PO-0535 Sustainable Reduction Of Positive Blood Cultures In A Tertiary Neonatal Intensive Care Unit: Impact Of Infection Prevention And Control Measures Over A 5 Year Period

Objective.Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitiveStaphylococcus aureus(MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC.Design.Retrospective chart review.Setting.A 24-bed, university-affiliated, inborn level 3 NICU.Participants.Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed.Interventions.Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased.Results.Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P< .002).Conclusion.Although this observational study cannot establish a causal relationship, there was a significant decrease in the incidence of NEC following implementation of enhanced infection prevention and control measures to manage an MSSA outbreak.Infect Control Hosp Epidemiol2012;33(1):29-33

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Evolution of the environmental microbiota of a new neonatal intensive care unit (NICU) and implications for infection prevention and control

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.396 ◽

2020 ◽

pp. 1-6

Author(s):

Philip Zachariah ◽

Felix D. Rozenberg ◽

Stephania Stump ◽

Dagmara I. Moscoso ◽

Ganga Krishnamurthy ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Prevention And Control ◽

Neonatal Intensive Care ◽

Infection Prevention ◽

Patient Transfer ◽

Infection Prevention And Control ◽

Differential Abundance ◽

And Control

Abstract Objective: To describe changes in the environmental microbiota of a new neonatal intensive care unit (NICU) and potential implications for infection prevention and control (IPC) efforts. Design: Prospective observational study. Setting: A newly constructed level IV neonatal cardiac intensive care unit (NCICU) before and after patient introduction and the original NICU prior to patient transfer. Methods: Environmental samples were obtained from the original NICU prior to patient transfer to a new NCICU. Serial sampling of patient rooms and provider areas of the new NICU was conducted immediately prior to patient introduction and over an 11-month study period. Microbiota at each sampling point were characterized using Illumina sequencing of the V3/V4 region of the 16S rRNA gene. Microbiota characteristics (α and β diversity and differential abundance) were compared based on time, location, and clinical factors (room-level antibiotic use and patient turnover). Results: An immediate increase in the environmental differential abundance of gut anaerobes were seen after patient introduction. There was an increase in the relative abundance of Staphylococcus spp, Klebsiella spp, Pseudomonas spp, and Streptococcus spp over time. The new NCICU consistently showed more diverse microbiota and remained distinct from the original NICU. The microbiota of the provider areas of the NCICU eventually formed a cluster separate from the patient rooms. Patient turnover increased room-level microbiota diversity. Conclusion: Microbiota characteristics of the new NICU were distinct from the original ICU despite housing similar patients. Patient and provider areas developed distinct microbiota profiles. Non–culture-based methods may be a useful adjunct to current IPC practice.

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

BMC Public Health ◽

10.1186/s12889-021-10768-y ◽

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.

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Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

BMC Infectious Diseases ◽

10.1186/s12879-021-06295-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhijie Zhang ◽

Yu Cao ◽

Yanjian Li ◽

Xufang Chen ◽

Chen Ding ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Biofilm Formation ◽

Prevention And Control ◽

Neonatal Intensive Care ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Anti Fungal ◽

Hospital Acquired ◽

And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

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Keeping the wolf at bay: Infection prevention and control measures for inpatient psychiatric facilities in the time of COVID-19

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2020.07.004 ◽

2020 ◽

Vol 66 ◽

pp. 51-53 ◽

Cited By ~ 2

Author(s):

Brian Barnett ◽

Frank Esper ◽

Charles B. Foster

Keyword(s):

Prevention And Control ◽

Infection Prevention ◽

Control Measures ◽

Infection Prevention And Control ◽

Prevention And Control Measures ◽

And Control ◽

Psychiatric Facilities

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AMR: effective infection prevention and control measures

Practice Nursing ◽

10.12968/pnur.2019.30.8.390 ◽

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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