C.1 Time Metrics and Clinical Outcomes of Thrombectomy in Acute Stroke
                        Patients Before and After Implementation of COVID-19 Infection Protocols in
                        Nine Canadian Stroke Centres

Background: The coronavirus disease 2019 (COVID-19) pandemic has led an implementation of institutional infection control protocols. This study will determine the effects of these protocols on outcomes of acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT). Methods: Uninterrupted time series analysis of the impact of COVID-19 safety protocols on AIS patients undergoing EVT. We analyze data from prospectively collected quality improvement databases at 9 centers from March 11, 2019 to March 10, 2021. The primary outcome is 90-day modified Rankin Score (mRS). The secondary outcomes are angiographic time metrics. Results: Preliminary analysis of one stroke center included 214 EVT patients (n=144 pre-pandemic). Baseline characteristics were comparable between the two periods. Time metrics “last seen normal to puncture” (305.7 vs 407.2 min; p=0.05) and “hospital arrival to puncture” (80.4 vs 121.2 min; p=0.04) were significantly longer during pandemic compared to pre-pandemic. We found no significant difference in 90-day mRS (2.0 vs 2.2; p=0.506) or successful EVT rate (89.6% vs 90%; p=0.93). Conclusions: Our results indicate an increase in key time metrics of EVT in AIS during the pandemic, likely related to infection control measures. Despite the delays, we found no difference in clinical outcomes between the two periods.

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Tuberculosis in Health Care Workers and the Impact of Implementation of Hospital Infection-Control Measures

Workplace Health & Safety ◽

10.1177/2165079920919133 ◽

2020 ◽

Vol 68 (11) ◽

pp. 519-525

Author(s):

Ana Cláudia Vasconcellos Azeredo ◽

Sizuane Rieger Holler ◽

Ellis Gabriela Correa de Almeida ◽

Otávio Augusto Gonçalves Dias Cionek ◽

Marcelle Martinez Loureiro ◽

...

Keyword(s):

Health Care ◽

Infection Control ◽

Health Care Workers ◽

Control Measures ◽

Control Plan ◽

Infection Control Measures ◽

Care Workers ◽

Hospital Infection Control ◽

Before And After ◽

The Impact

Background: Most studies that have evaluated the impact of infection-control measures (ICM) reported a decrease in latent tuberculosis (TB) and not in TB. The objective of this study was to evaluate the impact of ICM on TB incidence among Health Care Workers (HCW’s). Methods: We conducted a retrospective record review study in a general, tertiary care, university-affiliated hospital. All TB case reports among HCWs in the hospital from 2005 to 2018 were reviewed. The TB incidence was measured before and after 2012 to evaluate the impact of ICM implemented. Findings: In total, there were 53 TB cases. The number of TB cases before and after the implementation of ICM was 42 (incidence: 100.0 cases/100,000 HCWs/year) and 11 (incidence: 26.2 cases/100,000 HCWs/year), respectively ( p < .0001). Conclusions/Application to Practice: TB incidence among HCWs reduced significantly after the implementation of ICM. The establishment of ICM, such as written TB infection control plan, monitoring, screening, training, and education, can reduce TB incidence.

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

Science ◽

10.1126/science.abf9648 ◽

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.

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

Infection Control and Hospital Epidemiology ◽

10.1086/658333 ◽

2011 ◽

Vol 32 (3) ◽

pp. 210-219 ◽

Cited By ~ 44

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.

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

Antimicrobial Stewardship & Healthcare Epidemiology ◽

10.1017/ash.2021.17 ◽

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

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Attitudes and practices of infection control among senior dental students at college of dentistry, university of Sharjah in the United Arab Emirates

European Journal of Dentistry ◽

10.4103/1305-7456.119058 ◽

2013 ◽

Vol 07 (S 01) ◽

pp. S015-S019 ◽

Cited By ~ 10

Author(s):

Betul Rahman ◽

Sheela Balu Abraham ◽

Amna Mohammed Alsalami ◽

Fatima Eisa Alkhaja ◽

Shaikha Ibrahim Najem

Keyword(s):

Infectious Diseases ◽

Infection Control ◽

United Arab Emirates ◽

Dental Students ◽

Control Measures ◽

Attitudes And Practices ◽

Infection Control Measures ◽

Significant Difference ◽

Control Procedures ◽

Students Attitudes

ABSTRACT Objective: The purpose of this study was to investigate compliance, awareness and practices of infection control procedures among senior dental students at the College of Dentistry, University of Sharjah, United Arab Emirates. Materials and Methods: The study comprised of 119 subjects of 4 th and 5 th year dental students. A questionnaire was developed with 25 open and closed-ended questions related to barrier techniques, vaccination status, infection control practices and awareness. This was distributed among the senior dental students and completed upon signing the consent form. Each questionnaire was coded to ensure the confidentiality of responses. Results: The questionnaire was distributed among 223 senior dental students at the University of Sharjah of which only 119 students (53%) responded. Compliance with the use of protective barriers was high with the exception of protective eye wear, utilized by a mere 27% of students. There was a significant difference between 4 th and 5 th year dental students′ attitudes (p < 0.05) regarding the treatment of patients with infectious diseases. Compared with 44.4% of the 5 th year students, 68.5% of the 4 th year students did not mind treating patients with infectious diseases. Owing to this, 61.9% of the 5 th year students suffered from non-sterile percutaneous and mucous membrane exposures compared with 44.6% of the 4 th year students (p < 0.05). Conclusions: Efforts are needed to improve attitudes, implement information and motivate students in the correct and routine use of infection control measures. With all infection control protocols already implemented in dental schools, the challenge remains on improving compliance with infection control recommendations.

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Early reperfusion and clinical outcomes in patients with M2 occlusion: pooled analysis of the PROACT II, IMS, and IMS II studies

Journal of Neurosurgery ◽

10.3171/2014.7.jns131430 ◽

2014 ◽

Vol 121 (6) ◽

pp. 1354-1358 ◽

Cited By ~ 15

Author(s):

Ralph Rahme ◽

Sharon D. Yeatts ◽

Todd A. Abruzzo ◽

Lincoln Jimenez ◽

Liqiong Fan ◽

...

Keyword(s):

Clinical Outcomes ◽

Functional Independence ◽

Pooled Analysis ◽

Modified Rankin Scale ◽

Early Reperfusion ◽

Glucose Levels ◽

Significant Difference ◽

Baseline Characteristics ◽

The Impact

Object The role of endovascular therapy in patients with acute ischemic stroke and a solitary M2 occlusion remains unclear. Through a pooled analysis of 3 interventional stroke trials, the authors sought to analyze the impact of successful early reperfusion of M2 occlusions on patient outcome. Methods Patients with a solitary M2 occlusion were identified from the Prolyse in Acute Cerebral Thromboembolism (PROACT) II, Interventional Management of Stroke (IMS), and IMS II trial databases and were divided into 2 groups: successful reperfusion (thrombolysis in cerebral infarction [TICI] 2–3) at 2 hours and failed reperfusion (TICI 0–1) at 2 hours. Baseline characteristics and clinical outcomes were compared. Results Sixty-three patients, 40 from PROACT II and 23 from IMS and IMS II, were identified. Successful early angiographic reperfusion (TICI 2–3) was observed in 31 patients (49.2%). No statistically significant difference in the rates of intracerebral hemorrhage (60.9% vs 47.6%, p = 0.55) or mortality (19.4% vs 15.6%, p = 0.75) was observed. However, there was a trend toward higher incidence of symptomatic hemorrhage in the TICI 2–3 group (17.4% vs 0%, p = 0.11). There was also a trend toward higher baseline glucose levels in this group (151.5 mg/dl vs 129.6 mg/ dl, p = 0.09). Despite these differences, the rate of functional independence (modified Rankin Scale Score 0–2) at 3 months was similar (TICI 2–3, 58.1% vs TICI 0–1, 53.1%; p = 0.80). Conclusions A positive correlation between successful early reperfusion and clinical outcome could not be demonstrated for patients with M2 occlusion. Irrespective of reperfusion status, such patients have better outcomes than those with more proximal occlusions, with more than 50% achieving functional independence at 3 months.

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Transmission and control in an institutional pandemic influenza A(H1N1) 2009 outbreak

Epidemiology and Infection ◽

10.1017/s0950268811001518 ◽

2011 ◽

Vol 140 (6) ◽

pp. 1102-1110 ◽

Cited By ~ 4

Author(s):

N. ARINAMINPATHY ◽

N. RAPHAELY ◽

L. SALDANA ◽

C. HODGEKISS ◽

J. DANDRIDGE ◽

...

Keyword(s):

High Risk ◽

Infection Control ◽

Pandemic Influenza ◽

Summer School ◽

Influenza A ◽

Control Measures ◽

Infection Control Measures ◽

Influenza A H1n1 ◽

Hygiene Measures ◽

The Impact

SUMMARYA pandemic influenza A(H1N1) 2009 outbreak in a summer school affected 117/276 (42%) students. Residential social contact was associated with risk of infection, and there was no evidence for transmission associated with the classroom setting. Although the summer school had new admissions each week, which provided susceptible students the outbreak was controlled using routine infection control measures (isolation of cases, basic hygiene measures and avoidance of particularly high-risk social events) and prompt treatment of cases. This was in the absence of chemoprophylaxis or vaccination and without altering the basic educational activities of the school. Modelling of the outbreak allowed estimation of the impact of interventions on transmission. These models and follow-up surveillance supported the effectiveness of routine infection control measures to stop the spread of influenza even in this high-risk setting for transmission.

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The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.711791 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jamile Marchi ◽

Nina Johansson ◽

Anna Sarkadi ◽

Georgina Warner

Keyword(s):

Mental Health ◽

Physical Activity ◽

Infection Control ◽

Children And Adolescents ◽

Scoping Review ◽

Well Being ◽

Control Measures ◽

Parenting Support ◽

Infection Control Measures ◽

The Impact

Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health.Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0–18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions.Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors.Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.

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Nurses Practice Regarding Infection Control Measures during The Second Stage of Labor: A Multicenter Study

Evidence-Based Nursing Research ◽

10.47104/ebnrojs3.v3i1.213 ◽

2021 ◽

Vol 3 (1) ◽

pp. 13

Author(s):

Somia F. E. Fahmi ◽

Zeinab A. A. Baraia ◽

Inaam H. Abdelati

Keyword(s):

Infection Control ◽

General Hospital ◽

Infection Control Practice ◽

Control Measures ◽

University Hospital ◽

Second Stage Of Labor ◽

Control Practice ◽

Second Stage ◽

Infection Control Measures ◽

Significant Difference

Context: Infection prevention remains a significant public health challenge for healthcare systems, especially in maternity and delivery units. Good understanding and compliance of nurses with infection control measures during delivery are essential factors that improve maternal and neonatal outcomes and decrease morbidity and mortality. Aim: This study aimed to assess nurses' practice regarding infection control measures during the second stage of labor in multiple centers. Methods: Cross-sectional descriptive observational study was adopted in this study. The study population included all nurses working in labor rooms of four hospitals (100 nurses), namely Suez Canal University Hospital, Zagazig University Hospital, Ismailia General Hospital, And Zagazig General Hospital. Data collection tool encompassed a structured interviewing questionnaire to assess nurses' general characteristics, physical and organizational barriers that prevent nurses from complying with infection control measures, infection control practice checklist to assess nurses` compliance with infection control measures during the second stage of labor. Results: The highest percentage of the studied nurses' age was between 19-<29 (56.6%, 63.8%). Near half were technical nurses (43.4%, 44.7%). The majority of the studied nurses had not had periodic checks. Also, most of them were vaccinated against viral hepatitis B (86.8%, 91.5%). There was a statistically significant difference between Ismalia and Zagazig hospitals in physical barriers. The highest mean percent for infection control practice was for perineal care 100%, using the invasive device during labor 92%, preparing birthing room and its equipment 75.9%. A satisfactory infection control practice was revealed among 88% of the studied nurses. The satisfactory practice of nurses was 100%, 92.1%, 86.9%, 44.1% in Zagazig General Hospital, Ismalia University Hospital, Zagazig University Hospital, Ismalia General Hospital, respectively. Conclusion: The result of the study concluded that most nurses' practice regarding infection control in the delivery room was satisfactory. The study recommended upgrading and qualifying nurses in the labor room to improve their practical skills in Obstetric Nursing.

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Impact of Changes in Infection Control Measures on the Dynamics of COVID-19 Infections in Schools and Pre-schools

Frontiers in Public Health ◽

10.3389/fpubh.2021.780039 ◽

2021 ◽

Vol 9 ◽

Author(s):

Martina Sombetzki ◽

Petra Lücker ◽

Manja Ehmke ◽

Sabrina Bock ◽

Martina Littmann ◽

...

Keyword(s):

Infection Control ◽

Regression Model ◽

Multivariate Regression ◽

Face Mask ◽

Multivariate Model ◽

Control Measures ◽

Infection Control Measures ◽

Factors Influencing ◽

The Impact ◽

Index Cases

Introduction: With the increased emergence of SARS-CoV-2 variants, the impact on schools and preschools remains a matter of debate. To ensure that schools and preschools are kept open safely, the identification of factors influencing the extent of outbreaks is of importance.Aim: To monitor dynamics of COVID-19 infections in schools and preschools and identify factors influencing the extent of outbreaks.Methods: In this prospective observational study we analyzed routine surveillance data of Mecklenburg-Western Pomerania, Germany, from calendar week (CW) 32, 2020 to CW19, 2021 regarding SARS-CoV-2 infection events in schools and preschools considering changes in infection control measures over time. A multivariate linear regression model was fitted to evaluate factors influencing the number of students, teachers and staff tested positive following index cases in schools and preschools. Due to an existing multicollinearity in the common multivariate regression model between the variables “face mask obligation for children” and “face mask obligation for adults”, two further separate regression models were set up (Multivariate Model Adults and Multivariate Model Children).Results: We observed a significant increase in secondary cases in preschools in the first quarter of 2021 (CW8 to CW15, 2021), and simultaneously a decrease in secondary cases in schools. In multivariate regression analysis, the strongest predictor of the extent of the outbreaks was the teacher/ caregiver mask obligation (B = −1.9; 95% CI: −2.9 to −1.0; p < 0.001). Furthermore, adult index cases (adult only or child+adult combinations) increased the likelihood of secondary cases (B = 1.3; 95% CI: 0.9 to 1.8; p < 0.001). The face mask obligation for children also showed a significant reduction in the number of secondary cases (B = −0.6; 95% CI: −0.9 to −0.2; p = 0.004.Conclusion: The present study indicates that outbreak events at schools and preschools are effectively contained by an obligation for adults and children to wear face masks.

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