Hands Of Healthcare Workers Research Articles

Formulation and Evalution of Herbal Beetroot Soap

The aim of our study was to develop the polyherbal hygienic soap by using cold process method and evaluate antimicrobial potential by agar Well diffusion method. Soap was prepared usin olive oil , Almond oil , Glycerine , Aloe Vera gel, Coffee powder , Vitamin E capsule, Glycerine soap base. Nosocomial infection has been recognized as a crucial issue in the outcome of hospital care, with Significant morbidity and mortality results. The primary routes of infection transmission to patients Are the hands of health-care workers. This also evokes utilization of antiseptics for hand- washing Purposes. Many of the antiseptics commercially available are sanitizers dependent on alcohol that Have certain shortcomings or harmful effects. Bacterial skin infections are most common amongst people, requiring significant attention for treatment and also for maintaining Healthy skin. Some herbal plant extracts and their oils were found to have antibacterial activity. The aim and objective of the present Study are to formulate and evaluate anti-bacterial herbal soapuse..

Assessment of Knowledge, Attitude, and Practice of Hand Hygiene Among Medical Students in a Tertiary Care Hospital.

Healthcare-associated infections (HCAIs) and emerging multi-drug resistance in nosocomial pathogens are perceived as a serious public health threat. Hands of healthcare workers (HCWs) become routinely colonized during patient care, serving as vehicles for transmission and leading to HCAIs.Hand hygiene (HH) is a globally accepted tool to avoid the broadcast of dangerous microorganisms and prevent HCAIs. A cross-sectional study was carried out to evaluate the knowledge, attitude, and practice toward HH among the medical students at Saveetha Medical College, Chennai, India. A 25-item validated questionnaire survey was formulated and circulated to100 medical students of all four academic years. There were 100 responses to the survey, and 44 (44%) participants performed HH appropriately for 20 seconds with alcohol-based hand rub. In our study, 25％ of the participants revealed that HH practices were not followed during emergencies. Many participants (40%) stated that the lack of sink, soaps, alcohol-based sanitizers, paper towels, and water is the reason for not performing HH. The gross knowledge of HH of the participants is moderate, but there were gaps between the knowledge and practice. Hence, it is essential to conduct structured training sessions and surveillance programs for medical students to address these gaps in knowledge and the correct HH procedures.

Staff Perspectives on Barriers & Facilitators to Meeting Hand Hygiene Goals in a Multicenter Academic Hospital System

Background: Proper hand hygiene is the most important practice to reduce the transmission of infections in healthcare settings. Despite this, healthcare institutions continue to struggle to achieve and maintain high rates of hand hygiene compliance among healthcare workers with some studies estimating national healthcare worker hand hygiene compliance to be approximately 50%. Methods: We conducted an anonymous one-time survey of our Lifespan Hospital System employees to evaluate barriers and facilitators to performing hand hygiene as well as interventions to improve hand hygiene compliance. The survey was designed with guidance from the Consolidated Framework for Implementation Research and input from Lifespan infection prevention staff. Result: Over four weeks 985 (6%) Lifespan employees completed the survey. Figure 1 shows the aggregate results of the first 4 survey questions which focused on hand hygiene infrastructure at Lifespan, including availability of sanitizer, staff to manage hand hygiene supplies, and educational materials/reminders. One significant finding was >70% of respondents reported that they either did not know if their unit/department has a person assigned to replace/monitor hand hygiene supplies, or if so, who that person is. We also asked employees to rate how effective different interventions would be at improving hand hygiene compliance. Figure 2 shows of five proposed interventions, three were rated as either “moderately effective” or “very effective” by >50% of respondents. These included displaying hand hygiene instructions, making hand hygiene data available to employees, and displaying materials/reminders promoting hand hygiene. There were also 977 free-text responses regarding “barriers or facilitators to proper hand hygiene”. Major barriers identified were a lack of staff to monitor and refill supplies, slow replacement of hand hygiene products, lack of sanitizer dispensers and sinks, inconsistency of sink location and dispenser placement, lack of hand hygiene reminders/educational materials, time constraints, skin irritation from sanitizer, and an inability to have dispensers in behavioral health units. Survey responses led us to enhance the following: educational materials and reminders in work areas; staff education; leadership involvement in hand hygiene initiatives; routine auditing and feedback; conveniently placed sanitizer dispensers and sinks at the point of care; and making hand hygiene compliance data readily available to staff. Conclusion: This survey identifies important barriers and facilitators to achieving high rates of hand hygiene compliance among healthcare workers and provides the basis for interventions aimed at improving hand hygiene compliance in a large multicenter academic hospital system.

Empowering Patient Hand Hygiene and Reducing Infection in the Oncology Population

Background: Significant focus has been placed on healthcare worker hand hygiene, but little attention is has been assigned to the role of patient hand hygiene (HH) in reducing hospital acquired infections. Therefore, in this quality improvement study, we examined the impact of providing patients with hand hygiene products around mealtime on increasing patient HH adherence and on reducing acquisition of nosocomial antibiotic resistant organisms. Methods: Patients on two inpatient leukemia units at a tertiary oncologic center were provided with a single use pre-packaged alcohol wipe on their meal trays prior to every meal (three times daily). Additionally, an information card explaining to patients how and when to use the alcohol wipe was provided on the meal trays three times a week. Both the wipe and instructions were designed with input from patient representatives at the hospital. Two oncologic control units were selected where no specific intervention for patient hand hygiene was conducted. Patient hand hygiene adherence on the control and intervention units were measured through once monthly patient interviews conducted after meals where patients were asked to recall whether they washed their hands prior to eating (using any product). Vancomycin Resistant Enterococcus (VRE) incidence was compared on the intervention and control units during the 7 months prior and 7 months following initiating the intervention. Results: During the seven-month intervention period, more than 15 000 wipes were dispensed to patients on the intervention units. Through interview, 91% of 87 patients on the intervention units reported cleaning their hands before eating a meal using any cleaning product compared to 72% of 68 patients on the control units (X2 = 9.32, p = 0.002). Furthermore, on the intervention units, 30 (38%) patients endorsed using the provided hand hygiene product. During intervention period, the combined incidence rate of VRE the intervention units was 1.85 case/1000 patient-days compared to 5.35 cases/1000 patient-days during the 7 months prior to intervention (t = 3.24, p=0.007)(Figure 1). Conclusions: This patient-centered quality improvement intervention increased patient hand hygiene and potentially reduced VRE incidence in a vulnerable oncologic population. This practical intervention that incorporated the patient perspective provided accessible hand hygiene products with simple instruction and reminders required minimal participation of unit staff. Further application of the intervention in non-oncologic populations is needed to further establish the relationship between patient hand hygiene and the acquisition of nosocomial infections.

An Outbreak of Pan-drug Resistant Providencia Species in an Intensive Care Unit: A Case-Series

Background: Providencia species are opportunistic pathogens that can rarely cause nosocomial infections. They possess numerous virulence characteristics, such as intrinsic antibiotic resistance, which enable them to cause lethal outbreaks. The emergence of pan-drug resistant (PDR) isolates amplifies the threat of Providencia spp. to human health. Objectives: We described an outbreak caused by PDR Providencia spp. in the intensive care unit (ICU) of our medical center. Methods: This outbreak occurred at Imam Hossein Hospital in Tehran, Iran, between 20 June and 28 July 2023. The majority of the 14 patients experienced ventilator-associated pneumonia (VAP); however, two others had surgical site infections (SSI) and peritoneal abscesses. Samples were subcultured on Blood agar, Chocolate agar, and MacConkey agar, as well as differential gallery mediums. Additionally, susceptibility to antimicrobial agents was determined by the disk diffusion protocol using Mueller-Hinton (MH) agar. Results: The rapid diagnosis of the outbreak and practical measures recommended by the infection prevention and control (IPC) committee (e.g., sampling from other patients, hands of healthcare workers, and the environment to identify further cases and the source of the infection, contact isolation, disinfection of the ICU with 1% chlorine solution, and combined antibiotic therapy) assisted us in managing it. Nevertheless, the outbreak resulted in the mortality of eight patients, despite these preventive and therapeutic measures. Conclusions: Clinicians should be aware of nosocomial infections caused by opportunistic pathogens such as Providencia spp., especially in ICU-admitted patients with prolonged hospitalizations and broad-spectrum antibiotic administration. Strong clinical suspicion and timely detection of outbreaks, investigation of further cases, contact isolation of infected patients, disinfection of the environment, treatment with combined antibiotic regimens, and re-sampling of patients and the environment are the cornerstones of managing outbreaks caused by Providencia spp.

Bacterial Contamination on Electronic Surfaces in ICU

Bacteria, especially MDR isolates, can infect inanimate surfaces and equipment in ICUs (such as bedrails, stethoscopes, medical charts, and ultrasound machines). Transmission of microbes from inanimate surfaces may play a major role in the colonization and infection of patients in intensive care units. Healthcare worker hands and patient discharge both have the potential to spread germs, which can live for months on dry surfaces. It has been reported that the rate of environmental contamination is higher near infected individuals than it is near colonized patients, and that within the latter group, there is a link between the frequency of environmental contamination and culture-positive body locations. In addition to acquiring germs from direct patient contact, healthcare personnel can pick them up through inanimate surfaces and equipment in the patient zone. Patient colonization or infection can occur if healthcare workers don't properly clean their hands before and after handling patients. Several pieces of equipment and frequently used objects in the intensive care unit (ICU) include bacteria with antibiotic susceptibility profiles that are quite similar to those of germs isolated from patients. In light of the patient-zone concept and the potential consequences for bacterial pathogen cross-transmission to critically ill patients, this review aims to present up-to-date knowledge concerning the contamination of inanimate surfaces and equipment in ICUs.

Surveillance of bacterial carriage in the nose and hands of healthcare workers and patients attending maternity and children's hospital.

Nosocomial infections have been acknowledged as a significant pathogen responsible for human illness due to the rise in the incidence of these infections that are mainly caused by resistant strains. As a result, it is important to prevent nosocomial infections. Therefore, in the epidemiology and pathogenesis of infection bacterial carriage appears to be of great importance and in healthy persons, three patterns of carriage are observed over time. The common ecological niches of microorganisms are the anterior nares and hands; hence, the present study aims to evaluate the surveillance of bacterial carriage from the hands and noses of healthcare workers that involve doctors, nurses, and housekeeping staffs and patients involving pregnant women or mothers. An observational prospective study was conducted for 1.5 years in which collection of swabs from both the hands and nose were taken and inoculated on mannitol salt agar, blood agar, and MacConkey agar and incubated at 37°C for 24 h following which biochemical reactions were performed from isolates and 160 nasal swabs and hand swabs were studied for bacterial growth. The percentages of bacterial growth in the hands of mothers, doctors, housekeeping staff, and nurses were 17.5, 12.5, 52.5, and 25%, respectively, and in the nose were 7.5, 5, 32.5, and 12.5%, respectively. Total bacterial carriage in hand and nose swabs were 26.87 and 14.37%, respectively. Methicillin-resistant Staphylococcus aureus was the most common microorganism isolated and as a result to prevent its spread along with other nosocomial microorganisms, appropriate precautions should be taken as the spreading of these organisms can lead to drug resistance strains.

Microbial Profile of Tourniquets Used in Phlebotomy at a Rural Tertiary Care Teaching Hospital.

Background Reusable phlebotomy tourniquets may become contaminated through repeated use on the skin surfaces of multiple patients, the hands of healthcare workers, or various surfaces. Noncompliance with the protocol guidelines for managing tourniquets can contribute to the cross-transmission of microorganisms among patients. This study was conducted to determine the microbial flora and antimicrobial sensitivity pattern of reusable phlebotomy tourniquets. Methodology Tourniquets were randomly sampled across the different areas of the hospital and were transported to the microbiology laboratory for isolation, identification, and antibiotic susceptibility testing of microorganisms using standard microbiological techniques. Results The overall bacterial colonization rate of the 50 tourniquets was 80%. The most prevalent isolate on tourniquets was Coagulase-negative Staphylococcus (9, 22.54%), followed by Micrococcus (6, 15%), Staphylococcus aureus (5, 12.5%), diphtheroid (5, 12.5%), Acinetobacter (4, 10%) Enterococcus (3, 7.5%), Pseudomonas (3, 7.5%), Bacillus (3, 7.5%), and Escherichia coli (2, 5%). Conclusions Regular surveillance and disinfection of reusable tourniquets in resource-poor settings are recommended to decrease healthcare infections and the transmission of multidrug-resistant (MDR) strains.

Barriers to hand hygiene compliance in intensive care units to prevent the spread of healthcare-associated infections

Abstract Background: Healthcare-associated infections cause significant challenges to the provision of health care. This is due to the strain on individuals, their families, and health services. Hand hygiene measures are cost-effective to reduce the spread of healthcare-associated infections and effectively prevent the transmission of microorganisms during patient care. The hands of healthcare workers have been proven to be the main route of transmission of healthcare-associated infections. Maintaining proper hand hygiene is a straightforward method for averting healthcare-associated infections. Despite its significance, evidence suggests a need for enhanced compliance among healthcare workers concerning hand hygiene practices. Multiple factors influence hand hygiene adherence. Hence, this study sought to elucidate healthcare workers’ encounters with obstacles impeding hand hygiene compliance within intensive care units (ICUs). Materials and Methods: Conducted via purposive sampling, this qualitative study involved 50 professionals, including doctors, anesthesiologists, nurses, physiotherapists, and attendants employed in ICUs. The study utilized semi-structured individual interviews to collect data, whereas data analysis was carried out using the Lundman and Graneheim method. Results: In this study, the primary theme of “obstacles hindering hand hygiene adherence” is segmented into three principal categories: 1.barriers linked to healthcare providers encompass subcategories, such as workload, inadequate knowledge, inappropriate attitudes, and incorrect behavioral patterns; 2.barriers associated with management are delineated through subcategories involving inadequate planning and training and improper departmental physical space design; and 3.barriers related to equipment and facilities, consisting of subcategories centered on insufficient availability of equipment and equipment of subpar quality. Conclusion: The outcomes of this study offer valuable insights that can assist relevant authorities in implementing effective strategies to eliminate obstacles in hand hygiene practices. These findings aim to encourage the cultivation of the correct attitudes and behaviors among healthcare workers.

Phenotypic Detection of Extended-Spectrum β-lactamases (ESBLs) and Aminopenicillin Cephalosporinase (AmpC)-Producing Bacterial Isolates from Surfaces of Hospital Fomites and Hands of Healthcare Workers

Phenotypic Detection of Extended-Spectrum β-lactamases (ESBLs) and Aminopenicillin Cephalosporinase (AmpC)-Producing Bacterial Isolates from Surfaces of Hospital Fomites and Hands of Healthcare Workers

Assessment of hand hygiene procedures during the pre- and post-pandemic period: a pre-post study

Background: hospital infections affect about 6% of hospitalised patients in Europe; the hands of healthcare workers, who are front-line staff and frequently exposed to infected patients and contaminated surfaces, are the primary source of microbial transmission. Thus, hand washing procedures are essential to lowering the risk of occupational exposure to infectious diseases, hospital-acquired infections, and micro-organism cross-transmission. The aim of this study was to see if the COVID-19 pandemic had any effect on hand-washing adherence rates by conducting a pre-post pandemic wave study from the pre-pandemic year 2019 to the post-pandemic years 2020/2022. Methods: an observational, retrospective, single-center study. The study considers hand hygiene observations of all personnel employed as healthcare staff from 2019, during the pre-pandemic period, and in the three years following the outbreak from 2020 to 2022, during the post-pandemic period and a specific study on hydroalcoholic gel consumption. The study will use the “Hand Hygiene Observation Form”, to evaluate adherence to best practices. Conclusions: a dedicated facility that promotes the application of the recommended hand hygiene behavior and ongoing improvement and training initiatives, is crucial to ensure and improve the compliance of all healthcare workers.

Using adenosine triphosphate bioluminescence level monitoring to identify bacterial reservoirs during two consecutive Enterococcus faecium and Staphylococcus capitis nosocomial infection outbreaks at a neonatal intensive care unit

IntroductionThis study aimed to assess the role of adenosine triphosphate (ATP) bioluminescence level monitoring for identifying reservoirs of the outbreak pathogen during two consecutive outbreaks caused by Enterococcus faecium and Staphylococcus capitis at a neonatal intensive care unit (NICU). The secondary aim was to evaluate the long-term sustainability of the infection control measures employed one year after the final intervention measures.MethodsTwo outbreaks occurred during a 53-day period in two disconnected subunits, A and B, that share the same attending physicians. ATP bioluminescence level monitoring, environmental cultures, and hand cultures from healthcare workers (HCW) in the NICU were performed. Pulsed-field gel electrophoresis (PFGE) typing was carried out to investigate the phylogenetic relatedness of the isolated strains.ResultsFour cases of E. faecium sepsis (patients A-8, A-7, A-9, B-8) and three cases of S. capitis sepsis (patients A-16, A-2, B-8) were diagnosed in six preterm infants over a span of 53 days. ATP levels remained high on keyboard 1 of the main station (2076 relative light unit [RLU]/100 cm2) and the keyboard of bed A-9 (4886 RLU/100 cm2). By guidance with the ATP results, environmental cultures showed that E. faecium isolated from the patients and from the main station’s keyboard 1 were genotypically indistinguishable. Two different S. capitis strains caused sepsis in three patients. A total 77.8% (n = 7/9) of S. capitis cultured from HCW's hands were genotypically indistinguishable to the strains isolated from A-2 and A-16. The remaining 22.2% (n = 2/9) were genotypically indistinguishable to patient B-8. Three interventions to decrease the risk of bacterial transmission were applied, with the final intervention including a switch of all keyboards and mice in NICU-A and B to disinfectable ones. Post-intervention prospective monitoring up to one year showed a decrease in blood culture positivity (P = 0.0019) and catheter-related blood stream infection rate (P = 0.016) before and after intervention.ConclusionATP monitoring is an effective tool in identifying difficult to disinfect areas in NICUs. Non-medical devices may serve as reservoirs of pathogens causing nosocomial outbreaks, and HCWs' hands contribute to bacterial transmission in NICUs.

Hand Hygiene Compliance and Healthcare Associated Infections Trends in a Tertiary Care Children Hospital, in Years 2016-2022

Healthcare workers hands are the most common vehicle for the transmission of healthcare-associated infections. Hand hygiene is considered the most effective measure for preventing microbial pathogen cross-transmission, and reducing healthcare-associated infections; thus, it’s key to maintain high healthcare workers compliance with this practice.
 We calculated trends of compliance to hand hygiene and healthcare-associated infections (HAIs) point prevalence in a tertiary care children hospital, in years 2016–2022. We observed a significantly increased hand hygiene compliance from 89.5% (95% CI: 89.1-89.9) in 2016 to 92.1% (95% CI: 91.7-92.4; p<0.001) in 2022. Hand hygiene compliance significantly increased for four out of five moments for hand hygiene, and for most of the professional categories observed. We observed a stable trend of HAIs point prevalence which was 1.8% (95% CI: 0.7-3.6) in 2016, and 2.0% (95% CI:1.0-3.7; p=0.6) in 2022. No significant trends were observed over time stratifying by type of HAIs.
 Our results document the increased adherence to hand hygiene in the context of pandemic emergency response, associated to maintenance of low prevalence of HAIs.

Functional dependence as a contributing factor for patient hand contamination by multidrug-resistant organisms in acute care

Background and objectives: Patients with functional disabilities are at higher risk of adverse outcomes, including infections. Although healthcare worker hand contamination has long been recognized as an important source of pathogen acquisition, the role of patient hands has been less clearly defined. We sought to determine whether the presence of functional disabilities is correlated with patient hand contamination by multidrug-resistant organisms (MDROs) and thus a potential target for patient hand hygiene (PHH) interventions. Methods: Case–control study of hand contamination with methicillin-resistant S. aureus, vancomycin-resistant enterococci, and gram-negative bacilli resistant to cephalosporins, fluoroquinolones, and/or carbapenems in 2 acute-care hospitals in southeastern Michigan. Cases (n = 40) and controls (n = 359) were defined as patients with or without hand contamination by MDROs, respectively. We assigned 3 exposure categories based on Katz activities of daily living scores: no functional disabilities (independent, reference group), 1–3 functional disabilities (partially dependent), and 4+ functional disabilities (dependent). We used stepwise logistic regression to identify confounding variables. Logistic regression was then used to establish the relationship between a patient’s functional dependence level and their hand contamination by MDROs. Results: The distribution of hand contamination of each target MDRO by level of patient dependence is shown in the Table. Overall, methicillin-resistant Staphylococcus aureus (MRSA) was the most represented, followed by resistant gram-negatives and vancomycin-resistant enterococci (VRE). Hospital site, sex, and history of MDROs were included in the model based on stepwise regression. The odds ratio (OR) of MRSA hand contamination in the dependent category was 3.19 (95% CI, 1.18–5.54) compared to the independent category, and for any MDRO the OR was 2.77 (95% CI, 1.22–6.32) (Fig. 1). The OR of MRSA hand contamination in the partially dependent category was 1.38 (95% CI, 0.27–7.07) compared to the independent group, and for any MDRO the OR was 0.86 (95% CI, 0.24–3.10) (Fig. 1). Feeding dependence had the highest single association with hand contamination (OR, 3.79, 95% CI, 1.26–11.43), with dressing dependence having the second highest association with hand contamination (OR, 2.82; 95% CI, 1.31–6.05) (Fig. 2). Conclusions: Patients with more functional dependencies were more likely to have MDRO hand contamination. This finding suggests a need for targeted PHH interventions in patients with functional disabilities to help prevent the spread of MDROs in the acute-care setting.Disclosures: None

Impact of COVID-19 pandemic waves on health-care worker hand hygiene activity in department of medicine and ICU as measured by an automated monitoring system.

Hand hygiene (HH) compliance among health-care workers is important for preventing transmission of infectious diseases. To describe health-care worker hand hygiene activity in ICU and non-ICU patients' rooms, using an automated monitoring system (AMS), before and after the onset of the COVID-19 pandemic. At the Intercommunal Hospital of Créteil, near Paris, France, alcohol-based hand sanitizer (ABHS) consumption in the Department of Medicine (DM) and ICU was recorded using an AMS during four periods: before, during, and after the first wave of the COVID-19 pandemic, and during its second wave. From 1st February to 30th November 2020, in the DM, the mean number of doses per patient-day for each of the four periods was, respectively, 5.7 (±0.3), 19.4 (±1.3), 17.6 (±0.7), and 7.9 (±0.2, P<0.0001). In contrast, ICU ABHS consumption remained relatively constant. In the DM, during the pandemic waves, ABHS consumption was higher in rooms of COVID-19 patients than in other patients' rooms. Multivariate analysis showed ABHS consumption was associated with the period in the DM, and with the number of HCWs in the ICU. An AMS allows real-time collection of ABHS consumption data that can be used to adapt training and prevention measures to specific hospital departments.

Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit.

The present study describes an epidemiological investigation into a carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak, which had occurred in a neonatal intensive care unit (NICU), and the subsequent strengthening of infection control interventions. Upon the onset of the outbreak, existing infection control interventions were reviewed, and a set of containment measures were instituted. All CRAB isolates were characterized in terms of antimicrobial susceptibility testing and their genetic relatedness. The investigation process identified gaps within the NICU's existing infection control measures, which had likely resulted in the outbreak. CRAB was isolated from nine preterm infants: five colonized and four infected. All five colonized patients were discharged well. However, three out of four of the infected infants died. Outbreak investigation and genomic subtyping of environmental swabs revealed that mini syringe drivers shared between patients and a sink in the milk preparation room had served as CRAB reservoirs with possible transmission via the hands of healthcare workers. Implementation of immediate actions such as reinforcement of hand hygiene practices, intensified environmental cleaning, geographical cohorting, reviewing of milk handling practices and sink management protocol had resulted in no further CRAB isolation. The CRAB outbreak in the NICU underlines the importance of consistent compliance with infection-control interventions. Integration of epidemiological and microbiological data, together with comprehensive preventive measures, successfully brought the outbreak to a halt.

Detection of Fungal Contamination of Ward Furnishing and Medical Equipment Used in intensive Care Unit and Neonatal Intensive Care Unit

Background: Nosocomial infections acquired during hospitalization depend on the characteristics of the microorganisms, with a high risk of being acquired when the contaminated environment. Cross-transmission of microorganisms by contaminated surfaces and the hands of health care workers are considered to be the main route of the spread of nosocomial infections.&#x0D; Aim of study: This study aim to detect the fungal contamination of ward furnishings and medical equipment used in the intensive care unit and Neonatal intensive care unit.&#x0D; Materials and Methods: Fifty environmental swabs were collected from ward furnishings and medical equipment including predefined surfaces (armrest beds, wash sinks, medical tables), between August and September 2021.Swab specimens were immediately inoculated onto plates that contained Sabouraud Dextrose Agar. After that samples were incubated for a 1 to 7 days period at 28°C and checked every day for growth.&#x0D; Results: Out of fifty swabs samples, 21(42%) yielded Fungal growth. From these isolated organisms Penicillum species was the predominant isolate 10 (47.6%) followed byAspergillus flavus.Penicillum species was the commonest fungal isolates among ICU, while Aspergillus flavus were the predominant isolates among Neonatal ICU. The most contaminant Equipment was found in Neonatal ICU samples 5(55.6%), and the most contaminant Place in ICU was the floors 3(25%).&#x0D; Conclusion: This study showed that ICU of the hospital may contain fungi indicating that may form potential source of cross-infection through health care workers to their patients.&#x0D; Keywords: Fungi, Neonatal, ICU, and Infection.

Screening for some virulent factors among bacterial isolates from surfaces of hospital fomites and hands of healthcare workers

The ability of the bacterial isolate to cause debilitating effects on the host is intricate and is a function of many factors, particularly that of the host and the bacteria. Among the bacterial factors are the virulence mechanisms. As such this research was a cross-sectional study conducted between October–December 2021 to establish the existence of virulence determinants on bacterial isolates from hospital fomites and the hands of healthcare workers. To achieve this, 100 samples (including sink, beddings, door handles, benches, and hands of healthcare workers) from children, female and male wards of Mubi General Hospital were analyzed for bacterial growth and were identified by standard procedure. Isolates were subsequently screened for virulent determinants (hemolysis, hemagglutination, biofilm production, and heteroresistance) phenotypically by standard methods. From the 72 bacterial isolates recovered, 23(31.9%) were biofilm-producing organisms. Of these, 15(20.8%) and 8(11.1%) were moderate and high biofilm-producing organisms respectively with no statistical difference (P=0.665). Pseudomonas aeruginosa (13.9%) was the most predominant biofilm-producing organism. Furthermore, hemolysin production was predominant in Staphylococcus aureus (71.4%), while positive hemagglutination reaction was predominant in P. aeruginosa (38.5%). Sixteen (16) bacterial isolates showed heteroresistance (HR) to various antibiotics; of these, Escherichia coli (43.8%) constitute the majority of the isolates. The expression of such virulence determinants by bacterial isolates in the study area may constitute a health risk to patients and hamper the quality of health care delivery.

SG-APSIC1038: Hospital-wide study to evaluate the tolerability and acceptability of alcohol-based hand rubs according to WHO protocol, and healthcare worker hand hygiene behavior during the COVID-19 pandemic

Objectives: To evaluate the tolerability and acceptability of 3 different alcohol-based hand rub (ABHR) products, and to determine factors influencing hand hygiene (HH) behavior among healthcare workers (HCWs) during the COVID-19 pandemic. Methods: A cross-sectional study was conducted in Sarawak General Hospital, a 1,034-bed tertiary-care state hospital. A self-administered 7-point Likert scale questionnaire was adapted from the WHO ‘Protocol for Evaluation of Tolerability and Acceptability of ABHR.’ The study was conducted between November 12 and 26, 2021, based on 3 types of ABHR products. Participation in answering the questionnaire was voluntary, so consent was implied. The Student t test was used to determine the significant differences among the ABHR product. The χ2 distribution test was performed to evaluate the characteristics of ABHR products. Results: We received a response rate of 35% (1,598 of 4,628); 82% of respondents were female, and the overall cohort had a mean age of 35 years. Also, 972 (61%) of 1,598 respondents were nurses, and 1,490 (93%) of 1,598 respondents used ABHR at least 5 days every week. Of 1,598 respondents, 1,156 (72%) indicated that ABHR products were easily accessible at the point of patient care. Evaluation of ABHR products showed that respondents were receptive to all product colors (P &lt; .0114) and had no color preference (P &gt; .05). Comparison among ABHR products yielded no statistical difference (P &gt; .05) for ‘smell,’ ‘stickiness,’ ‘irritation,’ or ‘drying speed.’ ‘Drying effect’ of all products was statistically significant (P &lt; .0252). The overall satisfaction for all products was good (P &lt; .0022). HCWs did not expect their HH compliance to improve even if they were provided with their preferred choice of ABHR. Of 1,598 respondents, 783 (49%) correctly used a palm-full of ABHR for HH, and 1, 275 (80%) indicated that hospital management should organize more HH-related awareness and continuous medical education on HH. Conclusions: A comparison among different ABHR characteristics mostly showed no statistically significant difference regarding tolerability and acceptability. These findings suggest that different ABHR products will not influence HH behavior during COVID-19 pandemic.

Health care worker carriage of drug-resistant bacteria and infection control practices at a tertiary care hospital in Uganda: a cross-sectional survey.

bacterial carriage by health care workers (HCWs) is a major risk factor for transmission of healthcare-associated infections (HAIs). Often, these pathogens are multiple drug resistant (MDR) and are transmitted from hospital environments. We aimed to study the carriage of pathogenic bacteria among HCWs at a tertiary care hospital in Uganda. a cross-sectional study was done at Naguru Regional Referral Hospital from June 2017 to August 2017. Five finger imprints of both hands-on blood and MacConkey agar were done. We assessed pathogenic bacterial carriage by HCWs and characterized drug sensitivity and relatedness of these isolates. Genotyping of extended-spectrum beta-lactamase (ESBL) and Methicillin-resistant Staphylococcus aureus (MRSA) positive isolates was done to determine intra-hospital transmission. A survey of the hospital's IPC de program was done. one hundred and eight (108) HCWs were enrolled. Carriage of pathogenic bacteria was highest in surgical and emergency wards at 36% and 35.6% respectively, p-value of 0.00. The proportion of microbial carriage was highest among nurses 16 (34.8%) followed by medical officers 11 (23.9%). Among the isolated pathogenic bacteria, 25 (36.2%) were Gram-positive and 44 (63.8%) were Gram-negative. Fifty percent of Staphylococcus aureus were methicillin-resistant, and one isolate was vancomycin-resistant. Fifty-four percent (54.6%) of HCWs had never been trained on moments of hand hygiene, only 44.4% recognized the presence of an IPC program in the hospital and 49% were not aware of problems associated with poor IPC practices. this study demonstrated that hands of HCWs at Naguru Regional Referral Hospital were colonized with pathogenic bacteria with varying prevalence, some with multidrug-resistant strains including MRSA and ESBL.