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Aveyard J, Richards S, Li M, Pitt G, Hughes GL, Akpan A, Akhtar R, Kazaili A, D'Sa RA. Nitric oxide releasing coatings for the prevention of viral and bacterial infections. Biomater Sci 2024. [PMID: 38980705 DOI: 10.1039/d4bm00172a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Healthcare associated infections (HCAI) represent a significant burden worldwide contributing to morbidity and mortality and result in substantial economic consequences equating to billions annually. Although the impacts of HCAI have been felt for many years, the coronavirus pandemic has had a profound effect, escalating rates of HCAI, even with extensive preventative measures such as vaccination, personal protective equipment, and deep cleaning regimes. Therefore, there is an urgent need for new solutions to mitigate this serious health emergency. In this paper, the fabrication of nitric oxide (NO) releasing dual action polymer coatings for use in healthcare applications is described. The coatings are doped with the NO donor S-nitroso-N-acetylpenicillamine (SNAP) and release high payloads of NO in a sustained manner for in excess of 50 hours. These coatings are extensively characterized in multiple biologically relevant solutions and the antibacterial/antiviral efficacy is studied. For the first time, we assess antibacterial activity in a time course study (1, 2, 4 and 24 h) in both nutrient rich and nutrient poor conditions. Coatings exhibit excellent activity against Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus (MRSA), with up to complete reduction observed over 24 hours. Additionally, when tested against SARS-CoV-2, the coatings significantly reduced active virus in as little as 10 minutes. These promising results suggest that these coatings could be a valuable addition to existing preventative measures in the fight against HCAIs.
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Affiliation(s)
- Jenny Aveyard
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Siobhan Richards
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Disease, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Man Li
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Graeme Pitt
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Grant L Hughes
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Disease, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Asangaedem Akpan
- Department of Musculoskeletal & Ageing Sciences, University of Liverpool, Liverpool L69 3GL, UK
- Liverpool University Hospitals NHS FT, Liverpool L7 8XP, UK
| | - Riaz Akhtar
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Ahmed Kazaili
- Department of Biochemistry & Systems Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Raechelle A D'Sa
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
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2
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Varney AM, Mannix-Fisher E, Thomas JC, McLean S. Evaluation of phenotypic and genotypic methods for the identification and characterization of bacterial isolates recovered from catheter-associated urinary tract infections. J Appl Microbiol 2024; 135:lxae155. [PMID: 38925648 DOI: 10.1093/jambio/lxae155] [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: 12/17/2023] [Revised: 06/19/2024] [Accepted: 06/25/2024] [Indexed: 06/28/2024]
Abstract
AIMS Urinary tract infections are the most common hospital-acquired infection, 80% of which are associated with catheterization. Diagnostic methods may influence the reported identities of these pathogens, and phenotypic testing under laboratory conditions may not reflect infection phenotypes. This study aimed to evaluate the efficacy of diagnostic methods and whether medium composition alters phenotypes by characterizing catheter-associated urinary tract infection isolates from a UK hospital. METHODS AND RESULTS We compared five bacterial identification methods, including biochemical testing, matrix-assisted laser desorption/ionization biotyping, and genome sequencing, finding differences in genus- or species-level identifications. Antibiotic susceptibility comparisons between phenotypic assays and genomic predictions showed high agreement only in multidrug-resistant strains. To determine whether growth rate and biofilm formation were affected by medium composition, strains were grown in both planktonic and biofilm states. Low planktonic growth and significant biofilm formation were observed in artificial urine compared to rich laboratory media, underscoring the importance of assay design. CONCLUSIONS This study highlights the risks of relying on a single diagnostic method for species identification, advocating for whole-genome sequencing for accuracy. It emphasizes the continued importance of phenotypic methods in understanding antibiotic resistance in clinical settings and the need for characterization conditions that mirror those encountered by pathogens in the body.
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Affiliation(s)
- Adam M Varney
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom
- Medical Technologies Innovation Facility (MTIF), Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, United Kingdom
| | - Eden Mannix-Fisher
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom
| | - Jonathan C Thomas
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom
| | - Samantha McLean
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom
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3
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Jeong SB, Heo KJ, Yoo JH, Kang DG, Santoni L, Knapp CE, Kafizas A, Carmalt CJ, Parkin IP, Shin JH, Hwang GB, Jung JH. Photobiocidal Activity of TiO 2/UHMWPE Composite Activated by Reduced Graphene Oxide under White Light. NANO LETTERS 2024. [PMID: 38917338 DOI: 10.1021/acs.nanolett.4c00939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Herein, we introduce a photobiocidal surface activated by white light. The photobiocidal surface was produced through thermocompressing a mixture of titanium dioxide (TiO2), ultra-high-molecular-weight polyethylene (UHMWPE), and reduced graphene oxide (rGO) powders. A photobiocidal activity was not observed on UHMWPE-TiO2. However, UHMWPE-TiO2@rGO exhibited potent photobiocidal activity (>3-log reduction) against Staphylococcus epidermidis and Escherichia coli bacteria after a 12 h exposure to white light. The activity was even more potent against the phage phi 6 virus, a SARS-CoV-2 surrogate, with a >5-log reduction after 6 h exposure to white light. Our mechanistic studies showed that the UHMWPE-TiO2@rGO was activated only by UV light, which accounts for 0.31% of the light emitted by the white LED lamp, producing reactive oxygen species that are lethal to microbes. This indicates that adding rGO to UHMWPE-TiO2 triggered intense photobiocidal activity even at shallow UV flux levels.
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Affiliation(s)
- Sang Bin Jeong
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Republic of Korea
- Indoor Environment Center, Korea Testing Laboratory, Seoul 08389, Republic of Korea
| | - Ki Joon Heo
- School of Mechanical Engineering, Chonnam National University, Gwangju 61186, Republic of Korea
| | | | - Dong-Gi Kang
- Department of Chemistry, University College London, London WC1H 0AJ, United Kingdom
| | - Leonardo Santoni
- Department of Chemistry, University College London, London WC1H 0AJ, United Kingdom
| | - Caroline E Knapp
- Department of Chemistry, University College London, London WC1H 0AJ, United Kingdom
| | - Andreas Kafizas
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus, 80 Wood Lane, London W12 OBZ, United Kingdom
| | - Claire J Carmalt
- Department of Chemistry, University College London, London WC1H 0AJ, United Kingdom
| | - Ivan P Parkin
- Department of Chemistry, University College London, London WC1H 0AJ, United Kingdom
| | - Jae Hak Shin
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Gi Byoung Hwang
- Department of Chemistry, University College London, London WC1H 0AJ, United Kingdom
| | - Jae Hee Jung
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Republic of Korea
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4
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Amini MS, Baseri Salehi M, Bahador N. Evaluating the antibacterial effect of meropenem-loaded chitosan/sodium tripolyphosphate (TPP) nanoparticles on Acinetobacter baumannii isolated from hospitalized patients. BMC Infect Dis 2024; 24:631. [PMID: 38914964 PMCID: PMC11197314 DOI: 10.1186/s12879-024-09522-7] [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: 03/08/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Acinetobacter baumannii is a health threat due to its antibiotic resistance. Herein, antibiotic susceptibility and its association with the Toxin-antitoxin (TA) system genes in A. baumannii clinical isolates from Iran were investigated. Next, we prepared meropenem-loaded chitosan nanoparticles (MP-CS) and investigated their antibacterial effects against meropenem-susceptible bacterial isolates. METHODS Out of 240 clinical specimens, 60 A. baumannii isolates were assessed. Antibiotic resistance of the isolates against conventional antibiotics was determined alongside investigating the presence of three TA system genes (mazEF, relBE, and higBA). Chitosan nanoparticles were characterized in terms of size, zeta potential, encapsulation efficiency, and meropenem release activity. Their antibacterial effects were assessed using the well diffusion method, minimum inhibitory concentration (MIC), and colony-forming unit (CFU) counting. Their cytotoxic effects and biocompatibility index were determined via the MTT, LDH, and ROS formation assays. RESULTS Ampicillin, ceftazidime, and colistin were the least effective, and amikacin and tobramycin were the most effective antibiotics. Out of the 60 isolates, 10 (16.7%), 5 (8.3%), and 45 (75%) were multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR), respectively. TA system genes had no significant effect on antibiotic resistance. MP-CS nanoparticles demonstrated an average size of 191.5 and zeta potential of 27.3 mV alongside a maximum encapsulation efficiency of 88.32% and release rate of 69.57%. MP-CS nanoparticles mediated similar antibacterial effects, as compared with free meropenem, against the A. baumannii isolates with significantly lower levels of meropenem. MP-CS nanoparticles remarkably prevented A549 and NCI-H292 cell infection by the A. baumannii isolates alongside demonstrating a favorable biocompatibility index. CONCLUSION Antibiotic-loaded nanoparticles should be further designed and investigated to increase their antibacterial effect against A. baumannii and assess their safety and applicability in vivo settings.
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Affiliation(s)
- Marziyeh Sadat Amini
- Department of Microbiology, Kazeroun Branch, Islamic Azad University, Kazeroun, Iran
| | - Majid Baseri Salehi
- Department of Microbiology, Kazeroun Branch, Islamic Azad University, Kazeroun, Iran.
| | - Nima Bahador
- Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
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Srivastava A, Sharma A, Jena MK, Vuppaladadiyam AK, Reguyal F, Joshi J, Sharma A, Shah K, Gupta A, Chin BLF, Saptoro A, Sarmah AK. Can pyrolysis handle biomedical wastes?: Assessing the potential of various biomedical waste treatment technologies in tackling pandemics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174167. [PMID: 38917898 DOI: 10.1016/j.scitotenv.2024.174167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/05/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024]
Abstract
Globally, COVID-19 has not only caused tremendous negative health, social and economic impacts, but it has also led to environmental issues such as a massive increase in biomedical waste. The biomedical waste (BMW) was generated from centralized (hospitals, clinics, and research facilities) and extended (quarantine camps, COVID-19 test camps, and quarantined homes) healthcare facilities. Many effects, such as the possibility of infection spread, unlawful dumping/disposal, and an increase in toxic emissions by common BMW treatment facilities, are conjectured because of the rise in waste generation. However, it is also an opportunity to critically analyze the current BMW treatment scenario and implement changes to make the system more economical and environmentally sustainable. In this review, the waste disposal guidelines of the BMW management infrastructure are critically analyzed for many functional parameters to bring out possible applications and limitations of individual interventions. In addition, an investigation was made to select appropriate technology based on the environmental setting.
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Affiliation(s)
- Akshay Srivastava
- Waste to Resources Laboratory, Department of Biotechnology & Chemical Engineering, Manipal University Jaipur, Jaipur 303007, India
| | - Anita Sharma
- Waste to Resources Laboratory, Department of Biotechnology & Chemical Engineering, Manipal University Jaipur, Jaipur 303007, India
| | - Manoj Kumar Jena
- School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | | | - Febelyn Reguyal
- Department of Civil & Environmental Engineering, Faculty of Engineering, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Jyeshtharaj Joshi
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai- 400094, India; Department of Chemical Engineering, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga, Mumbai-19, India
| | - Abhishek Sharma
- Waste to Resources Laboratory, Department of Biotechnology & Chemical Engineering, Manipal University Jaipur, Jaipur 303007, India; School of Engineering, RMIT University, Melbourne, VIC 3000, Australia.
| | - Kalpit Shah
- School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Akhilendra Gupta
- Malaviya National Institute of Technology, Malviya Nagar, Jaipur, Rajasthan 302017, India
| | - Bridgid Lai Fui Chin
- Department of Chemical and Energy Engineering, Curtin University Malaysia, 250 CDT, 98009 Miri, Sarawak, Malaysia
| | - Agus Saptoro
- Energy and Environment Research Cluster, Faculty of Engineering and Science, Curtin University Malaysia, 250 CDT, 98009 Miri, Sarawak, Malaysia
| | - Ajit K Sarmah
- Department of Civil & Environmental Engineering, Faculty of Engineering, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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Darjees D, Dhandapani S, Priyadarshi K, Cherian A, Sastry AS. Impact of care bundle audit on compliance to device care bundles and device associated infections in the Critical Care Unit of a tertiary care hospital, Southern India - A before-after interventional study. Indian J Med Microbiol 2024; 50:100651. [PMID: 38906328 DOI: 10.1016/j.ijmmb.2024.100651] [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: 12/12/2023] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND A care bundle comprises a set of evidence-based practices in patient care that are grouped together with the assumption that these practices when performed together will result in better clinical outcomes than when these practices are performed separately. Care bundles for devices when implemented effectively can bring about a reduction in device associated infection rates. METHODS The study was conducted in three phases, 1 month pre-interventional and interventional phases and 11 months of post-interventional phase in a critical care unit. Compliance to care bundles were recorded by direct observation during daily audit rounds. An educational intervention addressing the healthcare workers regarding bundle care approach was conducted and supplemented with bedside "audit and feedback" during the interventional phase. Audit was conducted in the post-interventional period to study the trend of device associated infections and compliance rates. RESULTS An increasing trend of month-wise compliance rates to the device care bundles were observed. The month-wise Ventilator Associated Events rates showed a decreasing trend. In the post-interventional phase, the average Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates showed a reduction from their respective baseline rates for the study setting. CONCLUSIONS An educational intervention targeted at the healthcare workers along with daily audit of care bundle practices in the critical care setting led to an increase in the compliance to device care bundles and a reduction in the incidence of Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates in the critical care setting.
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Affiliation(s)
- Dijo Darjees
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Gorimedu, Pondicherry, 605006, India.
| | - Sarumathi Dhandapani
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Gorimedu, Pondicherry, 605006, India.
| | - Ketan Priyadarshi
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Patna - Aurangabad Rd, Phulwari Sharif, Patna, Bihar, 801507, India.
| | - Anusha Cherian
- Department of Anesthesiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Gorimedu, Pondicherry, 605006, India.
| | - Apurba Sankar Sastry
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Gorimedu, Pondicherry, 605006, India.
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Doveri L, Diaz Fernandez YA, Dacarro G. Nanomaterials for Photothermal Antimicrobial Surfaces. ACS OMEGA 2024; 9:25575-25590. [PMID: 38911752 PMCID: PMC11190936 DOI: 10.1021/acsomega.4c01449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/25/2024]
Abstract
Microbial infection diseases are a major threat to human health and have become one of the main causes of mortality. The search for novel antimicrobial strategies is an important challenge for the scientific community, considering also the constant increase of antimicrobial resistance and the rise of new diseases. Among the new strategies to combat microbial infections, the photothermal effect seems to be one of the most promising. Hyperthermia is an effective and broad spectrum strategy for the removal of microbial infections. Among all of the strategies to reduce the diffusion of microbial infections, the preparation of antimicrobial surfaces seems of primary importance. In many cases, in fact, an infection can be diffused through surfaces just by touching them, or by inoculating microbes through an internalizable device, such as an implant, a prosthesis, or a catheter. In this review, we will summarize the recent advances in the preparation of photothermal antibacterial surfaces.
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Affiliation(s)
- Lavinia Doveri
- Department
of Chemistry, University of Pavia, Via Taramelli 12, I-27100 Pavia, Italy
| | | | - Giacomo Dacarro
- Department
of Chemistry, University of Pavia, Via Taramelli 12, I-27100 Pavia, Italy
- Centre
for Health Technologies (CHT), University
of Pavia, I-27100 Pavia, Italy
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Lau LHW, Lam QSK, Siu MMY, Tang TSK, Suen LKP, Lam SC. Compliance of healthcare workers in a psychiatric inpatient ward to infection control practices during the COVID-19 pandemic: a participant observation study supplemented with a self-reported survey. BMC Infect Dis 2024; 24:592. [PMID: 38886634 PMCID: PMC11181547 DOI: 10.1186/s12879-024-09429-3] [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: 02/24/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic. METHODS A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison. RESULTS A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%. CONCLUSION The compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary.
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Affiliation(s)
| | | | - Minnie Mei Yi Siu
- School of Nursing, Union Hospital, New Territories, Hong Kong SAR, China
| | | | | | - Simon Ching Lam
- School of Nursing, Tung Wah College, Kowloon, Hong Kong SAR, China.
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Igwe U, Okolie OJ, Ismail SU, Adukwu E. Effectiveness of Infection Prevention and Control Interventions in Healthcare Facilities in Africa: A Systematic Review. Am J Infect Control 2024:S0196-6553(24)00535-2. [PMID: 38871086 DOI: 10.1016/j.ajic.2024.06.004] [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: 02/25/2024] [Revised: 06/02/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Healthcare associated infections (HAIs) are a major threat to patient safety and quality care. However, they are avoidable by implementing evidence-based infection prevention and control measures. This review evaluated the evidence of the effectiveness of Infection Prevention and Control (IPC) interventions in reducing rates of HAIs in healthcare settings in Africa. METHOD We searched several databases: CENTRAL, EMBASE, PUBMED, CINAHL, WHO IRIS and AJOL for primary studies reporting rates of the four most frequent HAIs: surgical site infections, central line-associated blood stream infections, catheter-associated urinary tract infections, ventilator-associated pneumoniae and increase in hand hygiene compliance. Two reviewers appraised the studies and PRISMA guidelines were followed. RESULTS Out of 4,624 studies identified from databases and additional sources, 15 studies were finally included in the review. Majority of studies were of pre and post-test study design. All the studies implemented a combination of interventions and not as stand-alone components. Across all included studies, an improvement was reported in at least one primary outcome. CONCLUSION Our review highlights the potential of IPC interventions in reducing HAIs and improving compliance with hand hygiene in healthcare facilities in Africa. However, the certainty of evidence was low for majority of the outcomes. For future research, we recommend more pragmatic study designs with improved methodological rigor.
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Affiliation(s)
- Uzoma Igwe
- School of Applied Sciences and Centre for Research in Biosciences, University of the West of England, Bristol. United Kingdom
| | - Obiageli Jovita Okolie
- School of Applied Sciences and Centre for Research in Biosciences, University of the West of England, Bristol. United Kingdom
| | - Sanda Umar Ismail
- School of Health and Social Wellbeing, University of the West of England, Bristol. United Kingdom
| | - Emmanuel Adukwu
- School of Applied Sciences and Centre for Research in Biosciences, University of the West of England, Bristol. United Kingdom.
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Sayrafi NA, Salami A, Ghssein G. Impact of Effort-Reward Imbalance and Burnout on the Compliance with Standard Precautions among Nurses and Midwives in Lebanese Hospitals. NURSING REPORTS 2024; 14:1477-1493. [PMID: 38921721 PMCID: PMC11206807 DOI: 10.3390/nursrep14020111] [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: 04/15/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Effort-reward imbalance (ERI) refers to the situation where there is a mismatch between the effort that healthcare workers (HCWs) put into their work and the rewards they receive in return. Burnout, on the other hand, is a psychological syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. This study aimed to assess the impact of ERI and burnout on the compliance with standard precautions (SPs) among nurses and midwives in Lebanese hospitals under the economic crisis and after the COVID-19 pandemic. METHODS Cross-sectional correlational study, based on self-administered questionnaire data, measuring the compliance with SPs, ERI, and burnout, in addition to the relationship between these factors, was performed among 409 nurses and midwives, working in Lebanese hospitals. RESULTS ERI was significantly associated with exposure to burnout among nurses and midwives, and burnout was found to be a significant predictor of nurses and midwives' self-reported adherence with SPs. CONCLUSIONS This study highlights the contribution of ERI and burnout to the chain of infection by decreased adherence to infection control SPs of nurses and midwives.
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Affiliation(s)
- Noha A. Sayrafi
- Faculty of Health Sciences, Beirut Arab University, Tareek Al Jadida, Afeef Al Tiba, Beirut 1105, Lebanon;
| | - Ali Salami
- Faculty of Sciences V, Lebanese University, Nabatieh 1700, Lebanon;
| | - Ghassan Ghssein
- Faculty of Public Health, Islamic University of Lebanon (IUL), Khalde 30014, Lebanon
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Srisuwan Y, Srihanam P, Rattanasuk S, Baimark Y. Preparation of Poly(L-lactide)- b-poly(ethylene glycol)- b-poly(L-lactide)/Zinc Oxide Nanocomposite Bioplastics for Potential Use as Flexible and Antibacterial Food Packaging. Polymers (Basel) 2024; 16:1660. [PMID: 38932010 PMCID: PMC11207334 DOI: 10.3390/polym16121660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
High-molecular-weight poly(L-lactide)-b-poly(ethylene glycol)-b-poly(L-lactide) (PLLA-PEG-PLLA) is a flexible and biodegradable bioplastic that has promising potential in flexible food packaging but it has no antibacterial ability. Thus, in this work, the effect of zinc oxide nanoparticles (nano-ZnOs) which have antimicrobial activity on various properties of PLLA-PEG-PLLA was determined. The addition of nano-ZnOs enhanced the crystallization, tensile, UV-barrier, and antibacterial properties of PLLA-PEG-PLLA. However, the crystallization and tensile properties of nanocomposite films decreased again as the nano-ZnO increased beyond 2 wt%. The nano-ZnO was well distributed in the PLLA-PEG-PLLA matrix when the nano-ZnO content did not exceed 2 wt% and exhibited some nano-ZnO agglomerates when the nano-ZnO content was higher than 2 wt%. The thermal stability and moisture uptake of the PLLA-PEG-PLLA matrix decreased and the film's opacity increased as the nano-ZnO content increased. The PLLA-PEG-PLLA/ZnO nanocomposite films showed good antibacterial activity against bacteria such as Escherichia coli and Staphylococcus aureus. It can be concluded that nano-ZnOs can be used as a multi-functional filler of the flexible PLLA-PEG-PLLA. As a result, the addition of nano-ZnOs as a nucleating, reinforcing, UV-screening, and antibacterial agent in the flexible PLLA-PEG-PLLA matrix may provide protection for both the food and the packaging during transportation and storage.
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Affiliation(s)
- Yaowalak Srisuwan
- Biodegradable Polymers Research Unit, Department of Chemistry and Centre of Excellence for Innovation in Chemistry, Faculty of Science, Mahasarakham University, Kantarawichai 44150, Mahasarakham, Thailand; (Y.S.); (P.S.)
| | - Prasong Srihanam
- Biodegradable Polymers Research Unit, Department of Chemistry and Centre of Excellence for Innovation in Chemistry, Faculty of Science, Mahasarakham University, Kantarawichai 44150, Mahasarakham, Thailand; (Y.S.); (P.S.)
| | - Surachai Rattanasuk
- Major of Biology, Department of Science and Technology, Faculty of Liberal Arts and Science, Roi-Et Rajabhat University, Selaphum 45120, Roi-Et, Thailand;
| | - Yodthong Baimark
- Biodegradable Polymers Research Unit, Department of Chemistry and Centre of Excellence for Innovation in Chemistry, Faculty of Science, Mahasarakham University, Kantarawichai 44150, Mahasarakham, Thailand; (Y.S.); (P.S.)
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Lee K, Han J. Analysis of the urine flow characteristics inside catheters for intermittent catheter selection. Sci Rep 2024; 14:13273. [PMID: 38858470 PMCID: PMC11164700 DOI: 10.1038/s41598-024-64395-9] [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: 12/19/2023] [Accepted: 06/07/2024] [Indexed: 06/12/2024] Open
Abstract
In this study, we conducted a numerical analysis on catheter sizes using computational fluid dynamics to assess urinary flow rates during intermittent catheterization (IC). The results revealed that the fluid (urine) movement within a catheter is driven by intravesical pressure, with friction against the catheter walls being the main hindrance to fluid movement. Higher-viscosity fluids experienced increased friction with increasing intravesical pressure, resulting in reduced fluid velocity, whereas lower-viscosity fluids experienced reduced friction under similar pressure, leading to increased fluid velocity. Regarding urine characteristics, the results indicated that bacteriuria, with lower viscosity, exhibited higher flow rates, whereas glucosuria exhibited the lowest flow rates. Additionally, velocity gradients decreased with increasing catheter diameters, reducing friction and enhancing fluid speed, while the friction increased with decreasing diameters, reducing fluid velocity. These findings confirm that flow rates increased with larger catheter sizes. Furthermore, in terms of specific gravity, the results showed that a 12Fr catheter did not meet the ISO-suggested average flow rate (50 cc/min). The significance of this study lies in its application of fluid dynamics to nursing, examining urinary flow characteristics in catheterization. It is expected to aid nurses in selecting appropriate catheters for intermittent catheterization based on urinary test results.
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Affiliation(s)
- Kyeongeun Lee
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Jeongwon Han
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea.
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Taguchi Y, Toma K, Iitani K, Arakawa T, Iwasaki Y, Mitsubayashi K. In Vitro Performance of a Long-Range Surface Plasmon Hydrogel Aptasensor for Continuous and Real-Time Vancomycin Measurement in Human Serum. ACS APPLIED MATERIALS & INTERFACES 2024; 16:28162-28171. [PMID: 38767334 DOI: 10.1021/acsami.4c03805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
This study investigated the suitability of surface modification for a long-range surface plasmon (LRSP) aptasensor using two different hydrogels, aiming at real-time monitoring of vancomycin (VCM) in undiluted serum and blood. Three different layer structures were formed on a gold surface of LRSP sensor chip using poly[2-methacryloyloxyethyl phosphorylcholine (MPC)-co-N-methacryloyl-(L)-tyrosinemethylester (MAT)] (PMM) and poly[MPC-co-2-ethylhexyl methacrylate (EHMA)-co-MAT] (PMEM). The peptide aptamer for VCM was immobilized in PMM and PMEM via MAT. Among four differently prepared sensor chips, the LRSP hydrogel aptasensor with PMM, referred to as the PMM hydrogel, exhibited the highest sensor output and superior antifouling properties. Following the optimization of the PMM hydrogel preparation conditions, the shelf life of the PMM hydrogel was determined to exceed 2 weeks, and the same sensor chip could be used for 102 days without significant performance deterioration. The PMM hydrogel was then applied for VCM measurement in undiluted serum in vitro, where it demonstrated a limit of detection of 0.098 μM and a dynamic range of 0.18-100 μM, covering the therapeutic range. Additionally, the PMM hydrogel enabled the continuous measurement of various VCM concentrations in serum without rinsing and showed a concentration-dependent output in undiluted blood. These findings underscore the potential of the PMM hydrogel for real-time and direct monitoring of VCM in body fluids.
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Affiliation(s)
- Yui Taguchi
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Koji Toma
- College of Engineering, Shibaura Institute of Technology, 3-7-5 Toyosu, Koto-ku, Tokyo 135-8548, Japan
| | - Kenta Iitani
- Department of Biomedical Devices and Instrumentation, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Takahiro Arakawa
- Department of Electric and Electronic Engineering, Tokyo University of Technology, 1404-1 Katakura, Hachioji City, Tokyo 192-0982, Japan
| | - Yasuhiko Iwasaki
- Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate-cho, Suita-shi, Osaka 564-8680, Japan
| | - Kohji Mitsubayashi
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
- Department of Biomedical Devices and Instrumentation, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
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Hunt BC, Brix V, Vath J, Guterman BL, Taddei SM, Learman BS, Brauer AL, Shen S, Qu J, Armbruster CE. Metabolic interplay between Proteus mirabilis and Enterococcus faecalis facilitates polymicrobial biofilm formation and invasive disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.03.17.533237. [PMID: 36993593 PMCID: PMC10055233 DOI: 10.1101/2023.03.17.533237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Polymicrobial biofilms play an important role in the development and pathogenesis of CAUTI. Proteus mirabilis and Enterococcus faecalis are common CAUTI pathogens that persistently co-colonize the catheterized urinary tract and form biofilms with increased biomass and antibiotic resistance. In this study, we uncover the metabolic interplay that drives biofilm enhancement and examine the contribution to CAUTI severity. Through compositional and proteomic biofilm analyses, we determined that the increase in biofilm biomass stems from an increase in the protein fraction of the polymicrobial biofilm matrix. We further observed an enrichment in proteins associated with ornithine and arginine metabolism in polymicrobial biofilms compared to single-species biofilms. We show that L-ornithine secretion by E. faecalis promotes arginine biosynthesis in P. mirabilis, and that disruption of this metabolic interplay abrogates the biofilm enhancement we see in vitro and leads to significant decreases in infection severity and dissemination in a murine CAUTI model.
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Affiliation(s)
- Benjamin C. Hunt
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Vitus Brix
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Joseph Vath
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Beryl L. Guterman
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Steven M. Taddei
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Brian S. Learman
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Aimee L. Brauer
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Shichen Shen
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
| | - Jun Qu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
- NYS Center of Excellence in Bioinformatics and Life Sciences, Buffalo, NY, 14203, United States of America
| | - Chelsie E. Armbruster
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14203, United States of America
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15
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Centeleghe I, Norville P, Maillard JY, Hughes L. Infection prevention control in practice: a survey of healthcare professionals' knowledge and experiences. Infect Prev Pract 2024; 6:100357. [PMID: 38854706 PMCID: PMC11156693 DOI: 10.1016/j.infpip.2024.100357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/24/2024] [Indexed: 06/11/2024] Open
Abstract
Background Laboratory experiments are crucial in understanding efficacy of disinfectant products, but without compliance and appropriate application, the effectiveness of products is compromised. This study aims to understand current perceptions and knowledge of healthcare professionals (HCPs) to common cleaning and disinfection routines and microbial contamination, including biofilms, in healthcare environments. Methods An online survey, including open and closed questions, was developed. Non-probability convenience and purposive sampling were used: those currently or previously in a healthcare profession were eligible. Survey responses were taken over 24 months, including the COVID-19 pandemic. Discussion 137 participants completed the survey; over 50% were nurses. Surface cleaning frequency increased post COVID-19 from 'twice a day' to 'three/more times a day'. Disinfection frequency reduced from 'between every patient' before COVID-19 to 'twice a day' afterwards. A multimethod approach to cleaning and disinfection (70.8%) was predominant when considering the best method to deliver infection control. Most areas of clinical settings were identified as high risk (13/19). Most (87.6%) participants had heard the term 'biofilm', mainly at conference/study days (60%). 39.1% said they were aware of dry surface biofilms (DSB) in the healthcare environment. Conclusions There remain mixed views on surface cleaning and disinfection within healthcare. Education is important for understanding microbial contamination and tackling problems. More people than expected had heard the term DSB. Infection control practices seemed consistent across responses, however whether this is reality is unknown. This study provides an initial insight into current opinions/knowledge of HCPs and can form basis for further in-depth investigation.
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Affiliation(s)
- Isabella Centeleghe
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | | | - Jean-Yves Maillard
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Louise Hughes
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
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16
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Ben-Amram H, Azrad M, Cohen-Assodi J, Sharabi-Nov A, Edelstein S, Agay-Shay K, Peretz A. Biofilm Formation by Hospital-Acquired Resistant Bacteria Isolated from Respiratory Samples. J Epidemiol Glob Health 2024; 14:291-297. [PMID: 38564110 PMCID: PMC11176280 DOI: 10.1007/s44197-024-00215-7] [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: 01/30/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Hospital-acquired resistant infections (HARI) are infections, which develop 48 h or more after admission to a healthcare facility. HARI pose a considerably acute challenge, due to limited treatment options. These infections are associated bacterial biofilms, which act as a physical barrier to diverse external stresses, such as desiccation, antimicrobials and biocides. We assessed the influence of multiple factors on biofilm production by HARI -associated bacteria. METHODS Bacteria were isolated from samples of patients with respiratory HARI who were hospitalized during 2020-2022 in north Israel. Following antibiotic susceptibility testing by disc diffusion or broth microdilution, biofilm formation capacities of resistant bacteria (methicillin-resistant staphylococcus aureus, extended spectrum beta-lactamase-producing Escherichia coli and Klebsiela pneumonia, and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii) was assessed using the crystalline violet staining method. Data regarding season, time to infection, bacterial species, patient age and gender, year, and medical department were collected from the patient medical records. RESULTS Among the 226 study isolates, K. pneumonia was the most prevalent (35.4%) bacteria, followed by P. aeruginosa (23.5%), and methicillin-resistant staphylococcus aureus (MRSA) (21.7%). A significantly higher rate of HARI was documented in 2022 compared to 2020-2021. The majority of isolates (63.3%) were strong biofilm producers, with K. pneumonia (50.3%) being most dominant, followed by P. aeruginosa (29.4%). Biofilm production strength was significantly affected by seasonality and hospitalization length, with strong biofilm production in autumn and in cases where hospitalization length exceeded 30 days. CONCLUSION Biofilm production by HARI bacteria is influenced by bacterial species, season and hospitalization length.
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Affiliation(s)
- Hila Ben-Amram
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- The Clinical Microbiology Laboratory, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Maya Azrad
- The Clinical Microbiology Laboratory, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Jackie Cohen-Assodi
- The Clinical Microbiology Laboratory, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | | | - Shimon Edelstein
- The Infectious Diseases, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, 1311502, Safed, Israel
| | - Keren Agay-Shay
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Avi Peretz
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
- The Clinical Microbiology Laboratory, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
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17
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Senges C, Herzer C, Norkus E, Krewing M, Mattner C, Rose L, Gebhardt T, Mattner F, Niesalla H. Workflows and locations matter - insights from electronic hand hygiene monitoring into the use of hand rub dispensers across diverse hospital wards. Infect Prev Pract 2024; 6:100364. [PMID: 38601127 PMCID: PMC11004075 DOI: 10.1016/j.infpip.2024.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/28/2024] [Indexed: 04/12/2024] Open
Abstract
Background While healthcare-associated infections (HAIs) affect approximately 3.2-6.5% of hospitalised patients in the US and Europe, improving hand hygiene (HH) could reduce HAI rates. Investigating HH is time-consuming and not always objective, and comprehensive, unbiased data is needed to develop effective strategies. Using electronic tools can provide new and detailed insights on the determinants of HH. Aim To evaluate location-dependent usage of wall-mounted dispensers (WMDs) and point-of-care dispensers (POCs) using an electronic HH recording system. Methods In this retrospective study, hand rub volumes were anonymously recorded for 931,446 disinfections from 17 wards in nine German hospitals using the electronic monitoring system NosoEx®. Number of disinfections and rub volumes of WMDs/POCs by ward and room type were analysed. Findings Generally, WMDs were most prevalent. With >3 dispensers per bed and >20 disinfections per patient day, availability and use were highest in intensive care (ICU) and intermediate care (IMC), but here rub volumes from WMDs were lowest (∼2.0 mL). Although most dispensers are located in patient rooms (∼42%), they are more frequently used in hallways. In surgical ICUs, dispensers are often used in patient rooms, where contact with open wounds is common. About 3.6 mL of hand rub is used per disinfection in treatment rooms, the highest volume of all room types. Conclusion Dispenser use was dependent on location, room type, ward specialisation and workflow. Optimising the location of hand rub dispensers (HRDs)s is not the only solution to improve HH, but can help reduce inconvenience, achieve more ergonomic workflows and better meet user needs.
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Affiliation(s)
- Christoph Senges
- HARTMANN SCIENCE CENTER, BODE Chemie GmbH a company of the HARTMANN GROUP, Hamburg, Germany
| | | | | | - Marco Krewing
- HARTMANN SCIENCE CENTER, BODE Chemie GmbH a company of the HARTMANN GROUP, Hamburg, Germany
| | - Clara Mattner
- Chair for Hygiene and Environmental Medicine, University Witten-Herdecke, Cologne Clinics, Cologne, Germany
- Institute of Rural Studies, Johann Heinrich von Thünen Institute, Braunschweig, Germany
| | - Leonard Rose
- Chair for Hygiene and Environmental Medicine, University Witten-Herdecke, Cologne Clinics, Cologne, Germany
| | | | - Frauke Mattner
- Chair for Hygiene and Environmental Medicine, University Witten-Herdecke, Cologne Clinics, Cologne, Germany
| | - Heide Niesalla
- HARTMANN SCIENCE CENTER, BODE Chemie GmbH a company of the HARTMANN GROUP, Hamburg, Germany
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Basak SS, Adak A. Physicochemical methods for disinfection of contaminated surfaces - a way to control infectious diseases. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2024; 22:53-64. [PMID: 38887763 PMCID: PMC11180059 DOI: 10.1007/s40201-024-00893-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/21/2024] [Indexed: 06/20/2024]
Abstract
This paper represents the reviews of recent advancements in different physicochemical methods for disinfecting contaminated surfaces, which are considered to be responsible for transmitting different bacterial, viral, and fungal infectious diseases. Surface disinfection can be achieved by applying chemicals, UV-based processes, ionization radiation (gamma-ray, X-ray and electron beam), application of self-disinfecting surfaces, no-touch room disinfection methods, and robotic disinfection methods for built-in settings. Application of different chemicals, such as alcohols, hydrogen peroxide, peracetic acid, quaternary ammonium salts, phenol, and iodine solution, are common and economical. However, the process is time-consuming and less efficient. The use of UVC light (wavelength: 200-280 nm, generated by low vapor mercury lamps or pulse xenon light) has gained much attention for disinfecting fomites worldwide. In recent times, the combination of UV and H2O2, based on the principle of the advanced oxidation process, has been applied for disinfecting inanimate surfaces. The process is very efficient and faster than chemical and UV processes. Heavy metals like copper, silver, zinc, and other metals can inactivate microbes and are used for surface modification to produce self-disinfecting surfaces and used in healthcare facilities. In combination with UVB (280-315 nm) and UVA (315-400 nm), titanium oxide has been utilized for disinfecting contaminated surfaces. Ionization radiation, one of the advanced methods, can be used in disinfecting medical devices and drugs. Post-COVID-19 pandemic, the no-touch and robotic disinfection methods utilizing chemicals or UVC lights have received much importance in built-in settings. Among these methods, surface disinfection by applying chemicals by fogging/vaporization and UV radiation methods has been widely reported in the literature compared to other methods. Supplementary Information The online version contains supplementary material available at 10.1007/s40201-024-00893-2.
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Affiliation(s)
- Shib Sankar Basak
- Department of Civil Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103 India
| | - Asok Adak
- Department of Civil Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103 India
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Tan M, Wang F, Yang J, Zhong Z, Chen G, Chen Z. Hydroxyl silicone oil grafting onto a rough thermoplastic polyurethane surface created durable super-hydrophobicity. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2024; 35:1359-1378. [PMID: 38490948 DOI: 10.1080/09205063.2024.2329453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
Indwelling medical catheters are frequently utilized in medical procedures, but they are highly susceptible to infection, posing a vital challenge for both health workers and patients. In this study, the superhydrophobic micro-nanostructure surface was constructed on the surface of thermoplastic polyurethane (TPU) membrane using heavy calcium carbonate (CaCO3) template. To decrease the surface free energy, hydroxyl silicone oil was grafted onto the surface, forming a super-hydrophobic surface. The water contact angle (WCA) increased from 91.1° to 143 ± 3° when the concentration of heavy calcium CaCO3 was 20% (weight-to-volume (w/v)). However, the increased WCA was unstable and tended to decrease over time. After grafting hydroxyl silicone oil, the WCA rose to 152.05 ± 1.62° and remained consistently high for a period of 30 min. Attenuated total reflection infrared spectroscopy (ATR-FTIR) analysis revealed a chemical crosslinking between silicone oil and the surface of TPU. Furthermore, Scanning electron microscope (SEM) image showed the presence of numerous nanoparticles on the micro surface. Atomic force microscope (AFM) testing indicated a significant improvement in surface roughness. This method of creating a hydrophobic surface demonstrated several advantages, including resistance to cell, bacterial, protein, and platelet adhesion and good biosecurity. Therefore, it holds promising potential for application in the development of TPU-based medical catheters with antibacterial properties.
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Affiliation(s)
- Miaomiao Tan
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Fuping Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Jinlan Yang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Zhengpeng Zhong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Guobao Chen
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Zhongmin Chen
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
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Zhang T, Yan L, Wang S, Chen M, Jiao Y, Sheng Z, Liu J, Liu L. Temporal patterns and clinical characteristics of healthcare-associated infections in surgery patients: A retrospective study in a major Chinese tertiary hospital. INFECTIOUS MEDICINE 2024; 3:100103. [PMID: 38764728 PMCID: PMC11096939 DOI: 10.1016/j.imj.2024.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/29/2023] [Accepted: 03/15/2024] [Indexed: 05/21/2024]
Abstract
Background Given the preventable nature of most healthcare-associated infections (HAIs), it is crucial to understand their characteristics and temporal patterns to reduce their occurrence. Methods A retrospective analysis of medical record cover pages from a Chinese hospital information system was conducted for surgery inpatients from 2010 to 2019. Association rules mining (ARM) was employed to explore the association between disease, procedure, and HAIs. Joinpoint models were used to estimate the annual HAI trend. The time series of each type of HAI was decomposed to analyze the temporal patterns of HAIs. Results The study included data from 623,290 surgery inpatients over 10 years, and a significant decline in the HAI rate was observed. Compared with patients without HAIs, those with HAIs had a longer length of stay (29 days vs. 9 days), higher medical costs (96226.57 CNY vs. 22351.98 CNY), and an increased risk of death (6.42% vs. 0.18%). The most common diseases for each type of HAI differed, although bone marrow and spleen operations were the most frequent procedures for most HAI types. ARM detected that some uncommon diagnoses could strongly associate with HAIs. The time series pattern varied for each type of HAI, with the peak occurring in January for respiratory system infections, and in August and July for surgical site and bloodstream infections, respectively. Conclusions Our findings demonstrate that HAIs impose a significant burden on surgery patients. The differing time series patterns for each type of HAI highlight the importance of tailored surveillance strategies for specific types of HAI.
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Affiliation(s)
- Tianyi Zhang
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing 100853, China
| | - Li Yan
- Cadet Company One, Graduate School of Chinese PLA General Hospital, Beijing 100853, China
| | - Shan Wang
- Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing 100853, China
| | - Ming Chen
- Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China
| | - Yunda Jiao
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhuoqi Sheng
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing 100853, China
| | - Jianchao Liu
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing 100853, China
- School of Humanities and Social Sciences, North China Electric Power University, Beijing 102206, China
| | - Lihua Liu
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing 100853, China
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Bajunaid RM, Saeed A, Bostaji M, Farsi NJ. Hand hygiene compliance and improvement interventions in the Eastern Mediterranean Region: a systematic review and meta-analysis. Infect Prev Pract 2024; 6:100363. [PMID: 38601128 PMCID: PMC11004405 DOI: 10.1016/j.infpip.2024.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/06/2024] [Indexed: 04/12/2024] Open
Abstract
Hand hygiene compliance among healthcare workers is crucial for preventing infections in healthcare settings. This systematic review and meta-analysis aimed to assess the compliance of healthcare workers in the Eastern Mediterranean region with hand hygiene guidelines and synthesize evidence on the success rate of strategies to improve hand hygiene. Five electronic databases (PubMed, CINAHL, Cochrane, Web of Science, and Scopus) were searched up to August 2020. Articles were included if they were conducted in the Eastern Mediterranean Region. A manual search was conducted for reference lists of included papers, and relevant additional references were reviewed. Two reviewers independently screened articles for inclusion, performed data extraction, and assessed quality. A meta-analysis was conducted to synthesize findings and determine the prevalence of hand hygiene compliance interventions. The search yielded 6678 articles. After removing duplicates and applying inclusion/exclusion criteria, 42 articles were included, of which 24 were meta-analyzed. The meta-analysis showed a compliance prevalence of 32% with significant heterogeneity (I2= 99.7% p <0.001). Interventions using the World Health Organization (WHO) guidelines were over two times more likely to improve compliance rates (OR= 2.26, [95% CI:(2.09 - 2.44)], I2= 95%, p<0.001) compared to no intervention. Other interventions were close to two times more likely to improve compliance rates (OR= 1.84, [95% CI:(1.66 - 2.04)], I2= 98% p= 0.001). Approximately two-thirds of healthcare providers in the Eastern Mediterranean region were non-compliant with standard hand hygiene practices, highlighting the need for increased efforts, awareness, observation, and control policies.
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Affiliation(s)
- Rbab M. Bajunaid
- Faculty of Medicine, King Abdulaziz University, P.O.Box 80213, Jeddah 22252, Saudi Arabia
| | | | - Muataz Bostaji
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nada J. Farsi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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22
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Fluck D, Fry CH, Robin J, Affley B, Kakar P, Sharma P, Han TS. Impact of healthcare-associated infections within 7-days of acute stroke on health outcomes and risk of care-dependency: a multi-centre registry-based cohort study. Intern Emerg Med 2024; 19:919-929. [PMID: 38517643 PMCID: PMC11186937 DOI: 10.1007/s11739-024-03543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/16/2024] [Indexed: 03/24/2024]
Abstract
Healthcare-associated infections (HCAIs) in patients admitted with acute conditions remain a major challenge to healthcare services. Here, we assessed the impact of HCAIs acquired within 7-days of acute stroke on indicators of care-quality outcomes and dependency. Data were prospectively collected (2014-2016) from the Sentinel Stroke National Audit Programme for 3309 patients (mean age = 76.2 yr, SD = 13.5) admitted to four UK hyperacute stroke units (HASU). Associations between variables were assessed by multivariable logistic regression (odds ratios, 95% confidence intervals), adjusted for age, sex, co-morbidities, pre-stroke disability, swallow screening, stroke type and severity. Within 7-days of admission, urinary tract infection (UTI) and pneumonia occurred in 7.6% and 11.3% of patients. Female (UTI only), older age, underlying hypertension, atrial fibrillation, previous stroke, pre-stroke disability, intracranial haemorrhage, severe stroke, and delay in swallow screening (pneumonia only) were independent risk factors of UTI and pneumonia. Compared to patients without UTI or pneumonia, those with either or both of these HCAIs were more likely to have prolonged stay (> 14-days) on HASU: 5.1 (3.8-6.8); high risk of malnutrition: 3.6 (2.9-4.5); palliative care: 4.5 (3.4-6.1); in-hospital mortality: 4.8 (3.8-6.2); disability at discharge: 7.5 (5.9-9.7); activity of daily living support: 1.6 (1.2-2.2); and discharge to care-home: 2.3 (1.6-3.3). In conclusion, HCAIs acquired within 7-days of an acute stroke led to prolonged hospitalisation, adverse health consequences and risk of care-dependency. These findings provide valuable information for timely intervention to reduce HCAIs, and minimising subsequent adverse outcomes.
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Affiliation(s)
- David Fluck
- Department of Cardiology, Ashford & St Peter's NHS Foundation Trust, Chertsey, GU9 0PZ, UK
| | - Christopher H Fry
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK
| | - Jonathan Robin
- Department of Acute Medicine, Ashford and St Peter's NHS Foundation Trust, Chertsey, GU9 0PZ, UK
| | - Brendan Affley
- Department of Stroke, Ashford and St Peter's NHS Foundation Trust, Chertsey, GU9 0PZ, UK
| | - Puneet Kakar
- Department of Stroke, Epsom and St Helier University Hospitals, Epsom, KT18 7EG, UK
| | - Pankaj Sharma
- Department of Clinical Neuroscience, Imperial College Healthcare NHS Trust, London, W6 8RF, UK
- Institute of Cardiovascular Research, Royal Holloway University of London, Egham, TW20 0EX, UK
| | - Thang S Han
- Institute of Cardiovascular Research, Royal Holloway University of London, Egham, TW20 0EX, UK.
- Department of Endocrinology, Ashford and St Peter's NHS Foundation Trust, Chertsey, GU9 0PZ, UK.
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Omeiri M, El Hadidi E, Awad R, Al Boukhari J, Yusef H. Aluminum oxide, cobalt aluminum oxide, and aluminum-doped zinc oxide nanoparticles as an effective antimicrobial agent against pathogens. Heliyon 2024; 10:e31462. [PMID: 38813232 PMCID: PMC11133899 DOI: 10.1016/j.heliyon.2024.e31462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 05/31/2024] Open
Abstract
Since the clock of antimicrobial resistance was set, modern medicine has shed light on a new cornerstone in technology to overcome the worldwide dread of the post-antimicrobial era. Research organizations are exploring the use of nanotechnology to modify metallic crystals from macro to nanoscale size, demonstrating significant interest in the field of antimicrobials. Herein, the antimicrobial activities of aluminum oxide (Al2O3), cobalt aluminum oxide (CoAl2O4), and aluminum doped zinc oxide (Zn0.9Al0.1O) nanoparticles were examined against some nosocomial pathogens. The study confirmed the formation and characterization of Al2O3, CoAl2O4, and Zn0.9Al0.1O nanoparticles using various techniques, revealing the generation of pure nanoscale nanoparticles. With inhibition zones ranging from 9 to 14 mm and minimum inhibitory concentrations varying from 4 mg/mL to 16 mg/mL, the produced nanoparticles showed strong antibacterial activity against Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. Meanwhile, the bactericidal concentrations ranged from 8 mg/mL to 40 mg/mL. In culture, Zn0.9Al0.1O NPs demonstrated a unique ability to inhibit the development of nosocomial infections with high bactericidal activity (8 mg/mL). Transmission electron microscope images revealed changes in cell shape, bacterial cell wall morphology, cytoplasmic membrane, and protoplasm due to the introduction of tested nanoparticles. These results pave the way for the use of these easily bacterial wall-piercing nanoparticles in combination with potent antibiotics to overcome the majority of bacterial strains' resistance.
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Affiliation(s)
- Mohamad Omeiri
- Department of Biology, Faculty of Arts and Sciences, University of Balamand, Beirut, Lebanon
| | - Esraa El Hadidi
- Department of Biological Sciences, Faculty of Science, Beirut Arab University, Beirut, Lebanon
| | - Ramadan Awad
- Department of Physics, Faculty of Science, Beirut Arab University, Beirut, Lebanon
- Department of Physics, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Jamalat Al Boukhari
- Department of Physics, Faculty of Science, Beirut Arab University, Beirut, Lebanon
| | - Hoda Yusef
- Department of Botany and Microbiology, Faculty of Science, Alexandria University, Alexandria, Egypt
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24
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Malshy K, Balen A, Golijanin B, Jentzsch M, Greenberg R, Kazal F, Glebocki R, Danaher K, Spence R, Hyams E, Golijanin D, Pareek G, Eaton S. Optimising postoperative care: Same-day discharge after transurethral resection of the prostate. J Perioper Pract 2024:17504589241251697. [PMID: 38785312 DOI: 10.1177/17504589241251697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
INTRODUCTION This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate. MATERIALS AND METHODS Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge). Logistic regression analysis was performed, controlling for clinicodemographic factors. Student's t-test compared continuous bladder irrigation and catheter dwell times. RESULTS A total of 459 patients were identified between 2016 and 2021, 280 in Group 1 and 179 in Group 2, with median ages of 71.0 (interquartile range 36-92) and 72.0 (interquartile range 47-101) years (p = 0.067), respectively. Same-day discharge rates notably increased post-2018 (p = 0.025). Median prostate tissue resected in Group 2 was 7.1g (3.4-12.4g) and in Group 1 was 4.9g (2.4-10.2g; p = 0.034). While continuous bladder irrigation >1 hour was significantly lower in Group 1 than Group 2 (96.8% versus 27.4%; p = 0.0001), catheter dwell times were comparable (70.1 and 70.8 hours, respectively). Control-adjusted results showed a 40% reduction in emergency department representation odds for Group 1 compared with Group 2 (odds ratio = 0.60; 95% confidence interval = 0.37-0.99; p = 0.04). Length of stay was not significantly associated with hospital readmissions (p = 0.11). Continuous bladder irrigation for <1 hour in Group 1 was associated with a reduced emergency department representation (odds ratio = 0.43; 95% confidence interval = 0.197-0.980) but not readmission (odds ratio = 0.413; 95% confidence interval = 0.166-1.104). CONCLUSIONS Same-day discharge post-transurethral resection of the prostate may be a viable and safe option for carefully selected patients.
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Affiliation(s)
- Kamil Malshy
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Alejandra Balen
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Borivoj Golijanin
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Rachel Greenberg
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Frances Kazal
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Katherine Danaher
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Ryland Spence
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Elias Hyams
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Dragan Golijanin
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Gyan Pareek
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Samuel Eaton
- Brown Urology, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
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25
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Ubah CS, Pokhrel LR, Williams JE, Akula SM, Richards SL, Kearney GD, Williams A. Antibacterial efficacy, mode of action, and safety of a novel nano-antibiotic against antibiotic-resistant Escherichia coli strains. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 925:171675. [PMID: 38485022 DOI: 10.1016/j.scitotenv.2024.171675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/17/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
Globally rising antibiotic-resistant (AR) and multi-drug resistant (MDR) bacterial infections are of public health concern due to treatment failure with current antibiotics. Enterobacteria, particularly Escherichia coli, cause infections of surgical wound, bloodstream, and urinary tract, including pneumonia and sepsis. Herein, we tested in vitro antibacterial efficacy, mode of action (MoA), and safety of novel amino-functionalized silver nanoparticles (NH2-AgNP) against the AR bacteria. Two AR E. coli strains (i.e., ampicillin- and kanamycin-resistant E. coli), including a susceptible strain of E. coli DH5α, were tested for susceptibility to NH2-AgNP using Kirby-Bauer disk diffusion and standard growth assays. Dynamic light scattering (DLS) was used to determine cell debris and relative conductance was used as a measure of cell leakage, and results were confirmed with transmission electron microscopy (TEM). Multiple oxidative stress assays were used for in vitro safety evaluation of NH2-AgNP in human lung epithelial cells. Results showed that ampicillin and kanamycin did not inhibit growth in either AR bacterial strain with doses up to 160 μg/mL tested. NH2-AgNP exhibited broad-spectrum bactericidal activity, inhibiting the growth of all three bacterial strains at doses ≥1 μg/mL. DLS and TEM revealed cell debris formation and cell leakage upon NH2-AgNP treatment, suggesting two possible MoAs: electrostatic interactions followed by cell wall damage. Safety evaluation revealed NH2-AgNP as noncytotoxic and antioxidative to human lung epithelial cells. Taken together, these results suggest that NH2-AgNP may serve as an effective and safer bactericidal therapy against AR bacterial infections compared to common antibiotics.
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Affiliation(s)
- Chukwudi S Ubah
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Lok R Pokhrel
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
| | - Jordan E Williams
- Environmental Health Science Program, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Shaw M Akula
- Department of Microbiology and Immunology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Stephanie L Richards
- Environmental Health Science Program, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Gregory D Kearney
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
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Datta S, Singh V, Nag S, Roy DN. Marine-Derived Cytosine Arabinoside (Ara-C) Inhibits Biofilm Formation by Inhibiting PEL Operon Proteins (Pel A and Pel B) of Pseudomonas aeruginosa: An In Silico Approach. Mol Biotechnol 2024:10.1007/s12033-024-01169-8. [PMID: 38739212 DOI: 10.1007/s12033-024-01169-8] [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: 12/05/2023] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
Pseudomonas aeruginosa (P. aeruginosa) is a gram-negative biofilm-forming opportunistic human pathogen whose vital mechanism is biofilm formation for better survival. PelA and PelB proteins of the PEL operon are essential for bacterial-synthesized pellicle polysaccharide (PEL), which is a vital structural component of the biofilm. It helps in adherence of biofilm on the surface and maintenance of cell-to-cell interactions and with other matrix components. Here, in-silico molecular docking and simulation studies were performed against PelA and PelB using ten natural bioactive compounds, individually [podocarpic acids, ferruginol, scopadulcic acid B, pisiferic acid, metachromin A, Cytarabine (cytosine arabinoside; Ara-C), ursolic acid, oleanolic acid, maslinic acid, and betulinic acid], those have already been established as anti-infectious compounds. The results obtained from AutoDock and Glide-Schordinger stated that a marine-derived cytosine arabinoside (Ara-C) among the ten compounds binds active sites of PelA and PelB, exhibiting strong binding affinity [Trp224 (hydrogen), Ser219 (polar), Val234 (hydrophobic) for PelA; Leu365 and Glu389 (hydrogen), Gln366 (polar) for PelB] with high negative binding energy - 5.518 kcal/mol and - 6.056 kcal/mol, respectively. The molecular dynamic and simulation studies for 100 ns showed the MMGBSA binding energy scores are - 16.4 kcal/mol (Ara-C with PelA), and - 22.25 kcal/mol (Ara-C with PelB). Further, ADME/T studies indicate the IC50 values of AraC are 6.10 mM for PelA and 18.78 mM for PelB, which is a comparatively very low dose. The zero violation of Lipinski's Rule of Five further established that Ara-C is a good candidate for drug development. Thus, Ara-C could be considered a potent anti-biofilm compound against PEL operon-dependent biofilm formation of P. aeruginosa.
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Affiliation(s)
- Susmita Datta
- Department of Chemical Engineering, National Institute of Technology - Agartala, Agartala, Tripura, India
| | - Vishal Singh
- Centre for Biotechnology, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be university), Bhubaneswar, Odisha, India
| | - Soma Nag
- Department of Chemical Engineering, National Institute of Technology - Agartala, Agartala, Tripura, India.
| | - Dijendra Nath Roy
- Department of Biotechnology, National Institute of Technology - Raipur, Raipur, Chhattisgarh, India.
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Ait Hssain A, Vahedian-Azimi A, Ibrahim AS, Hassan IF, Azoulay E, Darmon M. Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis. Crit Care 2024; 28:158. [PMID: 38730424 PMCID: PMC11088079 DOI: 10.1186/s13054-024-04946-8] [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: 03/26/2024] [Accepted: 05/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult. METHODS We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model. RESULTS Among the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14-38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74-0.96, P = 0.01) and 0.80 (95% CI 0.71-0.90, P < 0.001), respectively. CONCLUSION Results showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI.
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Affiliation(s)
- Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar
- College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Sheykh Bahayi Street, Vanak Square, P.O. Box 19575-174, Tehran, Iran.
| | - Abdulsalam Saif Ibrahim
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Ibrahim Fawzy Hassan
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Elie Azoulay
- Médecine Intensive et Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Michael Darmon
- Médecine Intensive et Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
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28
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Costantino M, Piazza O, Coscioni E, Vozzella EA, Longanella W, De Caro F. Analyzing Pre-operative Hospital Stay and Incidence of Hospital Acquired Infection: A Retrospective Study. Transl Med UniSa 2024; 26:46-51. [PMID: 38957730 PMCID: PMC11218752 DOI: 10.37825/2239-9747.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 07/04/2024] Open
Abstract
Background and objectives Healthcare-associated infections (HCAIs) pose a significant challenge, impacting patient safety and treatment effectiveness. This retrospective study investigates the correlation between pre-operative hospital stays and HCAIs in ICU cardiac surgery patients. Materials and methods Medical records of 35 patients who died post-cardiac surgery in the ICU were analyzed, focusing on the duration of pre-operative hospitalization. Results Prolonged pre-operative stays strongly correlate (r = 0.993) with increased HCAIs, indicating a critical risk factor. Conclusions The duration of pre-operative hospital stays is pivotal in HCAI risk. Prospective multicenter studies are needed for validation, which is crucial for enhancing patient safety and treatment efficacy.
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Affiliation(s)
- Maria Costantino
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno,
Italy
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi,
Italy
| | - Ornella Piazza
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno,
Italy
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi,
Italy
| | - Enrico Coscioni
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi,
Italy
| | - Emilia A. Vozzella
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno,
Italy
| | - Walter Longanella
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno,
Italy
| | - Francesco De Caro
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno,
Italy
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi,
Italy
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29
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Bouhrour N, Nibbering PH, Bendali F. Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens. Pathogens 2024; 13:393. [PMID: 38787246 PMCID: PMC11124157 DOI: 10.3390/pathogens13050393] [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: 03/27/2024] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Medical devices such as venous catheters (VCs) and urinary catheters (UCs) are widely used in the hospital setting. However, the implantation of these devices is often accompanied by complications. About 60 to 70% of nosocomial infections (NIs) are linked to biofilms. The main complication is the ability of microorganisms to adhere to surfaces and form biofilms which protect them and help them to persist in the host. Indeed, by crossing the skin barrier, the insertion of VC inevitably allows skin flora or accidental environmental contaminants to access the underlying tissues and cause fatal complications like bloodstream infections (BSIs). In fact, 80,000 central venous catheters-BSIs (CVC-BSIs)-mainly occur in intensive care units (ICUs) with a death rate of 12 to 25%. Similarly, catheter-associated urinary tract infections (CA-UTIs) are the most commonlyhospital-acquired infections (HAIs) worldwide.These infections represent up to 40% of NIs.In this review, we present a summary of biofilm formation steps. We provide an overview of two main and important infections in clinical settings linked to medical devices, namely the catheter-asociated bloodstream infections (CA-BSIs) and catheter-associated urinary tract infections (CA-UTIs), and highlight also the most multidrug resistant bacteria implicated in these infections. Furthermore, we draw attention toseveral useful prevention strategies, and advanced antimicrobial and antifouling approaches developed to reduce bacterial colonization on catheter surfaces and the incidence of the catheter-related infections.
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Affiliation(s)
- Nesrine Bouhrour
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
| | - Peter H. Nibbering
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands;
| | - Farida Bendali
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
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30
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de la Rosa-Zamboni D, Villa-Guillén M, Bustos-Hamdan A, Rosas-Mateos MI, Medina-Pelcastre M, Torres-García M, Franco-Hernández MI, Del Carmen Castellanos-Cruz M, Parra-Ortega I, Fest-Parra E, Casillas-Casillas MC, Guerrero-Díaz AC. Effect of UV-C disinfection and copper plating on healthcare-associated infections in a NICU with high ESBL infections. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024:S2529-993X(24)00117-5. [PMID: 38705751 DOI: 10.1016/j.eimce.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/18/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Healthcare-associated infections (HCAIs) in neonates are frequent and highly lethal, in particular those caused by extended spectrum beta-lactamase (ESBL) producing bacteria. We evaluated the beneficial effects of ultraviolet C (UV-C) disinfection and copper adhesive plating on HCAIs in the Neonatal Intensive Care Unit (NICU) of a third level paediatric hospital in Mexico City, both in combination of hand-hygiene (HH) and prevention bundles. METHODS All NICU patients were included. There were 4 periods (P): P1: HH monitoring and prevention bundles; P2: P1+UV-C disinfection; P3: P2+Copper adhesive plating on frequent-contact surfaces and P4: Monitoring of P3 actions. RESULTS 552 neonates were monitored during 15,467 patient days (PD). HCAI rates decreased from 11.03/1000 PD in P1 to 5.35/1000 PD in P4 (p=0.006). HCAIs with bacterial isolates dropped from 5.39/1000 PD in PI to 1.79/1000 PD in P4 (p=0.011). UV-C and copper were associated with significant HCAI prevention (RR 0.49, CI95% 0.30-0.81, p=0.005) and with lesser HCAIs with bacterial isolates (RR 0.33, CI95% 0.14-0.77, p=0.011). CONCLUSIONS Copper adhesive plating combined with UV-C disinfection were associated with a drop in HCAI rates and with the elimination of ESBL-caused HCAIs. Hence, we propose that these strategies be considered in MDRO proliferation preventions.
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Affiliation(s)
| | - Mónica Villa-Guillén
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
| | - Anaíd Bustos-Hamdan
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
| | | | - Marisol Medina-Pelcastre
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
| | - Margarita Torres-García
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
| | | | | | - Israel Parra-Ortega
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
| | - Edmedt Fest-Parra
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
| | | | - Ana Carmen Guerrero-Díaz
- Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Doctores, Ciudad de México, Mexico
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31
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Wynn M. Online spaces and the control of communicable diseases: implications for nursing practice. Nurs Stand 2024; 39:39-44. [PMID: 38369909 DOI: 10.7748/ns.2024.e12174] [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] [Accepted: 07/04/2023] [Indexed: 02/20/2024]
Abstract
The digital revolution has significantly altered healthcare, including communicable disease control, with online spaces emerging as vital tools in preventing, identifying and controlling the spread of diseases. However, healthcare professionals, including nurses, need to find a balance between harnessing the benefits of mass communication and mitigating the potentially harmful effects of online misinformation. This article explores the benefits and challenges of using online spaces such as social media platforms in the control of communicable diseases and discusses the potential use of telehealth in reducing the risk of healthcare-associated infection and antimicrobial resistance. The author also describes a framework that nurses can use to explore potential roles and practice in the context of communicable disease control in online spaces.
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Ciccacci F, De Santo C, Mosconi C, Orlando S, Carestia M, Guarente L, Liotta G, Palombi L, Emberti Gialloreti L. Not only COVID-19: a systematic review of anti-COVID-19 measures and their effect on healthcare-associated infections. J Hosp Infect 2024; 147:133-145. [PMID: 38423132 DOI: 10.1016/j.jhin.2024.02.008] [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: 11/13/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) burden healthcare globally. Amid the SARS-CoV-2 pandemic, intensified infection control measures, such as mask usage and hand hygiene, were implemented. AIM To assess the efficacy of these measures in preventing HAIs among hospitalized patients. METHODS Using the PICO framework (Population, Intervention, Comparison, Outcome), the study focused on hospitalized patients and the effectiveness of anti-COVID-19 measures in preventing HAIs. A systematic review of literature published in 2020-2022 was conducted, examining interventions such as mask usage, hand hygiene, and environmental cleaning. FINDINGS This systematic review analysed 42 studies: two in 2020, 21 in 2021, and 19 in 2022. Most studies were from high-income countries (28). Most studies (30 out of 42) reported a reduction in HAIs after implementing anti-COVID-19 measures. Gastrointestinal infections and respiratory tract infections showed significant reduction, unlike bloodstream infections and urinary tract infections. Some wards, like cardiology and neurology, experienced reduced HAIs, unlike intensive care units and coronary care units. There was an increase in studies reporting no effect of hygiene measures on HAIs in 2022, eventually indicating a shift in effectiveness over time. CONCLUSION Anti-COVID-19 measures have shown selective efficacy in preventing HAIs. The study emphasizes the need for context-specific strategies and increased focus on regions with limited resources. Continued research is essential to refine infection control practices, especially in high-risk settings.
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Affiliation(s)
- F Ciccacci
- Departmental Faculty of Medicine and Surgery, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - C De Santo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - C Mosconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - S Orlando
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - M Carestia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - L Guarente
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - G Liotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - L Palombi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Catholic University Our Lady of Good Counsel, Tirana, Albania
| | - L Emberti Gialloreti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Liporaci F, Carlotti D, Carlotti A. A machine learning model for the early diagnosis of bloodstream infection in patients admitted to the pediatric intensive care unit. PLoS One 2024; 19:e0299884. [PMID: 38691554 PMCID: PMC11062549 DOI: 10.1371/journal.pone.0299884] [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: 07/20/2023] [Accepted: 02/16/2024] [Indexed: 05/03/2024] Open
Abstract
Bloodstream infection (BSI) is associated with increased morbidity and mortality in the pediatric intensive care unit (PICU) and high healthcare costs. Early detection and appropriate treatment of BSI may improve patient's outcome. Data on machine-learning models to predict BSI in pediatric patients are limited and neither study included time series data. We aimed to develop a machine learning model to predict an early diagnosis of BSI in patients admitted to the PICU. This was a retrospective cohort study of patients who had at least one positive blood culture result during stay at a PICU of a tertiary-care university hospital, from January 1st to December 31st 2019. Patients with positive blood culture results with growth of contaminants and those with incomplete data were excluded. Models were developed using demographic, clinical and laboratory data collected from the electronic medical record. Laboratory data (complete blood cell counts with differential and C-reactive protein) and vital signs (heart rate, respiratory rate, blood pressure, temperature, oxygen saturation) were obtained 72 hours before and on the day of blood culture collection. A total of 8816 data from 76 patients were processed by the models. The machine committee was the best-performing model, showing accuracy of 99.33%, precision of 98.89%, sensitivity of 100% and specificity of 98.46%. Hence, we developed a model using demographic, clinical and laboratory data collected on a routine basis that was able to detect BSI with excellent accuracy and precision, and high sensitivity and specificity. The inclusion of vital signs and laboratory data variation over time allowed the model to identify temporal changes that could be suggestive of the diagnosis of BSI. Our model might help the medical team in clinical-decision making by creating an alert in the electronic medical record, which may allow early antimicrobial initiation and better outcomes.
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Affiliation(s)
- Felipe Liporaci
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Danilo Carlotti
- Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Ana Carlotti
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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Wang J, Ninan N, Nguyen NH, Nguyen MT, Sahu R, Nguyen TT, Mierczynska-Vasilev A, Vasilev K, Truong VK, Tang Y. Biomimetic Bacterium-like Particles Loaded with Aggregation-Induced Emission Photosensitizers as Plasma Coatings for Implant-Associated Infections. ACS APPLIED MATERIALS & INTERFACES 2024; 16:18449-18458. [PMID: 38578282 DOI: 10.1021/acsami.3c19484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Developing novel antibacterial strategies has become an urgent requisite to overcome the increasing pervasiveness of antimicrobial-resistant bacteria and the advent of biofilms. Aggregation-induced emission-based photosensitizers (AIE PSs) are promising candidates due to their unique photodynamic and photothermal properties. Bioengineering structure-inherent AIE PSs for developing thin film coatings is still an unexplored area in the field of nanoscience. We have adopted a synergistic approach combining plasma technology and AIE PS-based photodynamic therapy to develop coatings that can eradicate bacterial infections. Here, we loaded AIE PSs within biomimetic bacterium-like particles derived from a probiotic strain, Lactobacillus fermentum. These hybrid conjugates are then immobilized on polyoxazoline-coated substrates to develop a bioinspired coating to fight against implant-associated infections. These coatings could selectively kill Gram-positive and Gram-negative bacteria, but not damage mammalian cells. The mechanistic studies revealed that the coatings can generate reactive oxygen species that can rupture the bacterial cell membranes. The mRNA gene expression of proinflammatory cytokines confirmed that they can modulate infection-related immune responses. Thus, this nature-inspired design has opened a new avenue for the fabrication of a next-generation antibacterial coating to reduce infections and associated burdens.
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Affiliation(s)
- Jianzhong Wang
- Institute for NanoScale Science and Technology, Medical Device Research Institute, College of Science and Engineering, Flinders University, South Australia 5042, Australia
- College of Veterinary Medicine, Jilin Provincial Engineering Research Center of Animal Probiotics, Jilin Provincial Key Laboratory of Animal Microecology and Healthy Breeding, Engineering Research Center of Microecological Vaccines (Drugs) for Major Animal Diseases, Ministry of Education, Jilin Agricultural University, Changchun 130118, China
| | - Neethu Ninan
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Ngoc Huu Nguyen
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Manh Tuong Nguyen
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Resmarani Sahu
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Tien Thanh Nguyen
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Agnieszka Mierczynska-Vasilev
- The Australian Wine Research Institute, Waite Precinct, Hartley Grove cnr Paratoo Road, Glen Osmond, South Australia 5064, Australia
| | - Krasimir Vasilev
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Vi Khanh Truong
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, South Australia 5042, Australia
| | - Youhong Tang
- Institute for NanoScale Science and Technology, Medical Device Research Institute, College of Science and Engineering, Flinders University, South Australia 5042, Australia
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Wang M, Li W, Wang H, Song P. Development and validation of machine learning-based models for predicting healthcare-associated bacterial/fungal infections among COVID-19 inpatients: a retrospective cohort study. Antimicrob Resist Infect Control 2024; 13:42. [PMID: 38616284 PMCID: PMC11017584 DOI: 10.1186/s13756-024-01392-7] [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: 01/09/2024] [Accepted: 03/30/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND COVID-19 and bacterial/fungal coinfections have posed significant challenges to human health. However, there is a lack of good tools for predicting coinfection risk to aid clinical work. OBJECTIVE We aimed to investigate the risk factors for bacterial/fungal coinfection among COVID-19 patients and to develop machine learning models to estimate the risk of coinfection. METHODS In this retrospective cohort study, we enrolled adult inpatients confirmed with COVID-19 in a tertiary hospital between January 1 and July 31, 2023, in China and collected baseline information at admission. All the data were randomly divided into a training set and a testing set at a ratio of 7:3. We developed the generalized linear and random forest models for coinfections in the training set and assessed the performance of the models in the testing set. Decision curve analysis was performed to evaluate the clinical applicability. RESULTS A total of 1244 patients were included in the training cohort with 62 healthcare-associated bacterial/fungal infections, while 534 were included in the testing cohort with 22 infections. We found that patients with comorbidities (diabetes, neurological disease) were at greater risk for coinfections than were those without comorbidities (OR = 2.78, 95%CI = 1.61-4.86; OR = 1.93, 95%CI = 1.11-3.35). An indwelling central venous catheter or urinary catheter was also associated with an increased risk (OR = 2.53, 95%CI = 1.39-4.64; OR = 2.28, 95%CI = 1.24-4.27) of coinfections. Patients with PCT > 0.5 ng/ml were 2.03 times (95%CI = 1.41-3.82) more likely to be infected. Interestingly, the risk of coinfection was also greater in patients with an IL-6 concentration < 10 pg/ml (OR = 1.69, 95%CI = 0.97-2.94). Patients with low baseline creatinine levels had a decreased risk of bacterial/fungal coinfections(OR = 0.40, 95%CI = 0.22-0.71). The generalized linear and random forest models demonstrated favorable receiver operating characteristic curves (ROC = 0.87, 95%CI = 0.80-0.94; ROC = 0.88, 95%CI = 0.82-0.93) with high accuracy, sensitivity and specificity of 0.86vs0.75, 0.82vs0.86, 0.87vs0.74, respectively. The corresponding calibration evaluation P statistics were 0.883 and 0.769. CONCLUSIONS Our machine learning models achieved strong predictive ability and may be effective clinical decision-support tools for identifying COVID-19 patients at risk for bacterial/fungal coinfection and guiding antibiotic administration. The levels of cytokines, such as IL-6, may affect the status of bacterial/fungal coinfection.
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Affiliation(s)
- Min Wang
- Department of Infection Management, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China
| | - Wenjuan Li
- Department of Medical Big Data, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China
| | - Hui Wang
- Department of Infection Management, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China
| | - Peixin Song
- Department of Infection Management, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China.
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Lee M, Park SW, Bang J, Lee E. Impact of medical waste bin on contamination of patient's environment: An experimental study. Am J Infect Control 2024:S0196-6553(24)00158-5. [PMID: 38588979 DOI: 10.1016/j.ajic.2024.03.015] [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: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Medical waste bins are a potential source of microbial contamination in the hospital environment, while there is no clear guidance for the management of them. We aimed to assess the impact of medical waste bins on patient's environment. METHODS This experimental study simulated microbial contamination by performing medical procedures on a patient model with fluorescent lotion. The waste bin was set as initially empty or two-thirds filled with waste, open or with a lid. The percentage of fluorescent-contaminated area in designated patient's environments was analyzed by 2 independent observers. RESULTS Among a total of 120 experiments, the sides of the bins were more contaminated in open-occupied bins compared to open-empty bins and in open-occupied bins compared to lid-occupied bins (median 1.9175% vs 0.0916% [P = .001] and 1.9175% vs 0.0899% [P = .003], respectively). The top of the bedside equipment trolley for preparing medical procedures was more contaminated in lid-occupied bins than open-occupied bins (median 0.0080% vs 0.0040%, P = .013). DISCUSSION In addition to reducing contamination of the bin itself, the manually operated lid had a potential risk of contributing to microbial transmission by contaminating the equipment trolley. CONCLUSIONS Medical waste bins should be kept no more than two-thirds full, and caution should be taken when using the manually operated lid, to avoid cross-contamination.
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Affiliation(s)
- Minkyeong Lee
- Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Won Park
- Department of Internal Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea
| | - Jihwan Bang
- Department of Internal Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea
| | - Eunyoung Lee
- Department of Internal Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, Korea.
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de la Rocha C, Caprara CDSC, Poester VR, Xavier MO, Porte AF, Galarça MM, Filgueira DDMVB, Votto APDS, Ramos DF. Highly effective decontamination in a hospital environment: An easy-to-operate, low-cost prototype. Photochem Photobiol 2024. [PMID: 38572693 DOI: 10.1111/php.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/02/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
Healthcare-associated infections (HAI) are illnesses acquired during healthcare and are often the most important adverse event during healthcare. With the aim of increasing the effectiveness of disinfection/decontamination processes in the health service with safe and not promote microbial resistance, we propose the development of portable equipment associated with type C ultraviolet light (UVC). The efficiency of the irradiance emitted by the equipment (at dosages 3.5, 5.0, and 60 mJ/cm2) was determined by the action exerted after exposure against four different bacterial (Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) and three different fungi (Candida albicans, C. parapsilosis, and Aspergillus section Fumigati). It was possible to observe that all treatments were capable of inactivating the bacterial species evaluated (p < 0.05), causing the irreversible death of these microorganisms. The most effective elimination of fungal agents was at a dose of 60 mJ/cm2 of UVC radiation, with a decrease in the fungal inoculum varying between 94% and 100% in relation to the control without exposure. Thus, our study showed that the application of the portable prototype with UVC light (254 nm) at a distance of 48 mm, allowed an average irradiance of 3.5 mW/cm2, with doses of 3.5 ≈ 60 mJ/cm2 (from 1 to 60 s of exposure), which can promote the total reduction of the bacteria evaluated and significantly reduce fungal growth. Therefore, this prototype could be used safely and effectively in the hospital environment, considerably reducing contamination and contributing to the reduction of healthcare-associated infection risk.
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Affiliation(s)
- Clarice de la Rocha
- Laboratório de Desenvolvimento de Novos Fármacos (LADEFA), Universidade Federal do Rio Grande-FURG, Rio Grande, Rio Grande do Sul, Brazil
| | | | | | | | - Anderson Favero Porte
- Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Sul, Rio Grande, Rio Grande do Sul, Brazil
| | - Marcelo Moraes Galarça
- Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Sul, Rio Grande, Rio Grande do Sul, Brazil
| | - Daza de Moraes Vaz Batista Filgueira
- Laboratório de Cultura Celular-Pós-graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas-FURG, Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Paula de Souza Votto
- Laboratório de Cultura Celular-Pós-graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas-FURG, Rio Grande, Rio Grande do Sul, Brazil
| | - Daniela Fernandes Ramos
- Laboratório de Desenvolvimento de Novos Fármacos (LADEFA), Universidade Federal do Rio Grande-FURG, Rio Grande, Rio Grande do Sul, Brazil
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Falana ROA, Ogidan OC, Fajemilehin BR. Barriers to infection prevention and control implementation in selected healthcare facilities in Nigeria. Infect Dis Now 2024; 54:104877. [PMID: 38395258 DOI: 10.1016/j.idnow.2024.104877] [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: 06/21/2023] [Revised: 12/01/2023] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE While infection prevention and control are of paramount importance, up until recently an assessment of implementation challenges and performance gaps was lacking. This study explored the barriers to infection prevention and control implementation at selected healthcare facilities, the objective being to find ways to improve their programs. MATERIAL AND METHOD A qualitative approach was applied. Purposive sampling was used to select thirty-three healthcare facilities in Ekiti State, Nigeria. They were globally assessed, and an Infection Prevention and Control team, represented by the Infection Prevention and Control referent in each of the selected facilities trained the participants. Data were collected using the Key Informant Interview Guide and analyzed by means of content and thematic analyses using Atlas.ti software. RESULTS Inadequate infection prevention and control materials, poor waste management, non-compliance of patients with infection prevention and control protocols, and poor infrastructure were identified as major barriers to infection prevention and control implementation. CONCLUSION The study concluded that a number of identified factors hindering infection prevention and control implementation in healthcare facilities in Ekiti State needed to be addressed.
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Affiliation(s)
- Rachael O A Falana
- Department of Nursing Science, Obafemi Awolowo University, Osun State, Nigeria.
| | - Oluwakemi C Ogidan
- Department of Nursing Science, Ekiti State University, Ado Ekiti, Ekiti State, Nigeria
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Kpegeol CK, Jain VS, Ansari D, Ammanuel SG, Page PS, Josiah DT. Surgical site infection rates in open versus endoscopic lumbar spinal decompression surgery: A retrospective cohort study. World Neurosurg X 2024; 22:100347. [PMID: 38440381 PMCID: PMC10911845 DOI: 10.1016/j.wnsx.2024.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/04/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
Background Lumbar decompression is a commonly performed procedure for the operative management of several degenerative lumbar spinal pathologies. Although open approaches are considered the traditional method, endoscopic techniques represent a relatively novel, less-invasive option to achieve neural element decompression. Here within, we examine if the use of endoscopic techniques decreases the risk of post operative infections. Methods We performed a retrospective cohort analysis to directly compare patients who underwent either open or endoscopic lumbar decompression at a single institution. Rates of postoperative outcomes such as surgical site infection, hospital length of stay, estimated blood loss, and others were compared between the two treatment groups. A multivariate logistic regression model was constructed using patient comorbidities and procedural characteristics to identify the risk factors for surgical site infection. Results 150 patients were identified as undergoing lumbar spine decompression surgeries that met inclusion criteria for the study, of whom 108 (72.0%) underwent open and 61 (28.0%) underwent endoscopic approaches. Unpaired analysis revealed positive associations between operative duration, estimated blood loss, drain placement rates. Multivariate logistic regression did not reveal an association between surgical approach (open versus endoscopic) and the development of surgical site infection. Conclusions Surgical site infections following endoscopic lumbar spine decompression are relatively uncommon, however, after adjusting for baseline differences between patient populations, surgical approach does not independently predict the development of postoperative infection.
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Affiliation(s)
| | | | - Darius Ansari
- Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, 53792, USA
| | - Simon G. Ammanuel
- Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, 53792, USA
| | - Paul S. Page
- Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, 53792, USA
| | - Darnell T. Josiah
- Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, 53792, USA
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Gozdzielewska L, Kc D, Butcher J, Molesworth M, Davis K, Barr L, DiBari C, Mortgat L, Deeves M, Kothari KU, Storr J, Allegranzi B, Reilly J, Price L. Interventions for preventing or controlling health care-associated infection among health care workers or patients within primary care facilities: A scoping review. Am J Infect Control 2024; 52:479-487. [PMID: 37944755 DOI: 10.1016/j.ajic.2023.10.011] [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: 06/29/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND This review aimed to synthesize the evidence on infection prevention and control interventions for the prevention of health care-associated infection among health care workers or patients within primary care facilities. METHODS PubMed, CINAHL, EMBASE, and CENTRAL databases were searched for quantitative studies published between 2011 and 2022. Study selection, data extraction, and quality assessment using Cochrane and Joanna Briggs tools, were conducted by independent review with additional sensitivity checking performed on study selection. RESULTS Four studies were included. A randomized trial and a cross-sectional survey, respectively, found no statistical difference in laboratory-confirmed influenza in health care workers wearing N95 versus medical masks (P = .18) and a significant inverse association between the implementation of tuberculosis control measures and tuberculosis incidence (P = .02). For the prevention of surgical site infections following minor surgery, randomized trials found nonsterile gloves (8.7%; 95% confidence interval, 4.9%-12.6%) to be noninferior to sterile gloves (9.3%; 95% confidence interval, 7.4%-11.1%) and no significant difference between prophylactic antibiotics compared to placebo (P = .064). All studies had a high risk of bias. CONCLUSIONS Evidence for infection prevention and control interventions for the prevention of health care-associated infection in primary care is very limited and insufficient to make practice recommendations. Nevertheless, the findings highlight the need for future research.
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Affiliation(s)
- Lucyna Gozdzielewska
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland.
| | - Deepti Kc
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - John Butcher
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Mark Molesworth
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Katie Davis
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Lisa Barr
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Carlotta DiBari
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Laure Mortgat
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Miranda Deeves
- Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Kavita U Kothari
- Consultant to Library & Digital Information Networks / Quality Assurance, Norms and Standards / Science Division, World Health Organization, Kobe, Japan
| | - Julie Storr
- Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jacqui Reilly
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Lesley Price
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
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Boyle M, Vaja R, Rochon M, Luhana S, Gopalaswamy M, Bhudia S, Raja S, Petrou M, Quarto C. Sex differences in surgical site infections following coronary artery bypass grafting: a retrospective observational study. J Hosp Infect 2024; 146:52-58. [PMID: 38309668 DOI: 10.1016/j.jhin.2024.01.013] [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: 09/15/2023] [Revised: 12/23/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Surgical site infection (SSI) following cardiac surgery poses a significant challenge for healthcare providers. Despite advances in surgical techniques and infection control measures, SSI remains a leading cause of morbidity and mortality, in addition to being a significant economic burden on healthcare services. Current literature suggests there is a reproducible difference in the incidence of SSI following cardiac surgery between sexes. We aim to assess the sex-specific predictive risk factors for sternal SSI following coronary artery bypass grafting (CABG) in addition to identifying any differences in the causative organisms between groups. METHODS Adult patients undergoing isolated CABG between January 2012 and December 2022 in one UK hospital organization were included. In this 10-year, retrospective observational study, a total of 10,208 patients met the inclusion criteria. Pre-operative risk factors were identified using univariate analysis. To assess dependence between sex and organism or Gram stain, a Pearson Chi-squared test with Yates correction for continuity was performed. RESULTS In total there were 8457 males of which 181 developed a sternal SSI (2.14%) and 1751 females, 128 of whom had a sternal SSI (7.31%). Male patients were found to be significantly more likely to develop an SSI secondary to a Gram-positive organism, whereas female patients were more likely to have a Gram-negative causative organism (P<0.00001). Staphylococcus was statistically more likely to be the causative organism genus in male patients. Pseudomonas aeruginosa was found to be twice as common in the female cohort compared with the male group. CONCLUSION In our study, we found a statistically significant difference in the causative organisms and Gram stain for post-CABG sternal SSIs between males and females. Male patients predominately have Gram-positive associated SSIs, whereas female SSI pathogens are more likely to be Gram negative. The preoperative risk profiles of both cohorts are similar, including being an insulin-dependent diabetic and triple vessel coronary artery disease. Given these findings, it prompts the question, should we be tailoring our SSI treatment strategies according to sex and associated risk profiles?
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Affiliation(s)
- M Boyle
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Vaja
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK; National Heart and Lung Institute, Imperial College London, UK.
| | - M Rochon
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Luhana
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Gopalaswamy
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Bhudia
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Raja
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Petrou
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Quarto
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Dessalegn A, Ali MS, Yohannes S, Tamir Y, Mulatu S, Zewdie A. Knowledge, practice and associated factors towards intravenous cannula-related infection prevention among nurses working at Northwest Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia. BMC Nurs 2024; 23:168. [PMID: 38462599 PMCID: PMC10926565 DOI: 10.1186/s12912-024-01737-y] [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: 02/02/2023] [Accepted: 01/15/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Intravenous cannula-related infections are one of the leading causes of healthcare-associated infections. It leads to morbidity and mortality in hospitalized patients. Nurses play a significant role in the prevention of these infections. Whereas in Ethiopia, there is limited information and published studies done on nurses' knowledge, practice, and associated factors and also most of other available studies done only the magnitude it lack associated factors. The purpose of this study was to assess nurses' knowledge, practice, and associated factors toward intravenous cannula-related infection prevention. METHODS An institution-based cross-sectional study was conducted at Northwest Amhara Regional State Comprehensive Specialized Hospitals on May 1-30/2022. By using single population proportion formula the sample size was determined; we used a 50% proportion value (0.05), and 95% Confidence Interval 5% margin of error. A simple random sampling method was used to select 423 nurses. The data were collected by using structured pretested self-administered questionnaires. Then coded, and enter into epi-data version 4.6 and exported into the statistical package for social science version 23 for cleaning and analyzing the data. Data were presented by texts, tables, and figures. A binary logistic regression model was used to assess the association between variables. Based on the adjusted odds ratio, variables having a p-value less than 0.05 with a 95% confidence interval were used to state associated with the outcome variables. RESULTS A total of 412 nurses participated in this study with 97.4% response rate. The participants had good knowledge and practice in proportions of (54. 9%) and (53. 4%) respectively. Being male, working wards/units, having training, and a higher educational level were factors that were significantly associated to having good knowledge. Working wards/units, having good knowledge, training, and access to guidelines were significantly associated with performing good practice. CONCLUSION The finding of this study revealed that nearly half of the nurses had poor knowledge and practice in intravenous cannula-related infection prevention. As a result, hospital administrators and other concerned stakeholders better to prepare and ensure that guidelines are available, provide training, and develop the educational levels of nurses.
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Affiliation(s)
- Alemwork Dessalegn
- Department of adult Health Nursing, school of Health Science, college of medicine and health science, Bahir Dar University, PO Box 79, Bahir Dar, Ethiopia.
| | - Mohammed Seid Ali
- Department of Pediatrics and child health nursing, college of medicine and health science, University of Gondar, Gondar, Ethiopia
| | - Senay Yohannes
- Departments of Surgical Nursing, college of medicine and health science, University of Gondar, Gondar, Ethiopia
| | - Yeshimebet Tamir
- Department of adult Health Nursing, school of Health Science, college of medicine and health science, Bahir Dar University, PO Box 79, Bahir Dar, Ethiopia
| | - Sileshi Mulatu
- Department of Pediatrics and child health nursing, college of medicine and health science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Zewdie
- Department of Nursing and Midwifery, Wollega University, Institute of Health Science, Wollega, Ethiopia
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Aranega-Bou P, Cornbill C, Rodger G, Bird M, Moore G, Roohi A, Hopkins KL, Hopkins S, Ribeca P, Stoesser N, Lipworth SI. WITHDRAWN: Evaluation of Fourier Transform Infrared spectroscopy (IR Biotyper) as a complement to Whole genome sequencing (WGS) to characterise Enterobacter cloacae , Citrobacter freundii and Klebsiella pneumoniae isolates recovered from hospital sinks. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.04.24.23289028. [PMID: 37214917 PMCID: PMC10193520 DOI: 10.1101/2023.04.24.23289028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The authors have withdrawn their manuscript due to becoming aware of methodology issues related to the curation of the training set used to determine cut-off values for Biotyper cluster assignation and lack of replicate measurements on different days for the isolates analysed. It is therefore unclear whether the conclusions of the manuscript are founded and no further work is possible to correct these issues as the instrument is no longer available to the authors. If you have any questions, please contact the corresponding author.
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Prabha Shankar A, Br KK, Shankar B, Babu RH, Dholariya R, Priya, Muralidhar S, Subramanya GM. Oncological Surgical Wound Care: A Comparison of Theruptor NXT Non-adherent Dressing and the Current Standard of Care. Cureus 2024; 16:e56593. [PMID: 38650774 PMCID: PMC11034897 DOI: 10.7759/cureus.56593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Background Oncological surgeries pose an elevated risk of surgical site infections (SSIs) due to their complexity and various associated treatments, impacting patient outcomes and healthcare costs. This has prompted a focus on advanced wound dressings that provide microbial protection, exudate absorption, and improved product performance, enhancing patient satisfaction. Our study aimed to compare the efficacy and safety of Theruptor NXT with the current standard of care (SOC) practice involving cotton/povidone/micropore dressings in the postoperative wound management of oncological surgeries. Methodology A total of 102 patients who underwent oncological surgeries in the Department of Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, India between May and September 2023 were randomized to Theruptor NXT and SOC dressing groups (51 patients each). The incidence of SSIs, wound pain score, cosmetic appearance of the wound, and adverse events were assessed in the two groups at various intervals, i.e., post-surgery day 2 ± 1, day of discharge, and post-surgery day 30 ± 7. Further, the subject satisfaction and product usage were evaluated on post-surgery day 2 ± 1. Results The baseline characteristics were found to be comparable in both groups, i.e., Theruptor NXT and SOC groups. Further, the SSI rates, scar outcomes, and physiological parameters were also similar between the Theruptor NXT and SOC groups, indicating a similar safety profile of both dressings (p > 0.05). However, the product usage assessment revealed statistically significant differences, favoring Theruptor NXT in terms of superior ease of application, stretchability, exudate management, breathability, and non-adherence properties (p < 0.05). Conclusions Our findings suggest that Theruptor NXT wound dressing is a promising, effective, and user-friendly alternative to SOC wound dressing in diverse clinical settings.
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Affiliation(s)
- Amritha Prabha Shankar
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Kiran Kumar Br
- Radiation Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Bharat Shankar
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Ravoori H Babu
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Rahul Dholariya
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Priya
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Shubhashree Muralidhar
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Ganesh M Subramanya
- Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
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Tabash MI, Abu Saada AAS, AbuQamar M, Mansour HH, Alajerami Y, Abushab K. Infection control measures at diagnostic imaging departments in governmental hospitals, Gaza-Strip. Radiography (Lond) 2024; 30:567-573. [PMID: 38286039 DOI: 10.1016/j.radi.2024.01.005] [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: 07/29/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Infection prevention and control (IPC) is crucial in safeguarding patient safety and minimizing the risk of healthcare-associated infections. AIM The study investigated infection prevention and control measures for diagnostic imaging departments at governmental hospitals in the Gaza Strip, Palestine. METHODS The study design was a cross-sectional analytical study. The sample included all radiographers (81) and radiologists (40) working at Al Shifa Medical Complex and European Gaza Hospital (EGH). Data was collected using an interview questionnaire (121) and an observation checklist. Data analysis was conducted using SPSS 26, and the result was significant (P < 0.05). RESULTS Only 27.3 % of the participants revealed the availability of training courses for IPC. More than half of the participants received their last training sessions one year ago, and most of them attended five basic in-service training sessions related to IPC. Radiologists' and medical radiographers' knowledge and practice scores regarding IPC measures were 85.3 % and 61.7 %, respectively, and there were statistically significant differences between the participants' practice domain and their years of experience (p-value .014). There is inadequate hand hygiene among radiographers in the radiology department, and only 29 % of the staff washed their hands immediately upon arrival at the unit. The total score of the Hand Hygiene Self-Assessment Framework domains is almost equal at the two hospitals (280/500). The total score of the eight domains of the IPC Assessment Framework is 568.5/800 for Al Shifa Hospital and 516/800 for EGH, which indicates an intermediate IPC level. CONCLUSION Efforts are needed to enhance the scope and quality of implementation and to concentrate on creating long-term plans to sustain and promote the existing IPC program activities. IMPLICATIONS FOR PRACTICE Regular assessments should be conducted to monitor progress, identify gaps, and guide quality improvement efforts. Assessment feedback should be used to develop targeted interventions and continuously enhance IPC measures.
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Affiliation(s)
- M I Tabash
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Palestine.
| | | | - M AbuQamar
- Department of Nursing, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Palestine
| | - H H Mansour
- Department of Medical Imaging, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Palestine
| | - Y Alajerami
- Department of Medical Imaging, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Palestine
| | - K Abushab
- Department of Medical Imaging, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Palestine
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Lee SH, Yang IS. Empowering hospital-associated infection prevention and control: A quasi-experimental study on the effect of scenario-based simulation training. Nurse Educ Pract 2024; 76:103936. [PMID: 38503111 DOI: 10.1016/j.nepr.2024.103936] [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: 01/14/2024] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
AIM This study aimed to investigate the effect of scenario-based simulation training on infection control, specifically in terms of knowledge, self-efficacy and adherence to standard precautions. BACKGROUND Hospital-associated infections can pose a threat to patient safety and are a critical public health issue that requires attention. DESIGN This quasi-experimental study employed a pre-test/post-test design using a nonequivalent control group. METHODS Infection control nurses were randomly assigned to two groups using lottery methods. The experimental group received scenario-based simulation training, whereas both the experimental and control groups received conventional education. Data were collected from 27 August to 1 December 1 2022. The chi-square test and t-test were used for data analysis. RESULTS The mean scores for knowledge of infection prevention and control (t = 3.679, p < 0.001) and self-efficacy (t = 2.444, p = 0.018) were significantly higher in the experimental group than in the control group. Furthermore, the mean score for adherence to standard precautions was significantly higher in the experimental group than in the control group (t = 2.030, p = 0.048). CONCLUSION Our results suggest that scenario-based simulation training for infection control might be effective in improving knowledge, self-efficacy and adherence to standard precautions. Scenario-based simulation training for infection control may be an effective educational intervention to enhance knowledge, self-efficacy and adherence to standard precautions, thus empowering nurses in infection prevention and control.
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Affiliation(s)
- Soon-Hee Lee
- Department of Nursing, Korea National University of Transportation, Jeungpyeong 27909, Republic of Korea
| | - In-Suk Yang
- Department of Nursing, Kyungil University, Gyeongsan 38428, Republic of Korea.
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van Zeggeren IE, Pennartz CJ, Ter Horst L, van de Beek D, Brouwer MC. Diagnostic accuracy of clinical and laboratory characteristics in suspected non-surgical nosocomial central nervous system infections. J Hosp Infect 2024; 145:99-105. [PMID: 38219837 DOI: 10.1016/j.jhin.2023.12.015] [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: 10/12/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND The diagnosis of meningitis in non-surgical hospitalized patients is often difficult and diagnostic accuracy of clinical, laboratory, and radiological characteristics is unknown. AIM To assess diagnostic accuracy for individual clinical characteristics of patients suspected of non-surgical nosocomial central nervous system (CNS) infections. METHODS In a prospective multi-centre cohort study in the Netherlands with adults suspected of CNS infections, consecutive patients who underwent a lumbar puncture for the suspicion of a non-surgical nosocomial CNS infection were included. All episodes were categorized into five final clinical diagnosis categories, as reference standard: CNS infection, CNS inflammatory disease, systemic infection, other neurological disease, or non-systemic, non-neurological disease. FINDINGS Between 2012 and 2022, 114 out of 1275 (9%) patients included in the cohort had suspected non-surgical nosocomial CNS infection: 16 (14%) had a confirmed diagnosis, including four (25%) with bacterial meningitis, nine (56%) with viral CNS infections, two (13%) fungal meningitis, and one (6%) parasitic meningitis. Diagnostic accuracy of individual clinical characteristics was generally low. Elevated CSF leucocyte count had the highest sensitivity (81%; 95% confidence interval (CI): 54-96) and negative predictive value (NPV) (96%; 95% CI: 90-99). When combining the presence of abnormalities in neurological or CSF examination, sensitivity for diagnosing a CNS infection was 100% (95% CI: 79-100) and NPV 100% (95% CI: 78-100). CSF examination changed clinical management in 47% of patients. CONCLUSION Diagnostic accuracy for individual clinical characteristics was low, with elevated CSF leucocyte count having the highest sensitivity and NPV.
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Affiliation(s)
- I E van Zeggeren
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef, Amsterdam, The Netherlands
| | - C J Pennartz
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef, Amsterdam, The Netherlands
| | - L Ter Horst
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef, Amsterdam, The Netherlands
| | - D van de Beek
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef, Amsterdam, The Netherlands
| | - M C Brouwer
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Meibergdreef, Amsterdam, The Netherlands.
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Ferrara M, Bertozzi G, Di Fazio N, Aquila I, Di Fazio A, Maiese A, Volonnino G, Frati P, La Russa R. Risk Management and Patient Safety in the Artificial Intelligence Era: A Systematic Review. Healthcare (Basel) 2024; 12:549. [PMID: 38470660 PMCID: PMC10931321 DOI: 10.3390/healthcare12050549] [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: 01/29/2024] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Healthcare systems represent complex organizations within which multiple factors (physical environment, human factor, technological devices, quality of care) interconnect to form a dense network whose imbalance is potentially able to compromise patient safety. In this scenario, the need for hospitals to expand reactive and proactive clinical risk management programs is easily understood, and artificial intelligence fits well in this context. This systematic review aims to investigate the state of the art regarding the impact of AI on clinical risk management processes. To simplify the analysis of the review outcomes and to motivate future standardized comparisons with any subsequent studies, the findings of the present review will be grouped according to the possibility of applying AI in the prevention of the different incident type groups as defined by the ICPS. MATERIALS AND METHODS On 3 November 2023, a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out using the SCOPUS and Medline (via PubMed) databases. A total of 297 articles were identified. After the selection process, 36 articles were included in the present systematic review. RESULTS AND DISCUSSION The studies included in this review allowed for the identification of three main "incident type" domains: clinical process, healthcare-associated infection, and medication. Another relevant application of AI in clinical risk management concerns the topic of incident reporting. CONCLUSIONS This review highlighted that AI can be applied transversely in various clinical contexts to enhance patient safety and facilitate the identification of errors. It appears to be a promising tool to improve clinical risk management, although its use requires human supervision and cannot completely replace human skills. To facilitate the analysis of the present review outcome and to enable comparison with future systematic reviews, it was deemed useful to refer to a pre-existing taxonomy for the identification of adverse events. However, the results of the present study highlighted the usefulness of AI not only for risk prevention in clinical practice, but also in improving the use of an essential risk identification tool, which is incident reporting. For this reason, the taxonomy of the areas of application of AI to clinical risk processes should include an additional class relating to risk identification and analysis tools. For this purpose, it was considered convenient to use ICPS classification.
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Affiliation(s)
- Michela Ferrara
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Giuseppe Bertozzi
- Complex Intercompany Structure of Forensic Medicine, 85100 Potenza, Italy;
| | - Nicola Di Fazio
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Isabella Aquila
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Aldo Di Fazio
- Regional Hospital “San Carlo”, 85100 Potenza, Italy;
| | - Aniello Maiese
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Gianpietro Volonnino
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.F.); (N.D.F.); (P.F.)
| | - Raffaele La Russa
- Department of Clinical Medicine, Public Health, Life and Environment Science, University of L’Aquila, 67100 L’Aquila, Italy;
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Mustafa AS. Whole Genome Sequencing: Applications in Clinical Bacteriology. Med Princ Pract 2024; 33:185-197. [PMID: 38402870 PMCID: PMC11221363 DOI: 10.1159/000538002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024] Open
Abstract
The success in determining the whole genome sequence of a bacterial pathogen was first achieved in 1995 by determining the complete nucleotide sequence of Haemophilus influenzae Rd using the chain-termination method established by Sanger et al. in 1977 and automated by Hood et al. in 1987. However, this technology was laborious, costly, and time-consuming. Since 2004, high-throughput next-generation sequencing technologies have been developed, which are highly efficient, require less time, and are cost-effective for whole genome sequencing (WGS) of all organisms, including bacterial pathogens. In recent years, the data obtained using WGS technologies coupled with bioinformatics analyses of the sequenced genomes have been projected to revolutionize clinical bacteriology. WGS technologies have been used in the identification of bacterial species, strains, and genotypes from cultured organisms and directly from clinical specimens. WGS has also helped in determining resistance to antibiotics by the detection of antimicrobial resistance genes and point mutations. Furthermore, WGS data have helped in the epidemiological tracking and surveillance of pathogenic bacteria in healthcare settings as well as in communities. This review focuses on the applications of WGS in clinical bacteriology.
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Affiliation(s)
- Abu Salim Mustafa
- Department of Microbiology, College of Medicine, Kuwait University, Kuwait City, Kuwait
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Ayub A, Cheong YK, Castro JC, Cumberlege O, Chrysanthou A. Use of Hydrogen Peroxide Vapour for Microbiological Disinfection in Hospital Environments: A Review. Bioengineering (Basel) 2024; 11:205. [PMID: 38534479 DOI: 10.3390/bioengineering11030205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
Disinfection of nosocomial pathogens in hospitals is crucial to combat healthcare-acquired infections, which can be acquired by patients, visitors and healthcare workers. However, the presence of a wide range of pathogens and biofilms, combined with the indiscriminate use of antibiotics, presents infection control teams in healthcare facilities with ongoing challenges in the selection of biocides and application methods. This necessitates the development of biocides and innovative disinfection methods that overcome the shortcomings of conventional methods. This comprehensive review finds the use of hydrogen peroxide vapour to be a superior alternative to conventional methods. Motivated by observations in previous studies, herein, we provide a comprehensive overview on the utilisation of hydrogen peroxide vapour as a superior high-level disinfection alternative in hospital settings. This review finds hydrogen peroxide vapour to be very close to an ideal disinfectant due to its proven efficacy against a wide range of microorganisms, safety to use, lack of toxicity concerns and good material compatibility. The superiority of hydrogen peroxide vapour was recently demonstrated in the case of decontamination of N95/FFP2 masks for reuse to address the critical shortage caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the COVID-19 pandemic. Despite the significant number of studies demonstrating antimicrobial activity, there remains a need to critically understand the mechanism of action by performing studies that simultaneously measure damage to all bacterial cell components and assess the correlation of this damage with a reduction in viable cell count. This can lead to improvement in antimicrobial efficacy and foster the development of superior approaches.
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Affiliation(s)
- Aaqib Ayub
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Yuen Ki Cheong
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Jesus Calvo Castro
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | | | - Andreas Chrysanthou
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK
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