The Seasonality of Peripheral Venous Catheter-Related Bloodstream Infections

Baseline and seasonal trends of Bacillus cereus and Bacillus subtilis from clinical samples in Japan

Background

Outbreaks of Bacillus cereus bloodstream infections (BSIs) are a concern in Japanese medical settings.

Aim

This study determined baseline values for B. cereus detection in clinical samples that are useful as reference values for hospitals when assessing the need for intervention.

Method

A retrospective analysis of B. cereus detection in the Japan Nosocomial Infections Surveillance data from 2008 to 2014 was performed; it included 950 individual hospitals across the country.

Findings

Bacillus spp. were detected in 0.54% of the clinical specimens submitted for bacteriological testing. Specimens positive for Bacillus spp. were mainly blood (24.6%), stool (26.5%), and respiratory specimens (23.3%). Identification of Bacillus spp. at the species level (i.e., B. cereus or B. subtilis) was reported in 55.3%, 14.7%, and 15.4% of cases, of which 88.9%, 48.3%, and 33.1% were B. cereus in blood, stool, and respiratory specimens, respectively. Of the 4105 hospital-years, 75.7% had blood specimens with Bacillus spp., with a median of 0.85 blood specimens/100 beds annually (interquartile range, 0.17-2.10). The B. cereus detection showed significant summer seasonality, regardless of specimen type or geographic distribution. The B. subtilis detection did not show seasonality, and its detection remained constant throughout the year. The seasonality of Bacillus spp. reflects the high proportion of B. cereus.

Conclusions

The increased detection rate of Bacillus spp. during summer should be interpreted as a risk factor for B. cereus BSIs. A post-summer decrease in Bacillus spp. should not be interpreted as an effect of interventions.

Prevention of central line-associated bloodstream infections: ICU nurses' knowledge and barriers

BACKGROUND

Central line-associated bloodstream infections (CLABSI) have been a significant challenge in care, increasing healthcare costs and leading to adverse outcomes, including mortality.

AIMS AND OBJECTIVES

The present study aimed to assess the knowledge of intensive care unit (ICU) nurses on the prevention of CLABSI and the implementation barriers of evidence-based guidelines in practice.

DESIGN

A cross-sectional study.

METHODS

Data were collected from adult, paediatric, and neonatal ICU nurses working in seven hospitals in Iran, using census sampling from April to July 2020.

RESULTS

A number 209 out of 220 ICU nurses participated in the present study (response rate of 95%). The median score of knowledge of ICU nurses towards the prevention of CLABSI was 3.00 out of 11. 50.72% of ICU nurses had insufficient knowledge. The most critical implementation barriers of evidence-based guidelines were high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

CONCLUSIONS

Overall, the knowledge of ICU nurses towards the prevention of CLABSI was insufficient. Study findings suggest that the knowledge of ICU nurses may be improved by reducing the workload, increasing the number of nursing staff in the ICU, having an adequate supply of equipment needed to ensure safe practice in the ICU, and providing regular related educational workshops for nurses working in the ICU.

RELEVANCE TO CLINICAL PRACTICE

The present study's findings suggest that regular training programs should be developed to improve the knowledge of ICU nurses in the care and prevention of CLABSI. Nursing policymakers and managers need to identify and address implementation barriers of evidence-based guidelines to improve nursing, such as high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.