Hand Hygiene Research Articles

Impact of an electronic surveillance system on compliance with isolation precaution measures: an interrupted time series study

Background Electronic surveillance systems (ESSs) may assist infection prevention and control (IPC) teams in detecting and monitoring patients infected or colonised by pathogens to prevent healthcare-associated infections. We aimed to assess the impact of implementing an ESS on compliance with isolation precaution measures for bacterial infections or colonizations. Methods A quasi-experimental before-after study was conducted using interrupted time series analysis from 1 March 2018 to 31 July 2024 at the University Hospital of Nancy (France). The ESS was implemented in October 2022. The results of audits conducted by IPC nurses to investigate isolation measures for inpatients that required isolation precautions were aggregated monthly. Results 1379 audits were included in the study. The implementation of the ESS had no significant immediate impact on isolation measures, except for an increase in the presence of adequate hand hygiene products (+10.1%, p < 0.01). After the COVID-19 period, all isolation measures decreased. The implementation of the ESS was associated with positive changes in trends of isolation measures, particularly for the prescription of isolation precautions (+1.1%/month, p < 0.01), the isolation signage (+1.2%/month, p < 0.001), the hand hygiene products (+0.8%/month, p < 0.01), and full compliance with isolation measures (+1.1%/month, p < 0.0001). The audit rate significantly increased in the first 7 months of ESS use but then decreased. Conclusions The positive impact of ESS on compliance with isolation measures was likely due to the increased presence and communication of the IPC team in care wards, which was facilitated by the time saved in the surveillance and detection of carriers through the ESS.

Infection prevention and control and water, sanitation, and hygiene status of healthcare facilities in the Greater Kampala Metropolitan region during the COVID-19 pandemic in Uganda

Infection Prevention and Control (IPC) and Water Sanitation and Hygiene (WASH) are critical in preventing the spread of healthcare Associated Infections, including COVID-19. However, there was limited evidence on the status of IPC/WASH in healthcare facilities (HCFs) in Uganda amidst the COVID-19 pandemic which complicated IPC/WASH planning for the COVID-19 response. This study assessed IPC/WASH status for HCFs in the Greater Kampala Metropolitan Area (GKMA), during the COVID-19 pandemic, so as to inform programming and policy. A mixed methods cross-sectional study was conducted in 75 HCFs following the first wave of COVID-19 in Uganda. The mWater tool was used to collect quantitative data which were then analyzed into STATA version 16. A key informants’ guide was used to collect qualitative data, which was analyzed thematically and themes and quotes used to support the quantitative findings. Overall, 86.7% (65/75) of HCFs had an IPC committee and 72.3% (47/65) of these were functional. Besides, 90.7% (68/75) of the HCFs had an IPC focal person, and 49.3% (37/75) had a clear annual IPC activity plan. Unfortunately, only 32.3% (21/65) of the functional IPC committees received budgetary support for their activities. In terms of WASH infrastructure, 96.0% (72/75), 10.7% (8/75), 60.0% (45/75), and 22.7% (17/75) had access to a basic water service, a basic sanitation service, a basic hand hygiene service and a basic environmental cleaning respectively. Our study reveals that while most HCFs have IPC committees and focal persons, functional support remains limited, with half having a clear annual plan and less than a third receiving budgetary support. Nearly all HCFs have basic water services, but there are significant gaps in sanitation and environmental cleanliness domains. These findings highlight the urgent need for improved support and investment in IPC/WASH supplies and infrastructure to enhance infection control and public health outcomes in Uganda.

A STUDY ON BACTERIOLOGICAL PROFILE OF SURGICAL SITE INFECTION AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN AT A TERTIARY CARE HOSPITAL IN TIRUPATI

Objective: Surgical Site Infections (SSIs) are defined as infections apparent within 30days of an operative procedure and most often between the 5th and 10th postoperative days. It constitutes a major public health problem worldwide; It is one of the most common causes of nosocomial infection. They are responsible for increasing the treatment cost, length of hospital stays and significant morbidity and mortality. Despite the technical advances in infection control and surgical practices, SSI still continue to be a major problem, even in hospitals with most modern facilities. The present study conducted to isolate and identify microbes from pus samples collected from patients who were suspected for SSI and to determine their antimicrobial susceptibility profiles in a tertiary care hospital. Methods: This is a cross-sectional study conducted in the Department of Microbiology, Sri Venkateswara Medical College, Tirupati for a period of 6 mo. A total of 390 various clinical samples were collected and processed. Isolates were tested for antibiotic susceptibility by a Kirby-Bauer disk diffusion method. Results: Out of 390 pus/wound discharge samples processed, 132 (34%) samples were culture positive, among which 107 (81%) were Gram-negative bacilli and 25 (19%) were Gram-positive cocci. Male to female ratio was 2:1. Most common age group affected was&gt;50yrs. Predominant isolates were Klebsiella pneumoniae (73.47%) followed by Pseudomonas aeruginosa (26.53%) and Staphylococcus aureus (17.4%). Gram-negative bacilli showed maximum susceptibility to Imipenam, Piperacillin-Tazobactam and Amikacin and Gram-positive cocci showed 100% to Linezolid, Vancomycin. Conclusion: SSI remains to be a significant challenge for the surgeon’s inspite of sterile surgical techniques and prophylactic use of antibiotics. Hospital infection control measures like hand hygiene, strict adherence to pre-operative measures, rational use of antibiotics and establishing active surveillance can reduce the prevalence of SSIs.

The basis of bacteriological safety in the neonatal intensive care unit (literature review)

Background. According to world statistics, 7% of patients out of 100 in high-income countries and 15% of patients out of 100 in low- and middle-income countries develop infections related to medical care. As follows from the report of the World Health Organization, one in four cases of hospital sepsis that occurred in the intensive care unit is caused by hospital strains. On average, one in ten of these patients has a hospital-acquired infection that is fatal. The high-risk group includes patients in intensive care units, including newborns. In 2023, 28973 cases of neonatal infections (including intrauterine infection) were registered in medical organizations of the Russian Federation. The highest rates of neonatal morbidity were recorded in the Sverdlovsk Region (42.2%), the Trans-Baikal Territory (33.0%), the Novosibirsk Region (26.0%), the Chelyabinsk Region (22.4%), the Krasnoyarsk Territory (21.8%) and the Irkutsk Region (21.3%). Thus, infection prevention and control strategies aimed at both patients and their environment are of paramount importance in neonatal intensive care units.Objective. To summarize current relevant data on the prevention of hospital infections in neonatal intensive care units.Materials and methods. A literature review was conducted using the MEDLINE database (PubMed) as of December 2024 using keywords and a filter: randomized controlled trial, meta-analysis, systematic review.Results. This review summarizes the main data on the prevention of hospital infections in neonatal intensive care units. According to the literature, ensuring bacteriological safety in relation to the development of hospital infections depends on many factors: hand hygiene of medical personnel, organization of venous access control, disinfection of medical equipment and premises, compliance with the rules of asepsis and antiseptics when performing invasive manipulations, the introduction of modern approaches in the care of premature infants.Conclusion. There are many tasks in the intensive care unit that require innovative strategies to ensure the safe care of premature newborns. Joint efforts to standardize the processing of specialized equipment, maintain the cleanliness of the environment, comply with vascular access care protocols, adequate hand hygiene, and the active introduction of parents into newborn care are an integral part of the program aimed at preventing nosocomial infections. Active cooperation between the neonatal intensive care unit and the epidemiological service of the institution will allow us to develop a rational policy for risk management and monitoring of hospital infections.

Analysis of the Effect of the Head of Room's Leadership Style and Nurse's Hand Hygiene Compliance on the Prevention of Nosocomial Infections in Hospital

This study aims to analyze the influence of the leadership style of the head of the room and nurses' handwashing compliance on the prevention of nosocomial infections in hospitals—quantitative research with a survey approach involving 123 respondents with a proportional random sampling method. Data acquisition was done using a questionnaire instrument to measure the perception of leadership style, compliance, and prevention of nosocomial infections, and it was analyzed using a correlation test. The results of the T-test showed a Sig. Value of 0.001 &lt;0.05, and the F test showed a Sig. Value of 0.002 &lt;0.05 with a calculated F value of 41.437 indicating a significant influence between the leadership style of the head of the room and handwashing compliance on the prevention of nosocomial infections. This study concludes that the leadership style of the head of the room and nurses' hand hygiene compliance plays an important role in efforts to prevent nosocomial infections.

Production Jelly Candy and Soap derived from marine seaweed for health branding and community empowerment in Mojokerto East Java

In this PKM program, our partner is residents in Mojokerto, Surabaya, East Java, Province. This community has generated the production of jelly candy and natural soap derived from marine seaweed. Seaweed processing has a very broad market potential due to the increasing demand and use of seaweed processing products, both in the fields of food, health, cosmetics, pharmaceuticals or industry. Seaweed development with an industrial concept approach that starts from upstream, processing basic products into formulated products with a lot of derivative products, both food and non-food products. In food ingredients, seaweed can be formulated into jelly candy that is in great demand from children to adults. In pharmaceutical grade, it can be formulated into cosmetics such as natural soap. Based on interviews and observations in the field, there are 3 main focuses of the problems currently faced by partners, namely: 1) lack of knowledge about seaweed, 2) seaweed application for food and non-food and 3) the packaging of product. Some of the things planned by the PKM team are innovating seaweed to be jelly candy and natural soap. The purpose of this activity is to provide knowledge and understanding of the diversification of processed seaweed products for both food and non-food purposes, which is expected to provide benefits in terms of increasing the added value of seaweed, awareness of hand washing hygiene, empowering women and at the same time increasing community income. This activity was realized with an approach in the form of making a sustainable cooperation program until the end of PKM, creating a family atmosphere between the two and understanding that the problems experienced were a shared problem so that they could be solved together according to the level of responsibility to achieve the expected benefits, namely increased yields, production and productivity and competitiveness, independence and welfare of the community.

Beyond BMI: Exploring Adolescent Lifestyle and Health Behaviours in Transylvania, Romania

Background/Objectives: This study aimed to investigate the lifestyle and the behavioral factors that influence the nutritional status of adolescents from Transylvania, Romania. Methods: The Global School-Based Student Health Survey (GSHS) was used to collect data from 900 adolescents between 11 and 18 years old from the Transylvania region, Romania. This study assessed nutritional status by calculating BMI indicators adjusted to Z-Score, cut-off points according to the World Health Organization (WHO), using self-reported weight and height; perceived health status; food vulnerability; physical activity; addictive behaviors (cigarette, alcohol and drug consumption); number of hours spent in front of the computer/phone; hand and oral hygiene; sitting time/day; and sleep. Multivariate logistic regression was used to establish the lifestyle factors that influenced nutritional status. Results: The results showed that 8.7% (n = 78) of girls and 15.2% (n = 137) boys were overweight and obese. In total, 75% of the respondents were engaged in sedentary behaviors, and 65.8% (n = 592) had more than 2 h/day of screen exposure, considering that 98.7% of the study population had a mobile phone. The Romanian adolescents had poor dietary behaviors: over 80% of them did not meet the recommended amount of vegetable and fruit intake per day. Increased BMI was associated with higher-strength physical exercise and with being a boy. Conclusions: While some positive trends are evident, such as good oral and hand hygiene and low prevalence of smoking and drug use, significant challenges remain in areas like nutrition, physical activity, alcohol consumption and screen time.

Ultraviolet-C-based sanitization is a cost-effective option for hospitals to manage health care-associated infection risks from high touch mobile phones

Mobile phones have become essential tools for health care workers around the world, but as high touch surfaces, they can harbor microorganisms that pose infection risks to patients and staff. As their use in hospitals increases, hospital managers must introduce measures to sanitize mobile phones and reduce risks of health care-associated infections. But such measures can involve substantial costs. Our objective in this paper was to consider two mobile phone risk mitigation strategies that managers of a hypothetical hospital could implement and determine which involves the lowest cost. The first strategy required all staff to sanitize their hands after every contact with a mobile phone. The second involved the hospital investing in ultraviolet-C-based mobile phone sanitization devices that allowed staff to decontaminate their mobile phones after every use. We assessed each intervention on material and opportunity costs assuming both achieved an equivalent reduction in microbe transmission within the hospital. We found that ultraviolet-C devices were the most cost-effective intervention, with median costs of approximately AUD360 per bed per year compared to AUD965 using hand hygiene protocols. Our results imply that a 200-bed hospital could potentially save AUD1–1.4 million over 10 years by investing in germicidal ultraviolet-C phone sanitizers rather than relying solely on hand hygiene protocols.

Epidemiological Analysis of a K. pneumoniae NDM Outbreak in a Temporary Ward for Patients with Primary COVID-19 Infection

The COVID-19 pandemic made the medical community realize how large a problem it would face. The epidemiological situation forced the opening of additional wards, the so-called “COVID wards”, where an increase in the rate of coexisting bacterial infections was observed. We report a hospital outbreak due to New Delhi carbapenemases producing K. pneumoniae clones. Twenty-eight K. pneumoniae strains were analyzed from patients with primary COVID-19 infection. The drug susceptibility of the strains was determined by the diffusion–circulation method and E-test. Phenotypic and PCR methods confirmed the production of carbapenemases. The phylogenetic similarity of the obtained strains was examined using pulsed-field electrophoresis. Most strains were isolated from bronchoalveolar lavage. All isolates obtained were resistant to β-lactams and fluoroquinolones. All strains produced New Delhi carbapenemases and were classified into two genetic clusters, A and B. Eight risk factors for secondary bacterial infection were analyzed. Following an intervention involving hand hygiene, strict contact prevention, and cleaning of the hospital environment and medical devices, this outbreak was successfully brought under control.

Using electronic medical records in hospital simulation for infection control intervention assessment.

Clinical trials for assessing the effects of infection prevention and control (IPC) interventions are expensive and have shown mixed results. Mathematical models can be relatively inexpensive tools for evaluating the potential of interventions. However, capturing nuances between institutions and in patient populations have adversely affected the power of computational models of nosocomial transmission. In this study, we present an agent-based model of ICUs in a tertiary care hospital, which directly uses data from the electronic medical records (EMR) to simulate pathogen transmission between patients, HCWs, and the environment. We demonstrate the application of our model to estimate the effects of IPC interventions at the local hospital level. Furthermore, we identify the most important sources of uncertainty, suggesting areas for prioritization in data collection. Our model suggests that the stochasticity in ICU infections was mainly due to the uncertainties in admission prevalence, hand hygiene compliance/efficacy, and environmental disinfection efficacy. Analysis of interventions found that improving mean HCW compliance to hand hygiene protocols to 95% from 70%, mean terminal room disinfection efficacy to 95% from 50%, and reducing post-handwashing residual contamination down to 1% from 50%, could reduce infections by an average of 36%, 31%, and 26%, respectively. In-silico models of transmission coupled to EMR data can improve the assessment of IPC interventions. However, reducing the uncertainty of the estimated effectiveness requires collecting data on unknown or lesser known epidemiological and operational parameters of transmission, particularly admission prevalence, hand hygiene compliance/efficacy, and environmental disinfection efficacy.

Water, sanitation, and hygiene among transgender population living in urban informal settlements: a qualitative study in Odisha, India

Background Access to safe drinking water, sanitation, and hygiene (WASH) is recognized as a fundamental human right. However, transgender people residing in low-resource settings such as urban slums encounter unique challenges in accessing WASH facilities. Aims To explore the WASH-related issues and health outcomes associated with these challenges among transgender people living in urban informal settlements in India. Materials and Methods A qualitative phenomenological approach was employed, involving in-depth interviews with 24 transgender people residing in urban informal slums in Odisha, India. The interviews were digitally recorded, transcribed, translated and analyzed using the thematic analysis methods. Results The findings reveal that transgender people faced significant challenges in accessing adequate sanitation facilities. Many of them used inadequate toilet facilities due to sex segregation, which exposed them to harassment and discrimination. Moreover, transgender people who engaged in sex work faced heightened risks of infections due to risky sexual practices driven by economic necessity and the need for gender validation. Despite these obstacles, transgender people have mobilized nonprofit organizations to address these issues comprehensively, prioritizing health and overall well-being. Conclusion The study underscores the critical need for improving sanitation infrastructure, regular maintenance, and comprehensive hygiene education tailored to the specific needs of transgender people. Efforts should prioritize enhancing sanitation facilities and promoting hygiene practices to mitigate health risks effectively. Additionally, awareness and education programs focusing on various aspects of hygiene, including hand hygiene, oral hygiene, and peri-anal hygiene, are essential to promote better health outcomes within the transgender community.

Analysis The Implementation of Healthy Canteens Elementary Schools in The Working Area Paal V Health Center, Jambi City

Background: Every child has the right to receive education in a healthy environment in accordance with the 1945 Constitution Article 31 paragraph 1. The health of the school environment, especially the existence of a healthy canteen, is an important component in supporting student growth and development. This study aims to analyze the implementation of healthy canteens in elementary schools in the working area of the Paal V Health Center in Jambi City. Methods: This study is a qualitative study with an analytical descriptive approach. Research data was collected through in-depth interviews, FGDs, observations, and documentation, with informants consisting of school principals, health center staff, teachers, canteen sellers, and students. Results: At SDN 64/IV Jambi City, there is a written policy regarding school healthy canteens. The average canteen handler has used an apron as personal protective equipment (PPE) and maintained hand and clothing hygiene. School canteen facilities are equipped with adequate lighting and the availability of clean water. However, it is still found that plastic containers are used for food containers. The informants agreed that the existence of healthy canteens in schools is very important and suggested that canteens only sell food that is filling and free from harmful chemicals. Conclusion: Schools with higher accreditation have better canteen management than schools with lower accreditation, especially in policies, facilities, and supervision.

REVIEW OF PHARMACOLOGICAL INTERVENTIONS FOR THE PREVENTION OF HEALTHCARE-ASSOCIATED INFECTIONS 2025

Healthcare-associated infections (HAIs) are a significant threat to patient safety, contributing to increased morbidity, mortality, and healthcare costs globally. Pharmacological interventions are pivotal in preventing HAIs and addressing antimicrobial resistance. Objective: This narrative review explores key pharmacological strategies for preventing HAIs, including prophylactic antibiotics, antimicrobial stewardship programs (ASPs), infection prevention bundles, and innovative approaches like probiotic cleaning systems. Methods: The review synthesizes recent literature on established and emerging HAI prevention strategies, evaluating their efficacy, challenges, and applicability across diverse healthcare settings. Results: Prophylactic antibiotics are highly effective in reducing surgical site infections when used judiciously, while ASPs optimize antibiotic use and combat resistance. Infection prevention bundles, incorporating evidence-based practices like hand hygiene and catheter care, significantly lower bloodstream infection rates. Innovative approaches, such as probiotic cleaning systems, offer sustainable solutions to reduce environmental contamination. However, challenges remain, including variable adherence to protocols, resource constraints, and the need for scalable solutions in low-resource settings. Conclusion: Pharmacological interventions, when integrated with multidisciplinary approaches, are crucial for reducing HAI rates and improving patient outcomes. Future research should focus on scalable innovations and context-specific strategies to enhance infection prevention globally. Keywords: Healthcare-associated infections, Antimicrobial stewardship, Prophylactic antibiotics, Infection prevention bundles, Multidrug resistance, Patient safety.

Visualizing the WHO "My Five Moments for Hand Hygiene," Framework: A Virtual Reality Training Program for Improving Hand Hygiene Adherence Among Nurses.

Healthcare-associated infections (HAIs) contribute to patient morbidity and mortality. Hand hygiene is essential for preventing HAIs, but training can fail to transfer to clinical practice. Experiential learning through virtual reality (VR) may improve adherence by offering realistic practice opportunities and feedback. We developed and evaluated a VR-based training program that uses the World Health Organization's (WHO) "My Five Moments for Hand Hygiene" framework to provide feedback about pathogen transmission and hand hygiene adherence in four clinical scenarios. Sixty-eight registered nurses from four hospitals in the United States completed the VR training program. Using the Theory of Planned Behavior, we assessed behavioral determinants (intention, attitudes, subjective norms, and perceived behavioral control [self-efficacy]) of hand hygiene adherence pre-, midway, and post-training. We also measured overall adherence to the Five Moments in each scenario. From the beginning to the end of the training program, self-efficacy scores and overall hand hygiene adherence in VR increased linearly by 11% (p = 0.02) and 68% (p <.001), respectively. Our findings support VR as an educational tool for enhancing hand hygiene practices of HCWs. Future research should assess the transfer of training to clinical settings and its impact on real-world adherence and HAIs.

Enhancing Infection Control in ICUS Through AI: A Literature Review.

Infection control in intensive care units (ICUs) is crucial due to the high risk of healthcare-associated infections (HAIs), which can increase patient morbidity, mortality, and costs. Effective measures such as hand hygiene, use of personal protective equipment (PPE), patient isolation, and environmental cleaning are vital to minimize these risks. The integration of artificial intelligence (AI) offers new opportunities to enhance infection control, from predicting outbreaks to optimizing antimicrobial use, ultimately improving patient safety and care in ICUs. The primary objectives are to explore AI's impact on predicting HAIs, real-time monitoring, automated sterilization, resource optimization, and personalized infection control plans. A comprehensive search of PubMed and Scopus was conducted for relevant articles up to January 2024, including case series, reports, and cohort studies. Animal studies and irrelevant articles were excluded, with a focus on those considered to have significant clinical relevance. The review highlights AI's prowess in predicting HAIs, surpassing conventional methods. Existing evidence demonstrates AI's efficacy in accurately predicting and mitigating HAIs. Real-time patient monitoring and alert systems powered by AI are shown to enhance infection detection and patient outcomes. The paper also addresses AI's role in automating sterilization and disinfection, with studies affirming its effectiveness in reducing infections. AI's resource optimization capabilities are exemplified in ICU settings, showcasing its potential to improve resource allocation efficiency. Furthermore, the review emphasizes AI's personalized approach to infection control post-procedures, elucidating its ability to analyze patient data and create tailored control plans.

Improved water, sanitation, hygiene and waste services in health-care facilities, Ukraine.

Water, sanitation and waste infrastructure and services in Ukrainian health-care facilities often fail to meet global and national standards, hindering the provision of safe, quality care. The war has worsened existing problems. To incrementally improve water, sanitation, hand hygiene, environmental cleaning and health-care waste practices, the World Health Organization (WHO) is working with the health ministry, the Ukrainian Public Health Centre and regional United States Centers for Disease Prevention and Control (CDC) to implement the Water and Sanitation for Health Facility Improvement Tool (WASH FIT). In December 2022, WHO trained staff from the regional CDC, Ukrainian Public Health Centre and nine priority health-care facilities. Facility teams assessed services, and developed and implemented improvement plans in January 2023. Follow-up assessments were conducted after six months. About 4300 health-care facilities operate in Ukraine. Funding for new water and sanitation infrastructure, as well as operating and maintaining existing services, is likely inadequate. After implementation, the average WASH FIT score increased from 66 out of a maximum of 100 (range: 57-73) to 83 (range: 69-93). Facilities more effectively managed water-related risks, replaced broken taps, improved waste management practices and installed backup water supply and storage sources. WASH FIT can be used to identify gaps in water, sanitation, hygiene and waste services and track progress towards addressing these gaps. Engaged local leaders, health-based national water, sanitation, hygiene standards, regular on-site training and mentoring drive these improvements. Strengthening public health entities is critical to institutionalize the process.

Should We Be Resurrecting the Handshake?

The simple handshake has been around for more than 3,000 years as a sign of friendship and as an indication that neither party is carrying a weapon. The physician-patient relationship often begins with a traditional handshake. Hand hygiene is an integral part of patient encounters to reduce the spread of infectious diseases; however, many physicians and allied health providers believe taking a break for hand hygiene interrupts the natural flow of the initial introduction and nonverbal body trust-inducing language. The elimination of the handshake may allow providers to focus on more culturally acceptable universal verbal and nonverbal communication skills that help us build essential trust with our patients. Yet, research indicates that handwashing reduces hospital-acquired infections, so it stands to reason that it should be integral to every patient visit.

Complications and Prevention in the Use of Central Venous Catheter: A Nursing Approach

Introduction: Hospital acquired infections represent a serious problem for healthcare systems, increasing morbidity, mortality and healthcare costs. According to the World Health Organization, up to 15% of patients in low- and middle-income countries contract infections during hospitalization, highlighting the need for preventive measures. Central Venous Catheters (CVC), although indispensable in the management of critically ill patients, are associated with infectious complications that constitute 14% of nosocomial infections, mainly bacteremia and sepsis.Development: CVCs are medical devices designed to administer substances directly into the bloodstream, being essential in treatments such as transfusions, parenteral nutrition and administration of irritant drugs. However, their use can generate mechanical, infectious and thrombotic complications. These complications are often associated with the lack of standardized protocols, inadequate biosafety practices and insufficient training of healthcare personnel. The review highlighted that infections are preventable through aseptic techniques, such as hand washing, use of sterile barriers, and proper cleaning of the insertion site and catheter connections.Conclusions: Successful prevention of complications associated with CVCs requires a multidisciplinary approach that includes ongoing staff training, implementation of evidence-based protocols, and use of monitoring tools such as checklists. These strategies not only ensure patient safety, but also reduce costs and improve clinical outcomes. The adoption of these practices is essential to optimize the quality of care in critically ill patients

Occurrence of multi-antibiotic resistant bacteria isolated from food handlers’ hands and utensils at different restaurants in Dhaka, Bangladesh

Restaurant customers consume food contaminated by germs, increasing the risk of foodborne disease. In this investigation, food handlers’ hands and utensils from many restaurants near Sadarghat launch station in Dhaka, Bangladesh, were tested to determine bacterial contamination incidence. Standard procedures were followed in isolation and identification of bacterial isolates. Of the 60 analyzed swabs, 46.7% showed a positive culture for one or more potential bacterial contaminants. The occurrence of Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Vibrio cholerae in the hands of food handlers was 50%, 33.4%, 33.4%, and 23.4%, respectively, and those in utensils was 33.4%, 16.7%, 16.7%, and 10%, respectively. The majority of tested isolates of P. aeruginosa (100%) showed the highest resistance phenomenon to ampicillin and tetracycline, V. cholerae (100%) to ampicillin, E. coli (80%) to ampicillin and streptomycin, and S. aureus (100%) to ciprofloxacin. All of the examined isolates of P. aeruginosa were found to be most sensitive to piperacillin-tazobactam, E. coli to imipenem and nitrofurantoin, S. aureus to gentamicin, amikacin, tetracycline and chloramphenicol, and V. cholerae to piperacillin-tazobactam, imipenem and amikacin. Remarkably, 100% of V. cholerae isolates were multidrug-resistant (MDR), with the highest multiple antibiotic resistance index (MARI) score of 0.428. Among the examined isolates, 75% of bacterial isolates showed MDR phenotype, while 90% of isolates recorded a MARI value greater than 0.2. Due to the increased risk of food contamination or cross-contamination from food handlers' hands and utensils, the findings of this study indicate that restaurant hygiene standards are inadequate and might have detrimental effects on the general public's health. Consequently, this highlighted the significance of further training to enhance food workers' understanding of proper hand-washing techniques.

Knowledge and occupational practices of beauticians and barbers in the transmission of viral hepatitis: A mixed-methods study in Volta Region of Ghana.

Hepatitis B and C viral (HBV and HCV) infections are endemic in Ghana. Also, the National Policy on Viral Hepatitis stipulates that there is unreliable data, limited knowledge, and a deficiency in research on viral hepatitis, especially among some high-risk workers in the eastern part of the country. This study therefore assessed the knowledge level and occupational practices of street beauticians and barbers in the transmission of HBV and HCV in the Volta Region of Ghana. A cross-sectional mixed methods study was conducted in Volta Ghana from April to June 2021. An in-depth interview was used to collect data from five environmental health officers who were selected as key informants in the qualitative stage. Structured questionnaires/checklists and direct observations were employed to collect data from 340 street beauticians and barbers in the quantitative stage. During the qualitative stage, the process of coding, and mind mapping via thematic analysis was carried out. Furthermore, descriptive and inferential analyses were performed using Stata version 17.0 at a 95% significance level in the quantitative stage. Most street beauticians and barbers reported poor knowledge levels about HBV and HCV (67.0%), although the awareness of this viral hepatitis was high (88.2%). While almost one-third of the participants observed safe occupational practices (31.5%), about 29.0%, 49.4%, and 55.3% of them also followed hand hygiene protocols, wore protective clothes/gloves, and sterilized or disinfected tools after use respectively. Street beauticians and barbers with higher (tertiary) education (AOR = 6.15; 95%CI = 1.26-29.9; p = 0.024), those who had heavy workload of more than 20 customers per day (AOR = 3.93; 95%CI = 1.26-12.3; p = 0.019), and those who had work experience of at least four years (AOR = 1.65; 95%CI = 1.02-2.69; p = 0.040) were more likely to have good knowledge level about viral hepatitis. Additionally, beauticians were more likely to adhere to safe occupational practices as compared to barbers (AOR = 11.2; 95%CI = 3.46-36.3; p<0.001). The key informant interviews revealed that there was a lack of licensing, monitoring, and planned training for street beauticians and barbers, although their services are rampant in the Volta Region. Participants showed high awareness but limited knowledge about HBV and HCV infections. The general safety practices among the participants were poor. Our study results suggest possible viral transmission through the activities of street beauticians and barbers which could be attributed to the lack of regulatory systems and training of these cosmetologists. Policy-makers and regulatory bodies should institute and enforce rigorous policies and guidelines on job-related safety measures and health practices including regular training, monitoring, screening, and vaccination programs for these high-risk community workers in Ghana.