Healthcare-associated Infections Research Articles

Bacterial contamination of new dental unit waterlines and efficacy of shock disinfection

BackgroundBacterial contamination of outlet water from dental unit waterlines (DUWLs) may lead to healthcare-associated infection. The aim of this study was to evaluate the contamination of DUWLs from new dental chairs before and after their initial shock disinfection with ICX Renew® and to determine the efficacy of this method of shock disinfection.MethodsThe microbiological quality of water samples obtained from the DUWLs of 17 new dental chairs installed at the University Hospital of Nancy, France, was assessed. Water samples were collected before and after an initial shock disinfection with one ICX Renew® treatment. Water analysis was used to assess total culturable aerobic bacteria (TCAB) at 22°C and 36°C, Legionella sp., Pseudomonas aeruginosa and total coliforms.ResultsAll the DUWLs (17/17) were contaminated by viable aerobic bacteria (TCAB at 22°C and 36°C > 300 CFU/mL), including P. aeruginosa, before shock disinfection. After shock disinfection with ICX Renew®, 24% of DUWLs (4/17) remained contaminated by aerobic bacteria (TCAB at 36°C > 300 CFU/mL for 3/17) and P. aeruginosa (> 100 CFU/100 mL for 1/17).ConclusionsTo reduce the contamination of new dental chairs, initial shock disinfection of DUWLs should be performed to remove biofilms and bacteria from the DUWLs. To ensure the security of care, microbiological analysis of outlet water from DUWLs should be systematically performed before the first clinical use of a new dental chair to determine the efficacy of shock disinfection and the agreement of the results with the dental recommendations for water quality.Clinical trial numberNot applicable.

Hospital-Acquired Complications in Critically Ill Children and PICU Length of Stay, Duration of Respiratory Support, and Economics: Propensity Score Matching in a Single-Center Cohort, 2015-2020.

To identify the health and economic costs of hospital-acquired complications (HACs) in children who require PICU admission. Propensity score matched cohort study analyzing routinely collected medical and costing data collected by the health service over 6 years (2015-2020). Tertiary referral PICU in Queensland, Australia. All children admitted to the PICU were included. None. We assessed ventilator- and respiratory support-free days at 30 days post-PICU admission, length of PICU stay, prevalence of individual HACs, and attributable healthcare costs. A total of 8437 admissions, representing 6054 unique patients were included in the analysis. Median (interquartile range) for cohort age was 2.1 years (0.4-7.7 yr), 56% were male. Healthcare-associated infections contributed the largest proportion of HACs (incidence rate per 100 bed days, 46.5; 95% CI, 29.5-47.9). In the propensity score matched analyses (total 3852; 1306 HAC and 1371 no HAC), HAC events were associated with reduced ventilator- (adjusted subhazard ratio [aSHR], 0.88 [95% CI, 0.82-0.94]) and respiratory support-free days (aSHR, 0.74 [95% CI, 0.69-0.79]) and increased PICU length of stay (aSHR, 0.63 [95% CI, 0.58-0.68]). Healthcare costs for children who developed a HAC were higher compared with children with no HAC, with mean additional cost ranging from Australian dollar (A$) 77,825 (one HAC [95% CI, $57,501-98,150]) to $310,877 (≥ 4 HACs [95% CI, $214,572-407,181]; in 2022, the average conversion of A$ to U.S. dollar was 0.74). In our PICU (2015-2020), the burden of HAC for critically ill children was highest for healthcare-associated infections. Further high-quality evidence regarding HAC prevention and prospective risk assessment could lead to improved patient outcomes and reduced costs.

Evaluating and Improving Surgical Site Infection Prevention: Outcomes of a Two-Cycle Audit and Targeted Interventions in a Low-Resource Setting.

Background Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAIs), leading to significant morbidity, mortality, and increased healthcare costs. Despite the existence of international guidelines, adherence to best practices remains inconsistent, particularly in low- and middle-income countries (LMICs). Objective The objectives of this study are to evaluate compliance with SSI prevention guidelines among medical professionals at Kasr El Ainy Teaching Hospital in Cairo, Egypt, identify gaps in practice and knowledge, and implement targeted interventions to improve outcomes. Methods A prospective two-cycle audit was conducted over a period of eight months involving 225 elective surgical patients and 229 healthcare providers. Questionnaires were distributed to foundation year (FY) doctors and surgical residents to assess their knowledge and practices related to SSI prevention across the preoperative, intraoperative, and postoperative phases. Patients were followed up to monitor the incidence of SSIs. Interventions implemented included educational sessions, dissemination of posters, and hands-on training to enhance adherence to best practices. Results The initial audit revealed an SSI rate of 12.6% and significant gaps in guidelines knowledge, including improper preoperative hair removal methods and prolonged postoperative antibiotic use (85.7%). Post-intervention, SSI rates decreased to 6.6%, with the questionnaire results showing marked improvements in understanding of key components in SSI prevention: 100% became aware ofappropriate intraoperative surgical antibiotic prophylaxis (SAP) (compared to 72.3%), a significant increase (p < 0.05) in the use of clippers (rather than razors) for hair removal (72.1% vs. 33.7%) and intraoperative (rather than preoperative) hair removal (91.8% vs. 10%) (p < 0.05), as well as the need for intraoperative warming practices (87.7% vs. 47.7%) (p < 0.05). Knowledge and adherence to aseptic techniques improved across all staff groups, with awareness increasing from 36.3% to 81.9% among junior doctors, representing a significant improvement(p < 0.05). Conclusion Targeted interventions, including education and practice standardization, significantly reduced SSI rates and improved compliance with prevention guidelines. These findings highlight the value of structured audits and educational programs in enhancing surgical outcomes and reducing the burden of SSI, particularly in resource-limited settings.

Hand hygiene, knowledge and training motivational drives: findings from a survey in a university hospital

This study assessed healthcare workers’ (HCWs) knowledge and adherence to hand hygiene principles in a large Italian university hospital, focusing on identifying knowledge gaps and evaluating training effectiveness. A specifically designed 17-item questionnaire, based on the World Health Organization (WHO) Hand Hygiene Knowledge Questionnaire, was used to measure theoretical knowledge, the role of training, and the impact of experience. The survey had an 8% participation rate (542 responses from a total of 6,749 HCWs), with higher responses among nurses and doctors. Results showed moderate knowledge of hand hygiene protocols, averaging 74%, but revealed gaps in comprehension, particularly in the correct use of hand rub and post-contact sanitation. Logistic regression analysis identified significant predictors of knowledge and adherence, with professional characteristics such as professional qualifications and length of service influencing outcomes (p &amp;lt; 0.05). The findings confirm the strong correlation between hand hygiene knowledge and compliance in reducing healthcare-associated infections (HAIs). Continuous education and customized interventions, including targeted training and feedback, are essential for targeting weak points and improving adherence. These insights emphasize the importance of ongoing training and monitoring to enhance hand hygiene practices, promote a culture of patient safety, and, as a consequence, reduce the incidence of HAIs.

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.

Epidemiology, microbiological profile and susceptibility pattern of uropathogens from a tertiary care hospital in central India

Urinary tract infections (UTIs) are the second most common infection in the community, whereas in hospitals, they are the most common healthcare-associated infections. Monitoring factors like the most common causative organisms and their susceptibility pattern is essential for tailored management and practicing antimicrobial stewardship. This study was done to determine the epidemiology, microbiological profile, and susceptibility pattern of uropathogens to make better antibiotic policy.: This was a retrospective descriptive study done at the Department of Microbiology, Pt. JNM Medical College, Raipur, Chhattisgarh in which analysis of the culture isolates obtained from urine samples received between January 2022 to December 2022 was performed.: Out of 2893 urine samples, 784 (27.1%) showed significant growth on culture. Females were more affected than males with male to female ratio being 1:2.3. Most common causative organism found in our study was (41.9%) followed by species (23.9%), non-albicans species(11.09%) and (10.3%). isolates showed 100% susceptibility to fosfomycin; 93% for nitrofurantoin, and 93% for carbapenems. In the case of isolates of the susceptibility percentage for nitrofurantoin and carbapenems were 59% and 82% respectively. In isolates were 100% susceptible to Teicoplanin and Fosfomycin, 82% for Nitrofurantoin.: followed by species the most common uropathogen. Nitrofurantoin and Fosfomycin were the most effective antibiotics against uropathogens.

Hospital Context Determinants of Variability in Healthcare-Associated Infection Prevalence: Multi-Level Analysis

Healthcare-associated infections (HAIs) represent a major challenge in patient safety that affects services disproportionally. This paper aimed to assess how the HAI prevalence varies between hospital services and what contextual characteristics may explain such variance. A cross-sectional study was conducted on adult patients in Portuguese hospitals, using data from the European point prevalence survey of HAI prevalence. The study variables included patient, structural, and process variables, tested as risk factors, with patients clustered in hospitals. Variables with a p-value ≤ 0.2 in univariate analyses were retested in a multivariable model. A total of 18,261 patients from 119 hospitals were included: 736 from 56 intensive care units (ICUs), 3160 from 72 surgical departments, and 8081 from 90 medical departments. The HAI prevalence was 7.9%, 5.9%, and 1.7%, respectively. In ICUs, only the number of devices was associated with the HAI prevalence. In surgical departments, age, comorbidities, being a specialized hospital, and a higher ratio of infection prevention and control (IPC) personnel were associated with higher SSI. The safety climate was associated with lower SSI. In medical departments, age and devices were positively associated, whereas a larger ratio of IPC nurses was negatively associated. These results may help implement targeted interventions to achieve optimal results in each department.

First Identification of Emerging Pathogenic Yeast in Clogmia albipunctata (Diptera: Psychodidae) at a Brazilian Hospital

Psychodinae (Diptera: Psychodidae), commonly known as “drain flies”, are a subfamily of insects adapted to environments modified by humans. While often regarded as harmless, it has been reported that they may carry pathogenic microorganisms, contributing to hospital environmental contamination and potentially playing a role in healthcare-associated infections. This study aimed to investigate drain flies in a hospital setting to assess their role in carrying microbial pathogens. Twenty-six drain flies were collected from a tertiary hospital using sterile tubes and processed within two hours. The insects were identified as Clogmia albipunctata (Williston, 1893). Whole-body macerates were cultured on EMB media, and fungal isolates were identified using MALDI-TOF MS and ITS region sequencing. The emergent pathogen Trichosporon asahii was isolated, highlighting the potential role of C. albipunctata as a mechanical vector of fungal pathogens associated with HAIs. These findings underscore the importance of monitoring drain flies as part of infection prevention and control strategies in healthcare settings.

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.

Comparação da qualidade de dietas distribuídas em seringas e frascos e seu custo em um lactário de um instituto nacional de saúde

Introduction: Healthcare-associated infections are considered a serious public health issue. When caring for newborns admitted to the Neonatal Intensive Care Unit, the administration of a diet contaminated with pathogenic microorganisms can help spread infections. Objective: To compare the cost and microbiological quality of the diet offered in syringes and bottles by the lactator for enteral administration to patients admitted to the Neonatal Intensive Care Unit (NICU). Methods: An exploratory experimental study “in loco” carried out between January and May 2019, consisting of the microbiological analysis of 72 samples of enteral diets and pasteurized donor human milk (PDHM) distributed in syringes and bottles. The microbiological parameters used were those of the Board of Health Collegiate Resolution No. 63/2000 and No. 171/2006. The microbiological quality of the water used in the reconstitution of the enteral diet; the swab of the manipulators’ hands and oropharynx; surfaces such as benches and equipment, utensils, and the air quality of the areas for diet preparation were also assessed. The critical control points of the diet manipulation flowcharts reviewed were defined. Results: In the enteral diet samples, coliforms at 35˚C and mesophilic aerobic microorganisms above the established standards levels were found in both modalities of the diet administration (bottle and syringe) during two days of collection (lots). In the LHOP samples, no microorganisms from the coliform group were found. When filling plastic bottles, mesophilic bacteria exceeding the established standards were detected. It was observed that the cost of distributing the diet in bottles was higher than that of using a syringe. Conclusion: It was found that the microbiological quality of the diets supplied in syringes was safer than that of the diets distributed in bottles. In addition, the diet infusion time was shorter and cost was lower with the use of the syringe.

Impact of COVID-19 pandemic on antimicrobial resistance of Proteus mirabilis in a Brazilian hospital.

This study analyzes the resistance and virulence profiles of Proteus mirabilis isolates obtained from patients admitted to the University Hospital of Londrina, Paraná, between 2019 and 2022. We evaluated the antimicrobial resistance phenotypes, genes associated with resistance, biofilm formation through a phenotypic assay, and the presence of specific virulence genes. When comparing the "pre-pandemic" (2019) and "pandemic" (2020-2022) periods, we observed an increase in resistance rates to all tested antimicrobials. Multidrug-resistant (MDR) pathogens producing extended-spectrum β-lactamase (ESBL) phenotypes were isolated in both periods, but their occurrence was significantly higher during the pandemic. We also observed an increase in the frequency of nearly all studied resistance genes. The virulence profiles remained largely unchanged. Analysis of patients' clinical and demographic data revealed that those hospitalized during the pandemic were older, required longer hospital stays, and had a higher usage of invasive devices. These findings suggest that the recent COVID-19 pandemic has impacted the antimicrobial resistance of P. mirabilis, a bacterium of significant clinical interest associated with urinary tract infections (UTIs) and healthcare-associated infections (HAIs).

Clostridioides difficile Infections and Antibiotherapy: Results of Four Years of Observation in a Romanian Tertiary Hospital

Clostridioides difficile infection (CDI) is one of the main causes of morbidity associated with antibiotic use, producing both healthcare-associated infections and community infections. This study aims to describe the epidemiological characteristics, the clinical outcomes, previous antibiotic exposure, and other risk factors of hospitalized patients with CDI in a tertiary infectious disease hospital in Bucharest, Romania. We performed a descriptive analysis based on four-year surveillance data, collected in a tertiary infectious disease hospital in Bucharest, Romania. The annual incidence of CDIs varied from 65.1 cases per 10,000 discharges in 2020 to 211.7 cases per 10,000 discharges in 2023, with a continuously ascending trend. Most of the cases were hospital-acquired cases. There was a high share of antibiotic consumption three months before admission (61.3%). Third-generation cephalosporins, β-lactams with inhibitor combination, and carbapenems were the most used antibiotics, with shares of 46.0%, 25.2%, and 18.6%, respectively. Hospitalization in the previous 12 months and contact with a confirmed CDI case were other frequent factors in the study group, the occurrences of which were recorded as 66.2% and 2.4%, respectively. The surveillance data identified that the annual trend in CDIs is very variable, suggesting the need for continuous and multiannual analysis.

Implementing a healthcare-associated bloodstream infection surveillance network in India: a mixed-methods study on the best practices, challenges and opportunities, 2022

BackgroundHealthcare-associated bloodstream infections (BSI) threaten patient safety and are the third most common healthcare-associated infection (HAI) in low- and middle-income countries. An intensive-care-unit (ICU) based HAI surveillance network recording BSIs was started in India in 2017. We evaluated this surveillance network’s ability to detect BSI to identify best practices, challenges, and opportunities in its implementation.MethodsWe conducted a mixed-methods descriptive study from January to May 2022 using the CDC guidelines for evaluation. We focused on hospitals reporting BSI surveillance data to the HAI network from May 2017 to December 2021, and collected data through interviews, surveys, record reviews, and site visits. We integrated quantitative and qualitative results and present mixed methods interpretation.ResultsThe HAI surveillance network included 39 hospitals across 22 states of India. We conducted 13 interviews, four site visits, and one focus-group discussion and collected 50 survey responses. Respondents included network coordinators, surveillance staff, data entry operators, and ICU physicians. Among surveyed staff, 83% rated the case definitions simple to use. Case definitions were correctly applied in 280/284 (98%) case reports. Among 21 site records reviewed, 24% reported using paper-based forms for laboratory reporting. Interviewees reported challenges, including funding, limited human resources, lack of digitalization, variable blood culture practices, and inconsistent information sharing.ConclusionImplementing a standardized HAI surveillance network reporting BSIs in India has been successful, and the case definitions developed were simple. Allocating personnel, digitalizing medical records, improving culturing practices, establishing feedback mechanisms, and funding commitment are crucial for its sustainability.

Hydrogen Peroxide Vapor Disinfection in Liver Transplantation: Effects on Multidrug-Resistant Organism Colonization and Recipient Outcomes

Introduction: The escalation of multidrug-resistant organism (MDRO) infections post-liver transplantation (LT) poses significant risks, with MDRO colonization amplifying infection susceptibility. Environmental disinfection is crucial in curbing healthcare-associated infections (HAI). Hydrogen peroxide vapor (HPV ) technology offers promise, yet its impact on MDRO infections and patient outcomes remains unclear. Methods: A cohort study enrolled 58 deceased adult LT recipients, comparing outcomes before and after routine HPV implementation. HPV disinfection followed terminal cleaning in surgical rooms and intensive care unit (ICU) boxes. Pathogen data included pre-transplant and post-discharge MDRO colonization. Clinical data covered recipient characteristics, disease severity, and donor-recipient relationships. Statistical analyses assessed associations and outcomes. Results: Twenty-seven patients were in the before-HPV group, 24 in the after-HPV group. Demographic and clinical characteristics were comparable between groups. HPV implementation significantly increased the likelihood of negative control swabs (odds ratio 2.33). Klebsiella pneumoniae carbapenemase was the most frequent pathogen, with surgical site infections being the primary site. Patients with negative swabs had shorter hospital stays (mean difference 10.54 days), notably diverging around the 8th day of hospitalization. HAI frequency and 90-day mortality were significantly lower in patients with negative swabs. Conclusion: HPV technology effectively reduced MDRO colonization in LT recipients. Negative swabs correlated with shorter hospital stays and lower HAI frequency, impacting 90-day mortality positively. Despite challenges in HPV implementation, its efficacy in reducing MDRO colonization suggests a valuable tool in infection control strategies for vulnerable populations like LT recipients.

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.

Salmonella enterica Serovar Infantis KPC-2 Producer: First Isolate Reported in Ecuador.

Antimicrobial resistance is currently considered a public health threat. Carbapenems are antimicrobials for hospital use, and Enterobacterales resistant to these β-lactams have spread alarmingly in recent years, especially those that cause health care-associated infections. The blaKPC gene is considered one of the most important genetic determinants disseminated by plasmids, promoting horizontal gene transfer. This study describes, for the first time in Ecuador, and worldwide, the presence of a blaKPC-2 gene in an isolate of Salmonella enterica serovar Infantis from a clinical sample. Through whole-genome sequencing, we characterized the genetic determinants of antimicrobial resistance in this Salmonella ST-32 strain. Our results showed the presence of several resistance genes, including blaCTX-M-65, and a conjugative plasmid Kpn-WC17-007-03 that may be responsible for the horizontal transference of these resistance mechanisms.

Phenotypic and Genotypic Detection of Hypervirulent Klebsiella pneumoniae Isolated from Hospital-Acquired Infections

Hypervirulent Klebsiella pneumoniae is a highly pathogenic variant of Klebsiella pneumonae, which represents a global public health issue because it is very virulent and spreads easily. The objectives of this study were to assess the predominance of hvKp among health care-associated infections in intensive care units of Tanta University Hospital and to compare hvKp with classical K. pneumoniae (cKp) in terms of antibiotic resistance, virulence, and molecular features. The study included 300 patients suffering from HAIs from different ICUs of Tanta University Hospitals. K. pneumoniae isolates were identified and subjected to string testing and antibiotic susceptibility testing, and the tissue culture assay for biofilm formation and polymerase chain reaction (PCR) tests were performed for the identification of capsular genes (K1, K2, K57) and virulence genes (rmpA, rmpA2, iuc A). Fifty-seven K. pneumonaie isolates were isolated. A total of 21 (36.8%) of them were hvKp and 36 (63.15%) were cKp. Significantly higher antibiotic resistance was detected in the cKp group. There was a significant difference between biofilm formation between cKp and hvKp isolates (p &lt; 0.004*). iucA, rmpA2, and K1 genes were significantly associated with hvKp. The string test shows 100% sensitivity and negative predictive value for the detection of hvKp. Consequently, using the string test alone for the screening of hvKp is required. However, combining aerobactin-positive with hypermucoviscous isolates while screening for hvKp is crucial.

Knowledge and Practice Towards Cleaning Medical Equipment among Nursing Students in a Malaysian Public University

Background: Healthcare-associated infections are infections acquired by patients during stay or receiving treatment within healthcare facility. High cases of healthcare-associated infections are contributed by poor medical equipment disinfection among healthcare workers, including nurses. It could be due to poor practice and awareness during their training in universities and colleges. This study aimed to assess the knowledge and practices regarding cleaning medical equipment and their association with socio-demographic characteristics among nursing students at International Islamic University Malaysia Kuantan Campus. Methods: A total of 252 nursing students were recruited using stratified random sampling. Data of socio-demographic characteristics, knowledge, and practices related to medical equipment disinfection were collected using an online questionnaire. Descriptive analysis and chi-square test were used to assess the level of knowledge and practice on medical equipment contamination and disinfection, and their association with socio-demographic characteristics. Results: Most respondents (84.1%) have a good level of knowledge regarding disinfecting medical equipment. Meanwhile, 50.8% of respondents have a good level of practice regarding disinfecting medical equipment. Further analysis revealed a significant strong association between academic year and level of knowledge (p&lt;0.05). Conclusion: The study showed that most of the nursing students have good knowledge and practice regarding medical equipment disinfection. The significant strong association between academic year and level of knowledge indicates the knowledge improvement among nursing students as their academic years increasing. Though, a larger study comprising of more universities are needed to gain the better insight on influence of nursing students on healthcare-associated infections in Malaysia.

Improving infection control protocols in healthcare settings: Redesigning workplace safety in aged care for future pandemics

Purpose: This study examines infection prevention and control after COVID-19 in aged care organisations to identify best practices for planning and staff protection for future pandemics. It investigates how technological solutions relate to standard sanitation practices and how they affect healthcare delivery effectiveness measurements and organisational performance. Methodology: The current study was a systematic review and meta-analysis of global studies published between 2019 and 2024 in peer-reviewed journals, using standard data extraction tools and the Mixed Methods Appraisal Tool. The study used Cooper’s Taxonomy of Literature Reviews, using quantitative and qualitative synthesis methods to assess infection control policies in various healthcare institutions. Findings: Facilities implementing integrated technological solutions demonstrated reduced transmission rates and an average of 65% improvement in protocol adherence. Advanced ventilation systems combined with regular staff training led to a reduction in healthcare-associated infections. Notably, smaller facilities achieved outcomes comparable to those of larger institutions when implementing comprehensive technological solutions. Contributions: This study defines a new paradigm for infection control that considers the need to satisfy safety necessities while not utterly disregarding residents’ psychosocial needs. This paper also shows that technology-enhanced protocols are feasible in large and small settings. The results contribute to policy guidelines for minimum technological infrastructure in the organisations while offering research-based recommendations for better preparation for future pandemics in aged care facilities.