Infection Control Research Articles

Surveillance of multidrug-resistant bacteria in an intensive care unit: a cross sectional study

Antimicrobial resistance is a global health threat. Intensive care units are particularly affected by this problem regarding patients’ history and invasive procedures use. The aim of this study was to determine the epidemiological and microbiological profile of multidrug-resistant (MDR) bacteria in a surgical intensive care unit and to assess the prevalence and cumulative incidence of multidrug-resistant bacteria in these patients. This was a cross-sectional study including all bacterial strains isolated from patients hospitalized in a surgical intensive care unit from January 1, 2022, to December 31, 2022. Out of 204 isolated bacteria, 119 (58.3%) were MDR. Among these isolates, 90.8% were of nosocomial origin. The most frequent MDR microorganisms were MDR Gram-negative bacilli, particularly 50.4% Acinetobacter baumannii and 24.4% Klebsiella pneumoniae. Carbapenem-resistant A. baumannii (CRAB) accounted for 50.4% of multidrug-resistant organisms (MDROs), followed by carbapenem-resistant Enterobacterales (CRE) (27.7%) and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (7.6%). Colistin resistance was tested in 8 CRE strains and one isolate was resistant. MDR strains were isolated from Distal Bronchial Samples (DBS) and blood cultures in respectively 41.2% and 19.3% of cases. Annual incidence rate was 39.2 per 100 admissions for CRAB, 21.5 per 100 admissions for CRE and 3.9 per 100 admissions for Methicillin-resistant Staphylococcus aureus. In the surgical intensive care unit, CRAB and CRE were the main MDROs isolated microorganism, primarily from BPBS and blood cultures. Annual incidence rates were high for these bacteria. Implementing infection prevention and control measures, along with rational antibiotic use, are necessary to decrease MDR bacterial infection in intensive care units.

Knowledge Attitude & Practice (Kap) About Infection Prevention Control (Ipc) And Waste Management During Covid-19 Among The Healthcare Workers In Primary Level Government Hospitals In Bangladesh

The goal of infection prevention and control is to systematically put a barrier between the organism and the susceptible host. Additionally, it refers to all measures taken by the healthcare facility to minimize or reduce the threat of the spread of infectious diseases. IPC is relatively an inexpensive way to prevent healthcare-associated infection. Patients, healthcare professionals, and communities are at danger when basic infection prevention and control procedures are not followed. In many developing countries, healthcare professionals do not follow infection prevention methods despite the rise in highly contagious illnesses like COVID-19. The aim of the study was to assess the status of knowledge attitude and practice on IPC and Waste management among the health care workers working in the primary level government hospitals. The study was a cross-sectional descriptive type of study. The target population was the healthcare workers working in the primary level government hospitals in Cumilla District. The study was be carried out from August 2021 to September 2022 in the 17 Upazilla of Cumilla District. Non-probability convenient sampling method was followed for sampling. Our calculated sample size was 261. A structured interview questionnaire was prepared to gather the required information. A Chi-square test and a logistic regression model were used to analyze the data. Prevalence of knowledge was 54.5%, 96.8% of the respondents have a positive attitude towards infection prevention control and 87.3% has maintain a good practice of IPC. From analysis age of the respondents which are <25 years are less knowledgeable than the other age groups. (AOR= 34.75; 95% CI: 4.532-266.554, AOR= 39.429; 95% CI: 4.959-313.462, AOR=39.429; 95% CI: 43.661-268.708). Health assistants (AOR= .015; 95% CI:.002-.111) and Nurses are AOR= .013; 95% CI: .001-.124) 98% less knowledgeable than physicians. Diploma students are less knowledgebale AOR= .012; 95% CI: .012-.002), then MBBS. The facility which has IPC team are more knowledge than those who don’t have (AOR=.103, 95% CI:.035-.307), Triage facility 76% less (AOR= .495; 95% CI:.236-1.037), The respondents who received Hand hygiene training sometimes are 89% less knowledgeable than who received often (AOR= .107; 95% CI: .029-.388) The study showed that majority of the health care workers were knowledgeable and practices IPC, Doctors and nurses are more knowledgeable, where other HCW are less knowledgeable and receives less trainings. Many of the facility do not have any IPC committee, Regular trainings, monitoring, and supervision is recommended to avoid the risk of accidental infection due to lack of IPC knowledge and practice. EWMCJ Vol. 13, No. 2, July 2025: 76-90

The Nosocomial Transmission of Carbapenem-Resistant Gram-Negative Bacteria in a Hospital in Baoding City, China

Background: The global rise of multidrug-resistant Gram-negative bacteria, particularly non-fermenting species and carbapenemase-producing Enterobacteriaceae, poses a significant challenge to hospital infection control. Methods: In this study, a total of 89 Acinetobacter spp. isolates, 14 Pseudomonas aeruginosa, and 14 carbapenem-resistant Enterobacteriaceae isolates were collected from patients in a tertiary hospital. Whole-genome sequencing and antimicrobial susceptibility testing were conducted. Resistance mechanisms and evolutionary relationships were analyzed using phylogenetic analysis and genetic context mapping. Results: Among the non-fermenting isolates, A. baumannii exhibited high resistance to carbapenems, clustering into distinct clonal groups enriched with genes associated with biofilm formation and virulence genes. P. aeruginosa isolates harbored fewer resistance genes but carried notable mutations in the efflux pump systems and the oprD gene. In Enterobacteriaceae, four blaNDM alleles were identified within a conservative structural sequence, while blaKPC-2 was located in a non-Tn4401 structure flanked by IS481- and IS1182-like insertion sequences. Phylogenetic analysis revealed that blaNDM-positive E. coli strains were closely related to susceptible lineages, indicating horizontal gene transfer. Conversely, K. pneumoniae isolates harboring blaKPC-2 formed a tight clonal cluster, suggesting clonal expansion. Conclusions: The study reveals distinct transmission patterns between resistance genes: horizontal dissemination of blaNDM and clonal expansion of blaKPC-2 in K. pneumoniae. These findings emphasize the need for resistance-gene-specific genomic surveillance and infection control strategies to prevent further nosocomial dissemination.

Core-Shell Microneedle Patch with Controlled Sequential Release of CuO2@ZIF-8 Nanoparticles and VEGF for Synergistic Treatment of Infected Wounds.

Infected wounds are difficult to treat due to biofilm formation, drug-resistant bacteria, and inefficient localized therapy. To address these challenges, we developed a core-shell microneedle (MN) patch that enables sequential delivery of copper peroxide (CuO2) nanoparticles and vascular endothelial growth factor (VEGF) for synergistic healing. CuO2 was encapsulated in zeolitic imidazolate framework-8 (CuO2@ZIF-8) to improve the aqueous stability and regulate reactive oxygen species (ROS) generation. The antibacterial nanocomposite was loaded into a pH-sensitive hyaluronic acid (HA) core layer for rapid release under a weakly acidic wound microenvironment, while VEGF was incorporated into a gelatin methacryloyl (GelMA) shell for sustained delivery. Upon application, the core dissolves to release Cu2+, Zn2+, and ROS, disrupting biofilms and killing bacteria. Subsequently, the shell swells and degrades to release VEGF, promoting angiogenesis and tissue regeneration. In a Staphylococcus aureus-infected wound model, the MN patch demonstrated potent antibacterial activity, enhanced neovascularization, and accelerated healing. This programmable, dual-functional MN platform offers an effective strategy for treating infected wounds by integrating infection control with tissue regeneration in a temporally coordinated manner.

Posterior fixation for pyogenic spondylitis following osteoporotic vertebral fracture: A retrospective study of five challenging cases.

Posterior fixation for pyogenic spondylitis following osteoporotic vertebral fracture: A retrospective study of five challenging cases.

Australian infection prevention and control governance, strategy and structure: Design for success.

Governance, strategy and organisational structure for Infection Prevention and Control (IPC) programs across Australia remain variable. The standardisation and integration of these functions across jurisdictions are critical for effective advancement of IPC across health systems. Across the Australian Federal, State and Territory jurisdictions, the study examined a twofold research question: first, what are the governance, strategy and organisational structures of IPC programs?; and second, what are the essential elements for a standardised, consistent IPC governance framework? Comprising four integrated steps: preconference document analysis of key jurisdictional program information; a survey of conference participants; open discussion - an expert panel of jurisdictional leads and conference participants; and expert panel review, incorporating mixed methods and a modified Delphi approach for consensus and validated guidance. IPC representatives across Australia participated in this study with 44 % (226/513) responses. Structures reported included: patient safety, public health, or infectious diseases. Reported key elements for effective IPC governance included IPC leadership expertise (42 %), a consistent and transparent structure (30 %), and adequate resourcing and funding for IPC (18 %). IPC governance structures across Australia remain substantially variable. The Australian Centre for Disease Control (AusCDC) is considered the pre-eminent IPC governance agency, that could enhance IPC governance, structure and strategic direction. Clear governance, strategy, and organisational structures have a critical role in the effectiveness of IPC programs and healthcare associated infection reduction strategies. The developed framework provides additional insight towards a comprehensive, standardised national IPC governance framework, offering opportunity for improvement and informing future priorities.

Infection prevention and control measures during the COVID-19 pandemic and airborne tuberculosis transmission during primary care visits in South Africa.

Tuberculosis (TB) transmission in crowded health care settings poses considerable risks in high-burden regions. We assessed how COVID-19 pandemic-related infection prevention and control (IPC) measures might impact TB transmission in a South African primary care clinic. In 2019 (prepandemic) and 2021 (pandemic), we collected clinical data, patient tracking data (person-time and spatial density), indoor CO2 levels, and concentrations of Mycobacterium tuberculosis (Mtb) DNA in bio-aerosol samples. We estimated the risk of Mtb transmission during a 1-hour visit based on ventilation rate and duration of exposure. During the pandemic, clinics were less crowded, with lower mean person-time per day (209 vs 258 hours; P < 0.001). TB prevalence among patients also declined (1.1% vs 4.7%; P = 0.052). Environmental indicators suggested improved air quality, with lower CO₂ levels (555 vs 856 parts-per-million; P < 0.001) and higher ventilation rates (15.8 vs 6.3 air changes per hour; P < 0.001). These changes corresponded with a reduction in modeled Mtb transmission risk (0.04% vs 1.36%; P = 0.046). Airborne Mtb DNA was detected in both periods. Pandemic-related IPC measures to control COVID-19 transmission were rigorously implemented and likely reduced transmission of airborne respiratory infections, supporting their continued implementation in healthcare settings postpandemic.

Diagnostic radiography students' neonatal mobile X-ray imaging infection prevention and control practices.

Diagnostic radiography students' neonatal mobile X-ray imaging infection prevention and control practices.

Exploring radiographers' practice and decision-making relating to infection prevention and control in the CT environment: An observation study in a simulated environment.

Exploring radiographers' practice and decision-making relating to infection prevention and control in the CT environment: An observation study in a simulated environment.

Utilizing Whole Genome Sequencing to Investigate a Coronavirus Disease 2019 Cluster Among Healthcare Workers in a Tertiary Care Facility in the Philippines: Insights and Implications for Infection Prevention and Control.

The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of genomic surveillance and whole genome sequencing (WGS) for identifying mutations and supporting epidemiologic investigations. Healthcare workers (HCWs) face unique risks for COVID-19, potentially amplifying outbreaks within healthcare facilities (HCFs). This report details the use of WGS to retrospectively investigate a COVID-19 cluster among HCWs in a tertiary care HCF in the Philippines. Epidemiologic investigation was conducted by the HCF infection prevention and control (IPC) staff. The Global Action in Healthcare Network (GAIHN) COVID-19 variant characterization project retrospectively conducted WGS on selected HCW and inpatient respiratory specimens associated with the cluster with reverse-transcription polymerase chain reaction cycle threshold ≤32. Phylogenetic analyses were conducted using Nextstrain. Subclusters were defined by shared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineage and epidemiologic data. Investigation by IPC staff identified 19 HCWs with COVID-19 diagnosed during 2-9 September 2022 from a single nursing unit. Specimens for WGS were collected from 8 of these HCWs and from 43 additional HCF staff and inpatients with COVID-19 diagnosed from 1 August through 30 September 2022. Phylogenetic analyses identified 12 unique SARS-CoV-2 lineages and 2 subclusters: subcluster A (BA.5.2 lineage, n = 6) and subcluster B (BA.5.10.1 lineage, n = 7). Pairwise substitution-by-site analyses, combined with epidemiological data, provided support for multiple potential transmission events. WGS identified SARS-CoV-2 subclusters associated with high-risk exposure settings among HCWs in a tertiary care facility, providing essential insights into transmission pathways and demonstrating its potential to guide targeted IPC interventions and improve outbreak response strategies.

Respiratory infectious disease transmission of dental healthcare workers.

Respiratory infectious disease transmission of dental healthcare workers.

Functional hydroxypropyl methyl cellulose-based thermosensitive hydrogels: Biomineralization, procoagulant and antibacterial properties.

Functional hydroxypropyl methyl cellulose-based thermosensitive hydrogels: Biomineralization, procoagulant and antibacterial properties.

Circulating monocytes upregulate CD52 and sustain innate immune function in cirrhosis unless acute decompensation emerges.

The susceptibility of patients with cirrhosis to infection, a major determinant of prognosis, relates to the development of immuneparesis, a complex interplay of different immunosuppressive cells and soluble factors. The mechanisms underlying the dynamics of immuneparesis of innate immunity remain unclear. We aimed to dissect the heterogeneity of circulating monocyte states in different stages of cirrhosis, and to determine the function of selected differentially expressed genes. We systematically investigated circulating monocytes in health and compensated/non-acutely decompensated cirrhosis using single-cell RNA sequencing. Selective genes were confirmed by flow cytometry and diverse functional assays on monocytes ex vivo. We partitioned monocytes into seven clusters. Their abundances varied between cirrhosis stages, confirming previously reported changes, i.e. the reduction in CD14lowCD16++ and emergence of monocytic myeloid-derived suppressor cells in advanced stages. Differentially expressed genes between health and disease and among stages were detected, including CD52 for the first time. CD52 expression on monocytes significantly increased through compensated and non-acutely decompensated cirrhosis. In patients with cirrhosis, CD52highCD14+CD16highHLA-DRhigh monocytes had a functional phenotype of active phagocytes, with enhanced migratory potential and increased cytokine production capacity but limited ability to activate T cells. Following acute decompensation, CD52 was cleaved by elevated PLC, and soluble CD52 was detected in the circulation. Inhibition and cleavage of CD52 significantly suppressed monocyte functions ex vivo and in vitro, while the predominance of immunosuppressive CD52low circulating monocytes in patients with acute decompensation was associated with infection and low transplant-free survival. CD52 may represent a biologically relevant target for future immunotherapy. Stabilising CD52 may enhance monocyte functions and infection control in the context of cirrhosis, guided by soluble CD52/PLC as biomarkers of immuneparesis. Monocyte dysfunction substantially contributes to infection susceptibility, which is a major determinant of the prognosis of patients with cirrhosis and represents a major unmet therapeutic need. Its underlying mechanisms remain poorly understood, although, among hepatologists, it is thought that the therapeutic reconstitution of monocyte function could enhance defence against infection and thus reduce morbidity and mortality of patients with cirrhosis. By systematically delineating the heterogeneity and function of circulating monocytes ex vivo, we identified that the absence of CD52 expression on monocytes represented a distinct biomarker of monocyte dysfunction in patients with cirrhosis, discriminating patients at substantial risk of infectious complications. Otherwise, given the beneficial antimicrobial functions of CD52-expressing monocytes, CD52 stablisation may also represent a therapeutic approach worth exploring.

Management of infected nonunion neck of femur fracture on an ipsilateral above knee amputation limb planned for total hip arthroplasty

Background Total hip arthroplasty (THA) is widely used to alleviate pain and restore mobility in patients with advanced hip pathologies. However, performing THA in patients with ipsilateral above-knee amputations (AKA) complicated by infected nonunion neck of femur fractures and avascular necrosis (AVN) presents significant challenges. These include addressing infection control, anatomical alterations, and increased mechanical demands on implants. Case Presentation We report a case of a 22-year-old male with an ipsilateral AKA following a motor vehicle accident, which resulted in a closed neck of femur fracture, open supracondylar femur fracture, and open midshaft tibia fracture. Initial surgical management involved screw fixation and external fixation; however, subsequent gangrene necessitated AKA. Persistent infection at the femoral neck site was treated with multiple debridement procedures, antibiotic therapy, and first-stage revision surgery using an antibiotic-loaded cement spacer. After confirming infection eradication via negative cultures and a low CRP level, second-stage revision THA was performed. A dual-mobility liner and cemented femoral stem were utilized because of osteopenia and concerns over abductor muscle integrity. Postoperatively, the patient demonstrated excellent functional recovery and regained independent mobility with the prosthesis. Discussion THA in patients with ipsilateral AKA poses unique surgical challenges including stump manipulation, femoral preparation, and infection control. Two-stage revision surgery remains the gold standard for managing chronic infections, and a multidisciplinary approach is critical for success. Dual-mobility implants and precise preoperative planning are key to achieving stability and function in such cases. Conclusion This case highlights the feasibility and positive outcomes of THA in complex scenarios involving the ipsilateral AKA and infection. Meticulous infection management, careful implant selection, and individualized rehabilitation plans are pivotal in achieving functional recovery and improving quality of life. This report underscores the importance of a tailored approach in managing such challenging cases.

Genetic diversity of respiratory syncytial virus in children with community-acquired pneumonia in Guangzhou: an epidemiological update.

Community-acquired pneumonia (CAP) is a common infectious disease with a mortality rate of 2-14%. Respiratory syncytial virus (RSV) frequently causes CAP in children. This study aimed to investigate RSV genetic diversity in children under 15 years of age with CAP, evaluate nucleotide substitution rates, and examine associations with clinical characteristics and outcomes. A retrospective observational study was conducted using nasal swab samples collected from children under 15 years of age diagnosed with CAP. RSV identification involved cell culture and immunofluorescence microscopy, followed by molecular analyses using qPCR, nested PCR, and Sanger sequencing. Bioinformatics tools were applied to assess phylogenetics, evolutionary trends, genetic distance, and nucleotide substitution rates. Statistical analysis of clinical and laboratory data was performed to identify correlations between RSV features and patient characteristics. Among 346 CAP cases, RSV was detected in 26.88%, with the highest prevalence in children aged 1-2 years. Subtype A exhibited higher nucleotide substitution rates than subtype B. Shortness of breath and high fever were significantly associated with increased nucleotide diversity. RSV infections peaked in winter, particularly in 2018 and 2019. Elevated substitution rates were linked to longer hospital stays, greater risk of complications such as secondary bacterial infections, and increased RSV-related morbidity. RSV higher nucleotide substitution rates, especially in children under 3 years of age, were associated with more severe clinical outcomes and prolonged hospitalization. Phylogenetic analysis indicated distinct evolutionary patterns, with subtype B exhibiting a more rapid evolutionary rate than subtype A. This study highlights the high prevalence of respiratory viruses, particularly respiratory syncytial virus (RSV), in children with community-acquired pneumonia in Guangzhou. It provides detailed molecular epidemiological data on RSV, including genetic variation patterns and evolutionary rates. The findings contribute regional data essential for epidemiological research and public health planning in similar geographic areas. These results support clinical decision-making and inform public health strategies, particularly those focused on RSV vaccination and infection control.

Assessing Knowledge and Awareness of Occupational Hazards and Preventive Measures among Dentists and Final-year Students in Two Dentistry Hospitals, Kabul, Afghanistan

Introduction This study aimed to evaluate the knowledge and awareness of occupational hazards and preventive measures among dentists and final-year students in two dentistry hospitals in Kabul, Afghanistan. Methods A cross-sectional descriptive study design was used in this research, which was distributed to 198 dental professionals, with Part A dealing with sociodemographic data, Part B focusing on awareness of occupational hazards, and Part C on preventive measures. Responses were analyzed to assess the level of awareness using a five-point scale. The data were also compared using Mann-Whitney U tests to examine the differences between male and female respondents and between final-year dental students and practicing dentists. Results The overall mean proportion of correct answers was 0.71 (71%), indicating moderately high awareness. Part B had a mean of 0.73 (high), and Part C had a mean of 0.69 (medium). High awareness was found in areas such as radiation safety (93.4%), infection control (97.5%) and ergonomics (85.9%). However, gaps were identified in knowledge of lead protective gowns (15.2%) and the inverse square law (8.1%). In Part C, high awareness was noted regarding safety guidelines for electrical devices (85.9%) and protective eyewear (93.4%), but low awareness was found regarding safety boxes for sharp instruments (19.7%) and the scoop technique (31.8%). Mann-Whitney U tests revealed significant differences between male and female respondents (p &lt; 0.001), with females showing higher awareness, although the effect size was small (r = -0.247). No significant difference was observed between the final-year students and practicing dentists (p = 0.575). Conclusions Although dental professionals exhibit a relatively high level of awareness regarding occupational hazards and preventive measures, specific knowledge gaps persist. Addressing these deficiencies through structured educational interventions and continuous professional training is essential to enhance the occupational safety and improve the overall well-being of dental practitioners.

Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support.

Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support.

Measles and Solid Organ Transplantation: Diagnosis, Treatment, and Prevention.

The recent international resurgence of measles has led to significant public health concerns and poses significant risks to immunocompromised patients, including those who have undergone solid organ transplantation (SOT). SOT recipients may present atypically and are at an increased risk of severe complications of measles infection, underscoring the importance of preventative measures. This review summarizes contemporary data regarding measles transmission, the clinical presentation, diagnosis, and treatment of SOT recipients, as well as strategies for measles prevention, infection control considerations, postexposure prophylaxis, and opportunities for the mitigation of donor-derived measles and measles vaccine viruses.

Inactivation effects of slightly acidic electrolyzed water on Cryptosporidium baileyi and Eimeria tenella.

Inactivation effects of slightly acidic electrolyzed water on Cryptosporidium baileyi and Eimeria tenella.

Preoperative nursing care before separation surgery in a case of symmetrical abdominal conjoined twins: A single case study.

Preoperative nursing care before separation surgery in a case of symmetrical abdominal conjoined twins: A single case study.