Using the Hierarchy of Control Technologies to Improve Healthcare Facility Infection Control: Lessons From Severe Acute Respiratory Syndrome

2004 ◽  
Vol 46 (7) ◽  
pp. 613-622 ◽  
Author(s):  
Craig D. Thorne ◽  
Shahram Khozin ◽  
Melissa A. McDiarmid
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Healthcare Facility ◽  
Control Technologies

scholarly journals Aggressive Colonization Screening and Infection Control Measures in Containment of NDM-5 Carbapenemase-Producing CRE

2020 ◽  
Vol 41 (S1) ◽  
pp. s458-s459
Author(s):  
Ishrat Kamal-Ahmed ◽  
Kate Tyner ◽  
Teresa Fitzgerald ◽  
Heather Adele Moulton-Meissner ◽  
Gillian McAllister ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Acute Care Hospital ◽  
Healthcare Facility ◽  
The United States ◽  
Control Measures ◽  
Care Hospital ◽  
Clinical Culture ◽  
Medical Histories ◽  
Asymptomatic Case

Background: In April 2019, Nebraska Public Health Laboratory identified an NDM-producing Enterobacter cloacae from a urine sample from a rehabilitation inpatient who had recently received care in a specialized unit (unit A) of an acute-care hospital (ACH-A). After additional infections occurred at ACH-A, we conducted a public health investigation to contain spread. Methods: A case was defined as isolation of NDM-producing carbapenem-resistant Enterobacteriaceae (CRE) from a patient with history of admission to ACH-A in 2019. We conducted clinical culture surveillance, and we offered colonization screening for carbapenemase-producing organisms to all patients admitted to unit A since February 2019. We assessed healthcare facility infection control practices in ACH-A and epidemiologically linked facilities by visits from the ICAP (Infection Control Assessment and Promotion) Program. The recent medical histories of case patients were reviewed. Isolates were evaluated by whole-genome sequencing (WGS). Results: Through June 2019, 7 cases were identified from 6 case patients: 4 from clinical cultures and 3 from 258 colonization screens including 1 prior unit A patient detected as an outpatient (Fig. 1). Organisms isolated were Klebsiella pneumoniae (n = 5), E. cloacae (n = 1), and Citrobacter freundii (n = 1); 1 patient had both NDM-producing K. pneumoniae and C. freundii. Also, 5 case patients had overlapping stays in unit A during February–May 2019 (Fig. 2); common exposures in unit A included rooms in close proximity, inhabiting the same room at different times and shared caregivers. One case-patient was not admitted to unit A but shared caregivers, equipment, and devices (including a colonoscope) with other case patients while admitted to other ACH-A units. No case patients reported travel outside the United States. Screening at epidemiologically linked facilities and clinical culture surveillance showed no evidence of transmission beyond ACH-A. Infection control assessments at ACH-A revealed deficiencies in hand hygiene, contact precautions adherence, and incomplete cleaning of shared equipment within and used to transport to/from a treatment room in unit A. Following implementation of recommended infection control interventions, no further cases were identified. Finally, 5 K. pneumoniae of ST-273 were related by WGS including carriage of NDM-5 and IncX3 plasmid supporting transmission of this strain. Further analysis is required to relate IncX3 plasmid carriage and potential transmission to other organisms and sequence types identified in this study. Conclusions: We identified a multiorganism outbreak of NDM-5–producing CRE in an ACH specialty care unit. Transmission was controlled through improved infection control practices and extensive colonization screening to identify asymptomatic case-patients. Multiple species with NDM-5 were identified, highlighting the potential role of genotype-based surveillance.Funding: NoneDisclosures: Muhammad Salman Ashraf reports that he is the principal investigator for a study funded by an investigator-initiated research grant.

Hospital-acquired infection awareness and control practices among healthcare staff: an evaluation

2021 ◽  
Vol 27 (11) ◽  
pp. 296-302
Author(s):  
Pallavi Saraswat ◽  
Rajnarayan R Tiwari ◽  
Muralidhar Varma ◽  
Sameer Phadnis ◽  
Monica Sindhu
Keyword(s):  
Infection Control ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Control Measures ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Control Policies ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Background/Aims Hospital-acquired infections pose a risk to the wellbeing of both patients and staff. They are largely preventable, particularly if hospital staff have adequate knowledge of and adherence to infection control policies. This study aimed to assess the knowledge, awareness and practice of hospital-acquired infection control measures among hospital staff. Methods A cross-sectional study was conducted among 71 staff members in a tertiary healthcare facility in Karnataka, India. The researchers distributed a questionnaire containing 33 questions regarding knowledge of hospital-acquired infections, awareness of infection control policies and adherence to control practices. The results were analysed using the Statistical Package for the Social Sciences, version 16.0 and a Kruskal–Wallis test. Results Respondents' mean percentage score on the knowledge of hospital-acquired infections section was 72%. Their mean percentage scores on the awareness and practice of infection prevention measures sections were 82% and 77% respectively. Doctors and those with more years of experience typically scored higher. Conclusion The respondents had an acceptable level of knowledge, awareness and adherence to infection control practices. However, continued training is essential in the prevention of hospital-acquired infections. The majority of the respondents stated that they were willing to undertake training in this area, and this opportunity should be provided in order to improve infection control quality.

scholarly journals Thoracic surgery during the coronavirus disease 2019 (COVID-19) pandemic in Madrid, Spain: single-centre report

2020 ◽  
Vol 58 (5) ◽  
pp. 991-996
Author(s):  
Lucas Hoyos Mejía ◽  
Alejandra Romero Román ◽  
Mariana Gil Barturen ◽  
Maria del Mar Córdoba Pelaez ◽  
José Luis Campo-Cañaveral de la Cruz ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Thoracic Surgery ◽  
Hospital Care ◽  
Test Results ◽  
Single Centre ◽  
Emergency Procedures ◽  
Related Symptom ◽  
Hospital Stays ◽  
Lung Transplants

Abstract OBJECTIVES We reviewed the incidence of coronavirus disease 2019 cases and the postoperative outcomes of patients who had thoracic surgery during the beginning and at the highest point of transmission in our community. METHODS We retrospectively reviewed patients who had undergone elective thoracic surgery from 12 February 2020 to 30 April 2020 and were symptomatic or tested positive for severe acute respiratory syndrome coronavirus 2 infection within 14 days after surgery, with a focus on their complications and potential deaths. RESULTS Out of 101 surgical procedures, including 57 primary oncological resections, 6 lung transplants and 18 emergency procedures, only 5 cases of coronavirus disease 2019 were identified, 3 in the immediate postoperative period and 2 as outpatients. All 5 patients had cancer; the median age was 64 years. The main virus-related symptom was fever (80%), and the median onset of coronavirus disease 2019 was 3 days. Although 80% of the patients who had positive test results for severe acute respiratory syndrome coronavirus 2 required in-hospital care, none of them were considered severe or critical and none died. CONCLUSIONS These results indicate that, in properly selected cases, with short preoperative in-hospital stays, strict isolation and infection control protocols, managed by a dedicated multidisciplinary team, a surgical procedure could be performed with a relatively low risk for the patient.

scholarly journals 2852. Epidemiology of Emerging Carbapenemase-Producing Organisms (CPO) in Chicago, Illinois, 2013–2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S73-S74
Author(s):  
Massimo Pacilli ◽  
Hira Adil ◽  
Kelly Walblay ◽  
Shannon N Xydis ◽  
Whitney Clegg ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Healthcare Facility ◽  
The United States ◽  
Resistant Organism ◽  
Molecular Testing ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Chicago Area

Abstract Background Emerging CPO in the Chicago area poses clinical and infection control challenges across the spectrum of care. Since November 2013, CPO are reportable to the Illinois’ Extensively Drug-resistant Organism (XDRO) registry. We examined trends in mechanism of resistance (MOR) among CPO reported through December 2018. Methods MOR reported into the XDRO registry were identified by clinical laboratories performing molecular methods on routine clinical cultures, by public health laboratories during point prevalence surveys (PPS) in response to clusters and as part of a project to assess CPO prevalence in high-risk Chicago area healthcare settings. Chicago patients with known MOR other than Klebsiella pneumoniae carbapenemase (KPC) are investigated by Chicago Department of Public Health (CDPH) to implement containment strategies and identify risk factors within 6 months of culture date. Results MOR was identified in 40% (1,216/3,587) of CPO-positive specimens collected from unique Chicago patients; 87% were KPC, 7% New Delhi metallo-β-lactamase (NDM), 5% Verona integron-mediated metallo-β-lactamase (VIM), 0.6% OXA-48-type carbapenemases, and 0.01% Imipenemase metallo-β-lactamase (IMP) (figure). Since 2017, 15 patients with CPO expressed more than one MOR; 14 were identified during PPS at ventilator capable skilled nursing facilities (vSNF) or long-term acute care hospitals (LTACH), and one was hospitalized in India. Among 156 patients with non-KPC CPO, the median age was 64 years (range, 20–97), 107 (69%) were identified from rectal screening and 49 (31%) were from clinical specimens, most of which were urine 23 (47%) or blood 6 (12%). Among 134 patients with risk factor history, 64% had history of tracheostomy (Table 1). Among 113 patients without documented travel outside of the United States, all stayed overnight at an Illinois healthcare facility; 62% stayed in a vSNF and 24% in an LTACH within 6 months of identification (Table 2). Conclusion We have increasingly detected non-KPC CPO in Chicago; however, estimates of prevalence are limited by lack of systematic surveillance and molecular testing. The high proportion of CPO patients without travel who stayed in vSNF or LTACH underscores the need for infection control training and surveillance in these settings. Disclosures All Authors: No reported Disclosures.

scholarly journals Lessons from Severe Acute Respiratory Syndrome (SARS): Implications for Infection Control

2005 ◽  
Vol 36 (6) ◽  
pp. 610-616 ◽  
Author(s):  
Richard P. Wenzel ◽  
Gonzalo Bearman ◽  
Michael B. Edmond
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control

Factors Associated With Critical-Care Healthcare Workers' Adherence to Recommended Barrier Precautions During the Toronto Severe Acute Respiratory Syndrome Outbreak

2007 ◽  
Vol 28 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
A. Shigayeva ◽  
K. Green ◽  
J. M. Raboud ◽  
B. Henry ◽  
A. E. Simor ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Healthcare Workers ◽  
Apache Ii ◽  
Recent Infection ◽  
Factors Associated ◽  
Interactive Training ◽  
Two Factors ◽  
Score Apache ◽  
Self Protection

Objective.To assess factors associated with adherence to recommended barrier precautions among healthcare workers (HCWs) providing care to critically ill patients with severe acute respiratory syndrome (SARS).Setting.Fifteen acute care hospitals in Ontario, CanadaDesign.Retrospective cohort study.Patients.All patients with SARS who required intubation during the Toronto SARS outbreak in 2003.Participants.HCWS who provided care to or entered the room of a SARS patient during the period from 24 hours before intubation until 4 hours after intubation.Methods.Standardized interviews were conducted with eligible HCWs to assess their interactions with the SARS patient, their use of barrier precautions, their practices for removing personal protective equipment, and the infection control training they received.Results.Of 879 eligible HCWs, 795 (90%) participated. In multivariate analysis, the following predictors of consistent adherence to recommended barrier precautions were identified: recognition of the patient as a SARS case (odds ratio [OR], 2.5 [95% confidence interval {CI}, 1.5-4.5); recent infection control training (OR for interactive training, 2.7 [95% CI, 1.7-4.4]; OR for passive training, 1.7 [95% CI, 1.0-3.0]), and working in a SARS unit (OR, 4.0 [95% CI, 1.8-8.9]) or intensive care unit (OR, 4.3 [95% CI, 2.0-9.0]). Two factors were associated with significantly lower rates of consistent adherence: the provision of care for patients with higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (OR for score APACHE II of 20 or greater, 0.4 [95% CI, 0.28-0.68]) and work on shifts that required more frequent room entry (OR for 6 or more entries per shift, 0.5 [95% CI, 0.32-0.86]).Conclusions.There were significant deficits in knowledge about self-protection that were partially corrected by education programs during the SARS outbreak. HCWs' adherence to self-protection guidelines was most closely associated with whether they provided care to patients who had received a definite diagnosis of SARS.

Nosocomial Acquisition of Methicillin-ResistantStaphylococcus aureusDuring an Outbreak of Severe Acute Respiratory Syndrome

2005 ◽  
Vol 26 (2) ◽  
pp. 134-137 ◽  
Author(s):  
Susan M. Poutanen ◽  
Mary Vearncombe ◽  
Allison J. McGeer ◽  
Michael Gardam ◽  
Grant Large ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Retrospective Cohort ◽  
Healthcare Workers ◽  
Community Hospital ◽  
Tertiary Care ◽  
Appropriate Use ◽  
Contact Precautions ◽  
Control Education ◽  
Tertiary Care Hospitals

AbstractObjective:The four hospitals assessed in this study use active surveillance cultures for methicillin-resistantStaphylococcus aureus(MRSA) and contact precautions for MRSA-positive patients as part of routine infection control practices. The objective of this study was to determine whether nosocomial acquisition of MRSA decreased in these hospitals during an outbreak of severe acute respiratory syndrome (SARS) when barrier precautions were routinely used for all patients.Design:Retrospective cohort study.Setting:Three tertiary-care hospitals (a 1,100-bed hospital; a 500-bed hospital; and an 823-bed hospital) and a 430-bed community hospital, each located in Toronto, Ontario, Canada.Patients:All admitted patients were included.Results:The nosocomial rate of MRSA in all four hospitals combined during the SARS outbreak (3.7 per 10,000 patient-days) was not significantly different from that before (4.7 per 10,000 patient-days) or after (3.4 per 10,000 patient-days) the outbreak (P= .30 andP= .76, respectively). The nosocomial rate of MRSA after the outbreak was significantly lower than that before the outbreak (P= .003). Inappropriate reuse of gloves and gowns and failure to wash hands between patients on non-SARS wards were observed during the outbreak. Increased attention was paid to infection control education following the outbreak.Conclusions:Inappropriate reuse of gloves and gowns and failure to wash hands between patients may have contributed to transmission of MRSA during the SARS outbreak. Attention should be paid to training healthcare workers regarding the appropriate use of precautions as a means to protect themselves and patients.

scholarly journals The Saudi Infection Control Guidance for Re-opening Dental Services in Governmental and Private Sectors During Coronavirus Disease-2019 Pandemic

2021 ◽  
Vol 15 (1) ◽  
pp. 64-70
Author(s):  
Ali AlAhdal ◽  
Haila Al-Huraishi ◽  
Ahmad Almalag ◽  
Adel Alrusayes ◽  
Saud M Orfali
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Dental Treatment ◽  
Dental Health ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Dental Services ◽  
And Control

Objective: Novel newly discovered coronavirus, also known as severe acute respiratory syndrome coronavirus-2, is a recently emerging virus that has been rapidly spreading globally since December 2019. Due to the vicinity inoro-dental treatment and aerosol production, people inside the dental office are at high risk of being infected with severe acute respiratory syndrome coronavirus-2. This guideline aims to protect the dental health-care workers during their plans to re-open and increasingly continue their routine services until further notice from their governing body. Methods: A panel of experts in dentistry and infection prevention and control reviewed the local and global research and guidelines related to infection prevention and control during coronavirus disease-2019, along with the re-opening guidance provided by different entities. Results: Such a document might either be adopted or adapted to any regional and international organization that wishes to use a revised professional guideline in infection prevention and control dental services. Conclusion: A careful re-opening plan should be developed and implemented, including strict infection control measures before resuming the dental practice.

scholarly journals INFECTION CONTROL IN DENTAL CLINICS DURING COVID 19 –Original Review

2020 ◽  
Author(s):  
Raunak Manjeet ◽  
KULDEEP D’MELLO ◽  
ATUL SINGH ◽  
SWATI SRIVASTAVA
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Virus Disease ◽  
Control Strategies ◽  
Dental Practice ◽  
Corona Virus ◽  
Management Protocol ◽  
Spread Pattern ◽  
Spread Of Infection ◽  
Aerosol Infection

The outbreak of severe acute respiratory syndrome corona virus 2 (SARS COV 2) and its linked corona virus disease has troubled the entire world community led to a serious public health concerns. Despite the various efforts to stop the spread of this disease globally, the outbreak is still on the rise because of the community spread pattern of this disease. This is believed to have originated in bats pangolins initially later it got transmitted to humans. Once it comes in the human body , this corona virus remains abundantly present in nasopharyngeal and salivary secretions of affected patients. Its spreading nature is mainly through the respiratory droplet spread / aerosol infection. Dental professionals, including Orthodontists , Oral Surgeons , Periodontists, Endodontists and Prosthodontists are all at high risk, since they may encounter patients with suspected or confirmed SARS COV 2 infection will have to act accordingly not only to provide care but at the same time prevent nosocomial spread of infection. Thus, the aim of this article is to provide a brief detailing of the cause, sign symptoms and different routes of transmission of this infection. In addition specific recommendations for dental practice are suggested for patient screening, infection control strategies and patient management protocol . KEY WORDS Coronavirus ,COVID 19, SARS COV 2 ,Dental practice ,Orthodontics ,OMFS, severe acute respiratory syndrome .

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