Contamination of Healthcare Workers' Hands with Clostridium difficile Spores after Caring for Patients with C. difficile Infection

2014 ◽  
Vol 35 (1) ◽  
pp. 10-15 ◽  
Author(s):  
C. Landelle ◽  
M. Verachten ◽  
P. Legrand ◽  
E. Girou ◽  
F. Barbut ◽  
...  
Keyword(s):  
High Risk ◽  
Clostridium Difficile ◽  
Healthcare Workers ◽  
Routine Care ◽  
Exposed Group ◽  
University Hospital ◽  
Risk Level ◽  
Contamination Rate ◽  
Unexposed Group ◽  
Fecal Soiling

Objective.We determined the percentage of healthcare workers' (HCWs') hands contaminated with Clostridium difficile spores after caring for patients with C. difficile infection (CDI) and risk factors associated with contamination.Design.Prospective study.Setting.A French university hospital.Methods.We compared the hand contamination rate among HCWs caring for patients with CDI (exposed group; n = 66) with that among an unexposed group (n = 44). Spores of C. difficile were recovered from the hands of HCWs after rubbing their fingers and palms in alcohol shortly after patient care. Associations between hand contamination and HCW category, type (patient or environment), and risk level (high or low risk) of HCW contacts and their respective duration as well as use of gloves were analyzed by bivariate and multivariate analysis.Results.C. difficile spores were detected on 24% of HCWs' hands in the exposed group and on 0% in the unexposed group (P < .001). In the exposed group, logistic regression, which adjusted for high-risk contact (ie, exposure to fecal soiling), contact with the environment, and contact with or without use of gloves, revealed that high-risk contact (adjusted odds ratio [aOR] per 1 contact increment, 2.78; 95% confidence interval [CI], 1.42–5.45; P = .003) and at least 1 contact without use of gloves (aOR, 6.26; 95% CI, 1.27–30.78; P = .02) were independently associated with HCW hand contamination by C. difficile spores.Conclusions.Nearly one-quarter of HCWs have hands contaminated with C. difficile spores after routine care of patients with CDI. Hand contamination is positively associated with exposure to fecal soiling and lack of glove use.

scholarly journals SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4540
Author(s):  
Johannes Korth ◽  
Benjamin Wilde ◽  
Sebastian Dolff ◽  
Jasmin Frisch ◽  
Michael Jahn ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Risk Group ◽  
Close Contact ◽  
Virus Transmission ◽  
High Risk Group ◽  
Low Risk ◽  
University Hospital ◽  
Intermediate Risk ◽  
Igg Antibody

SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March–May to 4.0% in June–July to 5.1% in October–December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.

Tuberculosis and Tuberculin Quality: Best Intentions, Misleading Results

2001 ◽  
Vol 22 (08) ◽  
pp. 481-484 ◽  
Author(s):  
M. Sigfrido Rangel-Frausto ◽  
Samuel Ponce-de-León-Rosales ◽  
Claudia Martinez-Abaroa ◽  
Kaare Hasløv
Keyword(s):  
Medical Students ◽  
High Risk ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Healthcare Workers ◽  
Low Risk ◽  
University Hospital ◽  
High Risk Population ◽  
Risk Population

Abstract Objective: To compare the performance of three purified protein derivative (PPD) formulations: Tubersol (Connaught); RT23, Statens Serum Institut (SSI); and RT23, Mexico, tested in Mexican populations at low and high risk for tuberculosis (TB). Design: A double-blinded clinical trial. Setting: A university hospital in Mexico City. Participants: The low-risk population was first or second-year medical students with no patient contact; the high-risk population was healthcare workers at a university hospital. Methods: Each of the study subjects received the three different PPD preparations. Risk factors for TB, including age, gender, occupation, bacille Calmette-Guerin (BCG) status, and TB exposure, were recorded. A 0.1-mL aliquot of each preparation was injected in the left and right forearms of volunteers using the Mantoux technique. Blind readings were done 48 to 72 hours later. Sensitivity and specificity were calculated at 10 mm of induration using Tubersol as the reference standard. The SSI tested the potency of the different PPD preparations in previously sensitized guinea pigs. Results: The low-risk population had a prevalence of positive PPD of 26%. In the low-risk population, RT23 prepared in Mexico, compared to the 5 TU of Tubersol, had a sensitivity of 51%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 86%. The RT23 prepared at the SSI had a sensitivity of 69%, a specificity of 99%, a positive predictive value of 95%, and a negative predictive value of 90%. In the high-risk population, the prevalence of positive PPD was 57%. The RT23 prepared in Mexico had a sensitivity of 33%, a specificity of 100%, and a positive predictive value of 53%; the RT23 prepared at the SSI had a sensitivity of 91%, a specificity of 98%, a positive predictive value of 98%, and a negative predictive value of 89%. RT23 used in Mexico had a potency of only 23% of that of the control. There was no statistical association among those with a positive PPD, irrespective of previous BCG vaccination (relative risk, 0.97; 95% confidence interval, 0.76-1.3; P=.78). Conclusions: Healthcare workers had twice the prevalence of positive PPD compared to medical students. RT23 prepared in Mexico had a low sensitivity in both populations compared to 5 TU of Tubersol and RT23 prepared at the SSI. Previous BCG vaccination did not correlate with a positive PPD. Low potency of the RT23 preparation in Mexico was confirmed in guinea pigs. Best intentions in a TB program are not enough if they are not followed by high-quality control.

A University hospital healthcare workers' high-risk contact with patients diagnosed with coronavirus disease (COVID-19): a cross- sectional evaluation

2021 ◽  
pp. 145-154
Author(s):  
Seyfi DURMAZ ◽  
Aslı Ata TENELER ◽  
Aysun CEVHERTAS ◽  
Nurdan Filis OZBAY ◽  
Atalay AKTUNA ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
University Hospital ◽  
Cross Sectional

scholarly journals 495. Effectiveness of Personal Protective Equipment in Preventing Transmission of COVID-19 in Healthcare Workers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S314-S314
Author(s):  
Aldon Li ◽  
Gunter Rieg ◽  
Ana Miranda Maldonado ◽  
June Concepcion
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Case Series ◽  
Low Risk ◽  
Urgent Care ◽  
Risk Level ◽  
Protective Equipment ◽  
Retrospective Case ◽  
Positive Rate

Abstract Background Human-to-human transmission of the SARS-CoV-2 occurs during exposure to infectious respiratory particles generated by humans with COVID-19. Global personal protective equipment (PPE) shortages necessitate further studies looking at the correlation between PPE use and transmission of COVID-19 to healthcare workers (HCW). This study aims to provide data on test positivity rates of HCW wearing different PPE. Methods Retrospective Case Series. During the study period from Mar-Apr 2020, HCW were tested for SARS-CoV-2 if they 1) were exposed to COVID-19 case OR 2) had symptoms of potential COVID-19 disease per CDC criteria. Respirator masks defined as N95 or higher were used in high risk departments (Emergency and Urgent Care (ERUC), Medical/Surgical (MSU), and Intensive Care (ICU) units). Medical masks defined as surgical or procedural masks were used in low risk, outpatient departments. All departments used gowns, gloves, eye protection, and appropriate masks. Results In low risk departments, 124/1578 (7.9%) of HCW tested positive, compared to 118/1499 (7.9%) of HCW who worked in high risk departments (p=0.9886). In high risk departments, 55/626 of HCW who worked in MSU, 37/459 of HCW who worked in ERUC, and 26/414 who worked in ICU tested positive. In a logistic regression model comparing tested individuals in high risk departments to those in ambulatory settings, a slightly lower risk of a positive test among ICU employees (OR=0.786, CI=0.508–1.217) was found, and a similar risk among ERUC employees (OR=1.028, CI=0.701–1.508) and MSU employees (OR=1.129, CI=0.810–1.574) was found, but the differences were not statistically significant (p=0.5364). Conclusion HCW in ambulatory settings who used medical masks did not test positive at a higher rate than providers in high risk departments using respirators. The slightly lower positive rate in ICU providers may suggest respirator masks are beneficial in settings with higher risk of aerosolizing generating procedures, or it maybe related to training and familiarity with infection control procedures. The level of mask used was equally appropriate across all risk level care settings, providing evidence for local strategies to optimize PPE stewardship based on department assignments while protecting HCW during the COVID-19 pandemic. Disclosures All Authors: No reported disclosures

scholarly journals Impact of social contacts on SARS-CoV-2 exposure among healthcare workers

2021 ◽  
Author(s):  
A N Emecen ◽  
S Keskin ◽  
E Boncukcu Eren ◽  
B Yildirim Ustuner ◽  
S G Celik ◽  
...  
Keyword(s):  
High Risk ◽  
Patient Care ◽  
Healthcare Workers ◽  
Conditional Logistic Regression ◽  
University Hospital ◽  
Contact Tracing ◽  
Risk Exposure ◽  
Social Contacts ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background Healthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure. Aims This study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm. Methods Contact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers. Results Of the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P &lt; 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P &lt; 0.001), in non-patient care settings (47%, P &lt; 0.001) and in the social contacts (57%, P &lt; 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62–4.69) in multivariate analysis. Conclusions A significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.

scholarly journals Seroprevalence of SARS CoV-2 antibodies in healthcare workers and administration employees: a prospective surveillance study at a 1,400-bed university hospital in Germany

2020 ◽  
Author(s):  
Christina Bahrs ◽  
Aurelia Kimmig ◽  
Sebastian Weis ◽  
Juliane Ankert ◽  
Stefan Hagel ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Clinical Symptoms ◽  
Low Risk ◽  
University Hospital ◽  
Intermediate Risk ◽  
Prospective Surveillance ◽  
Risk Area ◽  
Additional Risk ◽  
Risk Areas

Background: Healthcare workers (HCWs) are at particular risk to acquire SARS-CoV-2 infections. Aim: The objectives of this study were to compare SARS-CoV-2 IgG seroprevalence and compliance to wear personal protective equipment (PPE) between HCWs working within (high-risk) or outside (intermediate-risk) units treating suspected or confirmed COVID-19 patients. In addition, administration staff (low-risk) was included. Materials: Co-HCW is a prospective cohort study among employees at the Jena University Hospital, Germany. Since 16th March 2020, 50 SARS-CoV-2 inpatients and 73 outpatients were treated in our hospital. Mandatory masking was implemented on 20th March 2020. We here evaluated seroprevalence using two IgG detecting immunoassays, assessed COVID-19 exposure, clinical symptoms and compliance to wear PPE. Findings: Between 19th May and 19th June 2020 we analysed 660 employees [out of 3,228; 20.4%]. Eighteen participants (2.7%) had SARS-CoV-2 antibodies in at least one immunoassay. Among them, 13 (72.2%) were not aware of direct COVID-19 exposure and 9 (50.0%) did not report any clinical symptoms. We observed no evidence for an association between seroprevalence and risk area (high-risk: 2 of 137 HCWs (1.5%), intermediate-risk: 10 of 343 HCWs (2.9%), low-risk: 6 of 180 administration employees (3.3%); p=0.574). Reported compliance to wear PPE differed (p<0.001) between working in high-risk (98.3%) and in intermediate-risk areas (69.8%). Conclusion: No evidence for higher seroprevalence against SARS-CoV-2 in HCWs working in high-risk COVID-19 areas could be observed, probably due to high compliance to wear PPE. Compared to administration employees, we observed no additional risk to acquire SARS-CoV-2 infections by patient care.

scholarly journals Study protocol for the assessment of nurses internal contamination by antineoplastic drugs in hospital centres: a cross-sectional multicentre descriptive study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033040 ◽  
Author(s):  
Antoine Villa ◽  
Mathieu Molimard ◽  
Emmanuelle Bignon ◽  
Béatrice Martinez ◽  
Magali Rouyer ◽  
...  
Keyword(s):  
Study Protocol ◽  
Target Population ◽  
Routine Care ◽  
University Hospital ◽  
Contamination Rate ◽  
Antineoplastic Drugs ◽  
Cross Sectional ◽  
Internal Contamination ◽  
Occupational Physicians ◽  
Occupational Risks

IntroductionAntineoplastic drugs (AD) are potentially carcinogenic and/or reprotoxic molecules. Healthcare professionals are increasingly exposed to these drugs and can be potentially contaminated by them. Internal contamination of professionals is a key concern for occupational physicians in the assessment and management of occupational risks in healthcare settings. Objectives of this study are to report AD internal contamination rate in nursing staff and to identify factors associated with internal contamination.Methods and analysisThis trial will be conducted in two French hospital centres: University Hospital of Bordeaux and IUCT-Oncopole of Toulouse. The target population is nurses practicing in one of the fifteen selected care departments where at least one of the five studied AD is handled (5-fluorouracil, cyclophosphamide, doxorubicin, ifosfamide, methotrexate). The trial will be conducted with the following steps: (1) development of analytical methods to quantify AD urine biomarkers, (2) study of the workplace and organization around AD in each care department (transport and handling, professional practices, personal and collective protection equipments available) (3) development of a self-questionnaire detailing professional activities during the day of inclusion, (4) nurses inclusion (urine samples and self-questionnaire collection), (5) urine assays, (6) data analysis.Ethics and disseminationThe study protocol has been approved by the French Advisory Committee on the Treatment of Information in Health Research (CCTIRS) and by the French Data Protection Authority (CNIL). Following the opinion of the Regional Committee for the Protection of Persons, this study is outside the scope of the provisions governing biomedical research and routine care (n°2014/87). The results will be submitted to peer-reviewed journals and reported at suitable national and international meetings.Trial registration numberNCT03137641.

scholarly journals Outcomes of COVID-19 contact tracing in hospital healthcare workers: a retrospective cohort study

2021 ◽  
Author(s):  
Seyfi Durmaz ◽  
Ece Fidan Kucuk ◽  
Sera Simsek ◽  
Kevser Durgun ◽  
Emine Bilge Karakas ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healthcare Workers ◽  
Hospital Setting ◽  
University Hospital ◽  
Contact Tracing ◽  
Specific Rate ◽  
Increased Risk

Objective: To determine risk-group-specific rate of becoming COVID-19-positive among healthcare workers having had contact with COVID-19 cases. Methods: The retrospective cohort study was conducted at the Ege University Hospital, Bornova, Turkey, and comprised all healthcare workers who had come into contact with COVID-19 cases between March 11 and May 31, 2020. The contacts were classified as low-risk, medium-risk and high-risk using the guidelines of the Turkish Ministry of Health. The outcome measures were the incidence of infection among contacts and the incubation period and serial interval among the new cases. Data was analysed using SPSS 23. Results: Of the 845 cases, 312(37%) had high risk, 263(31%) medium and 270(32%) low. Overall, there were 490(58%) females, 355(41%) males, 565(67%) aged <40 years, and 277(33%) aged >40 years. Of the total, 27(3.20%) healthcare workers tested COVID-19-positive and distribution among the risk-based groups was significant (p=0.037). There was a significantly increased risk of incidence among repeated contacts, no mask use, and the source being a colleague (p<0.05). Conclusion: The detection of high-risk contacts was found to be important for controlling COVID-19 infection in a hospital setting. Key Words: SARS-CoV-2, Healthcare workers, Contact tracing, Contact-based surveillance. Continuous...

scholarly journals A University Hospital Healthcare Workers' High-Risk Contact with Patients Diagnosed with Coronavirus Disease (COVID-19): a Cross-Sectional Evaluation

2021 ◽  
Vol 60 (2) ◽  
pp. 145-154
Author(s):  
Seyfi DURMAZ ◽  
Aslı ATA TENELER ◽  
Aysun CEVHERTAŞ ◽  
Nurdan FİLİS ◽  
Atalay AKTUNA ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
University Hospital ◽  
Cross Sectional
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