Infection Control Precautions Research Articles

572. The Burden of RSV Infections Among Nursing Home Residents, Monroe County, NY, October 2022 to April 2023

Abstract Background RSV causes significant morbidity and mortality in older adults. Outbreaks are common in nursing home (NH) residents, but little is known about the burden of disease in this vulnerable population. We analyzed population-based data on laboratory-confirmed RSV infections and hospitalizations from the CDC Respiratory Syncytial Virus Hospitalization Surveillance Network to understand the burden of RSV on the NH population compared to community-dwelling older adults. Weekly Number of Positive RSV Tests Reported by Nursing Homes in Monroe County, NY, October 2022 to April 2023 Methods We reviewed positive RSV tests from all clinical labs utilized by Monroe County, NY residents from October 2022 to April 2023. Cases in patients ≥65 years of age were attributed to a NH or the community through medical chart review. RSV rates were calculated in NH residents using occupied bed census averaged over the season and in community-dwelling residents using county population data. Incidence and outcomes including hospitalization, ICU admission and in-hospital mortality were calculated weekly and across the season. Healthcare utilization among nursing home residents with laboratory-confirmed RSV hospitalizations in Monroe County, NY, October 2022 to April 2023 Results Of 766 laboratory-confirmed RSV cases in patients ≥65 years of age, 134 were among NH residents. Incidence per NH ranged from 25.5 to 3,163.1 per 10,000 residents. NH cases often clustered in time (Figure 1), with a peak weekly attack rate of 17.7% in one facility. Three NHs had a seasonal attack rate >20%. Of 170 hospitalizations in patients ≥65 years, 24 occurred in NH residents; 18% (24/134) of all NH residents with RSV were hospitalized. NH residents accounted for 295 hospital days (Table 1). Four NH residents required ICU admission, utilizing 20 ICU days, and 6 died in the hospital. NH residents were hospitalized at a rate 5.6 times greater than community dwelling older adults (Table 2). Rates of laboratory-confirmed RSV infection and hospitalization among adults ≥65 years of age in Monroe County, NY, October 2022 to April 2023 Conclusion Our data emphasize that NH residents are particularly vulnerable to RSV infection and complications. The tight clustering of laboratory-confirmed cases within facilities likely represents within-facility transmission, the magnitude of which may be underestimated due to NH testing practices. Early recognition of infection and swift implementation of appropriate infection control precautions are needed to limit outbreaks. Additional preventive measures including resident vaccination and policies discouraging working or visiting while ill should be prioritized. Disclosures Brenda L. Tesini, MD, Merck: Honoraria

P-1052. Identifying Facility and Specimen Type Associated with Screening-to-Clinical Candida auris Patients in the United States, 2013–2022

Abstract Background Candida auris (C. auris) is an emerging healthcare-associated fungal pathogen associated with high mortality and antifungal resistance. Targeted screening based on patient risk factors and facility type is important for identifying colonized patients and implementing recommended infection prevention and control (IPC) precautions. Understanding the epidemiology of C. auris colonized patients who subsequently have positive clinical specimens (screening-to-clinical patients (STC)) can help us understand the clinical course and impact of colonization. Methods Using national case surveillance data from 34 states and Washington DC, we described C. auris adult patients, as defined by Council of State and Territorial Epidemiologists, during 2013–2022. We analyzed facility and specimen source for STC patients and compared with screening or clinical only patients using chi-squared tests. Results Among 13,341 screening patients, 1,151 (9%) were STC. STC patients were more likely than screening only patients to be screened at long-term acute-care hospitals (LTACH) (48% vs 40%; p< 0.001) and were more likely than clinical only patients to have positive clinical specimens taken at LTACHs (35% vs 10%; p< 0.001). While blood was the most frequent clinical specimen source for STC and clinical only patients (39% and 35% respectively), respiratory specimens were more likely to be taken from STC patients than clinical only patients (12% vs 8%; p< 0.001). The median time between STC specimen collection was 47 days [interquartile range (IQR) 19-111] and was shorter for patients in LTACHs (median 37 days [IQR 17–78]) than ACHs (median 53 days [IQR 21–116]). Conclusion About half of STC patients were screened at LTACHs and over half of STC clinical specimens were collected at LTACHs. While blood specimens were most frequent clinical specimen source among STC, respiratory sources were more likely to be taken from STC patients than clinical only patients. As high-risk respiratory devices (e.g., mechanical ventilation) are associated with invasive infections, our findings emphasize the importance of timely diagnosis and monitoring STC patients with clinical respiratory sources in LTACHs to reduce risk of invasive infection. Disclosures All Authors: No reported disclosures

Knowledge and attitude of nosocomial infection prevention and control precautions among healthcare personnel at Kiruddu Referral Hospital in Kampala, Uganda

BackgroundA key concern for global public health is nosocomial infections. Essential to the fight against nosocomial infection, is healthcare professionals’ knowledge and attitudes. Therefore, this study investigated healthcare professionals’ knowledge and attitudes toward nosocomial infection at the Kiruddu Referral Hospital, Kampala, Uganda.MethodsA facility-based cross-sectional study was carried out at Kiruddu Referral Hospital in Kampala, Uganda. We selected the participants using simple random sampling. Data were collected from a total of 78 healthcare personnel using pretested, structured, self-administered questionnaires. We used SPSS version 20.0 for data analysis and applied descriptive statistics to present the frequencies and percentages. Pearson’s Chi-square test was used to evaluate the association between independent factors and knowledge and attitude (KA) ratings on hospital-acquired infection (HAI) prevention. P-values less than 0.05 were regarded as statistically significant.ResultsAmong the different categories of health workers, doctors exhibited the highest level of knowledge. There was a significant association between knowledge scores and occupation (χ2LR = 25.610; P = 0.000). The mean knowledge scores across different infection prevention aspects were as follows: hand hygiene (82.2 ± 18.9), PPE use (71.8 ± 23.1), sharp disposal and sharp injuries (59.2 ± 25.7), and waste management (57.4 ± 29.9). Notably, 20.5% of participants did not change PPE between patients, and 44.9% indicated that their workload negatively impacted their ability to follow infection prevention standards.ConclusionThe study highlighted gaps in healthcare personnel’s knowledge and attitudes toward infection prevention. It is therefore important to provide regular targeted training programs emphasizing underrepresented areas, PPE availability, strengthen policy enforcement, and integrate infection prevention education into medical and nursing curricula.

Metagenomics: a new frontier for routine pathology testing of gastrointestinal pathogens

BackgroundAccurate and comprehensive identification of enteropathogens, causing infectious gastroenteritis, is essential for optimal patient treatment and effective isolation processes in health care systems. Traditional diagnostic techniques are well established and optimised in low-cost formats. However, thorough testing for a wider range of causal agents is time consuming and remains limited to a subset of pathogenic organisms. Metagenomic next-generation sequencing (mNGS) allows the identification of all pathogens in a sample in a single test, without a reliance on culture or introduction of target selection bias. This study aims to determine the ability to routinely apply mNGS testing, in comparison to traditional culture or polymerase chain reaction (PCR) based tests, for the identification of causal pathogens for gastrointestinal infections.ResultsThe performance of mNGS, PCR and microscopy, culture and sensitivity (MCS) assays was established using 2,619 prospectively collected faecal samples from patients with symptomology indicative of infectious gastroenteritiss. Commonly experienced pathogens including Aeromonas spp, Campylobacter spp, Salmonella spp and Giardia spp, in single and co-infected patients, were used to establish test outcomes. When testing for these organisms, using the combined result from either or both PCR and MCS testing as the comparator, the mNGS assay had clinically acceptable sensitivity (89.2–100%). Further, the mNGS assay detected 14 additional enteropathogens, that were either not detected or not tested, by initial PCR/MCS testing.ConclusionsThe advantage of mNGS compared to other syndromic testing systems is the broad range of detectable targets and the ability to interrogate samples without clinician informed or assay specific bias. With the development of newer sequencing assays, it is now feasible to test for a wide range of target organisms in a sample using a single mNGS test. Overall, the mNGS based approach enabled pathogen detection that was comparable to conventional diagnostics and was shown to have the potential to be extended for the detection of many pathogens and genes of clinical interest. In conclusion, the mNGS assay offers an easy, sample to answer workflow with rapid detection of enteropathogens and has the potential to improve diagnosis, therapy and infection control precautions.

Assessment of Knowledge, Attitude, and Practice of Standard Infection Control Precautions among Health-care Workers in Baghdad, Al-Rusafa, 2023

Abstract Background: Hospital stays, mortality, and expenditures rise with health-care-associated infections, especially in developing countries. Public health promotes infection control. Aim: The aim of this study was to assess health-care workers’ (HCWs) infection control knowledge, attitude, and practice and determine how sociodemographic and job descriptive variables affect them. Settings and Design: A cross-sectional study at four Baghdad/Al-Rusafa government hospitals (Shaikh Zayed Hospital, Al-Shaheed Al-Sader Hospital, Ibn Al-Balady Children and Maternity Hospital, and Fatima Al-Zahraa Children and Maternity Hospital). Subjects and Methods: All resident doctors, nurses, and laboratory personnel who were present during data collection and agreed to participate were included in this study. Statistical Analysis: Data were entered using Excel 2019 and then analyzed using SPSS 26. Frequency and percentage analyzed quantitative data, while Chi-square test analyzed categorical data. P <0.05 indicated statistical significance. Results: Knowledge level was higher among HCWs aged 30–39 years (79.4%), doctors (81.0%), individuals with more than 5 years of experience (75.0%), and those who received training (83.7%). Positive attitudes were most prevalent among HCWs aged 49 years and older (68.6%), laboratory workers (59.4%), individuals with more than 5 years of experience (55.5%), and those who received training (60.6%). A higher level of practice was observed in individuals aged 30–39 years (83.2%), laboratory personnel (80.4%), those with 5–14 years of experience (80.4%), and trainees (83.0%). Conclusions: Three-quarters of HCWs had good knowledge and practice regarding infection control precautions, and nearly half of them had a positive attitude. The knowledge, attitude, and practice of HCWs were increasing with progress in age, increasing work experience, and also with training.

Characterizing Escherichia coli carrying plasmid-mediated AmpC β-lactamases to optimize detection in a diagnostic laboratory setting.

Plasmid-mediated AmpC β-lactamases are a cause of acquired cephalosporin resistance in Gram-negative bacteria. However, consensus regarding the optimal detection method is yet to be achieved and varies depending on local epidemiology and laboratory capacity. We determined the acquired genotypic resistance mechanisms of 250 Escherichia coli isolates with a positive AmpC screen, defined as cefoxitin MIC ≥ 8 mg/L and a positive AmpC double- disc diffusion test, using in-house designed high-resolution melt PCR, detecting plasmid-acquired genes from the CIT and DHA families. A proportion of these isolates (n = 170, 68%) underwent further genotypic characterization using whole- genome sequencing (WGS). Of 250 isolates with a positive screening test, 72 (28.8%) were determined to carry an acquired AmpC gene. There was 100% concordance between PCR and WGS in the identification of acquired AmpC genes. The phenotypic criteria were then assessed to determine their utility in predicting acquired AmpC gene carriage. Criteria 1 (cefoxitin MIC > 8 mg/L plus ceftriaxone MIC > 1 mg/L and/or ceftazidime MIC > 1 mg/L) yielded a sensitivity of 93.1% and a specificity of 47.8%. Criteria 2 (cefoxitin MIC > 16 mg/L plus ceftriaxone MIC > 4 mg/L) had a sensitivity of 33.3% and a specificity of 98.9%. DHA genes, whose expression may be induced following antibiotic exposure, were present in 19% of isolates testing susceptible to ceftriaxone (MIC ≤ 1 mg/L) and were significantly more likely than CIT genes to be detected in susceptible isolates (P < 0.0001). These findings highlight the importance of using genotypic methods to detect acquired AmpC resistance in E. coli isolates that meet phenotypic screening criteria.IMPORTANCEDetection of transmissible AmpC resistance remains a challenging problem for diagnostic laboratories, especially in Escherichia coli where the expression of its intrinsic AmpC gene can result in phenotypic resistance patterns indistinguishable from plasmid-mediated resistance. In conjunction with whole- genome sequencing (WGS), we describe the development and performance of a novel melt-curve PCR to identify the two most prevalent plasmid-mediated AmpC gene families: CIT and DHA. We then describe phenotypic testing algorithms that incorporate this PCR and can differentiate these from non-acquired resistance in E. coli. It is important to distinguish these, not only to spare patients from unnecessarily being treated with infection control precautions, but also to identify plasmid-mediated genes, especially of the DHA family, that have been associated with inducible drug resistance to third- generation cephalosporins.

Transmission dynamics of MERS-CoV in a transgenic human DPP4 mouse model

Since 2002, three novel coronavirus outbreaks have occurred: severe acute respiratory syndrome coronavirus (SARS-CoV-1), Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2. A better understanding of the transmission potential of coronaviruses will result in adequate infection control precautions and an early halt of transmission within the human population. Experiments on the stability of coronaviruses in the environment, as well as transmission models, are thus pertinent.Here, we show that transgenic mice expressing human DPP4 can be infected with MERS-CoV via the aerosol route. Exposure to 5 × 106 TCID50 and 5 × 104 TCID50 MERS-CoV per cage via fomites resulted in transmission in 15 out of 20 and 11 out of 18 animals, respectively. Exposure of sentinel mice to donor mice one day post inoculation with 105 TCID50 MERS-CoV resulted in transmission in 1 out of 38 mice via direct contact and 4 out of 54 mice via airborne contact. Exposure to donor mice inoculated with 104 TCID50 MERS-CoV resulted in transmission in 0 out of 20 pairs via direct contact and 0 out of 5 pairs via the airborne route. Our model shows limited transmission of MERS-CoV via the fomite, direct contact, and airborne routes. The hDPP4 mouse model will allow assessment of the ongoing evolution of MERS-CoV in the context of acquiring enhanced human-to-human transmission kinetics and will inform the development of other transmission models.

Evaluation of Screening Results for Vancomycin-Resistant Enterococci: Three-Year Surveillance.

Enterococci are facultative anaerobic, binary, or chained Gram-positive cocci. The gastrointestinal colonization of hospitalized patients is the most important reservoir of vancomycin-resistant enterococci. We aimed to evaluate retrospectively the screening results of vancomycin-resistant enterococci, studied by the simultaneous (real-time) polymerase chain reaction method on rectal swabs of adult and pediatric patients hospitalized in our hospital in 2019-2021. Adult and pediatric patients were included in our study between Jan 2019 and Dec 2021. The results of vancomycin-resistant enterococci, studied with the real-time polymerase chain reaction method from rectal swabs sent from intensive care units and services, were analyzed retrospectively. Isolation of the samples was performed using the Fluorion VRE QLP 1.0 real-time polymerase chain reaction kit (Iontek, Turkey), and detection was performed with the Fluorion Detection System (Iontek, Turkey) real-time polymerase chain reaction device. Overall, 31,725 patients were included in our study. When evaluated in order of years, in 2019, 379 (7%) of 5,389 adults, 322 (7.4%) of 4,003 children, 234 (5.5%) of 4,185 adults in 2020, 157 (2.4%) of 6,499 children, and in 2021, vancomycin-resistant enterococci were detected in 469 (7.5%) of 6,232 adults and 224 (4.1%) of 5,417 children. The prevalence of vancomycin-resistant enterococci is greater in adults, particularly in intensive care units, compared to children. Infection control precautions and training be augmented in high-risk clinics, while the unnecessary utilization of glycopeptides should be limited.

Infection prevention and control: understanding the fundamentals.

Infection prevention and control is crucial to prevent patients and healthcare staff from being harmed by avoidable infections, including healthcare-associated infections. This article outlines the main elements of standard precautions for infection prevention and control, as set out by the World Health Organization. Nurses and other healthcare professionals can use this information to refresh their knowledge of infection prevention and control, understand the appropriate practices that should be adopted to reduce the risk of infection transmission, and increase their awareness of the importance of sustainability and education.

KNOWLEDGE, ATTITUDE, AND PRACTICE OF HEALTHCARE PROFESSIONALS REGARDING INFECTION PREVENTION AT THE TERTIARY CARE HOSPITAL OF PESHAWAR KPK

Occupational health and safety is a crucial element in every organization, especially in a health care setting. Health care workers (HCWs) play a role as vectors and reservoirs for the spread of infection from patient to patient and staff as well. Infection control and prevention practices are essential elements of quality health care and patient safety in health facilities. Objectives: This study was aimed at assessing the levels of knowledge, attitude, and practice scores of the HCWs towards infection control at three public sector hospitals in Peshawar KPK. The study will help policymakers in the design and development of appropriate infection prevention programs and strategic plans by identifying the gap in infection control practices. Method: An institution-based cross-sectional study was conducted to assess the knowledge, attitudes, and practices of nurses regarding infection prevention and control by using a validated and structured questionnaire in three tertiary care hospitals in KPK. The sample size was calculated by using the Raosoft calculator, and the sample size was 318 nurses from these three hospitals, including those nurses who were willing to participate in the study and nurses who had more than one year of experience. Data was analyzed using SPSS version 22. Result: The participants were 55% male and 45% female; 55% were married, 42% were unmarried, 2% were divorced, 51% were diploma holders, 49% were degree holders, and most of the participants were charge nurses, which is 89%, and 11% were working in different administrative positions. Most of the participants who completed the survey were working in intensive care units, which is 66%, and others working in general wards and OPDs. 61% of nurses got information about safety precautions from training, 61% and 29% from books, and 10% from other resources. Participants who got training were 52%, and 48% of participants did not get any training on infection control precautions. Nurses who had knowledge about safety precautions were 84%; only 16% had not enough knowledge about infection control precautions. In attitude and practice about infection control, 58% were in compliance with practice, and 88% showed a positive attitude regarding infection control practices. Conclusion: In the conclusion, we can say that there is enough knowledge among nurses regarding infection control practice, but implementation of this knowledge in practice should be ensured by doing strict supervision of infection control practices in every health care facility.

Families' Perception toward Application of Infection Control Precautions with Corona Virus at Home

Families' Perception toward Application of Infection Control Precautions with Corona Virus at Home

Knowledge, Attitude, and Practice of Standard Infection Control Precautions Among Medical Students at King Khalid University Hospital.

Background Healthcare-associated infection (HAI) risk extends beyond patients to healthcare workers and medical students. However, many HAIs are preventable by adhering to standard infection control precautions (SICPs). This study assesses medical students' knowledge, attitudes, and practices regarding SICPs at the College of Medicine, King Saud University. Methodology A cross-sectional study was undertaken at the College of Medicine, King Saud University, Riyadh, Saudi Arabia, involving interns and medical students from years 1 to 5. The researchers constructed and validated an electronic questionnaire, which was used for data collection from December 2022 to June 2023. The estimated sample size was 371 students and interns, stratified by sex and educational level. The data collected included demographic characteristics, knowledge, attitudes, and practices regarding SICPs. Results Out of371 participants, approximately a quarter (25.1%) had a good knowledge score, 25.6% had a positive attitude, and 26.7% had good infection control practice. There was an association between good knowledge and male gender; being in clinical years 3, 4, 5, and interns; and attending infection control training (p < 0.05). A significant difference in practice was noted among females (p = 0.002). Conclusions This study showed low-to-moderate knowledge, attitude, and practice toward SICPs. These findings indicate a gap between the recommended guidelines and their implementation in healthcare settings, highlighting the necessity for integrating infection control education throughout the medical curriculum. Further research involving a larger sample from multiple institutions is warranted.

Use of Respiratory and Contact Precautions to Decrease the Spread of SARS-CoV-2 Infection Was Not Associated with a Decrease in Endometritis-Intra-Amniotic Infection.

To decrease the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the Mount Sinai Hospital's obstetric service, additional contact and respiratory precautions for patients and staff were implemented. Patients were allowed only one support person, SARS-CoV-2 tested on admission, and required to mask during hospitalization. Staff were required to wear masks and eye shields, gloves for all patient care, and gowns for care with SARS-CoV-2-infected patients. This study determined if the risk of endometritis/intra-amniotic infection (IAI) changed under the new pandemic precautions. A single-center, historical cohort study via electronic medical record review compared singleton deliveries among patients who labored during the "pandemic period" (from March 1 through May 31, 2020) with those who labored during the "prepandemic period" (March 1 through May 31, 2019) to determine if the risk of endometritis/IAI differed. The analysis was done using logistic regression with inverse probability of treatment weighting (IPTW) to adjust for possible differences in obstetric practice and patient population between the two periods. Four percent (53/1,318) of patients in the pandemic period and 5.1% (82/1,596) of patients in the prepandemic period were diagnosed with endometritis/IAI (p = 0.15). Compared with patients who delivered in the prepandemic period, those who delivered during the pandemic period had a higher body mass index at delivery (median: 28.36 [interquartile range, IQR: 25.70, 32.07] vs. 28.00 [IQR: 25.23, 31.50], p = 0.01) and experienced fewer digital exams (median: 4 [range: 1, 10] vs. 4 (range: 1, 19], p = 0.004), a practice not included in the SARS-CoV-2 prevention strategy. In multivariable logistic regression with IPTW adjusting for risk factors for endometritis/IAI, period of delivery was not associated with endometritis/IAI (odds ratio = 0.76, 95% confidence interval [0.52, 1.11], p = 0.15). The use of respiratory and contact precautions to limit the spread of SARS-CoV-2 was not associated with risk of endometritis/IAI. · Pandemic infection control precautions were not associated with a decrease in endometritis/IAIs.. · The early months of the pandemic were associated with the performance of fewer digital cervical exams.. · The early months of the pandemic were associated with a higher BMI at delivery..

Examining the impact and response to an outbreak of carbapenemase-producing Enterobacterales in a neonatal unit in the United Kingdom: An outbreak report.

Carbapenemase-producing Enterobacterales (CPE) are a group of Gram-negative bacteria causing global concern due to their resistance to carbapenems. In this report, we detail the learning points from a CPE outbreak in a tertiary neonatal unit (NU) in the UK. Routine surveillance screening (rectal swabs) of babies on the NU identified a potential cluster of CPE carriage. Samples were sent to a reference laboratory for confirmatory testing. Environmental screening and cot mapping were undertaken to determine movements of babies within the unit. Regular audits of cleaning standards, hand hygiene, and maternal hygiene when expressing breast milk were carried out. The outbreak lasted 19weeks. During the outbreak, there were 360 admissions, with 11 babies being colonised with the outbreak strain. Once the outbreak was declared, there were enhanced Infection Prevention and Control (IPC) precautions (including increased environmental and equipment cleaning frequency). CPE screening frequency was increased and cot capacity was reduced. Hand hygiene compliance improved from 92% at the start of the outbreak to 100% by its close. Cleaning standards remained compliant. Maternal hygiene standards varied from 78% to 100%, but no cross-infection links were identified. Environmental screening was negative. No route of cross-infection was identified. Notably, no babies developed invasive CPE infection. This is the first report of a CPE outbreak in a UK NU. Although no specific mode of cross-transmission was identified and the outbreak's end cannot be attributed to any single intervention, the bundle of interventions proved successful after a 5-month period.

Factors responsible for student nurses' use of non-sterile gloves: An exploratory qualitative study.

Disposable non-sterile gloves are part of the personal protective equipment (PPE) to be considered to protect oneself from the risk of infection. They have subsequently become the topic of concern related to increased use, inappropriate use, and potentially increasing the risk of cross-infection and environmental impact of plastic waste. This study aimed to explore the views of pre-registration student nurses about non-sterile glove use in clinical practice and to identify the factors that impact student nurses' decision on whether to wear non- sterile gloves. Using a social constructivist approach, the study was organised in a higher education institution. Semi-structured interviews were conducted with second year student nurses, utilising a theoretical domains framework (TDF). The key findings showed that students had limited awareness of the national infection prevention and control best practice procedures. The primary influential factors for non-sterile gloves use behaviour were personal protection, the type of care interventions required and the observations of peers and role models. The study found limited awareness on the importance of infection prevention and control precautions, including the correct procedure for donning, and doffing of personal protection equipment, along with a lack of confidence to challenge non-compliance.

Knowledge, attitudes, and practices toward infection control precautions among nurses in Palestinian hospitals.

Healthcare-associated infections (HAIs) are common complications in healthcare services, often caused by unsystematic antibiotic use. Despite advancements in medical care and technologies, the burden of HAIs continues to increase globally. Thus, this study purposed to evaluate the levels of knowledge, attitudes, and practices toward infection control precautions among nurses in Palestinian hospitals and identify the predictors of practices of infection control precautions. A cross‑sectional study was conducted on 285 nurses who work at Palestinian hospitals in the West Bank. A self-reported questionnaire was used to collect data during the period from November 2022 to January 2023. The results revealed that 95.8 % of the participants endorsed good knowledge levels, 83.5 % reported positive attitude levels, and 91.2 % endorsed good practice levels toward infection control precautions. Also, gender as being female, attending a training program on infection control, and having good knowledge of infection control precautions were the main factors influencing practices of infection control precautions. It is necessary tomaintain nurses' knowledge, attitudes, and practices toward infection control precautions by continuously conducting training workshops about infection control updating knowledge, and enhancing the work environment by implementing infection control policies and guidelines and providing sufficient resources and equipment to ensure safe practices.

KNOWLEDGE AND PREDICTORS OF IMPLEMENTATION OF STANDARD PRECAUTIONS FOR INFECTION PREVENTION AND CONTROL AMONG HEALTH CARE PRACTITIONERS.

Infection prevention and control involve health care practitioners, who are saddled with the duty of ensuring implementation of standard preventive measures to prevent healthcare associated infections. To assess the knowledge and predictors of implementation of standard precautions for infection prevention and control among health care practitioners (HCPs). A questionnaire-based cross-sectional design was employed in assessing HCPs in Uganda in from April - October 2023. Data were analyzed using descriptive, Pearsons' correlation, linear and binary logistic regression with the aid of SPSS Version 22. Among the 222 healthcare practitioners assessed, 127 (57.2%) and 115 (51.8 %) had good knowledge and practice towards implementation of standard infection prevention and control precautions respectively. Chi square analysis indicated that age of healthcare practitioner (p=0.02; CI: 0.018 - 0.23), hospital unit of practice (p=0.003; CI: 0.002 - 0.004) and the type of facility where the health care practitioner works is significantly associated with their knowledge, while profession of the healthcare practitioner (p=0.002; CI: 0.001-0.003) and hospital unit of practice (p=0.002; CI: 0.001-0.003) were associated with implementation of the standard infection prevention and control precautions. Linear regression revealed knowledge is a significant predictor of good practice towards implementation of preventive measures (OR = 0.19; CI 0.102 - 0.272; p < 0.001). Healthcare practitioners had poor knowledge and practice towards infection prevention. Thus, emphasizing continuous education and training for all healthcare professionals about infection prevention and control interventions as well as strict adherence to proper infection prevention and control practices.

Using whole genome sequencing to characterize Clostridioides difficile isolates at a tertiary center in Melbourne, Australia.

Clostridioides difficile infection (CDI) is the commonest cause of healthcare-associated diarrhea and undergoes standardized surveillance and mandatory reporting in most Australian states and territories. Historically attributed to nosocomial spread, local and international whole genome sequencing (WGS) data suggest varied sources of acquisition. This study describes C. difficile genotypes isolated at a tertiary center in Melbourne, Australia, their likely source of acquisition, and common risk factors. Retrospective observational study. The Royal Melbourne Hospital (RMH), a 570-bed tertiary center in Victoria, Australia. Short-read whole genome sequencing was performed on 75 out of 137 C. difficile isolates obtained from 1/5/2021 to 28/2/2022 and compared to previous data from 8/11/2015 to 1/11/2016. Existing data from infection control surveillance and electronic medical records were used for epidemiological and risk factor analysis. Eighty-five (62.1%) of the 137 cases were defined as healthcare-associated from epidemiological data. On genome sequencing, 33 different multi-locus sequence type (MLST) subtypes were identified, with changes in population structure compared to the 2015-16 period. Risk factors for CDI were present in 130 (94.9%) cases, including 108 (78.8%) on antibiotics, 86 (62.8%) on acid suppression therapy, and 25 (18.2) on chemotherapy. In both study periods, most C. difficile isolates were not closely related, suggesting varied sources of acquisition and that spread of C. difficile within the hospital was unlikely. Current infection control precautions may therefore warrant review. Underlying risk factors for CDI were common and may contribute to the proportion of healthcare-associated infections in the absence of proven hospital transmission.

Practices and Adherence of Nurses with Standard Precautions of Infection Control in Intensive Care Units of Public Sector Hospitals in Lahore

&lt;p&gt;Abstract&lt;/p&gt;&#x0D; &lt;p&gt;Background and objective: Severely ill patients are at a higher risk of carrying nosocomial infections especially when admitted to the intensive care units (ICUs). Therefore, it is the professional obligation of all health workers to adhere to the scientifically accepted criteria for infection control in clinical settings. This study was conducted to assess intensive care nurses&amp;rsquo; adherence to standard precautions (SPs) and to assess the practices of SPs in intensive care.&lt;/p&gt;&#x0D; &lt;p&gt;Methods: This cross-sectional study was carried out at ICUs of two public sector hospitals in Lahore, Pakistan, from March to September, 2022. A total of 150 nurses were selected for the study who worked in the medical-surgical, general, and specialized ICUs. The extent to which the behavior of a worker coincides with the prescribed standard (Adherence) and performing work repeatedly till it becomes a routine competency (Practice) was assessed using a structured questionnaire. The chi-square test was used to determine the link between adherence to SPs and the practice carried out by nurses. Data were analyzed and a p-value &amp;le; 0.05 was taken as significant.&lt;/p&gt;&#x0D; &lt;p&gt;Results: A total of 84.7% of nurses showed adherence while practice was demonstrated by 52.7% of nurses. No significant correlation (p-value:0.95) was however found between the practice and adherence to the SPs, despite the fact that a notable gap was observed between the practice and adherence to SPs among ICU nurses.&lt;/p&gt;&#x0D; &lt;p&gt;Conclusion: It is concluded that a compromised adherence to SPs of infection control in ICUs of public sector hospitals in Lahore is exhibited by the nurses.&lt;/p&gt;

Knowledge, Attitude and Practice of Infection Control among Medical Imaging Students in Unisza

Healthcare-associated infections risk in health care settings has caused a great concern to medical imaging students during clinical attachment due to high interaction rate with patients. Students may spread infections through inadequate knowledge and poor practice, which may then degrade the standard of care. Preventive measures and infection control policies have been developed to prevent the spread of infections, lower morbidity and medical care costs. However, recent evidence revealed poor level of health science students’ knowledge regarding infection control. This cross-sectional survey-based study is aimed to determine level of knowledge, attitude and practice towards infection control. This study is also aimed to determine the association between knowledge, attitude, and practice level of infection control and standard precautions among uniSZA medical imaging students. The sampling method used was purposive sampling. An online questionnaire was distributed using social media platforms, Whatsapp from 21th March to 22th April 2023. The questionnaire consists of 12 items on knowledge, 7 items on attitude and 10 items on practice about infection control. A total of 136 medical imaging students participated in this study, 98 Bachelor’s degree students and 38 Diploma students. Overall knowledge, attitude and practice level among students were good. The percentage of respondents had good knowledge, positive attitude and good practice were 100% (n=136), 100% (n=136) and 98.5% (n=134) respectively. Fisher’s exact test shows there was no association between attitude level and practice level of infection control among respondents (p =1.00). Continuous infection control training and education program are still required to enhance awareness of standard precautions and thus reduce infection exposure. Future recommendations are to include all health science students and medical students to participate in the survey. Further studies to assess the extent of public knowledge regarding infection control may also be conducted.