Nurses' knowledge, practices and perceptions regarding Clostridioides difficile: Survey results.

BACKGROUND: Clostridioides difficile infection (CDI) can cause patients debilitating symptoms, places additional demands on nurses' and midwives' and is increasingly prevalent. Understanding the knowledge base of nurses caring for patients with CDI may contribute to improving care practices. METHODS: A cross-sectional anonymous survey across our Hospital and Health Services was conducted. Descriptive statistics and thematic analysis techniques were used to analyse, summarise, and report data. RESULTS: A total of 198 completed surveys by nurses were included in the analysis. Most respondents (73.2%) could not recall having any recent CDI education. Nearly all agreed that CDI is an important infection control issue (80. 8%), and that CDI education was important (94.9%). Knowledge of the potentially fatal outcome of CDI was not well known with only 53% responding correctly to this question. Respondents were confident in fundamental infection control precautions of patient placement (93.4%) and environmental cleaning (86.4%). Knowledge of the microbiological aspects of CDI were less well known. The impact to workload and the additional burden of caring for patients with CDI was evident in the overwhelming response (83%) to the two open-ended questions about what makes it "easy" and what make it "hard" to implement infection control strategies for CDI patients. CONCLUSION: Respondents identified many factors that could contribute to less-than optimal care and management of inpatients with CDI, and identified some solutions that would facilitate the provision of best practice. An educational intervention, with emphasis on the areas of greatest knowledge deficits, has been developed.

Hospital acquired viral respiratory tract infections: An underrecognized nosocomial infection.

BACKGROUND: Our study aimed to describe the incidence, epidemiology of respiratory viruses and outcomes in hospital acquired viral respiratory infections (HAVRI). METHODS: We conducted a retrospective observational study on all adults and children with hospital acquired viral respiratory infections between July 2012 and April 2019. Clinical and microbiological data were collected in a major tertiary level hospital in North Queensland. Morbidity indicators were the length of stay, need for intensive care and mechanical ventilation. Length of stay was analyzed with the Kruskal-Wallis test and mortality with the Chi-Square test. RESULTS: A total of 283 patients tested positive for a respiratory virus and fulfilled the criteria for a hospital acquired infection. Individuals in the younger age group were more likely to be admitted to intensive care and need mechanical ventilation. A higher mortality was found with individuals in the older age category. The morbidity and mortality did not differ based on the virus type. Influenza A was the most common respiratory virus associated with hospital acquired viral respiratory infections. CONCLUSION: Hospital acquired viral respiratory infections contribute significantly to morbidity and mortality regardless of the virus species.

Molecular evidence of Chlamydia pecorum and arthropod-associated Chlamydiae in an expanded range of marsupials.

The order Chlamydiales are biphasic intracellular bacterial pathogens infecting humans and domesticated animals. Wildlife infections have also been reported, with the most studied example being Chlamydia pecorum infections in the koala, an iconic Australian marsupial. In koalas, molecular evidence suggests that spill-over from C. pecorum infected livestock imported into Australia may have had a historical or contemporary role. Despite preliminary evidence that other native Australian marsupials also carry C. pecorum, their potential as reservoirs of this pathogen and other Chlamydia-related bacteria (CRBs) has been understudied. Mucosal epithelial samples collected from over 200 native Australian marsupials of different species and geographic regions across Australia were PCR screened for Chlamydiales. Previously described and genetically distinct C. pecorum genotypes and a range of 16S rRNA genotypes sharing similarity to different CRBs in the broader Chlamydiales order were present. One 16S rRNA Chlamydiales genotype recently described in Australian ticks that parasitise native Australian marsupials was also identified. This study provides further evidence that chlamydial infections are widespread in native fauna and that detailed investigations are required to understand the influence these infections have on host species conservation, but also whether infection spill-over plays a role in their epidemiology.