Hospital Infection Prevention Research Articles

The prevalence of hospital acquired infection and associated factors among patients admitted at Wolaita Sodo University Comprehensive Specialized Hospital, in Ethiopia

Hospital-acquired infection is an infection acquired a major global concern of well-being, affecting the quality of care in the healthcare setting. Routine surveillance of infection is an important part of infection prevention and quality assurance in hospitals. to determine the prevalence and associated factors of hospital-acquired infection among inpatients, in Wolaita Sodo University Comprehensive Specialized Hospital.Across-sectional study was conducted among inpatients in Wolaita Sodo University Comprehensive Specialized Hospital. All eligible inpatients admitted at least more three days of the survey were included. The study was conducted from April 1 to July 30/2023. Environmental health professionals and nurses collected the data according to the Centers for Disease Control through observational assessments documented by physicians. Univariate and multivariable logistic regression analyses were used to determine the prevalence of hospital-acquired infections and the associations between independent and dependent variables. A total of 413 patients were included in this study, the median age of the participants was 26 years. A total of 352 (85.2%) patients were diagnosed with non-fatal disease during the survey. 49 patients had hospital-acquired infections developed, with a mean prevalence of 11.9 %. Coagulate-negative staphylococcus 27.27%), and E. coli (27.27) were the most frequently reported hospital-acquired infection-causing pathogens from the result of the study. The factors of patient admission diagnosis, length of hospital stay (more than five days of hospital stay), and absence of running tap water in the patient’s room with the occurrence of hospital-acquired infection were statistically significant.Surgical site infections and bloodstream infections were the most common types of hospital-acquired infections. Then, Hospital management and healthcare workers should give more attention to the practice of infection prevention to achieve a reduced prevalence of hospital-acquired infections in the study setting.

What we learned from the COVID-19 infection control and what we need in the future, a quantitative and qualitative study on hospital infection prevention and control practitioners (HIPCPs) in Tianjin, China

BackgroundIn December 2022, the epidemic prevention and control policy was upgraded and China came to a different stage of epidemic control. There have been no studies from the perspective of infection prevention and control practitioners (HIPCP) about the historic surge. ObjectiveTo understand the needs of the healthcare system during the epidemic and to identify implications for better healthcare supply and infection control in the future. MethodsA longitudinal quantitative and qualitative study was performed based on two comprehensive questionnaire surveys among 497 HIPCPs before and during the epidemic peak in Tianjin, China. ResultsThe workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs. 61.8%, P < 0.05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for healthcare personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors in advance are the most important things we learned. ConclusionAlthough it has been four years since the first outbreak of COVID-19, more improvements should be made to prepare for the next wave of COVID-19 or other diseases.

Emerging challenges in antimicrobial resistance: implications for pathogenic microorganisms, novel antibiotics, and their impact on sustainability.

Overuse of antibiotics is accelerating the antimicrobial resistance among pathogenic microbes which is a growing public health challenge at the global level. Higher resistance causes severe infections, high complications, longer stays at hospitals and even increased mortality rates. Antimicrobial resistance (AMR) has a significant impact on national economies and their health systems, as it affects the productivity of patients or caregivers due to prolonged hospital stays with high economic costs. The main factor of AMR includes improper and excessive use of antimicrobials; lack of access to clean water, sanitation, and hygiene for humans and animals; poor infection prevention and control measures in hospitals; poor access to medicines and vaccines; lack of awareness and knowledge; and irregularities with legislation. AMR represents a global public health problem, for which epidemiological surveillance systems have been established, aiming to promote collaborations directed at the well-being of human and animal health and the balance of the ecosystem. MDR bacteria such as E. coli, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., Acinetobacter spp., and Klebsiella pneumonia can even cause death. These microorganisms use a variety of antibiotic resistance mechanisms, such as the development of drug-deactivating targets, alterations in antibiotic targets, or a decrease in intracellular antibiotic concentration, to render themselves resistant to numerous antibiotics. In context, the United Nations issued the Sustainable Development Goals (SDGs) in 2015 to serve as a worldwide blueprint for a better, more equal, and more sustainable existence on our planet. The SDGs place antimicrobial resistance (AMR) in the context of global public health and socioeconomic issues; also, the continued growth of AMR may hinder the achievement of numerous SDGs. In this review, we discuss the role of environmental pollution in the rise of AMR, different mechanisms underlying the antibiotic resistance, the threats posed by pathogenic microbes, novel antibiotics, strategies such as One Health to combat AMR, and the impact of resistance on sustainability and sustainable development goals.

Knowledge and Practices of Nurses Regarding Aseptic Techniques for Infection Prevention in Operating Room at Tertiary Care Hospital

Background: Surgical site infections (SSIs) remain a significant concern in operating rooms, largely influenced by the adherence to aseptic techniques by healthcare professionals. Despite the critical role of operating room nurses in preventing these infections, gaps in knowledge and practice persist, affecting the overall quality of patient care in tertiary healthcare settings. Objective: This study aimed to assess the knowledge and practices of operating room nurses regarding aseptic techniques for infection prevention in tertiary care hospitals. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital in Lahore, involving 130 operating room nurses with over a year of service. The study employed purposive sampling to administer a validated questionnaire assessing demographic data, knowledge, and practices related to aseptic techniques. Data were collected from January to March 2023 and analyzed using SPSS version 25, employing descriptive and inferential statistics to explore the relationship between demographic factors and knowledge/practices of aseptic techniques. Results: The study found that 60% of nurses were aware that a gown is considered sterile in specified areas, and 54.6% understood the contamination risks of dropped sterile packages. Approximately 62.3% recognized the importance of maintaining a safe distance during procedures. Despite these knowledge indicators, 94% of nurses routinely practiced sterile techniques, and 91% adhered to proper handwashing protocols. However, the overall level of knowledge concerning aseptic techniques was low, with significant gaps that could potentially impact patient safety. Conclusion: The study highlights a discrepancy between the knowledge and practices of operating room nurses regarding aseptic techniques, indicating a critical need for enhanced training and continuous education to bridge these gaps and improve infection control measures in surgical settings.

Assessment of Hospital Infection Prevention and Control Practices: Insights from Kampala International University Teaching Hospital, Ishaka, Uganda

The study aimed to identify factors affecting hospital infection prevention and control practices among medical personnel at Kampala International University Teaching Hospital in Ishaka, Uganda. The research was conducted using a quantitative descriptive research design. The result revealed that 76% of respondents felt they had sufficient knowledge about infection control and prevention practices. However, 34% of respondents found precautionary measures interfered with their work, and 70% recap needles after use. Only 32% reported a 0.3% chance of acquiring HIV after a needle stick injury. The study also showed 44% of respondents had received training on hand washing within 6 months. Most respondents 78% were able to wash hands before and after procedures. Only 44% of respondents had received training on waste segregation within a 6-month period. Policies and guidelines also influenced infection prevention and control practices. 52% of respondents considered the hospital infection prevention and control committee active, and 78% of them believed that waste segregation and post-exposure prophylaxis policies were available in their departments. The study found that hand washing is being carried out as recommended due to adequate on-the-job training. However, 54% of staff perceive hand washing as a challenge, and 78% were able to wash hands before and after every procedure as recommended. Only 30% of workers have access to a regular supply of soap and detergents for washing hands. Waste segregation is being practiced as recommended, but challenges persist for medical personnel. The management team should integrate infection prevention and control into the regular supervision of healthcare providers. The study suggests that promoting hand washing in a hospital requires adequate training, facilities, supplies, staffing, and a positive attitude. It recommends frequent hand washing training, accessible running water infrastructure, disposable towels, and soap and detergents. Staff should be trained on attitude change and proper waste segregation. Keywords: Hospital, Infection, Waste, Hand washing, supplies, training.

Infections Associated with Medtronic Duet External Ventricular Drains - Rhode Island Hospital, Providence, Rhode Island, January 2023-January 2024.

External ventricular drains (EVDs) are medical devices that are inserted into the ventricles of the brain to drain excess fluid, manage intracranial hypertension, monitor intracranial pressure, and administer medications. Unintentional disconnections and breaks or fractures (breaks) of EVDs or associated drainage system components can result in cerebrospinal fluid (CSF) leakage and increased risk for EVD-associated infections. After replacement of Integra Life Sciences EVD systems with Medtronic Duet EVD systems at Rhode Island Hospital in mid-September 2023, a threefold increase was observed in the prevalence of positive CSF cultures, from 2.8 per 1,000 days with an EVD in place (EVD days) during January-September 2023 to 11.4 per 1,000 EVD days during October 2023-January 2024 (rate ratio [RR] = 5.7; 95% CI = 1.5-22.0; p = 0.01) and an eightfold increase in the prevalence of infections, from 0.7 to 6.5 per 1,000 EVD days (RR = 9.8; 95% CI = 1.1-87.3; p = 0.04). An investigation by Rhode Island Hospital Infection Control during December 2023-January 2024 identified frequent reports of disconnections and breaks of the Medtronic Duet EVD system. A search of the Food and Drug Administration Manufacturer and User Facility Device Experience database identified 326 reports nationwide of disconnection and breaks of components of the Duet EVD system, including 175 during 2023. A Medical Product Safety Network report was filed. The Duet EVD product was ultimately recalled in January 2024, citing disconnections of the EVD system and reports of CSF leakage and infection. Given the widespread use of EVD systems by neurosurgery centers and the risk for EVD-associated infections, a strategy for future consideration by hospital infection prevention and control programs might be inclusion of EVD-associated infections in hospital surveillance programs to rapidly identify increases in these events and determine factors related to such infections to prevent additional infections.

Adaptive Architecture and Infection Prevention in Hospitals

In healthcare facility design, especially in hospitals, infection control is paramount due to the vulnerability of patients to nosocomial or healthcare-associated infections (HAIs). Despite advancements in medical practices and infection control measures, HAIs remain a significant challenge to patient safety and public health, particularly within hospital settings. Integrating adaptive architecture principles into hospital design and infrastructure presents a promising approach to addressing this issue. This paper examines the intersection of adaptive architecture and infection prevention in hospitals, with a focus on designing and constructing healthcare facilities to effectively curb the spread of infections. By incorporating adaptive architecture, hospitals can create environments that are responsive to the dynamic needs of patients, staff, and infection control protocols. Design elements such as flexible room layouts, easily adaptable ventilation systems, and antimicrobial surfaces can help minimize the risk of HAIs by reducing pathogen transmission and promoting cleanliness. Additionally, strategic placement of hand hygiene stations, isolation rooms, and patient flow pathways can optimize infection control practices and enhance patient safety. Strategically locating hand hygiene stations, isolation rooms, and patient flow pathways optimizes infection control practices and improves patient safety. By combining innovative design strategies and advanced technology, hospitals can better combat HAIs, fostering safer environments for patients and healthcare staff. This paper investigates how the collaboration of adaptive architecture and infection prevention can yield more robust and efficient healthcare facilities in the fight against HAIs. Keywords - HAIs, Adaptive Architecture, Infection, adaptable ventilation, flexible layouts, antimicrobial surfaces.

Evaluating the impact of genomic epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) on hospital infection prevention and control decisions.

Genomic epidemiology enhances the ability to detect and refute methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in healthcare settings, but its routine introduction requires further evidence of benefits for patients and resource utilization. We performed a 12 month prospective study at Cambridge University Hospitals NHS Foundation Trust in the UK to capture its impact on hospital infection prevention and control (IPC) decisions. MRSA-positive samples were identified via the hospital microbiology laboratory between November 2018 and November 2019. We included samples from in-patients, clinic out-patients, people reviewed in the Emergency Department and healthcare workers screened by Occupational Health. We sequenced the first MRSA isolate from 823 consecutive individuals, defined their pairwise genetic relatedness, and sought epidemiological links in the hospital and community. Genomic analysis of 823 MRSA isolates identified 72 genetic clusters of two or more isolates containing 339/823 (41 %) of the cases. Epidemiological links were identified between two or more cases for 190 (23 %) individuals in 34/72 clusters. Weekly genomic epidemiology updates were shared with the IPC team, culminating in 49 face-to-face meetings and 21 written communications. Seventeen clusters were identified that were consistent with hospital MRSA transmission, discussion of which led to additional IPC actions in 14 of these. Two outbreaks were also identified where transmission had occurred in the community prior to hospital presentation; these were escalated to relevant IPC teams. We identified 38 instances where two or more in-patients shared a ward location on overlapping dates but carried unrelated MRSA isolates (pseudo-outbreaks); research data led to de-escalation of investigations in six of these. Our findings provide further support for the routine use of genomic epidemiology to enhance and target IPC resources.

A Method for Detecting Five Carbapenemases in Bacteria Based on CRISPR-Cas12a Multiple RPA Rapid Detection Technology.

As the last line of defense for clinical treatment, Carbapenem antibiotics are increasingly challenged by multi-drug resistant bacteria containing carbapenemases. The rapid spread of these multidrug-resistant bacteria is the greatest threat to severe global health problems. To solve the problem of rapid transmission of this multidrug-resistant bacteria, we have developed a rapid detection technology using CRPSPR-Cas12a gene editing based on multiple Recombinase polymerase amplification. This technical method can directly isolate the genes of carbapenemase-containing bacteria from samples, with a relatively short detection time of 30 minutes. The instrument used for the detection is relatively inexpensive. Only a water bath can complete the entire experiment of Recombinase polymerase amplification and trans cleavage. This reaction requires no lid during the entire process while reducing a large amount of aerosol pollution. The detection sensitivity of this method is 1.5 CFU/mL, and the specificity is 100%. This multi-scene detection method is suitable for screening populations in wild low-resource environments and large-scale indoor crowds. It can be widely used in hospital infection control and prevention and to provide theoretical insights for clinical diagnosis and treatment.

Data quality review of the Brazilian nosocomial infections surveillance system

BackgroundSurveillance of healthcare-associated infections (HAIs) is an essential component of hospital infection prevention and control systems. We aimed to assess the quality of the data compiled by the Brazilian HAI Surveillance System from pediatric (PICUs) and neonatal intensive care units (NICUs), between 2012 and 2021. MethodsData Quality Review, including adherence, completeness, internal consistency, consistency over time, and consistency of population trend, were computed at both national and state levels based on quality metrics from World Health Organization Toolkit. Incidence rates (or incidence density) of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI) were obtained from the Brazilian National Nosocomial Infections Surveillance (NNIS) system. Data on sepsis-related mortality, spanning the period from 2012 to 2021, were extracted from the Brazilian National Health Service database (DATASUS). Additionally, correlations between sepsis-related mortality and incidence rates of VAP or CLABSI were calculated. ResultsThroughout the majority of the study period, adherence to VAP reporting remained below 75%, exhibiting a positive trend post-2016. Widespread outliers, as well as inconsistencies over time and in population trends, were evident across all 27 states. Only four states maintained consistent adherence levels above 75% for more than 8 years regarding HAI incidence rates. Notably, CLABSI in NICUs boasted the highest reporting adherence among all HAIs, with 148 periods out of 270 (54.8%) exhibiting reporting adherence surpassing 75%. Three states achieved commendable metrics for CLABSI in PICUs, while five states demonstrated favorable results for CLABSI in NICUs. ConclusionsWhile adherence to HAI report is improving among Brazilian states, an important room for improvement in the Brazilian NNIS exists. Additional efforts should be made by the Brazilian government to improve the reliability of HAI data, which could serve as valuable guidance for hospital infection prevention and control policies.

The experience on the construction of the cluster prevention and control system for COVID-19 infection in designated hospitals during the period of "Category B infectious disease treated as Category A"

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Hygienestandards im OP – führen sie nachhaltig zur Verbesserung der Qualität?

In Germany, nosocomial infections and postoperative wound infections are a significant burden for the healthcare system and the patients affected. A postoperative wound infection is often accompanied by a massive deterioration in the quality of the treatment success of surgical measures in terms of patient stress, the functional results and the cost-effectiveness of a treatment for the service provider. The aim of this article is to present the current hygiene requirements for the perioperative setting in a comprehensible manner and to explain them to everyone involved in the surgical procedure. First of all, the importance of hygienic measures is explained, as well as a brief overview of the development up to modern hygiene concepts of today. Then the current recommendations of the KRINKO (Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute): "Prevention of postoperative wound infections, recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute" are presented. Hygienic work is a basic prerequisite for work in the surgical area, because convincing treatment results with good functional results cannot be achieved in many areas (e.g. modern endoprosthetics) without sufficient hygiene. The modern requirements for hygienic work are complex and affect all areas of the hospital. The best possible degree of process quality can only be guaranteed if all pillars of modern hygiene concepts are observed.

Acinetobacter baumannii infection in intensive care unit: analysis of distribution and drug resistance.

The isolation rate and drug resistance rate of Acinetobacter baumannii (A.baumannii) have increased over the years, which has become one of the main causes of infection and death in intensive care unit (ICU) patients. Analysis of the distribution characteristics, drug resistance and influencing factors of A.baumannii in ICU could provide basis and reference for the infection prevention and clinical treatment. In this study, patients diagnosed with A.baumannii infection in ICU from January 2020 to December 2021 were selected. Samples of patients were collected for bacterial culture, drug sensitivity test analysis and drug resistant gene detection of A.baumannii. A total of 197 strains of A.baumannii were cultured in 2021, which was 18 strains more than in 2020. The specimens were mainly from lower respiratory tract secretions, and the isolated strains were multi-drug resistant. The resistance of isolates to tobramycin, gentamicin, and trimethoprim-sulfamethoxazole in 2021 showed a significant increase compared to 2020, while there were no significant differences observed in other resistance changes. The prevalence of multi-drug resistant A.baumannii in ICU remains high. Among them, all imipenem-resistant A.baumannii strains carried OXA-23 gene. Clinical treatment should use antibiotics reasonably based on the characteristics of bacterial resistance, and strengthen the prevention and control of hospital infection, pay more attention to the disinfection and isolation to reduce the risk of cross infection.

Explaining the Performance of Nurses in Order to Prevent Nosocomial Infections in Urmia City Hospitals: Application of the Health Belief Model

Background Nosocomial infections (NIs) are one of the medical, social, and economic problems in developing countries and can be prevented. Studying the etiology of NI is one of the most essential activities for designing prevention programs. The purpose of this study was to explain the constructs of the health belief model (HBM) regarding nurses' compliance with standard precautions for the prevention of NI in Urmia hospitals. Methods This cross-sectional study was conducted on 224 nurses of Urmia hospitals who were selected by employing the multi-stage method. The data collection tool was a questionnaire containing demographic characteristics, an HBM questionnaire associated with the prevention of NI, and questions related to the observance of nurses in the field of standard precautions to prevent NI. Data were analyzed using descriptive and inferential statistical methods in SPSS software version 22. Results The results of this study showed the average performance score of nurses in relation to adopting preventive behaviors against NI (71.97 ± 11.08) as acceptable. Also, the results of the study showed that among the constructs of the HBM, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy are the most important predictors of adopting preventive behaviors against NI with a variance of 52% among the nurses. Conclusion According to the results of this study, the constructs of self-efficacy, perceived barriers, cue to action, perceived benefits, and perceived intensity are, respectively, the strongest predictors of compliance with standard precautions to prevent hospital infections. Therefore, the results of this study can be useful for health service providers in planning and designing interventions, and determining appropriate strategies for the prevention and control of NI.

Research on the relationship between nurses' compliance with standard precautions, servant leadership and emotional exhaustion: A cross-sectional survey.

This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience. A cross-sectional survey. This descriptive cross-sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third-class general hospital in Chongqing, China. The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed. We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care. There was no patient or public involvement. Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's 'knowledge, belief, and action' to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance.

Infection prevention in medical education - results of a descriptive cross-sectional study in Germany.

The aim of the study was to assess the current curricular status of content on infection prevention in hospitals during medical education prior to the development of a serious game on infection prevention in hospitals. In addition, the data collected was to be contrasted with the training for a specialist nurse in hygiene and infection prevention (FKHI). In an online survey, persons in charge of medical degree programs and continuing education centers for FKHI, SkillsLabs and professional associations in Germany were asked to answer 28 questions on framework conditions, teaching, examinations, and gamification. Data was collected for 22 medical degree programs and 5 FKHI continuing education centers. Due to the low response rate, the data for the FKHI was only analyzed in summary form. On average, 13.5 teaching units (median) are available in medical studies. Six degree programs have a longitudinal curriculum. In 7 of the 22 degree programs, teaching is based on the National Competency-Based Learning Objectives Catalogue (NKLM). Almost all locations teach this content in lectures (n=18) and/or in internships (n=13). Teaching and examinations are most common in the third year of study (n=12). In addition to practical OSCE examinations (n=5), written (n=12) and computer-based (n=8) examinations are used in particular. Gamification is known as a didactic approach to some extent but is not used for teaching infection prevention. Infection prevention in hospitals is given relatively low priority in medical education. Teaching and examinations are based on traditional knowledge-oriented formats, although practical teaching and practical examinations are established at some locations. In contrast to the FKHI, learning objectives currently appear to be less standardized. Further interprofessional development of teaching would be desirable in the future.

Hygiene requirements for cleaning and disinfection of surfaces: recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute.

This recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) addresses not only hospitals, but also outpatient health care facilities and compiles current evidence. The following criteria are the basis for the indications for cleaning and disinfection: Infectious bioburden and tenacity of potential pathogens on surfaces and their transmission routes, influence of disinfecting surface cleaning on the rate of nosocomial infections, interruption of cross infections due to multidrug-resistant organisms, and outbreak control by disinfecting cleaning within bundles. The criteria for the selection of disinfectants are determined by the requirements for effectiveness, the efficacy spectrum, the compatibility for humans and the environment, as well as the risk potential for the development of tolerance and resistance. Detailed instructions on the organization and implementation of cleaning and disinfection measures, including structural and equipment requirements, serve as the basis for their implementation. Since the agents for surface disinfection and disinfecting surface cleaning have been classified as biocides in Europe since 2013, the regulatory consequences are explained. As possible addition to surface disinfection, probiotic cleaning, is pointed out. In an informative appendix (only in German), the pathogen characteristics for their acquisition of surfaces, such as tenacity, infectious dose and biofilm formation, and the toxicological and ecotoxicological characteristics of microbicidal agents as the basis for their selection are explained, and methods for the evaluation of the resulting quality of cleaning or disinfecting surface cleaning are presented.

Strengthening hospital epidemiology & infection prevention research capacity in India to curb antimicrobial resistance.

Strengthening hospital epidemiology & infection prevention research capacity in India to curb antimicrobial resistance.

Assessing changes in the pattern of healthcare-associated infectious agents in intensive care units during a novel coronavirus infection pandemic (COVID-19)

Introduction. The novel coronavirus infection (COVID-19) pandemic has been a major challenge to the global healthcare system, affecting more than 32 million patients worldwide. Unprecedented anti-epidemic measures carried out in hospitals allowed clinicians to hope for a decrease of hospital infection, however, the pandemic exacerbated the problem of the spread and circulation of multidrug-resistant bacteria in hospitals. The goal of study to conduct a comparative assessment of changes in the microbial landscape and the level of antibiotic resistance of the main pathogens of lower respiratory tract infections in ICU patients who were in different epidemiological conditions during the COVID-19 pandemic in comparison with the “pre-Covid” period. Materials and methods. A multicenter retrospective observational cohort study was conducted, which included the ICU of 4 hospitals in Yekaterinburg, which were in different epidemiological situations during the COVID-19 pandemic, as well as a comparative analysis of the length of stay of patients in the ICU, the frequency and duration of mechanical ventilation, the resuscitation mortality rate, and also the results of microbiological examination of sputum with an assessment of the structure of pathogens and the level of their antibiotic resistance. Results. The structure of pathogens in sputum in ICU patients of the “green zone” has not fundamentally changed. In the “red zone” there was an increase in the number of documented infections of the lower respiratory tract and blood flow, while hospitals showed differences in changes in the microbial landscape. The microbiological situation in the ICU of the “red zone” was characterized by a decrease in the number of isolated strains of Enterobacterales and non-fermenting Gram-negative bacteria by the end of the pandemic, as well as a significant increase fungi in sputum. In hospitals, where there was an alternation of periods of work in the “red” and “green” zones, there was a decrease of Enterobacterales, an increase in non-fermenting Gram-negative bacteria and a fungi. Among the microflora isolated by bacteriological methods in patients with COVID-19, gram-negative bacteria and fungi predominated, mainly Klebsiella pneumonia, Acinetobacter baumanii and fungi of the Candida spp. A significant increase in the proportion of fungi in sputum was noted in ICU patients in infectious diseases hospitals during the pandemic period. An increase in the level of antibiotic resistance of the main pathogens of lower respiratory tract infections was revealed with the appearance of multi-resistant and extremely resistant strains of Klebsiella pneumoniae and Acinetobacter baumanii. Discussion. Changes in the microbial landscape may indirectly reflect the features of immune damage in patients with a new coronavirus infection COVID-19, which, combined with the severity of the disease and the characteristics of its therapy, led to an increase in complications in the form of a secondary bacterial infection. The reasons for the increase in HAI cases include: an increase in the number of patients with severe comorbidities in an artificial closed ecosystem - the “red zone”; features of the methods of treatment (glucocorticosteroids, genetically engineered biological products - IL-6 inhibitors, etc.); high frequency of unreasonable use of antibacterial drugs; increase in the duration ofuse of various invasive devices and mechanical ventilation; changing the structure and practice of staffing hospitals, increasing the number of inexperienced medical workers and volunteers; inadequate hand hygiene, use of unsuitable individual protection means with a lack of developed methods for their processing in the new conditions. Conclusion. The results obtained indicate the importance of the work of a multidisciplinary with a microbiologist, epidemiologist, clinical pharmacologist in order to improve the quality of care for patients, especially in a difficult epidemiological situation. Surveillance over the spread of HAI pathogens should be attributed to the most progressive form of anti-epidemic activity. Microbiological monitoring and its results can serve as the basis for making managerial decisions to combat and prevent hospital infections. It is the main method for assessing the etiology, phenotype, mechanisms of resistance to antimicrobial drugs, allows you to identify epidemiological relationships between diseases, reasonably prescribe antibiotic therapy, and conduct targeted purchases of drugs (antibiotics) for the needs of this hospital.

Analysis of Implementation of Infection Prevention and Control at Royal Prima Marelan General Hospital

Nosocomial infections or Healthcare-Associated Infections (HAIs) are a serious problem for global public health, including Indonesia. HAIs are infections experienced by patients during treatment and health care procedures ≥ 48 hours and ≤ 30 days after leaving the health facility. This study aims to analyze the implementation of infection prevention and control at the Royal Prima Marelan General Hospital. This research is a quantitative study with an observational analytical approach with a Cross Sectional Study design, namely in the form of data collection aimed at analyzing the implementation of infection prevention and control at the Royal Prima Marelan General Hospital for the period July to August 2023. The population in this study was 100 people who included hospital management who were considered competent in providing information. The population sample for this study that met the inclusion and exclusion criteria was 50 people. The results of bivariate analysis show that the variables related to infection prevention and control are knowledge, motivation, supervision and workload. The results of multivariate analysis show that the variable that partially influences the prevention and control of nosocomial infections in hospitals is knowledge.