Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/drug effects , Bacterial Infections/microbiology , Intensive Care Units, Neonatal , Bacteria/classification , Bacteria/isolation & purification , Bacterial Infections/epidemiology , Humans , Infant, Newborn , Mass Screening , Microbial Sensitivity Tests , Pharynx/microbiology , Rectum/microbiology , Tertiary Care CentersSubject(s)
Brain Abscess/immunology , Immunocompromised Host/immunology , Infectious Encephalitis/diagnosis , Infectious Encephalitis/immunology , Mycoses/diagnosis , Mycoses/immunology , Aged , Ascomycota/immunology , Ascomycota/isolation & purification , Brain Abscess/diagnosis , Diagnosis, Differential , Fatal Outcome , Female , Humans , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methodsABSTRACT
Hand hygiene is considered as the pillar of infection control and prevention. Healthcare-associated infections have a great impact on morbidity, length of hospital stay, and treatment costs. Hand disinfection is considered to be the single most effective tool to prevent healthcare-associated infections and cross-transmission of multi-drug resistant bacteria. The WHO defined "5 moments" for hand hygiene and highlighted the need for new strategies to improve everyday hand hygiene practices on the basis of the current low compliance. Reasons for non-compliance are multifaceted and behavioural, religious, and sociocultural aspects have to be considered when designing intervention programs. Despite all these barriers it is worth the effort to aim at quality of care improvement.
Subject(s)
Bacterial Infections/prevention & control , Cross Infection/prevention & control , Hand Disinfection/standards , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Virus Diseases/prevention & control , 2-Propanol , Cross-Cultural Comparison , Germany , Gloves, Surgical , Guideline Adherence , Humans , Religion and Medicine , World Health OrganizationSubject(s)
Endophthalmitis/etiology , Endophthalmitis/pathology , Pneumococcal Infections/diagnosis , Pneumococcal Infections/etiology , Vitrectomy/adverse effects , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Endophthalmitis/drug therapy , Humans , Male , Pneumococcal Infections/drug therapy , Treatment OutcomeABSTRACT
Hand hygiene is considered to be the single most effective measure to prevent healthcare-associated infection. Although there have been several reports on hand hygiene compliance, data on patients with multidrug-resistant (MDR) organisms in special isolation conditions are lacking. Therefore, we conducted a prospective observational study of indications for, and compliance with, hand hygiene in patients colonised or infected with meticillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum ß-lactamase (ESBL)-producing enterobacteria in surgical intensive and intermediate care units. Hand disinfectant used during care of patients with MRSA was measured. Observed daily hand hygiene indications were higher in MRSA isolation conditions than in ESBL isolation conditions. Observed compliance rates were 47% and 43% for the MRSA group and 54% and 51% for the ESBL group in the surgical intensive care unit and the intermediate care unit, respectively. Compliance rates before patient contact or aseptic tasks were significantly lower (17-47%) than after contact with patient, body fluid or patient's surroundings (31-78%). Glove usage instead of disinfection was employed in up to 100% before patient contact. However, compliance rates calculated from disinfectant usage were two-fold lower (intensive care: 24% vs 47%; intermediate care: 21% vs 43%). This study is the first to provide data on hand hygiene in patients with MDR bacteria and includes a comparison of observed and calculated compliance. Compliance is low in patients under special isolation conditions, even for the indications of greatest impact in preventing healthcare-associated infections. These data may help to focus measures to reduce transmission of MDR bacteria and improve patient safety.
