Hospital Infection Control Research Articles

Analysis of the Role of Nursing Management in Hospital Infection Control in Outpatient Department of Stomatology

Analysis of the Role of Nursing Management in Hospital Infection Control in Outpatient Department of Stomatology

Standard precautions for infection control in a tertiary care hospital

standard precautions for infection control in a tertiary care hospital

Rapid Detection and Differentiation of KPC and MBL Carbapenemases among Enterobacterales Isolates by a Modified Combined-Disk Test.

This study was conducted to develop a cheap, rapid, and accurate modified combined-disk test (mCDT) approach to detect and differentiate KPC and MBL carbapenemases among clinical carbapenem-resistant Enterobacterales (CRE) isolates and simultaneously distinguish them from carbapenem-susceptible Enterobacterales (CSE) isolates. A total of 163 CRE and 90 third-generation cephalosporin-resistant Enterobacterales isolates were tested using imipenem and meropenem disks and different concentrations of carbapenemase inhibitors. The optimal sensitivity and specificity for detecting KPC carbapenemase were 97.2% and 100%, respectively. The sensitivity and specificity for detecting MBL carbapenemase were 100% and 100% with imipenem or meropenem and carbapenemase inhibitors within six hours. The inhibitory zone diameter of 18 mm for imipenem or meropenem disks without inhibitor could distinguish CRE from CSE isolates. Therefore, this mCDT approach may be a useful tool in clinical laboratories to detect CRE isolates and differentiate KPC and MBL producers, which is beneficial for patient management and hospital infection prevention and control.

Surveillance of Wisconsin Organisms for Trends in Antimicrobial Resistance and Epidemiology (SWOTARE): 2018-2019 Report on Enterobacter cloacae and Klebsiella pneumoniae Clinical Isolates.

Objectives: Both Enterobacter cloacae and Klebsiella pneumoniae have been regarded as important opportunistic pathogens for humans. Recent data have described the spread of multi-resistant strains of these organisms. Development of novel resistance phenotypes may result in a reduction in anti-infective efficacy, therefore making patient treatment decisions challenging. The Surveillance of Wisconsin Organisms for Trends in Antimicrobial Resistance and Epidemiology (SWOTARE) program aims to combat this issue and improve antibiotic stewardship by monitoring antimicrobial resistance at a local level.Design: Multi-center laboratory surveillance, with testing at a single location utilizing standardized media and susceptibility testing protocolsMethods: In the years 2018 and 2019, a total of 591 clinically-significant E. cloacae and 668 clinically-significant K. pneumoniae isolates were collected through this initiative; limited demographic data were also supplied. Isolates were tested by broth microdilution procedures advocated by Clinical and Laboratory Standards Institute.Results: On a statewide level, both E. cloacae and K. pneumoniae demonstrated in vitro potency to carbapenem and aminoglycoside agents at rates exceeding 96%. K. pneumoniae isolates were generally more susceptible to cephem and monobactam agents than E. cloacae isolates; the converse was true for fluoroquinolone agents. Patterns of local antimicrobial resistance were revealed that were not apparent at the state level. E. cloacae isolates submitted from the Northcentral and Southeast regions demonstrated decreased susceptibility to five antimicrobial agents (notably third- and fourth-generation cephems) when compared to the state average. Isolates derived from males, older individuals, and urogenital sources exhibited decreased susceptibility to third- and fourth-generation cephem agents (P ≤ 0.047). With respect to K. pneumoniae, antimicrobial resistance phenotype was not a function of geography or gender. However, isolates emanating from older patients and the respiratory tract showed decreased susceptibility to ampicillin/sulbactam and cefazolin, respectively (P ≤ 0.019).Conclusions: Antimicrobial resistance surveillance at a local level provides utility to community/rural hospital clinicians, pharmacists, and infection control practitioners. With respect to E. cloacae, further surveillance efforts may be necessary in the Northcentral and Southeast regions of Wisconsin. Subanalysis of demographic data indicated cephem-resistance correlates that are not apparent at the statewide level.

Surveillance of device-associated infections at a tertiary care hospital of Punjab

Background: Surveillance of health-care-associated infections (HAIs) plays a key role in the hospital infection control programme and reduction of HAIs. Device-associated infections (DAIs) are an important cause of excessive stay and mortality. The prevalence of HAIs is underreported from developing nations due to a lack of systematic surveillance. Aims and Objectives: The aim of the study was to know the rate and microbiological profile of DAIs. Materials and Methods: This surveillance study was conducted over a period of 2 years. Patients with indwelling devices were included. The data were collected and analysed by infection control team and labelled DAIs as per the CDC guidelines. The rates of HAIs and the profile of pathogens isolated were analysed. Results: A total of 294 patients developed DAIs, of which 181 were male and 113 were female. A total of 239 device-associated infections were reported in 2019 and 55 in 2020 and overall rate of DAIs was 1.81 and 0.58/1000 device days, respectively. Among DAIs, 50 were ventilator-associated pneumonia (VAP), 71 central line-associated bloodstream infections (CLABSI) and 173 catheter-associated urinary tract infection (CAUTI) cases. Overall, the rate was 2.02,1.21,1.21/1000 device days for VAP, CLABSI and CAUTI, respectively. In DAI's, majority were males and maximum cases developed after 6–10 days, 15 days and 11–15 days of device use in VAP/CAUTI and CLABSI, respectively. Gram-negative isolates (85.1%) were predominant, and among these, most common were Klebsiella spp, Acinetobacter spp and Escherichia coli. A high rate of multidrug resistance was observed. Conclusions: The present surveillance shows high resistance pattern of Gram-negative organisms causing DAIs. To reduce the risk of infection in hospitalised patients, DA-HAI surveillance is of primary importance as it helps in implementing preventive measures.

ECOLOGIST’S PERFORMANCE IN THE HEALTH SERVICE

Environmental awareness is emerging in society, and with this, managers, commercial activities, institutions and health services are no different, especially when there are legal environmental requirements related to monitoring and mandatory environmental management for its operation. This fact makes professions linked to environmental monitoring essential for carrying out these jobs in these services. Therefore, the objective of this study is to elucidate the participation of the ecologist working professionally in health services, more specifically in hospital units. The study is characterized as a qualitative research, it does not intend to achieve what is right or wrong, only to understand the reality of its actions and transformations. It was noticed that a hospital management signals as benefits for management the performance of the ecological professional, mainly in the development of actions on environmental issues: Waste from Health Services RSS, preparation of the Health Waste Management plan, monitoring of water quality, monitoring and control of pests and insects, assistance in epidemiological surveillance actions and monitoring and control of hospital infections, composting projects, recycling projects, solidarity economy, and continuing education actions such as training on RSS and biosafety, all of which are fundamental to fostering sustainability within the hospital environment. Considering this, the performance of the ecology professional in health units, innovative in hospital units, this can be an aggregator to the interdisciplinary model to seek environmental improvements considered complex, but that achieve a successfully hospital environmental management.

Influence on Social Distancing Implement of Knowledge and Awareness on Standard Precautions of Hospital Infection Control in Nursing students

목적 본 연구는 간호대학생의 병원감염 표준주의 지식과 인식이 사회적 거리두기 실천에 미치는 영향을 확인하기 위해 실시된 서술적 조사연구이다. 방법 연구 대상은 C대학 간호학과에 재학 중인 학생 142명이었다. 자료수집은 2020년 06월 23일부터 07월 07일까지였으며, 자기기입식 설문지를 이용하였다. 자료분석은 SPSS/WIN 21.0 프로그램을 이용하여 기술통계, t-test, ANOVA, Pearson s Corelation Coefficients과 다중회귀분석을 실시하였다. 결과 간호대학생의 표준주의지침 인식은 사회적 거리두기와 양의 상관관계를 나타내었다(r=.25, p=.002). 사회적 거리두기에 영향을 미치는 요인은 표준주의지침 인식(β=.20, p=.026)과 전공만족도(β=-.17, p=.034)로 나타났으며, 설명력은 11.1%였다(F=4.28, p=.003). 결론 간호대학생들에게 감염관리에 대한 중요성을 인식할 수 있는 실무교육이 함께 제공되어야 할 것이다.

High ESBL-E colonization rate among children in Gabon: a follow-up study

A previous study conducted in Gabon, Central Africa, in 2010/11 found a high colonization rate with extended-spectrum β-lactamase-producing enterobacterales (ESBL-E) among children of ~34 %. Eight years later, we aimed to reassess the ESBL-E rate and previously identified risk factors for colonization in children from Gabon. We conducted a cross-sectional cohort study in 2018 on 92 outpatients under 5 years of age with diarrhoea in Lambaréné, Gabon, in whom a rectal swab was obtained at the initial medical encounter (baseline). Fifty-eight of these provided a further rectal swab 1 week afterwards. ESBL-E colonization was assessed [following the European Committee on Antimicrobial Susceptibility Testing (EUCAST)], and in confirmed ESBL-E isolates the susceptibility to meropenem and the prevalence of the most abundant ESBL genes, bla CTX-M, bla SHV, and bla TEM, were investigated. At baseline, the ESBL-E colonization rate was 57 % (52/92; 95 % CI: 46-67). Hospitalization during the previous year, chicken consumption in the past week and young age were identified as independent risk factors for ESBL-E colonization at baseline. On day 7, the ESBL-E carriage rate was 72 % (42/58; 95 % CI: 59-83). All ESBL-E isolates (n=293) were susceptible to meropenem and bla CTX-M was the most frequently detected β-lactamase gene. The ESBL-E colonization rate among children from Gabon is alarmingly high, with indications of further increase over recent years. While all ESBL-E strains remain currently susceptible to meropenem, in practice no adequate treatment is available locally for severe infections with such isolates. It is thus of the utmost importance to invest in improved hospital infection prevention and control measures to combat ESBL-E effectively.

Developing an Infection Prevention and Control Educational Program for Critical Care Nurses:Intervention Mapping Protocol and Social Cognitive Theory

Aim: This study aims to apply the Intervention Mapping protocol and Social Cognitive Theory in thedevelopment of an infection prevention and control education program aimed at critical care nurses.Background:Education programs have been widely used to improve awareness toward infection preventionand control, but the development of an integrated theory- and evidence-based education program tailored tocritical care nurses has not yet been discussed.Subject and Methods: Data are from the Hospital Universiti Sains Malaysia infection control records. The6-step Intervention Mapping protocol and the Social Cognitive Theory were used to develop an infectionprevention and control education material tailored to critical care nurses. The educational material was alsoinfluenced by Previous literature, hospital infection control committee, and in-charge nurses of intensivecare unit.Results: The educational material was tailored to target knowledge, self-efficacy, and risk perception thatidentified as the individual determinants of critical care nurses health behavior during assessment phase. Inaddition to physical environment and organizational support that determined as external determinants. Amatrix of change objectives was mapped out for each health behavior determinant, teaching methods, andtheir practical applications.Conclusion: Applying the Intervention Mapping protocol and the Social Cognitive Theory is effective indeveloping educational material tailored to critical care nurses to improve their self-confidence and promoteknowledge-based practice in infection prevention and control.

Adherence to Infection Prevention and Control Practices among Health Care Workers and its Outcome in Non-COVID Areas in a Tertiary Care Hospital

International Journal of Medicine and Public Health,2021,11,3,146-149.DOI:10.5530/ijmedph.2021.3.26Published:August 2021Type:Original ArticleAdherence to Infection Prevention and Control Practices among Health Care Workers and its Outcome in Non-COVID Areas in a Tertiary Care HospitalMini Palathingal Narayanan, Anuja Mohan, Priya Chandran, Durga Neelakandan, and Beena Philomina Jose Mini Palathingal Narayanan1,*, Anuja Mohan1, Priya Chandran2, Durga Neelakandan1, Beena Philomina Jose1 1Department of Microbiology, Government Medical College Kozhikode, Kerala, INDIA. 2Department of Community Medicine, Government Medical College Kozhikode, Kerala, INDIA. Abstract:Aim and Objective: 1. To study the adherence to Infection Prevention and Control (IPC) practices by health care workers in Non-COVID areas. 2. To compare the proportion of COVID affected health care workers among those adhering to proper IPC and those with non-adherence. Background: Hospitals serve as frontline health care institutions caring for the increased number of COVID-19 patients. The health care personnel working in hospitals are at increased risk of acquiring the disease during the pandemic. It is the prime responsibility of the Hospital Infection Control Committee to protect the health care workers (HCW) and prevent nosocomial transmission. Materials and Methods: In the cross sectional study,all health care workers from non-COVID areas of the hospital who were exposed to COVID-19 patient during the study period were assessed according to the risk assessment criteria. Results: A total of 1049 health care workers had contact with COVID-19 patients. Of this only 6 health care workers were diagnosed with COVID-19. Conclusion: The HCW diagnosed with COVID-19 was less than one percentage of exposed. This implies the impact that the IPC training had on the HCW which made them ensure their own safety and prevent the nosocomial spread of SARS-CoV-2 within the hospital. Keywords:Adherence, Frontline health care workers, Nosocomial infectionView:PDF (150.3 KB)

Barriers and Opportunities for Sustainable Hand Hygiene Interventions in Rural Liberian Hospitals.

Hand hygiene is central to hospital infection control. During the 2014–2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March–May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% (n = 42) of hospital wards, piped running water in 23% (n = 11), and soap in 62% (n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers (n = 8) and 95% of pocket-size dispensers (n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement.

Risk Groups for SARS-CoV-2 Infection among Healthcare Workers: Community Versus Hospital Transmission.

Background: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020 before the vaccination era. Methods: We surveyed SARS-CoV-2 infection among the HCWs in a hospital through screening for antibody levels and the detection of viral RNA by RT-PCR between May 2020 and December 2020. Occupational and non-occupational potential predictors of disease were surveyed for the HCWs included in this study. Results: Among 1925 personnel in the hospital, 1732 were included to the study with a response rate of 90%. The overall infection rate of HCWs was 16.3% at the end of 2020, before vaccinations started. In the multivariate analysis, being janitorial staff (OR: 2.24, CI: 1.21–4.14, p = 0.011), being a medical secretary (OR: 4.17, CI: 2.12–8.18, p < 0.001), having at least one household member with a COVID-19 diagnosis (OR: 8.98, CI: 6.64–12.15, p < 0.001), and number of household members > 3 (OR: 1.67, CI: 1.26–2.22, p < 0.001) were found to be significantly associated with SARS-CoV-2 infection. Conclusions: Medical secretaries and janitorial staff were under increased risk of SARS-CoV-2 infection. The community-hospital gradient can explain the mode of transmission for infection among HCWs. In the setting of this study, community measures were less strict, whereas hospital infection control was adequate and provided necessary personal protective equipment. Increasing risk in larger households and households with diagnosed COVID-19 patient indicates the community-acquired transmission of the infection.

Paradigm Shift in Antimicrobial Resistance Pattern of Bacterial Isolates during the COVID-19 Pandemic.

Antimicrobial resistance (AMR) is an emerging public health problem in modern times and the current COVID-19 pandemic has further exaggerated this problem. Due to bacterial co-infection in COVID-19 cases, an irrational consumption of antibiotics has occurred during the pandemic. This study aimed to observe the COVID-19 patients hospitalized from 1 March 2019 to 31 December 2020 and to evaluate the AMR pattern of bacterial agents isolated. This was a single-center study comprising 494 bacterial isolates (blood and urine) that were obtained from patients with SARS-CoV-2 admitted to the ICU and investigated in the Department of Microbiology of a tertiary care hospital in Delhi, India. Out of the total bacterial isolates, 55.46% were gram negative and 44.53% were gram positive pathogens. Of the blood samples processed, the most common isolates were CoNS (Coagulase Negative Staphylococcus) and Staphylococcus aureus. Amongst the urinary isolates, most common pathogens were Escherichia coli and Staphylococcus aureus. A total of 60% MRSA was observed in urine and blood isolates. Up to 40% increase in AMR was observed amongst these isolates obtained during COVID-19 period compared to pre-COVID-19 times. The overuse of antibiotics gave abundant opportunity for the bacterial pathogens to gradually develop mechanisms and to acquire resistance. Since the dynamics of SARS-COV-2 are unpredictable, a compromise on hospital antibiotic policy may ultimately escalate the burden of drug resistant pathogens in hospitals. A shortage of trained staff during COVID-19 pandemic renders it impossible to maintain these records in places where the entire hospital staff is struggling to save lives. This study highlights the extensive rise in the use of antibiotics for respiratory illness due to COVID-19 compared to antibiotic use prior to COVID-19 in ICUs. The regular prescription audit followed by a constant surveillance of hospital infection control practices by the dedicated teams and training of clinicians can improve the quality of medications in the long run and help to fight the menace of AMR.

Prevalence of Nosocomial Infection Microorganisms and the Presence of Antimicrobial Multi-Resistance

BACKGROUND AND OBJECTIVES: hospitals represent the place where multidrug-resistant bacteria are concentrated and from where they spread within the institution and to the community. Thus, this research aimed to verify the profile of microorganisms related to nosocomial infection and to analyze the existence of multidrug-resistant bacteria at the Hospital de Caridade de Santo Ângelo/RS, the largest hospital in the city. METHODS: hospital infection data from 100 medical records, from August/2016 to March/2017, maintained by the Hospital Infection Control Committee were used. Bacterial identification was carried out by the Microbiology Laboratory of the hospital using morpho-tinting and biochemical methods; and antimicrobial susceptibility was determined by the disk diffusion method. Bacterial multidrug-resistance was considered based on resistance to three or more classes of antimicrobials. RESULTS: the three most prevalent microorganisms were Acinetobacter baumannii (17%), Escherichia coli (16%), and Staphylococcus aureus (8%). The hospital unit with the highest number of isolates was the adult Intensive Care Unit, with 41% of the cases. Tracheal secretion, urine, and wound secretion samples provided the highest number of isolates. Sixteen different species/groups of multidrug-resistant bacteria were identified, as follows: Morganella morganii (100%), Hafnia alvei (100%), Enterobacter sakazaki (100%), Serratia spp. (100%), Enterobacter aerogenes (100%), Proteus vulgaris (100%), Acinetobacter baumannii (100%), Klebsiella pneumoniae (83%), Enterobacter spp. (75%), Klebsiella ozaenae (66%), coagulase-negative Staphylococcus (66%), Escherichia coli (56%), Serratia rubidaea (50%), Serratia marcensces (50%), Staphylococcus aureus (37%) e Pseudomonas aeruginosa (28%). CONCLUSION: the large number of multidrug-resistant isolates reinforces the importance of isolation and restriction strategies to avoid cross-contamination to inside and outside the hospital.

Effect of Detail Nursing Management on Hospital Infection Control

Effect of Detail Nursing Management on Hospital Infection Control

The Use of a Three-in-One Practice-Management-Innovation Training Model in the Construction of an Infection Control Team.

ObjectiveThis study aims to explore the role of a three-in-one practice, management, and innovation training model (also called as three-in-one practice-management-innovation training model) in the construction of an infection control team.MethodsThis study retrospectively analyzed the position structure, mastery of professional knowledge, and working methods of the full-time and part-time personnel of the Changzhou Cancer Hospital, compared the training content of Jiangsu Hospital Infection Control Center with the actual situation of the hospital, and formulated and implemented a three-in-one practice-management-innovation training model. First, the team members were selected for the construction and management of the Hospital Infection Management Department according to the relevant responsibility and management requirements, and their learning and mastery of the basic knowledge and skills concerning infection control were completed based on their professional roles. In line with the regulations of the hospital and department, full-time personnel were ensured of having the opportunity to participate in provincial- and municipal-level academic exchanges and then learn from each other, through collaboration between doctors and nurses, how to exercise basic management skills. At the same time, a fair competitive incentive mechanism was established through the three-level network of the hospital infection committee, the hospital infection management department, and nosocomial infection management department to implement innovative project-based management and cultivate an awareness of hospital infection control in all employees.ResultsThe professional structure of the full-time infection control personnel has been optimized, the awareness of the infection control team concerning active participation in practice has gradually increased, and infection control management and innovation has been significantly improved.ConclusionAfter the selection of an infection control management team and the delivery of well-planned training, the quality of infection control management has improved.

Methicillin and Vancomycin Resistant Staphylococcus aureus and Associated Factors from Surgical Ward Inpatients at Debre Markos Referral Hospital, Northwest Ethiopia.

IntroductionStaphylococcus aureus is a well-known superbug and leading causes of wound infections. The clinical epidemiology of methicillin resistant S. aureus (MRSA) and vancomycin resistant S. aureus (VRSA) is not well documented in Ethiopia. The aim of this study was to determine the proportion of MRSA, VRSA and associated factors from surgical inpatients in Debre Markos Referral Hospital (DMRH), Northwest Ethiopia.MethodsA facility-based cross-sectional study was conducted from February to April 2020 at DMRH. A structured questionnaire was used to gather demographic and clinical data. Wound swab was collected from inpatients and then inoculated on blood agar and mannitol salt agar. The presence of MRSA and VRSA was determined using the cefoxitin (30 μg) antibiotic disk diffusion and vancomycin E-test methods, respectively. The data were analyzed using SPSS 20. Data were analyzed using bivariate and multivariate logistic regression analysis. A P-value <0.05 was considered statistically significant.ResultsA total of 242 wound cases were enrolled and the majority of them were males 172 (71.1%). Among the total enrolled cases, S. aureus was identified from 71 (29.3%) of the admitted patients. The proportion of MRSA was 32 (13.22%) and that of VRSA was 4.1%. The proportion of vancomycin intermediate S. aureus (VISA) was gauged at 4.5%. Hospital stay over 72 hrs, wound depth, current antibiotic use, and previous history of wound infection showed statistically significant association with MRSA. On the contrary, VRSA did not showed any significant association against the analyzed variables.ConclusionHigh proportions of S. aureus isolates became MRSA; resistant to all β-lactam antimicrobial agents excluding newer cephalosporin. In addition, the proportion of VRSA/VISA was also high. Multiple variables demonstrated significant associations with MRSA. Hence, intervention measures for MRSA risk groups must be in place. Furthermore, hospital infection control and an antibiotic stewardship program should be strengthened.

Influenza vaccination coverage and obstacles in healthcare workers (HCWs) and the follow up of side effects: a multicenter investigation in Iran.

SummaryIntroductionSeasonal influenza is an annual common occurrence in cold seasons; but the COVID-19 pandemic is also currently ongoing. These two diseases can’t be distinguished from their symptoms alone; therefore, the importance of preventing influenza by vaccination is more than ever. Due to the high exposure of hospital personnel, widespread influenza vaccination of these high-risk groups seems to be a necessity. This Study conducted to determine vaccination coverage in the personnel of four tertiary referral collegiate hospitals in 2019 and to further investigate individual obstacles for Influenza vaccination.MethodsIn this cross-sectional descriptive study, 637 personnel were selected randomly from distinctive hospitals in a list-wised. Ones vaccinated filled the side effects questionnaire and who not vaccinated filled the vaccination obstacles questionnaire. The study was approved by the ethics committee of Tehran University of Medical Sciences with this reference number: IR.TUMS.IKHC.REC.1398.218ResultsThe mean vaccination coverage was 29.4% and the coverage difference among centers was not statistically significant (p = 0.192). The following items had the most impact on personnel decision: confidence about one’s immune system (p < 0.05), the experience of side effects from previous vaccinations (p = 0.011), attitude about vaccination in colleagues (p = 0.021) and work experience (p < 0.05). About 23% of vaccinated individuals reported side effects following vaccination and the most common side effect was mild cold symptoms with 12.3% prevalence.ConclusionThe results of the current study revealed that influenza vaccination coverage among HCWs is not satisfactory in Iran. Hospital authorities and infection control units should plan to remove the obstacles of influenza vaccination.

Healthcare-associated infections and antimicrobial use in surgical wards of a large urban central hospital in Blantyre, Malawi: a point prevalence survey

SummaryBackgroundThere are limited data on healthcare-associated infections (HAI) from African countries like Malawi.AimWe undertook a point prevalence survey of HAI and antimicrobial use in the surgery department of Queen Elizabeth Central Hospital (QECH) in Malawi and ascertained the associated risk factors for HAI.MethodsA cross-sectional point prevalence survey (PPS) was carried out in the surgery department of QECH. The European Centre for Disease Prevention and Control PPS protocol version 5.3 was adapted to our setting and used as a data collection tool.Findings105 patients were included in the analysis; median age was 34 (IQR: 24–47) years and 55.2% patients were male. Point prevalence of HAI was 11.4% (n=12/105) (95% CI: 6.0%–19.1%), including four surgical site infections, four urinary tract infections, three bloodstream infections and one bone/joint infection. We identified the following risk factors for HAI; length-of-stay between 8 and 14 days (OR=14.4, 95% CI: 1.65–124.7, p=0.0143), presence of indwelling urinary catheter (OR=8.3, 95% CI: 2.24–30.70, p=0.003) and history of surgery in the past 30 days (OR=5.11, 95% CI: 1.46–17.83, p=0.011). 29/105 patients (27.6%) were prescribed antimicrobials, most commonly the 3rd-generation cephalosporin, ceftriaxone (n=15).ConclusionThe prevalence rates of HAI and antimicrobial use in surgery wards at QECH are relatively high. Hospital infection prevention and control measures need to be strengthened to reduce the burden of HAI at QECH.

Carbapenem-resistant bacteria on hand-held and hands-free electronic devices of healthcare workers and non-healthcare workers in Delhi, India

SummaryBackgroundMonitoring sensitivity profiles of circulating hospital strains is a key activity of a hospital infection control policy. The hospital environment and equipment may be reservoirs for carbapenem-resistant bacteria. Mobile phones have been shown to be a potential source for the transmission of bacteria in the healthcare environment.MethodsBacteria were cultured from seven common electronic devices. These included touchpads, chargers, hands-free headphones/microphones, laptops, digital wristwatches and computer mice which were used by healthcare workers and non-healthcare workers including family members and patient attendants. The Gram-negative bacteria were further analysed for phenotypic and genotypic (blaKPC, blaNDM-1 genes) carbapenem resistance.Results110 Gram-negative bacteria were isolated Mobile phones were found to be the most heavily contaminated devices and hands-free devices the least. 53.6% (n=59/110) Gram-negative bacteria were phenotypically carbapenem-resistant of which 36.37% (n=40) were metallo-β-lactamase positive. 40% (n=44/110) were genotypically resistant and 30% (n=33) were blaNDM-1 gene positive. 9% (n=10) bacteria had both blaNDM–1and blaKPC genes.ConclusionsCarbapenem-resistant bacteria are widespread in India's hospital environment and present a challenge in healthcare. Electronic devices are a potential vehicle for the transmission of carbapenem-resistant bacteria. The results of the study support that hands-free electronic devices are less likely to be contaminated with carbapenem-resistant bacteria and that promoting the use of hands-free devices may help to reduce the spread of multidrug resistant bacteria in healthcare.