Infection Prevention Control Measures Research Articles

Prevalence and patterns of multidrug-resistant bacteria isolated from sputum samples of patients with bacterial pneumonia at a tertiary hospital in Tanzania

BackgroundAntimicrobial resistance affects the treatment of several bacterial infections, including pneumonia. This subsequently increased the morbidity and mortality rates of patients with bacterial pneumonia, especially in resource-limited settings. In this study, we aimed to determine the patterns of multidrug-resistant (MDR) bacteria isolated from the sputum samples of patients with bacterial pneumonia attending a tertiary hospital in Tanzania.MethodologyA retrospective cross-sectional study was conducted. It involved reviewing the laboratory sputum data in the laboratory information system at Muhimbili National Hospital in Tanzania. The sputum samples were previously processed using standard methods (culture, Gram staining, and biochemical tests) to isolate and identify the bacteria. At the same time, antibiogram profiles were determined using antimicrobial susceptibility tests. Bacterial isolates that expressed MDR patterns were identified. Demographic information was collected from patients' medical records. We used the chi-square test to determine factors associated with MDR. A p-value < 0.05 was considered significant.ResultsWe retrieved and analysed 169 laboratory records of patients with a provisional clinical diagnosis of bacterial pneumonia confirmed in the microbiology laboratory. Nearly 98% of the records were from adult patients. The patients’ mean age was 48.3 years and 17.3 standard deviations. About 84% of the isolated bacteria were Gram-negative; the most predominant was Klebsiella pneumoniae (59/142; 41.5%). The predominant Gram-positive bacteria was Staphylococcus aureus (25/27; 92.6%). Furthermore, 80 out of 169 (47.3%) bacteria were MDR; Klebsiella pneumoniae (32.5%) was predominant. In addition, 50% of Staphylococcus aureus was methicillin resistance. MDR bacterial pneumonia was highly observed in patients admitted to the Intensive Care Unit (p < 0.05).ConclusionsAlthough our study was limited by variations in the number of bacterial isolates subjected to the same antibiotic drugs and a lack of information on risk factors such as occupation, smoking history, and marital status, we observed that a high proportion of bacterial pneumonia is caused by MDR Gram-negative bacteria in our local setting. These results inform the need to improve infection prevention control measures in hospitals to reduce the burden of MDR bacteria in our settings and other similar resource-limited settings.

A qualitative study examining the health system's response to COVID-19 in Sierra Leone.

The paper examines the health system's response to COVID-19 in Sierra Leone. It aims to explore how the pandemic affected service delivery, health workers, patient access to services, leadership, and governance. It also examines to what extent the legacy of the 2013-16 Ebola outbreak influenced the COVID-19 response and public perception. Using the WHO Health System Building Blocks Framework, we conducted a qualitative study in Sierra Leone where semi-structured interviews were conducted with health workers, policymakers, and patients between Oct-Dec 2020. We applied thematic analysis using both deductive and inductive approaches. Twelve themes emerged from the analysis: nine on the WHO building blocks, two on patients' experiences, and one on Ebola. We found that routine services were impacted by enhanced infection prevention control measures. Health workers faced additional responsibilities and training needs. Communication and decision-making within facilities were reported to be coordinated and effective, although updates cascading from the national level to facilities were lacking. In contrast with previous health emergencies which were heavily influenced by international organisations, we found that the COVID-19 response was led by the national leadership. Experiences of Ebola resulted in less fear of COVID-19 and a greater understanding of public health measures. However, these measures also negatively affected patients' livelihoods and their willingness to visit facilities. We conclude, it is important to address existing challenges in the health system such as resources that affect the capacity of health systems to respond to emergencies. Prioritising the well-being of health workers and the continued provision of essential routine health services is important. The socio-economic impact of public health measures on the population needs to be considered before measures are implemented.

Infection prevention and control measures to reduce the transmission of mpox: A systematic review.

To make inferences regarding the effectiveness of respiratory interventions and case isolation measures in reducing or preventing the transmission of mpox based on synthesis of available literature. The WHO Clinical Management and Infection Prevention and Control 2022 guideline and droplet precautions in healthcare facilities and home isolation infection prevention control measures for patients with mpox. We conducted a systematic review that included a broad search of five electronic databases. In a two-stage process, we initially sought only randomized controlled trials and observational comparative studies; when the search failed to yield eligible studies, the subsequent search included all study designs including clinical and environmental sampling studies. No studies were identified that directly addressed airborne and droplet precautions and home isolation infection prevention control measures. To inform the review questions the review team synthesized route of transmission data in mpox. There were 2366/4309 (54.9%) cases in which investigators identified mpox infection occurring following transmission through direct physical sexual contact. There were no reported mpox cases in which investigators identified inhalation as a single route of transmission. There were 2/4309 cases in which investigators identified fomite as a single route of transmission. Clinical and environmental sampling studies isolated mpox virus in a minority of saliva, oropharangeal swabs, mpox skin lesions, and hospital room air. Current findings provide compelling evidence that transmission of mpox occurs through direct physical contact. Because investigators have not reported any cases of transmission via inhalation alone, the impact of airborne and droplet infection prevention control measures in reducing transmission will be minimal. Avoiding physical contact with others, covering mpox lesions and wearing a medical mask is likely to reduce onward mpox transmission; there may be minimal reduction in transmission from additionally physically isolating patients with mild disease at home.

Implementasi Manajemen Risiko Penularan Covid-19 terhadap Perawat Indonesia di Kuwait melalui Metode Bowtie

Purpose: The purpose of this service is to obtain an overview of the implementation of COVID-19 transmission risk management for Indonesian nurses working in Kuwait through the Bowtie method. Methodology: This research is quantitative in nature using a scientific approach to the implementation of risk management for the transmission of COVID-19 in Indonesian nurses working in Kuwait where these nurses work in various health services in Kuwait. This research was conducted using a descriptive analytic method using a cross-sectional study design. Result: The results of the study found that: 1) The application of risk management (risk control or mitigation) in handling COVID-19 in various health services in Kuwait such as the implementation of hospitalization for staff who were confirmed positive and the existence of a COVID-19 vaccination program had a significant effect on the transmission of COVID-19 -19 in Indonesian Nurses working in Kuwait. 2) The level of knowledge about the importance of preventing and transmitting COVID-19 to Indonesian nurses in Kuwait has a very significant influence on the transmission of COVID-19. 3) The level of compliance of Indonesian nurses with infection prevention control measures or health protocols has a significant effect on the transmission of COVID-19 in Indonesian nurses working in various health services in Kuwait.

Antibiotic resistance and the COVID-19 pandemic: A dual crisis with complex challenges in LMICs.

Antimicrobial resistance (AMR), a global health crisis of mounting urgency, has been further complicated by the ongoing COVID-19 pandemic. The intricate relationship between these two phenomena is especially pronounced in low- and middle-income countries (LMICs) due to the distinct obstacles encountered by their healthcare systems and policy structures. This study aims to explore the complex challenges arising from the coexistence of these two crises in LMICs and proffer specific recommendations for holistic management. An exhaustive bibliographic survey was executed, employing search queries in specialized databases such as PubMed, SCOPUS, and Web of Science's SCI-EXPANDED index. The timeframe for the literature search extended from January 2020 to January 2023. The search strategy employed key terms including antibiotic resistance, AMR, COVID-19 pandemic, low- and middle-income countries, SARS-CoV-2, and LMICs. The pandemic has aggravated various drivers of AMR in LMICs, including limited capabilities, weak frameworks, and socioeconomic factors. New challenges have emerged, such as disruptions in the antibiotic supply chain and an increased risk of healthcare-associated infections. The interaction between these drivers presents a complex problem that demands a coordinated response. Specific recommendations include strengthening health systems, funding research and innovation, and enhancing infection prevention control measures. The coexistence of AMR and the COVID-19 pandemic in LMICs demands an integrated approach involving multiple stakeholders. Emphasis must be placed on constructing aligned regulatory frameworks, nurturing regional collaborations, and focusing on accessible therapeutic options. The study underscores the necessity for actionable strategies to achieve sustainable access to clean water and sanitation and also highlights the importance of long-term planning, funding, and specialized expertise in emerging modalities like phage therapy.

Implementasi Manajemen Risiko Penularan Covid-19 terhadap Perawat Indonesia di Kuwait melalui Metode Bowtie

Purpose: The purpose of this service is to obtain an overview of the implementation of COVID-19 transmission risk management for Indonesian nurses working in Kuwait through the Bowtie method. Methodology: This research is quantitative in nature using a scientific approach to the implementation of risk management for the transmission of COVID-19 in Indonesian nurses working in Kuwait where these nurses work in various health services in Kuwait. This research was conducted using a descriptive analytic method using a cross-sectional study design. Result: The results of the study found that: 1) The application of risk management (risk control or mitigation) in handling COVID-19 in various health services in Kuwait such as the implementation of hospitalization for staff who were confirmed positive and the existence of a COVID-19 vaccination program had a significant effect on the transmission of COVID-19 -19 in Indonesian Nurses working in Kuwait. 2) The level of knowledge about the importance of preventing and transmitting COVID-19 to Indonesian nurses in Kuwait has a very significant influence on the transmission of COVID-19. 3) The level of compliance of Indonesian nurses with infection prevention control measures or health protocols has a significant effect on the transmission of COVID-19 in Indonesian nurses working in various health services in Kuwait.

Evaluate Nurses knowledge and Adherence to Infection Prevention Control Measures during Caring for Covid19 Patients

Evaluate Nurses knowledge and Adherence to Infection Prevention Control Measures during Caring for Covid19 Patients

Infection Prevention and Control Practice among Healthcare Professionals in Two Public Hospitals in Edo State, Nigeria.

Background: Effective infection prevention control (IPC) have been shown to reduce healthcare associated infections and to curtail epidemics and pandemics. Compliance by healthcare professionals (HCPs) is an important part of IPC measures. Objectives: This study investigated IPC practice, barriers and enablers among healthcare professionals (HCPs) in secondary and tertiary healthcare facilities. Methods: This was a cross-sectional study among 370 HCPs in a tertiary and secondary healthcare facility. Data was collected using an interviewer-administered questionnaire and the assessment was done using defined scoring systems. SPSS version 22 and Graphpad Instat were used for data analysis. Associations between variables were assessed using Chi-square and student’s t tests with significance level set at p&lt;0.05. Results: Of the 370 participants, 195 (52.7%) had an average score for IPC practice and 269 (72.7%) of participants had good score for hand hygiene. HCPs in tertiary institution had a higher mean score compared to those in secondary institution on IPC (41.52±5.96/41.07±8.46-p=0.0009) and hand hygiene practice (30.72±5.979/29.08±5.63; p=0.1747) respectively. Nurses had a higher mean score compared to physicians on IPC (31.19±4.801/25.60±7.937; p=&lt;0.001) and hand hygiene (43.34±4.170/39.83±3.673; p=0.001). Barriers to IPC are work overload 299(80.8%), lack of adequate materials 319 (86.3%) and lack of hand hygiene facilities 260 (70.8%). Conclusion: This study revealed that many HCPs had moderate practice of IPC and good practice of hand hygiene. Differences in practice among HCPs was observed which can be addressed with hospital leaders creating a stronger IPC culture and routine training of HCPs.

Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021

BackgroundSchools and preschools have largely remained open in Norway throughout the pandemic, with flexible mitigation measures in place. This contrasts with many other high-income countries that closed schools for long periods of time. Here we describe cases and outbreaks of COVID-19 in schools and preschools during the academic year 2020/2021, to evaluate the strategy of keeping these open with infection prevention control measures in place.MethodsIn this descriptive study, the Norwegian Institute of Public Health initiated systematic surveillance for COVID-19 cases and outbreaks in schools and preschools in October 2020. Data was compiled from the national outbreak alert system VESUV, municipality websites, and media scanning combined with the national emergency preparedness register Beredt C-19. An outbreak was defined as ≥ 2 cases among pupils or staff within 14 days at the same educational setting. Settings were categorized as preschool (1–5-years), primary school (6–12-years), lower secondary school (13–15-years) and upper secondary school (16–18- years). We reported the incidence rate among preschool and school-aged pupils and gave a descriptive overview of outbreaks and included cases per educational setting.ResultsDuring the whole academic year, a total of 1203 outbreaks in preschools and school settings were identified, out of a total of 8311 preschools and schools nationwide. The incidence of COVID-19 in preschool- and school-aged children and the rates of outbreaks in these settings largely followed the community trend. Most of the outbreaks occurred in primary schools (40%) and preschools (25%). Outbreaks across all settings were mostly small (median 3 cases, range 2 to 72), however, 40 outbreaks (3% of total) included 20 or more cases. The larger outbreaks were predominantly seen in primary schools (43%).ConclusionsWe observed few large outbreaks in open schools and preschools in Norway during the academic year of 2020/2021, also when the Alpha variant was predominant. This illustrates that it is possible to keep schools and preschools open even during periods of high community transmission of COVID-19. Adherence to targeted IPC measures adaptable to the local situation has been essential to keep educational settings open, and thus reduce the total burden on children and adolescents.

A retrospective cohort study of the effect of SARS-CoV-2 point of care rapid RT-PCR at the Emergency Department on targeted admission

BackgroundTo prevent nosocomial transmission of SARS-CoV-2, infection prevention control (IPC) measures are implemented for patients with symptoms compatible with COVID-19 until reliable test results are available. This delays admission to the most appropriate ward based on the medical condition. SARS-CoV-2 rapid antigen detection (RAD) tests and point-of-care (POC) rapid RT-PCR (VitaPCR) were introduced at emergency department (ED) at Skåne University Hospital, Sweden in late 2020, but the consequence on patient flow and targeted admission is unknown.MethodsPatients presenting at the emergency department of a referral hospital (N = 2940) between 13-Nov-2020 and 12-Jan-2021 were included. The study period was delimited into three periods by the introduction of RAD tests and the VitaPCR. Participant data was collected from hospital records, and outcome variables were Length-of-Stay (LoS), intrahospital transfers and targeted admission to COVID-19 ward.ResultsCompared to baseline (RT-PCR only), RAD tests reduced ED Length-of-Stay (LoS) for participants with positive tests. Negative VitaPCR results reduced mean hospital LoS by 1.5 (95% CI 0.3–2.7) days and admissions to COVID-19 wards from 34.5 (95% CI 28.9–40.5) to 14.7 (95% CI 11.1–19.1) per 100 admissions and reduced transfers between hospital wards in the first 5 days from 50.0 (95% CI 45.0–55.0) to 34.0 (95% CI 30.3–37.9) per 100 admissions.ConclusionRAD tests enabled prompt detection of SARS-CoV-2 infection which had pronounced effects on LoS at the ED. Negative VitaPCR enabled cessation of IPC measures and a negative test was associated with increased targeted admissions, reduced intrahospital transfers and shorter LoS at the hospital.

Diagnostic assessments during a pandemic

Easy read summary■This paper is about how our team changed our service during Covid-19.■We explain how we were able to carry on with assessments for learning disability, autism, and dementia.■This is important because it makes sure people with learning disabilities get the best support.From March 2020, many services had to make rapid changes to standard practice to accommodate new Covid-19 infection prevention control measures. Essential diagnostic assessment of intellectual disability, autism, and dementia continued only following adaptation to usual processes. While face-to-face contact was minimised as much as possible, where it was necessary, new protocols were developed to ensure social distancing, no sharing of resources, and quarantining of materials between assessments. Implications of this, particularly in balancing risk and needs and in the clinical interpretation of assessments, are discussed.

Malaria service provision in Manicaland Province, Zimbabwe during the coronavirus pandemic: a cross-sectional survey of health facilities

Background The ongoing coronavirus disease 2019 (COVID-19) pandemic has disrupted essential health services globally. COVID-19 related disruptions threaten malaria control and elimination as untreated and inappropriately treated malaria cases can lead to excess mortality and impede the COVID-19 response. This study characterized malaria service provision during the pandemic in Manicaland Province, Zimbabwe. Methods A cross-sectional survey was conducted in randomly selected health facilities in Buhera, Makoni, and Mutare districts in August 2020. Data on the provision of malaria services, the availability of infection prevention control measures and the display of COVID-19 related information, education, and communication (IEC) materials were collected using a standardized questionnaire. Descriptive analyses by facility type, managing authority, and district were used. Results A total of 100 health facilities were surveyed and most were publicly managed health centers and clinics. 5% of health facilities reported testing for COVID-19, 3% reported COVID-19 related health worker absences and 1% reported disruptions to any essential health services. About two-thirds (67%) of facilities displayed COVID-19 related IEC materials and 75% had infection prevention control measures available. Despite inequities in malaria readiness by managing authority, district, and type of facility, 70% of facilities were considered “ready” to provide malaria services. Conclusions Malaria services were fairly available with very few COVID-19 related disruptions to essential health services. Maintaining essential malaria services remains crucial in preventing excess malaria morbidity and mortality.

Workplace infection prevention control measures and work engagement during the COVID-19 pandemic among Japanese workers: A prospective cohort study.

ObjectivesOur objective was to assess the effect of appropriate workplace IPC measures on employees' work engagement. It could be important to note how workplace infection prevention control (IPC) measures for COVID‐19 contribute to positive mental health among workers. We hypothesized that if workplace IPC measures are adequately implemented, they would have a positive effect on employees' work engagement.MethodsWe conducted an internet‐based prospective cohort study from December 2020 (baseline) to December 2021 (follow‐up after 1 year) using self‐administered questionnaires. At baseline, 27036 workers completed the questionnaires, while 18 560 (68.7%) participated in the one‐year follow‐up. After excluding the 6578 participants who changed jobs or retired during the survey period, or telecommuted more than 4 days per week, 11 982 participants were analyzed. We asked participants about the implementation of workplace IPC measures at baseline and conducted a follow‐up using a nine‐item version of the Utrecht Work Engagement Scale (UWES‐9).ResultsFour groups were created according to the number of workplace IPC measures implemented. The mean (SD) UWES‐9 score of the “0–2” group was the lowest at 18.3 (13.2), while that of the “8” group was the highest at 22.6 (12.6). The scores of the “3–5,” “6–7,” and “8” groups were significantly higher than that of the “0–2” group (all, p < .001). The p trend of the four groups was also significant (p < .001).ConclusionsPromoting workplace IPC measures improves workers' work engagement, and a dose–response relationship exists between workplace IPC measures and work engagement.

A Quality Improvement Project to Minimize COVID-19 Infections in Patients Receiving Haemodialysis and the Role of Routine Surveillance Using Nose and Throat Swabs for SARS-CoV-2 rRT-PCR and Serum Antibody Testing

Background: Patients receiving in-centre haemodialysis (ICHD) are highly vulnerable to COVID-19. Objective: We created a quality improvement (QI) project aimed to eliminate outbreaks of COVID-19 in haemodialysis units and evaluated the utility of surveillance rRT-PCR test and SARS-CoV-2 serum antibodies for prompt identification of patients infected with COVID-19. Methods: A multifaceted QI programme including a bundle of infection prevention control (IPC) measures was implemented across 5 ICHD units following the first wave of the pandemic in June 2020. Primary outcomes evaluated before and after QI implementation were incidence of outbreaks and severe COVID-19 illness defined as COVID-19-related death or hospitalization. Secondary outcomes included the proportion of patients identified in the pre-symptomatic/asymptomatic phase on surveillance rRT-PCR screening and the incidence and longevity of SARS-CoV-2 antibody response. Results: Following the implementation of the QI project, there were no further outbreaks. Pre- and post-implementation comparison showed a significant reduction in COVID-19-related mortality and hospitalization (26 vs. 13 events, respectively, p < 0.001). Surveillance rRT-PCR screening identified 39 asymptomatic or pre-symptomatic cases out of a total of 59 rRT-PCR-positive patients (39/59, 66%). SARS-CoV-2 antibody levels were detected in 72/74 (97%) rRT-PCR-positive patients. Amongst rRT-PCR-positive patients diagnosed before August 2020, 96% had detectable antibodies until January 2021 (days from the rRT-PCR test to last antibody testing, 245–280). Conclusions: Systematic implementation of a bundle of IPC measures using QI methodology and surveillance rRT-PCR eliminated outbreaks in HD facilities. Most HD patients mount and sustain antibody response to COVID-19 for over 8 months.

Assessing the management of healthcare waste for disease prevention and environment protection at selected hospitals in Kinshasa, Democratic Republic of Congo.

Incineration is the most used healthcare waste (HCW) disposal method. Disease outbreaks due to Ebola virus and SARS-CoV2 require attention to HCW management to avoid pathogens spread and spillover. This study describes HCW management prior to incineration and hospital incinerators performance by analysing bottom ashes from hospitals in Kinshasa, Democratic Republic of Congo. We used semi-structured interviews to capture information on pre-incineration waste management and analysed the chemical composition of 27 samples of incinerator bottom ashes using the energy dispersive X-ray fluorescence. Neither sorting nor waste management measures were applied at hospitals surveyed. Incinerator operators were poorly equipped and their knowledge was limited. The bottom ash concentrations of cadmium, chromium, nickel and lead ranged between 0.61-10.44, 40.15-737.01, 9.11-97.55 and 16.37-240.03 mg kg-1, respectively. Compared to Chinese incinerator performance, the concentrations of some elements were found to be lower than those from China. This discrepancy may be explained by the difference in the composition of HCW. The authors conclude that health care waste in Kinshasa hospitals is poorly managed, higher concentrations of heavy metals are found in incinerator bottom ashes and the incinerators quality is poor. They recommend the strict application of infection prevention control measures, the training of incinerator operators and the use of high-performance incinerators.

Exploring the promise and reality of ward-based primary healthcare outreach teams conducting TB household contact tracing in three districts of South Africa.

BackgroundTuberculosis (TB) household contact tracing is a form of targeted active case-finding for which community health workers (‘outreach teams’) in South Africa are primarily responsible for its implementation. We conducted an exploratory qualitative study to understand the role of outreach teams in delivering TB household contact tracing.MethodsThe study took place in three districts of South Africa between May 2016 and February 2017. We conducted 78 in-depth interviews (IDI) (comprising 35 key stakeholders, 31 TB index patients and 12 HHCs) and five focus group discussions (FGD) (40 outreach team members in four FGDs and 12 community stakeholders in one FGD).ResultsOutreach teams contributed positively by working across health-related programmes, providing home-based care and assisting with tracing of persons lost to TB care. However, outreach teams had a limited focus on TB household contact tracing activities, likely due to the broad scope of their work and insufficient programmatic support. Outreach teams often confused TB household contact tracing activities with finding persons lost to TB care. The community also had some reservations on the role of outreach teams conducting TB household contact tracing activities.ConclusionsCreating awareness among outreach workers and clinic personnel about the importance of and activities related to TB household contact tracing would be required to strengthen the delivery of TB household contact tracing through the community-based primary health care teams. We need better monitoring and evaluation systems, stronger integration within a realistic scope of work, adequate training on TB household contact tracing and TB infection prevention control measures. Involving the community and educating them on the role of outreach teams could improve acceptance of future activities. These timely results and lessons learned should inform contact tracing approaches in the context of COVID-19.

COVID-19 and cancer screening in Scotland: A national and coordinated approach to minimising harm

Screening is an important component of cancer control internationally. In Scotland, the National Health Service Scotland provides screening programmes for cervical, bowel and breast cancers. The COVID-19 pandemic resulted in the suspension of these programmes in March 2020. We describe the integrated approach to managing the impact of the pandemic on cancer screening programmes in Scotland throughout 2020. We outline the policy context and decision-making process leading to suspension, and the criteria and framework informing the subsequent, staggered, restart in subsequent months.The decision to suspend screening services in order to protect screening invitees and staff, and manage NHS capacity, was made after review of numbers of screening participants likely to be affected, and the potential number of delayed cancer diagnoses. Restart principles and a detailed route map plan were developed for each programme, seeking to ensure broad consistency of approach across the programmes and nationally. Early data indicates bowel, breast and cervical screening participation has increased since restart. Primary care has had to adapt to new infection prevention control measures for delivery of cervical screening. Cancer charities provided cancer intelligence and policy briefs to national bodies and Scottish Government, as well as supporting the public, patients and screening invitees through information and awareness campaigns.Emerging from the pandemic, there is recognition of the need and the opportunity to transform and renew both cancer and screening services in Scotland, and in particular to address long-standing workforce capacity problems through innovation and investment, and to continue to prioritise addressing health inequalities.

Occupational exposure of healthcare workers to COVID-19 and infection prevention control measures in haemodialysis facilities in North West of England

SummaryCOVID-19 infection rates in haemodialysis (HD) facilities are extremely high and are attributed to the high burden of comorbidities of HD patients coupled with inability to self-isolate needing thrice weekly attendance for HD treatment. Healthcare workers (HCW) in HD facilities are at risk of occupational exposure to COVID-19. Infection prevention control (IPC) measures were introduced during the pandemic aiming at reducing transmission and occupational exposure risk of COVID-19. Here we describe the results of our baseline and follow up occupational exposure audit in a renal centre in the North West of England following the implementation of a multifaceted IPC bundle.

Determinants of Confidence in Overall Knowledge About COVID-19 Among Healthcare Workers in South Africa: Results From an Online Survey.

Background: Adequate information and knowledge about COVID-19 has been shown to induce the confidence and positive performance among healthcare workers (HCWs). Therefore, assessing the relationship between confidence in knowledge and associated factors among HCWs is vital in the fight against COVID-19. This paper investigates factors associated with HCWs' confidence in their overall knowledge about COVID-19 in South Africa in the early stages of the epidemic.Methods: Data utilized in this paper were from an online survey conducted among HCWs using a structured questionnaire on a data free online platform. The study population were all the medical fraternity in South Africa including medical and nurse practitioners as well as other healthcare professionals. Bivariate and multivariate logistic regression models were performed to examine the factors associated with confidence in HCWs' overall knowledge about COVID-19.Results: Overall, just below half (47.4%) of respondents indicated that they had confidence in their overall knowledge about COVID-19. Increased odds of having confidence in the knowledge about COVID-19 were significantly associated with being male [aOR = 1.31 95% CI (1.03–1.65), p < 0.05], having a doctorate degree [aOR = 2.01 (1.23–3.28), p < 0.05], being satisfied with the information about COVID-19 guidelines [aOR = 6.01 (4.89–7.39), p < 0.001], having received training in 6–8 areas [aOR = 2.54 (1.89–3.43), p < 0.001] and having received training in 9–11 areas [aOR = 5.33 (3.81–7.47), p < 0.001], and having already treated COVID-19 patients [aOR = 1.43 (1.08–1.90), p < 0.001]. Those who were highly concerned with the levels of training of HCWs [aOR = 0.47 (0.24–0.92), p < 0.05] had decreased odds of having confidence in their overall knowledge about COVID-19.Conclusion: This study sheds light on the importance of capacitating HCWs with knowledge and adequate relevant training as part of infection prevention control measures during pandemics. Future training and information sharing should be sensitive to knowledge gaps by age, gender, qualifications, professional categories, and experience.

Establishment and application to environment sample test of novel coronavirus

Background: Since the COVID-19 outbreak, the existence of SARS-CoV-2 virus in the air and objects surface has been proved, how to detect the novel coronavirus effectively and accurately has become the current focus. a detection method for new coronavirus in environmental sample should be established to provide basis for the protection and disinfection of novel coronavirus in the future. Methods: Environmental samples were collected primarily from isolation rooms for COVID-19 patients. In the environmental samples, the air samples are collected by bioaerosol samplers. For objects surface samples, a cotton swab was moistened with the collection liquid, and then used to wipe the surface of the object once. Results: In total, we collected 46 air samples, one of these samples' testing results was positive, which from the corridor closed to isolation rooms, and 107 object surface samples, four of these samples' testing results were positive and three were weak positive which from bathroom in the isolation rooms. Conclusions: The detection method of the novel coronavirus in environmental samples was established successfully, which provides a basis for environmental disinfection and control of the spread of new coronavirus pneumonia. And this indicated that medical staff should strengthen personal protection, strictly implement infection prevention control measures. © 2021 AME Publishing Company. All rights reserved.