scholarly journals Evaluation of a Continuously Active Disinfectant for Disinfection of Mobile Equipment

2020 ◽  
Vol 41 (S1) ◽  
pp. s225-s226
Author(s):  
Sarah Redmond ◽  
Sandra Y Silva ◽  
Jennifer Cadnum ◽  
Matthew Carlisle ◽  
Curtis Donskey
Keyword(s):  
Quaternary Ammonium ◽  
Group Versus ◽  
Care Facility ◽  
Healthcare Setting ◽  
Portable Devices ◽  
Spray Application ◽  
Term Care ◽  
Long Term Care Facility ◽  
Baseline Levels ◽  
Group Recovery

Background: One of the limitations of current cleaning and disinfection strategies is that cleaned surfaces rapidly become recontaminated. In laboratory testing, a novel quaternary ammonium disinfectant provided sustained antimicrobial activity against multiple pathogens on surfaces after 24 hours. We hypothesized that this continuously active disinfectant would be effective in reducing contamination of portable medical equipment in a real-world healthcare setting.Methods: In a hospital and affiliated long-term care facility, 114 portable devices were randomized to receive no treatment (N = 38) or a single spray application of a quaternary ammonium-alcohol disinfectant (N = 38) or of the continuously active disinfectant (N = 38). The devices were cultured at baseline and on days 1, 4, and 7 after treatment for total aerobic colony counts, methicillin-resistant Staphylococcus aureus (MRSA), and enterococci.Results: As shown in Fig. 1, both spray disinfectants significantly reduced total aerobic colony counts in comparison to the untreated controls. The continuously active disinfectant resulted in sustained significant reductions in aerobic colony counts in comparison to baseline levels (P < .05), whereas counts returned to baseline levels by day 4 in the quaternary ammonium-alcohol disinfectant group. Recovery of MRSA and enterococci was significantly reduced on days 1–7 in the continuously active disinfectant group versus untreated controls (3 of 93, 3% vs 20 of 97, 21% respectively; P = .002), but not in the quaternary ammonium-alcohol disinfectant (11 of 97, 11%; P = .12). Conclusions: A single spray application of a continuously active disinfectant resulted in sustained reductions in total aerobic colony counts over 7 days and reduced recovery of MRSA and enterococci. The continuously active disinfectant could potentially reduce the risk for transmission of pathogens by portable devices.Funding: NoneDisclosures: None

scholarly journals 178. Implementation of the Core Elements of Antibiotic Stewardship in Nursing Homes – National Healthcare Safety Network (NHSN), 2016–2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S96-S96
Author(s):  
Katryna A Gouin ◽  
Sarah Kabbani; Angela Anttila ◽  
Josephine Mak ◽  
Elisabeth Mungai ◽  
Ti Tanissha McCray ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Antibiotic Stewardship ◽  
Care Facility ◽  
Antibiotic Use ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Long Term Care Facility ◽  
The Core ◽  
Use Of Resources ◽  
Core Elements

Abstract Background Since 2016, nursing homes (NHs) enrolled in the Centers for Disease Control and Prevention’s NHSN Long-term Care Facility (LTCF) Component have reported on their implementation of the core elements of antibiotic stewardship. In 2016, 42% of NHs reported implementing all seven core elements. Recent regulations require antibiotic stewardship programs in NHs. The objectives of this analysis were to track national progress in implementation of the core elements and evaluate how time dedicated to infection prevention and control (IPC) is associated with the implementation of the core elements. Methods We used the NHSN LTCF 2016–2018 Annual Surveys to assess NH characteristics and implementation of the core elements, defined as self-reported implementation of at least one corresponding stewardship activity. We reported absolute differences in percent implementation. We used log-binomial regression models to estimate the association between weekly IPC hours and the implementation of all seven core elements, while controlling for confounding by facility characteristics. Results We included 7,506 surveys from 2016–2018. In 2018, 71% of NHs reported implementation of all seven core elements, a 28% increase from 2016 (Fig. 1). The greatest increases in implementation from 2016–2018 were in Education (+19%), Reporting (+18%) and Drug Expertise (+15%) (Fig. 2). Ninety-eight percent of NHs had an individual responsible for antibiotic stewardship activities (Accountability), with 30% indicating that the role was fulfilled by an infection preventionist. Furthermore, 71% of NHs reported pharmacist involvement in improving antibiotic use, an increase of 27% since 2016. NHs that reported at least 20 hours of IPC activity per week were 14% more likely to implement all seven core elements, when controlling for facility ownership and affiliation, 95% CI: (1.07, 1.20). Conclusion NHs reported substantial progress in antibiotic stewardship implementation from 2016–2018. Improvements in accessing drug expertise, providing education and reporting antibiotic use may reflect increased stewardship awareness and use of resources among NH providers under new regulatory requirements. NHs with at least 20 hours dedicated to IPC per week may have greater capacity to implement all core elements. Disclosures All Authors: No reported disclosures

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

scholarly journals COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitch van Hensbergen ◽  
Casper D. J. den Heijer ◽  
Petra Wolffs ◽  
Volker Hackert ◽  
Henriëtte L. G. ter Waarbeek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Border Region ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Cross Border

Abstract Background The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically. Methods Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections. Results Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Conclusions Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

scholarly journals The Effectiveness of a Board Game-Based Oral Hygiene Education Program on Oral Hygiene Knowledge and Plaque Index of Adults with Intellectual Disability: A Pilot Study

2021 ◽  
Vol 18 (3) ◽  
pp. 946
Author(s):  
Hsiu-Yueh Liu ◽  
Ping-Ho Chen ◽  
Wun-Jyun Chen ◽  
Shan-Shan Huang ◽  
Jen-Hao Chen ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Oral Hygiene ◽  
Care Facility ◽  
Plaque Index ◽  
Board Game ◽  
Term Care ◽  
Long Term Care Facility ◽  
Post Test ◽  
Health Related ◽  
Two Stages

An oral hygiene board game was designed as an intervention tool and applied to explore the effectiveness for the oral health related knowledge (OHK) score and plaque index (PI) of adults with intellectual disability (ID). This one-group pre/post-test design study was conducted in a residential long-term care facility for 42 participants. The study had one pre-test (baseline) and three post-tests evaluated in both control and intervention stages, respectively. The participants participated in a 60-min oral hygiene board game twice a week during the intervention stage. Total OHK score and PI of the participants were recorded to determine the effectiveness of intervention. There were no differences in OHK score and PI between the two stages at baseline. The results in intervention stage demonstrated a significant gradual increase and reduction in the OHK score when compared with the control stage. A statistically significant improvement in the OHK score and PI (42.29% and −33.28%, respectively) at the end of intervention between two stages was recorded. This study proved a board game is deemed an effective education method applicable to promote the OHK and skills of ID adults.

scholarly journals Outbreak of SARS-CoV-2 infection in a long-term care facility after COVID-19 BNT162b2 mRNA vaccination

2021 ◽  
Author(s):  
Martin Martinot ◽  
Stéphane Carnein ◽  
Christian Kempf ◽  
Pierre Gantner ◽  
Floriane Gallais ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Investigation of a Prolonged Group A Streptococcus Outbreak Among Residents and Outpatients Receiving Wound Care at a Long-Term Care Facility (LTCF)

2020 ◽  
Vol 41 (S1) ◽  
pp. s305-s306
Author(s):  
Alana Cilwick ◽  
April Burdorf ◽  
Wendy Bamberg ◽  
Christopher Czaja ◽  
Alexis Burakoff ◽  
...  
Keyword(s):  
Infection Control ◽  
Staff Member ◽  
Long Term Care ◽  
Wound Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Group A

Background: In February 2019, the Colorado Department of Public Health and Environment (CDPHE) identified a cluster of 3 invasive group A Streptococcus (GAS) infections in residents receiving wound care in a long-term care facility (LTCF). An investigation revealed a larger outbreak that extended to nonresidents receiving outpatient wound care at the LTCF. Methods: A case was defined as a positive culture for GAS emm type 82 from an individual with exposure to the LTCF between January and June 2019. Cases were categorized as clinical (symptoms of GAS disease or GAS isolated from a wound or sterile site) or carriage (no symptoms). Carriers were identified via samples collected from throat and skin lesions. Screening occurred in 2 rounds and included residents of affected units followed by screening of all wound-care staff and residents facility-wide. Available isolates were sent for emm type testing and whole-genome sequencing (WGS) at the CDC. CDPHE staff performed infection control observations. Results: We identified 14 cases: 8 clinical and 6 carriage (from 5 residents and 1 staff member). Two patients with invasive GAS died. Of 8 patients with clinical GAS, 6 resided in the facility on or 1 day prior to symptom onset; 2 were not residents but received outpatient therapy at the LTCF. All 8 patients with clinical GAS (100%) and 3 carriers had received wound care. The staff member with emm 82 carriage had provided wound care and occupational therapy to the affected residents and the 2 outpatients. Two additional cases were detected with onset dates following staff member decolonization. Moreover, 13 of the 14 emm 82 isolates were found to be identical by WGS. Infection control observations identified lapses in staff wound care and hand hygiene practices in the residential and outpatient settings of the facility. Conclusions: This investigation details a large GAS outbreak in an LTCF associated with asymptomatic carriage in residents and staff that included patients who had only received care in the outpatient portion of the facility. The outbreak was halted following decolonization of a staff member and improvements in infection control, including in the outpatient setting. Outpatient services, particularly wound care, provided by LTCFs should be considered when investigating LTCF-related GAS cases and outbreaks.Funding: NoneDisclosures: None

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