scholarly journals Healthcare-associated Transmission of COVID-19 Among Thai Healthcare Personnel Who Receive 2 Doses of a COVID-19 Vaccine: A Call for Considering a Booster Dose

2021 ◽  
pp. 1-9
Author(s):  
Anucha Apisarnthanarak ◽  
Sira Nantapisal ◽  
Thanus Pienthong ◽  
Piyaporn Apisarnthanarak ◽  
David J. Weber
Keyword(s):  
Booster Dose ◽  
Healthcare Personnel ◽  
Healthcare Associated

scholarly journals Infection Prevention and Antimicrobial Stewardship Knowledge for Selected Infections Among Nursing Home Personnel

2016 ◽  
Vol 38 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Barbara W. Trautner ◽  
M. Todd Greene ◽  
Sarah L. Krein ◽  
Heidi L. Wald ◽  
Sanjay Saint ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Nursing Home ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
Infection Prevention ◽  
Asymptomatic Bacteriuria ◽  
Healthcare Personnel ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETo assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative.DESIGNBaseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections.SETTINGNursing homes across 14 states participating in the national “Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection.”PARTICIPANTSLicensed (RNs, LPNs, APRNs, MDs) and unlicensed (clinical nursing assistants) healthcare personnel.METHODSEach facility aimed to obtain responses from at least 10 employees (5 licensed and 5 unlicensed). We assessed the percentage of correct responses.RESULTSA total of 184 (78%) of 236 participating facilities provided 1 response or more. Of the 1,626 respondents, 822 (50.6%) were licensed; 117 facilities (63.6%) were for-profit. While 99.1% of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1% knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria. Among unlicensed personnel, 99.6% knew to notify a nurse if a resident developed fever or confusion, but only 27.7% knew that cloudy, smelly urine should not routinely be cultured. Although 100% of respondents reported receiving training in hand hygiene, less than 30% knew how long to rub hands (28.5% licensed, 25.2% unlicensed) or the most effective agent to use (11.7% licensed, 10.6% unlicensed).CONCLUSIONSThis national assessment demonstrates an important need to enhance infection prevention knowledge among healthcare personnel working in nursing homes to improve resident safety and quality of care.Infect. Control Hosp. Epidemiol. 2016;1–6

scholarly journals 807. A Risk-Stratified Approach to Healthcare-Associated Tuberculosis Exposures Following the “Stone in the Pond” Principle

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S289-S289
Author(s):  
Dana E Pepe ◽  
Michael Aniskiewicz ◽  
George Paci ◽  
Linda Sullivan ◽  
Louise-Marie Dembry ◽  
...  
Keyword(s):  
Scoring System ◽  
Large Scale ◽  
Medical Center ◽  
Academic Medical Center ◽  
Risk Groups ◽  
Low Risk ◽  
Contact Tracing ◽  
Healthcare Personnel ◽  
Foreign Born ◽  
Healthcare Associated

Abstract Background Large-scale tuberculosis (TB) exposure investigations cause anxiety to healthcare personnel (HCP) and patients, in addition to being resource and time intensive. TB contact tracing in England and Singapore follow the “stone in the pond” principle. We propose a similar risk-stratified approach to TB exposure investigations in an area of low incidence. Methods This retrospective study was conducted at a 1,541 bed academic medical center in New Haven, CT between January 14 and 11, 2017. Microbiology records, patient charts, and infection prevention databases were reviewed to find TB exposures. A scoring system adapted from CDC’s “Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis” was developed to predict infectivity (two points for laryngeal TB, one point each for: cavitary TB, ≥1 positive respiratory acid fast bacilli smear or Xpert MTB/RIF, multi-drug-resistant (MDR) TB, foreign-born status, immunocompromised status, cough/hemoptysis, or procedure associated with positive TB culture). Using the “stone in the pond” principle, contacts were graded based on the type of exposure (Figure 1). Based on high, medium, and low risk, our new risk-stratified approach was applied to contact tracing. Results During the study period, 17 of 29 patients with pulmonary TB led to exposures. A subset of seven TB patients with complete exposure data was selected for further analysis. The original exposure investigations led to contact tracing of 586 HCP and 72 patients. No active or latent TB cases were identified among these exposed contacts. Using our scoring system, these seven patients were categorized into three high, two medium, and two low infectivity risk groups. On applying our new risk-stratified approach, contact tracing could be reduced by 42% and 84% for medium and low-risk exposures, respectively, by excluding these HCP groups from investigation (Figure 2). Conclusion We recommend a risk-stratified approach to healthcare-associated TB exposure investigations similar to the “stone in the pond” principle, based on index patient’s infectivity risk and type of exposure. This has potential to optimize resources and possibly reduce anxiety in medium and low-risk TB exposures in an area of low TB incidence. Disclosures All authors: No reported disclosures.

ID: 103: COMPARATIVE ANTIMICROBIAL EFFICACY OF TWO HAND-HYGIENE PRODUCTS IN INTENSIVE CARE UNITS: A RANDOMIZED CONTROLLED TRIAL

2016 ◽  
Vol 64 (4) ◽  
pp. 953.2-954
Author(s):  
A Deshpande ◽  
J Fox ◽  
S Schramm ◽  
KK Wong ◽  
TG Fraser ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Crossover Design ◽  
Healthcare Personnel ◽  
Direct Patient Care ◽  
Paired Data ◽  
Bacterial Colony ◽  
Medical Icus ◽  
Skin Flora ◽  
Healthcare Associated

BackgroundContaminated hands of healthcare workers (HCW) are an important source of transmission of healthcare-associated infections in the intensive care unit (ICU). Alcohol-based hand sanitizers, the primary form of hand hygiene in healthcare settings, are effective but do not provide sustained antimicrobial activity. The aim of this study was to quantitatively visualize the immediate and persistent antimicrobial effectiveness of 1% chlorhexidine gluconate (CHG)+61% ethanol versus 70% ethanol at 2-time points: immediately after application on normal skin flora and after hand contamination with environmental microbes in the ICU.MethodsA prospective, randomized, double-blind clinical trial with crossover design and paired data was done in three medical ICUs in a large academic teaching hospital. Eligible personnel included permanent and temporary HCWs involved with direct patient care in the ICU. HCWs were randomly assigned to one of two hand hygiene products using a crossover design. Hand prints were obtained immediately after hand hygiene was performed and again after spending >5 minutes in the ICU common areas. The numbers of aerobic colony-forming units (CFU) were compared for the two groups after log transformation.ResultsA total of 51 HCWs completed testing of both products. On bare hands, use of CHG+alcohol was associated with significantly lower recovery of aerobic CFU, both immediately after use (0.27±0.38 and 0.88±0.55 log10 CFU; P=.035) and after spending time in the ICU common areas (1.81±0.48 and 2.17±0.35 log10 CFU; P<.0001). Both of the antiseptics were well tolerated by HCWs with no adverse events.ConclusionsThe CHG+alcohol product was associated with significantly lower aerobic bacterial colony counts on hands of healthcare personnel, both immediately after use and after spending time in ICU common areas. Further studies are needed to determine if the use of the CHG+alcohol product results in sustained antimicrobial protection against healthcare-associated pathogens on hands of HCW.

scholarly journals O Impacto da Monitorização Eletrónica nas Infeções Associadas aos Cuidados de Saúde: O Papel da Plataforma HViTAL

2016 ◽  
Vol 29 (11) ◽  
pp. 734
Author(s):  
Rita Fontes De Oliveira ◽  
Lídia Castro ◽  
José Pedro Almeida ◽  
Carlos Alves ◽  
António Ferreira
Keyword(s):  
Electronic Monitoring ◽  
Positive Impact ◽  
Healthcare Personnel ◽  
Healthcare Associated Infections ◽  
Upward Trend ◽  
Awareness Campaigns ◽  
Computerized Records ◽  
Infection Parameters ◽  
Healthcare Associated ◽  
The Impact

Introduction: In Portugal, 9.8% of patients admitted were inflicted with healthcare associated infections, corresponding to a prevalence of 11.7%. The Hospital de São João has developed a business intelligence platform able to supervise (the patients), monitor (the clinical condition) and notify (the healthcare personnel): HViTAL. This study aims to assess the impact of electronic monitoring on healthcare associated infections since the year of HViTAL implementation.Material and Methods: We evaluated data since January 2008 (moment from which computerized records exist) until December 2011, comparing them with subsequent data, those corresponding to January 2012 (implementation date of HViTAL) until 19 October 2015.Results: There was an upward trend of infection parameters in the 2008 - 2011 period. Since January 2012 and October 2015, all parameters of the infection indicator showed a negative linear trend.Discussion: The results are very suggestive that the HVITAL may have had an impact on improving parameters associated tohealthcare associated infections. Basic measures of infection control were highlighted since 2005, with an increasing number of health professional awareness campaigns, a fact which, although not analyzed in this report, may also have contributed to the observed improvement. Our study did not include other variables such as investment in human capital.Conclusion: There was a clear improvement in all areas characterizing the healthcare associated infections, with obvious positive impact with the introduction of HViTAL.

scholarly journals Differential Effects of Chlorhexidine Skin Cleansing Methods on Residual Chlorhexidine Skin Concentrations and Bacterial Recovery

2018 ◽  
Vol 39 (4) ◽  
pp. 405-411 ◽  
Author(s):  
Yoona Rhee ◽  
Louisa J. Palmer ◽  
Koh Okamoto ◽  
Sean Gemunden ◽  
Khaled Hammouda ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Teaching Hospitals ◽  
Resistant Organism ◽  
Sterile Water ◽  
Polyester Cloth ◽  
Surgical Icus ◽  
Healthcare Associated ◽  
Skin Cleansing

BACKGROUNDBathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)–impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results.OBJECTIVETo determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin.DESIGNProspective, randomized 2-center study with blinded assessment.PARTICIPANTS AND SETTINGHealthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016.INTERVENTIONCleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non–antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C).RESULTSIn total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001).CONCLUSIONIn healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined.Infect Control Hosp Epidemiol 2018;39:405–411

Poziom wiedzy i nawyki personelu jako czynniki wpływające na poprawność realizacji higieny rąk w obszarze medycznym

2020 ◽  
Vol 11 (6) ◽  
pp. 301-306
Author(s):  
Małgorzata Cichońska ◽  
Dorota Maciąg
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Medical Personnel ◽  
Healthcare Services ◽  
Routine Care ◽  
Healthcare Personnel ◽  
Hygiene Practices ◽  
Compliance Coefficient ◽  
Correct Technique ◽  
Healthcare Associated

Hand hygiene continues to be the most important part of the strategy to combat healthcare associated infections and the first step in reducing them. Hand hygiene procedures are fully performed by less than half of healthcare workers and research confirms a low compliance coefficient for hygiene (at the level of 1.4–6). The list of factors influencing the adherence to hand hygiene routine protocols (as per WHO guidelines) includes factors related to poor hand hygiene practices, poor hand hygiene practices reported by staff and additional perceived obstacles to good hand hygiene. The following are the barriers and reasons why healthcare workers do not sufficiently adhere to the correct technique of washing and disinfecting hands: forgetting to perform this procedure, excessive workload, haste during routine care activities, lack of a pattern of behavior among other employees and superiors, lack of habits, as well as a shortage of disinfectants and disposable towels in patient rooms, or irritation of the skin of the hands caused by the disinfectant. To sum up, it can be concluded that hand hygiene is and will be an issue that requires continuous action and permanent education of healthcare personnel and recipients of healthcare services. The list of factors causing poor hand hygiene is quite long. It includes, among others, the level of knowledge and habits of medical personnel and requires constant updating, as in the place of confirmed and verified reasons for low rates, newer ones which are specific for the current situation, will appear.

scholarly journals Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

2019 ◽  
Vol 69 (11) ◽  
pp. 1837-1844 ◽  
Author(s):  
Lona Mody ◽  
Laraine L Washer ◽  
Keith S Kaye ◽  
Kristen Gibson ◽  
Sanjay Saint ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Resistant Organism ◽  
Dominant Hand ◽  
Paired Samples ◽  
Environmental Surfaces ◽  
Healthcare Associated ◽  
The Impact ◽  
Panton Valentine Leukocidin

AbstractBackgroundThe impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further.MethodsPatients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients’ hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing.ResultsA total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces.ConclusionsOur data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.

Transmission of Staphylococcus aureus from dry surface biofilm (DSB) via different types of gloves

2018 ◽  
Vol 40 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Shamaila Tahir ◽  
Durdana Chowdhury ◽  
Mark Legge ◽  
Honghua Hu ◽  
Greg Whiteley ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Extracellular Polymeric Substances ◽  
Transmission Rate ◽  
Healthcare Personnel ◽  
Bacterial Cells ◽  
Surgical Gloves ◽  
Latex Gloves ◽  
Horse Blood ◽  
Healthcare Associated

AbstractBackgroundPathogens can survive for extended periods when incorporated into biofilm on dry hospital surfaces (ie, dry-surface biofilm, DSB). Bacteria within biofilm are protected from desiccation and have increased tolerance to cleaning agents and disinfectants.ObjectiveWe hypothesized that gloved hands of healthcare personnel (HCP) become contaminated with DSB bacteria and hence may transmit bacteria associated with healthcare-associated infections (HAIs).MethodStaphylococcus aureus DSB was grown in vitro on coupons in a bioreactor over 12 days with periodic nutrition interspersed with long periods of dehydration. Each coupon had ~107 DSB bacterial cells. Transmission was tested with nitrile, latex, and surgical gloves by gripping DSB-covered coupons then pressing finger tips onto a sterile horse blood agar surface for up to 19 consecutive touches and counting the number of colony-forming units (CFU) transferred. Coupons were immersed in 5% neutral detergent to simulate cleaning, and the experiment was repeated.ResultsBacterial cells were readily transmitted by all 3 types of gloves commonly used by HCP. Surprisingly, sufficient S. aureus to cause infection were transferred from 1 DSB touch up to 19 consecutive touches. Also, 6 times more bacteria were transferred by nitrile and surgical gloves than to latex gloves (P <.001). Treating the DSB with 5% neutral detergent increased the transmission rate of DSB bacteria 10-fold.ConclusionStaphylococcus aureus incorporated into environmental DSB and covered by extracellular polymeric substances readily contaminates gloved hands and can be transferred to another surface. These results confirm the possibility that DSB contributes to HAI acquisition.

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