Prevent Cross Infection Research Articles

Chlorhexidine Bathing Strategies for Multidrug-Resistant Organisms: A Summary of Recent Evidence.

ObjectiveThe aim of the study was to summarize the latest evidence for patient bathing with a 2% to 4% chlorhexidine gluconate solution to reduce multidrug-resistant organism (MDRO) transmission and infection.MethodsWe searched 3 databases (CINAHL, MEDLINE, and Cochrane) for a combination of the key words “chlorhexidine bathing” and MeSH terms “cross-infection prevention,” “drug resistance, multiple, bacterial,” and “drug resistance, microbial.” Articles from January 1, 2008, to December 31, 2018, were included, as well as any key articles published after December 31.ResultsOur findings focused on health care–associated infections (HAIs) and 3 categories of MDROs: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and carbapenem-resistant Enterobacteriaceae (CRE). Chlorhexidine bathing reduces MRSA acquisition and carriage, but not all studies found significant reductions in MRSA infections. Several studies found that chlorhexidine bathing reduced VRE acquisition and carriage, and one study showed lower VRE infections in the bathing group. Two studies found that bathing reduced CRE carriage (no studies examined CRE infections). Two very large studies (more than 140,000 total patients) found bathing significantly reduced HAIs, but these reductions may be smaller when HAIs are already well controlled by other means.ConclusionsThere is a high level of evidence supporting chlorhexidine bathing to reduce MDRO acquisition; less evidence is available on reducing infections. Chlorhexidine bathing is low cost to implement, and adverse events are rare and resolve when chlorhexidine use is stopped. There is evidence of chlorhexidine resistance, but not at concentrations in typical use. Further research is needed on chlorhexidine bathing’s impact on outcomes, such as mortality and length of stay.

Management plan of a paediatric outpatient department during the SARS-CoV-2 epidemic.

With the novel coronavirus (2019-nCoV) infection outbreak and spread, serious cases of infection and neonatal infection have been reported. Moreover, children show milder cases and a better prognosis than adults. The outpatient Department of Paediatrics has played a crucial role in the prevention and control of novel coronavirus (2019-nCoV) infection in children. Based on previous experience and existing diagnosis and treatment guidelines, we present the relevant strategies of this particular paediatric outpatient department when responding to the epidemic. Conclusion: Concurrently, we hope that this article can act as a reference in the fight against SARS-CoV-2 infection. Further modifications will be made in the future with the increase in clinical experience and changes in the disease. This article is protected by copyright. All rights reserved.

During and post COVID-19 pandemic: prevention of cross infection at dental practices in country with tropical climate

Background: COVID-19 has been regarded as a new pandemic in the world. This disease is highly contagious and can be transmitted easily through droplets and air. This matter is considered as a red flag to all dentists all over the globe. Until today, there is only a few specific guideline in regards to dental practice during and after the pandemic. The protocol only revolves around the limitation of patients’ appointments and using level 3 personal protection equipment. There is no specific mention on the preparation method of the practice room especially in Indonesia. Purpose: This study aims to review literature on infection control in dental settings during COVID-19 pandemic and discuss possible recommendations based on available evidence. Review: The review also discussed the background of COVID-19, transmission, clinical findings, physicochemical properties, and cross infection in dental practice. Despite the usage of personal protective equipment, the rooms need to be set to specific requirement to reduce contamination inside the room. Until today, COVID-19 transmission must be prevented with the best method available. Conclusion: No single protocol may fully guarantee the safety of the patients and dental workers. We suggest to combine the protocol listed above to minimize to self and cross-contamination ’new normal’ practice.

COVID-19 is a New Challenge for Dental Practitioners: Advice on Patients’ Management from Prevention of Cross Infections to Telemedicine

Background: The COVID-19, originated in China in December 2019, has spread worldwide pandemically. Infection control measures are especially needed for healthcare professionals who meet potentially infected patients. Objective: The authors aimed to provide general knowledge about COVID-19 disease and indications for the management of emergency dental procedures based on recent literature and experience gained. Methods: A literature search was performed to identify scientific information on COVID-19 and prevention of cross infection appropriate for the practice of dentistry. Results: The authors provided relevant information about SARS-CoV-2 virus, COVID-19 disease, and prevention of cross infections in the dental office. Furthermore, the authors described their experience and highlighted the potential of telemedicine. Conclusion: This article, based on relevant researches, guidelines and Authors’ experience in a COVID-19 Hospital, introduces essential knowledge about COVID-19 and transmission routes and provides recommended management protocols for dental practitioners.

Trans theoretical Model in Seminar and Hands-on of Cross-Infection Prevention Effort by Creative Dental Hygienists

Trans theoretical Model in Seminar and Hands-on of Cross-Infection Prevention Effort by Creative Dental Hygienists

The Cutting Edge of Thoracic Anesthesia During the Coronavirus Disease 2019 (COVID-19) Outbreak

Coronavirus disease 2019 (COVID-19) has quickly spread globally, causing a real pandemic. In this critical scenario, lung cancer patients scheduled for surgical treatment need to continue to receive optimal care while protecting them from an eventual severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Adequate use of personal protective equipment (PPE) during aerosol-generating procedures (AGPs) and a COVID-19 specific intraoperative management are paramount in order to prevent cross infections. New suggestions or improvement of existing contagion control guidance are needed, even in case of non-symptomatic patients, possibly responsible for virus spread.

Walkthrough Sanitization Gates for COVID-19: A Preventive Measure or Public Health Concern?

.As the COVID-19 pandemic continues to gain momentum around the world, several measures are being put in place to control its spread. One such effort includes the installation of walkthrough sanitization gates to disinfect passersby and prevent cross infection. However, there is lack of clinical evidence on the effectiveness of these walkthrough gates to contain COVID-19. Moreover, there are potential public health concerns associated with these walkthrough gates. Spraying individuals with disinfectant chemicals is strongly discouraged by various health authorities around the globe because of their propensity for eye and skin irritation, bronchospasm following inhalation, and gastrointestinal effects such as nausea and vomiting. This article underscores that the risks associated with the use of these walkthrough gates overweigh any potential benefits. Health authorities must discourage their use and should focus efforts on other preventive measures such as social distancing, wearing masks, and hand hygiene to prevent the spread of COVID-19 among the general public.

Microbiological purity of syringes containing composites in the context of cross-infection prevention in dental practices

Abstract Cross-infection involves the transmission of microorganisms through secretions, bodily fluids and excreta, as well as undisinfected surfaces and medical equipment. In the dental office, diseases are transmitted via various routes, e.g. from patient to dentist or other member of dental team, from doctor or dental team member to patient, from patient to another patient, from dental office to community and from community to patient. The study was conducted to evaluate the effectiveness of infection control in dental practices based on the qualitative and quantitative assessment of microbiological contaminants detected on the surface of filling material packaging used in dental offices. The material for research were 9 packages containing dental materials during their use in 3 dental settings. The packages were placed in sterile flasks and rinsed to wash microorganisms from the surfaces. The washes were filtered through membrane filters and cultured under proper aerobic and anaerobic conditions, and at elevated CO2 concentration. Microbial growth on TIO and TSB media was observed. The contamination of most samples remained low as indicated by the growth from one to a maximum of five colonies on TSA. The contamination remained at the level of 10-50 CFU/package, i.e. <100 CFU/single package. The tests evaluating the contamination of dental package surfaces with aerobic bacteria confirmed high hygiene standards observed in dental offices from which the packages were brought.

MANAGEMENT OF COVID-19 IN PERSPECTIVE OF CARDIOLOGISTS

MANAGEMENT OF COVID-19 IN PERSPECTIVE OF CARDIOLOGISTS

Evaluation of Infection Control Measures of Iraqi Dentists in Dental Practices

Objectives: The objective of this study was to investigate the knowledge, attitudes, and behavior of Iraqidentists in Al-Najaf City regarding infection control measures.Materials and Method: A questionnaire was designed to obtain information about procedures used forthe prevention of cross infection in dental practices. The study population included all dentists in Al-NajafCity, Iraq, in September 2019 (n=500) to whom the questionnaires were distributed. The questionnairewas designed to collect data on sociodemographic characteristics, knowledge and practice of infectioncontrol procedures, cleaning, disinfection, sterilization, hand hygiene, use of personal protective equipment,immunization, prevention and handling of occupational hazards, and antisepsis.Results: From the 500 dentists to whom the questionnaires were submitted, 372 participated in the study(overall response rate 74.4%). Half of the dentists (50%) expressed concern about risks of infectiontransmitted in dental practices. The rate of vaccination against hepatitis B was good among dentists (76%).Iraqi practitioners widely apply certain basic infection control measures, such as hand washing (85%) andwearing gloves (90%) and face masks (84%), but poorly address other important issues, such as examiningmedical history records (65%), wearing protective eye wear (41%) and disposable gowns for surgery (30%),and using rubber dam (18%), preoperative mouth rinses (25%) and puncture-resistant containers (34%).Conclusions: The knowledge, attitude, and behavior of Iraqi dentists about infection control measures arerelatively weak. Improved compliance with recommended infection control measures is required for alldentists. Continuing education programs and short courses/workshops about cross infection and infectioncontrol measures are important to improve the knowledge, awareness, attitude, and behavior of Iraqi dentists.

Comparison of knowledge, attitudes and hand hygiene behavioral intention in medical and nursing students.

SummaryIntroductionHand hygiene is crucial to prevent cross infection. Healthcare students are in a prime position to learn hand hygiene skills. The aim of this study was to analyze hand hygiene behavioral intentions of healthcare students before and after contact with the patient and to compare the knowledge of and attitude towards hand hygiene between medical and nursing students.MethodsIn a descriptive survey research design, convenience selection of a sample of medical students (n=657) and nursing students (n=303) was done from modules taught by the Department of Preventive Medicine and Public Health in both Medicine and Nursing undergraduate degrees in four Spanish universities. The hand hygiene Questionnaire, a validated instrument to evaluate behavior, knowledge, and attitudes, was used.ResultsA significantly lower percentage of students reported always or almost always carrying out hand hygiene before contact with the patient or invasive procedures in comparison to the percentage complying after contact with secretions or with the patient. Although hand hygiene knowledge appears acceptable, its importance is not sufficiently valued.ConclusionsThere are deficiencies in behavioral intention, knowledge, and attitudes related to hand hygiene in medical and nursing students. Better results are observed among nursing students, especially those who have received specific training.

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Treatment strategy for gastrointestinal tumor under the outbreak of novel coronavirus pneumonia in China

The outbreak of the novel coronavirus pneumonia (NCP) has become a public health emergency in China. Chinese authorities and health agencies had devoted great efforts to control this disease. As surgeons specialized in the treatment of gastrointestinal tumors, we should always be aware of the prevention for NCP and incorporate this awareness into every detail of clinical practice. For the patients with gastrointestinal tumors, pre-admission screening should be done in order to rule out NCP. Real-time RT-PCR panel and chest CT scan should be conducted for patients with fever (>37.3℃), travel history to Hubei Province within 14 days, or contact history with residents from Wuhan district within 14 days. Prevention measures for both medical staffs and the screen-negative admitted patients should also be enhanced because false negative is possible. Medical instruments should be properly discarded or disinfected according to standardized procedures established by the local center for disease control and prevention (CDC). Surgical operation should be reduced at a minimal level to prevent cross infection in this special period.Surgical intervention for benign tumor should be postponed. For malignant tumor, multidisciplinary therapy (MDT) is recommended and non-surgical anti-tumor therapy should be selected with higher priority. Neoadjuvant therapy is highly recommended for gastrointestinal cancer at advanced stages that meet the indications of NCCN guideline (gastric cancer T stage ≥ 2/rectal cancer T stage ≥ 3/unresectable colon cancer). Gastric or esophagogastricjunction (EGJ) malignant tumor with obstruction can be managed with gastric tube decompression or stent placement to relieve the symptoms. Transnasal enteral feeding tube intubation/percutaneous endoscopic gastrostomy could be adopted to ensure enteral nutrition supply. For colorectal malignancy with simple intestinal obstruction, stent placement can achieve a high success rate, which not only helps avoid emergency surgery, but also creates a better condition for subsequent surgery. Transcatheter arterial embolization for hemostasis is an alternative choice for gastrointestinal tumor with bleeding. However, emergency operation still must be performed for patients with acute uncontrolled bleeding, obstruction or after other alternative treatment measures fail. All cases with suspicious or confirmed with NCP must be reported to the local CDC department. All invasive intervention must be performed in a designated isolation area. Tertiary prevention measure must be adopted for all anesthetists with additional face mask or medical goggle protection to prevent respiratory droplet transmission. Preventive enterostomy is preferable in lower digestive tract surgery. Thoroughly disinfecting the operating room after surgery is necessary. Fever after surgery must be carefully differentiated whether it's caused by post-surgery abdominal infection/inflammation or NCP. Single-room isolation and related examinations should be performed according to the standard procedures. We believe that with the unprecedentedly joint efforts of doctors and patients, we will eventually win this war against NCP.

Guidance on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period (First Edition)

Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period. Key words: Novel Coronavirus; Novel Coronavirus Pneumonia; Child; Fever outpatient; Process; Management

Dynamic Gesture Controlled User Interface Expert HCI System using Adaptative Background Masking: An Aid to Prevent Cross Infections

Human-Computer Interaction (HCI) interfaces need unambiguous instructions in the form of mouse clicks or keyboard taps from the user and thus gets complex. To simplify this monotonous task, a real-time hand gesture recognition method using computer vision, image, and video processing techniques has been proposed. Controlling infections has turned out to be the major concern of the healthcare environment. Several input devices such as keyboards, mouse, touch screens can be considered as a breeding ground for various micro pathogens and bacteria. Direct use of hands as an input device is an innovative method for providing natural HCI ensuring minimal physical contact with the devices i.e., less transmission of bacteria and thus can prevent cross infections. Convolutional Neural Network (CNN) has been used for object detection and classification. CNN architecture for 3d object recognition has been proposed which consists of two models: 1) A detector, a CNN architecture for detection of gestures; and 2) A classifier, a CNN for classification of the detected gestures. By using dynamic hand gesture recognition to interact with the system, the interactions can be increased with the help of multidimensional use of hand gestures as compared to other input methods. The dynamic hand gesture recognition method focuses to replace the mouse for interaction with the virtual objects. This work centralises the efforts of implementing a method that employs computer vision algorithms and gesture recognition techniques for developing a low-cost interface device for interacting with objects in the virtual environment such as screens using hand gestures.

Drive-Through Screening Center for COVID-19: a Safe and Efficient Screening System against Massive Community Outbreak

As the coronavirus disease 2019 (COVID-19) outbreak is ongoing, the number of individuals to be tested for COVID-19 is rapidly increasing. For safe and efficient screening for COVID-19, drive-through (DT) screening centers have been designed and implemented in Korea. Herein, we present the overall concept, advantages, and limitations of the COVID-19 DT screening centers. The steps of the DT centers include registration, examination, specimen collection, and instructions. The entire service takes about 10 minutes for one testee without leaving his or her cars. Increased testing capacity over 100 tests per day and prevention of cross-infection between testees in the waiting space are the major advantages, while protection of staff from the outdoor atmosphere is challenging. It could be implemented in other countries to cope with the global COVID-19 outbreak and transformed according to their own situations.

A study to assess the microbial profile and index of microbial air contamination in dental operatories.

Microbial contamination of air in dental operatory is an important source of infection. In this study, passive air sampling using settle plates was used as an effective method to assess the microbial profile and index of microbial air contamination (IMA) in dental operatories. To assess the microbial profile and index of microbial air contamination (IMA) in dental operatories. This study design was a experimental cum diagnosis study and was conducted in four outpatient dental operatories in a self-financing dental college using stratified random sampling technique. Twenty air samples were collected by leaving blood agar plates open for 1 h, 1 m above the floor and 1 m from the wall. After incubation at 37°C for 48 h, colonies were counted to assess the number of colony-forming units (CFUs) per plate. The number of CFU is the IMA. The evaluation of aerobic bacterial and fungal profiles of representative colonies was done by standard microbiological methods. Independent sample 't' test was applied for this study. All air samples collected near the dental treatment unit showed more contamination than the ambient air. As per the IMA classes, the IMA near the dental treatment unit ranged from fair to poor. IMA of ambient air in all the four operatories was within the acceptable values. The most common microorganism isolated was Staphylococcus species. Passive air sampling is one of the effective ways of quantifying airborne bacteria as used in the present study. Air microbial level evaluation is a step towards cross-infection prevention.

NOTTO transplant specific guidelines with reference to COVID-19

NOTTO transplant specific guidelines with reference to COVID-19

Major COVID-19-positive burns treated successfully

Extensive burns are severe form of trauma causing a great threat to life. Approximately 300,000 deaths is attributed to burns annually, majority (>95%) of which occur in developing countries. Survival rate of patients decreases as the rate of burn increases. Coronavirus disease (COVID-19) pandemic has affected all the communities worldwide. It has strong infectivity and high transmission rate. When treating corona-virus-infected burns patients, prevention of cross infection to health workers becomes of utmost importance. Here, authors present a case of extensive burns along with COVID-19 infection, the precautions taken to prevent infection among health workers and protocols followed for management. The patient was treated over a span of 75 days where the patient was cured of COVID-19 in 21 days and underwent two surgeries with homograft and autograft application. Multidisciplinary approach with strict protocols of safety and vigilant monitoring is key to successful management.

Development of a preoperative Early Warning Scoring System to identify highly suspect COVID-19 patients.

Background and Aims:The coronavirus disease 2019 (COVID-19) is spreading at an unprecedented speed. Lack of resources to test every patient scheduled for surgery and false negative test results contribute to considerable stress to anesthesiologists, along with health risks to both caregivers and other patients. The study aimed to develop an early warning screening tool to rapidly detect 'highly suspect' among the patients scheduled for surgery.Methods:Review of literature was conducted using terms 'coronavirus' OR 'nCoV 2019' OR 'SARS-CoV-2' OR 'COVID-19' AND 'clinical characteristics' in PUBMED and MedRxiv. Suitable articles were analysed for symptoms and investigations commonly found in COVID-19 patients. Additionally, COVID-19 patient's symptomatology and investigation profiles were obtained through a survey from 20 COVID-19 facilities in India. Based on literature evidence and the survey information, an Early Warning Scoring System was developed.Results:Literature search yielded 3737 publications, of which 195 were considered relevant. Of these 195 studies, those already included in the meta-analyses were not considered for independent assessment. Based on the combined data from meta-analyses and survey, risk factors of COVID-19 disease identified were as follows: history of exposure, fever, cough, myalgias, lymphocytopaenia, elevated C-reactive protein (CRP)/lactate dehydrogenase (LDH) and radiographic infiltrates.Conclusion:Development of this Early Warning Scoring System for preoperative screening of patients may help in identifying 'highly suspect' COVID-19 patients, alerting the physician and other healthcare workers on the need for adequate personal protection and also to implement necessary measures to prevent cross infection and contamination during the perioperative period.