| 1. |
- Blomgren, Per-Ola, 1986-, et al.
(författare)
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Hand hygiene knowledge among nurses and nursing students : a descriptive cross-sectional comparative survey using the WHO's "Hand Hygiene Knowledge Questionnaire"
- 2024
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- AimTo determine the level of knowledge and explore the difference of hand hygiene between nursing students and nurses.BackgroundAnnually, 3.8 million people in Europe acquire healthcare-associated infections, highlighting the importance of hand hygiene. Despite WHO's emphasis on the fact that greater hand hygiene knowledge correlates with improved hand hygiene compliance, several studies have shown knowledge gaps among nurses and nursing students regarding hand hygiene.DesignDescriptive cross-sectional comparative survey.MethodsA version of the WHO “Hand Hygiene Knowledge Questionnaire”, translated into Swedish, was used for data collection among nursing students in the first and last semester, and registered nurses from a university and associated hospital. Data were analyzed by descriptive statistics, and comparison between groups with Fisher's exact test, one-way ANOVA, and post-hoc tests (Pairwise Z-Tests, Tukey HSD).ResultsThe survey, conducted between December 2020 and January 2021, received responses from 201 participants, including 71 first semester students, 46 last semester students and 84 registered nurses, showing moderate (55.7% [50–74% correct answers]) to good (43.8% [75–100% correct answers]) knowledge levels. First-semester students scored lower (17.0 ± 2.1) than last-semester students (18.8 ± 1.8) and registered nurses (18.3 ± 2.1) out of 25 questions.DiscussionIt is necessary for all groups to receive proper education on hand hygiene knowledge and to have an educational program that does not separate the groups but combines them with continuing education, since the students will someday be influencing future hand hygiene knowledge as a peer, together with the nurse.
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| 2. |
- Farzana, Refath, et al.
(författare)
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Molecular and genetic characterization of emerging carbapenemase-producing Acinetobacter baumannii strains from patients and hospital environments in Bangladesh
- 2022
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Carbapenemase-producing multidrug-resistant (MDR) Acinetobacter bau-mannii is a global health care problem. MDR A. baumannii has emerged as an important nosocomial pathogen, costing many lives worldwide including Bangladesh.Aim: To investigate the detailed molecular epidemiology of carbapenem-resistant A. baumannii (CRAB) both from patients and the hospital environment, to shed light on genetic characteristics and transmission dynamics.Methods: A set of 49 clinical A. baumannii strains collected during early 2015 was received from the clinical microbiology laboratory of Dhaka Medical College Hospital (DMCH) in Bangladesh. Additionaly, 100 environmental samples were also collected from the hospital surfaces of Dhaka Medical College Hospital and analyzed for carbapenamase-producing A. baumannii. CRAB were identified by culture on selective plates, biochemical testing and MALDI-TOF. All isolates were characterized by susceptibility testing, realtime-PCRs, conventional PCR, MLST and sequencing.Findings: Clinical A. baumannii were resistant to ciprofloxacin (100%), imipenem (91.8%), meropenem (91.8%), gentamicin (91.8%), amikacin (87.7%), and trimethoprim-sulfamethoxazole (61.2%). The majority (59%) of the isolates were MDR. All environ-mental A. baumannii (n1/410) were resistant to imipenem, meropenem, gentamicin, ami-kacin, and ciprofloxacin. Strains carried the following antibiotic resistant genes; blaOXA-23, blaOXA-58, blaPER-7, qnrB1, qnrC1, aac(60)1b-cr and armA. A total of 36 different clones were identified by rep-PCR and common clonal clusters were found both in patients and hospital environments. MLST analysis revealed different sequence types (ST2, ST10, ST149, ST575, ST1063 and ST1065). In clinical and environmental settings. A. baumannii ST2 dominated in both clinical and environmental settings. Both clinical and environmental A. baumannii strains with known STs carried several biofilm-related genes; bap, csuE, and pgaB. Conclusion: Widespread dissemination of MDR A. baumannii in the DMC hospital of Ban-gladesh is a serious problem.
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| 3. |
- Gideskog, Maria, et al.
(författare)
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Cluster of S. maltophilia among patients with respiratory tract infections at an intensive care unit
- 2020
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 2:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stenotrophomonas maltophilia is associated with respiratory tract infections in immunocompromised patients, and it has emerged as an important nosocomial patho- gen, with admission to intensive care units (ICUs) and ventilators as recognized risk factors.Aim: To describe the investigation of a sudden increase in patients with pneumonia caused by S. maltophilia at a Swedish ICU and the control measures taken.Methods: Lower respiratory tract cultures from patients admitted to the ICU were obtained, and environmental cultures were collected from sink drains and medical equipment. Isolates identified as S. maltophilia were subjected to antibiotic susceptibility testing and whole genome sequencing (WGS).Findings: A total of 17 S. maltophilia isolates were found (four from patients and 13 from the environment). The WGS identified two outbreak clones, sequence type (ST) 361 and ST138, and seven unique ones. Most likely, the outbreak clones originated from two sinks, and transmission was enhanced by a calorimeter. After changing the sink and calorimeter routines, no more cases were registered.Conclusion: Acquisition of S. maltophilia from the hospital environment appears to be easy, especially if water is involved. To control this bacterium, better knowledge of its transmission routes in hospital environments is required.
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| 4. |
- Juhlin, D., et al.
(författare)
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Microbiological colonization of peripheral venous catheters : a prospective observational study in a Swedish county hospital
- 2021
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most peripheral venous catheters (PVCs) used in Scandinavia are fitted with an injection port, creating an open PVC system. This port is difficult to disinfect, which may lead to the introduction of micro-organisms upon use.Aim: To investigate the prevalence of microbiological colonization of the injection port and internal lumen of ported PVCs with a minimum dwell time of 48 h at sample collection.Methods: Adult patients admitted to different medical and surgical departments and the intensive care unit were invited to participate in this prospective observational study. With the PVC in situ, the injection port and internal lumen were swabbed and cultured separately. Demographic and clinical data were collected to compare patients with colonized and non-colonized PVCs.Findings: In total, 300 PVCs from 300 patients were analysed. Of these, 33 patients (11.0%) had at least one positive culture. The colonization locations were as follows: port only, 26 (8.7%); internal lumen only, 5 (1.7%); and port and internal lumen, 2 (0.7%). The colonization rate was significantly higher in the injection port than in the internal lumen (P<0.0001). A ported PVC inserted in the hand incurred a significant risk of colonization (P=0.03). The odds ratio for colonization among patients in the infectious diseases department was 0.1 (95% confidence interval 0.1-1; P<0.06) compared with patients in the medical department.Conclusion: This study showed that 11% of ported PVCs were colonized by micro-organisms, with the vast majority (8.7%) of colonization occurring in the injection port.Clinical trial registration: ClinicalTrials.gov; ID NCT03351725.
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| 5. |
- Lindberg, M., 1977-, et al.
(författare)
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Continued wearing of gloves : a risk behaviour in patient care
- 2020
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 2:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: The wearing of gloves is included in the standard principles for preventing healthcare associated infections. A continued wearing of gloves may, however, result in the transmission of organisms instead of preventing infections. Few studies have explored how common it is for surfaces to be touched by potentially contaminated gloves.Methods: Secondary analysis of field notes from 48 hours of unstructured observations of healthcare personnel's actions during patient care. The new focus was on to what extent healthcare personnel wore gloves that should have been removed or changed, what sur-faces were touched by contaminated gloves and what patient-related activities were involved.Results: A continued wearing of gloves occurred in about half of the observed episodes of patient care. On average, 3.3 surfaces were touched by contaminated gloves. The surfaces most frequently touched were 'unused single-use items', 'equipment controls/switches/ regulators/flush buttons' and 'bed linen'. This occurred mostly while helping patients with 'personal hygiene', when performing 'test taking' or during procedures involving the operation of medical or other 'equipment'.Conclusion: The continued wearing of gloves during patient-related activities carries the risk of organism transmission, as the gloves touch many surfaces. The most critical moments seem to be when the use of gloves is considered essential. A better under-standing of the motivators of improper glove-use behaviour is needed to develop inter-ventions that rectify the improper use of gloves.
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| 6. |
- Markström, Ida, et al.
(författare)
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Impact of postoperative skin disinfection with chlorhexidine on bacterial colonisation following shoulder arthroplasty surgery : a controlled randomised study
- 2024
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Surgical site infections are a significant threat to patient safety. Shoulder arthroplasty carries an increased risk due to foreign implants. Skin preparation in general is a key preoperative preventive intervention, and the use of chlorhexidine can have a prolonged effect on bacterial colonisation. There is a lack of evidence regarding whether postoperative disinfection has an impact on bacterial colonisation during the first 48 hours after surgery. Our hypothesis was that applying postoperative antiseptic with 5 mg/ml chlorhexidine in 70% ethanol would lead to reduced bacterial colonisation with Staphylococcus aureus, coagulase-negative staphylococcus and Cutibacterium acnes around the surgical wound within the initial 48 hours after elective shoulder surgery, compared with the use of sodium chloride. METHODS: A single-blinded, controlled study was conducted at a county hospital in Sweden. Swabs from the skin were collected four times: at baseline, preoperatively, after the intervention and after 48 hours.RESULTS: Our hypothesis was not confirmed. Although not statistically significant, the chlorhexidine group had a higher prevalence of bacterial colonisation of clinically relevant bacteria.CONCLUSIONS: Our study could not confirm that postoperative disinfection with chlorhexidine reduces bacterial colonisation compared with sodium chloride. The results highlight the complexity of SSIs and the importance of evidence-based preventive skin preparation to ensure patient safety. Further research is needed, considering the study's limitations, to explore and evaluate the effectiveness of different skin cleansing solutions and preventive strategies in diverse surgical contexts.
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| 7. |
- Rockholt, Mika M., et al.
(författare)
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Sustained low catheter related infection (CRI) incidence in an observational follow-up study of 9924 catheters using automated data scripts as quality assurance for central venous catheter (CVC) management
- 2023
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Ingår i: Infection Prevention in Practice. - : Elsevier BV. - 2590-0889. ; 5:2, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: To maintain a low incidence of Catheter Related Infections (CRI) and Catheter Related Bloodstream Infections (CRBSI), continuous follow-up studies on catheter management are necessary. The aims of the present study were to investigate the incidence of catheter tip colonisation, CRI and CRBSI in the Region, to further explore the feasibility of automatic data collection and to investigate associations between independent variables and CRI. Methods: Data from electronic patient charts on all documented central venous catheter (CVC) insertions from multiple hospitals in southern Sweden, between March 2019 and August 2020, were automatically extracted. Multivariable regression analyses were used to identify associated risk factors. Results: In total, 9924 CVC insertions were included. The prevalence of CRI and CRBSI were 0.7% (n = 74) and 0.02% (n = 20) with incidences of 1.2/1000 catheter days and 0.3/1000 catheter days, respectively. Conclusions: We found a sustained low incidence of CRI and CRBSI in the Region. Catheter tips were less likely to be colonised when the subclavian route was used compared to the internal jugular route and male sex as well as increased number of catheter lumens were associated with both catheter tip colonisation and CRI. By using automated scripts, data extraction was efficient and feasible but also demonstrated that real-time quality assurance should be recommended, since this is superior to current standard.
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| 8. |
- Sandström, Nadia, 1995-, et al.
(författare)
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Addition of benzylpenicillin to antibiotic prophylaxis reduces deep sternal wound infection after cardiac surgery
- 2021
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In Sweden, cloxacillin is recommended as the sole antibiotic prophylaxis for prevention of surgical site infections after cardiac surgery. Cutibacterium acnes, formerly Propionibacterium acnes, has been shown to be present in the surgical wound. Formerly an overlooked pathogen, there are increasing reports that C acnes can cause surgical site infections, including sternal wound infections. Cloxacillin may not be optimal for prevention of C acnes infection, therefore benzylpenicillin was added to our routine intraoperative prophylaxis in 2015. The aim of this study was to investigate the effect of benzylpenicillin on incidence of sternal wound infection.Methods: We included 3920 consecutive patients that underwent cardiac surgery via median sternotomy at our centre from 2009 thru 2018. All patients were followed up two months postoperatively. The rate of sternal wound infection before and after 2015 were compared. Logistic multivariable analysis was used to adjust for potential confounders.Results: The mean incidence of sternal wound infection that required surgical revision decreased from 4.7% to 1.7% after addition of benzylpenicillin (p < 0.001). Significant decrease was seen in sternal wound infections caused by Coagulase negative staphylococci, either alone (p<0.001) or concomitant with C acnes (p=0.008). Addition of benzylpenicillin remained independently associated with the reduction of sternal wound infections in the multivariable analysis (OR=0.36 CI=0.23-0.56, p<0.001).Conclusions: Addition of benzylpenicillin was associated with a reduction in surgically treated infections and might be effective against infection caused by CoNS with and without co-infection by C acnes, although the exact underlying mechanism is unknown.
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| 9. |
- Seth Caous, Josefin, et al.
(författare)
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Instrument tables equipped with local unidirectional airflow units reduce bacterial contamination during orthopedic implant surgery in an operating room with a displacement ventilation system
- 2022
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Ingår i: Infection Prevention in Practice. - : Elsevier Ltd. - 2590-0889. ; 4:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Airborne bacteria present in the operating room may be a cause of surgical site infection, either contaminating the surgical wound directly, or indirectly via e.g. surgical instruments. The aim of this study was to evaluate if instrument and assistant tables equipped with local unidirectional airflow reduce bacterial contamination of the instrument area to ultra clean levels, during orthopedic implant surgery in an operating room with displacement ventilation. Methods: Local airflow units of instrument and assistant tables were either active or inactive. Colony forming units were sampled intraoperatively from the air above the instruments and from instrument dummies. A minimum of three air samples and two-three samples from instrument dummies were taken during each surgery. Samples were incubated on agar for total aerobic bacterial count. The mean air and instrument contamination during each surgery was calculated and used to analyze the difference in contamination depending on use of local airflow or not. All procedures were performed in the same OR. Results: 188 air and 124 instrument samples were collected during 48 orthopedic implant procedures. Analysis showed that local unidirectional airflow above the surgical instruments significantly reduced the bacterial count in the air above assistant table (P<0.001) and instrument table (P=0.002), as well as on the instrument dummies from the assistant table (P=0.001). Conclusions: Instrumentation tables equipped with local unidirectional airflow protect the surgical instruments from bacterial contamination during orthopedic implant surgery and may therefore reduce the risk of indirect wound contamination. © 2022 The Authors
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| 10. |
- Sid Ahmed, Mazen, 1970-, et al.
(författare)
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Emergence of Multidrug- and Pandrug- Resistant Pseudomonas aeruginosa from Five Hospitals in Qatar
- 2019
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 1:3-4
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Tidskriftsartikel (refereegranskat)abstract
- Background: A global rise in multidrug-resistant (MDR) nosocomial infections has led to a significant increase in morbidity and mortality. MDR Gram-negative bacteria (GNB) are recognised for rapidly developing drug resistance. Despite Pseudomonas aeruginosa being the second most common GNB isolated from healthcare associated infections, the magnitude of MDR P. aeruginosa (MDR-PA) has not been evaluated in Qatar.Aim: To assess the prevalence and antimicrobial susceptibility patterns of MDR-PA from 5major hospitals in Qatar.Methods: A total of 2533P. aeruginosaclinical isolates were collected over a one-year period. MDR-PA was defined as resistance to at least one agent of3 antibiotic classes. Clinical and demographic data were collected prospectively.Findings: The overall prevalence of MDR-PA isolates was 8.1% (205/2533); the majority of isolates were from patients exposed to antibiotics during 90 days prior to isolation (85.4%,177/205), and the infections were mainly hospital-acquired (95.1%, 195/205) with only 4.9% from the community. The majority of MDR-PA isolates were resistant to cefepime (96.6%, 198/205), ciprofloxacin, piperacillin/tazobactam (91%, 186/205), and meropenem (90%, 184/205). Patient comorbidities with MDR-PA were diabetes mellitus (47.3%, n¼97), malignancy (17.1%, n¼35), end-stage renal disease (13.7%, n¼28) and heart failure (10.7%, n¼22).Conclusion: There was a significant prevalence of MDR-PA in Qatar, primarily from healthcare facilities and associated with prior antibiotic treatment. There was an alarming level of antimicrobial resistance to carbapenems. Our results are part of a national surveillance of MDR to establish effective containment plans.
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