Spread Of Healthcare-associated Infections Research Articles

Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities.

The correct method of surface disinfection in hospitals is an essential tool in the fight against the spread of healthcare-associated infections caused by multi-resistant microorganisms. Currently, there are many disinfectants on the market that can be used against different microorganisms. However, the effectiveness of different active molecules is controversial in the literature. The aim of this study was to evaluate the effectiveness of wipes based on hydrogen peroxide (1.0 %) and highly specific plant-based surfactants, contained in H2O2TM (Hi-speed H2O2TM) products, against some hospital-associated microorganisms. The effectiveness of the wipes was tested against nosocomial and control strains of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae carbapenemase, Aspergillus fumigatus and Candida parapsilosis. Specifically, in vitro activity was assessed using three different techniques: stainless steel surface testing, surface diffusion testing and well diffusion test. The three different methods tested confirm the wipes' good effectiveness against the most common multi-resistant bacteria and against fungi. These data show that the tested wipes could be a valid adjunct to the disinfection process and could assist in the prevention of healthcare-associated infections.

Assessing the impact of hand hygiene training on medical students' knowledge: A study in a tertiary care hospital in West Bengal.

Background: Healthcare-associated infections (HAIs) continue to pose significant challenges to patient safety and healthcare systems worldwide. Poor hand hygiene among healthcare professionals remains a major contributing factor to the spread of HAIs. Despite its importance, hand hygiene compliance among healthcare workers, including medical students, remains low. Training programs to improve hand hygiene knowledge and compliance have been implemented globally. This study aimed to assess the impact of a hand hygiene training program on medical students at Burdwan Medical College & Hospital in West Bengal.
 Methodology: A cross-sectional study was conducted involving 122 Professional MBBS students who were selected through purposive sampling. Written informed consent was obtained from each participant. The students' baseline hand hygiene knowledge was assessed using the WHO questionnaire before providing hand hygiene training. Post-training, the same questionnaire was used to evaluate the level of knowledge acquired. The data were analyzed using the student t-test to determine the statistical significance of the training program.
 Results: The mean pre-test score was 11.24±5.29, while the mean post-test score significantly increased to 17.34±5.4 (p<0.001, 95% CI). This finding indicates a substantial improvement in hand hygiene knowledge among medical students after undergoing the training program.
 Conclusion: Regular and frequent training programs on hand hygiene, accompanied by monitoring and timely feedback, are crucial for increasing awareness and compliance among medical students. It is essential for medical colleges to establish an Infection Prevention and Control Committee to organize and oversee such training initiatives, which play a pivotal role in mitigating the risk of HAIs.

Hospital Environmental Services and their Needs

Critically ill or seriously injured people visit Hospitals to seek care. Unfortunately, some patients end up with catching infection and suffering from another disease while they are hospitalized [1]. The Center for Disease Control (CDC) estimate that 687,000 patients every year, or one in every 31 hospital patients, develop an infection known as a healthcare-associated infection (HAI) [2]. An HAI is a type of infection that a patient contract while getting treatment in the hospital or an infection which was not there at the first place when the patient got admitted in the Hospital. These infections are tough to treat causing increase in the length of stay as well as they have financial implications too. These are antibiotic-resistant infections, and hospitals need to be watchful to avert the spread of such bacterial, fungal, and viral infections that cause HAIs. In order to combat these infections, a special type of cleaning processes is introduced in Healthcare generally known as Environmental Services. Hospital Environmental Services, or EVS, is the term in use to represent dedicated disinfecting and cleaning services accomplished by highly skilled technical workforce to impede the spread of HAIs in medical units and other Hospital areas. The Environmental Services staff in Hospital includes the cleaning staff, janitorial staff and Housekeeping Staff [3]. From absence of recognition of EVS contributions, in maintaining a clean and safe environment to a lack of training and resources while being obligated to take on apparently never-ending duties, EVS professionals have to traverse multifaceted trials every day while keeping in view the fact that how their everyday tasking can jeopardies their health. Despite their crucial role in averting infection, EVS staff always stay unappreciated and their jobs are unrewarding due to their apparent “low status” being placed at the lowest of the hospital employee hierarchy in terms of education and salary (as compared to other Hospital Staff) specially in LMICs like Pakistan [4]. This underlines the significance of small, pre-emptive gestures that coworkers can exercise to upsurge trust through different departments. To discontinue the pattern of social hierarchies and disassemble stereotypes, use of interpersonal maneuvers to increase social and emotive connections, can be emphasized to promote acknowledgment for EVS through deliberate appreciation initiatives [4]. There is lack of detailed Training Programs for EVS Staff at the Level of Universities and Colleges The teaching institutes should introduce such training programs, as well as relevant Hospital Departments should design short hands on certificate courses for their own staff too. The EVS Staff should have clear understanding of how to prevent themselves from infection and then how to prevent others from Infections. Their training and development courses should include details of communicable and non- communicable diseases, especially with reference to the routes of spread on infection. They should be equipped with knowledge about right cleaning agents, methods and disinfection and different types of contaminants. They should be trained to work in resource constraint environments. For example, they should have clear ideas about where use of gloves and other PPE is highly recommended and where it is not required. Similarly, which surfaces need to be cleaned and disinfected with what types of solutions and they should have a definite know how on dilutions [5]. They essentially have to perform accurate cleaning processes in different places in different times at hospitals (Isolation room, intensive care ward, operation room, wards, procedure room, reception room, delivery room, hospital lobby and stairways, offices, diner, kitchen, bathrooms). They should be sensitized with the alteration of cleaning plans as and when required. The experiences of EVS, who are indispensable but unacknowledged workers, can aid in shedding light on actionable insight for practical and policy changes directly. As the surge of HAIs continues to overwhelm hospitals, the healthcare delivery systems and interdisciplinary coworkers should identify staffing and resource strains for EVS. Implementation of Strategies that focus on appreciation and recognition for EVS through emotional support, native language education, provision of sufficient PPE supplies should be practiced as well as they should be offered enhanced reimbursements and wage [6].

How Well Are Hand Hygiene Practices and Promotion Implemented in Sierra Leone? A Cross-Sectional Study in 13 Public Hospitals.

Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021. The mean score for all hospitals was 273 ± 46, indicating an intermediate level of hand hygiene. Nine hospitals achieved an intermediate level and four a basic level. More secondary hospitals 5 (83%) were at the intermediate level, compared to tertiary hospitals 4 (57%). Tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education. Lack of budgets to support hand hygiene implementation is a priority gap underlying this poor performance. These gaps hinder hand hygiene practice and promotion, contributing to the continued spread of HAIs. Enhancing the distribution of hand hygiene resources and encouraging an embedded culture of hand hygiene practice in hospitals will reduce HAIs.

Monitoring microbial communities in intensive care units over one year in China

Healthcare-associated infections (HAIs) seriously threaten patient health in intensive care units (ICUs). Profiling the microbial composition and diversity in ICU is important to prevent HAI-related spreading. Given that microbial communities vary across different environments, the time-scale characteristics of pathogens in ICUs have not been explored in China. In our study, to study the bacterial communities of two different ICUs in China, we proceeded dynamic monitoring using 16S rRNA sequencing for a whole year among the bed sheets, bed rails, shared pulse oximeters, bedside lockers, nurses' hands, floor, and carts. Our results showed that the microbial composition significantly changed within months. Significant differences in alpha and beta diversities were also observed among the 12 sampling months in each ICU. Additionally, we found the persistence of several HAI-related bacteria, including Acinetobacter, Pseudomonas, Staphylococcus, Escherichia, and Enterococcus. Source tracking analysis showed that most bacteria in both ICUs came from buildings or human skin. With deep investigations of hospital microbial surveillance on a long-term time-scale, we hope that these results will provide constructive guidelines to prevent the spread of HAIs in ICUs.

Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates from Inanimate Hospital Environments at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia.

IntroductionMicrobial contamination of the hospital environment plays an important role in the spread of healthcare-associated infections (HCAIs). This study was conducted to determine bacterial contamination, bacterial profiles, and antimicrobial susceptibility pattern of bacterial isolates from environmental surfaces and medical equipment.MethodsA cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) from June to September 2018. A total of 164 inanimate surfaces located at intensive care units (ICUs) and operation theaters (OTs) were swabbed. All isolates were identified by using routine bacterial culture, Gram staining, and a panel of biochemical tests. For each identified bacteria, antibiogram profiles were determined by the Kirby–Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI).ResultsOut of the 164 swabbed samples, 141 (86%) were positive for bacterial growth. The predominant bacteria identified from OTs and ICUs were Staphylococci aureus (23% vs 11.5%), Acinetobacter baumannii (3.8% vs 17.5%) and coagulase-negative Staphylococcus (CoNS) (12.6% vs 2.7%) respectively. Linens were the most contaminated materials among items studied at the hospital (14.8%). Gram-positive bacteria (GPB) had significantly high resistance levels to penicillin (92.8%), cefoxitin (83.5%), and erythromycin (53.6%). On the other hand, Gram-negative bacteria (GNB) revealed the highest resistance levels to ampicillin (97.5%), ceftazidime (91.3%), ceftriaxone (91.3%), and aztreonam (90%). However, a low resistance level was recorded for amikacin (25%) followed by Ciprofloxacin (37.5%). Of the 63 S. aureus isolates, 54 (85.7%) were methicillin-resistant S. aureus (MRSA).ConclusionThe inanimate surfaces and commonly touched medical equipment within OTs and ICUs are reservoirs of potentially pathogenic bacteria that could predispose critically ill patients to acquire HCAIs. The proportions of the antimicrobial resistance profile of the isolates are much higher from studied clean inanimate environments.

Secure Health Care Workers' Health and Safety Methodically During COVID-19 Epidemic in Taiwan.

The aim of this article is to assess the effectiveness of 3 measures of COVID-19 (coronavirus disease) containment for securing health care workers' (HCWs) safety and health at 5 medical university-affiliated hospitals in Taiwan. Three measures were to enforce the reporting of HCWs with unknown fever, acute respiratory illness, and other symptoms; to conduct ongoing surveillance to obtain early warning of potential contagion exposure; and to perform epidemiological investigation and outbreak management. A 17-week surveillance data were collected, 374 (6.17%) HCWs with unknown fever or acute respiratory infection symptoms detected by online body temperature surveillance system were reported, there were no cases of nosocomial infection of COVID-19 among HCWs. Via contact tracing and reporting system, 133 (2.19%) HCWs reported footprints in different epidemic events, but no HCWs were infected. No onward transmission to HCWs occurred after containment measures were formulated. Integrated measures of surveillance, managing epidemic transmission chain, and encouraging individual responsibility have been effective approaches among HCWs in the ongoing COVID-19 epidemic. Despite the absence of ongoing local transmission, vigilance and compliance must be maintained to prevent spread of health care-associated infections in all areas and in social mingling among HCWs outside hospitals. These 3 methodical measures secured HCWs' health and safety successfully and preserved health care delivery continuously.

The Sixth Decennial International Conference on Healthcare-Associated Infections Abstracts, March 2020

Global Solutions to Antibiotic Resistance in HealthcareHeld once every 10 years, the Decennial International Conference on Healthcare-Associated Infections reviews the advances of the previous decade as well as the opportunities and trends for the fields of healthcare epidemiology, infectious diseases, and infection prevention and control in the future. Due to the coronavirus disease 2019 (COVID-19) global pandemic, the SHEA Board and the Decennial 2020 Steering and Program Committee made the difficult decision to cancel the Sixth Decennial International Conference on Healthcare-Associated Infections (Decennial 2020), which was slated to take place in March 2020.Given the ongoing global situation with COVID-19, it is essential that healthcare and public health professionals remain in their workplaces and continue to direct and implement the national and international response activities related to COVID-19. Both the SHEA and the Centers for Disease Control and Prevention are aware of the challenges our country is facing at this moment as leaders in public health and infection prevention and control. We understand the vital need to direct time and energy to the critical situation we are facing in this rapidly changing environment.Although the conference has been canceled, we are pleased to present to you this supplemental issue of Infection Control and Hospital Epidemiology featuring select Scientific Abstracts from the Decennial 2020. The program for the Decennial 2020 intended to highlight 3 narrative themes that encapsulate many of the imperatives for driving progress forward in the field:(1) Innovation: The development of novel prevention tools, strategies, diagnostics, and therapeutics has been critical in the progress of infection prevention and in addressing the threat of antibiotic resistance. Further innovation related to healthcare technology, practices, policies, and programs are needed to continue to move toward the goal of eliminating healthcare-associated infections (HAIs) and slowing antibiotic resistance.(2) Data for action: Facilities, states, clinicians, and other stakeholders need data to drive detection and prevention strategies to eliminate HAIs and to combat antibiotic resistance. Improvements in use of surveillance, epidemiologic, clinical, and laboratory data are critical to closing knowledge gaps and allowing the implementation of effective strategies to provide safe care.(3) Addressing AMR without borders: Many factors impact the local and global burden and transmission of antibiotic resistance. To prevent resistant pathogens from spreading within and between healthcare facilities and the environment, constant vigilance and action are needed. The spread of antibiotic resistance does not respect borders. The antibiotic resistance experience of any given facility, region, or country is directly influenced by the movement of colonized or infected patients with its neighboring facilities, regions, and countries. Global success in containing the spread of HAIs and antibiotic resistance will require coordinated responses at the local, regional, and international levels. Public health and healthcare systems must work together to share information to detect and to implement effective practices to prevent infections from occurring and spreading.The abstracts presented in this supplement highlight these themes, and we are excited to share with you all of the exciting research taking place to advance efforts to prevent infections, combat antibiotic resistance, and provide safe healthcare at every encounter.We thank the Abstract Subcommittee for reviewing and selecting the abstracts presented in this supplement. We received a record number of abstracts, and we appreciate the effort each author contributed. The hours of work that our volunteer reviewers contributed was invaluable in selecting high-quality research for the Decennial 2020.Disclaimer: The large number of submitted abstracts and the deadlines associated with publication do not permit full author communication, abstract revisions, or ICHE editorial review. The abstracts are presented, as they were submitted to the Decennial 2020 Program Committee. Although efforts were made to ensure accuracy, some information related to disclosures and funding may be omitted.The Society for Healthcare Epidemiology of America and The Centers for Disease Control and Prevention

Infection prevention and control of bedside blood purification treatment in patients with COVID-19

To explore the infection prevention and control strategy of bedside blood purification treatment in corona virus disease 2019 (COVID-19) isolation ward, and to evaluate the effect of infection prevention and control management measures. We summarized and analyzed the clinical features, infection status, outcome and infection prevention and control measures of bedside blood purification treatment patients in COVID-19 isolation ward from February 8, 2020 to March 31, 2020, analyzed the COVID-19 cross-infection between the patients and medical staffs, and the blood-borne pathogens cross-infection situation between the patients, and analyzed the effect of bundle prevention and control measures in controlling the occurrence and spread of cross-infection. A total of 101 COVID-19 patients were hospitalized in this COVID-19 isolation ward, of whom 10 patients (9.90%) received bedside blood purification treatment and the blood purification treatment method was continuous hemodialysis filtration (CVVHDF), and the 10 patients received 79 times of blood purification treatment in total. The prevention and control management measures adopted included divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room air purification, object surfaces, medical devices and medical fabrics dis-infection management. There were no occurrence and spread of COVID-19 in the medical healthcare workers and blood-borne pathogens cross-infection in the patients. And all the twice throat swabs (two sampling interval > 1 day) of the medical staffs in COVID-19 virus nucleic acid test were negative. The 2 suspected COVID-19 patients' throat swab virus nucleic acid test and the COVID-19 IgG, IgM were always both negative, the chest CT showed no viral pneumonia. Bedside blood purification treatment in the COVID-19 isolation ward, the occurrence and spread of healthcare associated infection can be effectively controlled through effective infection prevention and control management, including divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room's air purification, object surfaces, medical devices and medical fabrics disinfection, which can provide experience for diagnosis, treatment and prevention and control of patients in the respiratory infectious disease ward.

IMPLEMENTATION OF WHO HAND HYGIENE IMPROVEMENT STRATEGY IN TRNAVA UNIVERSITY HOSPITAL, SLOVAKIA

Hand hygiene is considered to be the most simple, effective and economic measure to prevent the spread of healthcare-associated infections and antimicrobial resistance. Based on the study, application of the World Health Organization’s Multimodal Hand Hygiene Improvement Strategy can improve hand hygiene compliance in hospital settings and reduce these infections. Trnava University Hospital was included to World Health Organization (WHO) launched a worldwide campaign focused on hand hygiene in 2013, when infection control specialist has started working on daily basis. Our objective was to evaluate the impact of implementing the Multimodal Hand Hygiene Strategy according to WHO. We assessed alcohol-based hand rub consumption during the period 2013 and 2018 and hand hygiene compliance in 2018 as a baseline. During observed period alcohol-based hand rub consumptions significantly increased from 15.7 L/1000 patient days to 24.3 L/1000 patient days (p<0.05). Overall compliance as per WHO guidelines were 38.9%.

Hand Hygiene Practices and Training Gap in a Neonatal Intensive Care Unit at Coastal Karnataka India

Background: Non-adherence to hand hygiene practices is a well-known factor contributing to healthcareassociated infections in any healthcare setting. Mere knowledge of such practices doesn’t guarantee the compliance to the practices by healthcare personnel. In this study we explored the quantum of adherence to handhygiene practices, the opportunity missed, the steps and the duration to be followed for hand hygiene practices and the training gap among the healthcare providers. Methodology: A six-month cross-sectional study using a mixed-method approach of observations, interview and feedback mechanism is used to find the effectiveness of hand hygiene practices and any training gap to prevent healthcare-associated infections. Observations for two thousand opportunities for hand washing and written interview of 40 healthcare workers is carried out on hand hygiene practices at a neonatal intensive care unit of coastal Karnataka, India. Results: The hand hygiene practices were as low as 0% observed while performing an non-invasive activity like clearing an alarm at the bedside. There is a gap found in the duration of hand-washing practices, hand hygiene before and after any care activity is performed on the neonate. This gap resulted in the spread of healthcare-associated infections. Conclusion: During the infections control training emphasis should also be given on the opportunities and hands on practices of hand hygiene.

Hospital knowledge and practice of doctors and nurses regarding hand hygiene in a survey.

The guidelines issued by the World Health Organization (WHO) in 2009 regarding hand hygiene (HH) in health care provided health care professionals with scientific evidence that argued that HH principles should be respected when dealing with patients. Despite the passage of years and strenuous attempts to introduce these recommendations to the Polish health care facilities for the prevention of healthcare-associated infections (HAI), these principles are still not being implemented in an optimal way for the patient's safety. The aim was to examine the views and attitudes of physicians (L) and nurses (P) towards the WHO rules of hand hygiene. The study was performed by means of a diagnostic survey using a questionnaire of our own design; random sampling was used. The study involved 231 LP: 173 (74.9%) women, 58 (25.1%) men, including 93 (40.3%) doctors and 138 (59.7%) nurses. The study was conducted in a multiprofile hospital in Małopolska in 2017. The difference between what the respondents think (their views) and what they do in reality (what attitudes they display) was examined in relation to WHO principles, such as wearing natural short nails and jewelry on their hands. Negative practice of observing these HH principles in relation to views was detected (R = -0.014, p<0.05, R2 = 0.016). Respondents supported the view that the ring could affect HAI and rarely used it in practice, the practice was positive (R = 0.298, p <0.001, R2 = 0.085). Women strongly emphasized the view that wearing long nails has an impact on HAI spread, but in practice they often declared keeping long nails, practice was negative (R = -0.241, p <0.01, R2 = 0.054). In response to the question about the impact of nail painting on the spread of HAI, this view was poorly represented, in practice some of them wore painted nails, the practice was negative (R = -0.226, p <0.01, R2 = 0.045). Despite high support for the principles of hand hygiene, in practice, these principles were not always respected, the impact on the practice was negative in areas such as: general adherence to the HH principles, wearing long and painted nails. The compatibility of views with practice was detected in relation to wearing a wedding ring.

Hand Hygiene Practices and Training Gap in a Neonatal Intensive Care Unit at Coastal Karnataka India

Background: Non-adherence to hand hygiene practices is a well-known factor contributing to healthcareassociated infections in any healthcare setting. Mere knowledge of such practices doesn’t guaran tee the compliance to the practices by healthcare personnel. In this study we explored the quantum of adherence to hand hygiene practices, the opportunity missed, the steps and the duration to be followed for hand hygiene practices and the training gap among the healthcare providers. Methodology: A six-month cross-sectional study using a mixed-method approach of observations, interview and feedback mechanism is used to find the effectiveness of hand hygiene practices and any training gap to prevent healthcare-associated infections. Observations for two thousand opportunities for hand washing and written interview of 40 healthcare workers is carried out on hand hygiene practices at a neonatal intensive care unit of coastal Karnataka, India. Results: The hand hygiene practices are as low as with nearly zero percent observed while with performing non-invasive activity like clearing an alarm at the bedside. There is a gap found in the duration of handwashing practices, hand hygiene before and after any care activity is performed on the neonate. This gap resulted in the spread of healthcare-associated infections. Conclusion: During the infections control training emphasis should also be given on the opportunities and hands on practices of hand hygiene.

2441. Automated, Rapid Detection of Potential Healthcare-Acquired Infection Clusters Based on Microbiology And Patient Geotemporal Data

BackgroundWhole-genome sequencing (WGS) has shown promise in identifying transmissions of healthcare-associated infections (HAIs), but it may be costly to sequence all potential HAIs. By automatically identifying samples likely to be HAIs, WGS can be focused on specific samples. We describe an algorithm that quickly identifies potential HAI clusters by analyzing patient geotemporal and pathogen microbiology data. This approach systematically triages potential HAI investigations to aid infection control professionals (ICPs) in their workflow.MethodsThis novel algorithm within Philips IntelliSpace Epidemiology scores the potential of transmission for pairs of infections. Inputs include microbiology (MB) data (genus- or species-level identification and antimicrobial susceptibility test results) and geotemporal (GT) data (timing of sample collection and shared location stays). From the resulting pairwise scores, clusters of potential HAIs are identified. Leveraging 9 months (June, 2018 – March, 2019) of data from a 900-bed US hospital (i.e., 2825 samples, 1814 patients and 13 organisms—of which a subset of 404 samples had WGS performed concomitantly with MB studies), we evaluated the extent to which this algorithm captures genetically similar sample pairs.ResultsPairwise scores enrich for genetically similar samples when considering MB data only (odds ratio: 17.3), GT only (odds ratio: 6.1) and a combination of both (odds ratio: 19.8), with highly significant P-values for all (P < 10−16). Considering MB only, 91% of samples group together in potential transmission clusters. With MB and GT data, this fraction drops to 24.6% (694 samples) forming 178 possible clusters, 173 of which contain fewer than ten samples each. The 5 larger clusters contain 40–64 samples each and span multiple units in the hospital.ConclusionThe proposed system automatically suggests potential HAI clusters. By combining MB and GT data, the number of samples to review is reduced, enabling ICPs to focus their attention and sequencing efforts. By focusing on a targeted group of higher probability clusters, ICPs may be able to increase their efficiency and effectiveness in controlling the spread of HAIs—thus boosting potential for patient safety and amelioration of cost of care.Disclosures All authors: No reported disclosures.

Public Health since the beginning: Neonatal incubators safety in a clinical setting.

The role of environmental cleaning as an effective measure to contain the diffusion of Healthcare Associated Infections (HAIs) has already been demonstrated. Among medical devices, neonatal incubators have been recognized as a source of pathogens involved in the spread of HAIs. Aim of the study was to assess the efficacy of a disinfection protocol for neonatal incubators. The cross sectional study took place in the "Neonatal Pediatric Unit" of the Teaching Hospital of Siena: twenty incubators, used for critical newborns, were swabbed in 13 sampling points before and after the implementation of the disinfection protocol. Sanitation procedures were performed by trained staff, implementing the product Umonium38® Neutralis as disinfectant. Different culture media for the identification of the microbial contamination were adopted: plates were incubated for the proper time and the results were referred to Colony Forming Units (CFUs)/swab per point. Descriptive statistical analysis was performed. It was also evaluated the 95% confidence interval (C.I.) of the mean and the percentage of CFUs reduction by the bootstrap bias corrected and accelerated resampling method. Matched points analyzed were 313. The average CFUs percentage of reduction was 93.5% [C.I. 90.6-95.9%]: it was higher, 97.0% [C.I. 94.1-99.1%], in points placed inside the incubators structure compared to the 88.4% [C.I. 83.6-93.0%] obtained outside. The disinfection protocol achieved good results. Routine surveillance and supervision of the various aspects of the disinfection processes (procedures, staff and disinfectants) could guarantee a safe environment during the first days of babies' life, avoiding harmful conditions for the newborns' health.

Role of healthcare personnel attire in the spread of healthcare-associated infections: Knowledge of healthcare workers in a tertiary hospital in northwest Nigeria

Background: Healthcare facilities are workplaces where healthcare-associated infections (HCAIs) predominate and disease pathogens are harbored by fomites. This situation could be aggravated by increase in number of resistant organisms and inadequate knowledge especially in developing countries. Objective: The aim of this article was to assess the knowledge on role of healthcare personnel attire in spread of HCAIs among healthcare workers (HCWs). Methodology: A descriptive cross-sectional study was carried out using a pretested structured interviewer-administered questionnaire. A total of 127 respondents were interviewed. Data was collected and analyzed using IBM Statistical Package for Social Sciences (SPSS) version 23. Data was presented using frequencies and percentages for categorical variables. Results: All respondents (100.0%) had heard of fomites and 124 (97.6%) of them knew that HCAIs could be spread through fomites. Among the respondents who wore ward coats/uniforms, 91.3% perceived that ward coats/uniforms have the potential of spreading infections. The rate of HCAIs was said to be low in about half (56.7%) the respondents and 54 (42.5%) reported that they did not have a HCAIs reporting system in their unit. Most respondents, 114 (89.8%), had good knowledge. Conclusion: Although knowledge of the role of HCWs’ attire in spread of HCAIs was good among HCWs, it can still be improved upon by training and retraining of HCWs by management. Most respondents reported lack of HCAIs reporting system in their units. Therefore, HCAIs reporting systems should be established in all units of the hospital by the management.

Infection control in the UK: an antimicrobial resistance perspective

The spread of healthcare-associated infections has become a matter of global concern. These infections, which were once isolated to hospital settings, have emerged in the community. Reduced infection control practices are a major cause of this rapid spread of infections, which has led to the increase in the occurrence of multi-drug resistant organisms. The state of infection control in the United Kingdom is of extreme importance because of several reported cases of infections caused by these organisms. In addition to antimicrobial usage in human medicine, antimicrobial agents used in agriculture must be considered as major factors in the prevalence of resistant organisms and the implications to the UK. However, this increased occurrence of antimicrobial resistant bacteria and their resulting infections could be reduced with the application of effective policies for antibiotic use in agricultural environments, stringent decontamination and sterilisation techniques and better regulations that encourage the search for, and development of, new and novel drugs.

Infection control in the UK: an antimicrobial resistance perspective

The spread of healthcare-associated infections has become a matter of global concern. These infections, which were once solely limited to hospital settings, have emerged in the community. Reduced infection control practices strengthen this rapid spread of infections, which has led to the increase in the occurrence of multidrug resistant organisms. The state of infection control in the United Kingdom is of extreme importance because of several reported cases of infections caused by these organisms. In addition to antimicrobial usage in human medicine, antimicrobial agents used in agriculture must be considered as major factors in the prevalence of resistant organisms and the implications to the UK. However, this increased occurrence of antimicrobial resistant bacteria and their resulting infections could be reduced with the application of effective policies for antibiotic use in agricultural environments, stringent decontamination and sterilisation techniques and better regulations that encourage the search for, and development of, new and novel drugs. Keywords: Infection control, healthcare associated infections, antimicrobial drug resistance, prophylaxis, health policy.

Beliefs - Misbeliefs, answering essential questions about hand hygiene from the view of the evidences

Contaminated hands can play pivotal role in the development and spread of healthcare-associated infections. Consequently hand hygiene practice performed with adequate technique and with adequate timing is an essential implement for patient safety. Inhibition of the practice of high level hand hygiene by the misconceptions or deficient knowledge of healthcare workers may lead to negative influence on the quality of patient care. Erroneous beliefs or "rumourous knowledge" acquired from colleagues can not only influence the attitude of healthcare workers, but can also give rise to insufficient hand hygiene compliance. Finding, interpreting and imparting the related evidence by delivering continuing education and lectures, highlighting the theoretical and practical know-how on hand hygiene could help to understand and imprint the evidence-based practice and adequate technique in the essential issue of hand hygiene. Orv. Hetil., 2017., 158(6), 212-219.

Superbugs versus Outsourced Cleaners

On any given day, about one in 25 hospital patients in the United States has a health care–associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached from the organization and the rest of the care team. As a result, the outsourcing of EVS workers could have the unintended consequence of increasing the incidence of HAIs. The authors demonstrate this relationship empirically, finding support for their theory by using a self-constructed data set that marries infection data to structural, organizational, and workforce features of California’s general acute care hospitals. The study thus advances the literature on nonstandard work arrangements—outsourcing in particular—while sounding a cautionary note to hospital administrators and health care policymakers.