scholarly journals Waves of trouble: MRSA strain dynamics and assessment of the impact of infection control

2011 ◽  
Vol 66 (12) ◽  
pp. 2685-2688 ◽  
Author(s):  
D. Wyllie ◽  
J. Paul ◽  
D. Crook
Keyword(s):  
Infection Control ◽  
The Impact

scholarly journals The impact of population-wide rapid antigen testing on SARS-CoV-2 prevalence in Slovakia

Science ◽  
2021 ◽  
pp. eabf9648
Author(s):  
Martin Pavelka ◽  
Kevin Van-Zandvoort ◽  
Sam Abbott ◽  
Katharine Sherratt ◽  
Marek Majdan ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Infection Control Measures ◽  
Household Members ◽  
The Impact ◽  
Antigen Testing

Slovakia conducted multiple rounds of population-wide rapid antigen testing for SARS-CoV-2 in late 2020, combined with a period of additional contact restrictions. Observed prevalence decreased by 58% (95% CI: 57-58%) within one week in the 45 counties that were subject to two rounds of mass testing, an estimate that remained robust when adjusting for multiple potential confounders. Adjusting for epidemic growth of 4.4% (1.1-6.9%) per day preceding the mass testing campaign, the estimated decrease in prevalence compared to a scenario of unmitigated growth was 70% (67-73%). Modelling indicated that this decrease could not be explained solely by infection control measures, but required the additional impact of isolation and quarantine of household members of those testing positive.

scholarly journals Impact of Each Component of a Ventilator Bundle on Preventing Ventilator-Associated Pneumonia and Lower Respiratory Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s259-s260
Author(s):  
Rafaela Pinho ◽  
Luciana Tanure ◽  
Jussara Pessoa ◽  
Leonardo Santos ◽  
Braulio Couto ◽  
...  
Keyword(s):  
Infection Control ◽  
Incidence Rate ◽  
Cuff Pressure ◽  
Oral Care ◽  
Ventilator Circuit ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage ◽  
The Impact ◽  
Control Service ◽  
Daily Sedation Interruption

Background: Ventilator-associated lower respiratory infections (LRIs) and pneumonia (VAP) are important healthcare-associated infections and are among the leading causes of death worldwide. Prevention of these infections are often based on care bundles. We investigated the incidence of VAP+LRI and the preventive efficacy of each component of our ventilator bundle. Methods: Our ventilator bundle includes 6 components that are daily checked by an infection control practitioner. These 6 evidence-based practices were implemented in 3 ICUs from a general tertiary-care private hospital in Belo Horizonte City (Brazil): (1) daily oral care with chlorhexidine; (2) elevate the head of the bed to between 30 and 45; (3) avoid scheduled ventilator circuit change; (4) monitor cuff pressure; (5) use subglottic secretion drainage; and (6) daily sedation interruption and daily assessment of readiness to extubate. VAP and ventilator-LRI definitions were obtained from the CDC NHSN. The impact of adherence rate to items in the ventilator bundle (%) on the incidence rate of VAP+LRI was assessed using linear regression and scatterplot analyses. Results: Between January 2018 and April 2019, 1,888 ventilator days were observed in the 3 ICUs, with 42 VAP and LRI events, an overall incidence rate of 22.2 cases per 1,000 ventilator days. After September 2018, the infection control service started a campaign to increase the ventilator bundle compliance (Fig. 1). Adherence rates to all 6 bundle components increased between January–August 2018 and September 2018–April 2019 from 25% to 55% for daily oral care, from 34% to 79% for elevating the head of the bed, 28% to 86% for avoiding scheduled ventilator circuit change, from 32% to 83% for cuff pressure monitoring, from 32% to 83% for subglottic secretion drainage, and from 33% to 85% for daily sedation interruption. PAV and LRI incidence decreased from 41 to 16 in ICU A, from 22 to 14 in ICU B and from 24 to 18 in ICU C. The impact of each bundle component was identified by linear regression, calculating the percentage of PAV+LRI incidence rate that is explained by bundle item adherence (r2) and correlation coefficient (r): daily sedation interruption (r2 = 48%; r = 0.69; P = .004) (Fig. 2), cuff pressure monitorization (r2 = 0.3721; r = 0.61; P = .016), subglottic secretion drainage (r2 = 36%; r = 0.60; P = .017), avoidance of scheduled ventilator circuit change (r2 = 34%; r = 0.58; P = .023), daily oral care (r2 = 25%; r = 0.50; P = .050), and elevate the head of the bed (r2 = 25%; r = 0.48; P = .067). Conclusions: The impact of each bundle component on preventing PAV+LRI was identified by the study. An educational intervention performed by the infection control service increased the adherence to the ventilator bundle, and the PAV and LRI incidence decreased.Funding: NoneDisclosures: None

scholarly journals The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

2021 ◽  
Author(s):  
Marina Yiasemidou
Keyword(s):  
Infection Control ◽  
Surgical Training ◽  
New Technologies ◽  
Negative Impact ◽  
Elective Surgery ◽  
Control Measures ◽  
Negative Consequences ◽  
Surgical Services ◽  
The World ◽  
The Impact

AbstractThe COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and ‘face-to-face’ clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.

Multihospital Outbreak ofClostridium difficileRibotype 027 Infection: Epidemiology and Analysis of Control Measures

2011 ◽  
Vol 32 (3) ◽  
pp. 210-219 ◽  
Author(s):  
Mamoon A. Aldeyab ◽  
Michael J. Devine ◽  
Peter Flanagan ◽  
Michael Mannion ◽  
Avril Craig ◽  
...  
Keyword(s):  
Infection Control ◽  
Action Plan ◽  
Essential Element ◽  
Control Measures ◽  
Environmental Hygiene ◽  
Ribotype 027 ◽  
Infection Control Measures ◽  
Health And Social Care ◽  
Large Outbreak ◽  
The Impact

Objective.To report a large outbreak ofClostridium difficileinfection (CDI; ribotype 027) between June 2007 and August 2008, describe infection control measures, and evaluate the impact of restricting the use of fluoroquinolones in controlling the outbreak.Design.Outbreak investigation in 3 acute care hospitals of the Northern Health and Social Care Trust in Northern Ireland.Interventions.Implementation of a series of CDI control measures that targeted high-risk antibiotic agents (ie, restriction of fluoroquinolones), infection control practices, and environmental hygiene.Results.A total of 318 cases of CDI were identified during the outbreak, which was the result of the interaction betweenC. difficileribotype 027 being introduced into the affected hospitals for the first time and other predisposing risk factors (ranging from host factors to suboptimal compliance with antibiotic guidelines and infection control policies). The 30-day all-cause mortality rate was 24.5%; however, CDI was the attributable cause of death for only 2.5% of the infected patients. Time series analysis showed that restricting the use of fluoroquinolones was associated with a significant reduction in the incidence of CDI (coefficient, —0.054; lag time, 4 months;P= .003).Conclusion.These findings provide additional evidence to support the value of antimicrobial stewardship as an essential element of multifaceted interventions to control CDI outbreaks. The present CDI outbreak was ended following the implementation of an action plan improving communication, antibiotic stewardship, infection control practices, environmental hygiene, and surveillance.

scholarly journals The Impact of Enhanced Antimicrobial Stewardship Support on Antibiotic Starts in Long-Term Care Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s527-s527
Author(s):  
Gabriela Andujar-Vazquez ◽  
Kirthana Beaulac ◽  
Shira Doron ◽  
David R Snydman
Keyword(s):  
Public Health ◽  
Pilot Study ◽  
Infection Control ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Medical Center ◽  
Term Care ◽  
Care Facilities ◽  
The Impact

Background: The Tufts Medical Center Antimicrobial Stewardship (ASP) Team has partnered with the Massachusetts Department of Public Health (MDPH) to provide broad-based educational programs (BBEP) to long-term care facilities (LTCFs) in an effort to improve ASP and infection control practices. LTCFs have consistently expressed interest in individualized and hands-on involvement by ASP experts, yet they lack resources. The goal of this study was to determine whether “enhanced” individualized guidance provided by an ASP expert would lead to antibiotic start decreases in LTCFs participating in our pilot study. Methods: A pilot study was conducted to test the feasibility and efficacy of providing enhanced ASP and infection control practices to LTCFs. In total, 10 facilities already participating in MDPH BBEP and submitting monthly antibiotic start data were enrolled, were stratified by bed size and presence of dementia unit, and were randomized 1:1 to the “enhanced” group (defined as reviewing protocols and antibiotic start cases, providing lectures and feedback to staff and answering questions) versus the “nonenhanced” group. Antibiotic start data were validated and collected prospectively from January 2018 to July 2019, and the interventions began in April 2019. Due to staff turnover and lack of engagement, intervention was not possible in 2 of the 5 LTCFs randomized to the enhanced group, which were therefore analyzed as a nonenhanced group. An incidence rate ratios (IRRs) with 95% CIs were calculated comparing the antibiotic start rate per 1,000 resident days between periods in the pilot groups. Results: The average bed sizes for enhanced groups versus nonenhanced groups were 121 (±71.0) versus 108 (±32.8); the average resident days per facility per month were 3,415.7 (±2,131.2) versus 2,911.4 (±964.3). Comparatively, 3 facilities in the enhanced group had dementia unit versus 4 in the nonenhanced group. In the per protocol analysis, the antibiotic start rate in the enhanced group before versus after the intervention was 11.35 versus 9.41 starts per 1,000 resident days (IRR, 0.829; 95% CI, 0.794–0.865). The antibiotic start rate in the nonenhanced group before versus after the intervention was 7.90 versus 8.23 antibiotic starts per 1,000 resident days (IRR, 1.048; 95% CI, 1.007–1.089). Physician hours required for ASP for the enhanced group totaled 8.9 (±2.2) per facility per month. Conclusions: Although the number of hours required for intervention by an expert was not onerous, maintaining engagement proved difficult and in 2 facilities could not be achieved. A statistically significant 20% decrease in the antibiotic start rate was achieved in the enhanced group after interventions, potentially reflecting the benefit of enhanced ASP support by an expert.Funding: This study was funded by the Leadership in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) fellowship training grant award from the CDC.Disclosures: None

Infection control: current status. risks, research, rules and recycling

2021 ◽  
Vol 14 (2) ◽  
pp. 59-66
Author(s):  
Jennifer Haworth ◽  
Jonathan Sandy ◽  
Anthony J Ireland
Keyword(s):  
Infection Control ◽  
Best Practice ◽  
Mainland China ◽  
Current Status ◽  
Infectious Agents ◽  
Emerging Infections ◽  
Healthcare Waste ◽  
Control Procedures ◽  
The Uk ◽  
The Impact

We are living through a period of immense change following the outbreak of the COVID-19 pandemic in mainland China in December 2019. Even before the pandemic, the cost of managing healthcare-associated infections in the UK was considerable. The risk of acquiring any infection from the dental environment must be reduced to a minimum. As we have observed in recent years, new infectious agents emerge frequently, and the dental profession must be ready to respond appropriately and quickly. Orthodontic practice presents unique challenges in relation to infection control procedures. The impact of healthcare waste on the environment must also be considered. CPD/Clinical Relevance: This paper describes the range of infectious agents posing a risk to dental team members and patients. The aim is to place the recent coronavirus pandemic in the context of other recent emerging infections. Some of the latest research regarding infection control procedures is reviewed. Current best practice is described.

scholarly journals Retrospective Study on Personal Protective Equipment During Pandemic Link to Outbreak of Carbpenem-Resistant Enterobacteriace

2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra
Keyword(s):  
Retrospective Study ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Horizontal Transmission ◽  
Control Measures ◽  
Protective Equipment ◽  
Local Health ◽  
Infection Rates ◽  
Infection Control Measures ◽  
The Impact

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None

scholarly journals Second Wave of COVID-19 Pandemic in Malaysia and the Impact on Nuclear Cardiology Services: An Institutional Experience

2021 ◽  
Vol 5 ◽  
pp. 25
Author(s):  
Ahmad Zaid Zanial ◽  
Syifaa Aminudin ◽  
FatinHayani Mohamad Najib ◽  
Siti Zarina Amir Hassan
Keyword(s):  
Nuclear Medicine ◽  
Infection Control ◽  
Nuclear Cardiology ◽  
Heart Diseases ◽  
Imaging Techniques ◽  
Main Difficulty ◽  
Technetium 99M ◽  
Institutional Experience ◽  
The Impact ◽  
Second Wave

Introduction: Nuclear cardiology applying radioactive tracer and hybrid imaging techniques are able to provide information needed to detect and evaluate ischaemic heart diseases. In our centre, nuclear cardiology services involving stress and rest myocardial perfusion scans and viability studies contribute about 40% of overall scan workload. The second wave of COVID- 19 pandemic in Malaysia announced by the end of February 2020 has affected nuclear cardiology services.Objectives: Our aims were to determine the impact of COVID-19 pandemic second wave on the nuclear cardiology imaging studies performed as well as to ascertain crucial institutional experience especially unavoidable problem and adjustment during the period.Methods: A review of Technetium-99m tetrofosmin radiopharmaceutical dispensing data and scan records for 1st February to 31st August 2019 and 2020 was conducted at Nuclear Medicine Department, Hospital Kuala Lumpur. Figures were compiled and statistical analysis done. Survey and focus discussion conducted involving nuclear medicine physicians, pharmacists and physic officers to identify the main difficulty faced and most important Job-adapting measure taken.Results: A total of 1109 cardiac radiopharmaceutical doses dispensed during the studied period but were less when compared to 1342 doses dispensed last year. Significant reduction was noted in April and May 2020 with only 69 and 67 cases respectively in comparison with monthly average of 192 cases in 2019. Although some scan appointments were postponed to avoid the usual waiting area congestions, the main difficulty faced was Technetium-99m generator supply disruption with limited production in Europe and international transportation restriction. Implementing infection control standard operating procedure (SOP) instructions as part of routine work practice with emphasis of time, distance and shielding concept was the most important Job-adapting measure.Conclusion: Nuclear cardiology services were affected by the second wave of COVID-19 pandemic locally. Main problem ascertained was disruption of radioactive supply. Most important adjustment was infection control SOP implementation.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S25

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