Pandora’s box in the dental clinic

2021 ◽  
pp. 1-5
Author(s):  
Debby Ben-David ◽  
Azza Vaturi ◽  
Ester Solter ◽  
Bina Rubinovitch ◽  
Jonathan Lellouche ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Dental Procedure ◽  
Dental Clinics ◽  
Intravenous Drugs ◽  
Environmental Surfaces ◽  
Outpatient Procedures ◽  
Polymerase Chain ◽  
And Control ◽  
Element Sequence

Abstract Background: In June 2018, the Ministry of Health received notification from 2 hospitals about 2 patients who presented with overwhelming Enterobacter kobei sepsis that developed within 24 hours after a dental procedure. We describe the investigation of this outbreak. Methods: The epidemiologic investigation included site visits in 2 dental clinics and interviews with all involved healthcare workers. Chart reviews were conducted for case and control subjects. Samples were taken from medications and antiseptics, environmental surfaces, dental water systems, and from the involved healthcare professionals. Isolate similarity was assessed using repetitive element sequence-based polymerase chain reaction (REP-PCR). Results: The 2 procedures were conducted in different dental clinics by different surgeons and dental technicians. A single anesthesiologist administered the systemic anesthetic in both cases. Cultures from medications, fluids and healthcare workers’ hands were negative, but E. kobei was detected from the anesthesiologist’s portable medication cart. The 2 human isolates and the environmental isolate shared the same REP-PCR fingerprinting profile. None of the 21 patients treated by the anesthesiologist in a general hospital during the same period, using the hospital’s medications, developed infection following surgery. Conclusions: An outbreak of post–dental-procedure sepsis was linked to a contaminated medication cart, emphasizing the importance of medication storage standards and strict aseptic technique when preparing intravenous drugs during anesthesia. Immediate reporting of sepsis following these outpatient procedures enabled early identification and termination of the outbreak.

A Study of the Efficiency of Modern Domestic Disinfectants in the System of TB Control Activities

2015 ◽  
Vol 2 (2) ◽  
pp. 26-31 ◽  
Author(s):  
A. Paliy ◽  
A. Zavgorodniy ◽  
B. Stegniy ◽  
A. Gerilovych
Keyword(s):  
Molecular Genetic ◽  
Critical Role ◽  
Bactericidal Effect ◽  
Chain Reaction ◽  
Tb Control ◽  
Source Of Infection ◽  
Polymerase Chain ◽  
And Control ◽  
Chemical Groups ◽  
Test Objects

Due to the absence of elaborated effi cient means for specifi c prevention of bovine tuberculosis, it is ex- tremely important to detect and eliminate the source of infection and to take veterinary and sanitary preven- tive measures. Here the critical role is attributed to disinfection, which breaks the epizootic chain due to the elimination of pathogenic microorganisms in the environment and involves the application of disinfectants of different chemical groups. Aim. To study the tuberculocidal properties of new disinfectants DZPT-2 and FAG against atypical mycobacteria Mycobacterium fortitum and a TB agent Mycobacterium bovis. Methods. The bacteriological and molecular-genetic methods were used. Results. It was determined that DZPT-2 prepara- tion has bactericidal effect on M. fortuitum when used in the concentration of 2.0 % of the active ingredient (AI) when exposed for 5–24 h, while disinfectant FAG has a bactericidal effect in the concentration of 2.0 % when exposed for 24 h. Disinfectant DZPT-2 in the concentration of 2.0 % of the AI, when exposed for 5–24 h, and FAG preparation in the concentration of 2.0 %, when exposed for 24 h, and with the norm of consump- tion rate of 1 cubic decimeter per 1 square meter disinfect the test-objects (batiste, wood, glazed tile, metal, glass), contaminated with the TB agent M. bovis. Conclusions. Disinfecting preparations of DZPT-2 in the concentration of 2.0 % of AI when exposed for 5 h and FAG in the concentration of 2.0 % when exposed for 24 h may be used in the complex of veterinary and sanitary measures to prevent and control TB of farm ani- mals. The possibility of using the polymerase chain reaction as an additional method of estimating tuberculo- cide activity of disinfectants was proven.

Barriers to infection prevention and control practice among Amhara region teaching hospitals in Ethiopia: Qualitative study

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Walelegn Worku Yallew ◽  
Abera Kumie ◽  
Feleke Moges Yehuala
Keyword(s):  
Healthcare Worker ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Teaching Hospitals ◽  
Infection Prevention And Control ◽  
Amhara Region ◽  
Implementation Barriers ◽  
Control Practice ◽  
And Control

Healthcare workers have good perception towards infection prevention, but there has been a poor practice towards it. Therefore, the aim of this study was to explore barriers to practice of infection prevention and control practice in teaching hospitals in Amhara region. A phenomenological approach used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. The data was collected from ten in-depth interviews and 23 focus group discussion participants, by face to face interview using open ended interview performed in safe and quiet places. Data was managed using OpenCode software version 4.03 and contents were analyzed thematically. Totally ten different barriers were identified, such as availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment, high patient flow, experience, emergency situation, healthcare worker behaviour and healthcare worker’s information about infection prevention, low awareness of patients and visitors and overflow of families and visitors to the hospital. For effective infection prevention practice implementation, barriers should be considered via identifying specific organizational, healthcare worker, patients and visitors as targets.

SARS-CoV-2 Transmission and Control Among Healthcare Workers in a Hospital Setting: A Modelling Study

2020 ◽  
Author(s):  
Qimin Huang ◽  
Anirban Mondal ◽  
Xiaobing Jiang ◽  
Mary Ann Horn ◽  
Fei Fan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Hospital Setting ◽  
And Control ◽  
Modelling Study

Challenges in prevention & control of COVID - 19 pandemic in dentistry: A review. (Preprint)

2020 ◽  
Author(s):  
Sameera Begum ◽  
Riaz Abdulla ◽  
Akhter Hussain
Keyword(s):  
Healthcare Professionals ◽  
Preventive Measures ◽  
Health Concern ◽  
Front Line ◽  
Public Health Concern ◽  
College Hospital ◽  
Dental Clinics ◽  
Dental Procedures ◽  
Spread Of Infection ◽  
High Chance

UNSTRUCTURED The menace of COVID 19 pandemic has become a major public health concern all over the world. It is a pandemic outbreak that originated from Wuhan, Hubei province of China in December 2019. All healthcare professionals including dental surgeons are in the front line and a high chance of constantly getting infected. Droplet and aerosol transmissions are the utmost concern in dental clinics and dental college hospitals. Hence, COVID 19 has a high risk of spread through droplets and aerosols generated during dental procedures from infected patients. This review article highlights the dental perspective and discusses the various preventive measures undertaken to control the spread of infection in dental clinics and dental college hospital setups.

scholarly journals Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom

2020 ◽  
pp. 175717742097679
Author(s):  
Kordo Saeed ◽  
Emanuela Pelosi ◽  
Nitin Mahobia ◽  
Nicola White ◽  
Christopher Labdon ◽  
...  
Keyword(s):  
Real Time ◽  
Healthcare Workers ◽  
Healthcare Facility ◽  
Rt Pcr ◽  
Serum Samples ◽  
The United Kingdom ◽  
Key Issues ◽  
Current Infection ◽  
Polymerase Chain ◽  
A Current

Background: We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility. Methodology: A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence. Results: Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff. Conclusion: To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.

scholarly journals 201 Reducing Noise Pollution on a Surgical Ward

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Shah
Keyword(s):  
Healthcare Professionals ◽  
Noise Pollution ◽  
Positive Role ◽  
Low Resource ◽  
Admission Rates ◽  
Quality Patient Care ◽  
Surgical Ward ◽  
Control Ward ◽  
Icu Psychosis ◽  
And Control

Abstract Noise pollution in surgical wards negatively influence the wellbeing of patients and healthcare professionals. In addition to disrupting sleep and impairing communication, recognised patient consequences include increased pain, increased re-admission rates and post-ICU psychosis. Ambient white-noise machines, sound-absorbing ceilings and retractable screens are purported as noise pollution reducing strategies (NPRS). These are expensive and impractical. We investigated the capacity of various low resource NPRSs. Noise was measured using “Sound Meter” app at four sites on two identical surgical wards. Ward A and B were designated as study and control ward, respectively. Measurements were taken at three time points (9am, 11am, 3pm) every day during a week. NPRSs were then implemented in ward A and data collection repeated. Prior to intervention there was no difference in noise between ward A and ward B (83dB and 87dB respectively, p > 0.05). After intervention, ward A was significantly quieter than ward B (64dB and 85dB respectively, p < 0.05). Restructuring ward environments presents several challenges. However, low resource interventions can have a positive role in reducing noise pollution. As hospitals become busier with resumption of normal services post-COVID-19, staff should be considerate of noise pollution in order to create an environment conducive to high quality patient care.

scholarly journals High prevalence of qnrA and qnrB genes among fluoroquinolone-resistant Escherichia coli isolates from a tertiary hospital in Southern Nigeria

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Chibuzor M. Nsofor ◽  
Mirabeau Y. Tattfeng ◽  
Chijioke A. Nsofor
Keyword(s):  
Escherichia Coli ◽  
Susceptibility Testing ◽  
Tertiary Hospital ◽  
Vaginal Swab ◽  
Fluoroquinolone Resistance ◽  
E Coli ◽  
Diffusion Technique ◽  
High Prevalence ◽  
Polymerase Chain ◽  
And Control

Abstract Background This study was aimed to determine the prevalence of qnr genes among fluoroquinolone-resistant Escherichia coli (FREC) isolates from Nigeria. Antimicrobial susceptibility testing was performed by disc diffusion technique. Polymerase chain reaction was used to identify Escherichia coli (E. coli) and for the detection of qnr genes. Results A total of 206 non-duplicate E. coli were isolated from 300 clinical specimens analyzed. In all, 30 (14.6%) of these isolates were FREC; the resistance to fluoroquinolones among these 30 FREC showed 80% (24), 86.7% (26), 86.7% (26), 100% (30), 86.7% (26), 93.3% (28) and 86.7% (26) were resistant to pefloxacin, ciprofloxacin, sparfloxacin, levofloxacin, nalidixic acid, ofloxacin and moxifloxacin, respectively. The distribution of FREC among the various sample sources analyzed showed that 14%, 10%, 13.3%, 16.7% and 20% of the isolates came from urine, stool, high vaginal swab, endo cervical swab and wound swab specimens, respectively. More FREC were isolated from female samples 73.3% (22) compared to male samples 26.7% (8) and were more prevalent among the age group 26–35 years (40%). Twenty eight out of the 30 (93.3%) FREC isolates possessed at least one fluoroquinolone resistance gene in the form of qnrA 10 (33.3%) and qnrB 18 (60%), respectively; qnrS was not detected among the FREC isolates analyzed and 13.5% of the isolates possessed both the qnrA and qnrB genes. Phylogenetic analysis showed that these isolates were genetically diverse. Conclusions These findings suggest a possible resistance to fluoroquinolone is of high interest for better management of patients and control of antimicrobial resistance in Nigeria.

scholarly journals Site Visits Reveal Common Gaps in Instrument Reprocessing and Sterilization at Philadelphia Dental Clinics

2020 ◽  
Vol 41 (S1) ◽  
pp. s389-s390
Author(s):  
Tiina Peritz ◽  
Susan Coffin
Keyword(s):  
Public Health ◽  
Infection Prevention And Control ◽  
Environmental Cleaning ◽  
Department Of State ◽  
Inappropriate Use ◽  
Dental Clinics ◽  
Point Of Use ◽  
Policies And Procedures ◽  
License Renewal ◽  
And Control

Background: Most dental clinics lack resources and oversight related to infection prevention and control (IPC) practices. Few dental clinics undergo inspections by regulatory authorities unless the state licensing authorities receive a specific complaint. Many states, including Pennsylvania, do not have continuing IPC education requirements for dental providers. In 2018–2019, the Philadelphia Department of Public Health (PDPH) received and responded to multiple complaints and concerns related to IPC practices at dental clinics. Complaints were investigated in collaboration with the Pennsylvania Department of State (PADOS). Methods: Unannounced site visits were conducted at 7 Philadelphia dental clinics from December 2018 through September 2019 as part of the public health responses. Clinic evaluations and observations by PDPH certified infection preventionists focused on (1) IPC policies and procedures, (2) staff IPC training, (3) hand hygiene, (4) personal protective equipment, (5) instrument reprocessing and sterilization, (6) injection safety, and (7) environmental cleaning and disinfection. The CDC and the Organization of Safety, Antisepsis and Prevention (OSAP) checklists were adapted for this purpose. Results: Most dental practices we visited were small, unaffiliated, owner-operated clinics. The most common gaps we identified were associated with instrument reprocessing and sterilization practices, including inadequate separation between clean and dirty work areas, limited space and availability of sinks, inappropriate use of glutaraldehyde products for instrument cleaning (n = 3, 43%), extended reuse of cleaning brushes (n = 5, 71%), sterilization or storage of sterilized instruments without appropriate packaging (n = 2, 29%), lack of spore testing or reviewing results (n = 2, 29%), and lack of documentation of sterilizer run cycles and maintenance (n = 7, 100%). Additionally, most clinics did not have well-developed IPC policies and procedures, and staff IPC trainings were neither documented nor conducted annually. Alcohol-based hand sanitizer was often not available at the point of use. Conclusions: In Philadelphia, dental clinics often lacked IPC support and oversight. Lapses across multiple key IPC domains were common. These findings suggest that public health may have a role in providing IPC support to unaffiliated dental clinics. Licensing entities can also serve a role in improving IPC practices by more widely mandating continuing IPC education as part of the dental license renewal process.Funding: NoneDisclosures: None

scholarly journals Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

2021 ◽  
Vol 18 (5) ◽  
pp. 2434
Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
General Medicine ◽  
Maslach Burnout Inventory ◽  
University Hospital ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

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