Prevention Of Nosocomial Infections Research Articles

Identification of key potential risk areas and key potential failure modes in hemodialysis rooms by the FMEA method following routine prevention and control of the COVID-19 pandemic.

Hemodialysis is an important part of nosocomial infection prevention and control (IPC). This study aimed to identify the key potential risk areas and failure modes in hemodialysis rooms in hospitals and put forward a series of improvement measures to prevent and control the spread of the coronavirus disease 2019 (COVID-19). Hemodialysis patients are highly susceptible to COVID-19 and usually have a high incidence of severe illness and mortality after infection with COVID-19. Therefore, IPC in hemodialysis patients is of crucial strategic significance. Based on 30 domain experts' interviews and careful analysis of prevention and control documents, we constructed a comprehensive failure system for a model that identifies the potential risks for nosocomial COVID-19 infection in the hemodialysis room. Subsequently, a thorough risk assessment of the potential failure factors identified in our model was conducted. The failure key factors corresponding to the human element in medical waste (garbage) disposal (C2) are verified to be the highest risk factors. They are as follows: The cleaning staff did not dispose of different types of medical waste (garbage) (C21), did not wear masks according to the regulations (C22), and lacked knowledge and norms of nosocomial IPC (C23). This study provides valuable insights for hospital decision-makers on the potential failure factors related to COVID-19 infections in hemodialysis rooms. By working with hospital infection specialists, the suggested improvement measures can help reduce the risk of virus exposure among hospital medical staff, patients, and cleaning staff.

Efficacy of Structured Teaching Intervention on Knowledge Regarding Prevention of Nosocomial Infections among Nursing Students in University of Buraimi, Oman

Efficacy of Structured Teaching Intervention on Knowledge Regarding Prevention of Nosocomial Infections among Nursing Students in University of Buraimi, Oman

TRACKING OF MICROORGANISMS ON THE SURFACE AND IN SERVERS A THE PUBLIC HOSPITAL IN PALMAS-TO

Hospital infection (HI) is a public health problem in Brazil. Resistant bacteria increase the risk of superinfections and raise the number of deaths, factors that may be associated with failures in antiseptic and environmental disinfection processes, favoring cross-contamination. This study investigated the presence of microorganisms on hospital surfaces, on employees' hands and nostrils, and analyzed retrospective infections suspected of hospital infection at a Public Hospital in Palmas, TO. The results revealed the predominant presence of microorganisms of the genus Staphylococcus. The analysis indicated shortcomings in antiseptic and disinfection procedures, highlighting the urgent need for more rigorous biosafety measures. The research emphasizes the importance of appropriate antimicrobial protocols to prevent and treat Healthcare-Associated Infections (HAIs) and underscores the need for awareness and training of healthcare professionals. The study also points to the growing antimicrobial resistance and frequent identification of multidrug-resistant strains. These findings have significant implications for improving patient safety in hospital settings and provide a solid foundation for the development of effective strategies for the prevention and control of nosocomial infections, aiming to reduce the incidence of HI and enhance the quality of healthcare.

Implementasi Five Moment Hand Hygiene Pada Perawat Di Ruang Rawat Medikal Bedah Rumah Sakit Santa Elisabeth Medan

The prevalence of nosocomial infections worldwide has become a serious concern for healthcare professionals, especially in hospitals. One contributing factor is the inadequate implementation of the five moments hand hygiene in handwashing procedures that do not conform to operational procedure standards. The aim of this research is to determine how the implementation of the five moments hand hygiene among nurses in the surgical medical care ward at Santa Elisabeth Hospital in Medan. This study utilized a descriptive cross-sectional approach, employing observation sheets. The sample size included 30 nurses in the Surgical Medical Care Ward at Santa Elisabeth Hospital in Medan, using total sampling technique. The measurement tool was an observation sheet, and the data analysis employed univariate analysis. The research findings revealed that, in the first moment before patient contact, 56.7% of nurses did not adhere to the practice, while 43.3% did. In the second moment, before aseptic procedures, 56.7% of nurses did not comply, and 43.3% did. In the third moment, after exposure to patient body fluids, all nurses (100%) adhered to the practice. In the fourth moment, after patient contact, all nurses (100%) complied. In the fifth moment, after contact with the patient's environment, all nurses (100%) followed the practice. It is hoped that nurses can consistently implement the five moments hand hygiene to prevent disease transmission and nosocomial infections, fostering a habit of incorporating these practices into nosocomial infection prevention.

Knowledge, attitudes and practices of health care workers regarding the prevention of nosocomial infections in the ICU

Background: The aim of this study was to evaluate the knowledge, attitudes and practices of health care personnel regarding the prevention of nosocomial infections in the ICU. Methods: This was a cross-sectional, descriptive, study that took place in the intensive care units of two university hospitals of Yaoundé. Our study was conducted in two phases: the first phase consisted of the administration of an anonymous, self-administered questionnaire to the health care personnel who agreed to participate in the study, and the second phase permitted us to evaluate the personnel’s’ practices using the WHO model observation form. Data analysis was done using CS-Pro version 7.5, Microsoft® Office Excel 2013 and S.P.S.S. 21.0. Results: Our sample consisted of 60 practitioners. The sex-ratio was 0.54. The mean age was 38.35 ± 8.86 years. Most of the staff had been in the ICU for less than 5 years and only 35% of the staff had received at least one continuing education course on infection control measures. Good knowledge was found in 70% of the staff assessed, 60% had incorrect attitudes, and 63% had inadequate practices. The rate of compliance with good hygiene practices was 55.2%. Conclusion: Knowledge were mean, attitudes were wrong and practices were inadequate regarding the management of nosocomial infections in the ICU.

Application of list management mode in nosocomial infection prevention in the prosthodontics clinic

Application of list management mode in nosocomial infection prevention in the prosthodontics clinic

Epidemiology, risk factors, clinical presentation and complications of late-onset neonatal sepsis among preterm neonates in Cyprus: a prospective case-control study.

Late-onset neonatal sepsis (LOS) is common in preterm neonates, with increasing incidence in recent years. In the present study, we examined the epidemiology, clinical presentation, and complications of LOS in Cyprus and quantified possible risk factors for the development of this condition. The study subjects were preterm neonates admitted in the Neonatal Intensive Care Unit (NICU) of Archbishop Makarios III Hospital, the only neonatal tertiary centre in Cyprus. A prospective, case-control study was designed, and carried out between April 2017-October 2018. Depending on blood culture results, preterm neonates were classified as "Confirmed LOS": positive blood culture - microorganism isolated and LOS symptoms, "Unconfirmed LOS": negative blood culture and LOS symptoms, and "Controls" group: negative blood culture and absence of LOS symptoms. Comparisons between the 3 groups were performed and the associations between demographic, clinical and treatment characteristics with the likelihood of LOS were assessed using univariate and multivariate logistic regression. A total of 350 preterm neonates were included in the study and the incidence of LOS was 41.1%. 79 (22.6%) and 65 (18.6%) neonates were classified as "Confirmed LOS", and "unconfirmed LOS" cases respectively while 206 (58.9%) served as controls. The rate of confirmed LOS ranged from 12.2% in moderate to late preterm neonates to 78.6% in extremely preterm neonates. In the multivariate model, we demonstrated an independent association between LOS and duration of hospitalization (OR: 1.06, 95%CI: 1.01-1.10), duration of ventilation (OR: 1.23, 95%CI: 1.07-1.43) and necrotising enterocolitis (OR: 3.41, 95%CI: 1.13-10.25). The present study highlights the epidemiology of LOS in preterm neonates in Cyprus and its association with the duration of ventilation and hospitalization as well as with necrotizing enterocolitis. Establishment of protocols for the prevention of nosocomial infections during hospitalization in the NICUs and mechanical ventilation of preterm neonates is recommended.

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Nurse Determinants of the Incidence of Nosocomial Infections in Hospitals

Nosocomial infections significantly affect the patient's health and can increase morbidity and mortality. The incidence of nosocomial diseases is still widely found, and nurse compliance in preventing and controlling infections is a significant factor in preventing nosocomial infections. The study aims to analyze the determinants of nurses on the incidence of nosocomial diseases. The study used qualitative methods with total sampling techniques. The results of statistical tests were obtained on the variables sex value p = 0.256, age value p = 1.000, nutritional status p = 0.710, and invasive action p = 1.000. It can be concluded that there is no influence of intrinsic factors (age, sex, and nutritional status) on nosocomial infections, and extrinsic factors that significantly affect the occurrence of nosocomial diseases are antibiotics. While what has no effect is the use of invasive measures. This needs serious attention from nurses because prevention of nosocomial infections will be beneficial in reducing the morbidity rate that occurs in hospitals. Prevention of nosocomial diseases in hospitals can be done by minimizing the administration of invasive measures, especially in patients, increasing special attention to patients who receive invasive procedures, and increasing personal hygiene efforts

Analysis of Implementation of Infection Prevention and Control at Royal Prima Marelan General Hospital

Nosocomial infections or Healthcare-Associated Infections (HAIs) are a serious problem for global public health, including Indonesia. HAIs are infections experienced by patients during treatment and health care procedures ≥ 48 hours and ≤ 30 days after leaving the health facility. This study aims to analyze the implementation of infection prevention and control at the Royal Prima Marelan General Hospital. This research is a quantitative study with an observational analytical approach with a Cross Sectional Study design, namely in the form of data collection aimed at analyzing the implementation of infection prevention and control at the Royal Prima Marelan General Hospital for the period July to August 2023. The population in this study was 100 people who included hospital management who were considered competent in providing information. The population sample for this study that met the inclusion and exclusion criteria was 50 people. The results of bivariate analysis show that the variables related to infection prevention and control are knowledge, motivation, supervision and workload. The results of multivariate analysis show that the variable that partially influences the prevention and control of nosocomial infections in hospitals is knowledge.

Characterization of ESBL/AmpC-producing extraintestinal Escherichia coli (ExPEC) in dogs treated at a veterinary hospital in Brazil

The clinical aspects and lineages involved in Extraintestinal pathogenic Escherichia coli (ExPEC) infections in dogs remain largely unknown. In this study, we investigated the antimicrobial resistance and molecular structures of ExPECs isolated from infected dogs in Brazil. Samples were obtained from dogs (n = 42) with suspected extraintestinal bacterial infections. Phylogroup B2 was predominant (65.1%). No association was observed between the site of infection, phylogroups, or virulence factors. Almost half of the isolates (44.2%) were MDR, and 20.9% were extended-spectrum β-lactamase (ESBL)-positive. E. coli isolates that were resistant to fluoroquinolones (27.9%) were more likely to be MDR. The CTX-M-15 enzyme was predominant among the ESBL-producing strains, and seven sequence types were identified, including the high-risk clones ST44 and ST131. Single SNPs analysis confirmed the presence of two clonal transmissions. The present study showed a high frequency of ExPECs from phylogroup B2 infecting various sites and a high frequency of ESBL-producing strains that included STs frequently associated with human infection. This study also confirmed the nosocomial transmission of ESBL-producing E. coli, highlighting the need for further studies on the prevention and diagnosis of nosocomial infections in veterinary settings.

Moringa oleifera/chitosan-coated silk sutures for improved wound healing

The potential of Moringa oleifera/chitosan, as an antibacterial coating material on sutures against surgical infections, was studied. Chitosan and Moringa oleifera powder, obtained via standard extraction and drying procedure, were mixed in a 1:2 ratio to produce the polymer-based film. A silk braided suture was coated by chitosan and Moringa oleifera mixture employing an electrophoretic deposition technique. The amount of Moringa oleifera released by the coated sutures was analyzed by inductively coupled plasma-mass spectroscopy (ICP-MS) throughout the degradation process. The antibacterial potential of the Moringa oleifera-coated sutures was evaluated by antibacterial testing against E. coli and S. aureus. For biocompatibility/cytotoxicity analysis of the Moringa oleifera-coated sutures, the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium) assay was considered through an indirect testing approach. For this, an elution attained from the extraction of the sutures for 7 days was placed in a 3T3 fibroblast cell culture. The outcomes presented that Moringa oleifera-coated sutures did not develop any notable adverse effect. This was the first investigation on silk-braided sutures coated with Moringa oleifera as a prevention of nosocomial infections and promoting wound healing.

Evaluation of Education and Training in Good Hygiene Practices among Health Professionals: A Cross-Sectional Study in Moroccan Hospitals

The education and continued training of healthcare professionals in good hygiene practices (GHP) is a key element in the fight against the risk of infection in public hospitals. The aim of this study is to evaluate the education and training of healthcare workers in GHP. Method: A cross-sectional study was carried out at the Sidi Kacem provincial hospital center using a questionnaire validated by Cronbach's Alpha test with a score of 0.786 to collect a maximum of information. The Chi-square test was used to compare and correlate categorical variables. Any p-value less than 0.05 is considered statistically significant. Results: our study concerned 126 healthcare professionals, 84.1% of the professionals questioned showed that they had not received continuous training on hand washing, 96% of the professionals questioned expressed their need to receive training on wearing and changing gloves, 61.9% stated that they had not received training on the prevention of nosocomial infections. Females were more likely to wash their hands than males, with a significant p-value of p= 0.011. In terms of seniority, we found that care workers with more than 10 years' experience were more respectful of this washing than the other categories, with a p-value of p=0.024. Our results show that there is a huge lack of continuous training on GHP, which affects the quality of care at hospital level.
  
 Received: 16 August 2023 / Accepted: 27 September 2023 / Published: 5 November 2023

A novel RCA-based DNA sensor system for specific and quantitative detection of Klebsiella pneumonia

The timely detection of Klebsiella pneumoniae (K. pneumoniae) infection is of great importance for patient management and the prevention of nosocomial infections. In this study, we present the development of a novel detection assay that enables sensitive and specific identification of K. pneumoniae-encoded topoisomerase IV (K. pneumoniae Topo IV) using a DNA sensor system in combination with Rolling Circle Amplification (RCA) technology. The DNA sensor system was designed by immobilizing DNA hairpin substrates on RCA primers modified slide surface. This modular reacting mode enhances the adaptability and flexibility of the sensor, thereby improving its universality as a sensing platform. When K. pneumoniae is present, the active Topo IV triggers the cleavage-ligation of DNA hairpin substrates, followed by RCA and labeling with fluorescent probes. This results in the visualization of K. pneumoniae at the single-molecule level by the DNA sensor, compared to situations when there are no K. pneumoniae present. The reliability and sensitivity of the DNA sensor were verified using purified enzymes and bacterial extracts, which establishes the foundation for quantitative detection of clinical samples. Notably, the sensor's detection limit for K. pneumoniae extracts was found to be 70 colony-forming units (CFU)/µL, a range considered clinically relevant for infections. Moreover, the DNA sensor system exhibited high sensitivity and accuracy in detecting K. pneumoniae from clinical samples, suggesting its potential application in clinical settings for detecting pathogenic microbes beyond K. pneumoniae.

Construction and effect evaluation of a hierarchical training system for nosocomial infection based on hospitals at all levels

INTRODUCTION: Nosocomial infection is a critical global public health issue. The education of medical personnel can effectively enhance compliance with nosocomial infection protocols and reduce the incidence of such infections. However, the current training provided to third-party staff is inadequate, necessitating an urgent enhancement of their knowledge on nosocomial infection through effective and tailored training programs.
 OBJECTIVES: The objective is to establish a hierarchical training system for nosocomial infection, customized to meet the specific requirements of hospitals at all levels, and evaluate its efficacy.
 METHODS: A questionnaire survey was conducted among third-party staff members at hospitals of different levels to assess their understanding of nosocomial infection prevention measures. Based on the survey results, a hierarchical training system was developed for nosocomial infection among the participants. After the training, a post-training assessment was carried out to evaluate the participants' comprehension of nosocomial infections.
 RESULTS: A total of 561 third-party employees participated in the baseline hospital infection knowledge questionnaire. The baseline findings unveiled disparities in the extent to which third-party staff members across various tiers of medical institutions have mastered their knowledge on nosocomial infections. After undergoing hierarchical training, the deficiencies of hospitals at all levels have been rectified, thereby effectively enhancing the level of knowledge regarding nosocomial infections among third-party personnel. The results of multivariate analysis indicate that individuals with limited work experience should enhance their training in medical waste disposal and acquire a deeper understanding of personal protection measures related to nosocomial infections. Moreover, infrequent annual training sessions may impede the comprehension of nosocomial infection among third-party staff.
 CONCLUSION: The knowledge of hospital infection among third-party staff at all levels of medical institutions exhibits varying deficiencies. Implementing a hierarchical training approach is a meaningful strategy that effectively enhances the level of hospital infection knowledge among these staff members.

A pilot study comparing the disinfecting effects of commercialized stable ClO2 solution (free of activation) with conventional H2O2 on dental unit waterlines in the dental practice setting.

Disinfection of dental unit waterlines (DUWLs) plays a key role in control and prevention of nosocomial infection in a dental clinic. The most conventional disinfectant is hydrogen peroxide (H2O2), while chlorine dioxide (ClO2) has been considered however was limited by the "activation" procedures. With the availability of commercialized stable ClO2 solution (free of activation), direct application of ClO2 in the dental practice became possible. This study was designed to compare the disinfecting effects of stable 5 ppm of ClO2 solution with conventional 0.24% of H2O2 on DUWLs in dental practice. Studies of colony-forming units (CFUs), confocal laser scanning microscopy (CLSM) and scanning electron microscope (SEM) were employed for evaluation. In CFUs studies, we found that the efficiency of ClO2 was no less than those of H2O2. In the morphological studies, the stronger disinfecting effects of ClO2 was verified by both CLSM and SEM studies for removal and prevention of biofilm. Importantly, ClO2 solution achieved a better disinfecting efficiency not only at the surface of bacterial biofilm, but also, it has penetrating effects, presented disinfecting effects from the surface to the bottom of the biofilm. This pilot study provided evidence regarding the efficiency of stable ClO2 solution on disinfection of DUWLs in the dental practice setting. Application of stable ClO2 solution in dental practice is therefore become possible.

Effectiveness of an artificial intelligence-based training and monitoring system in prevention of nosocomial infections: A pilot study of hospital-based data.

This work describes a novel artificial intelligence-based training and monitoring system (AITMS) that was used to control and prevent nosocomial infections (NIs) by improving the skills of donning/removing personal protective equipment (PPE). The AITMS has two working modes, namely an AI-based protective equipment surveillance mode and an AI-based training mode, that were used for routine surveillance and training, respectively. Data revealed that the accuracy rate of donning/removing PPE improved as a result of the AITMS. Interestingly, the frequency of NIs decreased with the use of the AITMS. This study suggested the key role of using PPE in controlling and preventing NIs. Data preliminarily proved that appropriate donning/removing PPE may help to reduce the risk of NIs. In addition, the newest computerized technologies, such as AI, have proven to be useful in controlling and preventing NIs. These findings should helpful to formulate a better strategy against NIs in the future.

Prevention and control of nosocomial infection in a certain endoscopy center under the management of COVID-19 with measures against Class B infectious diseases

Prevention and control of nosocomial infection in a certain endoscopy center under the management of COVID-19 with measures against Class B infectious diseases

Dissemination and characteristics of carbapenem-resistant Klebsiella pneumoniae in nine district hospitals in southwestern China.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is epidemically transmitted globally, but few studies focused on the prevalence in district-level hospitals. In this study, we investigated CRKP strains collected from nine district hospitals from September 2019 to September 2020, aiming to determine the resistance mechanisms, virulence profiles, and molecular epidemiological characteristics of CRKP in district hospitals in Southwest China. A total of 51 CRKP strains were collected from 9 district-level hospitals. Matrix-assisted laser desorption/ionization-time of flight mass spectrometer was used for strain identification review, and the micro-broth dilution method was used for antibiotic sensitivity detection. Molecular epidemiological investigation of strains was performed by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) methods. PCR and efflux pump inhibition tests were used to detect CRKP resistance mechanisms. PCR and serum killing tests were used to detect capsular serotype, virulence-related genes, and virulence validation. The CRKP strains in district hospitals presented high levels of MIC50 and MIC90 in carbapenem antibiotics especially ertapenem and meropenem. A total of 90.2% (46/51) CRKP strains were detected as carbapenemase producers, and the proportion of strains co-expressing carbapenemases was 11.8% (6/51). All CRKP strains were grouped into eight MLST types, and ST11 was the most prevalent genotype. A total of 11.8% (6/51) CRKP isolates were positive for the string test, and three strains of hypervirulent and carbapenem-resistant K. pneumoniae (HV-CRKP) were positive in serum killing test. The molecular typing of all the CRKP isolates was grouped into 29 different PFGE patterns, and 40 ST11 isolates belonged to 20 different PFGE clusters. CRKP strains showed high-level antibiotic resistance and virulence phenotype in district hospitals in Southwest China, which suggested that we should immediately pay attention to the rapid dissemination of the CRKP in regional hospitals. Our study will provide new insights into the epidemiology of CRKP in regional hospitals, which will help regional hospitals develop nosocomial infection prevention and control policies tailored to local conditions.

Does Consciousness Level Determine the Timing of Successful Removal of Urinary Catheters at Neurosurgery Intensive Care Unit-Implication to Nosocomial Infection Prevention

Objective This study aimed to investigate whether the level of consciousness can be used as an indicator to determine the successful removal of urinary catheters in post-stroke patients admitted to the neurosurgical intensive care unit (NICU). Methods The study included 97 patients who had urinary catheters in NICU and were divided into three groups based on their level of consciousness. Our analyses was performed by various statistical methods, including the chi-square test, one-way ANOVA, univariate and multivariate regression. Results The overall success rate of catheter removal was found to be 62.9%. On average, the catheters were retained for 6.3 ± 3.6 days. The presence of diabetes mellitus was identified as the only factor that significantly influenced the successful removal of catheters (Adjusted Odds Ratio = 0.236, p = 0.035). No significant differences were observed among patients with different degrees of consciousness impairment. Implementing a nursing-driven circle strategy and bladder sonography scan protocol significantly could decrease the catheter-associated urinary infection (CAUTI) rate from 10.25/1,000 catheter days to 6.69/1,000 catheter days. Conclusions Based on our findings, we recommend removing urinary catheters five days after initial placement for patients with a Glasgow Coma Scale (GCS) score greater than eight and for non-intubated patients, as well as for intubated patients and aphasic patients in the NICU with a GCS score greater than 4. This protocol can potentially prevent CAUTI cases resulting from delayed UC removal