Standard Preventive Measures Research Articles

P-1182. Impact of Standard Infection Prevention Measures, Including Contact Precautions, on Serratia marcescens Outbreaks in the Neonatal ICU

Abstract Background Serratia marcescens outbreaks attributed to lapses in hand hygiene, contaminated sinks or drains, and other sources of environmental contamination have been observed in the neonatal intensive care unit (NICU).1S. marcescens outbreaks were identified in the St. Louis Children’s Hospital (SLCH) NICU, a level IV NICU with 150 beds, in 2019 and 2023. NICU Location and Infant Body Sites of Serratia marcescens Infections Proportion of 2019-2024 Quarter 1 Serratia marcescens infections from specific NICU locations (1A) and infant body sites (1B). Methods A detailed review of NICU S. marcescens infections was performed and quarterly infection rates per 1,000 patient-days were followed. The following response measures were implemented in ­­2020: 1. Contact isolation precautions (CP) for infants with S. marcescens infections. 2. Education provided to NICU staff: a. Impact of S. marcescens infections in infants. b. Potential sources of S. marcescens in the NICU. c. Importance of standard infection prevention measures, including hand hygiene, nail hygiene, isolation precautions, and environmental cleaning. 3. Cleaning or exchange of NICU sink aerators. 4. Installation of splash guards next to sinks in medication rooms. The following response measures were implemented in 2023: 5. Steps 1-3 above were re-implemented. 6. Sterile water was substituted for tap water during infant baths. 7. Whole genome sequencing was performed on seven S. marcescens isolates. A cutoff of >30 allelic differences between isolates indicated genetically unrelated strains. Annotated NICU Serratia marcescens Infection Rate Annotated neonatal intensive care unit (NICU) nosocomial Serratia marcescens infection rates per 1,000 patient-days by quarter and selected interventions. The dotted grey line indicates the average annual infection rate. Results Geographic clustering was identified in specific NICU locations (Figure 1A). The most common body site of infection was the respiratory tract, followed by bloodstream (Figure 1B). A sustained decrease in S. marcescens infection rates was observed following 2020 response measures (Figure 2). As such, CP for infants with S. marcescens was paused. In 2023, S. marcescens infection rates again doubled and re-implementation of interventions resulted in decreased infection rates. Isolates were genetically unrelated based on whole genome sequencing (Figure 3). Whole Genome Sequencing Results Minimum Spanning Tree showing patient Serratia marcescens isolates, including NICU room location (and date) of collection in circles and the number of allelic differences on linking lines between the circles. Conclusion Standard infection prevention measures, including CP, and mitigation of potential water exposure sources resulted in decreased S. marcescens infection rates following two separate outbreaks in the NICU. Despite temporal and geographic clustering, isolates were genetically unrelated. Disclosures All Authors: No reported disclosures

Innovative Solutions for Multidrug-resistant Organisms Infections in ICU: A Joint Efficacy Evaluation of Multi-disciplinary Team and SHEL Model (Software, Hardware, Environment, Liveware)

BackgroundThe escalating threat of Multidrug-resistant organisms (MDROs) in Intensive Care Units (ICU) demands innovative management strategies to curb the rising infection rates and associated clinical challenges. ObjectiveTo assess the effectiveness of integrating the Multi-disciplinary team (MDT) approach with the SHEL model (Software, Hardware, Environment, Liveware) in reducing MDROs infections within ICU settings. MethodsFrom January 2021 to April 2024, a prospective, randomized controlled study was conducted in the ICU of Nantong Fourth People's Hospital, enrolling 411 patients with MDROs infections. These patients were randomly assigned into three groups: the MDT group, the SHEL model group, and a combined group. The intervention lasted for four weeks, during which the effects on the MDROs detection rate, infection rate, healthcare staff's infection control execution scores, and the rationality of antibiotic use were assessed, aiming to determine the efficacy of each approach in managing MDROs in the ICU setting. ResultsThe overall infection rate of MDROs in the ICU of our hospital from 2021 to 2024 was 60.18%, with sputum infection sources accounting for 68.37% of the total sources, making it the primary source of infection. The detection rate of MOROs in the combined group was significantly higher than that in the MDT group and the SHEL group, with the SHEL group having a higher detection rate than the MDT group (P<0.05). The infection rate of MOROs in the combined group was significantly lower than that in both the MDT group and the SHEL group, with the SHEL group having a lower detection rate than the MDT group (P<0.05). The implementation scores of the combination group in standard prevention, hand hygiene, antibiotic management, and isolation measures were significantly higher than those of the MDT and SHEL groups, with the SHEL group scoring higher than the MDT group (P<0.05). The rational use of antibiotics in the combined group was also higher than in both the MDT group and the SHEL group, with the SHEL group having a higher level than the MDT group (P<0.05). ConclusionThe integrated MDT and SHEL model significantly reduced MDROs infections in ICU, improved healthcare workers' infection prevention and nursing quality, and promoted the appropriate use of antibiotics, advocating for its clinical application.

The incidence and risk factors of intraoperative bacterial contamination in primary total knee arthroplasty.

Infection is a devasting complication after arthroplasty. Identifying potential sources contributing to intraoperative bacterial transmission can help to reduce surgical-site infections. The aim of this study was to identify the incidence and risk factors of intraoperative bacterial contamination (IBC) in primary total knee arthroplasty (TKA) procedures. Active surveillance cultures were used to detect IBC from 125 consecutive unilateral primary TKAs. The cultures were taken from different sites (surgical instruments, gloves of surgeons and surgical incisions) at different time points (before surgery, 30 min and at the end of the surgery) during arthroplasty procedures. Patient characteristics, including age, height, body weight, body mass index, comorbidity of diabetes mellitus, operative duration, intraoperative blood loss, types of prophylactic antibiotics were recorded. The white blood cell level before, the 3rd and 7th day after surgery were measured and recorded. In addition, patients were also followed for fever and surgical-site infections within 14 days after surgery. In total, 1,000 cultures were taken. 91 (9.1%) of them showed an IBC. None of bacterial cultures of gloves and instruments before surgery were positive. At 30 min from the beginning of the procedure, 29 cultures (7.7%) from 16 patients (12.8%) showed a contamination. At the end of the surgery, 62 cultures (16.5%) from 32 patients (25.6%) showed a contamination. There were 15 cases (12.0%) of fever within 14 days after surgery, of which 11 cases with IBC, and 4 cases without IBC. No postoperative surgical-site infection occurred in all consecutive unilateral primary TKAs. The binomial logistic regression analyses confirmed that operative duration was the risk factor of IBC [OR 1.137 (95% CI 1.023 to 1.322), p = 0.014]. Moreover, compared to control group, the patients with IBC had a greater change of white blood cell level in the 3rd day after surgery (p = 0.022), and a higher risk of fever within 14 days after surgery (p < 0.001). The bacterial contamination rate during primary TKA is relatively high, despite the practice of standard preventive measures. Intraoperative bacterial contamination increases with long operating time, which may be one of the factors contributing to fever and leukocytosis after surgery.

Risk factors for central line-associated bloodstream infection in the pediatric intensive care setting despite standard prevention measures.

Identify risk factors for central line-associated bloodstream infections (CLABSI) in pediatric intensive care settings in an era with high focus on prevention measures. Matched, case-control study. Quaternary children's hospital. Cases had a CLABSI during an intensive care unit (ICU) stay between January 1, 2015 and December 31, 2020. Controls were matched 4:1 by ICU and admission date and did not develop a CLABSI. Multivariable, mixed-effects logistic regression. 129 cases were matched to 516 controls. Central venous catheter (CVC) maintenance bundle compliance was >70%. Independent CLABSI risk factors included administration of continuous non-opioid sedative (adjusted odds ratio (aOR) 2.96, 95% CI [1.16, 7.52], P = 0.023), number of days with one or more CVC in place (aOR 1.42 per 10 days [1.16, 1.74], P = 0.001), and the combination of a chronic CVC with administration of parenteral nutrition (aOR 4.82 [1.38, 16.9], P = 0.014). Variables independently associated with lower odds of CLABSI included CVC location in an upper extremity (aOR 0.16 [0.05, 0.55], P = 0.004); non-tunneled CVC (aOR 0.17 [0.04, 0.63], P = 0.008); presence of an endotracheal tube (aOR 0.21 [0.08, 0.6], P = 0.004), Foley catheter (aOR 0.3 [0.13, 0.68], P = 0.004); transport to radiology (aOR 0.31 [0.1, 0.94], P = 0.039); continuous neuromuscular blockade (aOR 0.29 [0.1, 0.86], P = 0.025); and administration of histamine H2 blocking medications (aOR 0.17 [0.06, 0.48], P = 0.001). Pediatric intensive care patients with chronic CVCs receiving parenteral nutrition, those on non-opioid sedative infusions, and those with more central line days are at increased risk for CLABSI despite current prevention measures.

Role of Nursing in Managing Noise-Related Hearing Loss in Children: A Retrospective Study of Earmuffs as a Protective Intervention.

Noise-induced hearing loss (NIHL) in children is a growing public health concern due to increased exposure to high noise levels in various environments. Early intervention is crucial to prevent long-term developmental and social impacts. This study evaluates the effectiveness of earmuffs as a protective intervention in managing NIHL in children. A prospective study was conducted involving 120 paediatric patients aged 5-12 years diagnosed with NIHL. Patients were divided into an intervention group (n = 60), who received standard treatment plus earmuffs, and a control group (n = 60), who received standard treatment only. Pure-tone audiometry tests were used to assess hearing thresholds at baseline and post-intervention. Family satisfaction was also assessed using a self-administered questionnaire. Hearing thresholds substantially improved in the intervention group compared with those in the control group. After the intervention, hearing thresholds in the intervention group reduced by 7.31 decibels (dB) at 500 Hertz (Hz), 6.73 dB at 1000 Hz, 6.66 dB at 2000 Hz and 6.92 dB at 4000 Hz (P < 0.05). In the control group, reductions were 3.74, 3.72, 3.64 and 3.80 dB, respectively (P < 0.05). Family satisfaction was significantly higher in the intervention group, with 91.7% expressing satisfaction, compared with 65.0% in the control group (P = 0.030). This study demonstrates the effectiveness of earmuffs in preventing NIHL in children, showing improvements in hearing thresholds and increased family satisfaction. These findings suggest that earmuffs could be beneficial as part of standard preventive measures for paediatric patients exposed to high noise levels and highlight their potential practical and clinical value.

Situation and associated factors of needle stick and sharps injuries among health-care workers in a tertiary hospital: a cross-sectional survey

PurposeThis study aimed to assess the prevalence of and factors associated with needle stick and sharps injuries (NSSIs) among health-care workers (HCWs) in a tertiary hospital in China.Materials and methodsThis retrospective survey was conducted with 562 HCWs at a tertiary hospital in China in July 2023. Information was collected using a self-designed questionnaire, and all enrolled members were required to fill in the demographic characteristics, occurrence of NSSIs and other associated factors in the past year. Logistic analysis was used to identify variables associated with NSSIs.ResultsThe proportion of participants with at least one injury within the year preceding the investigation was 21.2%. Male (AOR = 2.116 [1.265, 3.538]), working hours per week > 40 (AOR = 1.718 [1.056,2.796]), rarely checking blood-borne infections before invasive operations (AOR = 2.219 [1.303,3.782]) were significantly associated with NSSIs.ConclusionThe prevalence of NSSIs was not low in the survey area, especially in male, individuals with longer working hours, and rarely checking blood-borne infections before invasive operations. Therefore, it is necessary to promote educational programs to enhance awareness of standard prevention measures, especially for key populations, and reduce heavy workloads to decrease the occurrence of such injuries.

Identifying Contact Time Required for Secondary Transmission of Clostridioides difficile Infections by Using Real-Time Locating System.

Considering patient room shortages and prevalence of other communicable diseases, reassessing the isolation of patients with Clostridioides difficile infection (CDI) is imperative. We conducted a retrospective study to investigate the secondary CDI transmission rate in a hospital in South Korea, where patients with CDI were not isolated. Using data from a real-time locating system and electronic medical records, we investigated patients who had both direct and indirect contact with CDI index patients. The primary outcome was secondary CDI transmission, identified by whole-genome sequencing. Among 909 direct and 2,711 indirect contact cases, 2 instances of secondary transmission were observed (2 [0.05%] of 3,620 cases), 1 transmission via direct contact and 1 via environmental sources. A low level of direct contact (113 minutes) was required for secondary CDI transmission. Our findings support the adoption of exhaustive standard preventive measures, including environmental decontamination, rather than contact isolation of CDI patients in nonoutbreak settings.

Identification of key potential infection processes and risk factors in the computed tomography examination process by FMEA method under COVID-19

PurposeTo identify the key infection processes and risk factors in Computed Tomography (CT) examination process within the standard prevention and control measures for the COVID-19 epidemic, aiming to mitigate cross-infection occurrences in the hospital.MethodThe case hospital has assembled a team of 30 experts specialized in CT examination. Based on the CT examination process, the potential failure modes were assessed from the perspective of severity (S), occurrence probability (O), and detectability (D); they were then combined with corresponding risk prevention measures. Finally, key infection processes and risk factors were identified according to the risk priority number (RPN) and expert analysis.ResultsThrough the application of RPN and further analysis, four key potential infection processes were identified, including “CT request form (A1),” “during the scan of CT patient (B2),” “CT room and objects disposal (C2),” and “medical waste (garbage) disposal (C3)”. In addition, eight key risk factors were also identified, including “cleaning personnel does not wear masks normatively (C32),” “nurse does not select the vein well, resulting in extravasation of the peripheral vein for enhanced CT (B25),” “patient cannot find the CT room (A13),” “patient has obtained a CT request form but does not know the procedure (A12),” “patient is too unwell to continue with the CT scan (B24),” “auxiliary staff (or technician) does not have a good grasp of the sterilization and disinfection standards (C21),” “auxiliary staff (or technician) does not sterilize the CT machine thoroughly (C22),” and “cleaning personnel lacks of knowledge of COVID-19 prevention and control (C33)”.ConclusionHospitals can publicize the precautions regarding CT examination through various channels, reducing the incidence of CT examination failure. Hospitals’ cleaning services are usually outsourced, and the educational background of the staff employed in these services is generally not high. Therefore, during training and communication, it is more necessary to provide a series of scope and training programs that are aligned with their understanding level. The model developed in this study effectively identifies the key infection prevention process and critical risk factors, enhancing the safety of medical staff and patients. This has significant research implications for the potential epidemic of major infectious diseases.

Quantitative Study on American COVID-19 Epidemic Predictions and Scenario Simulations

The COVID-19 pandemic has had a profound impact on people’s lives, making accurate prediction of epidemic trends a central focus in COVID-19 research. This study innovatively utilizes a spatiotemporal heterogeneity analysis (GTNNWR) model to predict COVID-19 deaths, simulate pandemic prevention scenarios, and quantitatively assess their preventive effects. The results show that the GTNNWR model exhibits superior predictive capacity to the conventional infectious disease dynamics model (SEIR model), which is approximately 9% higher, and reflects the spatial and temporal heterogeneity well. In scenario simulations, this study established five scenarios for epidemic prevention measures, and the results indicate that masks are the most influential single preventive measure, reducing deaths by 5.38%, followed by vaccination at 3.59%, and social distancing mandates at 2.69%. However, implementing single stringent preventive measures does not guarantee effectiveness across all states and months, such as California in January 2025, Florida in August 2024, and March–April 2024 in the continental U.S. On the other hand, the combined implementation of preventive measures proves 5 to-10-fold more effective than any single stringent measure, reducing deaths by 27.2%. The deaths under combined implementation measures never exceed that of standard preventive measures in any month. The research found that the combined implementation of measures in mask wearing, vaccination, and social distancing during winter can reduce the deaths by approximately 45%, which is approximately 1.5–3-fold higher than in the other seasons. This study provides valuable insights for COVID-19 epidemic prevention and control in America.

Post circumcision Fournier’s gangrene in an infant: A case report

Fournier’s gangrene is a rare life-threatening condition that is characterized by rapid necrotizing spread from the scrotum and perineal area along facial planes to the abdominal wall, the flanks and the upper thighs. We present a case report of post-circumcision Fournier’s gangrene in an infant that was associated with spontaneous rupture of the lower pole of the left scrotum. This report highlights the need for practitioners of circumcision to be skillful in the procedure, use sterile instruments for it and adhere to standard infection prevention and control measures in health facilities.

KNOWLEDGE AND PREDICTORS OF IMPLEMENTATION OF STANDARD PRECAUTIONS FOR INFECTION PREVENTION AND CONTROL AMONG HEALTH CARE PRACTITIONERS.

Infection prevention and control involve health care practitioners, who are saddled with the duty of ensuring implementation of standard preventive measures to prevent healthcare associated infections. To assess the knowledge and predictors of implementation of standard precautions for infection prevention and control among health care practitioners (HCPs). A questionnaire-based cross-sectional design was employed in assessing HCPs in Uganda in from April - October 2023. Data were analyzed using descriptive, Pearsons' correlation, linear and binary logistic regression with the aid of SPSS Version 22. Among the 222 healthcare practitioners assessed, 127 (57.2%) and 115 (51.8 %) had good knowledge and practice towards implementation of standard infection prevention and control precautions respectively. Chi square analysis indicated that age of healthcare practitioner (p=0.02; CI: 0.018 - 0.23), hospital unit of practice (p=0.003; CI: 0.002 - 0.004) and the type of facility where the health care practitioner works is significantly associated with their knowledge, while profession of the healthcare practitioner (p=0.002; CI: 0.001-0.003) and hospital unit of practice (p=0.002; CI: 0.001-0.003) were associated with implementation of the standard infection prevention and control precautions. Linear regression revealed knowledge is a significant predictor of good practice towards implementation of preventive measures (OR = 0.19; CI 0.102 - 0.272; p < 0.001). Healthcare practitioners had poor knowledge and practice towards infection prevention. Thus, emphasizing continuous education and training for all healthcare professionals about infection prevention and control interventions as well as strict adherence to proper infection prevention and control practices.

Intensive oral prophylaxis does not alter the tongue microbiome in young patients with chronic kidney disease: longitudinal, randomized, controlled study.

Gingivitis is a common intraoral disease in patients with chronic kidney disease (CKD), which poses a particular interdisciplinary challenge. We aimed to determine the influence of an intensive oral prophylaxis program (OPP) compared to standard prevention measures on the tongue microbiome of young patients with CKD. Thirty patients with CKD (mean age 14.2 ± 5.2 years) and generalized gingivitis were included. The effects of the intensive OPP were compared with standard prophylaxis according to statutory health insurance (treatment as usual, TAU) as a control. Tongue swabs were taken from the patients at baseline (t1) and after 3 (t2) and 6 (t3) months. Next-generation sequencing of 16S rDNA genes was used to quantitatively characterize microbial communities. There were no differences in the abundance, richness, or diversity of the observed genera and species between the two study groups at baseline or after 3 or 6 months. Furthermore, no change in predefined gingivitis and oral health bacterial clusters were found. At the phylum level, Firmicutes were decreased after intervention in the TAU group (t2TAU 42.9 ± 7.1 to t3TAU 34.8 ± 4.7 (npairs=14), p=0.003; false discovery rate 0.02). The decrease of Firmicutes was not significant in the OPP group. Despite the intensity of dental prophylaxis and decreasing clinical signs of inflammation and decreasing plaque amount, no clinically relevant changes in the tongue microbiome were observed. Our results confirm the conserved and stable nature of the tongue microbiome, even in children with CKD.

Ayurveda formulations for prophylaxis against coronavirus disease-2019 infection - A prospective community-based study in identified containment zones of 19 districts across India

Abstract Background: The severe acute respiratory syndrome coronavirus 2 steady mutation lead to the desperate search for effective treatment and preventive measures for coronavirus disease-2019 (COVID-19) globally. Ayurveda describes various medications that have been recognized for their pharmacological properties, particularly immunomodulation and anti-viral properties. Objective: The objective of this study was comparative assessment of Guduchi Ghana Vati and Sudarshana Ghana Vati intake for the prophylaxis of COVID-19, with a control arm of standard prophylactic care in a population in a containment zone. Materials and methods: Communities having at least one confirmed case of COVID-19 were identified in 19 districts of India in 14 states. Twenty thousand healthy participants, irrespective of gender, in the intervention group and 10,000 healthy participants in the control group were enrolled from these selected communities through the Central Council for Research in Ayurvedic Sciences identified 15 institutes. Two tablets (250 mg each) of Guduchi Ghana Vati were given twice daily with warm water after food or two tablets (500 mg each) of Sudarshana Ghana Vati were given twice daily with warm water after food for 30 days in the intervention group and standard of care issued by central/state/local health authorities as part of standard preventive measure against COVID-19 was followed in the control group. The primary outcome measure of the study was the comparative assessment of the occurrence of COVID-19 infection in clinically stable participants in the community having at least one confirmed case already identified with the control arm of standard prophylactic care. The secondary outcome measures were a comparative assessment of the severity of COVID-19 infection in participants taking Guduchi Ghana Vati or Sudarshana Ghana Vati and the control arm by assessment of participants not requiring hospitalization, the severity of symptoms of hospitalized patients in wards and patients requiring intensive care unit admission/ventilator support, global assessment of overall change as per the investigator and safety assessment by the evaluation of occurrence of adverse event (AE)/serious AE (SAE) due to consumption of Ayurvedic intervention. A P value of &lt; 0.05 was considered as significant. Results: The rate of COVID-19 positivity in the intervention group was 0.07% (n = 14) and in the control group was 0.04% (n = 4). Among 14 participants in the intervention group who tested COVID-19 positive, only one participant required hospitalization for management of COVID-19. The 4 participants who tested COVID-19 positive in the control group were hospitalized for management of COVID-19. After 30 days of intervention, the mean Immune Status Questionnaire (ISQ) score in the intervention group at baseline was 8.50, which increased to 9.16 on the 30th day (mean difference = 0.66), depicting the better immune status of the participants. Whereas, in the control group, the mean ISQ score at baseline was 8.68, which after 30 days reached 8.91 (mean difference = 0.23). No adverse drug reactions were reported in the study. Conclusion: Guduchi Ghana Vati and Sudarshana Ghana Vati were well tolerated and safe and showed potential benefits in the prophylaxis of COVID-19 in the participants. The study population is limited in representing people affected by COVID-19. Subsequent randomized controlled clinical research on diverse population may be undertaken to substantiate the prophylactic role of trial drugs in varied population.

Systematic Literature Review: Penerapan Manajemen Keselamatan dan Kesehatan Kerja di Puskesmas

The research evaluates the implementation of Occupational Safety and Health (K3) in Indonesian Community Health Centers (Puskesmas), with a focus on risk management, standard preventive measures, and fatal work accidents. Despite efforts to implement an Occupational Safety and Health Management System (SMK3), research shows gaps in the understanding and awareness of Community Health Center officers regarding standard preventive measures. Fatal accidents, such as electric shocks and fires, highlight the need for holistic risk management. Recommendations include regular training, equipment maintenance, and ongoing evaluation to improve OSH practices in these health facilities. These measures support the quality of healthcare and patient safety. This research was conducted using a systematic literature review guided by the PICO Framework to formulate specific and focused research questions. This research shows that careful planning has a key role in the successful implementation of Occupational Safety and Health (K3) in Community Health Centers, with the use of technology such as web-based reporting systems to increase efficiency. Continuous evaluation is an important instrument for identifying successes and challenges in K3 implementation, while external involvement and support is needed to overcome internal and external obstacles. Constraints such as lack of resources are the main focus, but evaluation also opens up opportunities for improvement, especially in the implementation of K3 policies and procedures. Optimizing K3 planning strategies is the key to increasing compliance and effectiveness of K3 management at the Community Health Center level, with an expanded focus on continuous supervision and monitoring.

CURRENT STRATEGIES IN THE PREVENTION OF POSTOPERATIVE INFECTIONS IN SPINAL SURGERY

This study aimed to analyze the strategies used to prevent postoperative infections in spinal surgery and evaluate their effectiveness in reducing the frequency of infections. The study design was retrospective and was conducted between January and December 2021 at the Department of Orthopedic &amp; Spine Surgery, Hayatabad Medical Complex. The study included a total of 90 patients who were divided into two groups based on the preventative techniques used. Group A (n=45) received standard preventive measures, such as preoperative antibiotics, accurate aseptic techniques, and postoperative wound care. In comparison, Group B (n=45) was given supplementary preventive measures such as antibiotic-impregnated bone grafts and wound irrigation with antiseptic solutions. The occurrence of postoperative infections, namely surgical site infections (SSIs) and deep wound infections, was documented and compared between the two groups. The mean age of patients in Group A was 55.2±8.6 years, while it was 57.8±9.2 years in Group B. Group A consisted of 27 (60%) male and 18 (40%) female patients, whereas Group B had 29 (64.44%) male and 16 (35.55%) female patients. Nine (20%) patients in Group A developed postoperative infections, while only three (6.7%) in Group B developed infections. The difference in postoperative infection incidence between the two groups was statistically significant (p&lt;0.05). Similarly, the incidence of SSIs was lower in Group B (4.4%) than in Group A (15.6%) (p&lt;0.05). Most patients in both groups (55.55% in Group A and 48.88% in Group B) received lumbar fusion surgery. Cervical fusion surgery was performed on 10 (22.22%) Group A patients and 12 (26.66%) Group B patients. Decompression surgery was performed on eight (17.77%) patients in Group A and nine (20%) individuals in Group B. The study's findings indicate that preventive techniques, such as antibiotic-impregnated bone grafts and wound irrigation with antiseptic solutions, can significantly reduce postoperative infections in spine surgery. However, further research is needed to determine the long-term effectiveness of these prevention approaches and explore alternative methods for preventing postoperative infections in spine surgery.

Assessment of the impact of reopening strategies on the spatial transmission risk of COVID-19 based on a data-driven transmission model

COVID-19 has dramatically changed people's mobility geste patterns and affected the operations of different functional spots. In the environment of the successful reopening of countries around the world since 2022, it's pivotal to understand whether the reopening of different types of locales poses a threat of wide epidemic transmission. In this paper, by establishing an epidemiological model based on mobile network data, combining the data handed by the Safegraph website, and taking into account the crowd inflow characteristics and the changes of susceptible and latent populations, the trends of the number of crowd visits and the number of epidemic infections at different functional points of interest after the perpetration of continuing strategies were simulated. The model was also validated with daily new cases in ten metropolitan areas in the United States from March to May 2020, and the results showed that the model fitted the evolutionary trend of realistic data more accurately. Further, the points of interest were classified into risk levels, and the corresponding reopening minimum standard prevention and control measures were proposed to be implemented according to different risk levels. The results showed that restaurants and gyms became high-risk points of interest after the perpetration of the continuing strategy, especially the general dine-in restaurants were at higher risk levels. Religious exertion centers were the points of interest with the loftiest average infection rates after the perpetration of the continuing strategy. Points of interest such as convenience stores, large shopping malls, and pharmacies were at a lower risk for outbreak impact after the continuing strategy was enforced. Based on this, continuing forestallment and control strategies for different functional points of interest are proposed to provide decision support for the development of precise forestallment and control measures for different spots.

Effect of eucalyptus oil on Streptococcus mutans and Enterococcus faecalis growth

ObjectivesThere is a significant apprehension in medicine and dentistry concerning the emergence of antibiotic-resistant pathogens, as it composes a significant threat to global health, particularly oral health. The growing concern that oral pathogens may develop resistance against standard preventive measures raises the need for alternative measures to prevent these pathogens’ growth without inducing microbial resistance. Therefore, this study aims to assess the antibacterial properties of eucalyptus oil (EO) against two main oral disease pathogens, Streptococcus mutans, and Enterococci faecalis.MethodsS. mutans and E. faecalis biofilms were initiated using brain-heart infusion (BHI) broth supplemented with 2% sucrose with and without diluted EO. After 24 h of biofilm formation, total absorbance was measured via spectrophotometer; then, the biofilm was fixed, stained with crystal violet dye, and measured at 490 nm. An Independent t-test was used to compare the outcomes.ResultsDiluted EO revealed significant total absorbance reduction against S. mutans and E. faecalis compared to the control (p ≤ 0.001). For the biofilm measurement, S. mutans and E. faecalis biofilms were reduced by around 60- and 30-fold, respectively, compared to the group with no EO (p ≤ 0.001).ConclusionBased on this study’s results, using EO as an organic compound could be considered an adjunctive tool in preventing the growth of oral pathogens causing dental caries and endodontic infection.

Occupational hand trauma – Mechanism of injury and transient risk factors in Jerusalem

IntroductionAlthough prevalent, and variable geographically, there is little information on the incidence and risk factors for occupation hand trauma in our health care system. This pilot study was designed to determine the optimal data collection methods for transient risk factors locally MethodsAll adult patients with occupational hand trauma treated at an emergency department (ED) during a three-month period were interviewed, either in person or by phone, using a case crossover designed questionnaire, regarding occupation and exposure to potential transient risk factor. ResultsOf 206 patients treated with occupational trauma during the study period, 94 had trauma distal to the elbow (46%). Patient compliance was high - 89% of the patients consented to phone interviews and 83% completed in-person ED interviews. In the 75 patients which participated in the study, several risk factors were found to be significant, including machine maintenance and being distracted, including by a cellular phone. We found lack of job experience, limited training on the job site and reports of previous injuries in these workplaces to be prevelent. DiscussionThe risk factors implicated in this study are similar to those reported in previous studies at other locations and are modifiable although this is the first report linking cellular phone use and occupation trauma. This finding should be further examined in a larger group and according to occupational categories. Compliance with the study was high, in person or with phone interviews, making these options viable for further studies. Several minor changes to the questionnaire were suggested although it did conform with the case-crossover study design. According to this study, standard preventive measures may be lacking in Jerusalem and should be implemented more uniformly, including specific workplace safety plans and education and taking into consideration the risk factors documented here.

Prevalence of anemia and its predictors among patients with chronic kidney disease admitted to a teaching hospital in Ethiopia: A hospital-based cross-sectional study.

Anemia is a common complication of chronic kidney disease (CKD) and is associated with adverse patient outcomes. However, data on the prevalence of anemia in CKD patients is sparse, particularly in resource-limited settings. Therefore, this study aimed to assess the prevalence of anemia and its predictors among patients with CKD admitted to the Jimma medical center, southwest Ethiopia. A hospital-based prospective cross-sectional study was conducted from September 1 to November 30, 2020. All adult patients with CKD aged ≥18 years who fulfilled the inclusion criteria were consecutively recruited into the study. Data were entered into the Epi data manager version 4.4.1 and then exported to SPSS version 22 (IBM Corp., Armonk, NY) for analysis. The predictors of anemia were determined using multivariable logistic regression analysis. Statistical significance was set at P < .05. A total of 150 patients were included in this study. Of these, 64.67% were male, 56.67% had stage 5 CKD, 78% had a CKD duration of less than 1 year, and 74% had proteinuria. Hypertension (40.7%) and diabetes (14.7%) were the common causes of CKD. The prevalence of anemia was 85.33%. Of the patients, 28.67%, 40.67%, and 16% had mild, moderate, and severe anemia, respectively. On multivariate logistic regression, stage 4 CKD (adjusted odds ratio [AOR] 3.2, confidence interval [CI]: 1.78-12.91, P = .025), stage 5 CKD (AOR 4.03, CI: 1.17-13.73, P = .016), and CKD duration of less than 1 year (AOR 3, CI: 1.19-9.11, P = .007) were significantly associated with anemia. The prevalence of anemia among stage 3 to 5 CKD patients was very high. Anemia was significantly associated with the severity and duration of CKD. Therefore, serial follow-up of patients with a long duration and advanced stages of CKD may help prevent anemia and its adverse consequences.

Seroprevalence of coxsackievirus A6 and enterovirus A71 infection in humans: a systematic review and meta-analysis.

Hand, foot, and mouth disease (HFMD) is a common infectious disease in children. Enterovirus A71 (EV-A71) is one of the main pathogens, and coxsackievirus A6 (CVA6) has gradually become the dominant pathogen of HFMD in recent years. This study was conducted mainly to assess the serological prevalence of EV-A71 and CVA6 antibodies in people of different ages, sexes, and regions through a systematic review and meta-analysis. A comprehensive study was performed based on the EV-A71 and CVA6 serological literature published before May 2022. Heterogeneity analysis (Cochrane's Q test and the I2 statistic) and random effect models were adopted. Subgroup and meta-regression analyses were used to identify potential sources of heterogeneity in the data, and all analysis was performed using STATA version 16.0. This study included 71 studies involving 55,176 people from 13 countries that met the inclusion criteria. The serological prevalence of EV-A71 antibody in different studies was 4.31-88.8%, and that of CVA6 antibody was 40.8-80.9%. Meta-analysis results showed that the serum positive rate for EV-A71 antibody was 45.9% (95% CI: 37.6-54.1%). The rate in the Chinese population was 47.8% (95% CI: 42.4-53.2%), and in the other countries, it was 38% (95% CI: 23-55%). The serum positive rate for CVA6 antibody was 58.3% (95% CI: 46.5-70.2%). The rate in the Chinese population was 49.1% (95% CI: 38.3-59.9%), and in the other countries, it was 68% (95% CI: 51-83%). Subgroup analysis was also conducted. The seroprevalence of EV-A71 and CVA6 antibodies is related to age rather than gender or region. The rates of EV-A71 and CVA6 seropositivity are considerably lower in children younger than five years of age. However, the rates gradually increase with age. The findings of this study suggest that children under five years of age may be susceptible to EV-A71 and CVA6. Thus, safety education and vaccination should be strengthened accordingly. This study provides a basis for understanding the risk factors for EV-A71 and CVA6 infection in China and for deciding how to formulate standard preventive measures to prevent the spread of the virus.