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Baffetta F, Buonsanti C, Moraschini L, Aprea S, Canè M, Lombardi S, Contorni M, Rondini S, Arora AK, Bardelli M, Finco O, Serruto D, Paccani SR. Lung mucosal immunity to NTHi vaccine antigens: Antibodies in sputum of chronic obstructive pulmonary disease patients. Hum Vaccin Immunother 2024; 20:2343544. [PMID: 38655676 DOI: 10.1080/21645515.2024.2343544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/12/2024] [Indexed: 04/26/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory illness in older adults. A major cause of COPD-related morbidity and mortality is acute exacerbation of COPD (AECOPD). Bacteria in the lungs play a role in exacerbation development, and the most common pathogen is non-typeable Haemophilus influenzae (NTHi). A vaccine to prevent AECOPD containing NTHi surface antigens was tested in a clinical trial. This study measured IgG and IgA against NTHi vaccine antigens in sputum. Sputum samples from 40 COPD patients vaccinated with the NTHi vaccine were collected at baseline and 30 days after the second dose. IgG and IgA antibodies against the target antigens and albumin were analyzed in the sputum. We compared antibody signals before and after vaccination, analyzed correlation with disease severity and between sputum and serum samples, and assessed transudation. Antigen-specific IgG were absent before vaccination and present with high titers after vaccination. Antigen-specific IgA before and after vaccination were low but significantly different for two antigens. IgG correlated between sputum and serum, and between sputum and disease severity. Sputum albumin was higher in patients with severe COPD than in those with moderate COPD, suggesting changes in transudation played a role. We demonstrated that immunization with the NTHi vaccine induces antigen-specific antibodies in sputum. The correlation between IgG from sputum and serum and the presence of albumin in the sputum of severe COPD patients suggested transudation of antibodies from the serum to the lungs, although local IgG production could not be excluded.Clinical Trial Registration: NCT02075541.
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Affiliation(s)
| | | | | | | | | | | | | | - Simona Rondini
- GSK Vaccines Institute for Global Health (GVGH), Siena, Italy
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da Silva RVC, Almeida AB, de Assis RIF, Dos Santos EJ, Rozendo DMM, Sallum AW. Treatment of peri-implantitis using nonsurgical debridement combined with bioresorbable doxycycline nanospheres: a case report with 3-year follow-up. Gen Dent 2024; 72:70-73. [PMID: 38640010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Treatment of peri-implant diseases focuses on reducing the bacterial load and consequent infection control. The use of local antimicrobials as an adjunct to mechanical therapy may result in a better outcome. Among antimicrobials, doxycycline stands out because of its local modulation of cytokines, microbial reduction, and clinical parameters in the treatment of periodontal diseases. The objective of this case report was to describe the combined application of mechanical debridement and bioresorbable doxycycline-loaded nanospheres for the treatment of peri-implantitis in a 71-year-old man. At the 3-year evaluation, the peri-implant tissues had improved, showing decreased probing depths, an absence of bleeding on probing, and no suppuration. This case report highlights the importance of supportive therapy, which is essential for the long-term success of peri-implantitis treatment.
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Smiddy MP, Burton E, Kingston L, Poovelikunnel TT, Moyo M, Flores A. Identifying research priorities for infection prevention and control. A mixed methods study with a convergent design. J Infect Prev 2024; 25:59-65. [PMID: 38584713 PMCID: PMC10998549 DOI: 10.1177/17571774241230676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 04/09/2024] Open
Abstract
Background Meaningful research creates evidence for Infection Prevention and Control (IPC) practice. Aim To establish Infection Prevention Society (IPS) members' research priorities to support future research projects. Methods A mixed methods convergent parallel design incorporating a cross-sectional survey of IPS members (2022-2023), and focus group findings from the IPS Consultative Committee, (October 2022). Quantitative data were analysed using descriptive statistics. Qualitative data were transcribed verbatim, entered into NVivo 12, and analysed using a thematic analysis approach. Findings/Results 132 IPS members responded to the survey, including 120 (90.9%) nurses. The three most prevalent priorities were: Quality Improvement and Patient Safety (n = 84, 16.1%); IPC Training and Education (n = 77, 14.8%); and IPC Evidence-based Guidelines (n = 76, 14.6%). Analysis of the focus group transcripts identified six emergent themes 'Patient Centred Care', 'Training and Education', 'IPC Role and Identity', 'IPC Leadership', 'IPC is Everyone's Responsibility', and 'Research Activity'. Triangulation of findings demonstrated concordance between quantitative and qualitative findings with Quality Improvement and Patient Safety (QIPS) and Training and Education identified as priority research areas. Discussion This study highlights the necessity of developing support systems and incorporating research priorities in QIPS, as well as Training and Education. The findings of this study align with the recommended core competencies and components for effective infection prevention and control programs, making them relevant to QIPS initiatives. The outcomes of the study will serve as a valuable resource to guide the IPS Research and Development Committee in delivering practical support to IPS members.
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Affiliation(s)
- MP Smiddy
- School of Public Health, University College Cork, Cork, Ireland
| | - E Burton
- School of Public Health, University College Cork, Cork, Ireland
- Pharmacy Department, Bon Secours Hospital, Cork, Ireland
| | - L Kingston
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - T Thomas Poovelikunnel
- Office of the National Director Health Protection, HSE - Health Protection Surveillance Centre, Dublin, Ireland
- Faculty of Nursing and Midwifery, RCSI, Dublin
| | - M Moyo
- Department of Social Sciences and Nursing, Solent University, Southampton, UK
| | - A Flores
- Infection Prevention and Control Department, Kings College Hospitals Foundation NHS Trust, London, UK
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Lyu S, Adegboye O, Adhinugraha KM, Emeto TI, Taniar D. Analysing the impact of comorbid conditions and media coverage on online symptom search data: a novel AI-based approach for COVID-19 tracking. Infect Dis (Lond) 2024; 56:348-358. [PMID: 38305899 DOI: 10.1080/23744235.2024.2311281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Web search data have proven to bea valuable early indicator of COVID-19 outbreaks. However, the influence of co-morbid conditions with similar symptoms and the effect of media coverage on symptom-related searches are often overlooked, leading to potential inaccuracies in COVID-19 simulations. METHOD This study introduces a machine learning-based approach to estimate the magnitude of the impact of media coverage and comorbid conditions with similar symptoms on online symptom searches, based on two scenarios with quantile levels 10-90 and 25-75. An incremental batch learning RNN-LSTM model was then developed for the COVID-19 simulation in Australia and New Zealand, allowing the model to dynamically simulate different infection rates and transmissibility of SARS-CoV-2 variants. RESULT The COVID-19 infected person-directed symptom searches were found to account for only a small proportion of the total search volume (on average 33.68% in Australia vs. 36.89% in New Zealand) compared to searches influenced by media coverage and comorbid conditions (on average 44.88% in Australia vs. 50.94% in New Zealand). The proposed method, which incorporates estimated symptom component ratios into the RNN-LSTM embedding model, significantly improved COVID-19 simulation performance. CONCLUSION Media coverage and comorbid conditions with similar symptoms dominate the total number of online symptom searches, suggesting that direct use of online symptom search data in COVID-19 simulations may overestimate COVID-19 infections. Our approach provides new insights into the accurate estimation of COVID-19 infections using online symptom searches, thereby assisting governments in developing complementary methods for public health surveillance.
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Affiliation(s)
- Shiyang Lyu
- School of Computer Science, Monash University, Melbourne, Australia
| | - Oyelola Adegboye
- Menzies School of Health Research, Darwin, Charles Darwin University, NT, Australia
| | | | - Theophilus I Emeto
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - David Taniar
- School of Computer Science, Monash University, Melbourne, Australia
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Kurita J, Iwasaki Y. Effect of Long-Distance Domestic Travel Ban Policies in Japan on COVID-19 Outbreak Dynamics During Dominance of the Ancestral Strain: Ex Post Facto Retrospective Observation Study. Online J Public Health Inform 2024; 16:e44931. [PMID: 38648635 PMCID: PMC11037452 DOI: 10.2196/44931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/08/2023] [Accepted: 12/27/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND In Japan, long-distance domestic travel was banned while the ancestral SARS-CoV-2 strain was dominant under the first declared state of emergency from March 2020 until the end of May 2020. Subsequently, the "Go To Travel" campaign travel subsidy policy was activated, allowing long-distance domestic travel, until the second state of emergency as of January 7, 2021. The effects of this long-distance domestic travel ban on SARS-CoV-2 infectivity have not been adequately evaluated. OBJECTIVE We evaluated the effects of the long-distance domestic travel ban in Japan on SARS-CoV-2 infectivity, considering climate conditions, mobility, and countermeasures such as the "Go To Travel" campaign and emergency status. METHODS We calculated the effective reproduction number R(t), representing infectivity, using the epidemic curve in Kagoshima prefecture based on the empirical distribution of the incubation period and procedurally delayed reporting from an earlier study. Kagoshima prefecture, in southern Japan, has several resorts, with an airport commonly used for transportation to Tokyo or Osaka. We regressed R(t) on the number of long-distance domestic travelers (based on the number of airport limousine bus users provided by the operating company), temperature, humidity, mobility, and countermeasures such as state of emergency declarations and the "Go To Travel" campaign in Kagoshima. The study period was June 20, 2020, through February 2021, before variant strains became dominant. A second state of emergency was not declared in Kagoshima prefecture but was declared in major cities such as Tokyo and Osaka. RESULTS Estimation results indicated a pattern of declining infectivity with reduced long-distance domestic travel volumes as measured by the number of airport limousine bus users. Moreover, infectivity was lower during the "Go To Travel" campaign and the second state of emergency. Regarding mobility, going to restaurants, shopping malls, and amusement venues was associated with increased infectivity. However, going to grocery stores and pharmacies was associated with decreased infectivity. Climate conditions showed no significant association with infectivity patterns. CONCLUSIONS The results of this retrospective analysis suggest that the volume of long-distance domestic travel might reduce SARS-CoV-2 infectivity. Infectivity was lower during the "Go To Travel" campaign period, during which long-distance domestic travel was promoted, compared to that outside this campaign period. These findings suggest that policies banning long-distance domestic travel had little legitimacy or rationale. Long-distance domestic travel with appropriate infection control measures might not increase SARS-CoV-2 infectivity in tourist areas. Even though this analysis was performed much later than the study period, if we had performed this study focusing on the period of April or May 2021, it would likely yield the same results. These findings might be helpful for government decision-making in considering restarting a "Go To Travel" campaign in light of evidence-based policy.
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Affiliation(s)
- Junko Kurita
- Department of Nursing, Faculty of Sports & Health Science, Daitobunka University, Higashimatsuyama-shi, Japan
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Guan H, Wang W. Factors Impacting Chinese Older Adults' Intention to Prevent COVID-19 in the Post-COVID-19 Pandemic Era: Survey Study. JMIR Form Res 2024; 8:e53608. [PMID: 38630517 PMCID: PMC11025601 DOI: 10.2196/53608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/21/2023] [Accepted: 01/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Understanding the factors influencing individuals' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of "no longer controlled" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people's decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention. OBJECTIVE This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure. METHODS In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China. RESULTS The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001). CONCLUSIONS This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.
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Affiliation(s)
- Huixin Guan
- USC-SJTU Institute of Cultural and Creative Industry, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Wang
- USC-SJTU Institute of Cultural and Creative Industry, Shanghai Jiao Tong University, Shanghai, China
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García YE, Schmidt AJ, Solis L, Daza-Torres ML, Montesinos-López JC, Pollock BH, Nuño M. Assessing SARS-CoV-2 Testing Adherence in a University Town: Recurrent Event Modeling Analysis. JMIR Public Health Surveill 2024; 10:e48784. [PMID: 38631033 PMCID: PMC11025600 DOI: 10.2196/48784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Healthy Davis Together was a program launched in September 2020 in the city of Davis, California, to mitigate the spread of COVID-19 and facilitate the return to normalcy. The program involved multiple interventions, including free saliva-based asymptomatic testing, targeted communication campaigns, education efforts, and distribution of personal protective equipment, community partnerships, and investments in the local economy. OBJECTIVE This study identified demographic characteristics of individuals that underwent testing and assessed adherence to testing over time in a community pandemic-response program launched in a college town in California, United States. METHODS This study outlines overall testing engagement, identifies demographic characteristics of participants, and evaluates testing participation changes over 4 periods of the COVID-19 pandemic, distinguished by the dominant variants Delta and Omicron. Additionally, a recurrent model is employed to explore testing patterns based on the participants' frequency, timing, and demographic characteristics. RESULTS A total of 770,165 tests were performed between November 18, 2020, and June 30, 2022, among 89,924 (41.1% of total population) residents of Yolo County, with significant participation from racially or ethnically diverse participants and across age groups. Most positive cases (6351 of total) and highest daily participation (895 per 100,000 population) were during the Omicron period. There were some gender and age-related differences in the pattern of recurrent COVID-19 testing. Men were slightly less likely (hazard ratio [HR] 0.969, 95% CI 0.943-0.996) to be retested and more likely (HR 1.104, 95% CI 1.075-1.134) to stop testing altogether than women. People aged between 20 and 34 years were less likely to be retested (HR 0.861, 95% CI 0.828-0.895) and more likely to stop testing altogether (HR 2.617, 95% CI 2.538-2.699). However, older age groups were less likely to stop testing, especially those aged between 65-74 years and 75-84 years, than those aged between 0 and 19 years. The likelihood of stopping testing was lower (HR 0.93, 95% CI 0.889-0.976) for the Asian group and higher for the Hispanic or Latino (HR 1.185, 95% CI 1.148-1.223) and Black or African American (HR 1.198, 95% CI 1.054-1.350) groups than the White group. CONCLUSIONS The unique features of a pandemic response program that supported community-wide access to free asymptomatic testing provide a unique opportunity to evaluate adherence to testing recommendations and testing trends over time. Identification of individual and group-level factors associated with testing behaviors can provide insights for identifying potential areas of improvement in future testing initiatives.
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Affiliation(s)
- Yury E García
- Department of Public Health Sciences, University of California, Davis, CA, United States
| | - Alec J Schmidt
- Department of Public Health Sciences, University of California, Davis, CA, United States
| | - Leslie Solis
- Clinical and Translational Science Center, University of California, Davis, CA, United States
| | - María L Daza-Torres
- Department of Public Health Sciences, University of California, Davis, CA, United States
| | | | - Brad H Pollock
- Department of Public Health Sciences, University of California, Davis, CA, United States
| | - Miriam Nuño
- Department of Public Health Sciences, University of California, Davis, CA, United States
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Kim H, Choi D, Shim H, Sohng KY, Choi MJ. Educational needs of community visiting nurses for infection prevention and control: Application of the Borich needs assessment and the Locus for Focus models. Public Health Nurs 2024. [PMID: 38623869 DOI: 10.1111/phn.13328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES This study aimed to assess the educational needs and analyze the priorities of infection prevention and control (IPC) for community-visiting nurses. DESIGN This is a cross-sectional descriptive study. SAMPLE This study was conducted with 144 visiting nurses working in public health centers and long-term care facilities in South Korea. METHOD A total of 23 questions in five subcategories were used to measure the current knowledge and perceived importance of IPC in community-visiting nursing. Data were collected from June 23 to October 30, 2021, during the COVID-19 pandemic. Data were analyzed paired t-test, the Borich needs assessment, and the Locus for Focus models. RESULTS Top-priority content was defined as content belonging to two models, the first 10 contents of Borich needs assessment and the contents located in the Quadrant I of the Locus for Focus models. "Reporting in case of infection-related accidents," "Mandatory vaccination for visiting nurses," "Standard precaution," "Airborne precaution," "Contact precautions," "Respiratory infection control," and "Post-visit management." CONCLUSIONS This study suggests that it is necessary to provide visiting nurses with more opportunities for IPC education and to develop standardized IPC programs that consider educational priorities.
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Affiliation(s)
- HyungSeon Kim
- Department of Nursing, Bucheon University, Gyeonggi-do, Republic of Korea
| | - Dongwon Choi
- College of Nursing, Incheon Catholic University, Incheon, Republic of Korea
| | - Haeun Shim
- Yonhee Seniors Nursing Home, Seoul, Republic of Korea
| | - Kyeong-Yae Sohng
- Professor Emeritus, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min-Jung Choi
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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Cerqueira FM, Bertsch J, DeMaet MA, York T, McDougal A, Patel JA, Ren P. Enhancing Candida auris Surveillance in High-Risk Settings by Implementing a High-Throughput Molecular Assay on the Hologic Fusion Open Access Platform. J Fungi (Basel) 2024; 10:285. [PMID: 38667956 DOI: 10.3390/jof10040285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/18/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Candida auris, a resilient pathogenic yeast with frequent multidrug resistance, presents a persistent challenge in healthcare settings. The timely identification of C. auris is crucial for infection control and prevention, especially in facilities facing unique hurdles, such as our institution, which serves four major hospitals and approximately 80% of the Texas inmate population. Understaffing, communal living, and financial constraints exacerbate infection control issues. To address common staff shortages, streamline testing services, and enhance testing efficiency, there was a pressing need for rapid and high-throughput detection of C. auris. This study presents the validation and utility of an assay implemented on the Hologic Fusion Open Access platform using samples collected from high-risk patients' axilla and groin areas, as well as environmental swab samples from patient rooms. Our assay complemented efforts to control C. auris outbreaks within our healthcare system, providing valuable insights into its presence within surveillance samples. This assay demonstrated the value of high-throughput molecular detection platforms in challenging healthcare environments by aiding infection preventionists in containing the spread of C. auris and preventing nosocomial infections. Our research contributes essential data on the suitability and performance of the Hologic Fusion Open Access platform for C. auris detection. These findings hold significant implications for enhancing surveillance and control measures in high-risk settings, making a significant impact on the field of infection control and prevention.
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Affiliation(s)
- Filipe M Cerqueira
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Jennifer Bertsch
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Mary Ann DeMaet
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Teresa York
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - April McDougal
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Janak A Patel
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Ping Ren
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Yu C, Yu Y, Lu Y, Quan K, Mao Z, Zheng Y, Qin L, Xia D. UiO-66/AgNPs Coating for Dental Implants in Preventing Bacterial Infections. J Dent Res 2024:220345241229646. [PMID: 38581213 DOI: 10.1177/00220345241229646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024] Open
Abstract
Titanium (Ti)-based biomaterials lack inherent antimicrobial activities, and the dental plaque formed on the implant surface is one of the main risk factors for implant infections. Construction of an antibacterial surface can effectively prevent implant infections and enhance implant success. Silver nanoparticles (AgNPs) exhibit broad antibacterial activity and a low tendency to induce drug resistance, but AgNPs easily self-aggregate in the aqueous environment, which significantly impairs their antibacterial activity. In this study, UiO-66/AgNP (U/A) nanocomposite was prepared, where zirconium metal-organic frameworks (UiO-66) were employed as the confinement matrix to control the particle size and prevent aggregation of AgNPs. The bactericidal activity of U/A against methicillin-resistant Staphylococcus aureus and Escherichia coli increased nearly 75.51 and 484.50 times compared with individually synthesized Ag. The antibacterial mechanism can be attributed to the enhanced membrane rupture caused by the ultrafine AgNPs on UiO-66, leading to protein leakage and generation of intracellular reactive oxygen species. Then, U/A was loaded onto Ti substrates (Ti-U/A) by using self-assembly deposition methods to construct an antibacterial surface coating. Ti-U/A exhibited excellent antibacterial activities and desired biocompatibility both in vitro and in vivo. The U/A nanocomposite coating technique is thus expected to be used as a promising surface modification strategy for Ti-based dental implants for preventing dental implant infections.
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Affiliation(s)
- C Yu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, China
- School of Environmental and Material Engineering, Yantai University, Yantai, Shandong, China
- School of Materials Science and Engineering, Peking University, Beijing, China
| | - Y Yu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Y Lu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - K Quan
- School of Materials Science and Engineering, Peking University, Beijing, China
| | - Z Mao
- School of Materials Science and Engineering, Peking University, Beijing, China
| | - Y Zheng
- School of Materials Science and Engineering, Peking University, Beijing, China
| | - L Qin
- School of Environmental and Material Engineering, Yantai University, Yantai, Shandong, China
| | - D Xia
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
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Różańska A, Baranowska-Tateno K, Pac A, Gajda M, Wójkowska-Mach J. Post-discharge surveillance of urinary tract infections in patients following hip and knee arthroplasty: identifying targets for infection prevention and control. Am J Infect Control 2024:S0196-6553(24)00165-2. [PMID: 38583774 DOI: 10.1016/j.ajic.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/09/2024]
Abstract
This population-based study aimed to evaluate the incidence of urinary tract infections (UTIs) following hip and knee arthroplasty (HPRO and KPRO) and to identify UTI risk factors among Polish patients. Analysis included data from 83,525 patients, with incidence rates of 0.7% and 0.49% after HPRO and KPRO, respectively. We identified women, individuals over 65 years old, residents of long-term care facilities, patients with chronic circulatory, endocrine, or digestive diseases, and those operated on due to trauma as targets for infection prevention and control.
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Affiliation(s)
- Anna Różańska
- Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Kraków, Poland
| | - Katarzyna Baranowska-Tateno
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Kraków, Poland.
| | - Agnieszka Pac
- Chair in Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Kraków, Poland
| | - Mateusz Gajda
- Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Kraków, Poland
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Boyanton BL, Frenner RA, Ingold A, Ambroggio L, Kennedy JL. SARS-CoV-2 pandemic non-pharmacologic interventions temporally associated with reduced pediatric infections due to Mycoplasma pneumoniae and co-infecting respiratory viruses in Arkansas. Microbiol Spectr 2024; 12:e0290823. [PMID: 38488365 DOI: 10.1128/spectrum.02908-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024] Open
Abstract
Non-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study evaluated the impact of NPIs on Mycoplasma pneumoniae infections in children, analyzing data from two hospitals in Arkansas and examining age-related differences and co-infections with other respiratory viruses. The study was approved by the Institutional Review Board and included patients (≤18 years) with upper respiratory tract symptoms. Data generated from the FilmArray Respiratory Panel were divided into pre-NPI, NPI, and post-NPI periods for analysis. Overall test positivity rate and positivity rate interval changes were evaluated. Statistical differences were determined by Chi-square (χ2 independence) analysis. A total of 100,077 tests were performed, with a statistical increase in testing volume during the NPI and post-NPI periods. The number of positive M. pneumoniae tests decreased by 77% (77 to 18) during the NPI period, then increased by 50% (18 to 27) during the post-NPI period. Preschool and elementary school age groups had the highest number of positive tests during the study at 59 (48%) and 40 (33%), respectively. Reduced M. pneumoniae infections were consistent across age groups. Co-infections with other respiratory viruses, particularly human rhinovirus/enterovirus, were observed at much lower levels. Pediatric M. pneumoniae infections in Arkansas were temporally associated with implementation and discontinuation of NPIs. Specific viral co-infections still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. Because of the slower growth of this bacterium, we expect M. pneumoniae infections to return to pre-pandemic levels within approximately 2 years. IMPORTANCE Non-pharmacologic interventions (NPIs) effectively curtailed the spread of SARS-CoV-2 and, fortuitously, many other aerosol-transmitted respiratory pathogens. This study included the largest data set of symptomatic, pediatric patients from within the United States spanning a period from November 2017 through December 2023, and encompassed individuals residing in both rural and urban settings. We observed a strong correlation between the implementation and cessation of NPIs with the rate of respiratory infections due to Mycoplasma pneumoniae and viral co-infections. These infections are returning to baseline levels approximately 2 years following NPI cessation. This observation was not unexpected since the replication time for viruses is exponentially faster than that of bacteria. The resurgence of M. pneumoniae and likely other atypical bacterial pathogens is currently in process. Healthcare providers should strongly consider these pathogens in individuals presenting with respiratory tract illnesses.
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Affiliation(s)
- Bobby L Boyanton
- Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Rachel A Frenner
- Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Ashton Ingold
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Lilliam Ambroggio
- Sections of Emergency Medicine and Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Joshua L Kennedy
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Departments of Pediatrics and Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Ishida T, Hayashi Y, Nose Y, Goto K, Ishii Y, Saito T, Yamashita K, Tanaka K, Yamamoto K, Makino T, Takahashi T, Kurokawa Y, Eguchi H, Doki Y, Nakajima K. Development of a new gastrointestinal endoscope forceps plug that can minimize gas leakage. DEN Open 2024; 4:e268. [PMID: 37397345 PMCID: PMC10309177 DOI: 10.1002/deo2.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/04/2023]
Abstract
Background and aims In our previous study, we visualized and systematically evaluated gas leakage from the forceps plug of the gastrointestinal endoscope system using the Schlieren system. In order to minimize the potential risk of infection from gas leakage from the gastrointestinal endoscope, the development of a new forceps plug was considered urgent. In this study, we analyzed the structure of commercially available forceps plugs and attempted to develop new forceps plugs with improvements. Methods Microfocus computed tomography was used to nondestructively analyze the structural changes that occur when forceps are inserted into a commercially available forceps plug. Based on the findings, the basic structure of the newly developed forceps plug was set. We examined the airtightness of these newly developed plugs using the Schlieren system and also compared their fractional resistance with those of commercially available plugs. Results As a result of the nondestructive analysis, all of the commercially available plugs had a single valve, and the cleavage created in the valve during forceps, insertion was large in the case of plugs with slit-type entrances. In the newly developed forceps plugs, all four types of plugs showed less gas leakage and similar or better usability compared to the commercially available plugs. Conclusions The structural weaknesses of the existing gastrointestinal endoscopic forceps plugs were identified. Based on the findings, we froze the design of a prototype of a new forceps plug that was airtight and not inferior in usability compared to commercially available plugs.
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Affiliation(s)
- Tomo Ishida
- Department of Next Generation Endoscopic Intervention (Project ENGINE)Osaka University Graduate School of MedicineOsakaJapan
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Yoshinori Hayashi
- Department of Next Generation Endoscopic Intervention (Project ENGINE)Osaka University Graduate School of MedicineOsakaJapan
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Yohei Nose
- Department of Next Generation Endoscopic Intervention (Project ENGINE)Osaka University Graduate School of MedicineOsakaJapan
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Kohei Goto
- Department of Endoscope‐related Products, Sales DivisionTOP CorporationTokyoJapan
| | - Yuji Ishii
- Medical and Welfare Development DivisionCastem CorporationHiroshimaJapan
| | - Takuro Saito
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Kotarou Yamashita
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Koji Tanaka
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Kazuyoshi Yamamoto
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Tomoki Makino
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Tsuyoshi Takahashi
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Yukinori Kurokawa
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Hidetoshi Eguchi
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Yuichiro Doki
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Kiyokazu Nakajima
- Department of Next Generation Endoscopic Intervention (Project ENGINE)Osaka University Graduate School of MedicineOsakaJapan
- Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
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Leon BR, Lubitz RM, Landsberger SA, Buckingham HD, Hiday RA, Bradner KN, Adaniya CH. Safety of Prolonged Exposure of Human Skin to Aqueous Ozone in a Test Hand Hygiene Model. Skin Res Technol 2024; 30:e13675. [PMID: 38558144 PMCID: PMC10982670 DOI: 10.1111/srt.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
AIMS This research assessed the safety of aqueous ozone (AO) on human skin after multiple exposures for up to 40 hours. METHODS AND RESULTS Full thickness recombinant human skin (EpiDerm FT, EFT-400) was exposed to AO for 7 seconds per minute for the first 6 minutes of each hour, repeated hourly over four time periods (4, 10, 20 and 40 hours). An MTT assay assessed viability of skin cells after exposure, compared to incubator control, negative control and vehicle control (distilled water). No significant difference in tissue viability was found between the AO condition and any of the control conditions through 20 hours of exposures. At 40 hours of exposure, tissue viability was lower in the AO group when compared with negative control (p = 0.030) but not the other controls. CONCLUSIONS The current study supports further consideration of repeated application of AO on human skin, such as for hand hygiene. IMPACT STATEMENT The present research is the first well-controlled in vitro study assessing the cytotoxicity of repeated exposures of AO on a full-thickness human skin model. This information helps to inform the evaluation of AO as a potential alternative for hand and wound antisepsis.
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Affiliation(s)
- Brian R. Leon
- School of MedicineIndiana UniversityIndianapolisIndianaUSA
| | | | | | - Hannah D. Buckingham
- John Sealy School of MedicineUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Rachael A. Hiday
- School of MedicineIndiana UniversityIndianapolisIndianaUSA
- Academic Health Center PharmacyIndiana University HealthIndianapolisIndianaUSA
| | - K. Nicole Bradner
- Academic Health Center PharmacyIndiana University HealthIndianapolisIndianaUSA
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Nose Y, Kato M, Aoyagi S, Akeo K, Yamashita K, Saito T, Tanaka K, Yamamoto K, Makino T, Takahashi T, Kurokawa Y, Eguchi H, Doki Y, Nakajima K. Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness. DEN Open 2024; 4:e367. [PMID: 38605997 PMCID: PMC11007223 DOI: 10.1002/deo2.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Objectives Flexible endoscopy does not have a system that can automatically evacuate surgical smoke generated in the gastrointestinal lumen. We aimed to investigate the feasibility and potential usefulness of automatic smoke evacuation systems in flexible endoscopy. Methods [Bench] After surgical smoke generated in the stomach was evacuated by the evacuator, the degree of residual smoke and gastric luminal collapse were evaluated to optimize the evacuator settings. [Animal] Insufflation, suction, and total operation time to complete the protocol of 10 cauterizations of the gastric mucosa were measured in three groups: "manual suction only," "manual suction with automatic evacuation (50% force)," and "manual suction with automatic evacuation (70% force)." The stability of endoscopic visualization and operability was evaluated by 10 endoscopists blinded to those suction settings, and the number of manual suctions, insufflations, and total operation time were measured. Results [Bench] The degree of residual smoke and gastric luminal collapse were inversely correlated. [Animal] When the automatic evacuator was partially used, there was no difference in the insufflation time, but the suction time (vs 50%; p = 0.011, vs. 70%; p = 0.011) and total operation time (vs. 50%; p = 0.012, vs. 70%; p = 0.036) were significantly reduced compared to manual operation only. Furthermore, manual suction with automatic evacuation (50% force) significantly improved the stability of endoscopic visualization and operability compared to manual operation only (p = 0.041, p = 0.0085). Conclusions The automatic smoke evacuation in flexible gastrointestinal endoscopy was potentially feasible and useful by improving the device setting.
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Affiliation(s)
- Yohei Nose
- Department of Next Generation Endoscopic Intervention (Project ENGINE)Graduate School of Medicine, Osaka UniversityOsakaJapan
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Motohiko Kato
- Center for Diagnostic and Therapeutic EndoscopyKeio University School of MedicineTokyoJapan
| | | | | | - Kotaro Yamashita
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Takuro Saito
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Koji Tanaka
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Kazuyoshi Yamamoto
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Tomoki Makino
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Tsuyoshi Takahashi
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Yukinori Kurokawa
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Hidetoshi Eguchi
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Yuichiro Doki
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
| | - Kiyokazu Nakajima
- Department of Next Generation Endoscopic Intervention (Project ENGINE)Graduate School of Medicine, Osaka UniversityOsakaJapan
- Department of Gastroenterological SurgeryGraduate School of Medicine Osaka UniversityOsakaJapan
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16
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Fukutoku Y, Kikuchi H, Hoshi K, Narita K, Asari T, Miyazawa K, Sawada Y, Hayamizu S, Tatsuta T, Oota S, Hasui K, Hiraga H, Chinda D, Mikami T, Subsomwong P, Asano K, Yamane K, Ogawa Y, Sasaki M, Koi T, Ohashi H, Nakane A, Sakuraba H. The new 222-nm far ultraviolet-C lowers bacterial contamination to endoscopists during esophagogastroduodenoscopy. DEN Open 2024; 4:e292. [PMID: 37711643 PMCID: PMC10497812 DOI: 10.1002/deo2.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 09/16/2023]
Abstract
Objectives This study aimed to clarify the disinfectant efficacy of the 222-nm far ultraviolet-C (UV-C) during esophagogastroduodenoscopy using bacterial cultures. Methods The endoscopists performed esophagogastroduodenoscopy wearing a gown with a tryptic soy agar medium plate on their epigastric region and were divided into two groups: 222-nm far UV-C irradiation (UV group) and non-UV irradiation (non-UV group). As a control group, tryptic soy agar medium plates were placed about 110 cm above the floor. The incidence of bacterial contamination was determined by positive bacterial culture. The cultured bacteria were identified by 16S rRNA sequencing. Additionally, the actual UV exposure dose was measured using the UV-indicator card which changed colors upon exposure to 222 nm far UV-C. Results The bacterial culture positivity in the UV group (5.03%) was significantly lower than that in the non-UV group (25.76%), p < 0.0001. Most of the bacteria identified in the UV and non-UV groups were normal constituents of the oral flora, including Streptococcus salivarius and Staphylococci. Conversely, pathogenic microbes were found in the control group. The actual exposure doses of 222-nm far UV-C at the endoscopists' face, neck, and epigastric region were 2.09 ± 0.29, 5.89 ± 0.49, and 7.36 ± 0.58 mJ/cm2, respectively. Conclusions The 222-nm far UV-C irradiation reduced bacterial contamination for endoscopists. It can be used with conventional physical coverings to provide more effective infection control.
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Affiliation(s)
- Yukari Fukutoku
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Hidezumi Kikuchi
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
- Department of Community MedicineHirosaki University Graduate School of MedicineAomoriJapan
| | - Kentaro Hoshi
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Kouji Narita
- Department of Microbiology and ImmunologyHirosaki University Graduate School of MedicineAomoriJapan
- Institute for Animal ExperimentationHirosaki University Graduate School of MedicineAomoriJapan
| | - Taka Asari
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Kuniaki Miyazawa
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Yohei Sawada
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Shiro Hayamizu
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Tetsuya Tatsuta
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Shinji Oota
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Keisuke Hasui
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Hiroto Hiraga
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Daisuke Chinda
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Tatsuya Mikami
- Department of Preemptive MedicineHirosaki University Graduate School of MedicineAomoriJapan
| | - Phawinee Subsomwong
- Department of Microbiology and ImmunologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Krisana Asano
- Department of Microbiology and ImmunologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Kyosuke Yamane
- Healthy Life Support Department, Marketing Division, Business Creation Division, Corporate HeadquartersUshio Inc.TokyoJapan
| | - Yoshimasa Ogawa
- Healthy Life Support Department, Marketing Division, Business Creation Division, Corporate HeadquartersUshio Inc.TokyoJapan
| | - Masahiro Sasaki
- Healthy Life Support Department, Marketing Division, Business Creation Division, Corporate HeadquartersUshio Inc.TokyoJapan
| | - Toru Koi
- Healthy Life Support Department, Marketing Division, Business Creation Division, Corporate HeadquartersUshio Inc.TokyoJapan
| | - Hiroyuki Ohashi
- Healthy Life Support Department, Marketing Division, Business Creation Division, Corporate HeadquartersUshio Inc.TokyoJapan
| | - Akio Nakane
- Department of Biopolymer and Health ScienceHirosaki University Graduate School of MedicineAomoriJapan
| | - Hirotake Sakuraba
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineAomoriJapan
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17
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Helset E, Cheng V, Sporsem H, Thorstensen C, Nordøy I, Gammelsrud KW, Hanssen G, Ponzi E, Lipman J, von der Lippe E. Meropenem pharmacokinetic/pharmacodynamic target attainment and clinical response in ICU patients: A prospective observational study. Acta Anaesthesiol Scand 2024; 68:502-511. [PMID: 38286568 DOI: 10.1111/aas.14376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/09/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Several studies report lack of meropenem pharmacokinetic/pharmacodynamic (PK/PD) target attainment (TA) and risk of therapeutic failure with intermittent bolus infusions in intensive care unit (ICU) patients. The aim of this study was to describe meropenem TA in an ICU population and the clinical response in the first 72 h after therapy initiation. METHODS A prospective observational study of ICU patients ≥18 years was conducted from 2014 to 2017. Patients with normal renal clearance (NRC) and augmented renal clearance (ARC) and patients on continuous renal replacement therapy (CRRT) were included. Meropenem was administered as intermittent bolus infusions, mainly at a dose of 1 g q6h. Peak, mid, and trough levels were sampled at 24, 48, and 72 h after therapy initiation. TA was defined as 100% T > 4× MIC or trough concentration above 4× MIC. Meropenem PK was estimated using traditional calculation methods and population pharmacokinetic modeling (P-metrics®). Clinical response was evaluated by change in C-reactive protein (CRP), Sequential Organ Failure Assessment (SOFA) score, leukocyte count, and defervescence. RESULTS Eighty-seven patients were included, with a median Simplified Acute Physiology (SAPS) II score 37 and 90 days mortality rate of 32%. Median TA was 100% for all groups except for the ARC group with 45.5%. Median CRP fell from 175 (interquartile range [IQR], 88-257) to 70 (IQR, 30-114) (p < .001) in the total population. A reduction in SOFA score was observed only in the non-CRRT groups (p < .001). CONCLUSION Intermittent meropenem bolus infusion q6h gives satisfactory TA in an ICU population with variable renal function and CRRT modality, except for ARC patients. No consistent relationship between TA and clinical endpoints were observed.
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Affiliation(s)
- Elin Helset
- Division of Emergencies and Critical care, Oslo University Hospital, Oslo, Norway
| | - Vesa Cheng
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | | | | | - Ingvild Nordøy
- Section for Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Karianne Wiger Gammelsrud
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gorm Hanssen
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Erica Ponzi
- Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jeffrey Lipman
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
- Scientific Consultant, Nimes University Hospital, University of Montpellier, Nimes, France
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Sun S, Jiang G, Dong J, Xie X, Liao J, Tian Y. Photothermal hydrogels for infection control and tissue regeneration. Front Bioeng Biotechnol 2024; 12:1389327. [PMID: 38605983 PMCID: PMC11007110 DOI: 10.3389/fbioe.2024.1389327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
In this review, we report investigating photothermal hydrogels, innovative biomedical materials designed for infection control and tissue regeneration. These hydrogels exhibit responsiveness to near-infrared (NIR) stimulation, altering their structure and properties, which is pivotal for medical applications. Photothermal hydrogels have emerged as a significant advancement in medical materials, harnessing photothermal agents (PTAs) to respond to NIR light. This responsiveness is crucial for controlling infections and promoting tissue healing. We discuss three construction methods for preparing photothermal hydrogels, emphasizing their design and synthesis, which incorporate PTAs to achieve the desired photothermal effects. The application of these hydrogels demonstrates enhanced infection control and tissue regeneration, supported by their unique photothermal properties. Although research progress in photothermal hydrogels is promising, challenges remain. We address these issues and explore future directions to enhance their therapeutic potential.
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Affiliation(s)
- Siyu Sun
- College of Biomass Science and Engineering, Sichuan University, Chengdu, China
| | - Guangyang Jiang
- College of Biomass Science and Engineering, Sichuan University, Chengdu, China
| | - Jianru Dong
- College of Biomass Science and Engineering, Sichuan University, Chengdu, China
| | - Xi Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinfeng Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yongqiang Tian
- College of Biomass Science and Engineering, Sichuan University, Chengdu, China
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19
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Preest E, Greenhalgh T, Farrier C, van der Westhuizen HM. Children's experiences of mask-wearing: a systemic review and narrative synthesis. J Eval Clin Pract 2024. [PMID: 38534010 DOI: 10.1111/jep.13982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
RATIONALE Masks have been widely used as a preventative tool during the COVID-19 pandemic. However, the use of masks by children has been controversial, with international guidelines recommending a risk-based approach to national policymakers. AIMS AND OBJECTIVES We aimed to conduct a systematic review that explores children's experiences of mask-wearing, drawing on an evidence base that describes mask-wearing in different contexts including air pollution, and to prevent the spread of infectious disease. METHODS We searched MEDLINE, Embase and PsycINFO in June 2021, with repeat searches in August 2022 and January 2024, for primary research studies exploring children's experiences of masks. Included studies reported on participants between 4 and 14 years (inclusive), with no restrictions on language where an English translation was available. Two reviewers independently screened titles and abstracts and reviewed full texts, with discrepancies resolved by a third reviewer. We used the Mixed Methods Appraisal Tool for quality appraisal and narrative synthesis to identify key findings. We also conducted stakeholder consultation (Patient and Public Involvement (PPI)) with nine children, where they submitted annotated drawings of their preferred masks to complement our review findings. RESULTS We screened 982 titles and abstracts and reviewed 94 full texts. 45 studies were included in the synthesis. Children's experiences of mask-wearing were influenced by their perceived necessity, social norms around their use and parental attitudes. Challenges related to mask-wearing were described, including difficulty reading facial expressions and physical discomfort. Children found it easier to wear masks when sitting and in cooler environments, and they benefited from unmasking during outdoor break time at school. As part of the PPI consultation, children highlighted the importance of mask design and the environmental impact of masks. CONCLUSION Children's experiences of mask-wearing were varied and context-dependent, with several mask-design challenges raised. Future policy on mask-wearing needs to consider the context in which mask-wearing would be most beneficial, and how local adaptations to policy can respond to children's needs.
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Affiliation(s)
- Elin Preest
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Christian Farrier
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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20
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Chien YS, Chen HT, Chiang HT, Luo TS, Yeh HI, Sheu JC, Li JY. Effect of Standardized Bundle Care and Bundle Compliance on Reducing Surgical Site Infections: A Pragmatic Retrospective Cohort Study. Med Sci Monit 2024; 30:e943493. [PMID: 38523334 PMCID: PMC10979649 DOI: 10.12659/msm.943493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/14/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Care bundles for infection control consist of a set of evidence-based measures to prevent infections. This retrospective study aimed to compare surgical site infections (SSIs) from a single hospital surveillance system between 2017 and 2020, before and after implementing a standardized care bundle across specialties in 2019. It also aimed to assess whether bundle compliance affects the rate of SSIs. MATERIAL AND METHODS A care bundle consisting of 4 components (peri-operative antibiotics use, peri-operative glycemic control, pre-operative skin preparation, and maintaining intra-operative body temperature) was launched in 2019. We compared the incidence rates of SSIs, standardized infection ratio (SIR), and clinical outcomes of surgical procedures enrolled in the surveillance system before and after introducing the bundle care. The level of bundle compliance, defined as the number of fully implemented bundle components, was evaluated. RESULTS We included 6059 procedures, with 2010 in the pre-bundle group and 4049 in the post-bundle group. Incidence rates of SSIs (1.7% vs 1.0%, P=0.013) and SIR (0.8 vs 1.48, P<0.01) were significantly lower in the post-bundle group. The incidence of SSIs was significantly lower when all bundle components were fully adhered to, compared with when only half of the components were adhered to (0.3% vs 4.0%, P<0.01). CONCLUSIONS SSIs decreased significantly after the application of a standardized care bundle for surgical procedures across specialties. Full adherence to all bundle components was the key to effectively reducing the risk of surgical site infections.
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Affiliation(s)
- Yu-san Chien
- Department of Critical Care, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of Medicine, Mackay Medical College, Taipei City, Taiwan
| | - Hsiang-ting Chen
- Department of Medical Quality, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Hsiu-tzy Chiang
- Infection Control Center, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Tz-shin Luo
- Department of Cardiovascular Surgery, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Hung-i Yeh
- Department of Internal Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Jin-Cherng Sheu
- Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Jiun-yi Li
- Department of Medicine, Mackay Medical College, Taipei City, Taiwan
- Department of Medical Quality, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of Cardiovascular Surgery, Mackay Memorial Hospital, Taipei City, Taiwan
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Zendri F, Schmidt V, Mauder N, Loeffler A, Jepson RE, Isgren C, Pinchbeck G, Haldenby S, Timofte D. Corrigendum: Rapid typing of Klebsiella pneumoniae and Pseudomonas aeruginosa by Fourier-transform Infrared spectroscopy informs infection control in veterinary settings. Front Microbiol 2024; 15:1396367. [PMID: 38572239 PMCID: PMC10987953 DOI: 10.3389/fmicb.2024.1396367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fmicb.2024.1334268.].
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Affiliation(s)
- Flavia Zendri
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Vanessa Schmidt
- Department of Small Animal Clinical Science, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | | | - Anette Loeffler
- Department of Clinical Science and Services, Royal Veterinary College Hawkshead Campus, Hatfield, Hertfordshire, United Kingdom
| | - Rosanne Ellen Jepson
- Department of Clinical Science and Services, Royal Veterinary College Hawkshead Campus, Hatfield, Hertfordshire, United Kingdom
| | - Cajsa Isgren
- Western Counties Equine Hospital Ltd., Culmstock, United Kingdom
| | - Gina Pinchbeck
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Sam Haldenby
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Dorina Timofte
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
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22
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Ribeiro AB, Pizziolo PG, Clemente LM, Aguiar HC, Poker BDC, Silva AAME, Makrakis LR, Fifolato MA, Souza GC, Oliveira VDC, Watanabe E, Lovato da Silva CH. Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review. Antibiotics (Basel) 2024; 13:273. [PMID: 38534708 DOI: 10.3390/antibiotics13030273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/01/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Pillar Gonçalves Pizziolo
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Helena Cristina Aguiar
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Beatriz de Camargo Poker
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Arthur Augusto Martins E Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Laís Ranieri Makrakis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Marco Aurelio Fifolato
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Giulia Cristina Souza
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Cláudia Helena Lovato da Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
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23
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Kirnon S. The role of decontamination in reducing healthcare-associated infections. Nurs Stand 2024:e12302. [PMID: 38462981 DOI: 10.7748/ns.2024.e12302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 03/12/2024]
Abstract
Effective decontamination is a vital aspect of infection prevention and control, and has a crucial role in reducing healthcare-associated infections (HCAIs). Various decontamination methods can be used in healthcare settings to ensure that medical devices, equipment and the clinical environment are safe. It is essential for nurses and other healthcare staff to have adequate knowledge of the decontamination methods and infection prevention and control practices required to prevent HCAIs. This article discusses the most common HCAIs, decontamination methods that can be used, and relevant UK legislation, policies and guidance. It also outlines nurses' responsibilities in relation to infection prevention and control and the importance of education and training in this area, with a particular focus on integrating human factors.
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Affiliation(s)
- Shirley Kirnon
- College of Nursing and Midwifery, Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, England
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24
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Langford BJ, Branch-Elliman W, Nori P, Marra AR, Bearman G. Confronting the Disruption of the Infectious Diseases Workforce by Artificial Intelligence: What This Means for Us and What We Can Do About It. Open Forum Infect Dis 2024; 11:ofae053. [PMID: 38434616 PMCID: PMC10906702 DOI: 10.1093/ofid/ofae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
With the rapid advancement of artificial intelligence (AI), the field of infectious diseases (ID) faces both innovation and disruption. AI and its subfields including machine learning, deep learning, and large language models can support ID clinicians' decision making and streamline their workflow. AI models may help ensure earlier detection of disease, more personalized empiric treatment recommendations, and allocation of human resources to support higher-yield antimicrobial stewardship and infection prevention strategies. AI is unlikely to replace the role of ID experts, but could instead augment it. However, its limitations will need to be carefully addressed and mitigated to ensure safe and effective implementation. ID experts can be engaged in AI implementation by participating in training and education, identifying use cases for AI to help improve patient care, designing, validating and evaluating algorithms, and continuing to advocate for their vital role in patient care.
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Affiliation(s)
- Bradley J Langford
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Hotel Dieu Shaver Health and Rehabilitation Centre, Department of Pharmacy, St Catharines, Ontario, Canada
| | - Westyn Branch-Elliman
- Department of Medicine, Section of Infectious Diseases, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
- National Artificial Intelligence Institute, Department of Veterans Affairs, Washington, District of Columbia, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Priya Nori
- Division of Infectious Diseases, Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Alexandre R Marra
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Gonzalo Bearman
- Division of Infectious Diseases, Virginia Commonwealth University Health, Virginia Commonwealth University, Richmond, Virginia, USA
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25
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Mutsonziwa GA, Mojab M, Katuwal M, Glew P. Influences of healthcare workers' behaviours towards infection prevention and control practices in the clinical setting: A systematic review. Nurs Open 2024; 11:e2132. [PMID: 38488425 PMCID: PMC10941556 DOI: 10.1002/nop2.2132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024] Open
Abstract
AIM To systematically evaluate empirical studies investigating the influences of healthcare workers' behaviours towards infection prevention and control practices in the Coronavirus clinical space, and to appraise and synthesise these findings. DESIGN A systematic review of the literature. METHODS The review used a five-step framework described by Khan et al. (Journal of the Royal Society of Medicine, 2003, 96 and 118) of Framing questions for a review; Identifying relevant work; Assessing the quality of studies; Summarising the evidence; and Interpreting the findings. Searches were conducted in CINHAL, MEDLINE, PsychINFO, Scopus, and Google Scholar databases to retrieve relevant peer-reviewed literature published in English between 2019 and 2023. Covidence and Joanna Briggs Quality appraisal tools were used for critical assessment. To improve transparent reporting, this review used a Synthesis Without Meta-analysis (SWiM) in systematic review guidelines, as informed by Campbell et al. (BMJ, 2020, 368). RESULTS Twenty studies were included in this review, identifying nine themes describing factors influencing HCWs' behaviours towards IPC practices in the coronavirus environment. The overarching influences emerged as knowledge-oriented, person-oriented, and environment-oriented. CONCLUSION Healthcare workers' responsibilities at point-of-care involve providing direct care to patients with highly transmissible infections and working in clinical settings that may be ill-designed for IPC practices, increasing the risk of transmission. Given the lack of a definitive solution to eradicate new mutant viruses and that IPC practices are the mainstay of prevention and control of transmissible, measures to improve are imperative. The identified HCWs' domains on behaviours towards IPC are critical in strategies to mitigate risks and further set an opportunity for developing an IPC model congruent with the rapid response required for HCWs during emerging or re-merging mutant virus outbreaks. This is significant, given that HCWs' preparedness with IPC practices at point-of-care is central to patient care, the workforce and community safety.
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Affiliation(s)
- Gift A. Mutsonziwa
- School of Nursing & MidwiferyWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Marwa Mojab
- Western Sydney UniversitySydneyNew South WalesAustralia
| | - Megha Katuwal
- Western Sydney UniversitySydneyNew South WalesAustralia
| | - Paul Glew
- Western Sydney UniversitySydneyNew South WalesAustralia
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26
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Mohammed Al-Aamri HH, Nair AS, Al Sawafi KM, Al Sharji I, Al Jabri A. Influence of surgical scrubs outside the operation theatre on post-operative infections - A systematic review. Indian J Anaesth 2024; 68:223-230. [PMID: 38476545 PMCID: PMC10926332 DOI: 10.4103/ija.ija_949_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 03/14/2024] Open
Abstract
Background and Aims Healthcare workers (HCWs), which include surgeons, anaesthesiologists, nurses, technicians, and other non-medical staff working in the operation theatre (OT), change to surgical scrubs for providing designated services. This study was intended to investigate the association of moving in and out of OT to other hospital areas without changing scrubs and its impact on bacterial infection. Methods After PROSPERO registration, we performed a systematic review to compare the occurrence of surgical site infections (SSIs) with or without the movement of HCWs outside OT. We searched PubMed, Scopus, and Cochrane Library using relevant keywords. RoB-2 and ROBINS-E tools were used to assess the risk of bias in randomised controlled trials (RCTs) and observational studies, respectively. Results We identified six articles that fulfilled the inclusion criteria: three RCTs and three observational studies. A risk of bias assessment revealed an overall low bias in the RCTs and an overall high bias in the observational studies. The analysis revealed a comparable incidence of bacterial infection in terms of colony-forming units when scrubs when HCWs moved in and out of OT with the same scrubs. A meta-analysis was not performed due to heterogeneity in participants and the OT set-up, as well as fewer studies and sample size. Conclusion The evidence is insufficient to suggest that wearing scrubs outside the OT could increase the incidence of SSI in surgical patients or transmit the organisms to patients, causing infection. The present review neither supports nor is against wearing surgical scrubs outside OT premises.
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Affiliation(s)
| | - Abhijit S. Nair
- Department of Anesthesiology, Ibra Hospital, Ministry of Health-Oman, Ibra-414, Sultanate of Oman
| | - Khalid M. Al Sawafi
- Department of Hospital Administration, North Sharqiya Governorate, Ibra-414, Sultanate of Oman
| | - Issa Al Sharji
- Department of Nursing, Ibra Hospital, Ministry of Health-Oman, Ibra-414, Sultanate of Oman
| | - Ahmed Al Jabri
- Department of Accident and Emergency Medicine, Ibra Hospital, Ministry of Health-Oman, Ibra-414, Sultanate of Oman
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27
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Dobrina R, Donati D, Giangreco M, De Benedictis A, Schreiber S, Bicego L, Scarsini S, Buchini S, Kwok SWH, Lam SC. Nurses' compliance to standard precautions prior to and during COVID-19. Int Nurs Rev 2024; 71:20-27. [PMID: 36696268 DOI: 10.1111/inr.12830] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/31/2022] [Indexed: 01/26/2023]
Abstract
AIMS To measure nurses' compliance with standard precautions during the COVID-19 pandemic, compare findings with previous assessments and describe the barriers affecting nurses' compliance. BACKGROUND Healthcare providers' compliance with standard precautions is still limited worldwide. Implementation of infection control policies in hospitals is needed internationally, especially during a pandemic. Surprisingly, studies exploring nurses' compliance with standard precautions are lacking during COVID-19. METHODS A multicenter cross-sectional study was adopted in two Italian hospitals. Nurses' compliance with standard precautions was measured through The Compliance with Standard Precautions Scale (Italian version). An open-ended question explored the barriers to nurses' compliance with standard precautions. Reporting, followed the STROBE guidelines. RESULTS A total of 201 nurses were enrolled in 2020. Nurses' compliance with standard precautions was suboptimal. A statistically significant improvement in the compliance rate with standard precautions was observed between pre- and during COVID-19 assessments. High compliance was found in the appropriate use of surgical masks, gloves and sharps disposal. Nurses perceived personal, structural and organizational barriers to standard precautions adherence. CONCLUSION Nurses' compliance with standard precautions was not 100%, and different factors impeded nurses to work safely. Our findings provide institutional leaders and educators with the basis for implementing policies to optimize nurse safety, well-being and patient care. IMPLICATIONS FOR NURSING AND HEALTH POLICIES Nurses have the right to work safely, and when the shortage of personal protective equipment and nurses during an emergency threatens healthcare quality worldwide, policymakers are challenged to act by establishing an effective allocation of resources for consistent compliance with standard precautions. Moreover, nurses should actively engage in the implementation of infection control policies to improve safe behaviours among citizens and students accessing hospitals.
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Affiliation(s)
- Raffaella Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', via dell'Istria 65/1, Trieste, Italy
| | - Daniele Donati
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 200, Rome, Italy
| | - Manuela Giangreco
- Clinical Epidemiology and Public Health Research Unit Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', via dell'Istria 65/1, Trieste, Italy
| | - Anna De Benedictis
- Healthcare Professions Department, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 200 Rome, Rome, Italy
| | - Silvana Schreiber
- Healthcare Professions Department, Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', via dell'Istria 65/1, Trieste, Italy
| | - Livia Bicego
- Healthcare Professions Department, Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', via dell'Istria 65/1, Trieste, Italy
| | - Sara Scarsini
- Healthcare Department, Azienda Sanitaria Universitaria 'Friuli Centrale', via Pozzuolo 330, Udine, Italy
| | - Sara Buchini
- Healthcare Professions Department, Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', via dell'Istria 65/1, Trieste, Italy
| | - Stephen Wai Hang Kwok
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong S.A.R., China
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28
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Gadbois EA, Brazier JF, White EM, Hawes C, Meehan A, Rafat A, Geng F, Rahman M, Grabowski DC, Shield RR. Caring for nursing home residents with dementia during the COVID-19 pandemic: Perspectives from administrators. J Am Geriatr Soc 2024; 72:935-941. [PMID: 37823457 DOI: 10.1111/jgs.18634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/08/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023]
Abstract
See related Editorial by Unroe and Towsley in this issue.
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Affiliation(s)
- Emily A Gadbois
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Joan F Brazier
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Elizabeth M White
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Courtney Hawes
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Amy Meehan
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Aseel Rafat
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Fangli Geng
- Harvard Medical School, Boston, Massachusetts, USA
| | - Momotazur Rahman
- Brown University School of Public Health, Providence, Rhode Island, USA
| | | | - Renee R Shield
- Brown University School of Public Health, Providence, Rhode Island, USA
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29
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Özkan SG, Kimiaei A, Safaei S, Sönmezoğlu M, Özkan HA. Granulocyte Transfusions in Neutropenic Infections: Insights From a Single-Center Study. Cureus 2024; 16:e55953. [PMID: 38601410 PMCID: PMC11005880 DOI: 10.7759/cureus.55953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Despite the development of modern antibiotic and antifungal therapies, neutropenic infections remain life-threatening. Granulocyte transfusion (GTX) is a less frequently used treatment modality in patients with refractory neutropenic infections. The role of donor GTX remains controversial, partly because of the lack of proper clinical trials. This study aimed to contribute to the literature by evaluating the efficacy and side effects of granulocyte transfusions in our center. Methods Eight febrile neutropenic patients with confirmed infections received granulocyte transfusions from ABO-compatible related and unrelated donors. Donors received filgrastim and dexamethasone stimulation, and granulocyte suspensions were irradiated and administered within six hours. Monitoring, antibiotic therapy, and granulocyte colony-stimulating factor (G-CSF) support were maintained. Results Our study observed a 28-day survival rate of 25%, which was lower than that reported in previous literature. The median number of transfusions was 3, with an average eight-day duration post-infection diagnosis, and no side effects were observed. Conclusion While some patients benefited from GTX, overall survival rates remained modest, indicating the need for further research. Prospective, well-powered randomized controlled trials are essential to address patient selection, dosing, and duration to determine the clinical utility of GTX. This study underscores the complexity of GTX in real-world clinical practice and provides insight into the ongoing debate regarding its efficacy in treating severe neutropenic infections.
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Affiliation(s)
| | - Ali Kimiaei
- Hematology, Bahçeşehir University, Istanbul, TUR
| | | | - Meral Sönmezoğlu
- Infectious Diseases, Yeditepe University Hospital, Istanbul, TUR
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30
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Wang G, Luo C, Cui C, Huang J. Study on the relationship between the fitness of three types of N95 respirators and facial dimensions. J Occup Environ Hyg 2024:1-7. [PMID: 38416473 DOI: 10.1080/15459624.2024.2311295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
N95 respirators are the core equipment used by healthcare workers to prevent the spread of respiratory diseases. The protective effect of N95 against infection spread depends on the fit of the N95 to the wearer, which is related to the wearer's facial dimensions. The purpose of this cross-sectional study was to assess the relationship between the fit of three types of N95 and facial dimensions. A total of 305 healthcare workers from ten hospitals in Beijing were recruited for this study. Facial dimensions of workers were measured using Intel RealSense Depth Camera D435. Fit testing was conducted on three types of N95 using the TSI-8038 Porta Count Pro + Respirator Fit Tester. Possible associations between the fit test results and facial dimension data were examined. A Porta Count reading of 100 was used as the criterion for an acceptable fit. The fit of the folding respirators was positively correlated with nose length (r = 0.13, p = 0.02), nose height (r = 0.14, p = 0.02), and face width (r = 0.12, p = 0.03), whereas that of flat respirators was correlated with nose width (r = 0.16, p < 0.01), chin length (r = 0.18, p < 0.01), and pro-face width (r = 0.13, p = 0.02), and that of arched respirators was correlated with the nose length (r = 0.13, p = 0.03). The fit of N95 for wearers depends on their facial features. The results of this study can provide advice for medical workers to choose the appropriate N95. Medical staff should fully consider their facial dimensions when choosing an appropriate N95 to improve the protective efficacy of respirators and to reduce the risk of infection by respiratory diseases.
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Affiliation(s)
- Guifang Wang
- Department of Infection Management and Disease Control and Prevention, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Changwei Luo
- Department of Electronic Engineering, Tsinghua University, Beijing, China
- Academy of Military Sciences, Beijing, China
| | - Can Cui
- Department of Infection Management and Disease Control and Prevention, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Jing Huang
- Department of Infection Control, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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31
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Mrvič T, Stevanoska S, Beović B, Logar M, Gregorčič S, Žnidaršič B, Seme K, Velimirović I, Švent Kučina N, Maver Vodičar P, Križan Hergouth V, Džeroski S, Pirs M. The Impact of COVID-19 on Multidrug-Resistant Bacteria at a Slovenian Tertiary Medical Center. Antibiotics (Basel) 2024; 13:214. [PMID: 38534649 DOI: 10.3390/antibiotics13030214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/02/2024] [Accepted: 02/18/2024] [Indexed: 03/28/2024] Open
Abstract
The COVID-19 pandemic has strained healthcare systems globally. Shortages of hospital beds, reassignment of healthcare workers to COVID-19-dedicated wards, an increased workload, and evolving infection prevention and control measures have potentially contributed to the spread of multidrug-resistant bacteria (MDRB). To determine the impact of the COVID-19 pandemic at the University Medical Center Ljubljana, a tertiary teaching hospital, we analyzed the monthly incidence of select bacterial species per patient from 2018 to 2022. The analysis was performed for all isolates and for MDRB isolates. The data were analyzed separately for isolates from all clinical samples, from blood culture only, and from clinical and surveillance samples. Our findings revealed an increased incidence density of patients with Enterococcus faecium, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa isolates from clinical samples during the COVID-19 period in the studied hospital. Notably, the incidence density of MDRB isolates-vancomycin-resistant E. faecium, extended-spectrum betalactamase-producing K. pneumoniae, and betalactam-resistant P. aeruginosa-from clinical samples increased during the COVID-19 period. There were no statistically significant differences in the incidence density of patients with blood culture MDRB isolates. We observed an increase in the overall MDRB burden (patients with MDRB isolates from both clinical and surveillance samples per 1000 patient days) in the COVID-19 period in the studied hospital for vancomycin-resistant E. faecium, carbapenem-resistant K. pneumoniae, and betalactam-resistant P. aeruginosa and a decrease in the methicillin-resistant S. aureus burden.
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Affiliation(s)
- Tatjana Mrvič
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Bojana Beović
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Mateja Logar
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Sergeja Gregorčič
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Benica Žnidaršič
- Infection Prevention and Control Unit, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Ivana Velimirović
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Nataša Švent Kučina
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Polona Maver Vodičar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Veronika Križan Hergouth
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Mateja Pirs
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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Macedo CE, Ferreira AM, Barcelos LDS, Alvim ALS, Carneiro LM, Martins SR, de Andrade D, Rigotti MA, Gasques RP, da Silva VA, de Oliveira LB, de Carvalho HEF, de Sousa AFL. Contamination of equipment and surfaces in the operating room anesthesia workspace: a cross-sectional study. SAO PAULO MED J 2024; 142:e2023177. [PMID: 38422242 PMCID: PMC10885631 DOI: 10.1590/1516-3180.2023.0177.r1.291123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 11/29/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Contamination of the breathing circuit and medication preparation surface of an anesthesia machine can increase the risk of cross-infection. OBJECTIVE To evaluate the contamination of the anesthetic medication preparation surface, respiratory circuits, and devices used in general anesthesia with assisted mechanical ventilation. DESIGN AND SETTING Cross-sectional, quantitative study conducted at the surgical center of a philanthropic hospital, of medium complexity located in the municipality of Três Lagoas, in the eastern region of the State of Mato Grosso do Sul. METHODS Eighty-two microbiological samples were collected from the breathing circuits. After repeating the samples in different culture media, 328 analyses were performed. RESULTS A higher occurrence of E. coli, Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, and Streptococcus pneumoniae (P < 0.001) were observed. Variations were observed depending on the culture medium and sample collection site. CONCLUSION The study findings underscore the inadequate disinfection of the inspiratory and expiratory branches, highlighting the importance of stringent cleaning and disinfection of high-touch surfaces.
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Affiliation(s)
- Carlos Eduardo Macedo
- MD. Physician, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande (MS), Brazil
| | - Adriano Menis Ferreira
- PhD. Nurse, Full Professor, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Três Lagoas (MS), Brazil
| | - Larissa da Silva Barcelos
- PhD. Associate Professor, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Três Lagoas (MS), Brazil
| | - André Luiz Silva Alvim
- PhD. Associate Professor, Graduate Program in Nursing, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Liliane Moretti Carneiro
- MSc, Nurse, Doctoral Student, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande (MS), Brazil
| | | | - Denise de Andrade
- PhD. Nurse, Full Professor, Ribeirão Preto College of Nursing, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo (SP), Brazil
| | - Marcelo Alessandro Rigotti
- PhD. Nurse, Associate Professor, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Três Lagoas (MS), Brazil
| | - Ruberval Peres Gasques
- Nurse. Master Student, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Três Lagoas (MS), Brazil
| | - Vanderlei Amaro da Silva
- BS. Biomedic, Postgraduate Program in Nursing, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande (MS), Brazil
| | - Layze Braz de Oliveira
- PhD, Nurse, Ribeirão Preto College of Nursing, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo (SP), Brazil
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Ito F, Terai H, Kondo M, Takemura R, Namkoong H, Asakura T, Chubachi S, Masuzawa K, Nakayama S, Suzuki Y, Hashiguchi M, Kagyo J, Shiomi T, Minematsu N, Manabe T, Fukui T, Funatsu Y, Koh H, Masaki K, Ohgino K, Miyata J, Kawada I, Ishii M, Sato Y, Fukunaga K. Cluster analysis of long COVID in Japan and association of its trajectory of symptoms and quality of life. BMJ Open Respir Res 2024; 11:e002111. [PMID: 38395459 PMCID: PMC10895225 DOI: 10.1136/bmjresp-2023-002111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Multiple prolonged symptoms observed in patients who recovered from COVID-19 are defined as long COVID. Although diverse phenotypic combinations are possible, they remain unclear. This study aimed to perform a cluster analysis of long COVID in Japan and clarify the association between its characteristics and background factors and quality of life (QOL). METHODS This multicentre prospective cohort study collected various symptoms and QOL after COVID-19 from January 2020 to February 2021. This study included 935 patients aged ≥18 years with COVID-19 at 26 participating medical facilities. Hierarchical cluster analysis was performed using 24 long COVID symptom at 3 months after diagnosis. RESULTS Participants were divided into the following five clusters: numerous symptoms across multiple organs (cluster 1, n=54); no or minor symptoms (cluster 2, n=546); taste and olfactory disorders (cluster 3, n=76); fatigue, psychoneurotic symptoms and dyspnoea (low prevalence of cough and sputum) (cluster 4, n=207) and fatigue and dyspnoea (high prevalence of cough and sputum) (cluster 5, n=52). Cluster 1 included elderly patients with severe symptoms, while cluster 3 included young female with mild symptoms. No significant differences were observed in the comorbidities. Cluster 1 showed the most impaired QOL, followed by clusters 4 and 5; these changes as well as the composition of symptoms were observed over 1 year. CONCLUSIONS We identified patients with long COVID with diverse characteristics into five clusters. Future analysis of these different pathologies could result in individualised treatment of long COVID. TRIAL REGISTRATION NUMBER The study protocol is registered at UMIN clinical trials registry (UMIN000042299).
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Affiliation(s)
- Fumimaro Ito
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Keio Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan
| | - Masahiro Kondo
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
- Graduate School of Health Management, Keio University, Kanagawa, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Asakura
- Department of Clinical Medicine (Laboratory of Bioregulatory Medicine), Kitasato University School of Pharmacy, Tokyo, Japan
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Keita Masuzawa
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Sohei Nakayama
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Mizuha Hashiguchi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Junko Kagyo
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, Japan
| | - Tetsuya Shiomi
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, Japan
| | - Naoto Minematsu
- Department of Internal Medicine, Hino Municipal Hospital, Tokyo, Japan
| | - Tadashi Manabe
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Takahiro Fukui
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Yohei Funatsu
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Hidefumi Koh
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Ishii
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Rhee C, Klompas M, Pak TR, Köhler JR. In Support of Universal Admission Testing for SARS-CoV-2 During Significant Community Transmission. Clin Infect Dis 2024; 78:439-444. [PMID: 37463411 DOI: 10.1093/cid/ciad424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
Many hospitals have stopped or are considering stopping universal admission testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We discuss reasons why admission testing should still be part of a layered system to prevent hospital-acquired SARS-CoV-2 infections during times of significant community transmission. These include the morbidity of SARS-CoV-2 in vulnerable patients, the predominant contribution of presymptomatic and asymptomatic people to transmission, the high rate of transmission between patients in shared rooms, and data suggesting surveillance testing is associated with fewer nosocomial infections. Preferences of diverse patient populations, particularly the hardest-hit communities, should be surveyed and used to inform prevention measures. Hospitals' ethical responsibility to protect patients from serious infections should predominate over concerns about costs, labor, and inconvenience. We call for more rigorous data on the incidence and morbidity of nosocomial SARS-CoV-2 infections and more research to help determine when to start, stop, and restart universal admission testing and other prevention measures.
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Affiliation(s)
- Chanu Rhee
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Healthcare Institute, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michael Klompas
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Healthcare Institute, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Theodore R Pak
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Healthcare Institute, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Julia R Köhler
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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Novais Â, Gonçalves AB, Ribeiro TG, Freitas AR, Méndez G, Mancera L, Read A, Alves V, López-Cerero L, Rodríguez-Baño J, Pascual Á, Peixe L. Development and validation of a quick, automated, and reproducible ATR FT-IR spectroscopy machine-learning model for Klebsiella pneumoniae typing. J Clin Microbiol 2024; 62:e0121123. [PMID: 38284762 PMCID: PMC10865814 DOI: 10.1128/jcm.01211-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
The reliability of Fourier-transform infrared (FT-IR) spectroscopy for Klebsiella pneumoniae typing and outbreak control has been previously assessed, but issues remain in standardization and reproducibility. We developed and validated a reproducible FT-IR with attenuated total reflectance (ATR) workflow for the identification of K. pneumoniae lineages. We used 293 isolates representing multidrug-resistant K. pneumoniae lineages causing outbreaks worldwide (2002-2021) to train a random forest classification (RF) model based on capsular (KL)-type discrimination. This model was validated with 280 contemporaneous isolates (2021-2022), using wzi sequencing and whole-genome sequencing as references. Repeatability and reproducibility were tested in different culture media and instruments throughout time. Our RF model allowed the classification of 33 capsular (KL)-types and up to 36 clinically relevant K. pneumoniae lineages based on the discrimination of specific KL- and O-type combinations. We obtained high rates of accuracy (89%), sensitivity (88%), and specificity (92%), including from cultures obtained directly from the clinical sample, allowing to obtain typing information the same day bacteria are identified. The workflow was reproducible in different instruments throughout time (>98% correct predictions). Direct colony application, spectral acquisition, and automated KL prediction through Clover MS Data analysis software allow a short time-to-result (5 min/isolate). We demonstrated that FT-IR ATR spectroscopy provides meaningful, reproducible, and accurate information at a very early stage (as soon as bacterial identification) to support infection control and public health surveillance. The high robustness together with automated and flexible workflows for data analysis provide opportunities to consolidate real-time applications at a global level. IMPORTANCE We created and validated an automated and simple workflow for the identification of clinically relevant Klebsiella pneumoniae lineages by FT-IR spectroscopy and machine-learning, a method that can be extremely useful to provide quick and reliable typing information to support real-time decisions of outbreak management and infection control. This method and workflow is of interest to support clinical microbiology diagnostics and to aid public health surveillance.
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Affiliation(s)
- Ângela Novais
- UCIBIO, Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Ana Beatriz Gonçalves
- UCIBIO, Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Teresa G. Ribeiro
- UCIBIO, Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- CCP, Culture Collection of Porto, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Ana R. Freitas
- UCIBIO, Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- 1H-TOXRUN, One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal
| | - Gema Méndez
- CLOVER Bioanalytical Software, Granada, Spain
| | | | - Antónia Read
- Clinical Microbiology Laboratory, Local Healthcare Unit, Matosinhos, Portugal
| | - Valquíria Alves
- Clinical Microbiology Laboratory, Local Healthcare Unit, Matosinhos, Portugal
| | - Lorena López-Cerero
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Vírgen Macarena, Instituto de Biomedicina de Sevilla (IBIS; CSIC/Hospital Virgen Macarena/Universidad de Sevilla), Sevilla, Spain
- Departamentos de Microbiología y Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Jesús Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Vírgen Macarena, Instituto de Biomedicina de Sevilla (IBIS; CSIC/Hospital Virgen Macarena/Universidad de Sevilla), Sevilla, Spain
- Departamentos de Microbiología y Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Álvaro Pascual
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Vírgen Macarena, Instituto de Biomedicina de Sevilla (IBIS; CSIC/Hospital Virgen Macarena/Universidad de Sevilla), Sevilla, Spain
- Departamentos de Microbiología y Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Luísa Peixe
- UCIBIO, Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- CCP, Culture Collection of Porto, Faculty of Pharmacy, University of Porto, Porto, Portugal
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Roche E, Jones A, Plunkett A. What factors in the workplace enable success in antimicrobial stewardship in paediatric intensive care? An exploration of antimicrobial stewardship excellence through thematic analysis of appreciative inquiry interviews with healthcare staff. BMJ Open 2024; 14:e074375. [PMID: 38309747 PMCID: PMC10840055 DOI: 10.1136/bmjopen-2023-074375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/02/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES Antimicrobial resistance (AMR) is a major global health problem. Efforts to mitigate AMR prioritise antimicrobial stewardship (AMS) interventions. These interventions typically focus on deficiencies in practice and providing negative or normative feedback. This approach may miss opportunities to learn from success. We aimed to identify factors that enable success in AMS practices in the paediatric intensive care unit (PICU) by analysing the data obtained from interviews with staff members who had achieved success in AMS. DESIGN Qualitative study design using thematic analysis of appreciative inquiry interviews with healthcare staff. SETTING 31-bedded PICU in the UK between January 2017 and January 2018. PARTICIPANTS 71 staff who had achieved success in AMS in the PICU. RESULTS Six themes were identified: (1) cultural factors including psychological safety, leadership and positive attitude are important enablers for delivering good clinical care; (2) ergonomic design of the physical environment and ready availability of tools and resources are key elements to support good practice and decision-making; (3) expertise and support from members of the multidisciplinary team contribute to good care delivery; (4) clarity of verbal and written communication is important for sharing mental models and aims of care within the clinical team; (5) a range of intrinsic factors influences the performance of individual HCPs, including organisation skill, fear of failure, response to positive reinforcement and empathetic considerations towards peers; (6) good clinical care is underpinned by a sound domain knowledge, which can be acquired through training, mentorship and experience. CONCLUSION The insights gained in this study originate from frontline staff who were interviewed about successful work-as-done. This strengths-based approach is an understudied area of healthcare, and therefore offers authentic intelligence which may be leveraged to effect tangible improvement changes. The methodology is not limited to AMS and could be applied to a wide range of healthcare settings.
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Affiliation(s)
- Emma Roche
- Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Alison Jones
- Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Adrian Plunkett
- Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
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Zendri F, Schmidt V, Mauder N, Loeffler A, Jepson RE, Isgren C, Pinchbeck G, Haldenby S, Timofte D. Rapid typing of Klebsiella pneumoniae and Pseudomonas aeruginosa by Fourier-transform Infrared spectroscopy informs infection control in veterinary settings. Front Microbiol 2024; 15:1334268. [PMID: 38371930 PMCID: PMC10869444 DOI: 10.3389/fmicb.2024.1334268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction The emergence of multi-drug resistant (MDR) pathogens linked to healthcare-associated infections (HCAIs) is an increasing concern in modern veterinary practice. Thus, rapid bacterial typing for real-time tracking of MDR hospital dissemination is still much needed to inform best infection control practices in a clinically relevant timeframe. To this end, the IR Biotyper using Fourier-Transform InfraRed (FTIR) spectroscopy has the potential to provide fast cluster analysis of potentially related organisms with substantial cost and turnaround time benefits. Materials and methods A collection of MDR bacterial isolates (n = 199, comprising 92 Klebsiella pneumoniae and 107 Pseudomonas aeruginosa) obtained from companion animal (i.e., dogs, cats and horses) clinical investigations, faecal and environmental screening from four veterinary facilities between 2012 and 2019 was analysed retrospectively by FTIR spectroscopy. Its performance was compared against MLST extracted from whole genomes of a subset of clustering isolates (proportionally to cluster size) for investigation of potential nosocomial transmission between patients and the surrounding hospital environments. Results Concordance between the FTIR and MLST types was overall high for K. pneumoniae (Adjusted Rand Index [ARI] of 0.958) and poor for P. aeruginosa (ARI of 0.313). FTIR K. pneumoniae clusters (n = 7) accurately segregated into their respective veterinary facility with evidence of intra-hospital spread of K. pneumoniae between patients and environmental surfaces. Notably, K. pneumoniae ST147 intensely circulated at one Small Animal Hospital ICU. Conversely, Pseudomonas aeruginosa FTIR clusters (n = 18) commonly contained isolates of diversified hospital source and heterogeneous genetic background (as also genetically related isolates spread across different clusters); nonetheless, dissemination of some clones, such as P. aeruginosa ST2644 in the equine hospital, was apparent. Importantly, FTIR clustering of clinical, colonisation and/or environmental isolates sharing genomically similar backgrounds was seen for both MDR organisms, highlighting likely cross-contamination events that led to clonal dissemination within settings. Conclusion FTIR spectroscopy has high discriminatory power for hospital epidemiological surveillance of veterinary K. pneumoniae and could provide sufficient information to support early detection of clonal dissemination, facilitating implementation of appropriate infection control measures. Further work and careful optimisation need to be carried out to improve its performance for typing of P. aeruginosa veterinary isolates.
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Affiliation(s)
- Flavia Zendri
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Vanessa Schmidt
- Department of Small Animal Clinical Science, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | | | - Anette Loeffler
- Western Counties Equine Hospital Ltd., Culmstock, United Kingdom
| | | | - Cajsa Isgren
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Gina Pinchbeck
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Sam Haldenby
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Dorina Timofte
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
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Vellappally S, Naik S, Thomas RP, Alsadon O, Alayadi H, Hashem M, Alwadi MAM, Thomas NG, Ali HM, Alsarani MM, Anil S. Knowledge of the monkeypox 2022 outbreak among dental hygienists and students in Saudi Arabia: A cross-sectional study. Int J Dent Hyg 2024; 22:187-193. [PMID: 37722074 DOI: 10.1111/idh.12744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 04/26/2023] [Accepted: 08/06/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE This study aimed to assess the knowledge of monkeypox infection among dental hygiene professionals and students in Saudi Arabia. METHODS A cross-sectional study was conducted among a convenience sample of dental hygiene professionals (n = 259). The questionnaire was developed based on previous literature, and descriptive analysis and a Chi-square test were performed. RESULTS A total of 159 dental hygienists responded to the questionnaire. Results indicated that only 1.7% had good knowledge, 7.7% had moderate knowledge and 90.6% had low knowledge of the monkeypox outbreak. The mean knowledge scores varied among dental hygiene students, practitioners and faculty members. Significant group differences were observed for some questions (p < 0.05). CONCLUSION Our study concludes that dental hygienists had moderate to low level of knowledge of the monkeypox infection and its implications for oral health and patient care, indicating a need for more education on the subject.
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Affiliation(s)
- Sajith Vellappally
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sachin Naik
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Rohit Philip Thomas
- Institute of Diagnostic and Interventional Radiology, Klinikum Oldenburg University Hospital, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Omar Alsadon
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Haya Alayadi
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Hashem
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maram Ali M Alwadi
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nebu George Thomas
- Department of Periodontology, Pushpagiri College of Dental Sciences, Thiruvalla, India
| | | | - Majed M Alsarani
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sukumaran Anil
- Department of Dentistry, Oral Health Institute, Hamad Medical Cooperation, Doha, Qatar
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Sivamani Chidambaram R, Rajmohan S, Olive Prasad P, Kalyani D, Mallikarjuna R, Ganiga Channaiah S. Evaluation of the Effectiveness of Disinfectants on Impression Materials. Cureus 2024; 16:e54846. [PMID: 38533142 PMCID: PMC10964117 DOI: 10.7759/cureus.54846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 03/28/2024] Open
Abstract
Background The disinfection of dental impression materials is a cornerstone of infection control in dental practice. This study aimed to evaluate the effectiveness of two disinfectants, sodium hypochlorite and iodophor, on alginate and silicone impression materials, which are prone to microbial contamination. Methods The study was structured into two main groups based on the impression material: Group I (alginate) and Group II (addition silicone), each further subdivided into two subgroups for disinfection with sodium hypochlorite and iodophor. For each subgroup, initial microbial swabs were taken before any treatment, followed by a second swab after rinsing and a final swab after disinfection. The mean colony-forming unit (CFU) counts, standard deviations, and standard errors of the mean were calculated for each stage of treatment. Results Prior to disinfection, Group I had a mean CFU count of 2,529.40, while Group II had a lower mean CFU of 1,417.40. After rinsing, there was a significant decrease in CFUs in both groups, with Group I at 1,337.10 and Group II at 415.10. Post-disinfection, Group I showed a mean CFU count of 73.00 for sodium hypochlorite and 0.00 for iodophor. Similarly, Group II achieved a CFU reduction of 99.00 with sodium hypochlorite and 0.00 with iodophor, demonstrating a marked reduction in microbial presence. Conclusion Iodophor was exceptionally effective in disinfecting both alginate and silicone impression materials, eliminating all detectable CFUs. Sodium hypochlorite also significantly reduced microbial counts but was not as effective as iodophor. Rinsing prior to disinfection was instrumental in reducing the microbial load, underscoring its importance in the disinfection protocol.
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Affiliation(s)
| | - Sudha Rajmohan
- Department of Preclinical Conservative Dentistry, Oman Dental College, Muscat, OMN
| | | | - Dorothy Kalyani
- Department of Microbiology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai, IND
| | - Rachappa Mallikarjuna
- Department of Pedodontics and Preventive Dentistry, Oman Dental College, Muscat, OMN
| | - Shivakumar Ganiga Channaiah
- Department of Oral Medicine and Radiology, People's College of Dental Sciences & Research Centre, Bhopal, IND
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Almalki M, Khayat W. The Use and Reprocessing of Endodontic Files in Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e54427. [PMID: 38510902 PMCID: PMC10951433 DOI: 10.7759/cureus.54427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/22/2024] Open
Abstract
Objectives This study aimed to assess the awareness, implementation, and compliance with the infection control policy recommended by the Saudi Ministry of Health (MOH) for the use and reprocessing of endodontic files and to examine the association between compliance and gender, experience, clinical ranks, and workplace sector. Methods This was a cross-sectional study conducted using a validated self-administered electronic questionnaire created and distributed to dentists who perform endodontic treatment in Saudi Arabia. Data were collected between June and July 2023. Descriptive statistics were reported as counts and percentages. Comparisons among the demographic groups were done using the Kruskal-Wallis and Mann-Whitney tests. Results A total of 402 dentists completed the survey. The results showed that 76.1% (n=306) of respondents claimed that they were aware of the infection control policy recommended by the Saudi MOH for the use and reprocessing of endodontic files in dental clinics. Only 13.2% (n=53) of dentists used single-use endodontic files, and 36.6% (n=147) did not use an endodontic box in their dental clinics. The most commonly reported method of tracing the number of uses of endodontic files was to write the ID of the patient or the number of uses on the sterilization pouch as reported by 37.6% of participants (n=151). The average compliance score percentage was 63.5 ± 16.7. Most of the respondents showed moderate to high levels of compliance (51.7% (n=208) and 42.0% (n=169) of dentists, respectively). Dentists with less than 5 years of experience showed significantly less compliance than dentists with more than 10 years of experience (p = 0.005). Gender, clinical rank, and workplace sector were not significantly associated with the extent of adhering to the evaluated infection control policy. Conclusions Our findings indicate a relatively high level of compliance with the Saudi MOH policy of using and reprocessing endodontic files. However, critical measures such as the single-use of endodontic files, sterilizing new endodontic files, and using the sterilized endodontic box for each patient need improvement. Hence, this study recommends enhancing awareness through continuous education and training.
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Affiliation(s)
- Majed Almalki
- Department of Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, SAU
| | - Waad Khayat
- Department of Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, SAU
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Brosseau LM, Gold DD, Materna B, McPhaul K, Rosen M, Seminario P, Thomason J. Preventing Aerosol-Transmissible Diseases in Healthcare Settings: The Need for Protective Guidelines and Standards-Workshop Report. New Solut 2024; 33:236-247. [PMID: 38128919 DOI: 10.1177/10482911231215498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
There is an urgent need for stronger protection from aerosol-transmissible diseases in healthcare settings-for workers, patients, volunteers, and visitors. Concerned that the Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) lacks diversity in expertise and experience and has not consulted widely with all concerned parties regarding a planned update to the 2007 Guideline for Isolation Precautions, a workshop was developed to consider the science and lessons learned before and during the COVID-19 pandemic. Sponsored by the New York/New Jersey Occupational Safety and Health Center, Preventing Aerosol-Transmissible Diseases in Healthcare Settings: The Need for Protective Guidelines and Standards was held on October 13, 2023, with these goals: describe current CDC/HICPAC infection prevention guidelines, review current scientific understanding of aerosol-transmissible pathogens, and consider perspectives from a wide range of groups currently excluded from the CDC HICPAC process.
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Affiliation(s)
| | | | | | - Kate McPhaul
- University of Maryland School of Public Health, College Park, MD
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Tu J, Liu F, Wang K, Mao Y, Qi Q, Zhang J. Donning and doffing of personal protective equipment for health care workers in a tertiary hospital in China: A simulation study. J Occup Environ Hyg 2024; 21:108-118. [PMID: 37812187 DOI: 10.1080/15459624.2023.2268727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
The application and removal of personal protective equipment (PPE) by health care workers (HCWs) is pivotal to their health and safety and the comprehensive efficacy of hospital infection control measures. This investigation was orchestrated to elucidate the challenges that HCWs may encounter during the donning and doffing of PPE. A total of 110 participants from a tertiary hospital in China were engaged. The study employed fluorescent markers to mimic the exposure of HCWs to tainted body fluids, quantified the contamination outcomes, and evaluated adherence to procedures for donning and doffing. Factors including gender, educational background, and the timing of the most recent instruction on PPE donning and doffing were found to influence the occurrence of contamination points (p < 0.05). No significant differences were identified in contamination frequency when assessing age, body mass index (BMI), occupation, educational background, positional title, working tenure, and experience in managing respiratory infectious diseases (p > 0.05). Predominant contamination sites for fluorescent marker residue included the shoulder (32.73%), neck (21.82%), forearm (16.36%), chest (12.73%), and abdomen (11.82%), with the shoulder being the most contaminated body part. A majority of HCWs exhibited susceptibility to errors during the removal of protective clothing, boot covers, and gloves. The contamination frequency was observed to be correlated with the timing of the last PPE training, educational background, and gender. In acknowledging the intricacy of PPE removal and the deficiencies in HCWs' removal techniques, there emerges a perpetual necessity to refine training methodologies and perpetuate regular PPE instruction.
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Affiliation(s)
- Jiajia Tu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Fang Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Kexuan Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yiping Mao
- School of Nursing, Xuzhou Medical University, Xuzhou, China
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qi Qi
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jie Zhang
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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McLaughlin ME, Henderson T, Leadon L. Process for maintaining appropriate air quality in a hospital setting during and following a nearby building implosion. J Occup Environ Hyg 2024; 21:119-125. [PMID: 37967319 DOI: 10.1080/15459624.2023.2284184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Air quality in a cancer facility is integral to the success of patient treatment. The organization must be committed to providing a patient care environment free of physical and biological hazards that result from construction and demolition activities. This project intended to safely demolish a derelict building in Texas while minimizing air quality risks and impacts to nearby hospitals and a proximal cancer hospital. Two of the neighboring facilities were less than 18 feet (5.5 m) away from the demolition location. Adjacent facilities included inpatient and outpatient cancer treatment clinics, a large data center, a pediatric hospital complex, and a heart institute. Plans to minimize infection risks and dust for respective facilities were designed before implosion and remained in place until total debris removal. Risk assessments of nearby buildings were completed to determine the appropriate precautions and physical barriers needed. Culturable and non-culturable fungal air samples were collected during implosion to verify the management of outside contaminants. Additionally, continuous particulate and routine sampling for culturable and non-culturable fungi were performed for approximately 7 months after the project demolition. Air sampling results from 32 internal areas indicated that most areas remained at pre-implosion background levels. Areas that experienced elevated particle counts were cleaned and resampled, and baseline values returned to pre-implosion levels within 12 hr. Fungal air sampling results were acceptable based on predetermined infection control guidelines. The building was successfully demolished via implosion with no injuries and minimal damage to nearby facilities. The team learned that an integrated approach to project management that includes all stakeholders is essential to success. Contingency planning should account for all variables; no assumptions should be made. Staffing plans should be reviewed to ensure the sampling strategy developed can be implemented appropriately.
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Affiliation(s)
- M Elena McLaughlin
- Environmental Health & Safety, The University of Texas at MD Anderson Cancer Center, Houston, TX, USA
| | - Tina Henderson
- Environmental Health & Safety, The University of Texas at MD Anderson Cancer Center, Houston, TX, USA
| | - Linette Leadon
- Environmental Health & Safety, The University of Texas at MD Anderson Cancer Center, Houston, TX, USA
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Cannas A, Butera O, Mazzarelli A, Messina F, Vulcano A, Parracino MP, Gualano G, Palmieri F, Di Caro A, Nisii C, Fontana C, Girardi E. Implementation of Whole Genome Sequencing of Tuberculosis Isolates in a Referral Center in Rome: Six Years' Experience in Characterizing Drug-Resistant TB and Disease Transmission. Antibiotics (Basel) 2024; 13:134. [PMID: 38391520 PMCID: PMC10885968 DOI: 10.3390/antibiotics13020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/16/2024] [Accepted: 01/27/2024] [Indexed: 02/24/2024] Open
Abstract
Over the past years, Tuberculosis (TB) control strategies have been effective in reducing drug-resistant (DR) TB globally; however, a wider implementation of new diagnostic strategies, such as Whole genome sequencing (WGS), would be critical for further improvement. The aim of this study, based on WGS of Mycobacterium tuberculosis (MTB) strains isolated in a TB referral center over 6 years, was to evaluate the efficacy of this methodology in improving therapy guidance for clinicians and in improving the understanding of the epidemiology of TB transmission. WGS was performed in addition to pDST on 1001 strains consecutively isolated between January 2016 and December 2021; the results allowed us to improve the quality of data on resistance and to identify possible clusters of transmission. Prediction of rifampicin-resistant (RR) or multi-drug-resistant TB strains (MDR-TB, defined as resistance to at least rifampicin and isoniazid) was obtained for 50 strains (5%). Mutations predictive of an MDR isolate were further characterized, and Ser450Leu and Ser315Thr were found to be the most frequent mutations in rpoB and katG genes, respectively. Discordances between WGS and phenotypic drug susceptibility testing (pDST) were found in few strains, and their impact on clinical decisions and outcome was addressed. The introduction of WGS in our Institute improved our diagnostic routine, allowing accurate patient management, and was a valid instrument for epidemiological investigations and infection control.
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Affiliation(s)
- Angela Cannas
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Ornella Butera
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Antonio Mazzarelli
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Francesco Messina
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Antonella Vulcano
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | | | - Gina Gualano
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Fabrizio Palmieri
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Antonino Di Caro
- Department of Medicine, UniCamillus International University, 00131 Rome, Italy
| | - Carla Nisii
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Carla Fontana
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, 00149 Rome, Italy
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Diamantis A, Velisariou I, Magiorkinis E. The cholera outbreak during the Balkan Wars in Greece and the anticholeric vaccine as a force multiplier of the Greek army. BMJ Mil Health 2024; 170:85-86. [PMID: 35292505 DOI: 10.1136/bmjmilitary-2022-002094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Aristidis Diamantis
- Office for the Study of the History of Hellenic Naval Medicine, Naval Hospital of Athens, Athens 11521, Greece
| | - I Velisariou
- Office for the Study of the History of Hellenic Naval Medicine, Naval Hospital of Athens, Athens 11521, Greece
| | - E Magiorkinis
- Office for the Study of the History of Hellenic Naval Medicine, Naval Hospital of Athens, Athens 11521, Greece
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Song MS, Jeong SY, Park S. Infection Control Experiences and Educational Needs of Geriatric Care Workers in Long-Term Care Facilities: A Pilot Study. Healthcare (Basel) 2024; 12:301. [PMID: 38338186 PMCID: PMC10855566 DOI: 10.3390/healthcare12030301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/05/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND In the post-COVID-19 condition, infection control education is important for geriatric care workers who care for the elderly and are vulnerable to emerging infectious diseases. This study was conducted to enhance the insight into the experiences of geriatric care workers in managing novel infectious diseases (COVID-19) and to identify the newly required educational requirements necessary to effectively implement infectious disease control. METHODS This is a qualitative and pilot study using focus group interviews. Data from 10 participants were collected using a focus group interview. The data were analyzed using Qualitative content analysis. RESULTS The findings showed that geriatric healthcare workers experienced difficulties following infection control protocols and emotional distress related to visitor restrictions and had an increased workload. The participants requested further education regarding general knowledge of infectious diseases to decrease their fears of infection and reported that visual and practical teaching methods were preferable. CONCLUSIONS Further attention is needed regarding the education of infection control to strengthen infection prevention in long-term care facilities vulnerable to the spread of emerging infectious diseases.
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Affiliation(s)
- Min Sun Song
- College of Nursing, Konyang University, 158, Gwanjeodong-ro, Seogu, Daejeon 35365, Republic of Korea; (M.S.S.); (S.Y.J.)
| | - Sun Young Jeong
- College of Nursing, Konyang University, 158, Gwanjeodong-ro, Seogu, Daejeon 35365, Republic of Korea; (M.S.S.); (S.Y.J.)
| | - Soohyun Park
- Department of Nursing, Eulji University, Seongnam, 553 Sanseong-daero, Sujeong-gu, Seongnam-si 13135, Republic of Korea
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Arzilli G, De Vita E, Pasquale M, Carloni LM, Pellegrini M, Di Giacomo M, Esposito E, Porretta AD, Rizzo C. Innovative Techniques for Infection Control and Surveillance in Hospital Settings and Long-Term Care Facilities: A Scoping Review. Antibiotics (Basel) 2024; 13:77. [PMID: 38247635 PMCID: PMC10812752 DOI: 10.3390/antibiotics13010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Healthcare-associated infections (HAIs) pose significant challenges in healthcare systems, with preventable surveillance playing a crucial role. Traditional surveillance, although effective, is resource-intensive. The development of new technologies, such as artificial intelligence (AI), can support traditional surveillance in analysing an increasing amount of health data or meeting patient needs. We conducted a scoping review, following the PRISMA-ScR guideline, searching for studies of new digital technologies applied to the surveillance, control, and prevention of HAIs in hospitals and LTCFs published from 2018 to 4 November 2023. The literature search yielded 1292 articles. After title/abstract screening and full-text screening, 43 articles were included. The mean study duration was 43.7 months. Surgical site infections (SSIs) were the most-investigated HAI and machine learning was the most-applied technology. Three main themes emerged from the thematic analysis: patient empowerment, workload reduction and cost reduction, and improved sensitivity and personalization. Comparative analysis between new technologies and traditional methods showed different population types, with machine learning methods examining larger populations for AI algorithm training. While digital tools show promise in HAI surveillance, especially for SSIs, challenges persist in resource distribution and interdisciplinary integration in healthcare settings, highlighting the need for ongoing development and implementation strategies.
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Affiliation(s)
- Guglielmo Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Erica De Vita
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Milena Pasquale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Luca Marcello Carloni
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Marzia Pellegrini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Martina Di Giacomo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Enrica Esposito
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
| | - Andrea Davide Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
- University Hospital of Pisa, 56124, Pisa, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (G.A.); (M.P.); (L.M.C.); (M.P.); (M.D.G.); (E.E.); (A.D.P.); (C.R.)
- University Hospital of Pisa, 56124, Pisa, Italy
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Hawes AM, Greene MT, Ratz D, Fowler KE, Kendall RE, Patel PK. Antimicrobial Stewardship Teams in Veterans Affairs and Nonfederal Hospitals in the United States: A National Survey of Antimicrobial Stewardship Practices. Open Forum Infect Dis 2024; 11:ofad620. [PMID: 38213633 PMCID: PMC10783152 DOI: 10.1093/ofid/ofad620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/16/2023] [Indexed: 01/13/2024] Open
Abstract
In a cross-sectional survey of US acute care hospitals, antimicrobial stewardship programs were present in most Veterans Affairs and nonfederal hospitals but varied in team composition, scope, and impact. Diagnostic stewardship was common across hospitals. Veterans Affairs hospitals had increased reach in outpatient settings. Telestewardship remains an opportunity in all hospital systems.
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Affiliation(s)
- Armani M Hawes
- Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - M Todd Greene
- Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Internal Medicine, VA/UM Patient Safety Enhancement Program, Ann Arbor, Michigan, USA
| | - David Ratz
- Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Internal Medicine, VA/UM Patient Safety Enhancement Program, Ann Arbor, Michigan, USA
| | - Karen E Fowler
- Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Internal Medicine, VA/UM Patient Safety Enhancement Program, Ann Arbor, Michigan, USA
| | - Ronald E Kendall
- Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Payal K Patel
- Department of Internal Medicine, VA/UM Patient Safety Enhancement Program, Ann Arbor, Michigan, USA
- Division of Infectious Diseases, Department of Internal Medicine, Intermountain Health, Salt Lake City, Utah, USA
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Al Hadid L, Al Barmawi M, Al-Rawajfah O, Al-Sagarat A. An Agreement Among Nurse Educators on Infection Prevention and Control Practices to Ensure Safe Clinical Training Post-COVID-19. Iran J Nurs Midwifery Res 2024; 29:85-90. [PMID: 38333332 PMCID: PMC10849274 DOI: 10.4103/ijnmr.ijnmr_415_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/08/2023] [Accepted: 09/08/2023] [Indexed: 02/10/2024]
Abstract
Background Infection Prevention and Control (IPC) practices during nursing students' clinical training are based on standardized precautions. However, the spread of COVID-19 raised the need to revise these practices. We aimed in this study to assess nurse educators' agreement on items that represent precautionary guidelines, which enhance safety during clinical training of students. It aimed to reach an agreement among nurse educators on IPC practices to ensure safe clinical training. Materials and Methods This descriptive explorative, cross-sectional study included 243 Jordanian and Omani educators. The study questionnaire was based mainly on evidence reported in the literature. The study questionnaire comprised items for trainers to practice and items to supervise students. It was developed based on available evidence and recommended training practices during COVID-19 suggested by the WHO and the literature. Both the face and content validity processes were adopted to validate the study questionnaire. The final version was composed of 26 items for trainers and 20 items for students subsumed in the following themes: protecting self, protecting others, and essential training needs. Results All questionnaire items were rated above the midpoint indicating agreement among participants on including the new IPC practices. All suggested practices (26 items for the trainers and 20 items for the students) were supported by the study participants. Conclusions Clinical training is an important component of nursing students' preparation. Findings suggest the importance of adding new IPC practices to improve student IPC practices, protect themselves and others, minimize cross-infections, and enhance students' training within a safe clinical environment.
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Affiliation(s)
| | - Marwa Al Barmawi
- Department of Nursing, Faculty of Nursing, Alzaytoonah University of Jordan (ZUJ), Jordan
| | - Omar Al-Rawajfah
- Department of Nursing, College of Nursing, Sultan Qaboos University, Sultanate of Oman
| | - Ahmad Al-Sagarat
- Community and Psychiatric Nursing Department, Faculty of Nursing, Mutah University, Al Karak, Jordan
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Krone M, Rauschenberger V, Blaschke V, Claus H, Kurzai O, Kampmeier S. Ralstonia pickettii bloodstream infections with potential genomic link to internationally distributed contaminated saline solution, Germany, October 2023. Euro Surveill 2024; 29:2400010. [PMID: 38240062 PMCID: PMC10797661 DOI: 10.2807/1560-7917.es.2024.29.3.2400010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/22/2024] Open
Abstract
Ralstonia pickettii is a Gram-negative rod which may cause invasive infections when they contaminate liquid medical products. After R. pickettii was detected in blood cultures and a stem cell product from three patients in a tertiary care hospital in Germany, whole genome sequencing of these three isolates and two water isolates from the environment was performed. Core genome multilocus sequence typing analysis showed that the three patient isolates were closely related and there was a large distance to the environmental isolates. In a genomic comparison, the patients' isolates were distantly related to an R. pickettii strain from a cluster in Australia suspected to be caused by contaminated saline produced in India, while all liquid medical products with a link to all patients were produced in Europe or the United States. Our data point towards an ongoing risk by an unknown common source that could be traced back to medical products contaminated with R. pickettii and potentially distributed worldwide. Investigating invasive R. pickettii infections, identifying and testing medical products administered to the patients and timely whole genome sequencing may help identify the exact source of this potentially global outbreak.
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Affiliation(s)
- Manuel Krone
- University Hospital Würzburg, Infection Control and Antimicrobial Stewardship Unit, Würzburg, Germany
- University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany
| | - Vera Rauschenberger
- University Hospital Würzburg, Infection Control and Antimicrobial Stewardship Unit, Würzburg, Germany
- University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany
| | - Vera Blaschke
- University Hospital Würzburg, Infection Control and Antimicrobial Stewardship Unit, Würzburg, Germany
- University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany
| | - Heike Claus
- University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany
| | - Oliver Kurzai
- University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany
- Leibniz Institute for Natural Product Research and Infection Biology - Hans-Knoell-Institute, Jena, Germany
| | - Stefanie Kampmeier
- University Hospital Würzburg, Infection Control and Antimicrobial Stewardship Unit, Würzburg, Germany
- University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany
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