Hospital Infection Prevention Research Articles

Contextual barriers to infection prevention and control program implementation in hospitals in Latin America: a mixed methods evaluation

BackgroundInfection prevention and control (IPC) programs are essential to prevent and control the spread of multidrug-resistant organisms in healthcare facilities (HCFs). The current implementation of these programs in Latin America remains largely unknown.MethodsWe conducted a mixed-methods evaluation of IPC program implementation in HCFs from Guatemala, Panama, Ecuador, and Argentina, March-July 2022. We used the World Health Organization (WHO) IPC Assessment Framework (IPCAF) survey, a previously validated structured questionnaire with an associated scoring system that evaluates the eight core components of IPC (IPC program; IPC guidelines; IPC education and training; healthcare-associated infection [HAI] surveillance; multimodal strategies; monitoring and audit of IPC practices and feedback; workload, staffing, and bed occupancy; and the built environment and materials and equipment for IPC). Each section generates a score 0–100. According to the final score, the HCF IPC program implementation is categorized into four levels: inadequate (0–200), basic (201–400), intermediate (401–600), or advanced (601–800). Additionally, we conducted semi-structured interviews among IPC personnel and microbiologists using the Systems Engineering Initiative for Patient Safety model to evaluate barriers and facilitators for IPC program implementation. We performed directed content analysis of interview transcripts to identify themes that focused on barriers and facilitators of IPC program implementation which are summarized descriptively.ResultsThirty-seven HCFs (15 for-profit and 22 non-profit) completed the IPCAF survey. The overall median score was 614 (IQR 569, 693) which corresponded to an “advanced” level of IPC implementation (32% [7/22] non-profit vs. 93% [14/15] for-profit HCFs in this category). The lowest scores were in workload, staffing and bed occupancy followed by IPC training and multimodal strategies. Forty individuals from 16 HCFs were interviewed. They perceived inadequate staffing and technical resources, limited leadership support, and cultural determinants as major barriers to effective IPC guideline implementation, while external accreditation and technical support from public health authorities were perceived as facilitators.ConclusionsEfforts to strengthen IPC activities in Latin American HCFs should focus on improving support from hospital leadership and public health authorities to ensure better resource allocation, promoting safety culture, and improving training in quality improvement.

CUIDADOS DE ENFERMAGEM NA PREVENÇÃO DE INFECÇÕES HOSPITALARES: ESTRATÉGIAS E PROTOCOLOS

Objective: The study aimed to analyze the strategies and protocols adopted by nursing professionals in order to evaluate their effectiveness and propose improvements. Method: A bibliographic methodology was used, reviewing the current literature on hand hygiene protocols, use of Personal Protective Equipment (PPE), and prevention of infections associated with invasive devices. Results: The results indicated that the fundamental protocols are effective in reducing infections, but highlighted the need for continuous training and the potential use of monitoring technologies to improve adherence and evaluation of practices. The study objectives were achieved, recommending regular updating of protocols, intensification of training, and the integration of new technologies to improve strategies for preventing hospital infections. Conclusion: This article investigated nursing care in the prevention of hospital infections. The justification for the study lies in the importance of optimizing infection prevention, a continuous challenge in hospital settings that impacts patient safety and health costs. Keywords: Hospital infections. Nursing care. Prevention. Control strategies.

CUIDADOS DE ENFERMAGEM NA PREVENÇÃO DE INFECÇÕES HOSPITALARES: ESTRATÉGIAS E PROTOCOLOS

Objective: The study aimed to analyze the strategies and protocols adopted by nursing professionals in order to evaluate their effectiveness and propose improvements. Method: A bibliographic methodology was used, reviewing the current literature on hand hygiene protocols, use of Personal Protective Equipment (PPE), and prevention of infections associated with invasive devices. Results: The results indicated that the fundamental protocols are effective in reducing infections, but highlighted the need for continuous training and the potential use of monitoring technologies to improve adherence and evaluation of practices. The study objectives were achieved, recommending regular updating of protocols, intensification of training, and the integration of new technologies to improve strategies for preventing hospital infections. Conclusion: This article investigated nursing care in the prevention of hospital infections. The justification for the study lies in the importance of optimizing infection prevention, a continuous challenge in hospital settings that impacts patient safety and health costs. Keywords: Hospital infections. Nursing care. Prevention. Control strategies.

Risk factors for antimicrobial-resistant Enterobacterales in dogs: a systematic review.

Identifying risk factors associated with the carriage of antimicrobial-resistant (AMR) bacteria in dogs is crucial to understanding their epidemiology and for developing and refining targeted control measures. However, relevant data is scattered and conflicting findings have been reported. This systematic review aimed to compile risk factors associated with the carriage of AMR-Enterobacterales in dogs worldwide and to identify relevant knowledge gaps for directing future research. A systematic review was conducted according to PRISMA guidelines, searching PubMed, CABi, and Scopus databases for studies reporting risk factors for acquiring AMR-Enterobacterales in dogs. After screening peer-reviewed, English-language studies by title/abstract, eligible studies were subjected to a full-text assessment, data extraction, risk-of-bias assessment, and qualitative synthesis. In the initial search, 774 articles were identified, including 274 duplicates. After screening by title/abstract, 77 articles were subjected to full-text review, from which 40 were eventually selected for data extraction, including 29 cross-sectional, six cohort, and five case-control studies. The most frequently investigated risk factors for AMR-Enterobacterales carriage in dogs were antimicrobial use (28 of 40), age (24), sex (22), hospitalization (19), and feeding raw diet (14). Of these, antimicrobial use was the most common risk factor significantly associated with AMR-Enterobacterales (19/28), followed by raw diet (9/14) and hospitalization (8/19). Our synthesis emphasized the importance of increasing awareness regarding the prudent use of critically important antimicrobials (CIAs), such as fluoroquinolones, in companion animal practices, strengthening infection prevention and control procedures in veterinary clinics and hospitals and educating caregivers about the potential risks of feeding raw diets in order to reduce the burden of AMR-bacteria in dogs.

Multicomponent Approaches to Reduce Multidrug-Resistant Organisms in Critical Care: Determining the Ideal Strategy.

Although there is ample proof of the advantages of infection prevention and Control (IPC) in acute-care hospitals, there is still some questions about the efficacy of IPC interventions for multidrug-resistant organisms (MDROs), and there is a need for the development of evidence-based practices. No healthcare facility has found a single effective technique to reduce MDRO. However, a multicomponent intervention that included improved barrier protection, chlorhexidine bathing, microbiological monitoring, and staff involvement significantly decreased the likelihood of infection in the patient surroundings with multidrug-resistant organisms. A practical strategy suited to reducing the burden of MDROs and their transmission potential in the critical care unit must be established in light of the global development of AMR. In this review, we summarize key findings of a multicomponent approaches to reduce MDROs in critical care units.

Vaccine-associated measles in an immunocompromised host: Hospital infection prevention and control and public health response

Introduction: Vaccine-associated measles is generally not considered to be transmissible, as opposed to wild-type measles, which is one of the most highly contagious diseases. Data on contact and exposure management of vaccine-associated measles is limited, with varied approaches to such cases described in the literature. Methods: We report the case of a 2-year-old immunosuppressed child who developed a febrile exanthem with mild conjunctivitis 18 days after receiving the measles-mumps-rubella-varicella vaccine. Results: Given the patient's recent measles-containing vaccination while on immunosuppressive medications, consistent clinical findings and the lack of epidemiological risk factors for wild-type infection, the decision was made to treat this as a presumptive case of vaccine-associated measles virus prior to return of confirmatory genotyping results. After consultation with public health experts, contact tracing was not considered necessary. No secondary measles cases were identified, despite a large exposure potential due to lack of consistent airborne precautions during hospital admission. Discussion: This case highlights the lack of transmissibility of vaccine-associated measles in immunocompromised hosts, adding to the scant body of literature on this topic, with the potential to inform hospital infection prevention and control as well as public health management in similar situations.

An assessment of infection prevention and control implementation in Malawian hospitals using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool

Infection prevention and control (IPC) is important for the reduction of healthcare-associated infections (HAI). The World Health Organization (WHO) developed the IPC Assessment Framework (IPCAF) tool to assess the level of IPC implementation and to identify areas for improvement in healthcare facilities. A cross -sectional survey was conducted using the WHO IPCAF tool from May to June 2023. The aim was to provide a baseline assessment of the IPC programme and activities within health care facilities in Malawi. Forty healthcare facilities were invited to participate. IPC teams were requested to complete the IPCAF and return the scores. The IPCAF tool scores were assessed as recommended in the WHO IPCAF tool. The response rate was 82.5%. The median IPCAF score was 445 out of 800 corresponding to an intermediate IPC implementation level. The results revealed that 66.7% facilities were at intermediate level, 26.4% at basic level, and 6.9% at advanced level. Most facilities (76%) had an IPC program in place with clear objectives and an IPC focal person. Few had a dedicated budget for IPC. The IPCAF domain "monitoring/audit of IPC practices and feedback" had the lowest median score of 15/100, and in 90% of facilities, no monitoring, audit, and feedback was done. HAI surveillance median score was 40/100, workload, staffing and bed occupancy median score was 45/100. Whilst there has been some degree of implementation of WHO IPC guidelines in Malawi's healthcare system, there is significant room for improvement. The IPCAF tool revealed that monitoring/audit and feedback, HAI surveillance and workload, staffing and bed occupancy need to be strengthened. The IPCAF scoring system may need reconsidering given the centrality of these domains to IPC.

Multivariate analysis of psychological health among hospital infection prevention and control practitioners in Tianjin

Objective: To understand the occupational stress and mental health status of hospital infection prevention and control practitioner (HIPCPs) in medical institutions, and analyze their main influencing factors. Methods: In November 2021, 550 nosocomial infection managers in Tianjin were randomly selected to conduct a questionnaire survey using the Concise Occupational Stress Questionnaire, Depression Screening Scale (PHQ-9) and Self-Rating Anxiety Scale (SAS). 497 valid questionnaires were obtained, and the total recovery efficiency was 90.36%. Single factor analysis and multivariate logistic regression method were used to analyze the main influencing factors of occupational stress and mental health status of psychiatric managers. Results: The detection rate of anxiety and depression among 497 HIPCPs was 22.73% (113/497) and 58.95% (293/497), respectively. Gender and major were the influencing factors of depression (P=0.000, 0.001). Average working hours>52 hours per week and night shift days>1 days per week were the influencing factors of anxiety (P=0.035, 0.014). Average working hours>52 h per week, night shift days >1 d per week and different majors were the influencing factors of occupational stress (P=0.000, 0.025, 0.010). Multivariate logistic regression results showed that the risk of anxiety in those who worked more than 52 hours per week was 1.753 times that of those who worked less than 52 hours per week (P=0.038), and the risk of depression in women was 3.071 times that of men (P=0.006) . Conclusion: Working hours are an important influencing factor for occupational stress and anxiety among HIPCPs. In order to reduce the occurrence of occupational stress and mental health problems, it is necessary to strengthen psychological counseling for HIPCPs and balance work and rest.

Research Progress in the Prevention and Control of Hospital-acquired Infections in Neonatal Units

Neonatal hospital-acquired infections are an important problem affecting the health and life safety of newborns. This paper reviews the research progress on the prevention and control of hospital-acquired infections in neonatology, discusses the risk factors of hospital-acquired infections in neonatology, summarizes the effective preventive and control measures such as strengthening the training and education on hospital-acquired infections, reducing invasive diagnostic and therapeutic operations, implementing disinfecting and isolating measures, rationally using antibiotics, and improving immunity for newborns, etc., and introduces common monitoring and detection techniques such as bacterial culture and drug susceptibility testing, molecular biology testing techniques, and biomarker detection and application. marker detection and application, and other commonly used surveillance and detection techniques. Future research should focus on strengthening the monitoring and study of pathogen resistance, optimizing the diagnosis and treatment process, strengthening the infection prevention and control training for healthcare workers, improving the infection prevention and control system in neonatal hospitals, and carrying out multidisciplinary collaborative research, so as to effectively reduce the incidence of infections and safeguard the health and safety of neonates.

European society of clinical microbiology and infectious diseases guidelines for antimicrobial stewardship in emergency departments (endorsed by European association of hospital pharmacists)

ScopeThis European Society of Clinical Microbiology and Infectious Diseases guideline provides evidence-based recommendations to support a selection of appropriate antibiotic use practices for patients seen in the emergency department (ED) and guidance for their implementation. The topics addressed in this guideline are (a) Do biomarkers or rapid pathogen tests improve antibiotic prescribing and/or clinical outcomes? (b) Does taking blood cultures in common infectious syndromes improve antibiotic prescribing and/or clinical outcomes? (c) Does watchful waiting without antibacterial therapy or with delayed antibiotic prescribing reduce antibiotic prescribing without worsening clinical outcomes in patients with specific infectious syndromes? (d) Do structured culture follow-up programs in patients discharged from the ED with cultures pending improve antibiotic prescribing? MethodsAn expert panel was convened by European Society of Clinical Microbiology and Infectious Diseases and the guideline chair. The panel selected in consensus the four most relevant antimicrobial stewardship topics according to pre-defined relevance criteria. For each main question for the four topics, a systematic review was performed, including randomized controlled trials and observational studies. Both clinical outcomes and stewardship process outcomes related to antibiotic use were deemed relevant. The literature searches were conducted between May 2021 and March 2022. In April 2022, the panel members were formally asked to suggest additional studies that were not identified in the initial searches. Data were summarized in a meta-analysis if possible or otherwise summarized narratively. The certainty of the evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation criteria. The guideline panel reviewed the evidence per topic critically appraising the evidence and formulated recommendations through a consensus-based process. The strength of the recommendations was classified as strong or weak. To substantiate the implementation process, implementation trials or observational studies describing facilitators/barriers for implementation were identified from the same searches and were summarized narratively. RecommendationsThe recommendations on the use of biomarkers and rapid pathogen diagnostic tests focus on the initiation of antibiotics in patients admitted through the ED. Their effect on the discontinuation or de-escalation of antibiotics during hospital stay was not reported, neither was their effect on hospital infection prevention and control practices. The recommendations on watchful waiting (i.e. withholding antibiotics with some form of follow-up) focus on specific infectious syndromes for which the primary care literature was also included. The recommendations on blood cultures focus on the indication in three common infectious syndromes in the ED explicitly excluding patients with sepsis or septic shock. Most recommendations are based on very low and low certainty of evidence, leading to weak recommendations or, when no evidence was available, to best practice statements. Implementation of these recommendations needs to be adapted to the specific settings and circumstances of the ED. The scarcity of high-quality studies in the area of antimicrobial stewardship in the ED highlights the need for future research in this field.

BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF SURGICAL SITE INFECTIONS IN A TEACHING HOSPITAL

Objective: Surgical site infections (SSI) are defined as infections occurring within 30 or 90 d after surgical operation or within 1 y, if an implant is left in place after procedure and affecting either incision or deep tissues at the operation site. SSI is one of the quality indicators of the healthcare system. Due to advent of newer antibiotics and emergence of multidrug-resistant bacteria, SSI requires reappraisal of the microbiological flora and in vitro antibiotic sensitivity pattern. The aim of the present study is to determine the incidence etiology of SSI, and determine their Antibiogram. Methods: Cross-sectional study conducted for a period of three months from January 2024 to March 2024. A total of fifty swabs/pus specimens from various types of surgical sites suspected to be infected on clinical grounds were collected from the post-operative wards of surgical departments and processed in Microbiology laboratory. Isolation and identification of bacterial agents were done as per standard protocols. Antimicrobial susceptibility testing was performed by Kirby-Bauer’s disc diffusion method. Results: Out of 50 samples, 32 were culture-positive. 87.50% showed monomicrobial growth and 12.50% showed polymicrobial growth. Analysis of bacterial profile shows Staphylococcus aureus (27.77%) was the predominant isolate, followed by Pseudomonas aeruginosa (19.44%) and Escherichia coli (19.44%). Antibiogram of gram-positive isolates showed sensitivity to Teicoplanin, Vancomycin, and linezolid, whereas gram-negative isolates were sensitive to Meropenem, Piperacillin-tazobactam and levofloxacin. Conclusion: Status of SSI is the main quality indicators of hospital infection control and prevention measures. Continuous surveillance on etiology and antibiogram of SSI is necessary to monitor antimicrobial resistance and guide in empirical treatment.

A Survey of the Prevalence of Infections Present among Inpatients in a Tertiary Care Hospital in 2023

Objective: To explore the current infection rate among inpatients in a tertiary hospital in 2023, to understand the infection situation in the hospital, and to provide a reliable basis for carrying out further hospital infection prevention and control and other work. Methods: Inpatients of a tertiary hospital on a certain date in 2023 were selected, and the survey data were extracted with the Apricot Grove real-time monitoring system using a combination of questionnaires and medical record data. Results: The infection rate was 12.63%, of which the hospital infection rate was 2.25% and the community infection rate was 10.38%. Lower respiratory tract infections accounted for 77.28% of the community infections, and lower respiratory tract infections accounted for 73.44% of the cases of hospital infections, with a total of 44 strains of pathogens isolated from hospital infections, and a total of 218 strains of pathogens isolated from community infections. The total application rate of antimicrobial drugs was 31.67%, the proportion of prophylactic drugs in the whole hospital was 9.66%, the proportion of therapeutic drugs was 90.33%, and the rate of bacterial culture delivery was 39.18%. Conclusion: The infection rate survey truly reflects the dynamics of infection in this hospital, makes clearer the key departments and key links of hospital infection prevention and control, further provides the basis for targeted infection control, and improves the knowledge and execution of hospital infection prevention and control by medical staff.

Temporal decreases in pathogen colonization and infection among hospitalized neonates following routine skin antisepsis with chlorhexidine gluconate: Botswana 2022 – 2023

Background: Multidrug-resistant Gram-negative bacteria are a major cause of sepsis among hospitalized neonates globally. Aqueous chlorhexidine gluconate (CHG) skin antisepsis has been shown to be safe for use in infants; however, its sustained effectiveness in preventing Gram-negative pathogen colonization, bloodstream infection (BSI), and mortality is unclear. Methods: We conducted a period prevalence survey, with 26 sampling events over 12 months (18 October 2022 – 31 October 2023) at a 33-bed neonatal unit in a tertiary public hospital in Botswana where ESBL-producing Klebsiella pneumoniae and carbapenem-resistant Acinetobacter baumannii are leading causes of BSI. Perirectal and periumbilical skin swabs were collected every two weeks from all inpatients. Swabs were inoculated onto chromogenic media selective and differential for extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E) and Acinetobacter spp. (CHROMagar™ ESBL, Acinetobacter). Colonization status was determined based on culture growth and colony morphology. Contemporaneous data on all-cause mortality and BSI were abstracted from routine surveillance records. Pre- and post-CHG prevalences were compared using a simple Chi-square test. During the surveillance period, an outbreak of K. pneumoniae linked to contaminated multi-use vials was detected, thus BSIs and deaths during the outbreak period (2 February–6 April, 2023) were excluded. In February 2023, the hospital infection prevention and control (IPC) team introduced twice-weekly whole-body cleansing with commercially available 2% aqueous CHG, performed by caregivers and healthcare workers on neonates >24 hours old and weighing ≥1 kg until discharge. Results: There were significant decreases in ESBL-E and Acinetobacter skin and perirectal colonization following the CHG intervention (Table 1; Figure 1). After the CHG intervention, the incidence of Acinetobacter BSIs declined significantly and there was a trend toward a decline in other BSIs and mortality. No adverse events associated with CHG were reported. Conclusions: Twice-weekly CHG application was temporally associated with significant reductions in neonatal ESBL-E and Actinetobacter skin and perirectal colonization and Acinetobacter BSI. This analysis was limited by a short pre-intervention surveillance period and thus may have been influenced by confounders such as seasonality, and intensified IPC efforts following the outbreak. Analysis of the routine CHG use in other settings and over longer surveillance periods are needed to better understand its effectiveness as an IPC strategy in settings where neonatal sepsis incidence is high. Table 1. Colonization prevalence, BSI incidence, and mortality surrounding introduction of CHG skin cleansing in a neonatal unit, 18 October 2022 – 31 October 2023.

ChatGPT in hospital infection prevention and control – assessing knowledge of an AI model based on a validated questionnaire

Introduction and aim. An AI model like ChatGPT is a good source of knowledge. We can explore the potential of AI models to complement the expertise of healthcare professionals by providing real-time, evidence-based information in infection prevention and control (IPC). Material and methods. This study involved 110 queries related to IPC, validated by subject experts in IPC. The responses from ChatGPT were evaluated using Bloom’s taxonomy by experienced microbiologists. The scores were divided as 4 as a good response. Statistical analysis was done by correlation coefficient and Cohen’s Kappa. Results. The overall score was 4.33 (95% CI, q1 3.65–q3 4.64) indicating ChatGPT’s substantial IPC knowledge. A good response (i.e.>4 score) was found in 70 (63.6%) questions, while in 10 (9%) questions, it showed a poor response. The poor response was seen in needle stick injury and personal protective equipment (PPE) doffing-related questions. The overall correlations were found to be significant. Cohen’s Kappa confirmed moderate to substantial agreement between evaluators. Conclusion. ChatGPT demonstrated a commendable understanding of IPC principles in various domains and the study identifies specific instances where the model may require further refinement especially in critical scenarios such as needlestick injuries and PPE doffing.

Healthcare-associated infections and antimicrobial resistance in Canadian acute care hospitals, 2018-2022.

Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) continue to contribute to excess morbidity and mortality among Canadians. This report describes epidemiologic and laboratory characteristics and trends of HAIs and AMR from 2018 to 2022 (Candida auris, 2012-2022) using surveillance and laboratory data submitted by hospitals to the Canadian Nosocomial Infection Surveillance Program (CNISP) and by provincial and territorial laboratories to the National Microbiology Laboratory. Data collected from 88 Canadian sentinel acute care hospitals between January 1, 2018, and December 31, 2022, for Clostridioides difficile infections (CDIs), carbapenemase-producing Enterobacterales (CPE) infections, methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) and vancomycin-resistant Enterococcus (VRE) BSIs. Candida auris (C. auris) surveillance was initiated in 2019 by CNISP and in 2017 (retrospectively to 2012) by the National Microbiology Laboratory. Trend analysis for case counts, rates, outcomes, molecular characterization and AMR profiles are presented. From 2018 to 2022, decreased rates per 10,000 patient days were observed for CDIs (7% decrease; 5.42-5.02) and MRSA BSIs (2.9% decrease; 1.04-1.01). Infection rates for VRE BSIs increased by 5.9% (0.34-0.36). Infection rates for CPE remained low but increased by 133% (0.06-0.14). Forty-three C. auris isolates were identified in Canada from 2012 to 2022, with the majority in Western and Central Canada (98%). From 2018 to 2022, the incidence of MRSA BSIs and CDIs decreased and VRE BSI and CPE infections increased in the Canadian acute care hospitals participating in a national sentinel network (CNISP). Few C. auris isolates were identified from 2012 to 2022. Reporting standardized surveillance data to inform the application of infection prevention and control practices in acute care hospitals is critical to help decrease the burden of HAIs and AMR in Canada.

Device and surgical procedure-related infections in Canadian acute care hospitals, 2018-2022.

Healthcare-associated infections (HAIs) are a significant healthcare burden in Canada. National surveillance of HAIs at sentinel acute care hospitals is conducted by the Canadian Nosocomial Infection Surveillance Program. This article describes device and surgical procedure-related HAI epidemiology in Canada from 2018 to 2022. Data were collected from over 60 Canadian sentinel acute care hospitals between January 1, 2018, and December 31, 2022, for central line-associated bloodstream infections (CLABSIs), hip and knee surgical site infections (SSIs), cerebrospinal fluid shunt (CSF) SSIs and paediatric cardiac SSIs. Case counts, rates, patient and hospital characteristics, pathogen distributions and antimicrobial resistance data are presented. Between 2018 and 2022, 2,258 device-related infections and 987 surgical procedure-related infections were reported. A significant rate increase was observed in adult mixed intensive care unit CLABSIs (1.07-1.93 infections per 1,000 line days, p=0.05) and a non-significant rate increase was observed in SSIs following knee arthroplasty (0.31-0.42 infections per 100 surgeries, p=0.45). A fluctuating rate trend was observed in CSF shunt SSIs over the time period and a significant rate decrease in paediatric cardiac SSIs was observed (68%, from 7.5-2.4 infections per 100 surgeries, p=0.01). The most commonly identified pathogens were coagulase-negative staphylococci (22.8%) among CLABSIs and Staphylococcus aureus (42%) among SSIs. Epidemiological and microbiological trends among selected device and surgical procedure-related HAIs are essential for benchmarking infection rates nationally and internationally, identifying any changes in infection rates or antimicrobial resistance patterns and helping inform hospital infection prevention and control and antimicrobial stewardship policies and programs.

Operating Room Airborne Microbial Load: Nonscrubbed Staff Apparel Matters

BackgroundInfection is a leading cause of total joint arthroplasty failure. In previous studies, we found correlations between the level of contamination, concentrations of airborne particles, and the number of staff present. In this study, we focused on the apparel of nonscrubbed operating room (OR) staff to elucidate their contribution to the airborne microbial load. MethodsWe compared hospital-laundered scrubs to disposable coveralls using 2 methods. (1) Participants entered an isolation chamber with a controlled environment and completed tasks for 1 hour wearing both the approved and alternative OR attire. Settle plates collected viable contaminants that were shed by the participants during testing. (2) Lab members conducted standardized maneuvers in a functional OR that simulated typical movements of the nurse, anesthesiologist, implant representative, and entering/exiting staff. An airborne particle counter and settle plates were positioned throughout the OR. After 1 hour, the staff changed apparel and repeated the test. Each session of both phases consisted of 2 tests by the same individuals on the same day. ResultsThere was approximately a 10-fold difference in the settlement rate of viable particles between groups when employing the isolation chamber. The settle rate for scrubs was 5,519 ± 1,381 colony forming units (CFUs)/m2/h, while the settle rate for coveralls was 505 ± 55 CFUs/m2/h (P = .008). During testing in the OR, 218.7 ± 35 CFUs/m2/h were captured for scrubs, compared with 50.5 ± 13 CFUs/m2/h for the coverall (P < .01). The concentration of airborne particles collected for scrubs was 4,952.1 ± 495 particles/m3 and 1,065 ± 53 particles/m3 for the coveralls (P < .01). This was a 77% and 79% reduction for both measures, respectively. ConclusionsThe open nature of standard scrubs allows contaminated particles to escape into the OR environment, whereas the one-piece design of the coveralls restricts pathways of escape. The results of this study may be helpful when developing hospital infection prevention policies.

Evaluating the antibacterial efficacy of a silver nanocomposite surface coating against nosocomial pathogens as an antibiofilm strategy to prevent hospital infections

Antimicrobial nanocoatings may be a means of preventing nosocomial infections, which account for significant morbidity and mortality. The role of hospital sink traps in these infections is also increasingly appreciated. We describe the preparation, material characterization and antibacterial activity of a pipe cement-based silver nanocoating applied to unplasticized polyvinyl chloride, a material widely used in wastewater plumbing. Three-dimensional surface topography imaging and scanning electron microscopy showed increased roughness in all surface finishes versus control, with grinding producing the roughest surfaces. Silver stability within nanocoatings was >99.89% in deionized water and bacteriological media seeded with bacteria. The nanocoating exhibited potent antibiofilm (99.82–100% inhibition) and antiplanktonic (99.59–99.99% killing) activity against three representative bacterial species and a microbial community recovered from hospital sink traps. Hospital sink trap microbiota were characterized by sequencing the 16S rRNA gene, revealing the presence of opportunistic pathogens from genera including Pseudomonas, Enterobacter and Clostridioides. In a benchtop model sink trap system, nanocoating antibiofilm activity against this community remained significant after 11 days but waned following 25 days. Silver nanocoated disks in real-world sink traps in two university buildings had a limited antibiofilm effect, even though in vitro experiments using microbial communities recovered from the same traps demonstrated that the nanocoating was effective, reducing biofilm formation by >99.6% and killing >98% of planktonic bacteria. We propose that conditioning films forming in the complex conditions of real-world sink traps negatively impact nanocoating performance, which may have wider relevance to development of antimicrobial nanocoatings that are not tested in the real-world.

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 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

In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic. A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China. The workload (8.2hours vs 10.14hours, P=0) and self-reported mental health problems (23.5% vs61.8%, P<.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. Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases.