Current status of hand hygiene practices among primary healthcare workers and its influencing factors / 上海预防医学

ObjectiveTo investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers， and to provide a reference for improving hand hygiene behavior in primary healthcare institutions. MethodsA self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District， Shanghai， using a cluster random sampling method. The data collected were subjected to descriptive statistics， reliability and validity tests， correlation analysis， and structural equation model fitting. ResultsA statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels （P<0.05）， and medical staff in clinical departments exhibited higher levels of hand hygiene compliance （P<0.05）. In the health belief model， among the core variables， healthcare workers’ perceived benefits， perceived barriers， and self-efficacy had a direct impact on hand hygiene behavior， with direct effect values of 0.341， -0.152， and 0.234， respectively. Meanwhile， cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior， with an indirect effect value of 0.066 and 0.062， respectively. ConclusionHealthcare workers generally exhibit a high degree of hand hygiene compliance， but there are variations in hand hygiene scores among healthcare workers with different characteristics. Enhancing healthcare worders’ perception of benefits， action cues， and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.

Enterotoxin gene profiles of Staphylococcus aureus isolated from environment and patients in a hospital in Shanghai from 2018 to 2021 / 上海预防医学

ObjectiveTo investigate the prevalence of Staphylococcus aureus in a hospital in Jiading District， Shanghai， and to determine the enterotoxin gene profiles of Staphylococcus aureus isolated from patients and environment. MethodsSpecimens were collected from environment and patients from a hospital for Staphylococcus aureus isolation and identification. Furthermore， enterotoxin genes （SEA‒SEE） of Staphylococcus aureus were detected. ResultsA total of 54 Staphylococcus aureus strains were isolated from 780 hospital environmental specimens from 2018 to 2021， with a prevalence of 6.92%. In the armrests in the wards， patient’s pillows/quilts， and bedside cupboards， the prevalence was determined to be 20.00%， 20.00% and 16.67%， respectively. In contrast， in the computer’s mouse and keyboard and work clothes of physicians and nurses， the prevalence was 17.42% and 16.67%， respectively. Meanwhile， from 2018 to 2021， a total of 75 strains were collected from patients， of which 36.00%， 14.67% and 14.67% were from the departments of intensive care medicine （ICU）， neurosurgery and orthopedics， respectively. The prevalence of Staphylococcus aureus enterotoxin genes were 48.15% and 61.33% in the environment and patients， respectively. Furthermore， the prevalence of SEA， SEB， SEC， SED， and SEE genes were 14.67%， 41.33%， 9.33%， 1.33%， 1.33% in patients， respectively ， whereas 20.37%， 25.93%， 1.85 %， 1.85% and 0% in environmental specimens， respectively. In the environmental specimens isolated from comprehensive ICU， the prevalence of enterotoxin genes was 77.27%. In the patient's specimens， Staphylococcus aureus was mostly isolated in sputum. Additionally， the prevalence of enterotoxin genes was high in the patients of departments of respiratory medicine， ICU， and orthopedics. ConclusionPrevalence of Staphylococcus aureus remains moderate in the hospital environment. Enterotoxin genes of Staphylococcus aureus are common， with seb gene as the most common gene， followed by SEA gene. It warrants strengthening the disinfection and control of Staphylococcus aureus in the hospital， especially in the ICU.