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Chen Y, Zhang Y, Nie S, Ning J, Wang Q, Yuan H, Wu H, Li B, Hu W, Wu C. Risk assessment and prediction of nosocomial infections based on surveillance data using machine learning methods. BMC Public Health 2024; 24:1780. [PMID: 38965513 PMCID: PMC11223322 DOI: 10.1186/s12889-024-19096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/10/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Nosocomial infections with heavy disease burden are becoming a major threat to the health care system around the world. Through long-term, systematic, continuous data collection and analysis, Nosocomial infection surveillance (NIS) systems are constructed in each hospital; while these data are only used as real-time surveillance but fail to realize the prediction and early warning function. Study is to screen effective predictors from the routine NIS data, through integrating the multiple risk factors and Machine learning (ML) methods, and eventually realize the trend prediction and risk threshold of Incidence of Nosocomial infection (INI). METHODS We selected two representative hospitals in southern and northern China, and collected NIS data from 2014 to 2021. Thirty-nine factors including hospital operation volume, nosocomial infection, antibacterial drug use and outdoor temperature data, etc. Five ML methods were used to fit the INI prediction model respectively, and to evaluate and compare their performance. RESULTS Compared with other models, Random Forest showed the best performance (5-fold AUC = 0.983) in both hospitals, followed by Support Vector Machine. Among all the factors, 12 indicators were significantly different between high-risk and low-risk groups for INI (P < 0.05). After screening the effective predictors through importance analysis, prediction model of the time trend was successfully constructed (R2 = 0.473 and 0.780, BIC = -1.537 and -0.731). CONCLUSIONS The number of surgeries, antibiotics use density, critical disease rate and unreasonable prescription rate and other key indicators could be fitted to be the threshold predictions of INI and quantitative early warning.
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Affiliation(s)
- Ying Chen
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Yonghong Zhang
- Department of Medical Affairs, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750004, PR China
| | - Shuping Nie
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Jie Ning
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Qinjin Wang
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Hanmei Yuan
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Hui Wu
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Bin Li
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Chao Wu
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518003, PR China.
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Ye M, Tang F, Chien CW, Chuang YC, Liou JJH, Qu X. Application of failure mode and effect analysis in ICU admission of potentially COVID-19 infected patients. Am J Infect Control 2024; 52:552-562. [PMID: 38142777 DOI: 10.1016/j.ajic.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND To analyze the admission and treatment process of potentially COVID-19-infected patients in the intensive care unit under normalization, prevention, and control of the pandemic. METHODS A multidisciplinary team was assembled to develop a flowchart of potentially COVID-19-infected patients admitted to the intensive care unit and identify potential failure steps and modes throughout the process using the failure mode and effect analysis method. Through risk priority number (RPN) analysis of each failure mode, those with the highest impact on nosocomial infection were identified, and the priority of implementation was determined. Related corrective measures have been developed to continuously improve clinical practice and management. RESULTS Eighty potential failure modes were identified, and 8 potential failure modes were identified with RPNs greater than 100. These high RPNs of the failure modes were associated with careless inquiries of epidemiological histories by nurses, inadequate implementation of management standards by nursing assistants, and exposure of attending physicians to potentially risky environments. Finally, 18 general corrective measures are proposed. CONCLUSIONS Application of the failure mode and effect analysis method for quality improvement is a powerful tool for predicting potential failures in the process and can suggest corrective measures that could help avoid nosocomial infection during a pandemic.
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Affiliation(s)
- Mao Ye
- Department of Intensive Care Unit, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Fuqin Tang
- Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, China
| | - Yen-Ching Chuang
- Business College, Taizhou University, Taizhou, Zhejiang, China; Institute of Public Health and Emergency Management, Taizhou University, Taizhou, Zhejiang, China; Key Laboratory of evidence-based Radiology of Taizhou, Linhai, Zhejiang, China.
| | - James J H Liou
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan.
| | - Xixi Qu
- Department of Intensive Care Unit, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.
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Lv Y, Huang X, Wu J, Xiao X, Ma C, Jiang X, Zhou P, Liu L, Jiang Y, Zou A, Niu H, Sun J, Hou L, Wang X, Dai Y, Peng S, Deng X, Xia H, Guo Y, Wang D, Huang T, Li C, He L, Xiong F, Xiong H, Cao H, Lu J, Liu X, Jian X, Luo W, An Y, Wu Y, Deng K, Kang X, Chen X, Tang B, Li L, Xiang Q. Economic burden attributable to healthcare-associated infections at western China hospitals: 6 Year, prospective cohort study. J Infect 2024; 88:112-122. [PMID: 38135161 DOI: 10.1016/j.jinf.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES Healthcare-associated infections (HAIs) represent a major threat to patient safety and are associated with significant economic burden. Calculating the costs attributable to HAIs is challenging given the various sources of bias. Although HAIs as a reasonably preventable medical harm should have been closely linked to medical insurance incentives, there was little linkage between HAIs and medicare in western China owing to the lack of economic evaluation data. The present study aimed to generate estimates of the attributable costs associated with HAIs and the magnitude of costs growth. METHODS In this cohort study designed horizontally and vertically from 2016 to 2022, we compared outcomes of randomly sampling patients with HAIs and individually matched patients without HAIs in two cohorts at a 6-year interval at 34 hospitals in western China. The primary outcome was the direct medical cost for the entire hospital stay, converted to US dollars ($ for the benchmark year), discounted at 3% annually, and estimated separately in the full analysis set (FAS) and the per protocol set (PPS). We used multiple linear regression to adjust the discounted costs and to assess subgroups effects within each cohort. We nested a dynamic vertical comparison of costs attributable to HAIs between the front and rear cohorts. RESULTS A total of 230 patients with HAIs in 2016 and 204 patients with HAIs in 2022 were enrolled. After a 1:1 match, all 431 pairs were recruited as FAS, of which 332 pairs as PPS met all matching restrictions. Compared to the 2016 cohort in FAS, the patients with HAIs in 2022 had a significantly older age (64.40 ± 16.45 years), higher repeat hospitalization rate (65 [32.02%] of 203), and lower immune function (69 [33.99%] of 203). The discounted costs and adjusted-discounted costs for patients with HAIs in the 2022 cohort were found to be significantly higher than those of patients without HAIs (discounted costs: $5484.60 [IQR 8426.03] vs $2554.04(4530.82), P < 0.001; adjusted-discounted costs: $5235.90 [3772.12] vs $3040.21(1823.36), P < 0.001, respectively), and also higher than those of patients with HAIs in the 2016 cohort (discounted costs: $5484.60 [8426.03] vs $3553.00 [6127.79], P < 0.001; adjusted-discounted costs: $5235.90 [3772.12] vs $3703.82 [3159.14], P < 0.001, respectively). In vertical comparison of PPS, the incremental costs of the 2022 cohort are 1.48 times higher than those of the 2016 cohort ($964.63(4076.15) vs $652.43 [2533.44], P = 0.084). CONCLUSIONS This meticulously designed study in western China has successfully and accurately examined the economic burden attributable to HAIs. Their rapidly increasing tendency poses a serious challenge to patients, hospitals, and the medical insurance. A closer linkage between HAIs and ongoing motivating system changes is urgently needed in western China.
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Affiliation(s)
- Yu Lv
- Healthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Xiaobo Huang
- Dean's Office, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Jiayu Wu
- Healthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Xueqin Xiao
- Healthcare-associated Infection Management Department, West China-Ziyang hospital, Sichuan University, The First People's Hospital of Ziyang, Ziyang 641399, China
| | - Chunhua Ma
- Healthcare-associated Infection Management Department, Mianyang Central Hospital, Mianyang 621099, China
| | - Xiaoyun Jiang
- Healthcare-associated Infection Management Department, Deyang People's Hospital, Deyang 618099, China
| | - Ping Zhou
- Healthcare-associated Infection Management Department, Zigong First People's Hospital, Zigong 643099, China
| | - Linlin Liu
- Healthcare-associated Infection Management Department, People's Hospital of Leshan, Leshan 614003, China
| | - Yiguo Jiang
- Healthcare-associated Infection Management Office, First People's Hospital of Liangshan Yi Autonomous Prefecture, Liangshan 615099, China
| | - Anna Zou
- Healthcare-associated Infection Management Department, First Peoples Hospital of Neijiang, Neijiang 641099, China
| | - Hui Niu
- Healthcare-associated Infection Management Department, Sichuan Science City Hospital, Chengdu 610299, China
| | - Juhua Sun
- Healthcare-associated Infection Management Department, Bazhong Central Hospital, Bazhong 636001, China
| | - Li Hou
- Healthcare-associated Infection Management Department, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang 621054, China
| | - Xiaomeng Wang
- Healthcare-associated Infection Management Department, The Fourth People's Hospital of Zigong City, Zigong 643099, China
| | - Yulin Dai
- Healthcare-associated Infection Management Department, Leshan Hospital of Traditional Chinese Medicine, Leshan 614003, China
| | - Shuling Peng
- Healthcare-associated Infection Management Department, Bazhong Hospital of Traditional Chinese Medicine, Bazhong 636001, China
| | - Xiaorong Deng
- Healthcare-associated Infection Management Department, Mianyang Hospital of Traditional Chinese Medicine, Mianyang 621053, China
| | - Hong Xia
- Healthcare-associated Infection Management Department, The Second Hospital of Traditional Chinese Medicine in Sichuan Province, Chengdu 610014, China
| | - Yao Guo
- Healthcare-associated Infection Management Department, Sichuan Provincial Judicial Police Hospital, Chengdu 610225, China
| | - Defen Wang
- Healthcare-associated Infection Management Department, Mianyang Orthopaedic Hospital, Mianyang 621052, China
| | - Ting Huang
- Healthcare-associated Infection Management Department, Nanchong Mental Health Center, Nanchong 637000, China
| | - Chunyu Li
- Healthcare-associated Infection Management Department, Yibin Rehabilitation Hospital, Yibin 644002, China
| | - Lirong He
- Healthcare-associated Infection Management Department, The People's Hospital of Xinjin, Chengdu 611430, China
| | - Fengqing Xiong
- Healthcare-associated Infection Management Department, Qionglai Medical Center Hospital, Chengdu 611535, China
| | - Hongmei Xiong
- Healthcare-associated Infection Management Department, Chengdu Longquanyi District Hospital of Traditional Chinese Medicine, Chengdu 610100, China
| | - Hongmei Cao
- Healthcare-associated Infection Management Department, Dayi County People's Hospital, Chengdu 611330, China
| | - Jie Lu
- Healthcare-associated Infection Management Department, Chengdu East New Area Hospital of Integrated Traditional Chinese Medicine, Chengdu 641499, China
| | - Xingfeng Liu
- Healthcare-associated Infection Management Department, Luojiang People's Hospital, Deyang 618599, China
| | - Xiaohong Jian
- Healthcare-associated Infection Management Department, Fushun People's Hospital, Zigong 643299, China
| | - Wanzhen Luo
- Healthcare-associated Infection Management Department, Fushun Hospital of Traditional Chinese Medicine, Zigong 643299, China
| | - Yanmei An
- Healthcare-associated Infection Management Department, Hejiang County People's Hospital, Luzhou 646299, China
| | - Yumei Wu
- Healthcare-associated Infection Management Department, Jiangyou Third People's Hospital, Mianyang 621799, China
| | - Keqin Deng
- Healthcare-associated Infection Management Department, Xingwen County People's Hospital, Yibin 644499, China
| | - Xiaoli Kang
- Healthcare-associated Infection Management Department, Anyue County People's Hospital, Ziyang 642350, China
| | - Xiaorong Chen
- Healthcare-associated Infection Management Department, An County People's Hospital, Mianyang 622651, China
| | - Beibei Tang
- Healthcare-associated Infection Management Department, Yanjiang People's Hospital, Ziyang 641399, China
| | - Li Li
- Healthcare-associated Infection Management Department, Wangcang People's Hospital, Guangyuan 628202, China
| | - Qian Xiang
- Healthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
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Kubde D, Badge AK, Ugemuge S, Shahu S. Importance of Hospital Infection Control. Cureus 2023; 15:e50931. [PMID: 38259418 PMCID: PMC10801286 DOI: 10.7759/cureus.50931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
The increasing demand for healthcare-acquired infection (HAI) control practices and services has intensified the need to evaluate care quality. The World Health Organization (WHO) introduced an infection prevention and control (IPC) framework to mitigate the impact of HAIs, crucial for ensuring patient safety in hospitals. HAIs acquired after hospitalization pose significant challenges due to factors such as compromised immunity, invasive medical procedures, and antibiotic-resistant pathogens, which have dire consequences, including higher mortality rates and increased healthcare costs. Healthcare workers (HCWs) are critical in implementing IPC measures. Infection control programs that include strategies such as hand hygiene, personal protective equipment (PPE), environmental cleaning, and surveillance have become standard. However, challenges such as resistance to change, resource limitations, patient turnover, and variability in patient conditions persist. Strategies to maintain hospital infection control involve rigorous compliance monitoring, staff education, advanced technologies such as artificial intelligence (AI), machine learning (ML), telemedicine, and innovative sanitation methods. The future of hospital infection control may involve increased integration of environmental monitoring, antimicrobial stewardship, and patient participation while leveraging collaboration among healthcare facilities. The review highlights the criticality of hospital infection control and suggests trends and opportunities to strengthen prevention efforts and patient safety.
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Affiliation(s)
- Dimple Kubde
- School of Allied Health Sciences, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Ankit K Badge
- Department of Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Sarita Ugemuge
- Department of Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Shivani Shahu
- School of Allied Health Sciences, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
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Konno A, Okubo T, Enoeda Y, Uno T, Sato T, Yokota SI, Yano R, Yamaguchi H. Human pathogenic bacteria on high-touch dry surfaces can be controlled by warming to human-skin temperature under moderate humidity. PLoS One 2023; 18:e0291765. [PMID: 37729194 PMCID: PMC10511134 DOI: 10.1371/journal.pone.0291765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Healthcare-associated infections have become a major health issue worldwide. One route of transmission of pathogenic bacteria is through contact with "high-touch" dry surfaces, such as handrails. Regular cleaning of surfaces with disinfectant chemicals is insufficient against pathogenic bacteria and alternative control methods are therefore required. We previously showed that warming to human-skin temperature affected the survival of pathogenic bacteria on dry surfaces, but humidity was not considered in that study. Here, we investigated environmental factors that affect the number of live bacteria on dry surfaces in hospitals by principal component analysis of previously-collected data (n = 576, for CFU counts), and experimentally verified the effect of warming to human-skin temperature on the survival of pathogenic bacteria on dry surfaces under humidity control. The results revealed that PCA divided hospital dry surfaces into four groups (Group 1~4) and hospital dry surfaces at low temperature and low humidity (Group 3) had much higher bacterial counts as compared to the others (Group 1 and 4) (p<0.05). Experimentally, warming to human-skin temperature (37°C with 90% humidity) for 18~72h significantly suppressed the survival of pathogenic bacteria on dry surfaces, such as plastic surfaces [p<0.05 vs. 15°C (Escherichia coli DH5α, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and blaNDM-5 E. coli)] or handrails [p<0.05 vs. 15~25°C (E. coli DH5α, S. aureus, P. aeruginosa, A. baumannii)], under moderate 55% humidity. Furthermore, intermittent heating to human-skin temperature reduced the survival of spore-forming bacteria (Bacillus subtilis) (p<0.01 vs. continuous heating to human-skin temperature). NhaA, an Na+/H+ antiporter, was found to regulate the survival of bacteria on dry surfaces, and the inhibitor 2-aminoperimidine enhanced the effect of warming at human-skin temperature on the survival of pathogenic bacteria (E. coli DH5α, S. aureus, A. baumannii) on dry surfaces. Thus, warming to human-skin temperature under moderate humidity is a useful method for impairing live pathogenic bacteria on high-touch surfaces, thereby helping to prevent the spread of healthcare-associated infections.
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Affiliation(s)
- Ayano Konno
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Torahiko Okubo
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Yoshiaki Enoeda
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Tomoko Uno
- Department of Nursing, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan
- Faculty of Health Sciences, Department of Fundamental Nursing, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Toyotaka Sato
- Department of Microbiology, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan
- Faculty of Veterinary Medicine, Laboratory of Veterinary Hygiene, Hokkaido University, Kita-ku, Sapporo, Japan
- Graduate School of Infectious Diseases, Hokkaido University, Kita-ku, Sapporo, Japan
- One Health Research Center, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Shin-ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan
| | - Rika Yano
- Faculty of Health Sciences, Department of Fundamental Nursing, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Hiroyuki Yamaguchi
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
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Du Y, Zhao F, Tao R, Liu B. Effect of forceful suction and air disinfection machines on aerosol removal. BMC Oral Health 2023; 23:652. [PMID: 37684672 PMCID: PMC10492290 DOI: 10.1186/s12903-023-03369-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUNDS Dental procedures involving drilling and grinding can produce a significant amount of suspended aerosol particles (PM) and bioaerosols. This study aims to analyze the size and concentration of aerosol particles generated during drilling and to investigate the effectiveness of two air exchange systems, namely forceful suction (FS) and air disinfection machines (DM), in removing PM. METHODS For this study, 100 extracted permanent teeth were collected and divided into three groups: without suction (n = 50), suction with forceful suction (n = 25), and suction with air disinfection machines (n = 25). The removal rate of suspended aerosol particles was analyzed using particle counters and air data multimeter. RESULTS When drilling and grinding were performed without vacuum, 0.75% of the aerosol particles generated were PM2.5-10, 78.25% of total suspended aerosol particles (TSP) were PM2.5, and 98.68% of TSP were PM1. The nanoanalyzer measurements revealed that the aerodynamic diameter of most aerosol particles was below 60 nm, with an average particle diameter of 52.61 nm and an average concentration of 2.6*1011 ultrafine aerosol particles. The air change per hour (ACH) was significantly lower in the air disinfection machines group compared to the forceful suction group. Additionally, the number of aerosol particles and mass concentration was significantly lower in the air disinfection machines group compared to the forceful suction group in terms of PM2.5 levels. However, the forceful suction group also reduced the mass concentration in PM10 level than the air disinfection machines group. CONCLUSION In conclusion, the air exchange system can reduce the aerosol particles generated during drilling and grinding. Comparing the two air exchange systems, it was found that the air disinfection machines group reduces the number of aerosol particles and mass concentration in PM2.5 levels, while the forceful suction group reduces the mass concentration in PM10 level.
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Affiliation(s)
- Yaru Du
- Department of hospital allergy, Medical department, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Fei Zhao
- Department of Periodontal I, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Ran Tao
- Medical department, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Bing Liu
- Department of Periodontal I, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
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Xie Z, Tan Y, Yan Y, Gu X, Chen H, Huang Q, Wang Z, Gu J, Huang J. Concerns about and stimuli of COVID-19 vaccination hesitancy among diverse occupational groups in metropolitan areas of China: a cross-sectional study. BMJ Open 2022; 12:e062032. [PMID: 36549746 PMCID: PMC9772125 DOI: 10.1136/bmjopen-2022-062032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES In this study, we aimed to identify concerns and stimuli regarding COVID-19 vaccination acceptance and to compare the findings by occupation. METHODS We conducted a cross-sectional study of individuals vaccinated against COVID-19 between 1 April and 30 June 2021 in four metropolitan areas of China. A total of 20 863 participants completed questionnaires, 20 767 of which were eligible for analysis. We used ordered logistic regression to assess the association of vaccination concerns and stimuli with vaccination hesitancy according to occupation. RESULTS Farmers were mainly concerned about the quality of vaccines (adjusted OR (aOR): 3.18, 95% CI (CI): 1.83 to 5.54). Among civil servants, media publicity reduced hesitancy (aOR: 0.44, 95% CI: 0.21 to 0.92). Among medical staff, concerns about a short duration of protective effects increased hesitancy (aOR: 8.31, 95% CI: 2.03 to 33.99). For most occupations, concerns about side effects, poor protective effects and health status increased hesitancy. In contrast, protecting oneself and protecting others acted as a stimulus to decrease hesitancy. Interestingly, 'people around me have been vaccinated' was associated with higher vaccination hesitancy among farmers (aOR: 2.19, 95% CI: 1.20 to 4.00). CONCLUSION The association of vaccination concerns and stimuli with vaccination hesitancy varied by occupation. The characteristics and concerns of specific target audiences should be considered when designing informational campaigns to promote vaccination against COVID-19.
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Affiliation(s)
- Zhilan Xie
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yinliang Tan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuge Yan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoqing Gu
- Xidu Community Health Service Center of Fengxian District, Shanghai, China
| | - Haiying Chen
- Xidu Community Health Service Center of Fengxian District, Shanghai, China
| | - Qian Huang
- Weifang Community Health Service Center of Pudong New District, Shanghai, China
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Gu
- Department of General Practition, Zhongshan Hospital Fudan University, Shanghai, China
- International Medical Center, Zhong Shan Hospital, Shanghai, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhou B, Liu T, Yi S, Huang Y, Guo Y, Huang S, Zhou C, Zhou R, Cao H. Reducing the Effectiveness of Ward Particulate Matter, Bacteria and Influenza Virus by Combining Two Complementary Air Purifiers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10446. [PMID: 36012090 PMCID: PMC9408449 DOI: 10.3390/ijerph191610446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Air purifiers should pay much attention to hospital-associated infections, but the role of a single air purifier is limited. The goal of this study was to evaluate the effectiveness of the combined application of the nonequilibrium positive and negative oxygen ion purifier (PNOI) and the high-efficiency particulate air filter (HEPA) on a complex, polluted environment. Two of the better performing purifiers were selected before the study. The efficacy of their use alone and in combination for purification of cigarette particulate matter (PM), Staphylococcus albicans, and influenza virus were then evaluated under a simulated contaminated ward. PNAI and HEPA alone are deficient. However, when they were combined, they achieved 98.44%, 99.75%, and 100% 30 min purification rates for cigarette PM, S. albus, and influenza virus, respectively. The purification of pollution of various particle sizes and positions was optimized and reduced differentials, and a subset of airborne influenza viruses is inactivated. Furthermore, they were superior to ultraviolet disinfection for microbial purification in air. This work demonstrates the strong purification capability of the combined application of these two air purifiers for complex air pollution, which provides a new idea for infection control in medical institutions.
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Affiliation(s)
- Bingliang Zhou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Tiantian Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China
| | - Siqi Yi
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510180, China
| | - Yuanyuan Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yubing Guo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510180, China
| | - Si Huang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510180, China
| | - Chengxing Zhou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Rong Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510180, China
| | - Hong Cao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
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9
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Brêda Mascarenhas LA, Machado BAS, Rodrigues LDAP, Saraiva Hodel KV, Bandeira Santos AÁ, Freitas Neves PR, da Silva Andrade LPC, Soares MB, de Andrade JB, Badaró R. Potential application of novel technology developed for instant decontamination of personal protective equipment before the doffing step. PLoS One 2021; 16:e0250854. [PMID: 34086691 PMCID: PMC8177472 DOI: 10.1371/journal.pone.0250854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
The use of personal protective equipment (PPE) has been considered the most effective way to avoid the contamination of healthcare workers by different microorganisms, including SARS-CoV-2. A spray disinfection technology (chamber) was developed, and its efficacy in instant decontamination of previously contaminated surfaces was evaluated in two exposure times. Seven test microorganisms were prepared and inoculated on the surface of seven types of PPE (respirator mask, face shield, shoe, glove, cap, safety glasses and lab coat). The tests were performed on previously contaminated PPE using a manikin with a motion device for exposure to the chamber with biocidal agent (sodium hypochlorite) for 10 and 30s. In 96.93% of the experimental conditions analyzed, the percentage reduction was >99% (the number of viable cells found on the surface ranged from 4.3x106 to <10 CFU/mL). The samples of E. faecalis collected from the glove showed the lowest percentages reduction, with 86.000 and 86.500% for exposure times of 10 and 30 s, respectively. The log10 reduction values varied between 0.85 log10 (E. faecalis at 30 s in glove surface) and 9.69 log10 (E. coli at 10 and 30 s in lab coat surface). In general, E. coli, S. aureus, C. freundii, P. mirabilis, C. albicans and C. parapsilosis showed susceptibility to the biocidal agent under the tested conditions, with >99% reduction after 10 and 30s, while E. faecalis and P. aeruginosa showed a lower susceptibility. The 30s exposure time was more effective for the inactivation of the tested microorganisms. The results show that the spray disinfection technology has the potential for instant decontamination of PPE, which can contribute to an additional barrier for infection control of healthcare workers in the hospital environment.
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Affiliation(s)
- Luís Alberto Brêda Mascarenhas
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Bruna Aparecida Souza Machado
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- SENAI CIMATEC, National Service of Industrial Learning–SENAI, Computational Modeling and Industrial Technology, University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Leticia de Alencar Pereira Rodrigues
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Katharine Valéria Saraiva Hodel
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Alex Álisson Bandeira Santos
- SENAI CIMATEC, National Service of Industrial Learning–SENAI, Computational Modeling and Industrial Technology, University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Paulo Roberto Freitas Neves
- SENAI CIMATEC, National Service of Industrial Learning–SENAI, Computational Modeling and Industrial Technology, University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Leone Peter Correia da Silva Andrade
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Milena Botelho Soares
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador, Bahia, Brazil
| | - Jailson Bittencourt de Andrade
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Roberto Badaró
- SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
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10
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Wagner CE, Prentice JA, Saad-Roy CM, Yang L, Grenfell BT, Levin SA, Laxminarayan R. Economic and Behavioral Influencers of Vaccination and Antimicrobial Use. Front Public Health 2020; 8:614113. [PMID: 33409264 PMCID: PMC7779682 DOI: 10.3389/fpubh.2020.614113] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/01/2020] [Indexed: 01/07/2023] Open
Abstract
Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for “philosophical belief-based” non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.
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Affiliation(s)
- Caroline E Wagner
- Department of Bioengineering, McGill University, Montreal, QC, Canada
| | - Joseph A Prentice
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Chadi M Saad-Roy
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, United States
| | - Luojun Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, United States.,Fogarty International Center, National Institutes of Health, Bethesda, MD, United States
| | - Simon A Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton Environmental Institute, Princeton University, Princeton, NJ, United States
| | - Ramanan Laxminarayan
- Princeton Environmental Institute, Princeton University, Princeton, NJ, United States.,Center for Disease Dynamics, Economics & Policy, Washington, DC, United States
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11
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Ong TWY, Liao W. Agroecological Transitions: A Mathematical Perspective on a Transdisciplinary Problem. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2020. [DOI: 10.3389/fsufs.2020.00091] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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12
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Anderson M, Schulze K, Cassini A, Plachouras D, Mossialos E. A governance framework for development and assessment of national action plans on antimicrobial resistance. THE LANCET. INFECTIOUS DISEASES 2019; 19:e371-e384. [PMID: 31588040 DOI: 10.1016/s1473-3099(19)30415-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 12/26/2022]
Abstract
Strengthening governance is an essential strategy to tackling antimicrobial resistance (AMR) at all levels: global, national, regional, and local. To date, no systematic approach to governance of national action plans on AMR exists. To address this issue, we aimed to develop the first governance framework to offer guidance for both the development and assessment of national action plans on AMR. We reviewed health system governance framework reviews to inform the basic structure of our framework, international guidance documents from WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the European Commission, and sought the input of 25 experts from international organisations, government ministries, policy institutes, and academic institutions to develop and refine our framework. The framework consists of 18 domains with 52 indicators that are contained within three governance areas: policy design, implementation tools, and monitoring and evaluation. To consider the dynamic nature of AMR, the framework is conceptualised as a cyclical process, which is responsive to the context and allows for continuous improvement and adaptation of national action plans on AMR.
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Affiliation(s)
- Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, London, UK.
| | - Kai Schulze
- Department of Health Policy, London School of Economics and Political Science, London, UK; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | | | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, UK
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