The impact of healthcare associated infections on mortality and length of stay in Singapore-A time-varying analysis

Healthcare-Associated Infections and the Use of Antibiotics in German Hospitals

BACKGROUND

A national point prevalence survey (PPS) of healthcare-associated infections (HAI) and antibiotic use (AU) was carried out in Germany in 2022 in the framework of the European PPS conducted by the European Centre for Disease Prevention and Control (ECDC). The objective was to determine the prevalence of HAI and AU in German hospitals and to compare the obtained values with those of the most recent previous PPS, which was carried out in 2016.

METHODS

The German National Reference Center for the Surveillance of Nosocomial Infections was entrusted with the organization of the PPS of 2022. As recommended by the ECDC, each hospital in a representative sample of 50 hospitals was invited to participate, and all other interested hospitals in Germany were also able to participate if desired. The data were collected by specially trained hospital staff in May, June, and July 2022. The definitions and methods put forth by the ECDC were used.

RESULTS

Data from 66 586 patients in 252 hospitals were included. The prevalence of HAI in all participating hospitals was 4.9%, and that of AU was 26.9%. The HAI and AU prevalences were essentially unchanged in comparison to 2016. The most common types of HAI were surgical site infection (23.5%), lower respiratory tract infection (21.6%), and urinary tract infection (19.0%).

CONCLUSION

HAI were just as frequent in 2022 as in 2016, affecting approximately one in twenty hospitalized patients on any given day.

Cell Phones in the OR: A Cross-Sectional Study of Norwegian Perioperative Nurses' Knowledge, Practice, and Attitudes

Few studies have focused on the use of cell phones in the OR. In Norway, researchers sought to assess perioperative nurses' knowledge, practice, and attitudes associated with cell phone use in the OR and distributed a nationwide questionnaire via a social media platform. More than 80% of the 332 respondents thought that cell phones were contaminated and that pathogens could contaminate hands. Almost all respondents brought their phone to work; approximately 61% of respondents carried it in their pocket in the OR. Responses to questions about phone cleaning showed that 39 (11.7%) of the respondents routinely cleaned their phone before entering the OR and 33 (9.9%) of the respondents cleaned it when leaving the OR. Less than 20% of respondents indicated their facility had guidelines for cleaning personal cell phones. Opportunities for improvement in cell phone cleaning in ORs exist and additional research involving all perioperative team members is needed.

Infection control knowledge and practices among radiographers at government hospitals in the Gaza Strip-Palestine: A cross-sectional study

INTRODUCTION

Infections acquired in hospitals are a major concern for patients, professionals and policymakers. They have an impact on the morbidity and mortality rates, length of stay, and microbial resistance. Radiology departments are at high risk for nosocomial infections, and radiographers must adhere to infection control protocols to avoid contracting illnesses and the spread of pathogens. The purpose of this study was to assess radiographers' knowledge and practise of infection control and standard precautions in the Gaza Strip-Palestine government hospitals and to identify the factors that impede radiographers' implementation of infection control.

METHODS

A hospital-based descriptive cross-sectional study design was applied. A self-administered questionnaire survey with 24 items was developed and distributed to examine radiographers' knowledge and practise of nosocomial infections control and standard precautions from September 2019 to February 2020. Descriptive and inferential statistics were generated using SPSS version 20.

RESULTS

With a response rate of 86.6%, 73 males and 37 females out of a total of 127 radiographers participated in this study. The vast majority of radiographers, 86 (78.2%), have never been trained in infection control. Total levels of knowledge and practise were 74.4% and 65.2%, respectively which corresponded to moderate levels. Age had a statistically significant impact on both knowledge and practise scores (P = 0.002 and p = 0.019, respectively). In addition, the differences between radiographers' years of work experience and their ratings on knowledge and practise were statistically significant (P = 0.001 and p = 0.011, respectively). A heavy workload, insufficient time, and a lack of training were the main barriers to implementing infection control measures in hospitals.

CONCLUSION

Palestinian radiographers reported a moderate level of knowledge and practise of infection control. The majority of radiographers have never had formal infection control training.

IMPLICATIONS FOR PRACTICE

This paper has highlighted the need for a continuing education and training programme for practising radiographers to improve their performance in infection control measures.

Efficacy and safety of neuromuscular electrical stimulation in the prevention of pressure injuries in critically ill patients: a randomized controlled trial

Background

Pressure injuries (PIs), especially in the sacral region are frequent, costly, and increase morbidity and mortality of patients in an intensive care unit (ICU). These injuries can occur as a result of prolonged pressure and/or shear forces. Neuromuscular electrical stimulation (NMES) can increase muscle mass and improve local circulation, potentially reducing the incidence of PI.

Methods

We performed a randomized controlled trial to assess the efficacy and safety of NMES in preventing PI in critically ill patients. We included patients with a period of less than 48 h in the ICU, aged ≥ 18 years. Participants were randomly selected (1:1 ratio) to receive NMES and usual care (NMES group) or only usual care (control group—CG) until discharge, death, or onset of a PI. To assess the effectiveness of NMES, we calculated the relative risk (RR) and number needed to treat (NNT). We assessed the muscle thickness of the gluteus maximus by ultrasonography. To assess safety, we analyzed the effects of NMES on vital signs and checked for the presence of skin burns in the stimulated areas. Clinical outcomes were assessed by time on mechanical ventilation, ICU mortality rate, and length of stay in the ICU.

Results

We enrolled 149 participants, 76 in the NMES group. PIs were present in 26 (35.6%) patients in the CG and 4 (5.3%) in the NMES group (p ˂ 0.001). The NMES group had an RR = 0.15 (95% CI 0.05–0.40) to develop a PI, NNT = 3.3 (95% CI 2.3–5.9). Moreover, the NMES group presented a shorter length of stay in the ICU: Δ = − 1.8 ± 1.2 days, p = 0.04. There was no significant difference in gluteus maximus thickness between groups (CG: Δ = − 0.37 ± 1.2 cm vs. NMES group: Δ = 0 ± 0.98 cm, p = 0.33). NMES did not promote deleterious changes in vital signs and we did not detect skin burns.

Conclusions

NMES is an effective and safe therapy for the prevention of PI in critically ill patients and may reduce length of stay in the ICU.

Trial registration RBR-8nt9m4. Registered prospectively on July 20th, 2018, https://ensaiosclinicos.gov.br/rg/RBR-8nt9m4

Characterization and Genomic Analysis of Bacteriophage vB_KpnM_IME346 Targeting Clinical Klebsiella pneumoniae Strain of the K63 Capsular Type

A Klebsiella pneumoniae bacteriophage (vB_KpnM_IME346) was isolated from a hospital sewage sample. This bacteriophage specifically infects a clinical K. pneumoniae strain with a K63 capsular polysaccharide structure. The phage genome was evaluated by next-generation sequencing, which revealed a linear double-stranded DNA genome consisting of 49,482 base pairs with a G+C content of 49.1%. The latent period of vB_KpnM_IME346 was shown to be 20 min, and the burst size was 25–30 pfu (plaque-forming units)/infected cell. Transmission electron microscopy and phylogenetic analysis showed that the JD001-like phage belongs to the genus Jedunavirus of the family Myoviridae. The newly isolated vB_KpnM_IME346 shows infectivity in the clinical host K. pneumoniae KP576 strain, indicating that it is a promising alternative to antibacterial agents for removing K. pneumoniae from patients.

Estimating the excess bed days and economic burden of healthcare-associated infections in Singapore public acute-care hospitals

We estimated the annual bed days lost and economic burden of healthcare-associated infections to Singapore hospitals using Monte Carlo simulation. The mean (standard deviation) cost of a single healthcare-associated infection was S$1,809 (S$440) [or US$1,362 (US$331)]. This translated to annual lost bed days and economic burden of 55,978 (20,506) days and S$152.0 million (S$37.1 million) [or US$114.4 million (US$27.9 million)], respectively.