the SHEL group having a higher detection rate than the MDT group (P<0.05). The infection rate of MOROs in the combined group was significantly lower than that in both the MDT group and the SHEL group, with the SHEL group having a lower detection rate than the MDT group (P<0.05). The implementation scores of the combination group in standard prevention, hand hygiene, antibiotic management, and isolation measures were significantly higher than those of the MDT and SHEL groups, with the SHEL group scoring higher than the MDT group (P<0.05). The rational use of antibiotics in the combined group was also higher than in both the MDT group and the SHEL group, with the SHEL group having a higher level than the MDT group (P<0.05). ConclusionThe integrated MDT and SHEL model significantly reduced MDROs infections in ICU, improved healthcare workers' infection prevention and nursing quality, and promoted the appropriate use of antibiotics, advocating for its clinical application.

Public surface disinfection every 2 hours can reduce the infection risk of norovirus in airports up to 83.

Norovirus, primarily transmitted via fomite route, poses a significant threat to global public health and the economy. Airports, as critical transportation hubs connecting people from around the world, has high potential risk of norovirus transmission due to large number of public surfaces. A total of 21.3 hours of video episodes were recorded across nine functional areas at the airport, capturing 25,925 touches. A surface transmission model based on a Markov chain was developed. Using the beta-Poisson dose-response model, the infection risk of norovirus and the effectiveness of various interventions in different airports' areas were quantified. Without any preventive measures, restaurants at airports exhibited the highest risk of norovirus transmission, with an infection probability of 8.8×10-3% (95% CI, 1.5×10-3% -2.1×10-2%). This means approximately 4.6 (95% CI, 0.8-10.9) out of 51,494 passengers who entered the restaurants would be infected by an infected passenger. Comparing with no surface disinfection, disinfecting public surfaces every 2 hours can reduce the risk of norovirus infection per visit to the airport by 83.2%. In contrast, comparing with no hand washing, handwashing every 2 hours can reduce the infection risk per visit to the airport by only 2.0%, making public surface disinfection significantly more effective than handwashing. If the mask-wearing rate increases from 0% to 50%, the infection risk of norovirus would be decreased by 48.0% (95% CI, 43.5-52.3%). Furthermore, using antimicrobial copper/copper-nickel alloy coatings for most public surfaces could reduce the infection risk by 15.9%-99.2%.

Burden of disease attributable to risk factors: Estimates of the Global Burden of Disease from 1990 to 2021

ObjectivesAnalyze the burden of diseases attributable to risk factors (RF) in Brazil according to age, sex, and Brazilian states between 1990 and 2021. MethodsThis study used data from the Global Burden of Disease study 1990 to 2021. The metrics used in this analysis included: mortality rates, disability-adjusted life years (DALYs) and Summary Exposure Value (SEV). A ranking of the risk factors was created by highlighting the changes between 1990 and 2021, according to sex, age group, and Brazilian state. RF were analyzed according to the Socio-Demographic Index (SDI). ResultsDecline the risk factors of tobacco (−50.2 %), environmental: water, sanitation and hand washing (−58.0 %), and air pollution (−45.0 %), as well as an increase in the burden attributable to BMI (+78.4 %), alcohol consumption (+15.7 %). High systolic blood pressure ranked first in all states in 2021, followed by high blood glucose; tobacco ranking third in most states. The burden of diseases attributable to RFs in Brazil varied considerably between men and women, age groups, and states. Trends in the period from 1990 to 2021 showed a strong correlation with the SDI, better results being observed in states with higher SDI. ConclusionsHigh blood pressure, high BMI and tobacco are the main risk factors for mortality and DALYs in 2021. The burden of disease has a high correlation with socio-economic indicator (SDI). It is important to strengthen public policies that promote healthy lifestyles, thus reducing disease and death.

Clinical and microbiological effectiveness of pulsed-xenon ultraviolet light disinfection in a neonatal intensive care unit in Japan

Meticillin-resistant Staphylococcus aureus (MRSA) is a common causative agent of serious healthcare-related infections in neonatal intensive care units (NICUs). In adult ICUs, pulsed-xenon ultraviolet (PX-UV) disinfection of environmental surfaces, along with alcohol-based hand hygiene and terminal cleaning, has been demonstrated to reduce the MRSA acquisition rate. However, the impact of PX-UV use in NICUs on reducing MRSA transmission remains unexplored. The incidence of newly detected MRSA cases was recorded for all patients between January 2021 and December 2022. UV irradiation was used in addition to terminal manual cleaning. During the baseline period, irradiation was performed on areas following the use by patients with MRSA, while in the intervention period, irradiation was performed after each patient's use. While there was no observed change in the frequency of hand hygiene compliance throughout the study period, the total number of MRSA cases detected per 1,000 patient days decreased significantly. In NICUs, UV irradiation of environmental surfaces, in addition to hand hygiene practices and conventional environmental maintenance, may be effective in reducing MRSA infection.