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OBJECTIVE: To analyze the role of nosocomial infection informatics surveillance system in the prevention and control of multidrug-resistant organisms(MDROs) infections. METHODS: The First Affiliated Hospital of Guangdong Pharmaceutical University was selected as the study subjects, which had adopted the nosocomial infection informatics surveillance system since Jan.2020. The period of Jan.to Dec.2020 were regarded as the study period, and Jan.to Dec.2019 were regarded as the control period. The situation of nosocomial infection and MDROs infections in the two periods were retrospectively analyzed. RESULTS: The incidence of nosocomial infections and underreporting of nosocomial infection cases in this hospital during the study period were 2.52%(1 325/52 624) and 1.74%(23/1 325), respectively, and the incidences of ventilator associated pneumonia(VAP), catheter related bloodstream infection(CRBSI), catheter related urinary tract infection(CAUTI)were 4.10(31/7 568), 2.11(14/6 634), and 2.50(25/9 993) respectively, which were lower than those during the control period(P< 0.05). The positive rate of pathogenic examination in the hospital during the study period was 77.95%(1 269/1 628), which was higher than that during the control period(P<0.05), the overall detection rate of MDROs was 15.77%(206/1 306), the detection rates of MDROs in Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa and Staphylococcus aureus were lower than those during the control period(P<0.05). CONCLUSION: The development and application of the informatics technology-based surveillance system of nosocomial infection could effectively reduce the incidence of nosocomial infections and device related infections, decrease the under-reporting of infection cases, and also reduce the detection rate of MDROs as well as the proportion of MDROs detected in common pathogenic species.
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Introduction: Respiratory infections including Coronavirus Disease-2019 (COVID-19) infection spread through droplet infections. Hence standard precautionary measures like handwashing and use of masks are essential to prevent transmission of these infections in healthcare setting. Aim: To determine the effect of COVID-19 pandemic on awareness level of resident doctors on prevention of spread of infective respiratory secretions. Materials and Methods: This cross-sectional study was conducted among two subsequent batches (year 2019-20 and 2020-21) of resident doctors at a medical college hospital, from February 2020 to September 2020. The 2019-2020 batch of resident doctors worked as residents from March 2019 to March 2020 and were considered as pre-COVID-19 batch. The 2020-2021 batch of resident doctors had their training period from April 2020 to April 2021 and were considered the COVID-19 batch. A pretested semi-structured questionnaire consisting of 14 questions to evaluate the awareness on prevention of spread of infective respiratory secretions was administered. The responses were evaluated, marks awarded and summated. Results: The response rate of pre-COVID-19 batch was 85% and that of COVID-19 batch was 86%. The mean (standard deviation) score obtained by the COVID-19 batch was 9.91 +/- 3.42 which was significant higher than that obtained by the pre-COVID-19 batch which was 7.1 +/- 1.83. The score obtained by COVID-19 batch for 11/14 questions was significantly higher compared to the pre-COVID-19 batch. Conclusion: A significant improvement was seen in the knowledge level in prevention of spread of infective respiratory secretions among resident doctors after the onset of the COVID-19 pandemic.
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This proceedings contains 112 s that cover a wide range of topics related to microbiology. The s cover a wide range of topics related to microbiology, including new paradigms in a microbe-threatened world, the human-animal spillover of SARS-CoV-2 and its implications for public health, preparing for the next pandemic, antimicrobial resistance and the fight against it. Furthermore, tuberculosis, monkeypox, and their potential threat on a global scale are also discussed. The presentations also cover a variety of other topics, such as vaccines and vaccinations, COVID-19 vaccines, addressing vaccine hesitancy, key issues related to the COVID-19 healthcare system, regional support for outbreak preparedness, enhancing regional health security in Asia through genomic surveillance, the role of molecular diagnostic capacity in COVID-19 control, antimicrobial resistance in COVID-19 times, paediatric nosocomial infections, prescription ethics from a primary care perspective, the BCG vaccine and its relevance in the prevention of tuberculosis and beyond, tuberculosis as a forgotten pandemic, vector-borne diseases during COVID-19, the role of media advocacy in vector-borne diseases control and management, engaging communities in tackling vector-borne diseases, the way forward in managing mental health in the COVID-19 endemic phase, the spread of zoonotic diseases, and whole genome sequencing of SARS-CoV-2: clinical applications and experience.
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[...]the mortality reduction has previously been reported in the prospective meta-analysis [2] conducted by The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group. Nonetheless, owing to relatively scarce evidence, it is still unclear whether monoclonal IL-6 antibodies reduce mortality in patients with COVID-19, similar to the IL-6 receptor inhibitors. [...]large-scale randomised trials should also be conducted to establish the role of monoclonal IL-6 antibodies in the treatment of COVID-19. [...]among hypothetical long-term complications, peripheral neuropathy would also be noticeable [10] and may contribute to the broad long COVID pattern. [...]there is a theoretical risk of altering the efficacy of immune checkpoint inhibitors during tumour disease management [11].
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This journal issue includes s of papers presented at the conference. Topics discussed are: sleeping characteristics among primary school children in Gampaha District, Sri Lanka;cosmetic effects of post thyroidectomy scar and evaluation of patient satisfaction;post-vaccination symptoms of COVID-19 vaccines among adults in Galle;multiple chest trauma in a victim of road traffic collision;anatomical variations of renal vein in a group of Sri Lankan cadavers;hospital acquired infections among patients in Intensive Care Units in Teaching Hospital, Karapitiya;serum Vitamin D level among 1 to 5-year-old children in Galle Municipality and Bope Poddala MOH area.
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BACKGROUND: Physiotherapists and physiotherapy undergraduates have direct contact with patients which make them transmitters of infections if they do not follow standard precautions. Hence, the purpose of this study was to assess the knowledge of nosocomial infections, standard precautions, and source of information among physiotherapy undergraduates in Sri Lanka. METHODS: An observational Google based survey study was conducted among 294 physiotherapy undergraduates, of which there were 103 in University of Peradeniya, 103 in University of Colombo, and 88 in General Sir John Kotelawala Defence University. The Infection Control Standardized Questionnaire comprising three domains: knowledge of nosocomial infections, standard precautions and hand hygiene was used for data collection along with a self-constructed data sheet for socio-demographic information and source of information. RESULTS: Participants achieved mean knowledge of 67.1 ± 16.8, 84.4 ± 14.7 and 66.4 ± 15.4 for nosocomial infections, standard precautions, and hand hygiene respectively. Of the total sample, 225 (76.5%) achieved adequate level of total knowledge. Eighty-three of them (28.3%) equally mentioned, formal teaching at faculty and informal sources as the most important source of knowledge. There was no significant impact of university and the duration of clinical exposure on knowledge of nosocomial infections, standard precautions, hand hygiene and total knowledge. The study year has a significant impact on standard precautions (P = 0.004) and total knowledge (P = 0.035) and final years had highest knowledge compared to the other study years. CONCLUSION: Knowledge of nosocomial infections and infection control measures were satisfactory among the physiotherapy undergraduates in Sri Lanka. Further developments of formal sources of information about nosocomial infections are recommended.
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Cross Infection , Humans , Cross Infection/prevention & control , Sri Lanka , Information Sources , Infection Control , Physical Therapy ModalitiesABSTRACT
The epidemic of coronavirus disease 2019 (COVID-19) has seriously affected people's normal work, life, and medical treatment. Since Mar. 2022, there has been a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in Shanghai. In order to meet the needs of hospitalization for patients, and at the same time for better control of epidemic and nosocomial infections, a large hospital in Shanghai innovatively set up a centralized transition ward in the hospital, and established scientific rules of medical work, regulations for prevention of nosocomial infections and efficient norms for patient admission. During the operation of the ward, a total of 211 patients were treated and one of the patients was confirmed of COVID-19 recurrence. All work was carried out methodically, and neither hospitalized patients nor medical staff had nosocomial infection of COVID-19. The preparation, operation and management of the central transition ward in our hospital are summarized here to provide guidance and reference for general hospitals to carry out similar work under the epidemic.
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Introduction: Rise of major Healthcare associated infections (HAIs) can be mitigated by inculcating good infection control practices which can only be possible by proper and timely educational training of healthcare workers. Aim: To reinforce infection prevention and control knowledge and practices of nursing staff through proper training program- To conduct the training in multiple sessions, to assess the immediate outcome of training program by conducting Pre and Post test (in written format only) Materials and Methods: This study was done in a tertiary care hospital in Davangere, Karnataka over a period of 2 years. Healthcare workers including 144 nurses and 12 doctors underwent training in four sessions where knowledge on how to identify, audit and conduct surveillance of major healthcare associated infections, management of needlestick injuries were imparted through interactive lectures and video demonstrations followed by hands on hand hygiene, proper use and disposal of personal protective equipments. Pre and Post test were given to know their basal knowledge and effect of our training intervention. Data was collected, analyzed and tabulated. Results: Out of four sessions covering a total of 144 nurses, 84 were trained before the onset of COVID-19 and remaining 60 were trained in the latter half of 2021, when the lockdown was relaxed in our region. The mean total Knowledge score in pre test and post test was 5.93 +or- 1.336 and 7.95 +or- 1.040. The mean difference was -2.021 and it was statistically significant by paired test. (p - 0.001). The mean total practice pretest and post test score was 3.57 +or- 1.48 and 4.56 +or- 1.114. Paired t test showed significant mean difference between the pretest and post test score. (p - 0.001). Conclusion: Our training intervention was effective in increasing their awareness on proper infection prevention and control practices. Repeated training and retraining of healthcare care workers have to be carried out to prevent and control healthcare associated infections.
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Hand hygiene is obligatory for all healthcare workers and vital for patient care. During COVID-19, adequate hand washing was among recommended measures for preventing virus transmission. A general hand-washing procedure consisting several steps is recommended by World Health Organization for ensuring hand hygiene. This process can vary from person to person and human supervision for inspection would be impractical. In this study, we propose computer vision-based new methods using 12 different neural network models and 4 different data models (RGB, Point Cloud, Point Gesture Map, Projection) for the classification of 8 universally accepted hand-washing steps. These methods can also perform well under situations where the order of steps is not observed or the duration of steps are varied. Using a custom dataset, we achieved 100% accuracy with one of the models, and 94.23% average accuracy for all models. We also developed a real-time robust data acquisition technique where RGB and depth streams from Kinect 2.0 camera were utilized. Results showed that with the proposed methods and data models, efficient hand hygiene control is possible.
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This double-blind field study tested the effectiveness of a baby-eyes image in promoting healthcare workers' hand-hygiene compliance in a hospital setting. Adults are inclined to take care of babies and aspire to be their role models;therefore, they should wash their hands thoroughly when being watched by babies. Participants were healthcare workers from the obstetrical and neonatology units of a women's hospital in Hangzhou. We recorded and coded 3,360 hours and 10,325 hand-hygiene events over a five-week period—from 16 October to 20 November 2018. Three types of stickers, depicting baby eyes, adult eyes, or flowers, were placed above handwashing basins to compare hand-hygiene behavior between the three conditions. Each condition continued for one week, and experimenters interchanged the stickers in each unit to control for the location and sequence effects. Participants in the baby-eyes condition (72.9%) were more likely to use sanitizer than those in the flowers condition (69.4%;χ2 = 9.74, p < .01, φc = 0.034). Moreover, participants in the baby-eyes condition were more likely to use sanitizer than those in the adult-eyes condition (70.8%);however, the difference only trended towards significance (χ2 = 2.38, p = .066, φc = 0.023). The mean handwashing time between the three conditions was significant (Welch's F(2, 3488.436) = 3.50, p < .05, η2 = 0.001). Washing time in the baby-eyes condition (17.41 ± 12.02) was significantly longer than in the adult-eyes condition (16.36 ± 11.47;p < .05). The presence of a baby-eyes image promoted hand-hygiene compliance in the hospital environment. This finding can be adopted to change public health behaviors. It also holds theoretical implications that enhance our understanding of how being monitored by children can enhance responsible behaviors.
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Hygiene is the most useful public health measure for preventing infections of important endemic and emerging diseases of global significance. This study aimed to assess the impact of these public health preventive measures on dirty hand diseases. A retrospective survey was conducted in the rural general hospitals of Taabo (south-central Côte d'Ivoire) and Marcory (urban Abidjan) to collect clinical data on dirty hand diseases in the patients' records from 2013 to 2020. In addition, focus group discussions (N = 8) were conducted in the communities in both settings to identify the sociocultural and economic hindering or fostering factors that affected the adoption of and the compliance with handwashing and disinfection practices. A total of 3245 and 8154 patients' records were examined in the general hospitals of Taabo and Marcory, respectively. Compared with women, men were more affected by typhoid fever (OR, 0.68 [95%CI, 0.53–0.88]) and influenza (OR, 0.87 [95%CI, 0.75–1]). Hygiene measures promoted during Ebola and COVID-19 outbreaks had no impact on the prevalence of typhoid fever in both settings;however, a positive impact was observed regarding influenza infections. Populations were aware of the importance of handwashing for public health but had difficulties adhering due to financial constraints, access to drinking water, and the absence or scarcity of handwashing facilities.
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Objective. To study spectrum of pathogens and the time to colonization of respiratory samples in patients with severe and critical COVID-19 as well as to analyze incidence of nosocomial infections and structure of prescribed antibacterial drugs. Materials and methods. The prospective observational study included patients aged 18 years and older with confirmed severe and critical COVID-19 from December 2021 to February 2022. During the first 48 hours and then every 2-3 days of hospitalization, a respiratory sample was collected: sputum, tracheal aspirate (if intubated), bronchoalveolar lavage (if bronchoscopy was performed) for microscopy and microbiological examination. Some patients were screened for invasive aspergillosis. Clinical and demographic data, comorbidities, pathogenetic therapy for COVID-19, antibiotic therapy, cases of probable/documented bacterial nosocomial infections, antibiotic-associated diarrhea, and hospital treatment outcomes were recorded. Results. A total of 82 patients were included in this study. Patients with lung parenchyma involvement of more than 50% by computer tomography predominated;most of them (77%) required intubation and mechanical ventilation due to progression of respiratory failure, and 76% of patients had a lethal outcome. During the first 48 hours, a respiratory sample was obtained from 47 patients;the rest of the patients presented with non-productive cough. No growth of microorganisms was detected in 31 (36.8%) cases;clinically significant pathogens were detected in 16 (19.5%) patients. A subsequent analysis included data from 63 patients with a sufficient number of samples for dynamic observation were used. During the first 3 days of ICU stay, the most common bacterial pathogens were Klebsiella pneumoniae without acquired antibiotic resistance and methicillin-susceptible Staphylococcus aureus. From 3rd day and afterwards, an increase in the proportion of Acinetobacter baumannii, other non-fermenting bacteria, and carbapenem-resistant Enterobacterales was noted. Among the pathogens causing lower respiratory tract infections, A. baumannii and carbapenem-resistant K. pneumoniae were predominant pathogens and accounted for 76% of cases. Positive galactomannan test results were obtained in 4 cases. Conclusions. The study confirmed importance of bacterial nosocomial infections in patients with severe and critical COVID-19. In the case of the development of nosocomial lower respiratory tract infections, empirical antimicrobial therapy should take into account the predominance of carbapenem-resistant Enterobacteria and A. baumannii, as well as the possibility of invasive aspergillosis.Copyright © 2022, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.
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Background: Nosocomial infections are a serious public health problem affecting both developed and developing countries. They are caused mainly by multi-drug-resistant pathogens that limit treatment options, leading to high morbidity and mortality, longer hospital stays and increased costs of health care. This study aimed to evaluate nosocomial infections, risk factors and causative pathogens at two large teaching hospitals in Zambia. Material and methods: A yearlong hospital-based cross-sectional study was conducted from April 2020 to April 2021 at two large tertiary-level hospitals in Zambia. Hospitalised and out-patients with previous hospital contact were screened for nosocomial infections, followed by the collection of specimens (skin swabs, urine or sputum) for bacteriological culture and Polymerase Chain Reaction (PCR) amplification of 16S rRNA gene fragments. Nosocomial infections were defined according to the World Health Organization case definitions. Frequencies were estimated, and the association between the outcome variable (positive culture) and categorical predictor variables were analysed using the Chi-square test. Results: Eight hundred and forty-one clinical specimens (skin swabs, urine or sputum) were collected and analysed, 640 from the University Teaching Hospital in Lusaka and 201 from the Ndola Teaching Hospital in Ndola. Of these, 71.2% were from male, with only 28.8% from female patients. The median age was 50 years old. Catheter-associated urinary tract infections (57%) were the most common, followed by those from pressure sores (38.7%). The most frequently observed pathogens included Escherichia coli (17.8%), Pseudomonas aeruginosa (13.7%), Klebsiella pneumonia (5.6%) and Proteus vulgaris (5.5%). Conclusions: The hospital infection rate at the two urban tertiary hospitals was very high. Age over 65 years, male gender, presence of medical devices, presence of a wound, longer hospital stays, previous hospital contacts and low systolic blood pressure were associated with the risk of developing nosocomial infections. Despite improved infection control following the COVID-19 waves, nosocomial infections have remained a significant public health threat. © 2023 The Author(s)
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The relationship between smoking and the lung damage volume in patients with a confirmed new coronavirus infection diagnosis, hospitalized in a temporary infectious hospital for the treatment of patients suffering from a new coronavirus infection and community-acquired pneumonia was evaluated. This was in the Odintsovo District's Patriot Park of the Moscow region. Smoking cigarettes, both active and passive, as well as exposure to tobacco smoke on the body, are important upper and lower respiratory tract infection risk factors due to local immune response suppression. Nevertheless, data from a number of international studies indicate a significantly lower number of hospitalized smoking patients compared to non-smokers. These indicators were investigated as the percentage and degree of lung damage, smoking history, the number of cigarettes smoked per day, and the smoker's index. In the course of the study, the data on a smaller percentage of smokers admitted to inpatient treatment were confirmed in comparison with non-smokers and smokers in the general population. There was no statistically significant difference in the volume of lung damage between smoking and non-smoking patients according to the chest organs computed tomography. At the same time, there was an increase in the volume of lung tissue damage, depending on the smoking experience. This is apparently due to the irreversible changes formation in lung tissue against a long-term smoking background. The median age of smoking patients was 56 years with a variation from 46 to 68 years. The minimum and maximum ages were 29 and 82. The median lung lesion was 32% with a variation from 23% to 39%. The minimum and maximum lung damage is 10% and 40%, respectively. A moderate correlation was found between the smoking experience and the volume of lung damage. An increase in lung damage by 0.309% should be expected with an increase in smoking experience by one full year. There was also no statistically significant difference in the number of cigarettes smoked per day and the smoker's index.
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In 2008, the Centers for Disease Control and Prevention (CDC, n.d.) National Healthcare Safety Network (NHSN) announced new requirements, enforced with fiscal penalties, for hospitals to address hospital-acquired infections (HAIs). [...]nurse leaders across the United States supported design of new protocols and procedures to reduce central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated pneumonia (VAP), surgical site infection (SSI), and more. Recognizing the impact of NVHAP on patient safety and the lack of requirements for hospitals to monitor or report NVHAP, a group of U.S. healthcare leaders sponsored by the Department of Veterans Affairs formed the nurse-led National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) in 2020. The survey also included questions related to known NVHAP prevention practices on policy, training, monitoring and documentation, family involvement, supply availability, and specific oral care practices related to the COVID19 pandemic. Because recent research demonstrated some promise in the use of antiseptic mouth rinses in eradicating SARS-CoV-2 virus, two questions were included related to use of mouth rinses (Casale et al., 2020;Pelletier et al., 2021).
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Recurrent Clostridioides difficile infection (RCDI) causes an increased burden on the healthcare system. We calculated RCDI incidence and identified factors associated with RCDI cases in New Haven County, Connecticut, USA, during 2015-2020 by using data from population-based laboratory surveillance. A subset of C. difficile cases had complete chart reviews conducted for RCDI and potentially associated variables. RCDI was defined as a positive C. difficile specimen occurring 2-8 weeks after incident C. difficile infection. We compared cases with and without RCDI by using multiple regression. RCDI occurred in 12.0% of 4,301 chart-reviewed C. difficile cases, showing a U-shaped time trend with a sharp increase in 2020, mostly because of an increase in hospital-onset cases. Malignancy (odds ratio 1.51 [95% CI 1.11-2.07]) and antecedent nitrofurantoin use (odds ratio 2.37 [95% CI 1.23-4.58]) were medical risk factors for RCDI. The 2020 increase may reflect the impact of the COVID-19 pandemic.
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COVID-19 , Clostridioides difficile , Clostridium Infections , Humans , Retrospective Studies , Connecticut/epidemiology , Pandemics , Recurrence , COVID-19/epidemiology , Risk Factors , Clostridium Infections/epidemiologyABSTRACT
The provision of cardiac surgery services nationwide has been affected by the COVID-19 pandemic. We noticed a high COVID-19 mortality rate in unvaccinated patients who were diagnosed with COVID-19 after recent cardiac surgery. All the patients were tested negative for COVID-19 before surgery. We conducted a review of our hospital data and reported our findings. We identified 15 patients and reported 7 deaths (46.7%). All the patients died from COVID-19 or its complications. We recommend that cardiac centres actively promote vaccination before cardiac surgery and also enhance infection control measures to prevent nosocomial infections.
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The study reviewed current standards of care for IVAD flush maintenance frequency, examined the characteristics of blood from IVADs by aspirating and observing contents prior to flushing when maintenance care is delayed beyond four weeks, and identified whether more research is required to determine optimal IVAD maintenance flush frequency methods: KEYWORDS port maintenance;guideline variations;flushing;oncology;standards of care;biofilm more than two billion intravascular devices, which are widely used in critical patients and patients with cancer, are inserted globally each year (He et al., 2019). Project Procedures A literature review included a search from January 2016 through April 2022 and encompassed current INS, Oncology Nursing Society, National Comprehensive Cancer Network, and Centers for Disease Control and Prevention guidelines and recommendations for practice, and manufacturer guidance. [...]once the Huber needle was inserted, aspiration was attempted to observe for a brisk blood return.
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Objective: To investigate a nosocomial infection outbreak of Omicron BA.5.1.3 strain of SARS-CoV-2, and to analyze the transmission mode of Omicron BA.5.1.3 strain in hospitals, in order to evaluate the effect of nosocomial infection control and provide a basis for the epidemic prevention and control of this strain in hospitals. Methods: The onsite epidemiological methods were used to investigate the confirmed cases and their close contacts, and the prevention and control measures of nosocomial infection caused by this outbreak were studied. Results: The outbreak time of nosocomial infection was from August 4 to August 8, and the incubation period was 1-5 days, with an average incubation period of 3.0 days. The first confirmed case was a 53-year-old woman who received three doses of COVID-19 vaccine and accompanied the family of the patient in the hospital. She had traveled to a high-risk area three days before onset of the disease, and the virus type was Omicron BA.5.1.3 strain. The outbreak area was two adjacent wards of the hospital, and the incidence rates of inpatients in the two wards were 66.67% (2/3) and 33.33% (1/3), respectively. A total of 967 people were affected, including 1 imported case, 4 hospitalized cases (3 hospitalized patients and 1 nurse), 537 close contacts and 425 secondary close contacts. On August 5, the city's disease control and prevention telephone notified the first confirmed COVID-19 case. Within 0.5 hours, the ward where the case was located was sealed and static management was carried out. Measures such as district grid management, nucleic acid test in the whole hospital and in-hospital flow control were initiated. Environmental sampling, whole environment disinfection and telephone flow adjustment of case 1 were completed within 4 hours. Close contacts, secondary close contacts sampling and control were completed within 24 hours. We paid attention to the dynamics of close contacts and secondary close contacts, as if whose nucleic acid was positive, further measures could be taken to eliminate the risks. The hospital returned to normal management on August 13. Conclusion: The novel coronavirus BA.5.1.3 strain shows strong pathogenicity, short incubation period, causing overall mild disease. Timely and comprehensive prevention and control measures were the key meathods to nosocomial infection control.