ABSTRACT
Digital technologies have the potential to improve the quality of nursing care. CARE REGIO is a Bavarian joint research project for digital transformation and technology in nursing care. The project goals are supporting the nursing staff, saving time, improving the quality of care as well as increasing the quality of life and safety of those in need of care. In Phase 1 of the project, literature and stakeholder analyses, and qualitative surveys were carried out. Subsequently, central fields of action were defined for Phase 2 of the project. CARE REGIO can make a significant contribution to evaluating existing digital solutions, developing new solutions, and accelerating their implementation into practice.
Subject(s)
Quality of Life , Technology , Humans , Surveys and QuestionnairesABSTRACT
The joint research project CARE REGIO aims to modernize the care system with digital solutions. We focus on the development of a uniform electronic care record, uniform data exchange between care facilities, and technical assistive systems, which shall all be unified in a standardized care-based storage solution.
Subject(s)
Nursing , GermanyABSTRACT
OBJECTIVES: Infections caused by vancomycin-resistant Enterococcus faecium (VREfm) represent a major public health concern due to limited treatment options. Among invasive isolates of VREfm, ST117, ST80 and ST78 represent the most frequently detected STs by MLST in Germany. In this study, we investigated the genetic diversity of isolates of VREfm recovered from different nosocomial outbreaks in Bavaria, Germany, by WGS. METHODS: Between January 2018 and April 2019, 99 non-replicate isolates of VREfm originating from nosocomial outbreaks at eight different hospitals in Bavaria were investigated for genetic diversity by WGS. In detail, complex types (CTs) were identified by core-genome MLST. Furthermore, an SNP analysis was performed for all VREfm strains. RESULTS: Most of the isolates of this study (76%) belonged to three major clonal groups, which occurred in at least three hospitals: ST80/CT1065 vanB (n = 45; six hospitals), ST117/CT71 vanB (n = 11; four hospitals) and ST78/CT894like vanA (n = 19; three hospitals). Moreover, isolates of the predominant lineage ST80/CT1065 vanB showed a maximum difference of 36 SNPs as revealed by SNP analysis. CONCLUSIONS: Whole-genome analysis of VREfm causing nosocomial outbreaks suggests the occurrence of few endemic clonal lineages in Bavarian hospital settings, namely ST80/CT1065 vanB, ST117/CT71 vanB and ST78/CT894like vanA. Further studies are needed for a better understanding of the factors affecting the successful spread of the above-mentioned lineages.
Subject(s)
Cross Infection , Enterococcus faecium , Gram-Positive Bacterial Infections , Vancomycin-Resistant Enterococci , Bacterial Proteins/genetics , Cross Infection/epidemiology , Disease Outbreaks , Enterococcus faecium/genetics , Genotype , Germany/epidemiology , Gram-Positive Bacterial Infections/epidemiology , Hospitals , Humans , Multilocus Sequence Typing , Vancomycin , Vancomycin-Resistant Enterococci/geneticsABSTRACT
BACKGROUND: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-E) are spreading worldwide in both hospital and community settings. In this study, the molecular epidemiology and the transmission modalities of ESBL-E in intensive care- and bone marrow transplant were investigated. METHODS: All patients included in this study were screened for presence of ESBL-E on admission and weekly. Relevant ß-lactamase genes were identified by PCR and sequencing. RESULTS: A total of 669 patients were included in this study. On admission, ESBL-producing Escherichia coli were detected in 49 (7.3%) patients and ESBL-producing Klebsiella pneumoniae in one patient. The most common ESBL types among E. coli isolates were CTX-M-15 (38.8%) and CTX-M-1 (38.8%). Furthermore, 12 of 49 (24.5%) ESBL-producing E. coli could be assigned to the epidemic clone ST131. A single patient acquired ESBL-producing E. coli during the hospital stay but cross-transmission could not be demonstrated. Among 1095 environmental samples none revealed ESBL. CONCLUSIONS: Our results suggest that early detection of ESBL-producing Enterobacteriaceae and consequent implementation of basic hygiene measures and contact isolation may reduce the transmission rate during the hospital stay.
