Comparison of Three Expanded-Spectrum Cephalosporin Hydrolysis Assays and the NG-Test CTX-M Multi Assay That Detects All CTX-M-Like Enzymes

Rapid detection of expanded-spectrum cephalosporins (ESC) hydrolysing enzymes is crucial to implement infection control measures and antibiotic stewardship. Here, we have evaluated three biochemical ESC hydrolysis assays (ESBL NDP test, β-LACTA™ test, LFIA-CTX assay) and the NG-Test® CTX-M MULTI that detects CTX-M enzymes, on 93 well-characterized Gram-negative isolates, including 60 Enterobacterales, 21 Pseudomonas spp. and 12 Acinetobacter spp. The performances were good for all three hydrolysis assays, with the LFIA-CTX being slightly more sensitive and specific on the tested panel of isolates especially with Enterobacterales, without ambiguous results. This study showed that LFIA-CTX may be used for the detection of ESC hydrolysis as a competitive alternative to already available assays (β-LACTA™ test and ESBL NDP test) without any specific equipment and reduced hands-on-time. The lateral flow immunoassay NG-Test® CTX-M MULTI has proven to be a useful, easy, rapid, and reliable confirmatory test in Enterobacterales for detection of CTX-M-type ESBLs, which account for most of the resistance mechanisms leading to ESC resistance in Enterobacterales, but it misses rare ESC hydrolysing β-lactamases (AmpC, minor ESBLs, and carbapenemases). Combining it with the LFIA-CTX assay would yield an assay detecting the most frequently-encountered ESBLs (CTX-M-like β-lactamases) together with ESC hydrolysis.

Risk of infection and appeal to public benefit increase compliance with infection control measures

To handle an infectious outbreak, the public must be informed about the infection risk and be motivated to comply with infection control measures. Perceiving the situation as threatening and seeing public benefits to complying may increase the public’s motivation to comply. The current study used a preregistered survey experiment to investigate if emphasizing high infection risk and appealing to societal benefits impacted intention to comply with infection control measures. The results show main effects of risk and of appeals to societal benefits. There was no interaction between risk scenario and motivational emphasis. The results suggest that to maximize compliance, information about disease outbreak should emphasize the individual risk of contracting the disease, and could also underline the public value of limiting infection spread. These findings can inform communication strategies during an infectious disease outbreak and help health authorities limit transmission.

Prevalence of SARS-CoV-2 IgG antibodies among dental teams in Germany

Objectives During the corona pandemic, dental practices temporarily closed their doors to patients except for emergency treatments. Due to the daily occupational exposure, the risk of SARS-CoV-2 transmission among dentists and their team is presumed to be higher than that in the general population. This study examined this issue among dental teams across Germany. Materials and methods In total, 2784 participants provided usable questionnaires and dry blood samples. Dry blood samples were used to detect IgG antibodies against SARS-CoV-2. The questionnaires were analyzed to investigate demographic data and working conditions during the pandemic. Multivariable logistic mixed-effects models were applied. Results We observed 146 participants with positive SARS-CoV-2 IgG antibodies (5.2%) and 30 subjects with a borderline finding (1.1%). Seventy-four out of the 146 participants with SARS-CoV-2 IgG antibodies did not report a positive SARS-CoV-2 PCR test (50.7%), while 27 participants without SARS-CoV-2 IgG antibodies reported a positive SARS-CoV-2 PCR test (1.1%). Combining the laboratory and self-reported information, the number of participants with a SARS-CoV-2 infection was 179 (6.5%). Though after adjustment for region, mixed-effects models indicated associations of use of rubber dams (OR 1.65; 95% CI: 1.01–2.72) and the number of protective measures (OR 1.16; 95% CI: 1.01–1.34) with increased risk for positive SARS-CoV-2 status, none of those variables was significantly associated with a SARS-CoV-2 status in fully adjusted models. Conclusions The risk of SARS-CoV-2 transmission was not higher among the dental team compared to the general population. Clinical relevance. Following hygienic regulations and infection control measures ensures the safety of the dental team and their patients.

Strategies for Prevention of COVID-19 Transmission in Hospitals: a Nationwide Survey of Controversial Issues Related to Infection Control and Prevention in Korea

Background: Infection-control measures against the coronavirus disease 2019 (COVID-19) within a hospital are often based on expert experience and intuition due to the lack of clear guidelines. This study aimed to survey the current strategies for the prevention of the spread of COVID-19 in medical institutions.Methods: In a systematic review of national-level guidelines, 13 key topics were selected. Six hospitals were provided an open survey between August 11 and 25, 2020, to assess their responses to these topics. Using these data, an online questionnaire was developed and sent to the infection-control teams of 46 hospitals in South Korea. The survey was conducted between January 31, 2021, and February 20, 2021.Results: All 46 hospitals responded to the survey. All hospitals operated screening clinics, while 89.1% (41/46) allowed symptomatic patients without COVID-19-associated symptoms to visit the general outpatient clinics. Most hospitals (87.2%; 34/39) conducted polymerase chain reaction (PCR) tests for all hospitalised patients. Moreover, 35 (76.1%) hospitals had preemptive isolation policies for hospitalised patients, of which 97.1% (34/35) released patients from isolation after a single negative PCR test. Most hospitals (76.9%; 20/26) allowed shared-room accommodation for patients who met the national criteria for release from isolation but showed positive PCR results with cycle threshold values above a certain threshold (34.6%; 9/26) or after a certain period that satisfied the national criteria (26.9%; 7/26). Conclusions: Various guidelines were being applied by each medical institution, but an explicit set of national guidelines to support these guidelines was unavailable.

A cross-sectional evaluation of knowledge, attitudes, practices, and perceived challenges among Palestinian pharmacists regarding COVID-19

Objectives: This study aims to evaluate knowledge, attitudes, practices, and perceived challenges regarding coronavirus disease 2019 among pharmacists in Palestine. Methods: An online method was used to collect the data. Three hundred sixty-four pharmacists participated in the study from all areas in the Palestinian territories. The questionnaire consisted of three sections: sociodemographics; knowledge, attitudes, practices regarding coronavirus disease 2019; and barriers that prevent the implementation of infection control measures. The Statistical Package for the Social Sciences program Version 21 was used to analyze the data. Variables were expressed as frequencies, percentages, mean, and median. The chi-square test, Kruskal–Wallis test, Mann–Whitney U test, and Pearson’s test were applied, along with logistic regression analysis. Results: The median age of the participants was 29 years old, and most of them were female (70.9%). The analysis found that 76.4% of pharmacists had good knowledge regarding coronavirus disease 2019, and 52.7% had good practices. The median attitude score recorded by the participants was 32 points [Q1–Q3: 30–34] out of 35. Notably, the level of concern regarding coronavirus disease 2019 was significantly associated with all three tools of measurement; knowledge ( p = 0.001), attitudes ( p = 0.001), and practices ( p = 0.001). It also appears that more years of experience had higher odds (3–5 years of experience: odds ratio, 2.560; 95% confidence interval, 1.413–4.639; p = 0.002, more than 5 years: odds ratio, 2.931; 95% confidence interval, 1.188–7.232; p = 0.020) of good practice. Conclusion: Although an acceptable level of knowledge was found, it might be considered inadequate. Moreover, there is a lack of appropriate adherence to safety measures from pharmacists. Therefore, we recommend the responsible authorities generate an organized training program to expand pharmacists’ knowledge and experience regarding coronavirus disease 2019.

Changes in Acute Respiratory Infection Before and After COVID-19

Objective: During the outbreak of COVID-19,several coping strategies were implemented including strengthened social distancing, wearing masks and hand hygiene. Thisinfection control method might have been effective for other respiratory infections; however, it had not yet been clearly revealed. Therefore,we investigatedwhetherthe incidence of infectious respiratory diseases has reduced after excluding the effect of decreased medical utilization because of COVID-19 control measures.Design or methods: We used the Korean national claims data and analyzed incidences of acute respiratory infections (ARI) and diseases except ARI. The incidence rates of winter 2019 and 2020 were compared.Results: Excluding ARI,the reduction in overall hospital visits decreased by only 2%; however,the number of visits due to ARI decreased by 13%, and the number of visits due to influenza particularly decreased by 26%.Conclusions: Using national database, this study confirmed that a significant reduction in ARI, including influenza, occurred during the COVID-19 pandemic. Infection control measures including nationally enforced social distancing may be effective in controlling the transmission of other respiratory infections. Further studies are necessary to clarify the causal relationship.

A cohort study of the effect of SARS-CoV-2 point of care rapid RT-PCR at the Emergency Department on targeted admission

(ii)AbstractBackgroundTo prevent nosocomial transmission of SARS-CoV-2, infection control measures are implemented for patients with symptoms compatible with COVID-19 until reliable test results are available. This delay targeted admission to the most appropriate ward based on the medical condition. SARS-CoV-2 rapid antigen detection (RAD) tests and point of care (POC) rapid RT-PCR were introduced at emergency departments (EDs) in late 2020, but the consequence on targeted admission is unknown.ObjectivesTo assess the effect of RAD tests and POC rapid RT-PCR (VitaPCR, Credo Diagnostics, Singapore) on targeted admission.MethodsPatients presenting at the ED of a referral hospital (N = 2,940) between 13-Nov-2020 and 12-Jan-2021 were included. The study period was delimited by introduction of RAD tests and VitaPCR. Participant data was collected retrospectively, and outcome variables were length-of-stay (LoS), intrahospital transfers and targeted admission to COVID-19 ward.ResultsRAD tests reduced ED LoS for participants with positive tests or that were not tested. Negative VitaPCR results reduced mean hospital LoS by 1.5 (95%CI: 0.3–2.7) days and admissions to COVID-19 wards from 34.5 (95%CI: 28.9-40.5) to 14.7 (95%CI: 11.1-19.1) per 100 admissions. Introduction of VitaPCR reduced transfers between hospital wards in the first 5 days from 50.0 (95%CI: 45.0-55.0) to 34.0 (95%CI: 30.3-37.9) per 100 admissions.ConclusionRAD tests enabled rapid detection of SARS-CoV-2 infection which had pronounced effects on LoS at the ED. VitaPCR added the possibility of exclusion of the infection which increased targeted admissions, reduced intrahospital transfers and lead to shorter stay at the hospital.

Tuberculosis infection control measures and knowledge in primary health centres in Bandung, Indonesia

Background Health care workers (HCWs) in low- and middle-income countries (LMICs) continue to have an unacceptably high prevalence and incidence of Mycobacterium tuberculosis infection due to high exposure to tuberculosis (TB) cases at health care facilities and often inadequate infection control measures. This can contribute to an increased risk of transmission not only to HCWs themselves but also to patients and the general population. Aim We assessed implementation of TB infection control measures in primary health centres (PHCs) in Bandung, Indonesia, and TB knowledge among HCWs. Methods A cross-sectional study was conducted between May and November 2017 amongst a stratified sample of the PHCs, and their HCWs, that manage TB patients in Bandung. Questionnaires were used to assess TB infection control measures plus HCW knowledge. Summary statistics, linear regression and the Kruskal–Wallis test were used for analysis. Results The median number of TB infection control measures implemented in 24 PHCs was 21 of 41 assessed. Only one of five management controls was implemented, 15 of 24 administrative controls, three of nine environmental controls and one of three personal respiratory protection controls. PHCs with TB laboratory facilities and high TB case numbers were more likely to implement TB infection control measures than other PHCs ( p=0.003). In 398 HCWs, the median number of correct responses for knowledge was 10 (IQR 9–11) out of 11. Discussion HCWs had good TB knowledge. TB infection control measures were generally not implemented and need to be strengthened in PHCs to reduce M. tuberculosis transmission to HCWs, patients and visitors.

Evaluation of Cross Infection Control in Dentistry; A Patients’ Perception Study

OBJECTIVE: To assess the perception of patients visiting a dental OPD in Karachi regarding cross infection control measures that should be taken in dental practice. METHODOLOGY: A cross-sectional study was conducted at the OPD of Altamash Institute of Dental Medicine from January to August 2020. A total of 546 patients aged 20-75 years of either gender coming for routine dental check-ups were included in the study using non-probability convenience sampling. A well-structured and validated questionnaire was used to assess the knowledge, attitude and practices of patients regarding cross infection measures that should be present in dental practices. SPSS-25 was used to analyze the data. Descriptive statistics was used to calculate frequency and percentage of qualitative (gender, socioeconomic and education status, knowledge attitude and practice levels of patients) and quantitative variables (age groups). Chi-square test was used to detect the relation of patient's knowledge levels with potential factors like the age groups, gender, socioeconomic and education status. The p-value of (< 0.05) was considered as significant. RESULTS: Out of the total participants, 79.1% had good knowledge about cross infection control measures in dental practice. Majority of the patients (84.6%) agreed that dentists should wear gloves during treatment, though majority were of the opinion that a dentist can treat several patients with the same set of gloves. About 4.9% of the patients said that they ask the dentist to wear face mask and gloves while treating them, and only 3.3% said that they ask the dentist about sterilization of instruments. The knowledge level of patients showed variation with their education status but not with respect to socioeconomic status, age and gender. CONCLUSION: Although overall the patients visiting dental clinics had good perception and showed positive attitudes towards cross infection control, the dental health practitioners need to disseminate basic technical information about the infection-control practices required for safe dental practice to dental patients and the community at large. KEYWORDS: cross infection, knowledge, dentist, dental patients, perception

A Decisive Review to Understand the Basic Fundamentals of Novel Corona Viruse Disease

With the development and spread of 2019 novel coronavirus (2019-nCoV), also known as the severe acute respiratory syndrome coronavirus 2, a new public health disaster is threatening the world (SARS-CoV-2). In December 2019, the virus was discovered in bats and transmitted to humans via unidentified intermediary species in Wuhan, Hubei Province, China. To date (05/03/2020), there have been roughly 96,000 recorded cases of coronavirus disease 2019 (COVID-2019) and 3300 documented deaths. The disease is spread through inhalation or contact with contaminated droplets, with a 2 to 14-day incubation period. Fever, cough, sore throat, dyspnea, weariness, and malaise are common symptoms. The disease is mild in most people; in some (usually the elderly and those with comorbidities), it can lead to pneumonia, ARDS (acute respiratory distress syndrome), and multi-organ failure. A large number of persons are asymptomatic. The case fatality rate is expected to be between 2 and 3%. Specimen collection, assay collection, serology, nucleic acid testing or molecular testing, and target selection for RT-PCR are all examples of laboratory diagnosis. Home isolation of suspected cases and those with mild illnesses, as well as tight infection control measures in hospitals, including contact and droplet precautions, are all part of the prevention strategy. The virus has a lower fatality rate than its two ancestors, SARS-CoV and Middle East respiratory sickness coronavirus (MERS-CoV). The global consequences of this new epidemic are still unknown.