A Crossover Trial of Antimicrobial Scrubs to Reduce Methicillin-Resistant Staphylococcus aureus Burden on Healthcare Worker Apparel

2012 ◽  
Vol 33 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Gonzalo M. L. Bearman ◽  
Adriana Rosato ◽  
Kara Elam ◽  
Kakotan Sanogo ◽  
Michael P. Stevens ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hand Hygiene ◽  
Healthcare Worker ◽  
Crossover Trial ◽  
Prospective Trial ◽  
Bacterial Burden ◽  
Log Reduction ◽  
Hygiene Practices ◽  
And Control ◽  
The Impact

Background.The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown.Objective.To determine die effectiveness of antimicrobial scrubs on hand and apparel bacterial burden.Design.Prospective, crossover trial.Setting and Participants.Thirty HCWs randomized to study versus control scrubs in an intensive care unit.Methods.Weekly microbiology samples were obtained from scrub abdominal area, cargo pocket, and hands. Mean log colony-forming unit (CFU) counts were calculated. Compliance with hand hygiene practices was measured. Apparel and hand mean log CFU counts were compared.Results.Adherence measures were 78% (910/1,173) for hand hygiene and 82% (223/273) for scrubs. Culture compliance was 67% (306/460). No differences were observed in bacterial hand burden or in HCWs with unique positive scrub cultures. No difference in vancomycin-resistant enterococci (VRE) and gram-negative rod (GNR) burden was observed. A difference in mean log mediicillin-resistant Staphylococcus aureus (MRSA) CFU count was found between study and control scrubs for leg cargo pocket (mean log CFUs, 11.84 control scrub vs 6.71 study scrub; P = .0002), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; P = .0056), leg cargo pocket at die beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; P = .0028), and abdominal area pocket at die end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; P = .0054).Conclusions.Study scrubs were associated witfi a 4–7 mean log reduction in MRSA burden but not VRE or GNRs. A prospective trial is needed to measure die impact of antimicrobial impregnated apparel on MRSA transmission rates.Infect Control Hosp Epidemiol 2012;33(3):268-275

scholarly journals COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices

2021 ◽  
Vol 111 ◽  
pp. 27-34 ◽  
Author(s):  
F. Huang ◽  
M. Armando ◽  
S. Dufau ◽  
O. Florea ◽  
P. Brouqui ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Worker ◽  
Behavioural Change ◽  
Hygiene Practices

scholarly journals The impact of a ‘milking the COW’ campaign in a regional hospital in Singapore

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Surinder Kaur M. S. Pada ◽  
Poh Lishi ◽  
Kim Sim Ng ◽  
Sarathamani Rethenam ◽  
Lilibeth Silagan Alenton ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Pathogenic Bacteria ◽  
Mixed Model ◽  
Mixed Model Analysis ◽  
Colony Forming Units ◽  
Skin Flora ◽  
Before And After ◽  
The Difference ◽  
And Control ◽  
The Impact

Abstract Background Computerisation of various processes in hospitals and reliance on electronic devices raises the concern of contamination of these devices from the patient environment. We undertook this study to determine if an attached hand hygiene device that unlocks the screen of a computer on wheels (COW) on usage can be effective in decreasing the microbiological burden on computer keyboards. Methods An electronic hand sanitizer was integrated onto the COW. A prospective cohort study with a crossover design involving 2 control and 2 intervention wards was used. The study end point was the number of colony forming units found on the keyboards. Bacteria were classified into 4 main groups; pathogenic, skin flora, from the environment or those thought to be commensals in healthy individuals. We then used a mixed effects model for the statistical analysis to determine if there were any differences before and after the intervention. Results Thirty-nine keyboards were swabbed at baseline, day 7 and 14, with 234 keyboards cultured, colony forming units (CFUs) counted and organisms isolated. By mixed model analysis, the difference of mean bacteria count between intervention and control for week 1 was 32.74 (− 32.74, CI − 94.29 to 28.75, p = 0.29), for week 2 by 155.86 (− 155.86, CI − 227.45 to − 83.53, p < 0.0001), and after the 2-week period by 157.04 (− 157.04, CI − 231.53 to − 82.67, p < 0.0001). In the sub-analysis, there were significant differences of pathogenic bacteria counts for the Intervention as compared to the Control in contrast with commensal counts. Conclusion A hand hygiene device attached to a COW may be effective in decreasing the microbiological burden on computer keyboards.

scholarly journals A mHealth intervention to promote hand-washing and cell phone cleaning in medical residents of a public hospital in Peru

2021 ◽  
Vol 15 (03) ◽  
pp. 428-435
Author(s):  
Maria Lazo-Porras ◽  
Matilde Corante ◽  
Tania De La Cruz-Saldaña ◽  
Ingrid Bohórquez ◽  
Kalina Campos ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hand Hygiene ◽  
Cell Phones ◽  
Bacterial Colonization ◽  
Hand Washing ◽  
Medical Residents ◽  
Chi Square ◽  
Mhealth Intervention ◽  
Hospital Acquired ◽  
The Impact

Introduction: We explore the limitations to adherence of hand-washing and evaluate the impact of a mHealth intervention for hand hygiene in residents. Methodology: We explore resident's perspectives about Hospital-acquired infections (HAI) and hand washing. In baseline, participants completed socio-demographic characteristics and hand-washing habits survey. The intervention consisted of sending SMS three times a week for two months about hand hygiene and “five moments” for hand washing. The cultures of hands and cell phones were analyzed at baseline, 2 months and 4 months. We used chi-square and adjusted Generalized Estimating Equations. Results: Five physicians were interviewed and 33 participants were included for quantitative analysis. Critical barriers that hinder hand washing were identified. The proportion of Staphylococcus aureus in hands was 54.5% at baseline and was significantly reduced at 2 months follow-up (p = 0.009), but, benefit was lost when the intervention was discontinued; Escherichia coli and Klebsiella sp. were observed in 22.2% of hands, no changes were noted with intervention. In cell phones, there was a tendency to lower values of bacterial colonization after intervention for Staphylococcus aureus growth. Conclusions: High prevalence of contamination in hands and phones in medical residents were found. Serious barriers to compliance with hand washing must be overcome. It is possible that prolonged or continuous interventions could be necessary to optimize hand washing and reduce hand and cell phones contamination.

scholarly journals Introduction of a Waterless Alcohol-Based Hand Rub in a Long-Term–Care Facility

2003 ◽  
Vol 24 (3) ◽  
pp. 165-171 ◽  
Author(s):  
Lona Mody ◽  
Shelly A. McNeil ◽  
Rongjun Sun ◽  
Suzanne F. Bradley ◽  
Carol A. Kauffman
Keyword(s):  
Hand Hygiene ◽  
Long Term Care ◽  
Care Facility ◽  
Microbial Colonization ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Hygiene Practices ◽  
The Impact

AbstractObjective:To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).Methods:Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique forStaphylococcus aureus,gram-negative bacilli (GNB),Candida,and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.Results:Hand hygiene practices, knowledge, and opinions did not change after the educational or rub intervention. Ward A HCWs thought that the rub was faster (P= .002) and less drying (P= .04) than soap. Hand hygiene frequency did not differ at baseline between the two floors, but increased on ward A by the end of the study (P= .04). HCWs were colonized frequently with GNB (66%),Candida(41%), S.aureus(20%), and VRE (9%). Although colonization did not change from baseline on either ward, the rub was more effective in clearing GNB (P= .03) and S.aureus(P= .003). Nosocomial infection rates did not change.Conclusion:The alcohol-based hand rub was a faster, more convenient, less drying method of hand hygiene for HCWs in an LTCF, and it improved compliance. Although microbial colonization did not change, the rub was more efficacious in removing pathogens already present on the hands of HCWs.

scholarly journals Hand Hygiene Noncompliance and the Cost of Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Infection

2010 ◽  
Vol 31 (4) ◽  
pp. 357-364 ◽  
Author(s):  
Keith L. Cummings ◽  
Deverick J. Anderson ◽  
Keith S. Kaye
Keyword(s):  
Staphylococcus Aureus ◽  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Healthcare Worker ◽  
Medical Center ◽  
Hospital Costs ◽  
Published Data ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Mean Cost

Background.Hand hygiene noncompliance is a major cause of nosocomial infection. Nosocomial infection cost data exist, but the effect of hand hygiene noncompliance is unknown.Objective.To estimate methicillin-resistant Staphylococcus aureus (MRSA)-related cost of an incident of hand hygiene noncompliance by a healthcare worker during patient care.Design.Two models were created to simulate sequential patient contacts by a hand hygiene-noncompliant healthcare worker. Model 1 involved encounters with patients of unknown MRSA status. Model 2 involved an encounter with an MRSA-colonized patient followed by an encounter with a patient of unknown MRSA status. The probability of new MRSA infection for the second patient was calculated using published data. A simulation of 1 million noncompliant events was performed. Total costs of resulting infections were aggregated and amortized over all events.Setting.Duke University Medical Center, a 750-bed tertiary medical center in Durham, North Carolina.Results.Model 1 was associated with 42 MRSA infections (infection rate, 0.0042%). Mean infection cost was $47,092 (95% confidence interval [CI], $26,040–$68,146); mean cost per noncompliant event was $1.98 (95% CI, $0.91–$3.04). Model 2 was associated with 980 MRSA infections (0.098%). Mean infection cost was $53,598 (95% CI, $50,098–$57,097); mean cost per noncompliant event was $52.53 (95% CI, $47.73–$57.32). A 200-bed hospital incurs $1,779,283 in annual MRSA infection-related expenses attributable to hand hygiene noncompliance. A 1.0% increase in hand hygiene compliance resulted in annual savings of $39,650 to a 200-bed hospital.Conclusions.Hand hygiene noncompliance is associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings.

scholarly journals The Combination of Rifampin plus Moxifloxacin Is Synergistic for Suppression of Resistance but Antagonistic for Cell Kill of Mycobacterium tuberculosis as Determined in a Hollow-Fiber Infection Model

mBio ◽  
2010 ◽  
Vol 1 (3) ◽  
Author(s):  
G. L. Drusano ◽  
Nicole Sgambati ◽  
Adam Eichas ◽  
David L. Brown ◽  
Robert Kulawy ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Combination Therapy ◽  
Hollow Fiber ◽  
Bacterial Cell ◽  
Infection Model ◽  
Bacterial Burden ◽  
Log Reduction ◽  
Significant Difference ◽  
Cell Kill ◽  
The Impact

ABSTRACTMoxifloxacin is under development for expanded use againstMycobacterium tuberculosis. Rifampin is a mainstay of therapy. We examined the interaction of moxifloxacin plus rifampin for log-phase and nonreplicating persister (NRP) organisms. For this evaluation, we employed our hollow-fiber infection model, in which organisms are exposed to clinically relevant drug concentration-time profiles and the impact on bacterial cell kill and resistant subpopulation amplification is determined. In log phase, resistance emergence was observed in all monotherapy regimens and in no combination therapy regimen. No difference was seen in time to a 3-log reduction in the bacterial burden; there was a significant difference in time to resistance emergence (P= 0.0006). In the NRP experiment, no resistance emergence was seen. There was a significant difference between the monotherapy and combination therapy regimens in time to a 3-log reduction in the bacterial burden (P= 0.042). The combination is efficacious for suppressing resistant organisms but is antagonistic for cell kill.IMPORTANCEM. tuberculosisinfects one-third of the world’s population. Multiresistant organisms have become more frequent, threatening our ability to provide adequate chemotherapy. Moxifloxacin has been seen as an important new agent with the potential to supplant isoniazid or add to the rifampin/isoniazid combination.M. tuberculosisalso exists in different physiological states, including the NRP phenotype. We examined the moxifloxacin/rifampin combination in a newin vitrosystem to allow judgment of how moxifloxacin would interact with rifampin and allow its performance in clinical trials to be placed into perspective. Importantly, the combination suppressed resistance emergence, but at the price of slightly slowing bacterial cell kill. This new combination is a welcome addition to the physician’s armamentarium.

scholarly journals Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Alejandro de Arriba-Fernández ◽  
◽  
Manuel Jesús Molina-Cabrillana ◽  
Lluís Serra Majem
Keyword(s):  
Hand Hygiene ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Nursing Assistants ◽  
Cross Sectional ◽  
Hygiene Practices ◽  
Healthcare It ◽  
Relevant Role ◽  
And Control ◽  
Level Hospital

Introduction. Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. Methods. Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. Results. Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). Conclusions. In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.

scholarly journals Science communication as a preventative tool in the COVID19 pandemic

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Gagan Matta
Keyword(s):  
Science Communication ◽  
Empirical Studies ◽  
Behavioural Change ◽  
Hygiene Practices ◽  
Linguistic Barriers ◽  
Technological Developments ◽  
History Of ◽  
Major Factors ◽  
And Control ◽  
The Impact

AbstractHumans have witnessed epidemics and pandemics periodically throughout history. Often, such infectious outbreaks have resulted in entire civilisations struggling against possible extinction. Despite recent clinical advancements and technological developments, issues of neglected sustainability and lax health hygiene practices, among others, have provided a context for the emergence of the COVID19 pandemic. Against such a backdrop, scientific communication using diversified tools could play a significant role in efforts towards preparedness and control, as well as the initiation of immediate remedial measures in the fight against epidemics and pandemics. These tools could help to increase understanding of the scientific solutions to minimise the outbreaks of infectious diseases, thereby strengthening societal immunity. This paper considers the history of epidemics/pandemics to draw attention to their occurrence, effects and potential impacts on human societies. In addition, it defines the major factors underpinning the various infectious outbreaks over the last three decades. Constructive preparation and preventative stages for authorities, scientists and researchers to check and diminish the impact of epidemics and pandemics during and post-outbreak are suggested while focusing on the need for science communication in the healthcare system. The paper also reviews recent empirical studies and WHO guidelines. Communication through appropriate communicators may help cut through the noise, share facts and boost confidence in science and governance. The impact of science communication on the interplay between government–expert–public or society could help promote positive behavioural change as well as overcome linguistic barriers.

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