Hygiene Precautions Research Articles

Risk of air and surface contamination of SARS-CoV-2 in isolation wards and its relationship with patient and environmental characteristics

Air and surface contamination of the SARS-CoV-2 have been reported by multiple studies. However, the evidence is limited for the change of environmental contamination of this virus in the surrounding of patients with COVID-19 at different time points during the course of disease and under different conditions of the patients. Therefore, this study aims to understand the risk factors associated with the appearance of SARS-CoV-2 through the period when the patients were staying in the isolation wards. In this study, COVID-19 patients admitted to the isolation wards were followed up for up to 10 days for daily collection of air and surface samples in their surroundings. The positivity rate of the environmental samples at different locations was plotted, and multiple multi-level mixed-effect logistic regressions were used to examine the association between the positivity of environmental samples and their daily health conditions and environmental factors. It found 6.6 % of surface samples (133/2031 samples) and 2.1 % of air samples (22/1075 samples) were positive, and the positivity rate reached to peak during 2–3 days after admission to the ward. The virus was more likely to present at bedrail, patients’ personal items and medical equipment, while less likely to be detected in the air outside the range of 2 m from the patients. It also revealed that higher positivity rate is associated with lower environmental temperature, fever and cough at the day of sampling, lower Ct values of latest test for respiratory tract samples, and pre-existing respiratory or cardiovascular conditions. The finding can be used to guide the hospital infection control strategies by identifying high-risk areas and patients. Extra personal hygiene precautions and equipment for continuously environmental disinfection can be used for these high-risk areas and patients to reduce the risk of hospital infection.

The impact of COVID-19 on the quality of life of older adults: a cross-sectional study in Athens, Greece

IntroductionThe COVID-19 has affected both physical and mental health of the elderly.ObjectivesThe purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people.MethodsA cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0Results 222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p <0.05) with female gender, low educational level and with comorbidities (coronary disease, diabetes mellitus and skeletomuscular diseases). Health precaution measures were negative correlated with mental health of the elderly. However, in participants with frequent contact with family and friends, lower anxiety levels were detected.ConclusionsOur results highlight that older adult has experienced negative impact on both quality of life and mental health during 2nd Covid-19 lockdown in Greece.DisclosureNo significant relationships.

Self-neglect: a review of opportunities and barriers to federal policy and research priorities

PurposeSelf-neglect is a public health concern that can manifest as failure to provide oneself adequate food, water, clothing, shelter, personal hygiene, medication or safety precautions. This paper sought to inform federal policy and research priorities regarding effective strategies to detect, prevent and address self-neglect. This study aims to inform federal policy and research priorities regarding effective strategies to detect, prevent, and address self-neglect.Design/methodology/approachThe authors conducted a rapid review of self-neglect literature and interviews with five national subject matter experts to inform federal policy and research priorities.FindingsThis study identified gaps in the literature and several approaches and numerous challenges to preventing, identifying and addressing self-neglect. The lack of a nationally accepted definition of self-neglect, a dearth of longitudinal studies which has limited research on self-neglect etiology and trends, and limited development and validation of screening tools, are among the challenges.Research limitations/implicationsFindings indicate that comparisons of self-neglect definitions, and longitudinal studies of self-neglect by subpopulations, are needed areas of future research. Issues for policy consideration include national self-neglect data collection and reporting requirements.Originality/valueThis study synthesizes recent literature on self-neglect, highlights gaps in the literature on self-neglect and points toward federal policy priorities for advancing effective strategies to detect, prevent and address self-neglect.

FOOD USAGE OF MACROTERMES (ISOPTERA, TERMITIDAE) ALATES IN LOME (SOUTHERN TOGO)

The consumption of insect including termites is gaining more interest nowadays even though many people still ignore the great benefit of enthomophagy. This study is a contribution to the valorization of Macrotermesalates in Lome (southern Togo). For this purpose, a survey was carried out in three municipalities of Golfe 3, Golfe 7 and Agoe-Nyive 1 (all located in the district of Lome) from June 14 to July 14, 2021. A total of 345 people were submitted to a set of questionary to assess the level of their knowledge and consequences related to the consumption of Macrotermes alates. The results revealed that more than 94% of the participants not only had a good knowledge of Macrotermes alates, but have also consumed them. Among the surveyed people, 48.67% consumed these alates for their taste while 28.67% consumed them for their nutritional value. Also, 43.70% of participants who had once consumed these alates, stated that they experienced gastrointestinal troubles following the consumption. Thus, although it is important to encourage the consumption of Macrotermes alates, hygienic precautions should be taken during the collection and processing of these alates in the interest of the health safety of consumers.

Awareness of Covid-19 and attitudes toward vaccination in parents of children between 0 and 18 years: A cross-sectional study

PurposeMany countries are struggling with the covid-19 pandemic. Although many measures have been adopted to reduce the transmission of the virus, vaccination is the only solution for controlling and ending the pandemic. The purpose of this study is to evaluate the awareness of covid-19 and attitudes toward covid-19 vaccination in parents. Design and studyThe research is a descriptive and cross-sectional study. The online survey was conducted. The population of the study consisted of parents of children aged 0–18 who agreed to participate through the social media (Facebook and Instagram) between May 26 and July 7, 2021. With the community research model, the minimum sample size was determined as 384. A parent description form and the Coronavirus (Covid-19) Awareness Scale (CAS) were used for data collection. ResultsThe mean Contagion Precaution Awareness sub-factor score of the CAS was 28.84 ± 10.55, the mean Awareness of Following Current Developments sub-factor score was 10.27 ± 4.63, and the Hygiene Precaution Awareness sub-factor score was 9.54 ± 3.55. Thirty-seven percent of the parents wanted their child/children to be vaccinated against Covid-19. A statistically significant association was determined between wished to have their child/children vaccinated against covid-19 and the mean CAS sub-factors scores (p < 0.05). Conclusions/practice implicationsParents' awareness of covid-19 in this study was moderate. The willingness of parents to have their children vaccinated against covid-19 was also low. In order to increase Covid-19 vaccination rates, doubts and lack of information concerning the vaccine need to be overcome by identifying reasons for vaccine hesitancy.

Maintaining safe office spaces to minimise risks of SARS-CoV-2 transmission.

BackgroundSARS-CoV-2 can be transmitted within offices. Traditional respiratory transmission modes have undergone reassessment and a new paradigm has emerged. This paradigm needs examining prior to identifying control measures to prevent office acquired infections (OAI).MethodsAn ongoing assessment of the SARS-CoV-2 transmission literature, including international public health guidance, began 30/1/2020 and continued to submission 7/2/2022. The evidence for the established respiratory transmission paradigm (either droplet or aerosols) and that of a newly emerging paradigm (aerosol and/or droplets) were explored. Based on the new paradigm control measures needed to minimise OAI were produced.ResultsThe old paradigm of respiratory transmission of being either droplet or airborne cannot be evidenced. SARS-CoV-2 is emitted in virus laden particles that can be inhaled and/or sprayed on facial mucous membranes (Airborne being the dominant route).Office hygiene measures include: minimising the opportunities for the virus to enter the building. Reducing the susceptibility of people to the virus. Minimising exposure risks within offices, and optimising success in deployment.ConclusionStandard office hygiene precautions are needed to reduce OAI risks from SARS-CoV-2. Efforts should focus on enabling the smooth functioning of the office whilst minimising risks that the virus will transmit therein. This includes: local risk assessments as transmission risks vary based on building design, ventilation, capacity, and ways of working. Additionally, using experts to optimise ventilation systems.

An Outbreak of Leclercia adecarboxylata from a Tertiary Neurocare Center

Background: Hospital-acquired infection (HAI) outbreaks are special-cause events having multiple factors involved in it. HAI outbreaks often reflect problems that are unique, urgent, unusual, or difficult to control. There are only a few case reports and case series of Leclercia adecarboxylata reported in the literature. Materials and Methods: The outbreak occurred in a 1000-bedded tertiary neurocare center. There was sudden isolation of an unusual organism from different samples such as tracheal secretion, ventriculo-peritoneal shunt tip, pus, wound swab, urine, and blood. All the samples were processed according to the standard protocol and antibiotic susceptibility was carried out by Kirby–Bauer disk-diffusion method and interpreted according to the Clinical and Laboratory Standards Institute guidelines. All the isolates were subjected to VITEK-2 system for confirmation. The steps involved in outbreak investigation were (1) case definition, (2) case confirmation, (3) establishing the background rate of disease and finding cases, (4) identification of source, (5) control measures, (6) communicate findings, and (7) maintain surveillance. Results: The organism was identified as L. adecarboxylata. All the isolates were resistant only to ampicillin. However, two isolates isolated from the blood of the same patient were sensitive only to imipenem and colistin. The source could not be identified with extensive efforts; however, the outbreak was controlled with strict practice of hand hygiene and other aseptic precautions. On surveillance, there was no further isolation of the organism. Conclusion: As HAI outbreaks are multifactorial, there should be preparedness for hospital infection outbreaks in all the hospitals to prevent morbidity and mortality.

Phenotypic and genotypic characterization of antibiotic resistance of Listeria monocytogenes isolated from raw milk samples collected from Polonnaruwa, Sri Lanka

Listeria monocytogenes is a food-borne pathogen that can cause severe invasive infection called ‘listerosis’ in humans. Development of antibiotic resistance is a major setback in the management of conditions caused by Listeria in both human and veterinary medicine. In this study, antibiotic resistance of fifty L. monocytogenes strains isolated from raw milk samples collected from farms in Polonnaruwa district, Sri Lanka was determined for four commonly used antibiotics; penicillin, ampicillin, streptomycin and tetracycline. The strains were also tested for the presence of selected antibiotic resistant genes (penA, ampC, strA, strB, tetA and tetB). L monocytogenes isolates showed resistance to ampicillin (60%), penicillin (40%) streptomycin (16%) and tetracycline (8%) in diffusion assays. Phenotypic multidrug resistance was exhibited by twenty isolates. The tetracycline resistant gene (tetA) was detected in seven isolates, while tetB was not detected in any. Presence of streptomycin resistant genes (strA or strB) was confirmed in seven isolates. Ampicillin (ampC) and penicillin (penA) resistant genes were not detected in any of the tested isolates. Except from the samples collected from Sungavila area, isolates from other sampling areas showed resistance to at least one of the antibiotics tested, suggesting that raw milk samples are prone to be contaminated with L. monocytogenes strains with different antibiotic resistant profiles. Therefore, necessary hygienic precautions are recommended to avoid any potential public health threats and to safeguard the health of raw milk consumers.

Dualism Between Human Rights and Public Interest in Using Mask During COVID-19 Pandemic

Background: COVID-19's appearance, and subsequent pandemic, stunned the world. The spread is rapid, and research continues to this day, prompting the WHO and government to develop ever-evolving rules. The group can break the chain of COVID-19 disease transmission by implementing hygiene precautions such as wearing masks, washing hands with soap, bringing hand sanitizers, and maintaining distance, or what is commonly referred to as social distancing and independent isolation.&#x0D; Aim: As the title states, this research aimed to study the dualism between human rights and public interest in using mask during COVID-19 era.&#x0D; Method: This analysis employs a research methodology that includes a review of normative legal studies.&#x0D; Findings: Using a mask is a fundamental right that everyone has to breathe safe, virus-free air. Additionally, a mask promotes group rather than individual interests. As a result, the government acts by enacting legislation restricting the use of masks and enforcing other health protocols during this COVID-19 pandemic period, using sanctions to educate citizens about the importance of mask use today.

Risk Factors and Epidemiological Profile of Multi-Resistant Bacteria in Nosocomial Pneumonia

Nosocomial pneumonia (NP) is the second most common cause of nosocomial infection in the intensive care unit (ICU). They pose significant diagnostic, therapeutic and economic problems and increase the risk of death by increasing the length of stay in the ICU. The emergence of resistance to last-resort antibiotics in therapy defines multi-resistant bacteria (MRB). Our work is a retrospective descriptive and analytical study spread over one year (from 1 to 30 December 2019) which focused on patients admitted to the intensive care unit of Ibn Tofail Hospital in Marrakech and who presented with a nosocomial MRB pneumopathy. BMRs were isolated in 38% of cases. Imipenem-resistant Acinetobacter baumanii (IRBA) was the most isolated multi-resistant pathogen. The high level of co-resistance to other antibiotic families leaves little room for treatment. The risk factors found to play a role in the acquisition of BMR NPs were: age between 36 and 45 years, length of hospital stay between 10 and 20 days, presence of co-morbidity, radiological picture suggestive of NPs and broad spectrum antibiotic therapy. Measures to prevent NP are increasingly being adopted as an indicator of quality of care in intensive care units worldwide. Thus, reducing the incidence of NP and MRB should be a goal for all hospitals. In our context, measures to control MRBs must be reinforced by hygiene measures and precautions, in particular the identification of infected or colonised patients, the technical and geographical isolation of patients carrying MRBs and the use of appropriate treatment. Thus, regular epidemiological surveillance is necessary to guide management and define an adequate prevention strategy adapted to the context.

An Anthropological Demographic Study on the Sociocultural Causes of Covid-19 Spread among the Highly Educated in Egypt: Five Case Studies from Cairo

Covid-19 is a disastrous pandemic that broke out into the world in 2019, and continued to spread until the date of this paper in 2021. However, the prediction of the onset of its symptoms did not always mitigate its spread. Though it was believed that the highly educated, with their hygienic precautions and health awareness were far from being infected by most infectious diseases, they could not escape its psychological and social effects. This paper aimed to uncover some of the possible reasons behind the infection of five cases from three traditional families chosen as examples to share in explaining the causes of the spread of this pandemic among a vulnerable cross-section of the middle aged and elderly highly educated, where the researcher passed through that experience in Cairo Egypt, since the early of April to the late of May 2021. Through the theory of Jennifer Johnson-Hanks with its application of demographic anthropology perspective, this study highlighted the importance of social and cultural factors in explaining causes and effects of demographic data, in addition to potential solutions as future precautions for that Pandemic.

Status of water, sanitation, and hygiene and standard precautions in healthcare facilities and its relevance to COVID-19 in Afghanistan.

BackgroundTo protect the health and safety of healthcare workers (HCWs), it is essential to ensure the provision of sustainable water, sanitation, and hygiene (WASH) services and standard precautions in healthcare facilities (HCF). The objectives of this short communication were 1) to assess the availability of WASH services and standard precautions in HCFs in seven provinces in Afghanistan before the COVID-19 pandemic, and 2) to elucidate the relevance of these patterns with the number of reported HCW infections from COVID-19 in the mentioned provinces.MethodsWe analyzed secondary data from the 2018-19 Afghanistan Service Provision Assessment survey, which included 142 public and private HCFs in seven major provinces in Afghanistan. Data on COVID-19 cases were obtained from the Afghanistan Ministry of Public Health Data Warehouse. Weighted prevalence of WASH services and standard precautions were calculated using frequencies and percentages. ArcGIS maps were used to visualize the distribution of COVID-19 cases, and scatter plots were created to visualize the relevance of WASH services and standard precautions to COVID-19 cases in provinces.ResultsOf the 142 facilities surveyed, about 97% had improved water sources, and over 94% had improved toilet for clients. Overall, HCFs had limited availability of hygiene services and standard precautions, which was lower in private than public facilities. More than half of the facilities had safe final disposal and appropriate storage of sharps and medical waste. Of the seven provinces, Herat province had the highest cumulative COVID-19 case rate among HCWs per 100,000 population and reported lower availability of WASH services and standard precautions in HCFs compared to other provinces.ConclusionOur findings show disparities in the availability of WASH services and standard precautions in public and private facilities. Private facilities had a lower availability of hygiene services and standard precautions than public facilities. Provinces with higher availability of WASH services and standard precautions in HCFs had a lower cumulative COVID-19 case rate among HCWs per 100,000 population. Pre-pandemic preparation of adequate WASH services and standard precautions in HCFs could be potentially important in combating infectious disease emergence.Supplementary informationThe online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00272.

Unmasking the Mask Issues among Healthcare Workers in COVID-19 Era

Introduction: Recent pandemic have showed importance of adequate availability of Personal Protective Equipment (PPE) most importantly the face mask and training of Healthcare Workers (HCWs) for its proper usage for protection from various infections to maintain smooth functioning of healthcare facility. Aim: To examine practices and barriers to compliance regarding face mask usage among HCWs. Materials and Methods: The present study was a crosssectional observational analytical study which was conducted at Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, India, from 30th June, 2020 to 24th July, 2020 during Coronavirus Disease-2019 (COVID-19) pandemic. Data was collected through semi-structured bilingual online questionnaire using Google form based on recommendations for mask use by World Health Organisation (WHO) and Centers for Disease Control and Prevention (CDC). Data was recorded in MS Excel and Statistical Package for the Social Sciences (SPSS) 16.0 software was used for statistical analysis. Qualitative data was expressed in percentages and continuous data was summarised in mean±Standard Deviation (SD). Chi-square test was used to check the association between the categorical variables. Results: Total 362 HCWs submitted responses, of which 44.7% respondents wore N95 masks to protect themselves from COVID-19. Only 34.2% were satisfied with availability of masks in healthcare facility. Itching and sweating on part inside mask was major problem faced by 52.8% of respondents. Only 58% followed proper hand hygiene precautions while handling mask whereas 62.7% took proper measures while doffing. Conclusion: There appears to be a lack of awareness about proper hand hygiene while handling mask, appropriate precautions for reuse and doffing. Availability of mask also needs to be addressed. Regular trainings are needed to increase awareness, improve behaviour and practices regarding mask usage for prevention of occupational spread of infection among HCWs.

Examining the effect of infection prevention and control awareness among nurses on patient and family education: A cross-sectional study.

The significance of patient engagement in infection prevention and control remains to be stressed as a means of improving patient safety. This study aimed to determine nurses' awareness of infection prevention and control, assess patient and family education on infection prevention and control, and examine the effect of nurses' infection prevention and control awareness on patient and family education. A multi-site, cross-sectional study was conducted among 566 nurses in Hungary. Nurses responded to a questionnaire of three parts: demographics, infection prevention, and control awareness; healthcare-associated infections, hand hygiene, and standard precautions; and patient and family education. High scores were reached in overall awareness and standard precautions. Nurses educated patients and family members the most on hand hygiene and respiratory hygiene. Nurses with higher awareness educated patients more than those with lower awareness, but the differences were only significant for respiratory hygiene and the reason for isolation. Nursing leaders are encouraged to enhance the culture that is based on nurse/patient partnership and to develop reminders to emphasize the importance of engaging patients and family members in infection prevention and control.

Response of Saudi Population to Strict Preventive Measures against COVID-19.

: BackgroundThe Saudi ministry of health (MOH) started the preventive measures very early on before having a single case of COVID-19. There were very few studies regarding the awareness and adherence to the preventive measures against COVID-19 among the Saudi population in the literature. Objectives: The study aims to examine the awareness and commitment to the strict Saudi government preventive measures against COVID-19. Methods: A cross-sectional online survey targeted Saudi and non-Saudi populations aged 18+ in March–April 2020. The online questionnaire was designed to explore the participant’s sociodemographic data, washing hygiene habits, the general level of awareness regarding COVID-19, and the extent to which they adhere to the government’s strict instructions. Results: Out of the 2958 participants in the survey, 23% washed their hands for between 20 and 30 s, 59.6% washed their hands after shaking hands with other people, 67.9% washed their hands after use of other’s utilities, 65.9% had appropriately followed the MOH recommended guidelines for home quarantine and social distancing. People in different age groups differed significantly on their practiced hygienic practices score p < 0.001. Respondents’ educational level had converged considerably and positively on their clean proper prevention practices score, f(2838.3) = 15.70. Conclusion: The majority of the participants adhere to the strict government instructions regarding COVID-19 as they have to obey the law. Health sector employees measured significantly greater hygienic preventive measures and precautions in comparison to other sectors. More public health efforts should increase hygienic best practice scores to achieve the best outcome.

Sonographic assessment of low muscle quantity identifies mortality risk during COVID-19: a prospective single-centre study.

BackgroundAssessment of muscle quantity by sonographic muscle indices could help identify patients at risk for fatal outcome during coronavirus disease‐2019 (COVID‐19). The aim of this study was to explore sonographic muscle indices as predictors of COVID‐19 outcome and to test the feasibility of sonographic muscle measurement in an isolation context.MethodsMuscle indices, derived from the psoas muscle or thigh muscles, were quantified by sonography in a cohort of patients without COVID‐19 to obtain reference values for low muscle quantity. Gender‐specific median of different muscle indices were defined as threshold value for low muscle quantity. The prognostic relevance of low muscle quantity, was prospectively explored in two cohorts of hospitalized COVID‐19 patients. Optimal muscle index cutoff values predictive for 30 day mortality during COVID‐19 were determined by receiver operating characteristic‐area under the curve and Youden index calculation. Muscle quantity and known prognostic factors of COVID‐19 were analysed by multivariable log‐regression.ResultsCompared with other muscle indices, the psoas muscle area index (PMAI) showed the most favourable characteristics to predict outcome of COVID‐19 disease. Sonographic morphometry of patients without COVID‐19 (n = 136) revealed a gender‐specific median for PMAI (male: 291.1 mm2/m2, female 260.6 mm2/m2) as threshold value of low muscle quantity. Subsequently, COVID‐19 patients (Cohort I: n = 58; Cohort II: n = 55) were prospectively assessed by bedside sonography. The studied COVID‐19 patients developed a critical course of disease in 22.4% (Cohort I: n = 13/58) and 34.5% (Cohort II: n = 20/55). Mortality rate reached 12.1% (Cohort I: n = 7/58) and 20.0% (Cohort I: n = 11/55) within 30 days of follow up. COVID‐19 patients with a PMAI below the gender‐specific median showed a higher 30 day mortality in both COVID‐19 cohorts (log rank, P < 0.05). The optimal PMAI cutoff value (206 mm2/m2) predicted 30 day mortality of hospitalized COVID‐19 patients with a sensitivity of 72% and specificity of 78.5% (receiver operating characteristic‐area under the curve: 0.793, 95% confidence interval 0.671–0.914, P = 0.008). Multivariable log‐regression analysis of PMAI, age, gender, BMI and comorbidities confirmed an independent association of low PMAI with 30 day mortality of COVID‐19 patients (P = 0.018).ConclusionsSonographic morphometry provides reliable muscle quantification under hygienic precautions and allows risk stratification of patients with COVID‐19.

Molecular Genetic Analysis of the Causative Agents of COVID-19–Associated Bacterial Pneumonia in Hospitals of Rostov-on-Don

Introduction: Hospital-acquired bacterial superinfections in COVID-19 patients are one of the main reasons of a severer course of the disease, a higher risk of adverse outcomes, and, consequently, a longer hospital stay. Much attention is, therefore, paid to the study of genetic markers enabling identification of clonal relationships between different isolates of the causative agents of bacterial co-infections, which, in their turn, help distinguish between hospital- and community-acquired cases of infectious diseases. Objective: To study the genetic diversity and clonal relationships of A. baumannii and P. aeruginosa isolated from patients with a novel coronavirus disease (COVID-19) in Rostov-on-Don. Materials and methods: We tested biological specimens from 217 in- and outpatients with community-acquired pneumonia in the city of Rostov-on-Don. Whole-genome sequencing of A. baumannii and P. aeruginosa strains was performed using a MiSeq sequencer (Illumina, USA). SNP markers were selected using proprietary software written in Java and Python. Cluster analysis and dendrogram construction were performed using the author's software using the UPGMA method. The MEGA 5 software was used to build the dendrogram. Results: We established the spectrum of bacteria causing the development of secondary infection associated with COVID-19. Results of the whole-genome sequencing of 10 pneumonia pathogens isolated from patients with the novel coronavirus disease revealed clonality of individual strains. The nosocomial origin of two isolates of P. aeruginosa and two of A. baumannii was demonstrated and confirmed by the analysis of their plasmid composition. Secondary bacterial infection in COVID-19 patients may be attributed to the pathological development of the dominant microflora of the upper respiratory tract mucosa, which provides normal biocenosis in healthy people, or non-compliance with basic principles of hospital hygiene and infection control precautions. Conclusion: The research helped determine the etiological structure of pneumonia in patients with COVID-19. Whole-genome sequencing and the following bioinformatic analysis revealed the nosocomial origin of a number of strains of P. aeruginosa and A. baumanii.

This Month in Anesthesiology

This Month in Anesthesiology

Lesson learned from the pandemic: Isolation and hygiene measures for COVID-19 could reduce the nosocomial infection rates in oncology wards

It was previously demonstrated that seasonal influenza incidence was significantly decreased during the COVID-19 pandemic, possibly due to respiratory and hygiene precautions. From this point, we hypothesized that the COVID-19 precautions could lead to a decrease in nosocomial infection rates in oncology inpatient wards. We evaluated the nosocomial infection rates in an inpatient palliative oncology ward in the first 3 months of the COVID-19 pandemic in our country and compared this rate with the same time frame of the previous year in our institution. The percentage of nosocomial infections complicating the hospitalization episodes were significantly reduced in the first 3 months of the pandemic compared to the previous year (43 vs. 55 nosocomial infection episodes; 18.6% vs. 32.2%, p = 0.002). The decrease in the nosocomial infections was consistent in the different types of infections, namely pneumonia (4.8% vs. 7.6%), urinary tract infection (5.2% vs. 7.6%), bacteremia (5.2% vs. 7%) and intraabdominal infections (2.6% vs. 3.5%). The median monthly disinfectant use was significantly increased to 98 liters (interquartile range: 82 - 114) in 2020 compared to 72 L (interquartile range: 36 - 72) in 2019 (p = 0.046). The continuation of the simple and feasible hygiene and distancing measures for healthcare workers and patient relatives and adaptations for earlier discharge could be beneficial for preventing nosocomial infections in oncology wards. These measures could be implemented routinely even after the COVID-19 pandemic for patient safety, especially in settings with higher nosocomial infection rates like inpatients palliative care units.

Salmonella Typhimurium environmental reduction in a farrow-to-finish pig herd using a live attenuated Salmonella Typhimurium vaccine

BackgroundSalmonella Typhimurium is an important zoonotic pathogen in pigs, that can cause clinical disease. Many sow herds and finishing herds are infected with Salmonella, and therefore pose a threat for the contamination of pork and pork products and ultimately consumers.Case presentationThis case study describes a farrow-to-finish pig herd, producing its own replacement gilts, which had experienced clinical outbreaks of salmonellosis since 2002. Outbreaks were characterised by profuse diarrhoea, dead pigs and high antimicrobial use (colistin sulphate). The aim of this study was to see whether using vaccination of sows and piglets with Salmoporc®, a live attenuated Salmonella Typhimurium vaccine, in combination with standard hygienic precautions, it was possible to reduce Salmonella Typhimurium to below the bacteriological detection limit. Monitoring of the presence of Salmonella was done using a total of 20 pooled faecal, sock and dust samples per herd visit in the period from September 2016 to October 2020. Within the first 10 months after the start of vaccination in August 2016, there was a rapid reduction in clinical symptoms, antimicrobial usage and the number of Salmonella-positive samples. During the winters of 2017/2018 and 2018/2019 the number of positive samples increased again, however with minimal need to use antimicrobials to treat the affected animals. In July 2019, only two samples from a corridor were positive. In September and November 2019 and in October 2020 all three samplings were completely negative for S. Typhimurium.ConclusionsThis case, together with other longitudinal studies, can be seen as a proof of the principle that long term vaccination with a live attenuated S. Typhimurium vaccine can reduce the level of S. Typhimurium in the herd environment to very low levels within a farrow-to-finish herd initially suffering from clinical salmonellosis. Also, clinical symptoms indicating salmonellosis were no longer observed and antimicrobials to treat clinically diseased pigs were no longer needed.