Risk Of Hospitalized Infection Research Articles

Improving patient compliance for intravitreal injections during the COVID-19 pandemic

Purpose: Intravitreal injections (IVT) of anti-vascular endothelial growth factor are standard treatment procedures in ophthalmology for many retinal diseases. We conducted a full-cycle clinical audit to evaluate patient compliance with IVT in Penang Hospital during the COVID-19 pandemic. Study design: Full cycle audit. Methods: A 3-month audit was carried out on patients scheduled to receive IVT in the operation theatre between August and October 2019 (COVID-19 pre-pandemic period). Patient compliance rates were calculated. We set a target of 95% patient compliance rate. Interventional steps taken to improve compliance were carried out from April 2020 to September 2021 (during the Movement Control Order period). A 3-month re-audit was conducted between October and December 2021. Results: A total of 481 patients were scheduled for IVT, and 50 patients (10.4%) did not present to the appointment. The compliance rate was 89.6%. The reasons for defaulting treatment included multiple hospital visits, transportation issues, cost of transportation, loss of daily wages, and fear of COVID-19 infection. Post-intervention, a total of 895 patients were scheduled for IVT in 3 months. Among these patients, 844 patients completed their IVT appointment, while 51 patients missed the scheduled IVT. The patients’ compliance rate also rose from 89.6% to 94.3%. There was also an increase of 87.1% in the total number of scheduled IVT as compared to the pre-intervention phase. Conclusion: These interventions not only increased the number of patients receiving treatment but also improved patients’ compliance with IVT despite the COVID-19 pandemic. Patients benefited from reduced hospital visits, the cost of follow-up, and the risk of hospital infection.

Risk of hospitalized infections in older elderly patients with rheumatoid arthritis treated with tocilizumab or other biological/targeted synthetic disease-modifying antirheumatic drugs: Evaluation of data from a Japanese claims database.

We compared the incidence rates of hospitalized infections (HIs) between tocilizumab (TCZ) and other biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults aged ≥75 years with rheumatoid arthritis (RA). We used a Japanese claims database from Medical Data Vision Co., Ltd (Tokyo, Japan) to perform a retrospective longitudinal population-based study in patients with RA who were prescribed b/tsDMARDs between 2014 and 2019. We calculated adjusted risk ratios (aRRs) for HIs in three age groups (<65, ≥65 and <75, and ≥75 years). Of 5506 patients, 2265 (41.1%) were <65 years, 1709 (31.0%) were 65-74 years, and 1532 (27.8%) were ≥75 years. Crude incidence rates (/100 person-years) of HIs were 3.99, 7.27, and 10.77, respectively. In the oldest group, aRRs (95% confidence interval) for HIs (b/tsDMARDs versus TCZ) were as follows: etanercept, 2.40 (1.24-4.61); adalimumab, 1.90 (0.75-4.83); golimumab, 1.21 (0.66-2.23); and abatacept, 0.89 (0.49-1.62). In the other age groups, the noticeable difference was a lower aRR of etanercept versus TCZ in the youngest group (0.30, 0.11-0.85). In patients with RA aged ≥75 years, b/tsDMARDs have a similar risk of HIs to tocilizumab except for etanercept.

Impact of ATP Bioluminescence Cleaning Verification System on Rates of Infection and Fecal Colonization in a Burn Unit of Tertiary Care Hospital in Egypt

Contaminated surfaces increase the risk of hospital infections. Traditional hospital cleanliness monitoring has become insufficient. ATP bioluminescence is a developed monitoring tool with limited clinical data in healthcare settings. Therefore, the current work aims to study the impact of the ATP monitoring tool on wound infection rates and fecal colonization among burn patients. The study was designed over two phases. Phase I involved conventional cleaning monitoring by visual inspection, while phase II involved the ATP bioluminescence tool. In both phases, clinical and environmental swabs were collected for microbial culture and identification. Gram-negative bacteria were screened for carbapenem resistance. Among the five selected cases, MALDI-TOF and Vitek2 were utilized to test for phenotypic relatedness between common isolates from different clinical and environmental sources. The wound infection rate was significantly reduced from 23% in phase I to 8% in phase II (p-value &lt;0.005). Fecal colonization by CR bacteria demonstrated 7% and 14% in phase I and phase II, respectively. Environmental culture demonstrated significantly decreased microbial isolation rates from 37% (phase I) to 10% (phase II) (p-value&lt;0.001) with a non-significant decrease in CR bacteria. Total pass and failed cleaning rates for ATP bioluminescence were 70.9% and 6.08%, respectively. Common isolates in 3 cases exhibited a similarity of &gt;65% by MALDI-TOF and the identical resistance phenotypes by Vitek2. The ATP bioluminescence cleaning verification system has been proven a rapid and objective tool that positively impacts microbial isolation rates from clinical and environmental samples.

Infection Control Risk Assessment Incidence of Infection at PKU Muhammadiyah Gamping Hospital

Background: The risk of infection in hospitals is a significant problem worldwide because it can prolong the length of patient care days and can cause patient death. Indonesia is one of the countries that have a high prevalence of infection, regarding several factors that influence the incidence of infection, and risk management to maintain the stability of the incidence of HAIs so that it does not increase by using ICRA tools which can later occur in every hospital unit. Methods: This research uses exploratory descriptive studies with quantitative and qualitative approaches. The number of informants was as many as 9 people consisting of leaders and employees, and a sample of 78 patients with purposive sampling technique. The research instrument is infection risk assessment data, interview guidelines and document review. Data analysis is descriptive analysis related to the incidence of infection and qualitative analysis. Results: The incidence of infection at PKU Muhammadiyah Yogyakarta Hospital in 2020 was phlebitis cases with a prevalence of 3.19% and a prevalence of SSI cases of 0.93%. The risk factors for the infection that occur in its application are the incidence of infection, namely service procedure factors, nursing factors and patient factors. Conclusion: The incidence of infection is relatively high, the workforce can increase awareness, knowledge, and competence of the workforce in carrying out service actions, management can carry out regular monitoring and evaluation, provide adequate tools, and provide regular training.

Risk of air and surface contamination of SARS-CoV-2 in isolation wards and its relationship with patient and environmental characteristics

Air and surface contamination of the SARS-CoV-2 have been reported by multiple studies. However, the evidence is limited for the change of environmental contamination of this virus in the surrounding of patients with COVID-19 at different time points during the course of disease and under different conditions of the patients. Therefore, this study aims to understand the risk factors associated with the appearance of SARS-CoV-2 through the period when the patients were staying in the isolation wards. In this study, COVID-19 patients admitted to the isolation wards were followed up for up to 10 days for daily collection of air and surface samples in their surroundings. The positivity rate of the environmental samples at different locations was plotted, and multiple multi-level mixed-effect logistic regressions were used to examine the association between the positivity of environmental samples and their daily health conditions and environmental factors. It found 6.6 % of surface samples (133/2031 samples) and 2.1 % of air samples (22/1075 samples) were positive, and the positivity rate reached to peak during 2–3 days after admission to the ward. The virus was more likely to present at bedrail, patients’ personal items and medical equipment, while less likely to be detected in the air outside the range of 2 m from the patients. It also revealed that higher positivity rate is associated with lower environmental temperature, fever and cough at the day of sampling, lower Ct values of latest test for respiratory tract samples, and pre-existing respiratory or cardiovascular conditions. The finding can be used to guide the hospital infection control strategies by identifying high-risk areas and patients. Extra personal hygiene precautions and equipment for continuously environmental disinfection can be used for these high-risk areas and patients to reduce the risk of hospital infection.

Outpatient Care and Short Hospitalization for the Elderly Patient with Inguinal Hernia

Introduction: The surgery of hernial disease of abdominal wall and especially of the inguinofemoral hernia has increase but in fact its prevalence is unknown. The objective of present study was to assess the result of surgical treatment of the inguinofemoral region hernia in third-age patients seen in the "Dr. Enrique Cabrera" Teaching General Hospital. Methods: A study was conducted in 2186 third-age patients operated on of inguinofemoral hernia from January, 2000 to December, 2020 in the above mentioned hospital. In all cases patients had the alternative to be operated on in ambulatory way or with a short hospital stay. Also, were included the patients operated on as an urgency. From the patients operated on in an elective way were excluded those suffering of associated, cardiopulmonary or thromboembolic ASA-III type diseases (classification of the American Society of Anesthesiology). Results: The great incidence of the inguinal hernia was found in ages from 60-69 years (59,3%). The indirect right inguinal hernia was the more frequent. The Desarda's anatomical surgical technique was the more applied one in the inguinal hernia and theLichtenstein's prosthetic technique with the 32% was the following in frequency. There were 20 relapses (0,9%). Local anesthesia was applied in the 75,4% of patients, in ambulatory way in the 76,4%. The total of complications was of 78 (7,1%). Conclusions: The surgical treatment of inguinofemoral hernias, ambulatory or with a short hospital stay is a suitable procedure in third-age patients since to increase the comfort of patients, to decrease the hospital infection risk, to reduce the waiting lists and the hospital costs.

Strong Antibacterial Properties of Cotton Fabrics Coated with Ceria Nanoparticles under High-Power Ultrasound.

Flexible materials, such as fabric, paper and plastic, with nanoscale particles that possess antimicrobial properties have a significant potential for the use in the healthcare sector and many other areas. The development of new antimicrobial coating formulations is an urgent topic, as such materials could reduce the risk of infection in hospitals and everyday life. To select the optimal composition, a comprehensive analysis that takes into account all the advantages and disadvantages in each specific case must be performed. In this study, we obtained an antimicrobial textile with a 100% suppression of E. coli on its surface. These CeO2 nanocoatings exhibit low toxicity, are easy to manufacture and have a high level of antimicrobial properties even at very low CeO2 concentrations. High-power ultrasonic treatment was used to coat the surface of cotton fabric with CeO2 nanoparticles.

Characterization of Patients with Inguinal Hernia Ambulatory Surgical Treatment

Introduction: the surgical treatment of inguinal hernia has increased in the last decade and its prevalence is not known. Objective: Characterization of patients with inguinal hernia ambulatory surgical treatment. Methods: an observational, descriptive and prospective study of 972 patients with the diagnosis of inguinal hernia was performed, which were operated on an outpatient basis in the General Teaching Hospital "Enrique Cabrera" since January. From 2009 to December 2020. Emergency operated patients were excluded. Results: the highest incidence of inguinal hernia was found between the ages of 60 and 80 years. Indirect right inguinal hernia appeared more frequently. Desarda's anatomic surgical technique was the most applied in 410 (42,1%) of the cases and Lichtenstein's hernioplasty with 224 (23.0%) followed in frequency. There was a total of 5 (0.5%) recurrences. Local anesthesia was applied in 828 (85.2%) of the patients, on an outpatient basis they were 100%. The total complications were 42 (4.3%). Conclusions: surgical treatment of inguinal hernia on an outpatient basis is an appropriate process. It creates comfort in patients, decreases the risk of hospital infection, and reduces waiting lists and hospital costs.

Exploration of COVID-19 related fears deterring from blood donation in India.

IntroductionThe coronavirus pandemic (COVID‐19) has impacted and pushed the healthcare settings to extremes across the globe. It was extremely challenging to sustain blood donation, and strategies could be formulated on knowing fears hindering blood donation.MethodsA cross‐sectional survey using Google Forms® through WhatsApp and email after obtaining the ethical clearance. The survey questionnaire was validated for content using the Delphi technique, and pilot tested for finalization.ResultsThe survey was attempted by 1066 participants, and 749 participants who had not donated since pandemic were included in the study. A little more than half, 415 (55%) reported either one or more than one fear during the pandemic which hindered blood donation. They reported lack of confidence in the safety measures at the hospitals and fear of transmitting infection to family, in 415 (55%) of the participants each, respectively. The fear of COVID‐19 hospital infection risk and hospital entry was statistically significant across the age groups that are eligible for blood donation.ConclusionsThe clear and dedicated confidence building measures to sustain blood donation using all communication modalities clearly emerge as the most important strategies to augment blood donation in the COVID‐19 pandemic. The measures should include information about implementation of safety measures to mitigate COVID‐19 transmission at the blood centres and that the act of blood donation does not increase risk of COVID‐19 and therefore the risk of transmission of infection to family.

Impact of coronavirus disease 2019 on the clinical diagnosis and treatment of breast cancer in China.

Impact of coronavirus disease 2019 on the clinical diagnosis and treatment of breast cancer in China.

Effect of Enteral Nutrition on In-hospital Infection and Hospital Expense in Stroke Patients: A Retrospective Assessment.

Infection is a common complication of stroke and is associated with unfavorable outcomes. Although nutritional intervention reduces the risk of postoperative infection, the impact of specific nutritional products remains unclear. From a hospital management perspective, we aimed to determine whether the provision of specific types of enteral nutrition in acute stroke patients affects infection control and hospital costs. In all, 45 acute hemorrhagic stroke patients receiving enteral nutrition in a single center (April 2017–March 2019) were retrospectively assessed. Patients were divided into two groups according to nutritional interventions: the 1.0-group with general nutrition (1.0 kcal/mL) (24 patients) and the 1.5+α-group with an initial high-protein, whey peptide-digested liquid diet (1.5 kcal/mL), followed by a highly fermentable fiber-containing liquid diet (1.5 kcal/mL initiated after 4 days) (21 patients). Changes in body mass index (BMI), duration of antibiotic use, incidence of postoperative infection, and medical cost were evaluated. Baseline patient characteristics were similar between groups. The mean BMI change was lower in the 1.5+α-group than in the 1.0-group, and the mean duration of antibiotic use throughout hospitalization was 12.8 and 18.3 days, respectively. Antibiotic use in the 1.5+α-group was lesser than that in Japanese patients from other hospitals. The incidence of postoperative infections was lower in the 1.5+α-group. Injection costs for the 1.5+α group (615 USD/patient) were lower than those for the 1.0-group. Enteral nutrition provided to acute stroke patients reduced the risk of hospital infection and medical costs.

The risk of hospitalized infection in patients with systemic lupus erythematosus treated with hydroxychloroquine.

To compare the risk of hospitalized infection (HI) between users and non-users of hydroxychloroquine (HCQ) in systemic lupus erythematosus (SLE). Using claims data, patients were defined as SLE cases by the following criteria: 1) they had at least one SLE diagnostic code; 2) they had a prescription for specific drugs, including corticosteroids, steroid pulse therapy, and immunosuppressive drugs; and 3) they were at least 16 years old between September 2015 and July 2017 (n = 17,483). The SLE cases with at least one prescription for HCQ were defined as the HCQ group (n = 1,431), while the others were defined as the non-HCQ group. Among the SLE cases, propensity score-matched cases were observed for 1 year (n = 1,095 in each group). The median age and proportion of female patients in both groups were about 42 years and 88%, respectively. The proportions of cases with HIs were similar (HCQ group, 4.5%; non-HCQ group, 5.6%; p = 0.240, McNemar test). The hazard ratio of the HCQ group for HIs after adjusting for patients' characteristics was not significant at 0.9 (0.6-1.3). The use of HCQ was not associated with a risk of HIs in patients with SLE.

How to manage an endoscopy unit during a COVID-19 pandemic.

COVID-19 has become a global public health concern.1 Because of potential aerosol transmission, GI endoscopy is considered a high-risk procedure during this pandemic.2 However, it is irrational to stop all endoscopic procedures. Instead, for a careful trade-off between potential risk of hospital infection and performance of lifesaving procedures, the selection of indications for emergency endoscopy cannot be overemphasized; necessary endoscopic procedures should be performed with patients and healthcare providers all well protected.

Application of failure mode and effects analysis on hospital infection control for gynecological malignant tumor

Objective To explore the effects of failure mode and effects analysis (FMEA) on hospital infection prevention for gynecological malignant tumor. Methods From January 2017 to December 2018, we selected 25 nurses and clinical staff of Department of Obstetrics and Gynecology in Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology as subjects by cluster sampling. And then, the gynecology hospital infection control group was built. Group members assessed the department's risk of hospital infection by FMEA and put forward improvements for the high risk factors. We compared the risk priority number (RPN) of gynecological malignant tumor patients, catheter-related bloodstream infection (CRBSI) and incidence of hospital infection before and after implementing FMEA. Results After implementing FMEA, the total score of RPN risk factors of gynecological malignant tumor patients decreased compared with those before implementation with statistical differences (P 0.05) . Conclusions FMEA has good application effects on hospital infection prevention for gynecological malignant tumor patients which can effectively reflect the weak link of hospital infection management to reduce the incidence of hospital infection of gynecological malignant tumor patients. Key words: Gynecology; Neoplasms; Hospital infection; Failure mode and effects analysis

Situation Awareness of Cough Etiquettes of Hospital Security Personnel and Janitors

Nosocomial infection is a major problem in hospitals around the world. To minimize the risk of infection in hospitals and other healthcare facilities, cough etiquette has to be applied. Thus, good situation awareness and the understanding why cough etiquette is important are necessary. The purpose of this study was to find out the effective education on cough etiquette on hospital security personnel’s and janitors’ situation awareness on cough etiquette. This research study followed quasy experimental design with pretest and post test control group design. The sampling technique was purposive sampling involving 24 respondents for experimental group and 27 respondents for the control group. The analysis of the data employed Wilcoxon test and it employed Mann Whitney test to find out the difference of independent variable medians. Questionnaires were used to gather data collection. The result of the analysis presented a mean of 97.7 on the post-test of control group and a mean of 116.3 on the post-test of treatment group. Wilcoxon and Mann Whitney tests resulted p = 0.001 ( &lt; 0.05 ), which meant there were significant differences. Education on cough etiquette is effective to raise hospital security personnel and the janitors’ awareness on cough etiquette situation.&#x0D; Bangladesh Med J. 2018 May; 47 (2): 35-37

Classification of bloodstream infections in patients recently discharged from acute-care facilities: Hospital acquired or healthcare-associated community onset?

Laboratory-identified bloodstream infections (LAB-ID BSIs) in recently discharged patients are likely to be classified as healthcare-associated community-onset (HCA-CO) infections, even though they may represent hospital-onset (HO) infections. A review of LAB-ID BSIs among patients discharged within 14 days revealed that 109 of 756 cases (14.4%) were HO infections. The BSI risk being misclassified as HCA CO may underestimate the hospital infection risk.

Situation Awareness of Cough etiquettes of Hospital Security personnel and Janitors

Background: Nosocomial infection is a major problem in hospitals around the world. To minimize the risk of infection in hospitals and other healthcare facilities, cough etiquette has to be applied. Thus, good situation awareness and the understanding why cough etiquette is important are necessary. The purpose of this study was to find out the effective education on cough etiquette on hospital security personnel’s and janitors’ situation awareness on cough etiquette.&#x0D; Methodology: This research study followed quasy experimental design with pretest and post test control group design. The sampling technique was purposive sampling involving 24 respondents for experimental group and 27 respondents for the control group. The analysis of the data employed Wilcoxon test and it employed Mann Whitney test to find out the difference of independent variable medians. Questionnaires were used to gather data collection.&#x0D; Results: The result of the analysis presented a mean of 97,7 on the post-test of control group and a mean of 116,3 on the post-test of treatment group. Wilcoxon and Mann Whitney tests resulted p = 0,001 (&lt; 0,05), which meant there were significant differences.&#x0D; Conclusion: Education on cough etiquette is effective to raise hospital security personnel and the janitors’ awareness on cough etiquette.&#x0D; Bangladesh Journal of Medical Science Vol.18(4) 2019 p.814-817

Restrictive measure for the commercialization of antimicrobials in Brazil: results achieved.

ABSTRACTOBJECTIVE To assess whether the incidence of hospital infection by a resistant microorganism decreased after the implementation of the restrictive measure of the National Health Surveillance Agency for the commercialization of antimicrobials.METHODS A historical cohort study of medical records of adult patients admitted to a general and public hospital from May 2010 to July 2011. A cohort was formed with patients admitted in the period before the restrictive measure for the commercialization of antimicrobials (Phase I) and a second cohort was formed with patients admitted after the implementation of the restrictive measure (Phase II).RESULTS The instantaneous risk of hospital infection by a resistant microorganism was estimated at seven by 1,000 people-time (95%CI 0.006–0.008) in Phase I, and four by 1,000 people-time (95%CI 0.003–0.005) in Phase II of the study. The differences between the survival curves in the different phases of the study and stratified by age group were also significant (p < 0.05).CONCLUSIONS The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism.

The Correlation of Education about Cough Etiquette and the Knowledge of Security Officers and Cleaning Service Officers

Background: Nosocomial infection is an infection that patients get when they are hospitalized. To minimize the risk of infection in hospitals, it is necessary to apply standard precautions. One of which is to follow the conduct of cough etiquette.Objective: This research is aimed to analyze the effectiveness of education of cough etiquette module to increase the knowledge about cough etiquette on security and cleaning service officers in hospital.Material and method: This study is a quasi-experiments with pretest and posttest control group design. The samples of this study were taken by using purposive sampling with 24 respondents in the experiment group and 27 respondents in the control group. The data was analyzed by using Wilcoxon and Independent sample T test. Meanwhile, the data was collected by using a questionnaire.Results: The result in this study shows that in the control group, the value of knowledge is p = 0.074 (p &gt; 0.05). In experiment group, the value of knowledge is p = 0.357 (p &gt; 0.05). The result of the control group and the group is p = 0.051 (p &gt; 0.05). The result shows that in the experiment group and in the control group, the comparison between the control and experiment group does not show a significant difference.Conclusion: The conclusion of this study is that there is no correlation between knowledge of cough etiquette before and after education.International Journal of Human and Health Sciences Vol. 03 No. 01 January’19. Page : 23-25

Why do Patients Still Catch Hospital Infections Despite the Practice of Infection Prevention and Control Programs?

Statement of the Problem: Very few publications provide sound scientific data used to determine which components are essential for infection prevention and control (IPC) programs in terms of effectiveness in reducing the risk of infection. In recent years, a range of regional best practice or policy principles have been developed that address what could be considered as core components of IPC programs. However there remains a major gap in relation to the availability of international best practice principles for core components of IPC programs. Purpose: The purpose of this study was to show why patients still catch hospital infections despite IPC programs. A better understanding of a variety of theories is needed that could explain the physiopathology of diverse diseases described in the medical past history, which are usually disregarded clinically today. A broader view seems to show the necessity of seeing the patient as a whole; not only focusing on the disease in the prevention of these hospital infections. Methodology: A review of these theories such as those presented by Hippocrates (Natural forces within us are the true healers of disease), as well as others from oriental medicine, which explain that diseases originate from three factors: external (exposure to cold, heat, humidity, wind and dryness), internal (emotional) and dietary. Findings: Having a broader view of the patient as a whole (Yin, Yang, Qi, blood energy and heat retention), we can understand better the formation of hospital infection which is a systemic energy reaction of our body undergoing normal hospital treatment. Conclusion: To understand better why a patient is still catching hospital infections, despite these IPC programs, we need to broaden our view observing all emotional, environmental and dietary factors, as well as studying the patient’s energy situation at the moment of admittance identifying the risk of hospital infection. Note: This work was presented in Joint Event on 22nd Edition of International Conference on Immunology and Evolution of Infectious Diseases & 12th Edition of International Conference on Tissue Engineering and Regenerative Medicine during May 10-11, 2018 Frankfurt, Germany