scholarly journals Bronchoscope-Related Outbreaks and Pseudo-Outbreaks: CDC Consultations—United States, 2014–2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s144-s144
Author(s):  
Ana Bardossy ◽  
Shannon Novosad ◽  
Kiran Perkins ◽  
Heather Adele Moulton-Meissner ◽  
Matthew Arduino ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Lymph Node Biopsy ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Local Health ◽  
Specimen Collection ◽  
Bronchial Wash ◽  
Clinical Culture ◽  
State And Local ◽  
And Control

Background: Exposure to medical devices can be a risk factor for the development of healthcare-associated infections; bronchoscopes are a leading cause of device-associated outbreaks. We describe bronchoscope-related outbreaks and pseudo-outbreaks reported to the Centers for Disease Control and Prevention’s Division of Healthcare Quality Promotion (DHQP), and we summarize investigation steps and control measures. Methods: We identified bronchoscope-related consultations with state and local health departments between July 1, 2014, and September 30, 2019, in the DHQP database. We abstracted data on patient symptoms, clinical culture results, investigation findings, and subsequent infection prevention and control interventions. Results: We identified 15 consultations involving 150 patients (range, 3–31 patients per consultation). Each consultation involved at least 1 cluster of the same organism. Organisms associated with bronchoscope-associated clusters were nontuberculous mycobacteria (n = 7), Candida spp (n = 3), Exophiala spp (n = 2), Pseudomonas aeruginosa (n = 2), Enterobacter spp (n = 2), and Raoultella planticola, Stenotrophomonas maltophilia, Achromobacter spp, Mycobacterium tuberculosis, and Aspergillus spp (1 each; 2 consultations involved multiple pathogens). Procedures from which these patient specimens were collected included bronchoalveolar lavage, bronchial wash, bronchial brushing, sputum swab, and lymph node biopsy. For the 7 outbreaks in which clinical data were available, 5 did not have patients with clinical infections related to the pathogen recovered. Two consultations involved pseudo-outbreaks: one involved contamination of specimen collection tubes and the other involved contamination of cultures within the laboratory. Potential underlying pathogen sources included contaminated bronchoscopes (inadequate reprocessing or device damage) (n = 10, 67%), use of nonsterile ice, water, or saline during the procedure (n = 4, 27%), contaminated specimen collection tubes (n = 1, 7%), contaminated bronchoscope suite (n = 1, 7%), and clinical laboratory contamination (n = 1, 7%). The most common interventions included improvement of reprocessing procedures (n = 5), removal of possibly damaged bronchoscopes (n = 4), and eliminating nonsterile ice and water exposures in bronchoscopy (n = 3). Conclusions: Water-related organisms were the most commonly identified pathogens in bronchoscope-related consultations, highlighting the important role that exposure to contaminated water during bronchoscopy and bronchoscope reprocessing might play in bronchoscopy-associated outbreaks and pseudo-outbreaks. During bronchoscope-related outbreaks identifying a common pathogen could indicate problems in bronchoscope handling or reprocessing, device damage, or exposure to nonsterile water.Funding: NoneDisclosures: None

scholarly journals Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rapeephan R. Maude ◽  
Monnaphat Jongdeepaisal ◽  
Sumawadee Skuntaniyom ◽  
Thanomvong Muntajit ◽  
Stuart D. Blacksell ◽  
...  
Keyword(s):  
General Public ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
The Public ◽  
Educational Videos ◽  
Prevention And Control Measures ◽  
And Control

Abstract Background Key infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. Results Knowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting. Conclusions Detailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide.

scholarly journals Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Stéphane Marot ◽  
◽  
Isabelle Malet ◽  
Valentin Leducq ◽  
Karen Zafilaza ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Healthcare Workers ◽  
Disease Onset ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Rapid Decline ◽  
Prevention And Control Measures ◽  
Few Data ◽  
Antibody Levels ◽  
And Control

AbstractThere are only few data concerning persistence of neutralizing antibodies (NAbs) among SARS-CoV-2-infected healthcare workers (HCW). These individuals are particularly exposed to SARS-CoV-2 infection and at potential risk of reinfection. We followed 26 HCW with mild COVID-19 three weeks (D21), two months (M2) and three months (M3) after the onset of symptoms. All the HCW had anti-receptor binding domain (RBD) IgA at D21, decreasing to 38.5% at M3 (p < 0.0001). Concomitantly a significant decrease in NAb titers was observed between D21 and M2 (p = 0.03) and between D21 and M3 (p < 0.0001). Here, we report that SARS-CoV-2 can elicit a NAb response correlated with anti-RBD antibody levels. However, this neutralizing activity declines, and may even be lost, in association with a decrease in systemic IgA antibody levels, from two months after disease onset. This short-lasting humoral protection supports strong recommendations to maintain infection prevention and control measures in HCW, and suggests that periodic boosts of SARS-CoV-2 vaccination may be required.

scholarly journals The effectiveness of a Comprehensive Device Associated Healthcare-Associated Infections Prevention and Control Program: results of a 3-year program in the Republic of Cyprus

2019 ◽  
Author(s):  
Stelios Iordanou ◽  
Nicos Middleton ◽  
Elizabeth Papathanassoglou ◽  
Lakis Palazis ◽  
VASILIOS RAFTOPOULOS
Keyword(s):  
Infection Control ◽  
Prevention And Control ◽  
Control Program ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Second Phase ◽  
Infection Control Program ◽  
The Republic ◽  
Republic Of Cyprus ◽  
And Control

Abstract Background: Device-associated health care-associated infections (DA-HAIs) are a major threat to patient safety, particularly in the Intensive Care Unit (ICU). The aim of this study was to evaluate the effectiveness of a bundle of infection control measures to reduce DA-HAIs in the ICU of a General Hospital in the Republic of Cyprus, over a three-year period. Methods: We studied 599 ICU patients with length of stay (LOS) for at least 48 hours. Our prospective cohort study was divided into three surveillance phases. VAP, CLABSI, and CAUTI incidence rates, LOS and mortality were calculated before, during and after the infection prevention and control program. Results: There was a statistically significant reduction in the number of DA-HAI events during the surveillance periods, associated with DA-HAIs prevention efforts. In 2015 (prior to program implementation), the baseline DA-HAIs instances were 43: 16 VAP (10.1/1000 Device Days), 21 (15.9/1000DD) CLABSIs and 6 (2.66/1000DD) CAUTIs, (n=198). During the second phase (2016), CLABSIs prevention measures were implemented and the number of infections were 24: 14 VAP (12.21/1000DD), 4 (4.2/1000DD) CLABSIs & 6 (3.22/1000DD) CAUTIs, (n=184). During the third phase (2017), VAP and CAUTI prevention measure were again implemented and the rates were 6: (3 VAP: 12.21/1000DD), 2 (1.95/1000DD) CLABSIs & 1 (0.41/1000DD) CAUTIs, (n=217). There was an overall reduction of 87% in the total number of DA-HAIs instances for the period 01/01/15 to 31/12/17. Conclusions: The significant overall reduction in DA-HAI rates, indicates that a comprehensive infection control program can affect DA-HAI rates.

scholarly journals Awareness of COVID-19 Before and After Quarantine Based on Crowdsourced Data From Rabigh City, Saudi Arabia: A Cross-Sectional and Comparative Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Mai Aldhahri ◽  
Rana Alghamdi
Keyword(s):  
Saudi Arabia ◽  
Online Survey ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
Second Stage ◽  
Before And After ◽  
Prevention And Control Measures ◽  
Two Stages ◽  
And Control

Background: Infection prevention and control measures are critical for the prevention of the spread of COVID-19.Aim: In this study, we aimed to measure and evaluate the level of awareness and knowledge of the prevention, symptoms, and transmission control of COVID-19 before and after quarantine among the residents of Rabigh city and adjacent villages in Saudi Arabia.Methods: A cross-sectional online survey was conducted in two stages: the first stage took place before quarantine and the second stage took place after quarantine. The survey was filled out electronically.Results: A total of 448 participants responded and filled out the questionnaires. Females (73.70%) formed the largest number of participants for both stages. The majority of the participants were &lt;30 years old (50.90%) and had a high education level in various sectors and levels (97.1%). It was noticeable that during the first stage, the participants' awareness of COVID-19 symptoms was not very high: 13.62% did not know about the symptoms. However, by the second stage, awareness about symptoms had increased (9.6%).Conclusion: The residents of Rabigh city and the surrounding villages had good levels of knowledge about COVID-19.

scholarly journals Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis in an Egyptian University Hospital.

2021 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Iman Heweidy ◽  
Samiha Abdu ◽  
Abouelata Omar ◽  
Caroline Ackley ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Theoretical Domains Framework ◽  
Control Measures ◽  
World Health ◽  
Infection Prevention And Control ◽  
Surgical Prophylaxis ◽  
Context Specific ◽  
And Control

Abstract Background: Antimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis in an orthopaedic surgery unit in Egypt.Methods: The project included a formative qualitative research study was based on the Theoretical Domains Framework (TDF) to explore the determinants for inappropriate prescription of surgical antibiotic prophylaxis at an orthopaedic unit. The intervention was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop with infection prevention and control experts that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. Results: The prescription of surgical prophylaxis was influenced by five TDF domains including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines) , professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. Conclusions The study showed that a theory based and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention need to piloted and scaled up.

Breastfeeding During the Covid-19 Pandemic

2021 ◽  
Vol 35 (3) ◽  
pp. 155-158
Author(s):  
JP Dadhich ◽  
Nupur Bidla
Keyword(s):  
Control Measures ◽  
Infection Prevention And Control ◽  
Evidence Based ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Childhood Morbidity ◽  
Infant And Young Child ◽  
Prevention And Control Measures ◽  
Evidence Based Guidelines ◽  
And Control

The COVID-19 pandemic has posed a serious challenge to the lactating women to practice optimal infant and young child feeding. Although international and national agencies developed appropriate evidence-based guidelines early in the pandemic, availability of this information to the mothers and their caregivers needs to be enhanced. This becomes important in view of apprehension about the risk of a decline in breastfeeding practices during the pandemic due to various factors. Any decrease in the breastfeeding rates may lead to increased childhood morbidity, mortality, and malnutrition. This article provides a glimpse of available evidence-based guidelines on breastfeeding by Covid-19 positive mothers and attempts by the baby food industry to exploit the situation by promoting their products. The article also deals with infection prevention and control measures to be observed by the mother while caring and breastfeeding her baby and other action required to protect breastfeeding from commercial influence.

Mass SARS-CoV-2 Testing in a Dormitory-Style Correctional Facility in Arkansas

2021 ◽  
pp. e1-e10
Author(s):  
Lindsay K. Tompkins ◽  
Jayleen K. L. Gunn ◽  
Blake Cherney ◽  
Jason E. Ham ◽  
Roberta Horth ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Close Contact ◽  
Correctional Facility ◽  
Mitigation Strategies ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Strict Enforcement ◽  
Prevention And Control Measures ◽  
And Control ◽  
Respiratory Specimens

Objectives. To assess SARS-CoV-2 transmission within a correctional facility and recommend mitigation strategies. Methods. From April 29 to May 15, 2020, we established the point prevalence of COVID-19 among incarcerated persons and staff within a correctional facility in Arkansas. Participants provided respiratory specimens for SARS-CoV-2 testing and completed questionnaires on symptoms and factors associated with transmission. Results. Of 1647 incarcerated persons and 128 staff tested, 30.5% of incarcerated persons (range by housing unit = 0.0%–58.2%) and 2.3% of staff tested positive for SARS-CoV-2. Among those who tested positive and responded to symptom questions (431 incarcerated persons, 3 staff), 81.2% and 33.3% were asymptomatic, respectively. Most incarcerated persons (58.0%) reported wearing cloth face coverings 8 hours or less per day, and 63.3% reported close contact with someone other than their bunkmate. Conclusions. If testing remained limited to symptomatic individuals, fewer cases would have been detected or detection would have been delayed, allowing transmission to continue. Rapid implementation of mass testing and strict enforcement of infection prevention and control measures may be needed to mitigate spread of SARS-CoV-2 in this setting. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306117 )

AMR: effective infection prevention and control measures

2019 ◽  
Vol 30 (8) ◽  
pp. 390-395
Author(s):  
Naomi Fleming
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Drug Resistant ◽  
Practice Nurses ◽  
Prevention And Control Measures ◽  
Spread Of Infection ◽  
And Control

Antimicrobial resistance is on the rise. As more infections are becoming resistant to antibiotic treatment, it would benefit practice nurses to be aware of the effective measures they can use to prevent the spread of infection, explains Naomi Fleming When micro-organisms are exposed to an antimicrobial, more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on resistance to their offspring. The use and misuse of antimicrobials has increased the number and types of resistant organisms. As a result, standard treatments become ineffective and infections persist and may spread. Infection prevention and control (IPC) is key to reducing demand for antimicrobial use and reducing the acquisition of antimicrobial resistance. Poor IPC can increase the spread of drug-resistant infections. Interventions such as effective hand hygiene and vaccination have significant potential to limit opportunities for drug-resistant strains to emerge. Effective leadership is vital and nurses are central to promoting IPC, leading on IPC compliance and ensuring uptake of vaccination in primary care.

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