Plasma virome and the risk of blood-borne infection in persons with substance use disorder

There is an urgent need for innovative methods to reduce transmission of bloodborne pathogens like HIV and HCV among people who inject drugs (PWID). We investigate if PWID who acquire non-pathogenic bloodborne viruses like anelloviruses and pegiviruses might be at greater risk of acquiring a bloodborne pathogen. PWID who later acquire HCV accumulate more non-pathogenic viruses in plasma than matched controls who do not acquire HCV infection. Additionally, phylogenetic analysis of those non-pathogenic virus sequences reveals drug use networks. Here we find first in Baltimore and confirm in San Francisco that the accumulation of non-pathogenic viruses in PWID is a harbinger for subsequent acquisition of pathogenic viruses, knowledge that may guide the prioritization of the public health resources to combat HIV and HCV.

A Rapid Single-Cell Antimicrobial Susceptibility Testing Workflow for Bloodstream Infections

Bloodstream infections are a significant cause of morbidity and mortality worldwide. The rapid initiation of effective antibiotic treatment is critical for patients with bloodstream infections. However, the diagnosis of bloodborne pathogens is largely complicated by the matrix effect of blood and the lengthy blood tube culture procedure. Here we report a culture-free workflow for the rapid isolation and enrichment of bacterial pathogens from whole blood for single-cell antimicrobial susceptibility testing (AST). A dextran sedimentation step reduces the concentration of blood cells by 4 orders of magnitude in 20–30 min while maintaining the effective concentration of bacteria in the sample. Red blood cell depletion facilitates the downstream centrifugation-based enrichment step at a sepsis-relevant bacteria concentration. The workflow is compatible with common antibiotic-resistant bacteria and does not influence the minimum inhibitory concentrations. By applying a microfluidic single-cell trapping device, we demonstrate the workflow for the rapid determination of bacterial infection and antimicrobial susceptibility testing at the single-cell level. The entire workflow from blood to categorical AST result can be completed in less than two hours.

SARS-CoV-2 Seroprevalence and Drug Use in Trauma Patients from Six Sites in the United States

In comparison to the general patient population, trauma patients show higher level detections of bloodborne infectious diseases, such as Hepatitis and Human Immunodeficiency Virus. In comparison to bloodborne pathogens, the prevalence of respiratory infections such as SARS-CoV-2 and how that relates with other variables, such as drug usage and trauma type, is currently unknown in trauma populations. Here, we evaluated SARSCoV2 seropositivity and antibody isotype profile in 2,542 trauma patients from six Level 1 trauma centers between April and October of 2020 during the first wave of the COVID19 pandemic. We found that the seroprevalence in trauma victims 18 to 44 years old (9.79%, 95% confidence interval/CI: 8.33 - 11.47) was much higher in comparison to older patients (45-69 years old: 6.03%, 4.59-5.88; 70+ years old: 4.33%, 2.54 - 7.20). Black/African American (9.54%, 7.77 - 11.65) and Hispanic/Latino patients (14.95%, 11.80 - 18.75) also had higher seroprevalence in comparison, respectively, to White (5.72%, 4.62 - 7.05) and Non-Latino patients (6.55%, 5.57 - 7.69). More than half (55.54%) of those tested for drug toxicology had at least one drug present in their system. Those that tested positive for depressants had a significant negative correlation with seropositivity, while those on anti-depressants trended positive. These findings represent an important consideration for both the patients and first responders that treat trauma patients facing potential risk of respiratory infectious diseases like SARSCoV2.

Needlestick Injuries Among Healthcare Workers Administering COVID-19 Vaccinations in the United States

As mass COVID-19 vaccination programs roll out across the country, we are potentially faced with compromising workers’ health for the sake of the broader public health, as it relates to occupational exposure to contaminated needles and syringes. We have the opportunity to provide recommendations that advance protection of workers through the industrial hygiene hierarchy of controls, especially in light of the twentieth anniversary of the Needlestick Safety and Prevention Act. Specifically, greater focus on institutional controls that can dictate the safety culture and climate of institutions that roll out COVID-19 vaccination programs, while maintaining careful focus on preventing sharps injuries and blood exposure. In addition, we provide suggestions for the role that engineering controls, such as devices with sharps injury prevention features play in protecting workers from exposure to bloodborne pathogens, as well as the importance of ongoing injury incident surveillance.

Factors affecting patient safety culture in terms of compliance with preventing bloodborne pathogens among general hospital nurses

Background: The present study aims to investigate the relationship between patient safety culture and the prevention of transmitting bloodborne pathogens among nurses at a general hospital.Methods: The participants were 284 nurses working at a general hospital located in a city, and the data were collected between April 26 and May 15, 2019. Questionnaires on patient safety culture and the prevention of bloodborne pathogens were used, and SPSS version 22.0 was used for descriptive and hierarchical regression analysis.Results: The results showed that the following factors affected the prevention of bloodborne pathogens: experience with needle stick and sharps injuries (β = -0.94), teamwork (β = 0.41), knowledge and attitude toward patient safety (β = 0.34), leadership (β = 0.15), and priority of patient safety (β = 0.14). The model's explanatory power was 53% (F = 32.26, p =< 0.001).Conclusions: To increase the compliance of general hospital nurses with practices that promote the prevention of bloodborne pathogens, it is necessary to actively prevent needle sticks and sharps injuries. It is also necessary to prioritize patient safety and to develop and verify the effects of various programs that emphasize factors of patient safety culture, such as leadership, teamwork, knowledge, and attitude.

Factors affecting patient safety culture in terms of compliance with preventing bloodborne pathogens among general hospital nurses

Background The present study aims to investigate the relationship between patient safety culture and the prevention of transmitting bloodborne pathogens among nurses at a general hospital. Methods The participants were 284 nurses working at a general hospital located in a city, and the data were collected between April 26 and May 15, 2019. Questionnaires on patient safety culture and the prevention of bloodborne pathogens were used, and SPSS version 22.0 was used for descriptive and hierarchical regression analysis. Results The results showed that the following factors affected the prevention of bloodborne pathogens: experience with needle stick and sharps injuries (β = − 0.94), teamwork (β = 0.41), knowledge and attitude toward patient safety (β = 0.34), leadership (β = 0.15), and priority of patient safety (β = 0.14). The model’s explanatory power was 53% (F = 32.26, p =< 0.001). Conclusions To increase the compliance of general hospital nurses with practices that promote the prevention of bloodborne pathogens, it is necessary to actively prevent needle sticks and sharps injuries. It is also necessary to prioritize patient safety and to develop and verify the effects of various programs that emphasize factors of patient safety culture, such as leadership, teamwork, knowledge, and attitude.

Assessment of the state of knowledge of bloodborne infections, occupational exposure and post-exposure prophylaxis and study of exposure to potentially infectious materials among students of selected medical faculties in Poland

Introduction. Occupational exposure to potentially infectious material (PIM) is a serious problem for healthcare workers, including medical students. Aim. We assessed the state of knowledge about occupational exposure and frequency of exposure among students of selected medical faculties in Poland. Material and methods. Retrospective analysis with proprietary questionnaires. Results. Only 34.5% from 753 respondents correctly indicated bloodborne pathogens and 9.3% PIM. There were 84 reports of exposure, mostly during intravenous injections. 10.4% students claimed probable occupational exposure which was not reported. Most common reason for not reporting was fear of negative supervisor reaction. Conclusion. Student’s knowledge of this matter is poor. Significant percentage of students has never participated in occupational exposure training. Occupational exposure was experienced by surprisingly large number of students. Students are afraid to report the incidents. Additional education would be useful in reducing exposure risk.

Factors affecting patient safety culture in terms of compliance with preventing bloodborne pathogens among general hospital nurses

Background: The present study aims to investigate the relationship between patient safety culture and prevention of transmitting bloodborne pathogens among nurses at a general hospital. Methods: The participants were 284 nurses working at a general hospital located in P city, and the data were collected between April 26 and May 15, 2019. Questionnaires on patient safety culture and prevention of bloodborne pathogens were used, and the data were examined on SPSS version 22.0 using for descriptive and hierarchical regression analysis. Results: The results showed that the following factors affected the prevention of bloodborne pathogens: experience of needle stick and sharp injuries (β = -0.94), teamwork (β = 0.41), knowledge and attitude toward patient safety (β = 0.34), leadership (β = 0.15), and priority of patient safety (β = 0.14). The model's explanatory power was 53 % (F = 32.26, p =< 0.001).Conclusions: To increase the compliance of general hospital nurses with practices that promote the prevention of bloodborne pathogens, it is necessary to actively prevent needle stick and sharp injuries. It is also necessary to prioritize patient safety and to develop and verify the effects of various programs that emphasize factors of patient safety culture, such as leadership, teamwork, knowledge, and attitude.

European Recommendations for the Management of Healthcare Workers Occupationally Exposed to Hepatitis

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, -or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBcIgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs -or=50 mIU/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs -or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected. Introduction Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) [1]. In the general population, HCV prevalence varies geographically from about 0.5 percent in northern countries to 2 percent in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3 percent to 3 percent. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV. The probability of acquiring a bloodborne infection following an occupational exposure has been estimated to be on average. Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) [1]. In the general population, HCV prevalence varies geographically from about 0.5 percent in northern countries to 2 percent in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3 percent to 3 percent. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV.We present here recommendations for the general management of occupational risk of bloodborne infections, HBV vaccination and management of HBV and HCV exposures. A description of the project and recommendations for HIV post-exposure management, including antiretroviral prophylaxis, has been previously published [2], and so issues related to occupational risk and prevention of HIV infection following an occupational exposure will not be discussed further.