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1.
Infect Control Hosp Epidemiol ; 44(1): 106-109, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35705231

RESUMO

At our hospital, universal severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) testing was performed upon admission and again after 2 inpatient days. As community-wide prevalence, admission, and vaccination rates varied, the number needed to benefit fluctuated between 16 and 769 and the cost per additional detection fluctuated between $800 and $29,400. These 2 metrics were negatively associated with new hospital admissions. No other community indicator was associated with the number needed to benefit and cost per additional detection.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Prevalência , Análise Custo-Benefício , Reação em Cadeia da Polimerase , Hospitalização , Hospitais , Vacinação , Teste para COVID-19
2.
PLoS One ; 17(1): e0261365, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35061676

RESUMO

BACKGROUND: Cleanliness of hospital surfaces helps prevent healthcare-associated infections, but comparative evaluations of various cleaning strategies during COVID-19 pandemic surges and worker shortages are scarce. PURPOSE AND METHODS: To evaluate the effectiveness of daily, enhanced terminal, and contingency-based cleaning strategies in an acute care hospital (ACH) and a long-term care facility (LTCF), using SARS-CoV-2 RT-PCR and adenosine triphosphate (ATP) assays. Daily cleaning involved light dusting and removal of visible debris while a patient is in the room. Enhanced terminal cleaning involved wet moping and surface wiping with disinfectants after a patient is permanently moved out of a room followed by ultraviolet light (UV-C), electrostatic spraying, or room fogging. Contingency-based strategies, performed only at the LTCF, involved cleaning by a commercial environmental remediation company with proprietary chemicals and room fogging. Ambient surface contamination was also assessed randomly, without regard to cleaning times. Near-patient or high-touch stationary and non-stationary environmental surfaces were sampled with pre-moistened swabs in viral transport media. RESULTS: At the ACH, SARS-CoV-2 RNA was detected on 66% of surfaces before cleaning and on 23% of those surfaces immediately after terminal cleaning, for a 65% post-cleaning reduction (p = 0.001). UV-C enhancement resulted in an 83% reduction (p = 0.023), while enhancement with electrostatic bleach application resulted in a 50% reduction (p = 0.010). ATP levels on RNA positive surfaces were not significantly different from those of RNA negative surfaces. LTCF contamination rates differed between the dementia, rehabilitation, and residential units (p = 0.005). 67% of surfaces had RNA after room fogging without terminal-style wiping. Fogging with wiping led to a -11% change in the proportion of positive surfaces. At the LTCF, mean ATP levels were lower after terminal cleaning (p = 0.016). CONCLUSION: Ambient surface contamination varied by type of unit and outbreak conditions, but not facility type. Removal of SARS-CoV-2 RNA varied according to cleaning strategy. IMPLICATIONS: Previous reports have shown time spent cleaning by hospital employed environmental services staff did not correlate with cleaning thoroughness. However, time spent cleaning by a commercial remediation company in this study was associated with cleaning effectiveness. These findings may be useful for optimizing allocation of cleaning resources during staffing shortages.


Assuntos
COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Pessoal de Saúde/organização & administração , Controle de Infecções/organização & administração , Assistência de Longa Duração/organização & administração , Trifosfato de Adenosina/análise , COVID-19/epidemiologia , Infecção Hospitalar/epidemiologia , Desinfetantes , Fômites/virologia , Instalações de Saúde , Humanos , New York/epidemiologia , Quartos de Pacientes , RNA Viral/análise , SARS-CoV-2/genética , SARS-CoV-2/patogenicidade , SARS-CoV-2/efeitos da radiação , Raios Ultravioleta
3.
Infect Control Hosp Epidemiol ; 41(11): 1344-1347, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32600491

RESUMO

Engagement of frontline staff, along with senior leadership, in competition-style healthcare-associated infection reduction efforts, combined with electronic clinical decision support tools, appeared to reduce antibiotic regimen initiations for urinary tract infections (P = .01). Mean monthly standardized infection and device utilization ratios also decreased (P < .003 and P < .0001, respectively).


Assuntos
Infecções Relacionadas a Cateter , Infecção Hospitalar , Infecções Urinárias , Antibacterianos/uso terapêutico , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/prevenção & controle , Equipamentos e Provisões , Humanos , Infecções Urinárias/tratamento farmacológico
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