Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 75
Filter
1.
Risk Manag Healthc Policy ; 13: 1563-1569, 2020.
Article in English | MEDLINE | ID: covidwho-1793247

ABSTRACT

BACKGROUND: Coronavirus disease-2019 (COVID-19) is a new infectious disease. The COVID-19 outbreak has quickly spread globally and now is having remarkable effects on public health and national economies. PURPOSE: Effective measures for prevention and control of nosocomial infection are urgently needed to control COVID-19 infection among medical staff. METHODS: Herein, we described COVID-19 prevention and control strategies that have been implemented in a tertiary hospital in the middle east of China. Hospital layout was adjusted to prevent and control transmission. Other procedures were then implemented to prevent the spread of the virus, including specialized training and evaluation of medical staff, pre-testing and triage, measures to promote early identification of patients, environmental cleaning and disinfection, new medical waste processing procedures, new patient management procedures, timely disinfection of potential sources of nosocomial infection, and strict protective measures. RESULTS: Since the new measures were implemented, to date there have only been three new confirmed cases of COVID-19 infection, no cases of medical staff infection, and no COVID-19-related deaths at the hospital. CONCLUSION: The current report provides a protocol that could be implemented in medical departments in similar cities worldwide.

2.
Clin Infect Dis ; 74(5): 802-811, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1701306

ABSTRACT

BACKGROUND: The COVID-19 pandemic has resulted in unprecedented healthcare challenges, and COVID-19 has been linked to secondary infections. Candidemia, a fungal healthcare-associated infection, has been described in patients hospitalized with severe COVID-19. However, studies of candidemia and COVID-19 coinfection have been limited in sample size and geographic scope. We assessed differences in patients with candidemia with and without a COVID-19 diagnosis. METHODS: We conducted a case-level analysis using population-based candidemia surveillance data collected through the Centers for Disease Control and Prevention's Emerging Infections Program during April-August 2020 to compare characteristics of candidemia patients with and without a positive test for COVID-19 in the 30 days before their Candida culture using chi-square or Fisher's exact tests. RESULTS: Of the 251 candidemia patients included, 64 (25.5%) were positive for SARS-CoV-2. Liver disease, solid-organ malignancies, and prior surgeries were each >3 times more common in patients without COVID-19 coinfection, whereas intensive care unit-level care, mechanical ventilation, having a central venous catheter, and receipt of corticosteroids and immunosuppressants were each >1.3 times more common in patients with COVID-19. All-cause in-hospital fatality was 2 times higher among those with COVID-19 (62.5%) than without (32.1%). CONCLUSIONS: One-quarter of candidemia patients had COVID-19. These patients were less likely to have certain underlying conditions and recent surgery commonly associated with candidemia and more likely to have acute risk factors linked to COVID-19 care, including immunosuppressive medications. Given the high mortality, it is important for clinicians to remain vigilant and take proactive measures to prevent candidemia in patients with COVID-19.


Subject(s)
COVID-19 , Candidemia , COVID-19/epidemiology , COVID-19 Testing , Candidemia/drug therapy , Humans , Pandemics , SARS-CoV-2
3.
Medicina (Kaunas) ; 57(5)2021 Apr 28.
Article in English | MEDLINE | ID: covidwho-1389438

ABSTRACT

Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Among them, metallo-ß-lactamases (MBLs)-producing Klebsiella pneumoniae are of global concern today. The ceftazidime/avibactam combination and the ceftazidime/avibactam + aztreonam combination currently represent the most promising antibiotic strategies to stave off these kinds of infections. We describe the case of a patient affected by thrombotic thrombocytopenic purpura (TTP) admitted in our ICU after developing a hospital-acquired SarsCoV2 interstitial pneumonia during his stay in the hematology department. His medical conditions during his ICU stay were further complicated by a K. Pneumoniae NDM sepsis. To our knowledge, the patient had no risk factors for multidrug-resistant bacteria exposure or contamination during his stay in the hematology department. During his stay in the ICU, we treated the sepsis with a combination therapy of ceftazidime/avibactam + aztreonam. The therapy solved his septic state, allowing for a progressive improvement in his general condition. Moreover, we noticed that the negativization of the hemocultures was also associated to a decontamination of his known rectal colonization. The ceftazidime/avibactam + aztreonam treatment could not only be a valid therapeutic option for these kinds of infections, but it could also be considered as a useful tool in selected patients' intestinal decolonizations.


Subject(s)
COVID-19 , Cross Infection , Purpura, Thrombotic Thrombocytopenic , Sepsis , Anti-Bacterial Agents/therapeutic use , Azabicyclo Compounds/therapeutic use , Aztreonam/therapeutic use , Ceftazidime/therapeutic use , Cross Infection/drug therapy , Drug Combinations , Humans , Klebsiella pneumoniae/genetics , Microbial Sensitivity Tests , Purpura, Thrombotic Thrombocytopenic/drug therapy , RNA, Viral , SARS-CoV-2 , Sepsis/drug therapy , beta-Lactamases
4.
J Nurs Educ ; 60(5): 277-280, 2021 May.
Article in English | MEDLINE | ID: covidwho-1278541

ABSTRACT

BACKGROUND: Improper stethoscope hygiene has been found to contribute to the development of health care associated infections, which affects approximately one in every 30 hospitalized patients. Various pathogens have been found on the stethoscopes of health care workers. METHOD: A correlational descriptive design was used to compare stethoscopes from 117 nursing students. Sterile swab samples were obtained from four separate areas of each stethoscope. Samples were plated and incubated for 24 to 48 hours. RESULTS: Bacteria were found on all parts of the stethoscopes from both undergraduate and graduate nursing students, with the earpiece having the highest percentage of contamination. Staphylococcus was the most prevalent microbe found on all four swab sites. CONCLUSION: Educating students about stethoscope hygiene and consistently reinforcing it in practice are essential to reduce the transmission of pathogens in the health care environment. Nurses can model best practice with students and other disciplines to increase the likelihood of adherence. [J Nurs Educ. 2021;60(5):277-280.].


Subject(s)
Education, Nursing , Hygiene , Stethoscopes , Cross Infection/prevention & control , Education, Nursing/standards , Education, Nursing/statistics & numerical data , Humans , Stethoscopes/standards , Stethoscopes/statistics & numerical data
5.
Clin Infect Dis ; 74(5): 802-811, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1276160

ABSTRACT

BACKGROUND: The COVID-19 pandemic has resulted in unprecedented healthcare challenges, and COVID-19 has been linked to secondary infections. Candidemia, a fungal healthcare-associated infection, has been described in patients hospitalized with severe COVID-19. However, studies of candidemia and COVID-19 coinfection have been limited in sample size and geographic scope. We assessed differences in patients with candidemia with and without a COVID-19 diagnosis. METHODS: We conducted a case-level analysis using population-based candidemia surveillance data collected through the Centers for Disease Control and Prevention's Emerging Infections Program during April-August 2020 to compare characteristics of candidemia patients with and without a positive test for COVID-19 in the 30 days before their Candida culture using chi-square or Fisher's exact tests. RESULTS: Of the 251 candidemia patients included, 64 (25.5%) were positive for SARS-CoV-2. Liver disease, solid-organ malignancies, and prior surgeries were each >3 times more common in patients without COVID-19 coinfection, whereas intensive care unit-level care, mechanical ventilation, having a central venous catheter, and receipt of corticosteroids and immunosuppressants were each >1.3 times more common in patients with COVID-19. All-cause in-hospital fatality was 2 times higher among those with COVID-19 (62.5%) than without (32.1%). CONCLUSIONS: One-quarter of candidemia patients had COVID-19. These patients were less likely to have certain underlying conditions and recent surgery commonly associated with candidemia and more likely to have acute risk factors linked to COVID-19 care, including immunosuppressive medications. Given the high mortality, it is important for clinicians to remain vigilant and take proactive measures to prevent candidemia in patients with COVID-19.


Subject(s)
COVID-19 , Candidemia , COVID-19/epidemiology , COVID-19 Testing , Candidemia/drug therapy , Humans , Pandemics , SARS-CoV-2
6.
Open Forum Infect Dis ; 8(6): ofab201, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1261052

ABSTRACT

BACKGROUND: Patients hospitalized with coronavirus disease 2019 (COVID-19) are at increased risk of health care-associated infections (HAIs), especially with prolonged hospital stays. We sought to identify incidence, antimicrobial susceptibilities, and outcomes associated with bacterial/fungal secondary infections in a large cohort of patients with COVID-19. METHODS: We evaluated adult patients diagnosed with COVID-19 between 2 March and 31 May 2020 and hospitalized >24 hours. Data extracted from medical records included diagnoses, vital signs, laboratory results, microbiological data, and antibiotic use. Microbiologically confirmed bacterial and fungal pathogens from clinical cultures were evaluated to characterize community- and health care-associated infections, including describing temporal changes in predominant organisms on presentation and throughout hospitalization. Univariable and multivariable logistic regression analyses were performed to investigate risk factors for HAIs. RESULTS: A total of 3028 patients were included and accounted for 899 positive clinical cultures. Overall, 516 (17%) patients with positive cultures met criteria for infection. Community-associated coinfections were identified in 183 (6%) patients, whereas HAIs occurred in 350 (12%) patients. Fifty-seven percent of HAIs were caused by gram-negative bacteria and 19% by fungi. Antibiotic resistance increased with longer hospital stays, with incremental increases in the proportion of vancomycin resistance among enterococci and ceftriaxone and carbapenem resistance among Enterobacterales. Intensive care unit stay, invasive mechanical ventilation, and steroids were associated with HAIs. CONCLUSIONS: HAIs occur in a small proportion of patients hospitalized with COVID-19 and are most often caused by gram-negative and fungal pathogens. Antibiotic resistance is more prevalent with prolonged hospital stays. Antimicrobial stewardship is imperative in this population to minimize unnecessary broad-spectrum antibiotic use.

7.
Clin Microbiol Infect ; 27(12): 1772-1776, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1260699

ABSTRACT

BACKGROUND: A wide range of bacterial infections occur in coronavirus disease 2019 (COVID-19) patients, particularly in those with severe coronaviral disease. Some of these are community-acquired co-infections. OBJECTIVE: To review recent data that indicate the occurrence of hospital-onset bacterial infections, including with antibiotic-resistant isolates, in COVID-19 patients. SOURCES: Using PubMed, the literature was searched using terms including: 'COVID-19'; 'SARS-CoV-2'; 'bacterial infection'; 'healthcare-associated infection'; 'antibiotic resistance'; 'antimicrobial resistance'; 'multi-drug resistance'; 'Streptococcus'; 'Staphylococcus'; 'Pseudomonas'; 'Escherichia'; 'Klebsiella'; 'Enterococcus'; 'Acinetobacter'; 'Haemophilus'; 'MRSA'; 'VRE'; 'ESBL'; 'NDM-CRE'; 'CR-Ab'; 'VRSA'; 'MDR'. CONTENT: There is a growing number of reports of bacterial infections acquired by patients with severe COVID-19 after hospital admission. Antibiotic-resistant pathogens found to cause healthcare-associated infections (HAIs) in COVID-19 patients include methicillin-resistant Staphylococcus aureus, New Delhi metallo-ß-lactamase-producing carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, extended-spectrum ß-lactamase Klebsiella pneumoniae and vancomycin-resistant enterococci. COVID-19 has impacted bacterial HAIs in a number of ways with an increase in the incidence of New Delhi metallo-ß-lactamase-producing carbapenem-resistant Enterobacterales and carbapenem-resistant A. baumannii reported at some hospital sites compared with before the pandemic. Recommended guidelines for antimicrobial stewardship in COVID-19 patient treatment are discussed regarding minimization of empiric broad-spectrum antibiotic use. Other studies have reported a decrease in methicillin-resistant S. aureus and vancomycin-resistant enterococci cases, which has been attributed to enhanced infection prevention and control practices introduced to minimize intra-hospital spread of COVID-19. IMPLICATIONS: Poorer outcomes have been observed in hospitalized COVID-19 patients with an antibiotic-resistant infection. Although heightened IPC measures have been accompanied by a reduction in some HAIs at specific sites, in other situations, COVID-19 has been associated with an increase in bacterial HAI incidence. Further research is needed to define the cost-benefit relationship of maintaining COVID-19-related infection prevention and control protocols beyond the pandemic to reduce the burden of HAIs. In addition, the longer-term impact of high usage of certain broad-spectrum antibiotics during the COVID-19 pandemic requires evaluation.


Subject(s)
Bacterial Infections , COVID-19 , Community-Acquired Infections , Cross Infection , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/drug effects , Bacterial Infections/drug therapy , Bacterial Infections/epidemiology , COVID-19/epidemiology , Carbapenems , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Cross Infection/drug therapy , Cross Infection/epidemiology , Delivery of Health Care , Drug Resistance, Bacterial , Humans , Methicillin-Resistant Staphylococcus aureus/drug effects , Pandemics
8.
Antimicrob Resist Infect Control ; 10(1): 87, 2021 06 04.
Article in English | MEDLINE | ID: covidwho-1259218

ABSTRACT

BACKGROUND: During the intensive care units' (ICUs) reorganization that was forced by the COVID-19 emergency, attention to traditional infection control measures may have been reduced. Nevertheless, evidence on the effect of the COVID-19 pandemic on healthcare-associated infections (HAIs) is still limited and mixed. In this study, we estimated the pandemic impact on HAI incidence and investigated the HAI type occurring in COVID-19 patients. METHODS: Patients admitted to the main ICU of the Umberto I teaching hospital of Rome from March 1st and April 4th 2020 were compared with patients hospitalized in 2019. We assessed the association of risk factors and time-to-first event through multivariable Fine and Grey's regression models, that consider the competitive risk of death on the development of HAI (Model 1) or device related-HAI (dr-HAI, Model 2) and provide estimates of the sub-distribution hazard ratio (SHR) and its associated confidence interval (CI). A subgroup analysis was performed on the 2020 cohort. RESULTS: Data from 104 patients were retrieved. Overall, 59 HAIs were recorded, 32 of which occurred in the COVID-19 group. Patients admitted in 2020 were found to be positively associated with both HAI and dr-HAI onset (SHR: 2.66, 95% CI 1.31-5.38, and SHR: 10.0, 95% CI 1.84-54.41, respectively). Despite being not confirmed at the multivariable analysis, a greater proportion of dr-HAIs seemed to occur in COVID-19 patients, especially ventilator-associated pneumonia, and catheter-related urinary tract infections. CONCLUSIONS: We observed an increase in the incidence of patients with HAIs, especially dr-HAIs, mainly sustained by COVID-19 patients. A greater susceptibility of these patients to device-related infections was hypothesized, but further studies are needed.


Subject(s)
COVID-19/epidemiology , Cross Infection/epidemiology , Intensive Care Units/statistics & numerical data , Aged , Catheter-Related Infections/epidemiology , Critical Care , Delivery of Health Care , Female , Hospitalization , Hospitals, Teaching , Humans , Incidence , Infection Control , Male , Middle Aged , Pandemics , Pneumonia, Ventilator-Associated/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification
9.
Eur J Hosp Pharm ; 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1236470

ABSTRACT

We report the case of a man in his early 70s with idiopathic acquired haemophilia A and persistent high-titre type II inhibitors on immunosuppressive treatment to eradicate the inhibitor. As complications, he had a nosocomial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which caused severe pneumonia and an explosive inflammatory reaction that required tocilizumab and remdesivir treatment, and a high-risk retroperitoneal haematoma. Recombinant porcine factor VIII, susoctocog alfa, was requested from the Pharmacy Service in view of the extreme risk of thromboembolism resulting from the concomitant inflammatory storm caused by SARS-CoV-2. Improvement in the SARS-CoV-2 infection made it possible to complete the immunosuppressive treatment with rituximab. The patient was discharged with mycophenolate mofetil as immunosuppressive treatment after 89 days in hospital and 22 days of treatment with susoctocog alfa. His SARS-CoV-2 infection resolved and the haematoma evolved favourably.

10.
BMC Nurs ; 20(1): 78, 2021 May 17.
Article in English | MEDLINE | ID: covidwho-1232427

ABSTRACT

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, exploring factors influencing nosocomial infection among frontline nurses may provide evidence to optimize prevention strategies in hospitals. METHOD: A large-scale online questionnaire survey of nurses' state-trait anxiety, job burnout, risk perception, workplace safety perception, knowledge about nosocomial infection, and preventive practices was conducted with 2795 frontline nurses working in the COVID-19 wards of six hospitals in Hubei Province, China, from February 1 to April 1, 2020. The questionnaire data were analyzed using the structural equation modeling (SEM) method to reveal the mechanisms influencing nurses' risk perception and preventive practices related to nosocomial COVID-19 infection. RESULTS: A model of the factors that influence nurses' risk perception and preventive practices regarding nosocomial COVID-19 infection was established. The model verified hypotheses regarding the impact of nurses' risk perception and preventive practices. Notably, the hypothesis that risk perception has an impact on nurses' preventive practices regarding nosocomial infection is not valid. Moreover, different marital and educational conditions are associated with significant differences in the impact of state anxiety on the execution of preventive practices, the impact of workplace safety perceptions on risk perception, and the impact of workplace safety perceptions on the execution of preventive practices. The effect of state anxiety on preventive practices differed significantly with different durations of work experience. CONCLUSIONS: According to the results of the influencing factor model, promoting the quality of training on nosocomial infection, meliorating workplace safety, and conducting timely and effective psychological interventions would aid in improving nurses' preventive practices. Meliorating workplace safety and easing state anxiety would be beneficial to reduce nurses' risk perception. These strategies are conducive to the optimization of policies for preventing nosocomial COVID-19 infections and similar infectious diseases.

11.
J Patient Saf ; 17(4): 323-330, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1231053

ABSTRACT

BACKGROUND: Although recommendations to prevent COVID-19 healthcare-associated infections (HAIs) have been proposed, data on their effectivity are currently limited. OBJECTIVE: The aim was to evaluate the effectivity of a program of control and prevention of COVID-19 in an academic general hospital in Spain. METHODS: We captured the number of COVID-19 cases and the type of contact that occurred in hospitalized patients and healthcare personnel (HCP). To evaluate the impact of the continuous use of a surgical mask among HCP, the number of patients with COVID-19 HAIs and accumulated incidence of HCP with COVID-19 was compared between the preintervention and intervention periods. RESULTS: Two hundred fifty-two patients with COVID-19 have been admitted to the hospital. Seven of them had an HAI origin (6 in the preintervention period and 1 in the intervention period). One hundred forty-two HCP were infected with SARS-CoV-2. Of them, 22 (15.5%) were attributed to healthcare (2 in the emergency department and none in the critical care departments), and 120 (84.5%) were attributed to social relations in the workplace or during their non-work-related personal interactions. The accumulated incidence during the preintervention period was 22.3 for every 1000 HCP and 8.2 for every 1000 HCP during the intervention period. The relative risk was 0.37 (95% confidence interval, 0.25 to 0.55) and the attributable risk was -0.014 (95% confidence interval, -0.020 to -0.009). CONCLUSIONS: A program of control and prevention of HAIs complemented with the recommendation for the continuous use of a surgical mask in the workplace and social environments of HCP effectively decreased the risk of COVID-19 HAIs in admitted patients and HCP.


Subject(s)
Academic Medical Centers , COVID-19/prevention & control , Cross Infection/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Adult , COVID-19/epidemiology , COVID-19/transmission , Cross Infection/epidemiology , Female , Humans , Incidence , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Male , Masks/statistics & numerical data , Middle Aged , Personnel, Hospital/statistics & numerical data , Program Evaluation , Risk Assessment/statistics & numerical data , SARS-CoV-2/isolation & purification , Spain/epidemiology
12.
Oncologist ; 26(8): e1427-e1433, 2021 08.
Article in English | MEDLINE | ID: covidwho-1210191

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted health care systems. However, to date, the trend of hospitalizations in the oncology patient population has not been studied, and the frequency of nosocomial spread to patients with cancer is not well understood. The objectives of this study were to evaluate the impact of COVID-19 on inpatient oncology census and determine the nosocomial rate of COVID-19 in patients with cancer admitted at a large academic center. MATERIALS AND METHODS: Medical records of patients with cancer diagnosed with COVID-19 and admitted were reviewed to evaluate the temporal trends in inpatient oncology census during pre-COVID-19 (January 2019 to February 2020), COVID-19 (March to May 2020), and post-COVID-19 surge (June to August 2020) in the region. In addition, nosocomial infection rates of SARS-CoV-2 were reviewed. RESULTS: Overall, the daily inpatient census was steady in 2019 (median, 103; range, 92-118) and until February 2020 (median, 112; range, 102-114). However, there was a major decline from March to May 2020 (median, 68; range, 57-104), with 45.4% lower admissions during April 2020. As the COVID-19 surge eased, the daily inpatient census over time returned to the pre-COVID-19 baseline (median, 103; range, 99-111). One patient (1/231, 0.004%) tested positive for SARS-CoV-2 13 days after hospitalization, and it is unclear if it was nosocomial or community spread. CONCLUSION: In this study, inpatient oncology admissions decreased substantially during the COVID-19 surge but over time returned to the pre-COVID-19 baseline. With aggressive infection control measures, the rates of nosocomial transmission were exceedingly low and should provide reassurance to those seeking medical care, including inpatient admissions when medically necessary. IMPLICATIONS FOR PRACTICE: The COVID-19 pandemic has had a major impact on the health care system, and cancer patients are a vulnerable population. This study observes a significant decline in the daily inpatient oncology census from March to May 2020 compared with the same time frame in the previous year and examines the potential reasons for this decline. In addition, nosocomial rates of COVID-19 were investigated, and rates were found to be very low. These findings suggest that aggressive infection control measures can mitigate the nosocomial infection risk among cancer patients and the inpatient setting is a safe environment, providing reassurance.


Subject(s)
COVID-19 , Cross Infection , Neoplasms , Censuses , Cross Infection/epidemiology , Humans , Inpatients , Neoplasms/complications , Neoplasms/epidemiology , Pandemics , SARS-CoV-2
13.
J Health Psychol ; : 13591053211008217, 2021 Apr 20.
Article in English | MEDLINE | ID: covidwho-1195905

ABSTRACT

Testing the Common-Sense Model, this random telephone survey examined the associations between illness representations of COVID-19 and behavioral intention to visit hospitals for scheduled medical consultations (BI-VHSMC), and the mediations via coping and fear of nosocomial infection among 300 Chinese adults. The prevalence of BI-VHSMC was 62.3%. Mediation analysis found that maladaptive coping (rumination and catastrophizing) and fear of nosocomial infection mediated the associations between various dimensions of illness representations of COVID-19 (e.g. consequence and controllability) and BI-VHSMC, both indirectly and serially. Illness representations, coping, and fear should be considered when planning related health promotion during the COVID-19 pandemic.

14.
Curr Med Sci ; 41(2): 306-311, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1193159

ABSTRACT

This retrospective study aimed to investigate the clinical characteristics and neonatal outcomes of pregnant women with SARS-COV-2 in Wuhan Children's Hospital and further suggested a possible management strategy for infected pregnant women under epidemic situation. In this study, 8 pregnant women with SARS-COV-2 who were admitted into Wuhan Children's Hospital, China from February 1, 2020 to March 30, 2020 and the clinical features, laboratory data, maternal and neonatal outcomes were analyzed. The mean age of the women at the time of admission was 30.6 years. The mean gestational age of the women was 37 weeks+4 days, and one woman presented with dichorionic diamniotic (DCDA) twin pregnancy. Except for one woman who was febrile, others had no typical clinical symptoms. For all pregnant women, the count of white blood cells and lymphocytes appeared normal, but 6 had a lower percentage of lymphocytes. C-reactive protein (CRP) levels were normal for all the women. One neonate was tested positive for the coronavirus IgG and IgM antibodies. The clinical symptoms of the pregnant women with SARS-COV-2 were mild, and the laboratory data showed similar characteristics to those of non-infected pregnant women. Since one neonate was tested positive for coronavirus, there is a possibility of vertical transmission of SARS-CoV-2. Prompt and efficient screening, triage, and isolation of pregnant women are effective management strategies to reduce nosocomial infection during the SARS-COV-2 epidemic.


Subject(s)
COVID-19/epidemiology , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2/pathogenicity , Adult , COVID-19/complications , COVID-19/physiopathology , COVID-19/virology , China/epidemiology , Female , Humans , Immunoglobulin M/blood , Infant , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/virology , Pregnant Women , Retrospective Studies
15.
Infect Control Hosp Epidemiol ; 43(3): 334-343, 2022 03.
Article in English | MEDLINE | ID: covidwho-1189150

ABSTRACT

BACKGROUND: Nosocomial outbreaks leading to healthcare worker (HCW) infection and death have been increasingly reported during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: We implemented a strategy to reduce nosocomial acquisition. METHODS: We summarized our experience in implementing a multipronged infection control strategy in the first 300 days (December 31, 2019, to October 25, 2020) of the COVID-19 pandemic under the governance of Hospital Authority in Hong Kong. RESULTS: Of 5,296 COVID-19 patients, 4,808 (90.8%) were diagnosed in the first pandemic wave (142 cases), second wave (896 cases), and third wave (3,770 cases) in Hong Kong. With the exception of 1 patient who died before admission, all COVID-19 patients were admitted to the public healthcare system for a total of 78,834 COVID-19 patient days. The median length of stay was 13 days (range, 1-128). Of 81,955 HCWs, 38 HCWs (0.05%; 2 doctors and 11 nurses and 25 nonprofessional staff) acquired COVID-19. With the exception of 5 of 38 HCWs (13.2%) infected by HCW-to-HCW transmission in the nonclinical settings, no HCW had documented transmission from COVID-19 patients in the hospitals. The incidence of COVID-19 among HCWs was significantly lower than that of our general population (0.46 per 1,000 HCWs vs 0.71 per 1,000 population; P = .008). The incidence of COVID-19 among professional staff was significantly lower than that of nonprofessional staff (0.30 vs 0.66 per 1,000 full-time equivalent; P = .022). CONCLUSIONS: A hospital-based approach spared our healthcare service from being overloaded. With our multipronged infection control strategy, no nosocomial COVID-19 in was identified among HCWs in the first 300 days of the COVID-19 pandemic in Hong Kong.


Subject(s)
COVID-19 , Cross Infection , COVID-19/epidemiology , COVID-19/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Health Personnel , Hong Kong/epidemiology , Hospitals , Humans , Infection Control , Pandemics/prevention & control
16.
J Matern Fetal Neonatal Med ; : 1-4, 2021 Mar 22.
Article in English | MEDLINE | ID: covidwho-1146572

ABSTRACT

BACKGROUND: Adopting the family-centered care (FCC) approach in the neonatal care has been shown to improve breastfeeding rate and parental satisfaction. To minimize the transmission of COVID-19, family visit in neonatal intensive care unit (NICU) was suspended in China. In order to maintain the benefits of FCC, the Hong Kong University-Shenzhen Hospital NICU modified FCC strategies. We evaluated the effects of new strategies and aimed to share our results and experience with other NICUs during the COVID-19 pandemic. METHODS: Using prospectively collected hospital databases, we retrospectively compared the demographic and clinical data of neonates, rates of breastfeeding at discharge, nosocomial infection and parental satisfaction one month before (open group) and after (closed group) the implementation of alternative FCC management strategies when family visit was suspended during COVID-19 pandemic. RESULTS: During the COVID-19 pandemic, we organized a multidisciplinary task force and adopted strategies of triage and screening, management of suspected infants, and breastfeeding promotion with effective communication. The nosocomial infection rate and parental satisfaction for open and closed groups (144 and 108 term and near-term neonates with brief hospitalization, respectively) were not different (1% vs. 0%, p = 1.00; 98.6 vs. 98.8, p = .80; respectively). Breastfeeding rate at discharge decreased but the difference was not significant (74% vs. 80%, p = .29). CONCLUSIONS: In our experience, in term and near-term neonates with brief hospitalization, the alternative FCC strategies maintained high parental satisfaction without increased nosocomial infection rate, but strong support for breastfeeding was needed. Through multidisciplinary collaboration, the continuation of "modified" FCC in a level III NICU is feasible in the context of COVID-19 pandemic with reduced family visitation and participation in the care.

17.
Curr Pain Headache Rep ; 25(4): 21, 2021 Mar 11.
Article in English | MEDLINE | ID: covidwho-1126627

ABSTRACT

PURPOSE OF REVIEW: This review aims to provide relevant, aggregate information about a variety of disinfectants and antiseptics, along with potential utility and limitations. While not exhaustive, this review's goal is to add to the body of literature available on this topic and give interventional providers and practitioners an additional resource to consider when performing procedures. RECENT FINDINGS: In the current SARS-CoV2 epidemiological environment, infection control and costs associated with healthcare-associated infections (HAIs) are of paramount importance. Even before the onset of SARS-CoV2, HAIs affected nearly 2million patients a year in the USA and resulted in nearly 90,000 deaths, all of which resulted in a cost to hospitals ranging from US$28 billion to 45 billion. The onset SARS-CoV2, though not spread by an airborne route, has heightened infection control protocols in hospitals and, as such, cast a renewed focus on disinfectants and their utility across different settings and organisms. The aim of this review is to provide a comprehensive overview of disinfectants used in the inpatient setting.


Subject(s)
Cross Infection/prevention & control , Disinfectants , Chlorine Compounds , Ethanol , Formaldehyde , Glutaral , Humans , Hydrogen Peroxide , Iodophors , Oxides , Peracetic Acid , Phenol , Povidone-Iodine , Quaternary Ammonium Compounds , Sodium Hypochlorite , Triazines
19.
Infect Control Hosp Epidemiol ; 42(4): 406-410, 2021 04.
Article in English | MEDLINE | ID: covidwho-1087384

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has induced a reinforcement of infection control measures in the hospital setting. Here, we assess the impact of the COVID-19 pandemic on the incidence of nosocomial Clostridioides difficile infection (CDI). METHODS: We retrospectively compared the incidence density (cases per 10,000 patient days) of healthcare-facility-associated (HCFA) CDI in a tertiary-care hospital in Madrid, Spain, during the maximum incidence of COVID-19 (March 11 to May 11, 2020) with the same period of the previous year (control period). We also assessed the aggregate in-hospital antibiotic use (ie, defined daily doses [DDD] per 100 occupied bed days [BD]) and incidence density (ie, movements per 1,000 patient days) of patient mobility during both periods. RESULTS: In total, 2,337 patients with reverse transcription-polymerase chain reaction-confirmed COVID-19 were admitted to the hospital during the COVID-19 period. Also, 12 HCFA CDI cases were reported at this time (incidence density, 2.68 per 10,000 patient days), whereas 34 HCFA CDI cases were identified during the control period (incidence density, 8.54 per 10,000 patient days) (P = .000257). Antibiotic consumption was slightly higher during the COVID-19 period (89.73 DDD per 100 BD) than during the control period (79.16 DDD per 100 BD). The incidence density of patient movements was 587.61 per 1,000 patient days during the control period and was significantly lower during the COVID-19 period (300.86 per 1,000 patient days) (P < .0001). CONCLUSIONS: The observed reduction of ~70% in the incidence density of HCFA CDI in a context of no reduction in antibiotic use supports the importance of reducing nosocomial transmission by healthcare workers and asymptomatic colonized patients, reinforcing cleaning procedures and reducing patient mobility in the epidemiological control of CDI.


Subject(s)
COVID-19/complications , Clostridium Infections/etiology , Cross Infection/etiology , Aged , Anti-Bacterial Agents/therapeutic use , COVID-19/prevention & control , Clostridium Infections/epidemiology , Clostridium Infections/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Humans , Incidence , Middle Aged , Retrospective Studies , Spain/epidemiology
20.
Eur Respir Rev ; 30(159)2021 Mar 31.
Article in English | MEDLINE | ID: covidwho-1079204

ABSTRACT

PURPOSE: Corticosteroids have been considered in medicine for a long time, and they are broadly prescribed. In infectious diseases, corticosteroids have been regarded as a thread due to their immunosuppressive effects and therefore their anti-inflammatory properties. MAIN: In recent years, there have been several studies published that aimed to determine the role of corticosteroids in patients with community-acquired pneumonia (CAP), because, despite significant advances in new antibiotics and supportive care, deaths of patients with CAP remain unacceptably high. While the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) CAP guidelines did not mention the use of corticosteroids in the management of CAP, the recently published 2019 IDSA/ATS guidelines recommended their use in patients with septic shock refractory to vasopressors and fluid resuscitation. Regarding viral infection, the use of corticosteroids in patients with influenza has shown to be associated with significantly higher mortality and higher incidence of nosocomial infection, while in patients with coronavirus disease 2019 (COVID-19) there is a good body of evidence of the benefit of corticosteroids in terms of mortality. CONCLUSIONS: The use of corticosteroids has been considered as a potential alternative co-adjuvant treatment in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear benefit of the use of corticosteroids in those patients presenting severe forms of disease.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , COVID-19/drug therapy , Community-Acquired Infections/drug therapy , Influenza, Human/drug therapy , Adrenal Cortex Hormones/adverse effects , Clinical Decision-Making , Humans , Patient Safety , Risk Assessment , Risk Factors , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL