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Tartari E, Kilpatrick C, Deeves M, Pittet D, Allegranzi B. Enhancing innovative training and education in infection prevention and control: a call to action for World Hand Hygiene Day 2024. Lancet Glob Health 2024; 12:e907-e908. [PMID: 38710184 DOI: 10.1016/s2214-109x(24)00117-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 05/08/2024]
Affiliation(s)
- Ermira Tartari
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland; Faculty of Health Sciences, University of Malta, Triq Dun Karm, Msida, Malta
| | - Claire Kilpatrick
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland
| | - Mandy Deeves
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland.
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Boyce JM, Pittet D. Rinse, gel, and foam - is there any evidence for a difference in their effectiveness in preventing infections? Antimicrob Resist Infect Control 2024; 13:49. [PMID: 38730473 PMCID: PMC11084031 DOI: 10.1186/s13756-024-01405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Following publication of the 2009 World Health Organizations Guidelines for Hand Hygiene in Health Care, a debate has emerged regarding the relative antimicrobial efficacy of the different formats (rinse, gel, foam) of ABHRs and their ability to contribute to reduction of healthcare-associated infections (HAIs). METHODS Data regarding the in-vivo antimicrobial efficacy of ABHRs and other factors that likely affect their effectiveness in reducing HAIs were reviewed, and a comprehensive review of studies that reported the effectiveness of each of the three ABHR formats to improve hand hygiene compliance and reduce HAIs was conducted. RESULTS The amount of rubbing time it takes for hands to feel dry (dry time) is the major driver of ABHR antimicrobial efficacy. ABHR format is not a major factor, and several studies found that rinse, gel, and foam ABHRs have comparable in-vivo antimicrobial efficacy. Other factors that likely impact the ability of ABHRs to reduce transmission of healthcare-associated pathogens and HAIs include ABHR formulation, the volume applied to hands, aesthetic characteristics, skin tolerance, acceptance by healthcare personnel, and hand hygiene compliance rates. When accompanied by complementary strategies, promoting the use of each of the three ABHR formats has been associated with improvements in hand hygiene compliance rates. A review of 67 studies failed to identify an ABHR format that was significantly more effective in yielding statistically significant reductions in transmission of healthcare-associated pathogens or HAIs. CONCLUSIONS Current evidence is insufficient to definitively determine if one ABHR format is more effective in reducing transmission of healthcare-associated pathogens and HAIs. More rigorous studies such as multicenter randomized controlled trials comparing the different formats are needed to establish if one format is significantly more effective in reducing HAIs.
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Affiliation(s)
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Kilpatrick C, Tartari E, Deeves M, Pittet D, Allegranzi B. World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: Clean Your Hands campaign: Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. J Infect Prev 2024; 25:49-50. [PMID: 38584712 PMCID: PMC10998551 DOI: 10.1177/17571774241239044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 04/09/2024] Open
Abstract
The World Health Organization's (WHO) World Hand Hygiene Day continues to "bring people together and accelerate hand hygiene action at the point of care in health care to contribute to a reduction in health care-associated infections and the achievement of safer, quality health care for all."
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Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Miranda Deeves
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
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Kilpatrick C, Tartari E, Deeves M, Pittet D, Allegranzi B. World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: Clean Your Hands campaign: Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. Am J Infect Control 2024; 52:621. [PMID: 38649222 DOI: 10.1016/j.ajic.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland.
| | - Miranda Deeves
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
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Kilpatrick C, Tartari E, Storr J, Pittet D, Allegranzi B. Why is sharing knowledge about hand hygiene and infection prevention and control still so important? Int J Infect Dis 2024; 144:107063. [PMID: 38657759 DOI: 10.1016/j.ijid.2024.107063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Msida, Malta.
| | - Julie Storr
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
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Tartari E, Garlasco J, Mezerville MHD, Ling ML, Márquez-Villarreal H, Seto WH, Simon A, Hennig TJ, Pittet D. Ten years of hand hygiene excellence: a summary of outcomes, and a comparison of indicators, from award-winning hospitals worldwide. Antimicrob Resist Infect Control 2024; 13:45. [PMID: 38637873 PMCID: PMC11027265 DOI: 10.1186/s13756-024-01399-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/07/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Hand hygiene is a crucial measure for the prevention of healthcare-associated infections (HAIs). The Hand Hygiene Excellence Award (HHEA) is an international programme acknowledging healthcare facilities for their leadership in implementing hand hygiene improvement programmes, including the World Health Organisation's Multimodal Improvement Strategy. This study aimed at summarising the results of the HHEA campaign between 2010 and 2021 and investigating the relationship between different hand hygiene parameters based on data from participating healthcare facilities. METHODS A retrospective analysis was performed on datasets from HHEA forms, including data on hand hygiene compliance, alcohol-based handrub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores. Descriptive statistics were reported for each variable. The correlation between variables was inspected through Kendall's test, while possible non-linear relationships between hand hygiene compliance, ABHR consumption and HHSAF scores were sought through the Locally Estimated Scatterplot Smoothing or logistic regression models. A tree-structured partitioning model was developed to further confirm the obtained findings. RESULTS Ninety-seven healthcare facilities from 28 countries in three world regions (Asia-Pacific, Europe, Latin America) were awarded the HHEA and thus included in the analysis. HHSAF scores indicated an advanced hand hygiene promotion level (median 445 points, IQR 395-480). System change (100 [95-100] points) and institutional safety climate (85 [70-95] points) showed the highest and lowest score, respectively. In most cases, hand hygiene compliance was above 70%, with heterogeneity between countries. ABHR consumption above 20 millilitres per patient-day (ml/PD) was widely reported, with overall increasing trends. HHSAF scores were positively correlated with hand hygiene compliance (τ = 0.211, p = 0.007). We observed a positive correlation between compliance rates and ABHR consumption (τ = 0.193, p < 0.001), although the average predicted consumption was stable around 55-60 ml/PD for compliance rates above 80-85%. Logistic regression and partitioning tree analyses revealed that higher HHSAF scores were more likely in the high-ABHR consumption group at cut-offs around 57-59 ml/PD. CONCLUSION Ten years after its inception, the HHEA proves to be a valuable hand hygiene improvement programme in healthcare facilities worldwide. Consistent results were provided by the different hand hygiene indicators and the HHSAF score represents a valuable proxy measure of hand hygiene compliance.
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Affiliation(s)
- Ermira Tartari
- Faculty of Health Sciences, University of Malta, 2080, Msida, Malta.
- Infection Prevention and Control Unit, Department of Integrated Health Services, WHO Headquarters, Geneva, Switzerland.
| | - Jacopo Garlasco
- Infectious Diseases Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Moi Lin Ling
- Infection Prevention and Epidemiology, Singapore General HospitalSingapore, 169608, Singapore, Singapore
| | | | - Wing-Hong Seto
- School of Public Health, WHO Collaborating Centre, The University of Hong Kong, Hong Kong, China
| | - Anne Simon
- Infection Control and Prevention, CHU Helora, Haine-Saint-Paul, Belgium
| | | | - Didier Pittet
- Faculty of Medicine & Clean Hospitals, University of Geneva, Geneva, Switzerland
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Kilpatrick C, Tartari E, Deeves M, Pittet D, Allegranzi B. World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: clean your hands campaign: promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. Antimicrob Resist Infect Control 2024; 13:41. [PMID: 38610050 PMCID: PMC11015592 DOI: 10.1186/s13756-024-01391-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Abstract
The World Health Organization's (WHO) World Hand Hygiene Day continues to "bring people together and accelerate hand hygiene action at the point of care in health care to contribute to a reduction in health care-associated infections and the achievement of safer, quality health care for all".
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Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Miranda Deeves
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland.
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Kilpatrick C, Tartari E, Deeves M, Pittet D, Allegranzi B. World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: Clean Your Hands campaign: Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. Infect Control Hosp Epidemiol 2024; 45:553. [PMID: 38591226 DOI: 10.1017/ice.2024.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Miranda Deeves
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
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Pittet D. Le devoir de mémoire: Professor Didier Pittet's reflections on an international career defying boundaries and expectations. Antimicrob Steward Healthc Epidemiol 2024; 4:e38. [PMID: 38533236 PMCID: PMC10964183 DOI: 10.1017/ash.2023.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 03/28/2024]
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Tartari E, Bellissimo-Rodrigues F, Pires D, Fankhauser C, Lotfinejad N, Saito H, Suchomel M, Kramer A, Allegranzi B, Boyce J, Sax H, Stewardson AJ, Pittet D. Updates and future directions regarding hand hygiene in the healthcare setting: insights from the 3rd ICPIC alcohol-based handrub (ABHR) task force. Antimicrob Resist Infect Control 2024; 13:26. [PMID: 38424571 PMCID: PMC10905912 DOI: 10.1186/s13756-024-01374-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) pose threats to global health. Effective hand hygiene is essential for preventing HAIs and the spread of AMR in healthcare. We aimed to highlight the recent progress and future directions in hand hygiene and alcohol-based handrub (ABHR) use in the healthcare setting. In September 2023, 42 experts in infection prevention and control (IPC) convened at the 3rd International Conference on Prevention and Infection Control (ICPIC) ABHR Taskforce in Geneva, Switzerland. The purpose of this meeting was to provide a synthesis of recent evidence and formulate a research agenda on four critical areas for the implementation of effective hand hygiene practices: (1) ABHR formulations and hand rubbing techniques, (2) low-resource settings and local production of ABHR, (3) hand hygiene monitoring and technological innovations, and (4) hand hygiene standards and guidelines.
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Affiliation(s)
- Ermira Tartari
- Faculty of Health Sciences, University of Malta, Msida, Malta
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | | | - Daniela Pires
- National Institute of Health and Care Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | | | - Nasim Lotfinejad
- Infection Control Program and WHO Collaborating Centre, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Hiroki Saito
- Department of Emergency and Critical Care Medicine. Faculty of Medicine, Institute of Global Health, . Mariana University Yokohama Seibu Hospital, University of Geneva, Geneva, Switzerland
| | - Miranda Suchomel
- Institute of Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - John Boyce
- J.M. Boyce Consulting, LLC, Hyde Park, NY, USA
| | - Hugo Sax
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
- Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andrew J Stewardson
- Department of Infectious Diseases, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia
| | - Didier Pittet
- Clean Hospitals, Geneva, Switzerland.
- Faculty of Medicine & Clean Hospitals, University of Geneva, Geneva, Switzerland.
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Kilpatrick C, Tartari E, Deeves M, Pittet D, Allegranzi B. World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: Clean Your Hands campaign: Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. Clin Microbiol Infect 2024:S1198-743X(24)00092-2. [PMID: 38431256 DOI: 10.1016/j.cmi.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland.
| | - Miranda Deeves
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
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Büchler AC, Haddad Galas M, Buetti N, Alp E, Apisarnthanarak A, Dziekan G, Fabre V, Gottwalt S, Jindai K, Ndoye B, Márquez Villareal H, Otaiza F, Pittet D, Schellack N, Gardiol C, Harbarth S. Challenges and success stories of the implementation of infection control and antimicrobial stewardship strategies: proceedings of the 5th Global Ministerial Summit on Patient Safety, 2023. Antimicrob Resist Infect Control 2024; 13:16. [PMID: 38331974 PMCID: PMC10854024 DOI: 10.1186/s13756-023-01344-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/25/2023] [Indexed: 02/10/2024] Open
Abstract
The 5th edition of the Global Ministerial Summit on Patient Safety was held in Montreux, Switzerland, in February 2023, delayed by three years due to the COVID-19 pandemic. The overarching theme of the summit was "Less Harm, Better Care - from Resolution to Implementation", focusing on the challenges of implementation of infection prevention and control (IPC) strategies as well as antimicrobial stewardship programs (ASP) around the world. IPC strategies and ASP are of increasing importance due to the substantial burden of healthcare-associated infections and antimicrobial resistance threatening patient safety. Here, we summarize countries' and regional experiences and activities related to the implementation of IPC strategies and ASP shared at the meeting. Full implementation of effective programs remains a major challenge in all settings due to limited support by political and healthcare leaders, and human and financial constraints. In addition, the COVID-19 pandemic challenged already well-established programs. By enforcing sustained implementation by dedicated, cross-disciplinary healthcare personnel with a broad skill set, a reduction in healthcare-associated infections and multidrug-resistant pathogens can be achieved, leading ultimately to improved patient safety.
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Affiliation(s)
- Andrea C Büchler
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, WHO Collaborating Center, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
| | - Murielle Haddad Galas
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, WHO Collaborating Center, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
| | - Niccolò Buetti
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, WHO Collaborating Center, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
- IAME UMR 1137, INSERM, Université Paris-Cité, Paris, France
| | - Emine Alp
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Türkiye
| | - Anucha Apisarnthanarak
- Division of Infectious Diseases, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand
| | - Gerald Dziekan
- Communicable Disease Division, Federal Office of Public Health FOPH, Bern, Switzerland
| | - Valeria Fabre
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Simon Gottwalt
- Communicable Disease Division, Federal Office of Public Health FOPH, Bern, Switzerland
| | - Kazuaki Jindai
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Healthcare Epidemiology, School of Public Health, Kyoto University, Kyoto, Japan
| | - Babacar Ndoye
- Infection Control and Patient Safety, WHO Afro Consultant, Brazzaville, Congo Republic
| | - Hilda Márquez Villareal
- Department of Public Health. University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
| | - Fernando Otaiza
- Department of Quality of Healthcare and Patient Safety, National Infection Control Program, Ministry of Health of Chile, Santiago, Chile
| | - Didier Pittet
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, WHO Collaborating Center, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
| | - Natalie Schellack
- Departement of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Céline Gardiol
- Communicable Disease Division, Federal Office of Public Health FOPH, Bern, Switzerland
| | - Stephan Harbarth
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, WHO Collaborating Center, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland.
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Fernandes DR, dos Santos BN, Guimarães CS, Ferreira EB, Margatho AS, dos Reis PED, Pittet D, Silveira RCDCP. Educational technologies for teaching hand hygiene: Systematic review. PLoS One 2024; 19:e0294725. [PMID: 38227588 PMCID: PMC10790983 DOI: 10.1371/journal.pone.0294725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/06/2023] [Indexed: 01/18/2024] Open
Abstract
AIM To gather available scientific evidence on technologies used to teach hand hygiene to professional populations and lays involved in health care in the hospital setting. This systematic review was designed as proposed by Preferred Reporting Items for Systematic Reviews and Meta-Analysis, included studies reporting primary, original, quantitative research findings with no date limit and written in English, Spanish or Portuguese. The search was performed in the following electronic databases: Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica dataBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde, US National Library of Medicine, Scopus, Web of Science, Google Scholar and ProQuest. The eligibility criteria were applied independently by two reviewers to select the studies, first by reading the titles and abstracts on the Rayyan platform and then by full text reading of the eligible studies. After a descriptive analysis, the studies were subjected to critical evaluation of their methodological quality using JBI tools. RESULTS Seven studies were included, addressing various methods for teaching hand hygiene using different technological resources, such as audiovisual electronic devices, videos, virtual reality, and gamification using tablets and smartphones, in different populations. CONCLUSION Using technologies to teach hand hygiene considerably helps patients, visitors, and relatives in learning the procedures and efficiently improves hand hygiene compliance rates among healthcare professionals, creating evidence-based repetitive learning opportunities for patients and caregivers.
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Affiliation(s)
| | | | | | | | - Amanda Salles Margatho
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Peters A, Parneix P, Pittet D. Clean Hospitals Day 2023 marks the global launch of a self-assessment tool. Antimicrob Resist Infect Control 2023; 12:111. [PMID: 37807034 PMCID: PMC10561439 DOI: 10.1186/s13756-023-01315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Affiliation(s)
- Alexandra Peters
- Infection Control Programme, Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland.
- Institute of Global Health, Faculty of Medicine, Geneva, Switzerland.
| | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
- French Society for Hospital Hygiene, Brest, France
| | - Didier Pittet
- Infection Control Programme, Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland
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Grant R, Benamouzig D, Catton H, Cheng VCC, Dhingra N, Laxminarayan R, Legido-Quigley H, Martinez SL, Marikar K, Mendelson M, Parneix P, Perencevich E, Singh H, Tschudin-Sutter S, Ushiro S, Wesangula E, Gardiol C, Dziekan G, Harbarth S, Pittet D. COVID-19 pandemic: a catalyst for accelerating global action on patient safety. Lancet Infect Dis 2023; 23:1108-1110. [PMID: 37572686 DOI: 10.1016/s1473-3099(23)00485-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/14/2023]
Affiliation(s)
- Rebecca Grant
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Daniel Benamouzig
- Sciences Po, Centre de Sociologie des Organisations and Chaire Santé, CNRS, Paris, France
| | - Howard Catton
- International Council of Nurses, Geneva, Switzerland
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | | | | | | | | | - Kadar Marikar
- Malaysian Society for Quality in Health, Kuala Lumpur, Malaysia
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Eli Perencevich
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Shin Ushiro
- Division of Patient Safety, Kyushu University Hospital, Fukuoka, Japan
| | - Evelyn Wesangula
- East Central and Southern Africa Health Community, Arusha, Tanzania; Patient and Health Workers Safety Division, Ministry of Health, Nairobi, Kenya
| | | | | | - Stephan Harbarth
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Peters A, Parneix P, Pittet D. Clean Hospitals Day 2023 and the launch of an environmental-hygiene self-assessment tool. Lancet Infect Dis 2023; 23:e390. [PMID: 37660708 DOI: 10.1016/s1473-3099(23)00545-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Alexandra Peters
- Infection Control Programme, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland; Institute for Global Health, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland
| | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France; French Society for Hospital Hygiene, Brest, France
| | - Didier Pittet
- Infection Control Programme, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland.
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Peters A, Parneix P, Pittet D. Clean hospitals day 2023 marks the global launch of a self-assessment tool. Infect Control Hosp Epidemiol 2023; 44:1704. [PMID: 37736689 DOI: 10.1017/ice.2023.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Affiliation(s)
- Alexandra Peters
- Infection Control Programme, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
- French Society for Hospital Hygiene, Brest, France
| | - Didier Pittet
- Infection Control Programme, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Shi C, O'Donoghue M, Yang L, Tsang H, Chen J, Zou J, Qin J, Mak YW, Pittet D, Xie YJ, Lai T, Li C, Cao J. Correction: Factors associated with hand washing effectiveness: an institution-based observational study. Antimicrob Resist Infect Control 2023; 12:107. [PMID: 37775834 PMCID: PMC10542683 DOI: 10.1186/s13756-023-01313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Affiliation(s)
- Chen Shi
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | | | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Hilda Tsang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jing Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jing Zou
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Timothy Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chen Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiannong Cao
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
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19
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Shi C, O'Donoghue M, Yang L, Tsang H, Chen J, Zou J, Qin J, Mak YW, Pittet D, Xie YJ, Lai T, Li C, Cao J. Factors associated with hand washing effectiveness: an institution-based observational study. Antimicrob Resist Infect Control 2023; 12:85. [PMID: 37649107 PMCID: PMC10469426 DOI: 10.1186/s13756-023-01293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Few studies have investigated how the effectiveness of hand washing in removing hand contaminants is influenced by the performance and duration of each step involved. We conducted an observational study by recruiting participants from a university campus, with the aim to comprehensively evaluate how performance, duration and demographic factors influence hand washing effectiveness. METHODS A total of 744 videos were collected from 664 participants in July-October 2022 and independently evaluated by two infection control experts through labelling videos for correct and incorrect performance of each step. The individual hand washing effectiveness was determined by quantifying the percentage of residual fluorescent gel on the dorsum and palm areas of each participant's hands. A logistic regression analysis was conducted to identify factors that were significantly associated with better hand washing effectiveness. An exposure-response relationship was constructed to identify optimal durations for each step. Approximately 2300 hand images were processed using advanced normalization algorithms and overlaid to visualize the areas with more fluorescence residuals after hand washing. RESULTS Step 3 (rub between fingers) was the most frequently omitted step and step 4 (rub the dorsum of fingers) was the most frequently incorrectly performed step. After adjustment for covariates, sex, performance of step 4 and step 7 (rub wrists), rubbing hands during rinsing, and rinsing time were significantly associated with hand washing effectiveness. The optimal overall hand washing time was 31 s from step 1 to step 7, and 28 s from step 1 to step 6, with each step ideally lasting 4-5 s, except step 3. The palms of both hands had less fluorescence residuals than the dorsums. The areas where residuals most likely appeared were wrists, followed by finger tips, finger webs and thumbs. CONCLUSIONS Performance and duration of some hand washing steps, sex and rinsing time were associated with hand washing effectiveness. The optimal duration might be applied to all seven steps to achieve the best decontamination results. Further studies are needed to refine hand hygiene standards and enhance compliance.
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Affiliation(s)
- Chen Shi
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | | | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Hilda Tsang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jing Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jing Zou
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Timothy Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chen Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiannong Cao
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
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20
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Saito H, Okamoto K, Fankhauser C, Tartari E, Pittet D. Train-the-Trainers in hand hygiene facilitate the implementation of the WHO hand hygiene multimodal improvement strategy in Japan: evidence for the role of local trainers, adaptation, and sustainability. Antimicrob Resist Infect Control 2023; 12:56. [PMID: 37296481 PMCID: PMC10250848 DOI: 10.1186/s13756-023-01262-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND "Train-the-Trainers in hand hygiene" (TTT) is a standardized training to train infection prevention and control (IPC) practitioners with the aim to promote hand hygiene in health care according to the World Health Organization (WHO) multimodal improvement strategy. Little is known in the literature about the sustained impact of hand hygiene and IPC trainings adapted locally. The aim of this study is to describe the impact of three TTT courses conducted annually in Japan on the adoption of the WHO multimodal improvement strategy by local IPC practitioners who became a "trainer" after their first TTT participation as a "trainee". METHODS Three TTT courses were conducted annually from 2020 to 2022 in Japan. A team "TTT-Japan" composed of more than 20 IPC practitioners who completed their first TTT participation adapted the original TTT program to reflect the local healthcare context in Japan, and subsequently convened the 2nd and 3rd TTTs. Pre- and post-course evaluations and post-course satisfaction surveys of the course participants were conducted to assess improvement in knowledge on hand hygiene and perception towards the course, respectively. Attitude and practice surveys of the TTT-Japan trainers were conducted to assess their perception and experience in hand hygiene promotion. The Hand Hygiene Self-Assessment Framework (HHSAF), a validated tool created by WHO to monitor the capacity of hand hygiene promotion at facility level, was applied at TTT-Japan trainers' facilities to compare results before and after trainers' engagement. We applied inductive thematic analysis for qualitative analyses of open-ended survey questions of the trainers' attitude and practice surveys, and the Wilcoxon Sign Rank test for quantitive comparisons of pre- and post-data for the surveys and HHSAF. RESULTS 158 Japanese healthcare workers participated in three TTT courses, the majority of whom (131, 82.9%) were nurses. Twenty-seven local trainers were involved in 2nd and 3rd TTTs. The scores of pre- and post-course evaluations significantly improved after the course (P < 0.001) and the improvement was consistent across all three TTTs. Post-course satisfaction survey showed that over 90% of the participants reported that the course met their expectations and that what they learned in the courses would be useful for their practice. Trainers' attitude and practice survey showed that more than three quarters (76.9%) of the trainers reported that their experience as a trainer had a positive impact on their practice at their own facilities. Qualitative analysis of the trainers' attitude and practice survey revealed that trainers appreciated continuous learning as a trainer, and group effort to promote hand hygiene as the TTT-Japan team. The HHSAF institutional climate change element at the trainers' facilities significantly improved after their engagement as a trainer (P = 0.012). CONCLUSIONS TTTs were successfully adapted and implemented in Japan, leading to sustained hand hygiene promotion activities by local trainers over three years. Further research is warranted to assess the long-term impact on local hand hygiene promotion in different settings.
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Affiliation(s)
- Hiroki Saito
- Department of Emergency and Critical Care Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1, Yasashi-Cho, Asahi-Ku, Yokohama, Kanagawa, Japan.
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Carolina Fankhauser
- Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
| | - Ermira Tartari
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Didier Pittet
- Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
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21
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Kilpatrick C, Tartari E, Pittet D, Allegranzi B. "Accelerate Action Together" the 5 May 2023 World Health Organization SAVE LIVES- Clean Your Hands campaign. Infect Control Hosp Epidemiol 2023; 44:1032-1033. [PMID: 37222156 PMCID: PMC10262165 DOI: 10.1017/ice.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 05/25/2023]
Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
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22
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Perez-Saez J, Zaballa ME, Lamour J, Yerly S, Dubos R, Courvoisier DS, Villers J, Balavoine JF, Pittet D, Kherad O, Vuilleumier N, Kaiser L, Guessous I, Stringhini S, Azman AS. Long term anti-SARS-CoV-2 antibody kinetics and correlate of protection against Omicron BA.1/BA.2 infection. Nat Commun 2023; 14:3032. [PMID: 37230973 DOI: 10.1038/s41467-023-38744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Binding antibody levels against SARS-CoV-2 have shown to be correlates of protection against infection with pre-Omicron lineages. This has been challenged by the emergence of immune-evasive variants, notably the Omicron sublineages, in an evolving immune landscape with high levels of cumulative incidence and vaccination coverage. This in turn limits the use of widely available commercial high-throughput methods to quantify binding antibodies as a tool to monitor protection at the population-level. Here we show that anti-Spike RBD antibody levels, as quantified by the immunoassay used in this study, are an indirect correlate of protection against Omicron BA.1/BA.2 for individuals previously infected by SARS-CoV-2. Leveraging repeated serological measurements between April 2020 and December 2021 on 1083 participants of a population-based cohort in Geneva, Switzerland, and using antibody kinetic modeling, we found up to a three-fold reduction in the hazard of having a documented positive SARS-CoV-2 infection during the Omicron BA.1/BA.2 wave for anti-S antibody levels above 800 IU/mL (HR 0.30, 95% CI 0.22-0.41). However, we did not detect a reduction in hazard among uninfected participants. These results provide reassuring insights into the continued interpretation of SARS-CoV-2 binding antibody measurements as an independent marker of protection at both the individual and population levels.
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Affiliation(s)
- Javier Perez-Saez
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - María-Eugenia Zaballa
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Lamour
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sabine Yerly
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - Richard Dubos
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Delphine S Courvoisier
- General Directorate of Health, Geneva, Switzerland
- Division of Quality of Care, Geneva University Hospitals, Geneva, Switzerland
| | - Jennifer Villers
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | | - Didier Pittet
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Infection Control Program and World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals, Geneva, Switzerland
| | - Omar Kherad
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Internal Medicine, Hôpital de la Tour, Geneva, Switzerland
| | - Nicolas Vuilleumier
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Kaiser
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Andrew S Azman
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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23
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Kilpatrick C, Tartari E, Allegranzi B, Pittet D. "Accelerate action together" World Health Organization World Hand Hygiene Day, May 5, 2023 SAVE LIVES: Clean Your Hands campaign. Am J Infect Control 2023; 51:481. [PMID: 37088520 DOI: 10.1016/j.ajic.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - Didier Pittet
- Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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24
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Tartari E, Kilpatrick C, Pittet D, Rogers PM, Allegranzi B. World Health Organization World Hand Hygiene Day, 5 May 2023 SAVE LIVES: Clean Your Hands campaign. J Hosp Infect 2023; 135:S0195-6701(23)00101-9. [PMID: 37003526 DOI: 10.1016/j.jhin.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/11/2023] [Indexed: 04/03/2023]
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25
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van der Kooi T, Sax H, Grundmann H, Pittet D, de Greeff S, van Dissel J, Clack L, Wu AW, Davitt J, Kostourou S, Maguinness A, Michalik A, Nedelcu V, Patyi M, Hajdinjak JP, Prosen M, Tellez D, Varga É, Veini F, Ziętkiewicz M, Zingg W. Correction: Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study. Antimicrob Resist Infect Control 2023; 12:13. [PMID: 36804991 PMCID: PMC9940425 DOI: 10.1186/s13756-023-01217-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Affiliation(s)
- Tjallie van der Kooi
- grid.31147.300000 0001 2208 0118RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hugo Sax
- grid.412004.30000 0004 0478 9977Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland ,grid.411656.10000 0004 0479 0855Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Hajo Grundmann
- grid.7708.80000 0000 9428 7911Medical Center – University of Freiburg, Freiburg, Germany
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812University of Geneva Hospitals, Geneva, Switzerland ,grid.3575.40000000121633745WHO Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland
| | - Sabine de Greeff
- grid.31147.300000 0001 2208 0118RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Jaap van Dissel
- grid.31147.300000 0001 2208 0118RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lauren Clack
- grid.412004.30000 0004 0478 9977Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Albert W. Wu
- grid.21107.350000 0001 2171 9311Center for Health Services and Outcomes Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA
| | - Judith Davitt
- grid.412440.70000 0004 0617 9371Galway University Hospital, Galway, Ireland
| | - Sofia Kostourou
- grid.414655.70000 0004 4670 4329Evangelismos Hospital, Athens, Attica Greece
| | - Alison Maguinness
- grid.474793.a0000 0004 0617 9152St. Michaels Hospital, Dún Laoghaire, Ireland
| | - Anna Michalik
- grid.431808.60000 0001 2107 7451Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
| | - Viorica Nedelcu
- grid.512211.40000 0004 0411 5868Emergency Institute for Cardiovascular Diseases “Prof. C.C. Iliescu”, Bucharest, Romania
| | - Márta Patyi
- grid.413169.80000 0000 9715 0291Bács-Kiskun Megyei Kórház (County Teaching Hospital), Kecskemet, Hungary
| | - Janja Perme Hajdinjak
- grid.29524.380000 0004 0571 7705University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Milena Prosen
- grid.29524.380000 0004 0571 7705University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - David Tellez
- grid.411083.f0000 0001 0675 8654Hospital Vall d’Hebron, Barcelona, Catalunya Spain
| | - Éva Varga
- grid.413169.80000 0000 9715 0291Bács-Kiskun Megyei Kórház (County Teaching Hospital), Kecskemet, Hungary
| | - Fani Veini
- grid.414655.70000 0004 4670 4329Evangelismos Hospital, Athens, Attica Greece
| | - Mirosław Ziętkiewicz
- grid.414734.10000 0004 0645 6500John Paul II Hospital, Kraków, Poland ,grid.5522.00000 0001 2162 9631Medical College Jagiellonian University, Kraków, Poland
| | - Walter Zingg
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. .,WHO Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland.
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26
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Peters A, Parneix P, Kiernan M, Severin JA, Gauci T, Pittet D. New frontiers in healthcare environmental hygiene: thoughts from the 2022 healthcare cleaning forum. Antimicrob Resist Infect Control 2023; 12:7. [PMID: 36750872 PMCID: PMC9902814 DOI: 10.1186/s13756-022-01185-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/11/2022] [Indexed: 02/09/2023] Open
Abstract
Healthcare environmental hygiene (HEH) has become recognized as being increasingly important for patient safety and the prevention of healthcare-associated infections. At the 2022 Healthcare Cleaning Forum at Interclean in Amsterdam, the academic lectures focused on a series of main areas of interest. These areas are indicative of some of the main trends and avenues for research in the coming years. Both industry and academia need to take steps to continue the momentum of HEH as we transition out of the acute phase of the Covid-19 pandemic. There is a need for new ways to facilitate collaboration between the academic and private sectors. The Clean Hospitals® network was presented in the context of the need for both cross-disciplinarity and evidence-based interventions in HEH. Governmental bodies have also become more involved in the field, and both the German DIN 13603 standard and the UK NHS Cleaning Standards were analyzed and compared. The challenge of environmental pathogens was explored through the example of how P. aeruginosa persists in the healthcare environment. New innovations in HEH were presented, from digitalization to tracking, and automated disinfection to antimicrobial surfaces. The need for sustainability in HEH was also explored, focusing on the burden of waste, the need for a circular economy, and trends towards increasingly local provision of goods and services. The continued focus on and expansion of these areas of HEH will result in safer patient care and contribute to better health systems.
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Affiliation(s)
- Alexandra Peters
- grid.8591.50000 0001 2322 4988Infection Control Programme and WHO Collaborating Center On Infection Prevention and Control and Antimicrobial Resistance, Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pierre Parneix
- grid.42399.350000 0004 0593 7118Nouvelle Aquitaine Health Care-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Martin Kiernan
- grid.81800.310000 0001 2185 7124Richard Wells Research Centre, University of West London, London, UK
| | - Juliëtte A. Severin
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Tracey Gauci
- grid.428852.10000 0001 0449 3568Hywel Dda University Health Board, NHS Wales, Carmarthen, UK
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Center On Infection Prevention and Control and Antimicrobial Resistance, Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Schrempft S, Pullen N, Baysson H, Wisniak A, Zaballa ME, Pennacchio F, Vollenweider P, Marques-Vidal P, Preisig M, Guessous I, Stringhini S, Arm-Vernez I, Azman AS, Ba F, Bachmann D, Bal A, Balavoine JF, Balavoine M, Barbe RP, Baysson H, Beigbeder L, Berthelot J, Bleich P, Boehm L, Bryand G, Bucolli V, Chappuis F, Collombet P, Courvoisier D, Cudet A, Davidovic V, de Mestral Vargas C, D'ippolito P, Dubos R, Dumont R, Eckerle I, El Merjani N, Flahault A, Francioli N, Frangville M, Graindorge C, Guessous I, Harnal S, Hurst S, Kaiser L, Kherad O, Lamour J, Lescuyer P, L'Huissier F, Lombard FB, Loizeau AJ, Lorthe E, Martinez C, Ménard L, Menon L, Metral-Boffod L, Meyer B, Moulin A, Nehme M, Noël N, Pennacchio F, Perez-Saez J, Pittet D, Portier J, Posfay-Barbe KM, Poulain G, Pugin C, Pullen N, Randrianandrasana ZF, Richard V, Rinaldi F, Rizzo J, Rochat D, Sakvarelidze I, Samir K, Santa Ramirez HA, Schrempft S, Semaani C, Stringhini S, Testini S, Rivas DU, Verolet C, Villers J, Violot G, Vuilleumier N, Wisniak A, Yerly S, Zaballa ME. Prevalence and predictors of psychological distress before, during, and after a COVID-19 pandemic wave in Switzerland, 2021. J Psychiatr Res 2023; 158:192-201. [PMID: 36592533 PMCID: PMC9794129 DOI: 10.1016/j.jpsychires.2022.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/04/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022]
Abstract
There are concerns about acute and long-term mental health effects of the COVID-19 pandemic. This study examined the prevalence and predictors of psychological distress before, during, and after a pandemic wave in Switzerland, 2021. Prevalence of psychological distress was estimated in adults aged 35-96 years using the General Health Questionnaire-12 administered in June 2021 (Specchio-COVID19 cohort, N = 3965), and compared to values from 2003 to 2006 (CoLaus|PsyCoLaus cohort, N = 5667). Anxiety and depression were assessed from February to June 2021 using the Generalised Anxiety Disorder scale-2 and the Patient Health Questionnaire-2, respectively. Prevalence of psychological distress in June 2021, after the pandemic wave (16.0% [95% CI, 14.6%-17.4%]) was comparable to pre-pandemic levels (15.1% [14.0%-16.2%]). Anxiety and depression were highest at the start of the pandemic wave in February 2021, and declined from February to June with the relaxation of measures. Predictors of psychological distress included being younger, female, a single parent, unemployed, a change in working hours or job loss in the past 6 months, greater perceived severity and contagiousness of COVID-19, and self-reported post COVID-19. By June 2021, following a pandemic wave, prevalence of psychological distress in Switzerland was closer to pre-pandemic levels. These findings highlight the need for additional mental health support during times of stricter government policies relating to COVID-19; yet they also suggest that individuals can adapt relatively quickly to the changing context.
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Affiliation(s)
- Stephanie Schrempft
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland.
| | - Nick Pullen
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - Hélène Baysson
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ania Wisniak
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - María-Eugenia Zaballa
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - Francesco Pennacchio
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Idris Guessous
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Silvia Stringhini
- Division of Primary Care, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland; University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
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Zaballa ME, Perez-Saez J, de Mestral C, Pullen N, Lamour J, Turelli P, Raclot C, Baysson H, Pennacchio F, Villers J, Duc J, Richard V, Dumont R, Semaani C, Loizeau AJ, Graindorge C, Lorthe E, Balavoine JF, Pittet D, Schibler M, Vuilleumier N, Chappuis F, Kherad O, Azman AS, Posfay-Barbe KM, Kaiser L, Trono D, Stringhini S, Guessous I. Seroprevalence of anti-SARS-CoV-2 antibodies and cross-variant neutralization capacity after the Omicron BA.2 wave in Geneva, Switzerland: a population-based study. Lancet Reg Health Eur 2023; 24:100547. [PMID: 36474728 PMCID: PMC9714630 DOI: 10.1016/j.lanepe.2022.100547] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 12/04/2022]
Abstract
Background More than two years into the COVID-19 pandemic, most of the population has developed anti-SARS-CoV-2 antibodies from infection and/or vaccination. However, public health decision-making is hindered by the lack of up-to-date and precise characterization of the immune landscape in the population. Here, we estimated anti-SARS-CoV-2 antibodies seroprevalence and cross-variant neutralization capacity after Omicron became dominant in Geneva, Switzerland. Methods We conducted a population-based serosurvey between April 29 and June 9, 2022, recruiting children and adults of all ages from age-stratified random samples of the general population of Geneva, Switzerland. We tested for anti-SARS-CoV-2 antibodies using commercial immunoassays targeting either the spike (S) or nucleocapsid (N) protein, and for antibody neutralization capacity against different SARS-CoV-2 variants using a cell-free Spike trimer-ACE2 binding-based surrogate neutralization assay. We estimated seroprevalence and neutralization capacity using a Bayesian modeling framework accounting for the demographics, vaccination, and infection statuses of the Geneva population. Findings Among the 2521 individuals included in the analysis, the estimated total antibodies seroprevalence was 93.8% (95% CrI 93.1-94.5), including 72.4% (70.0-74.7) for infection-induced antibodies. Estimates of neutralizing antibodies in a representative subsample (N = 1160) ranged from 79.5% (77.1-81.8) against the Alpha variant to 46.7% (43.0-50.4) against the Omicron BA.4/BA.5 subvariants. Despite having high seroprevalence of infection-induced antibodies (76.7% [69.7-83.0] for ages 0-5 years, 90.5% [86.5-94.1] for ages 6-11 years), children aged <12 years had substantially lower neutralizing activity than older participants, particularly against Omicron subvariants. Overall, vaccination was associated with higher neutralizing activity against pre-Omicron variants. Vaccine booster alongside recent infection was associated with higher neutralizing activity against Omicron subvariants. Interpretation While most of the Geneva population has developed anti-SARS-CoV-2 antibodies through vaccination and/or infection, less than half has neutralizing activity against the currently circulating Omicron BA.5 subvariant. Hybrid immunity obtained through booster vaccination and infection confers the greatest neutralization capacity, including against Omicron. Funding General Directorate of Health in Geneva canton, Private Foundation of the Geneva University Hospitals, European Commission ("CoVICIS" grant), and a private foundation advised by CARIGEST SA.
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Affiliation(s)
- María-Eugenia Zaballa
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Javier Perez-Saez
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Carlos de Mestral
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland,University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Nick Pullen
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Lamour
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Priscilla Turelli
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Charlène Raclot
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Hélène Baysson
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland,Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Francesco Pennacchio
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jennifer Villers
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Duc
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Viviane Richard
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Roxane Dumont
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Claire Semaani
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Andrea Jutta Loizeau
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Clément Graindorge
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | | - Didier Pittet
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Infection Control Program and World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals, Geneva, Switzerland
| | - Manuel Schibler
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Vuilleumier
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - François Chappuis
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Omar Kherad
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Division of Internal Medicine, Hôpital de la Tour, Geneva, Switzerland
| | - Andrew S. Azman
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Klara M. Posfay-Barbe
- Department of Woman, Child, and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland,Department of Pediatrics, Gynecology & Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Kaiser
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland,Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland,Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Didier Trono
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland,University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland,Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Corresponding author. Division of Primary Care, Geneva University Hospitals, 1205, Geneva, Switzerland
| | - Idris Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland,Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
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Wernli D, Tediosi F, Blanchet K, Lee K, Morel C, Pittet D, Levrat N, Young O. A Complexity Lens on the COVID-19 Pandemic. Int J Health Policy Manag 2022; 11:2769-2772. [PMID: 34124870 PMCID: PMC9818100 DOI: 10.34172/ijhpm.2021.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 04/30/2021] [Indexed: 01/21/2023] Open
Affiliation(s)
- Didier Wernli
- Geneva Transformative Governance Lab, Global Studies Institute, University of Geneva, Geneva, Switzerland
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva and Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Chantal Morel
- Geneva Transformative Governance Lab, Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Nicolas Levrat
- Geneva Transformative Governance Lab, Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Oran Young
- Bren School of Environmental Science and Management, University of California at Santa Barbara, Santa Barbara, CA, USA
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Peters A, Carry J, Cave C, Sauser J, Pittet D. Acceptability of an alcohol-based handrub gel with superfatting agents among healthcare workers: a randomized crossover controlled study. Antimicrob Resist Infect Control 2022; 11:97. [PMID: 35841075 PMCID: PMC9283849 DOI: 10.1186/s13756-022-01129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Healthcare workers often experience skin dryness and irritation from performing hand hygiene frequently. Low acceptability and tolerability of a formulation are barriers to hand hygiene compliance, though little research has been conducted on what specific types of formulation have higher acceptability than others. Objective To compare the acceptability and tolerability of an ethanol-based handrub gel with superfatting agents to the isopropanol-based formulations (a rub and a gel formulation) currently used by healthcare workers at the University of Geneva Hospitals, Geneva, Switzerland. Methods Forty-two participants were randomized to two sequences, testing the isopropanol-based formulation that they are using currently (Hopirub® or Hopigel®), and the ethanol-based formulation containing superfatting agents (Saniswiss Sanitizer Hands H1). Participants tested each of the formulations over 7–10 day work shifts, after which skin condition was assessed and feedback was collected. Results H1 scored significantly better than the control formulations for skin dryness (P = 0.0209), and participants felt less discomfort in their hands when using that formulation (P = 0.0448). H1 caused less skin dryness than Hopirub®/Hopigel® (P = 0.0210). Though overall preference was quite polarized, 21 participants preferred H1 intervention formulation and 17 preferred the Hopirub®/Hopigel® formulation that they normally used in their care activities. Conclusion We observed a difference in acceptability and strongly polarized preferences among the participants' reactions to the formulations tested. These results indicate that giving healthcare workers a choice between different high-quality products is important to ensure maximum acceptability. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01129-4.
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Price L, Gozdzielewska L, Alejandre JC, Jorgenson A, Stewart E, Pittet D, Reilly J. Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare. Antimicrob Resist Infect Control 2022; 11:16. [PMID: 35073993 PMCID: PMC8785453 DOI: 10.1186/s13756-021-01049-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. Aim To evaluate the impact of ABHR volume, application time, rubbing friction and hand size on microbiological load reduction, hand surface coverage or drying time.
Methods Medline, CINAHL, Web of Science and ScienceDirect databases were searched for healthcare or laboratory-based primary studies, published in English, (1980- February 2021), investigating the impact of ABHR volume, application time, rubbing friction or hand size on bacterial load reduction, hand coverage or drying time. Two reviewers independently performed data extraction and quality assessment. The results are presented narratively. Findings Twenty studies were included in the review. Categories included: ABHR volume, application time and rubbing friction. Sub-categories: bacterial load reduction, hand size, drying time or hand surface coverage. All used experimental or quasi-experimental designs. Findings showed as ABHR volume increased, bacterial load reduced, and drying times increased. Furthermore, one study showed that the application of sprayed ABHR without hand rubbing resulted in significantly lower bacterial load reduction than poured or sprayed ABHR with hand rubbing (− 0.70; 95%CI: − 1.13 to − 0.28). Evidence was heterogeneous in application time, volume, technique, and product. All studies were assessed as high risk of bias. Conclusions There is insufficient evidence to change WHO recommendation of a palmful of ABHR in a cupped hand applied for 20–30 s or manufacturer-recommended volume applied for about 20 s (Centers for Disease Control and Prevention). Future hand hygiene research should standardise volume, application time, and consider hand size. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-01049-9.
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Tartari E, Kilpatrick C, Allegranzi B, Pittet D. “Unite for safety – clean your hands”: the 5 May 2022 World Health Organization SAVE LIVES—Clean Your Hands campaign. Antimicrob Resist Infect Control 2022; 11:63. [PMID: 35488302 PMCID: PMC9052484 DOI: 10.1186/s13756-022-01105-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Peters A, Schmid MN, Kraker MEAD, Parneix P, Pittet D. Results of an international pilot survey on health care environmental hygiene at the facility level. Am J Infect Control 2022; 50:1302-1310. [PMID: 35644296 DOI: 10.1016/j.ajic.2022.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Health care-associated infections (HAIs) are a major threat to patient safety worldwide. The importance of the health care environment in patient care is not always adequately addressed. Currently, no overview exists of how health care environmental hygiene (HEH) is performed around the world. METHODS Our pilot survey tested a preliminary version of a framework for HEH self-assessment. It aimed to gather data to improve the framework as well as evaluate the strengths and challenges in HEH programs around the world, and across resource levels. The survey was developed by a group of experts, and based on the hand hygiene multimodal improvement strategy. The online survey was sent to 743 health care facilities (HCFs) from all of the World Bank income levels, aiming for at least 4 participants from each level. Overall responses were analyzed as a group as well as stratified per income level using OpenEpi. RESULTS Overall, 51 HCFs from 35 countries participated. Almost all HCFs surveyed (50/51, 98%) were found lacking in some or all of the 5 components of the WHO multimodal strategy independent of income level. The results demonstrate the widespread challenges in HEH institutions are facing around the world. CONCLUSION The feedback from survey participants allowed for the improvement of the self-assessment tool. There is a clear need for more focus on and investment in HEH programs in HCFs worldwide.
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Affiliation(s)
- Alexandra Peters
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; University of Geneva, Geneva, Switzerland
| | | | - Marlieke E A de Kraker
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Pierre Parneix
- Nouvelle Aquitaine Health Care-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Nomoto H, Saito H, Ishikane M, Gu Y, Ohmagari N, Pittet D, Kunishima H, Allegranzi B, Yoshida M. First nationwide survey of infection prevention and control among healthcare facilities in Japan: impact of the national regulatory system. Antimicrob Resist Infect Control 2022; 11:135. [PMID: 36352429 PMCID: PMC9647990 DOI: 10.1186/s13756-022-01175-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Infection prevention and control (IPC) measures in Japan are facilitated by a financial incentive process at the national level, where facilities are categorized into three groups (Tier 1, Tier 2, or no financial incentive). However, its impact on IPC at the facility level using a validated tool has not been measured. METHODS A nationwide cross-sectional study was conducted from August 2019 to January 2020 to evaluate the situation of IPC programs in Japan, using the global IPC Assessment Framework (IPCAF) developed by the World Health Organization. Combined with the information on the national financial incentive system, the demographics of facilities and each IPCAF item were descriptively analyzed. IPCAF scores were analyzed according to the facility level of care and the national financial incentive system for IPC facility status, using Dunn-Bonferroni and Mann-Whitney U tests. RESULTS Fifty-nine facilities in Japan responded to the IPCAF survey: 34 private facilities (57.6%) and 25 public facilities (42.4%). Of these, 11 (18.6%), 29 (49.2%), and 19 (32.3%) were primary, secondary, and tertiary care facilities, respectively. According to the national financial incentive system for IPC, 45 (76.3%), 11 (18.6%), and three (5.1%) facilities were categorized as Tier 1, Tier 2, and no financial incentive system, respectively. Based on the IPCAF total score, more than half of the facilities were categorized as "Advanced" (n = 31, 55.3%), followed by "Intermediate" (n = 21, 37.5%). The IPCAF total score increased as the facility level of care increased, while no statistically significant difference was identified between the secondary and tertiary care facilities (p = 0.79). There was a significant difference between Tier 1 and Tier 2 for all core components and total scores. Core components 5 (multimodal strategies for implementation of IPC interventions) and 6 (monitoring/audit of IPC and feedback) were characteristically low in Japan with a median score of 65.0 (interquartile range 40.0-85.0) and 67.5 (interquartile range 52.5-87.5), respectively. CONCLUSIONS The national financial incentive system was associated with IPC programs at facility level in Japan. The current financial incentive system does not emphasize the multimodal strategy or cover monitoring/audit, and an additional systematic approach may be required to further promote IPC for more practical healthcare-associated infection prevention.
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Affiliation(s)
- Hidetoshi Nomoto
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Hiroki Saito
- grid.8591.50000 0001 2322 4988Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland ,grid.412764.20000 0004 0372 3116Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine Yokohama Seibu Hospital, Kanagawa, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Gu
- grid.265073.50000 0001 1014 9130Department of Infectious Diseases, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Ohmagari
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Hiroyuki Kunishima
- grid.412764.20000 0004 0372 3116Department of Infectious Diseases, St Marianna University School of Medicine, Kanagawa, Japan
| | - Benedetta Allegranzi
- grid.3575.40000000121633745Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Masaki Yoshida
- grid.411898.d0000 0001 0661 2073Department of Infectious Diseases and Infection Control, The Jikei University School of Medicine, Tokyo, Japan
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Lotfinejad N, Tartari E, Sauser J, Fankhauser-Rodriguez C, Pires D, Pittet D. Are emojis ready to promote the WHO 5 moments for hand hygiene in healthcare? Antimicrob Resist Infect Control 2022; 11:127. [PMID: 36289506 PMCID: PMC9607812 DOI: 10.1186/s13756-022-01164-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Background Hand hygiene is universally recognized as a cornerstone measure for the prevention of healthcare-associated infections. Although the WHO “My five Moments for hand hygiene” poster has been used for more than a decade to delineate hand hygiene indications and promote action, adherence levels among healthcare workers are still notoriously low and disquieting. To compensate for the lack of effective hand hygiene communication, we aimed to evaluate emojis as possible surrogates for the non-verbal aspects of hand hygiene behaviour. Methods Following a thorough review of the Unicode version 12.0, the most applicable emojis to the terms used in the WHO 5 Moments poster were extracted. We developed a self-administered questionnaire to assess the view of infection prevention and control (IPC) practitioners regarding the use of emojis to show the WHO 5 Moments. Completed questionnaires were collected and analysed to determine the suitability of the existing emojis to illustrate a unified emoji poster. Data were analysed using R (version 3.6.3). Results A total of 95 IPC practitioners completed the questionnaire from May to October 2019 from different countries. Of these, 69 (74%) were female, and the mean age of the participants was 44.6 ± 10.87 years. We found appropriate emojis for six of the words used in the poster, including
for touching (72%),
for patient (63%),
for clean (53%),
for procedure (56%),
for body fluid (58%), and
for exposure risk (71%). The existing emojis proposed for the words “hygiene”, “aseptic”, and “surrounding” seemed to be less satisfactory. Conclusions In summary, the findings of this study indicate that the existing emojis may not be able to substitute the words used in the WHO 5 Moments poster. Emojis might be helpful to address hand hygiene indications in healthcare that may eventually play a role in promoting this measure. However, emojis should be further studied to choose the most appropriate ones and avoid ambiguity and misinterpretation. More emojis to convey health related messages are needed. We recommend further research in this area to evaluate the effect of using emojis in healthcare-related behaviours. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01164-1.
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Affiliation(s)
- Nasim Lotfinejad
- grid.150338.c0000 0001 0721 9812Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.150338.c0000 0001 0721 9812Infection Control Programme, WHO Collaborating Centre on Infection Prevention and Control & Antimicrobial Resistance, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ermira Tartari
- grid.150338.c0000 0001 0721 9812Infection Control Programme, WHO Collaborating Centre on Infection Prevention and Control & Antimicrobial Resistance, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland ,grid.4462.40000 0001 2176 9482Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Julien Sauser
- grid.150338.c0000 0001 0721 9812Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.150338.c0000 0001 0721 9812Infection Control Programme, WHO Collaborating Centre on Infection Prevention and Control & Antimicrobial Resistance, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Carolina Fankhauser-Rodriguez
- grid.150338.c0000 0001 0721 9812Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.150338.c0000 0001 0721 9812Infection Control Programme, WHO Collaborating Centre on Infection Prevention and Control & Antimicrobial Resistance, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Daniela Pires
- grid.150338.c0000 0001 0721 9812Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812Infection Control Programme, Faculty of Medicine, University of Geneva Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.150338.c0000 0001 0721 9812Infection Control Programme, WHO Collaborating Centre on Infection Prevention and Control & Antimicrobial Resistance, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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van der Kooi T, Sax H, Grundmann H, Pittet D, de Greeff S, van Dissel J, Clack L, Wu AW, Davitt J, Kostourou S, Maguinness A, Michalik A, Nedelcu V, Patyi M, Perme Hajdinjak J, Prosen M, Tellez D, Varga É, Veini F, Ziętkiewicz M, Zingg W. Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study. Antimicrob Resist Infect Control 2022; 11:123. [PMID: 36199149 PMCID: PMC9536014 DOI: 10.1186/s13756-022-01148-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the "Prevention of Hospital Infections by Intervention and Training" (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect. METHODS We included HCWs who contributed at least two observation sessions before and after intervention. Improving, non-changing, and worsening HCWs were defined with a threshold of 20% compliance change. We used multivariable linear regression and spearman's rank correlation to estimate determinants for the individual response to the intervention and correlation to overall change. Swarm graphs visualized ICU-specific patterns. RESULTS In total 280 HCWs contributed 17,748 HH opportunities during 2677 observation sessions. Overall, pooled HH compliance increased from 43.1 to 58.7%. The proportion of improving HCWs ranged from 33 to 95% among ICUs. The median HH increase per improving HCW ranged from 16 to 34 percentage points. ICU wide improvement correlated significantly with both the proportion of improving HCWs (ρ = 0.82 [95% CI 0.18-0.97], and their median HH increase (ρ = 0.79 [0.08-0.97]). Multilevel regression demonstrated that individual improvement was significantly associated with nurse profession, lower activity index, higher nurse-to-patient ratio, and lower baseline compliance. CONCLUSIONS Both the proportion of improving HCWs and their median individual improvement differed substantially among ICUs but correlated with the ICUs' overall HH improvement. With comparable overall means the range in individual HH varied considerably between some hospitals, implying different transmission risks. Greater insight into improvement dynamics might help to design more effective HH interventions in the future.
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Affiliation(s)
- Tjallie van der Kooi
- grid.31147.300000 0001 2208 0118RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hugo Sax
- grid.412004.30000 0004 0478 9977Clinic for Infectious Diseases and Hospital Hygiene, University Hospital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Hajo Grundmann
- grid.7708.80000 0000 9428 7911Medical Center – University of Freiburg, Freiburg, Germany
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812University of Geneva Hospitals, Geneva, Switzerland ,grid.3575.40000000121633745WHO Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland
| | - Sabine de Greeff
- grid.31147.300000 0001 2208 0118RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Jaap van Dissel
- grid.31147.300000 0001 2208 0118RIVM National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lauren Clack
- grid.412004.30000 0004 0478 9977Clinic for Infectious Diseases and Hospital Hygiene, University Hospital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Albert W. Wu
- grid.21107.350000 0001 2171 9311Center for Health Services and Outcomes Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA
| | - Judith Davitt
- grid.412440.70000 0004 0617 9371Galway University Hospital, Galway, Ireland
| | - Sofia Kostourou
- grid.414655.70000 0004 4670 4329Evangelismos Hospital, Athens, Attica Greece
| | - Alison Maguinness
- grid.474793.a0000 0004 0617 9152St. Michaels Hospital, Dún Laoghaire, Ireland
| | - Anna Michalik
- grid.431808.60000 0001 2107 7451Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
| | - Viorica Nedelcu
- grid.512211.40000 0004 0411 5868Emergency Institute for Cardiovascular Diseases “Prof. C.C. Iliescu”, Bucharest, Romania
| | - Márta Patyi
- grid.413169.80000 0000 9715 0291Bács-Kiskun Megyei Kórház (County Teaching Hospital), Kecskemet, Hungary
| | - Janja Perme Hajdinjak
- grid.29524.380000 0004 0571 7705University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Milena Prosen
- grid.29524.380000 0004 0571 7705University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - David Tellez
- grid.411083.f0000 0001 0675 8654Hospital Vall d’Hebron, Barcelona, Catalunya Spain
| | - Éva Varga
- grid.413169.80000 0000 9715 0291Bács-Kiskun Megyei Kórház (County Teaching Hospital), Kecskemet, Hungary
| | - Fani Veini
- grid.414655.70000 0004 4670 4329Evangelismos Hospital, Athens, Attica Greece
| | - Mirosław Ziętkiewicz
- grid.414734.10000 0004 0645 6500John Paul II Hospital, Kraków, Poland ,grid.5522.00000 0001 2162 9631Medical College Jagiellonian University, Kraków, Poland
| | - Walter Zingg
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. .,WHO Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland.
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Lopes AER, Menegueti MG, Gaspar GG, Tartari E, da Silva Canini SRM, Pittet D, Bellissimo-Rodrigues F. Comparing surgeons' skin tolerance and acceptability to alcohol-based surgical hand preparation vs traditional surgical scrub: A matched quasi-experimental study. Am J Infect Control 2022; 50:1091-1097. [PMID: 35150804 DOI: 10.1016/j.ajic.2022.01.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We aimed to compare the tolerance and acceptability of alcohol-based surgical hand preparation versus handscrubbing with antimicrobial soap and water by surgeons. METHODS Matched quasi-experimental trial in an academic quaternary care hospital in Ribeirão Preto, Brazil, from April 1 to October, 31, 2017. Participants were cardiac and orthopedics surgeons from the study facility. In the first study phase, they performed handscrubbing with either 2% chlorhexidine (CHG) or 10% iodopovidone (PVP-I) and, in the second phase, they performed handrubbing with alcohol-based handrub (ABHR). Surgeons' skin tolerance and acceptability were evaluated using WHO-validated tools. Data were analyzed using the MacNemar's test within STATA. RESULTS A total of 33 surgeons participated to the "per protocol" population; the majority were male (94%); mean age of 35 years (SD, 8.5). On product tolerance, there was a minimal variation in redness, scaliness, fissures, and visual evaluation of the skin when handrubbing with ABHR was compared to handscrubbing with either PVP-I or CHX. Regarding acceptability, participants rated better handrubbing with ABHR than handscrubbing with PVP-I when assessing product smell (66.6% vs 0%, p=0.002), color (73.3% vs 0%, p=0.001), product texture (60% vs 0%, p=0.004), skin dryness (60% vs 0%, p=0.004), ease of application (66.6% vs 0%, p=0.002) and overall satisfaction (66.6% vs 6.7% p=0.011). Participants rated similarly handrubbing with ABHR and handscrubbing with CHX, except for product texture, where handrubbing rated better (71,4% vs. 0%, p=0.002). Handrubbing with ABHR was preferred by 73.3%. CONCLUSION Although handrubbing and handscrubbing were equally well tolerated by surgeons, alcohol-based surgical hand preparation fell into the personal preference for most of them. TRIAL REGISTRATION Brazilian Clinical Trials Registry (ReBEC), RBR-8ym9yj.
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Affiliation(s)
- Ana Elisa Ricci Lopes
- Department of Fundamental Nursing, Ribeirão Preto Nursing School, University of São Paulo, Ribeirão Preto, Brazil
| | - Mayra Gonçalves Menegueti
- Department of Fundamental Nursing, Ribeirão Preto Nursing School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gilberto Gambero Gaspar
- Infection Control Service, University Hospital of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ermira Tartari
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | | | - Didier Pittet
- Infection Prevention and Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Price L, Gozdzielewska L, Matuluko A, Pittet D, Allegranzi B, Reilly J. Comparing the effectiveness of hand hygiene techniques in reducing the microbial load and covering hand surfaces in healthcare workers: Updated systematic review. Am J Infect Control 2022; 50:1079-1090. [PMID: 35167898 DOI: 10.1016/j.ajic.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND This review, commissioned by the World Health Organization (WHO), examined the effectiveness of the WHO 6-step hand hygiene (HH) technique in reducing microbial load on hands and covering hand surfaces, and compared its effectiveness to other techniques. METHODS Medline, CINAHL, ProQuest, Web of Science, Mednar, and Google Scholar were searched for primary studies, published in English (1978-February 2021), evaluating the microbiological effectiveness or hand surface coverage of HH techniques in healthcare workers. Reviewers independently performed quality assessment using Cochrane tools. The protocol for the narrative review was registered (PROSPERO 2021: CRD42021236138). RESULTS Nine studies were included. Evidence demonstrated that the WHO technique reduced microbial load on hands. One study found the WHO technique more effective than the 3-step technique (P = .02), while another found no difference between these 2 techniques (P = .08). An adapted 3-step technique was more effective than the WHO technique in laboratory settings (P = .021), but not in clinical practice (P = .629). One study demonstrated that an adapted 6-step technique was more effective than the WHO technique (P = .001). Evidence was heterogeneous in application time, product, and volume. All studies were high risk of bias. CONCLUSIONS Eight studies found that the WHO 6-step technique reduced microbial load on healthcare workers' hands; but the studies were heterogeneous and further research is required to identify the most effective, yet feasible technique.
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Affiliation(s)
- Lesley Price
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
| | - Lucyna Gozdzielewska
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK.
| | - Ayodeji Matuluko
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Center on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jacqui Reilly
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
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Kramer A, Arvand M, Christiansen B, Dancer S, Eggers M, Exner M, Müller D, Mutters NT, Schwebke I, Pittet D. Ethanol is indispensable for virucidal hand antisepsis: memorandum from the alcohol-based hand rub (ABHR) Task Force, WHO Collaborating Centre on Patient Safety, and the Commission for Hospital Hygiene and Infection Prevention (KRINKO), Robert Koch Institute, Berlin, Germany. Antimicrob Resist Infect Control 2022; 11:93. [PMID: 35794648 PMCID: PMC9257567 DOI: 10.1186/s13756-022-01134-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007. This follows concern over alcohol uptake from ethanol-based hand rubs (EBHR). If ethanol is classified as carcinogenic, mutagenic, or reprotoxic by the European Chemicals Agency (ECHA), then this would affect infection prevention and control practices. AIM A review was performed to prove that ethanol is toxicological uncritical and indispensable for hand antisepsis because of its unique activity against non-enveloped viruses and thus the resulting lack of alternatives. Therefore, the following main points are analyzed: The effectiveness of ethanol in hand hygiene, the evidence of ethanol at blood/tissue levels through hand hygiene in healthcare, and the evidence of toxicity of different blood/tissue ethanol levels and the non-comparability with alcoholic consumption and industrial exposure. RESULTS EBHR are essential for preventing infections caused by non-enveloped viruses, especially in healthcare, nursing homes, food industry and other areas. Propanols are effective against enveloped viruses as opposed to non-enveloped viruses but there are no other alternatives for virucidal hand antisepsis. Long-term ingestion of ethanol in the form of alcoholic beverages can cause tumours. However, lifetime exposure to ethanol from occupational exposure < 500 ppm does not significantly contribute to the cancer risk. Mutagenic effects were observed only at doses within the toxic range in animal studies. While reprotoxicity is linked with abuse of alcoholic beverages, there is no epidemiological evidence for this from EBHR use in healthcare facilities or from products containing ethanol in non-healthcare settings. CONCLUSION The body of evidence shows EBHRs have strong efficacy in killing non-enveloped viruses, whereas 1-propanol and 2-propanol do not kill non-enveloped viruses, that pose significant risk of infection. Ethanol absorbed through the skin during hand hygiene is similar to consumption of beverages with hidden ethanol content (< 0.5% v/v), such as apple juice or kefir. There is no risk of carcinogenicity, mutagenicity or reprotoxicity from repeated use of EBHR. Hence, the WHO Task Force strongly recommend retaining ethanol as an essential constituent in hand rubs for healthcare.
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Affiliation(s)
- Axel Kramer
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany. .,WHO Task Force Alcohol-Based Hand Rub, Zürich, Switzerland. .,Institute of Hygiene and Environmental Medicine University Medicine Greifswald, Walther-Rathenau-Straße 38, 17475, Greifswald, Germany.
| | - Mardjan Arvand
- Division Hospital Hygiene, Infection Prevention and Control, Robert-Koch Institute, Berlin, Germany
| | - Bärbel Christiansen
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany.,Department of Hospital Hygiene, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Stephanie Dancer
- Department of Microbiology, University Hospital Hairmyres, Glasgow, UK.,School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Maren Eggers
- Labor Prof. Dr. G. Enders MVZ GbR, Stuttgart, Germany
| | - Martin Exner
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany.,Institute of Hygiene and Public Health, University Hospital, Bonn, Germany
| | - Dieter Müller
- Department of Occupational Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Nico T Mutters
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany.,Institute of Hygiene and Public Health, University Hospital, Bonn, Germany
| | - Ingeborg Schwebke
- German Association for the Control of Virus Diseases (DVV e. V.), Berlin, Germany
| | - Didier Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva, Hospitals and Faculty of Medicine, Geneva, Switzerland
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Buetti N, Abbas M, Pittet D, Chraiti MN, Sauvan V, De Kraker MEA, Boisson M, Teixeira D, Zingg W, Harbarth S. Lower risk of peripheral venous catheter-related bloodstream infection by hand insertion. Antimicrob Resist Infect Control 2022; 11:80. [PMID: 35659775 PMCID: PMC9164319 DOI: 10.1186/s13756-022-01117-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/20/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Little is known about the bloodstream infection (BSI) risk associated with short-term peripheral venous catheters (PVCs) and no large study investigated the insertion site-related risk for PVC-BSI. METHODS We performed a cohort study at the University of Geneva Hospitals using the prospective hospital-wide BSI surveillance database. We analyzed the association between insertion site and risk of PVC-BSI on the upper extremity using univariable and multivariable marginal Cox models. RESULTS Between 2016 and 2020, utilization of 403'206 peripheral venous catheters were prospectively recorded in a 2000-bed hospital consortium with ten sites. Twenty-seven percent of PVC (n = 109'686) were inserted in the hand. After adjustment for confounding factors, hand insertion was associated with a decreased PVC-BSI risk (adjusted hazard ratio [HR] 0.42, 95% CI 0.18-0.98, p = 0.046) compared to more proximal insertion sites. In a sensitivity analysis for PVCs with ≥ 3 days of dwell time, we confirmed a decreased PVC-BSI risk after hand insertion (HR 0.37, 95% CI 0.15-0.93, p = 0.035). CONCLUSION Hand insertion should be considered for reducing PVC infections, especially for catheters with an expected dwell time of more than 2 days.
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Affiliation(s)
- Niccolò Buetti
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.508487.60000 0004 7885 7602UMR 1137, IAME, INSERM, Université de Paris, 75018 Paris, France
| | - Mohamed Abbas
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Marie-Noëlle Chraiti
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Valérie Sauvan
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Marlieke E. A. De Kraker
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Matthieu Boisson
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Daniel Teixeira
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Walter Zingg
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland ,grid.412004.30000 0004 0478 9977Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Stephan Harbarth
- grid.150338.c0000 0001 0721 9812Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Service PCI, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
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de Kraker MEA, Tartari E, Tomczyk S, Twyman A, Francioli LC, Cassini A, Allegranzi B, Pittet D. Implementation of hand hygiene in health-care facilities: results from the WHO Hand Hygiene Self-Assessment Framework global survey 2019. Lancet Infect Dis 2022; 22:835-844. [PMID: 35202600 PMCID: PMC9132778 DOI: 10.1016/s1473-3099(21)00618-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/02/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hand hygiene is at the core of effective infection prevention and control (IPC) programmes. 10 years after the development of the WHO Multimodal Hand Hygiene Improvement Strategy, we aimed to ascertain the level of hand hygiene implementation and its drivers in health-care facilities through a global WHO survey. METHODS From Jan 16 to Dec 31, 2019, IPC professionals were invited through email and campaigns to complete the online Hand Hygiene Self-Assessment Framework (HHSAF). A geospatial clustering algorithm selected unique health-care facilities responses and post-stratification weighting was applied to improve representativeness. Weighted median HHSAF scores and IQR were reported. Drivers of the HHSAF score were determined through a generalised estimation equation. FINDINGS 3206 unique responses from 90 countries (46% WHO Member States) were included. The HHSAF score indicated an intermediate hand hygiene implementation level (350 points, IQR 248-430), which was positively associated with country income level and health-care facility funding structure. System Change had the highest score (85 points, IQR 55-100), whereby alcohol-based hand rub at the point of care has become standard practice in many health-care facilities, especially in high-income countries. Institutional Safety Climate had the lowest score (55 points, IQR 35-75). From 2015 to 2019, the median HHSAF score in health-care facilities participating in both HHSAF surveys (n=190) stagnated. INTERPRETATION Most health-care facilities had an intermediate level of hand hygiene implementation or higher, for which health-care facility funding and country income level were important drivers. Availability of resources, leadership, and organisational support are key elements to further improve quality of care and provide access to safe care for all. FUNDING WHO, Geneva University Hospitals and Faculty of Medicine, and WHO Collaborating Center on Patient Safety, Geneva, Switzerland.
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Affiliation(s)
- Marlieke E A de Kraker
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Ermira Tartari
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Sara Tomczyk
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany; Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Anthony Twyman
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Laurent C Francioli
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Alessandro Cassini
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Tomczyk S, Twyman A, de Kraker MEA, Coutinho Rehse AP, Tartari E, Toledo JP, Cassini A, Pittet D, Allegranzi B. The first WHO global survey on infection prevention and control in health-care facilities. Lancet Infect Dis 2022; 22:845-856. [PMID: 35202599 PMCID: PMC9132775 DOI: 10.1016/s1473-3099(21)00809-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/19/2021] [Accepted: 12/10/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND WHO core components for infection prevention and control (IPC) are important building blocks for effective IPC programmes. To our knowledge, we did the first WHO global survey to assess implementation of these programmes in health-care facilities. METHODS In this cross-sectional survey, IPC professionals were invited through global outreach and national coordinated efforts to complete the online WHO IPC assessment framework (IPCAF). The survey was created in English and was then translated into ten languages: Arabic, Chinese, English, French, German, Italian, Japanese, Russian, Spanish, and Thai. Post-stratification weighting was applied and countries with low response rates were excluded to improve representativeness. Weighted median scores and IQRs as well as weighted proportions (Nw) meeting defined IPCAF minimum requirements were reported. Indicators associated with the IPCAF score were assessed using a generalised estimating equation. FINDINGS From Jan 16 to Dec 31, 2019, 4440 responses were received from 81 countries. The overall weighted IPCAF median score indicated an advanced level of implementation (605, IQR 450·4-705·0), but significantly lower scores were found in low-income (385, 279·7-442·9) and lower-middle-income countries (500·4, 345·0-657·5), and public facilities (515, 385-637·8). Core component 8 (built environment; 90·0, IQR 75·0-100·0) and core component 2 (guidelines; 87·5, 70·0-97·5) scored the highest, and core component 7 (workload, staffing, and bed occupancy; 70·0, 50-90) and core component 3 (education and training; 70 ·0, 50·0-85·0) scored the lowest. Overall, only 15·2% (Nw: 588 of 3873) of facilities met all IPCAF minimum requirements, ranging from 0% (0 of 417) in low-income countries to 25·6% (278 of 1087) in primary facilities, 9% (24 of 268) in secondary facilities, and 19% (18 of 95) in tertiary facilities in high-income countries. INTERPRETATION Despite an overall high IPCAF score globally, important gaps in IPC facility implementation and core components across income levels hinder IPC progress. Increased support for more effective and sustainable IPC programmes is crucial to reduce risks posed by outbreaks to global health security and to ensure patient and health worker safety. FUNDING WHO and the Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine. TRANSLATIONS For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sara Tomczyk
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland; Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
| | - Anthony Twyman
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Marlieke E A de Kraker
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ana Paula Coutinho Rehse
- Infectious Hazard Management Programme, Health Emergencies Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland; Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Msida, Malta
| | - João Paulo Toledo
- Clinical Management of Infectious Diseases, Health Emergencies Department, Pan American Health Organization, Washington, DC, USA
| | - Alessandro Cassini
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
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Walsh TR, Pittet D. To our friend, John. Lancet Infect Dis 2022; 22:583-584. [PMID: 35298897 DOI: 10.1016/s1473-3099(22)00182-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Timothy R Walsh
- Ineos-Oxford Institute of Antimicrobial Research, University of Oxford, Oxford, OX1 3SZ, UK.
| | - Didier Pittet
- Infection Control Programme, Geneva University Hospitals, Geneva, Switzerland
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Tartari E, Kilpatrick C, Allegranzi B, Pittet D. WHO SAVE LIVES: Clean Your Hands campaign. Lancet Infect Dis 2022; 22:577-579. [PMID: 35364021 DOI: 10.1016/s1473-3099(22)00211-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Malta
| | - Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva 1205, Switzerland.
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Wernli D, Harbarth S, Levrat N, Pittet D. A 'whole of United Nations approach' to tackle antimicrobial resistance? A mapping of the mandate and activities of international organisations. BMJ Glob Health 2022; 7:bmjgh-2021-008181. [PMID: 35613837 PMCID: PMC9134163 DOI: 10.1136/bmjgh-2021-008181] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/08/2022] [Indexed: 01/19/2023] Open
Abstract
The 2015 World Health Organization Global Action Plan and other international policy documents have stressed the need for a 'whole of United Nations approach' in addressing antimicrobial resistance (AMR). As several years have passed, the goal of this paper is to take stock of the current role, mandate, and activities of international organisations and other global stakeholders on AMR. Relevant information is identified through a web-based search and a review of policy documents from international organisations. Based on the assessment of 78 organisations, 21 have AMR-specific activities in the broader sense, although for many of these organisations, their involvement is limited in scope, and 36 have AMR-sensitive activities reflecting the wide scope of AMR. An interdisciplinary framework based on six relevant challenges of global collective actions regarding AMR as well as the main functions of international organisations in global governance is used to organise the findings into several ‘clusters’. AMR is not a priority for many international organisations, but some of them can leverage current efforts to tackle AMR while contributing to their core agenda. Overall, a ‘whole of UN approach’ to AMR within the framework of Sustainable Development Goals is critical to move the global governance of AMR forward.
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Affiliation(s)
- Didier Wernli
- Geneva Transformative Governance Lab, Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.,WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Nicolas Levrat
- Geneva Transformative Governance Lab, Global Studies Institute, University of Geneva, Geneva, Switzerland.,Faculty of Law, University of Geneva, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.,WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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46
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Tartari E, Kilpatrick C, Allegranzi B, Pittet D. "Unite for safety - clean your hands": the 5 May 2022 World Health Organization SAVE LIVES: Clean Your Hands campaign. J Hosp Infect 2022; 123:108-111. [PMID: 35525537 DOI: 10.1016/j.jhin.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 01/13/2023]
Affiliation(s)
- E Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Malta
| | - C Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - B Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - D Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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47
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Tartari E, Kilpatrick C, Allegranzi B, Pittet D. “Unite for safety – Clean your hands”: the 5 May 2022 World Health Organization SAVE LIVES: clean your hands campaign. Clin Microbiol Infect 2022; 28:757-758. [DOI: 10.1016/j.cmi.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/03/2022]
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Peters A, Schmid MN, Parneix P, Lebowitz D, de Kraker M, Sauser J, Zingg W, Pittet D. Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrob Resist Infect Control 2022; 11:38. [PMID: 35183259 PMCID: PMC8857881 DOI: 10.1186/s13756-022-01075-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/01/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Healthcare-associated infections (HAI) are one of the gravest threats to patient safety worldwide. The importance of the hospital environment has recently been revalued in infection prevention and control. Though the literature is evolving rapidly, many institutions still do not consider healthcare environmental hygiene (HEH) very important for patient safety. The evidence for interventions in the healthcare environment on patient colonization and HAI with multidrug-resistant microorganisms (MDROs) or other epidemiologically relevant pathogens was reviewed. METHODS We performed a systematic review according to the PRISMA guidelines using the PubMed and Web of Science databases. All original studies were eligible if published before December 31, 2019, and if the effect of an HEH intervention on HAI or patient colonization was measured. Studies were not eligible if they were conducted in vitro, did not include patient colonization or HAI as an outcome, were bundled with hand hygiene interventions, included a complete structural rebuild of the healthcare facility or were implemented during an outbreak. The primary outcome was the comparison of the intervention on patient colonization or HAI compared to baseline or control. Interventions were categorized by mechanical, chemical, human factors, or bundles. Study quality was assessed using a specifically-designed tool that considered study design, sample size, control, confounders, and issues with reporting. The effect of HEH interventions on environmental bioburden was studied as a secondary outcome. FINDINGS After deduplication, 952 records were scrutinized, of which 44 were included for full text assessment. A total of 26 articles were included in the review and analyzed. Most studies demonstrated a reduction of patient colonization or HAI, and all that analyzed bioburden demonstrated a reduction following the HEH intervention. Studies tested mechanical interventions (n = 8), chemical interventions (n = 7), human factors interventions (n = 3), and bundled interventions (n = 8). The majority of studies (21/26, 81%) analyzed either S. aureus, C. difficile, and/or vancomycin-resistant enterococci. Most studies (23/26, 88%) reported a decrease of MDRO-colonization or HAI for at least one of the tested organisms, while 58% reported a significant decrease of MDRO-colonization or HAI for all tested microorganisms. Forty-two percent were of good quality according to the scoring system. The majority (21/26, 81%) of study interventions were recommended for application by the authors. Studies were often not powered adequately to measure statistically significant reductions. INTERPRETATION Improving HEH helps keep patients safe. Most studies demonstrated that interventions in the hospital environment were related with lower HAI and/or patient colonization. Most of the studies were not of high quality; additional adequately-powered, high-quality studies are needed. Systematic registration number: CRD42020204909.
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Affiliation(s)
- Alexandra Peters
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland.,University of Geneva, Geneva, Switzerland
| | | | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Dan Lebowitz
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland
| | - Marlieke de Kraker
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland
| | - Julien Sauser
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland
| | - Walter Zingg
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva 14, Switzerland.
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Allegranzi B, Kilpatrick C, Sax H, Pittet D. 'My Five Moments': understanding a user-centred approach to hand hygiene improvement within a broader implementation strategy. BMJ Qual Saf 2022; 31:259-262. [PMID: 35131895 DOI: 10.1136/bmjqs-2021-013680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Hugo Sax
- Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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50
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Baysson H, Pennachio F, Wisniak A, Zabella ME, Pullen N, Collombet P, Lorthe E, Joost S, Balavoine JF, Bachmann D, Azman A, Pittet D, Chappuis F, Kherad O, Kaiser L, Guessous I, Stringhini S. Specchio-COVID19 cohort study: a longitudinal follow-up of SARS-CoV-2 serosurvey participants in the canton of Geneva, Switzerland. BMJ Open 2022; 12:e055515. [PMID: 35105645 PMCID: PMC8804307 DOI: 10.1136/bmjopen-2021-055515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has affected billions of people around the world both directly through the infection itself and indirectly through its economic, social and sanitary impact. Collecting data over time is essential for the understanding of the disease spread, the incidence of COVID-19-like symptoms, the level and dynamics of immunity, as well as the long-term impact of the pandemic. The objective of the study was to set up a longitudinal follow-up of adult participants of serosurveys carried out in the canton of Geneva, Switzerland, during the COVID-19 pandemic. This follow-up aims at monitoring COVID-19 related symptoms and SARS-CoV-2 seroconversion, as well as the overall impact of the pandemic on several dimensions of health and on socioeconomic factors over a period of at least 2 years. METHODS AND ANALYSIS Serosurvey participants were invited to create an account on the dedicated digital platform Specchio-COVID19 (https://www.specchio-covid19.ch/). On registration, an initial questionnaire assessed sociodemographic and lifestyle characteristics (including housing conditions, physical activity, diet, alcohol and tobacco consumption), anthropometry, general health and experience related to COVID-19 (symptoms, COVID-19 test results, quarantines, hospitalisations). Weekly, participants were invited to fill in a short questionnaire with updates on self-reported COVID-19-compatible symptoms, SARS-CoV-2 infection testing and vaccination. A more detailed questionnaire about mental health, well-being, risk perception and changes in working conditions was proposed monthly. Supplementary questionnaires were proposed at regular intervals to assess more in depth the impact of the pandemic on physical and mental health, vaccination adherence, healthcare consumption and changes in health behaviours. At baseline, serology testing allowed to assess the spread of SARS-CoV-2 infection among the general population and subgroups of workers. Additionally, seropositive participants and a sample of randomly selected participants were invited for serologic testing at regular intervals in order to monitor both the seropersistance of anti-SARS-CoV-2 antibodies and the seroprevalence of anti-SARS-CoV-2 antibodies in the population of the canton of Geneva. ETHICS AND DISSEMINATION The study was approved by the Cantonal Research Ethics Commission of Geneva, Switzerland (CCER Project ID 2020-00881). Results will be disseminated in a variety of ways, via the Specchio-COVID-19 platform, social media posts, press releases and through regular scientific dissemination methods (open-access articles, conferences).
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Affiliation(s)
- Helene Baysson
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Francesco Pennachio
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ania Wisniak
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria Eugenia Zabella
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Nick Pullen
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Prune Collombet
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphane Joost
- Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental engineering (ENAC), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Delphine Bachmann
- Hirslanden Clinique des Grangettes and Hislanden Clinique La Colline, Geneva, Switzerland
| | - Andrew Azman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Program and World Health Organization Collaborating Center on Patient Safety, Geneva University Hospitals and Faculty of Medecine, University of Geneva, Geneva, Switzerland
| | - François Chappuis
- Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Geneva, Switzerland
| | - Omar Kherad
- Division of Internal Medicine, Hôpital de la Tour and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Kaiser
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Geneva Center of Emerging Viral Diseases and Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
- Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Center for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
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