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- Aganovic, A., et al.
(författare)
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Ventilation design conditions associated with airborne bacteria levels within the wound area during surgical procedures: a systematic review
- 2021
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Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701 .- 1532-2939. ; 113, s. 85-95
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Forskningsöversikt (refereegranskat)abstract
- Background: Without confirmation of the ventilation design conditions (typology and airflow rate), the common practice of identifying unidirectional airflow (UDAF) systems as equivalent to ultra-clean air ventilation systems may be misleading, but also any claims about the ineffectiveness of UDAF systems should be doubted. The aim of this review was to assess and compare ventilation system design conditions for which ultra-clean air (mean <10 cfu/m ) within 50 cm from the wound has been reported. Six medical databases were systematically searched to identify and select studies reporting intraoperative airborne levels expressed as cfu/m close to the wound site, and ventilation system design conditions. Available data on confounding factors such as the number of persons present in the operating room, number of door openings, and clothing material were also included. Predictors for achieving mean airborne bacteria levels within <10 cfu/m were identified using a penalized multivariate logistic regression model. Twelve studies met the eligibility criteria and were included for analysis. UDAF systems considered had significantly higher air volume flows compared with turbulent ventilation (TV) systems considered. Ultra-clean environments were reported in all UDAF-ventilated (N = 7) rooms compared with four of 11 operating rooms equipped with TV. On multivariate analysis, the total number of air exchange rates (P=0.019; odds ratio (OR) 95% confidence interval (CI): 0.66–0.96) and type of clothing material (P=0.031; OR 95% CI: 0.01–0.71) were significantly associated with achieving mean levels of airborne bacteria <10 cfu/m . High-volume UDAF systems complying with DIN 1946-4:2008 standards for the airflow rate and ceiling diffuser size unconditionally achieve ultra-clean air close to the wound site. In conclusion, the studied articles demonstrate that high-volume UDAF systems perform as ultra-clean air systems and are superior to TV systems in reducing airborne bacteria levels close to the wound site. 3 3 3 3
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| 2. |
- Ahmed, Anisuddin, et al.
(författare)
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Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control : a multi-centre study in Bangladesh
- 2024
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Ingår i: Journal of Hospital Infection. - : Elsevier. - 0195-6701 .- 1532-2939. ; 145, s. 22-33
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Tidskriftsartikel (refereegranskat)abstract
- Background: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high -quality healthcare services, and eliminating avoidable healthcare -associated infections (HAIs) in health facilities, predominantly in populationdense settings such as Bangladesh.Aim: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh.Methods: We conducted a pre -post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0 -200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities.Results: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level.Conclusion: The integrated intervention package improved IPCAF score in all facilities.
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| 3. |
- Blomgren, Per-Ola, et al.
(författare)
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Healthcare workers' perceptions and acceptance of an electronic reminder system for hand hygiene
- 2021
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Ingår i: Journal of Hospital Infection. - : Elsevier. - 0195-6701 .- 1532-2939. ; 108, s. 197-204
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Tidskriftsartikel (refereegranskat)abstract
- Background:Healthcare-associated infections (HCAIs) have a large negative impact onmorbidity, mortality, and quality of life. Approximately 9% of all patients hospitalized inSweden suffer from HCAI. Hand hygiene plays a key role and is considered the single mostimportant measure to reduce HCAI. The hospital organization works actively to reduceHCAI. Implementing electronic systems to remind and/or notify healthcare workers raisesawareness of and adherence to hand hygiene. However, there is a paucity of studiesaddressing individuals’ perceptions of having such a system and how the organizationworks.Aim:To investigate healthcare workers’ perceptions of infection prevention in thehealthcare organization and perceptions and acceptance of an electronic reminder systemthat encourages good hand hygiene.Methods:Qualitative descriptive design with data collected in eight focus group inter-views including assistant nurses, nurses, and physicians (N¼38). Content analysis wasapplied and data were related to the Theory of Planned Behaviour.Findings:Healthcare workers perceive lack of feedback from the hospital organizationand are positive towards an electronic reminder system to increase adherence to handhygiene. The electronic reminder system should not register data at an individual levelsince it could be used as an instrument for control by the management that could bestressful for staff.Conclusion:In general, there is positive acceptance of the electronic reminder system,and the respondents perceived it as having the ability to change behaviour. However, theconcept has to be further developed to protect the individual’s integrity and needs to beused with feedback on a group level
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| 6. |
- Edner, Ann, et al.
(författare)
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Low risk of transmission of pathogenic bacteria between children and the assistance dog during animal-assisted if strict rules are followed
- 2021
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Ingår i: Journal of Hospital Infection. - : Elsevier. - 0195-6701 .- 1532-2939. ; 115, s. 5-9
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Tidskriftsartikel (refereegranskat)abstract
- This study explored the bacterial transmission between patients and dogs during dog assisted therapy (DAT). Twenty children (55% girls) with a median age of 7 years (range 3-17 years) were included. Two dogs assisted and the conditions were more restricted hygienically with dog 2. Samples from child and dog were collected and cultured before and after each DAT visit. The results showed that dog 1 transmitted bacteria repeatedly to the children. No bacteria were transmitted with dog 2. In conclusion, exchange of bacteria can occur between dog and child during DAT, but it can be reduced by simple infection control measures. (c) 2021 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.
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| 8. |
- Grevskott, D. H., et al.
(författare)
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Emergence and dissemination of epidemic-causing OXA-244 carbapenemase-producing Escherichia coli ST38 through hospital sewage in Norway, 2020-2022
- 2024
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Ingår i: JOURNAL OF HOSPITAL INFECTION. - 0195-6701 .- 1532-2939. ; 145, s. 165-173
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population -based sewage surveillance has emerged as a promising approach for studying the prevalence of antibiotic resistance in pathogens. Aim: To determine the temporal prevalence of cefotaxime-resistant Escherichia coli in sewage from five sewage treatment plants located in Bergen city, to determine whether ESBL- and carbapenemase-producing E. coli are consistently disseminated in the receiving environment through sewage. Method: A total of 569 cefotaxime-resistant E. coli were isolated over a period of 19 months (August 2020 to February 2022) using ECC CHROMagarTM plates from 82 samples, antibiotic sensitivity profiles were determined, using SensititreTM plates. The draft genome sequences were determined, using Illumina MiSeq-based sequencing. Complete genome sequences were determined, using Oxford Nanopore-based sequencing. Findings: All 569 strains obtained from influent (N1/4461) and effluent (N1/4108) were multidrug resistant. Most of the sequenced strains (52 of 61) carried blaCTX-M-15 (38.5%) and blaCTX-M-27 (34.6%). The most prevalent sequence types (STs) for ESBL-carrying strains were ST131 (32.8%) and ST38 (21.3%). All CTX-M-27-carrying ST131 strains belonged to clade A or C1, while CTX-M-15-harbouring strains were present in all the clades. Five OXA-244producing ST38 strains, genetically similar to epidemic -causing strains from Western Norway, France and the Netherlands, were isolated only from raw and treated sewage of the treatment plant receiving hospital sewage.
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| 10. |
- Lytsy, Birgitta, 1968-, et al.
(författare)
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Evaluating the effect of Novarerus NV800 air purifier units during orthopaedic surgery to reduce bioburden in the air
- 2022
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Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701 .- 1532-2939. ; 130, s. 108-111
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Tidskriftsartikel (refereegranskat)abstract
- Background: A locally installed air purifier unit (Novaerus Protect 800) has been shown to reduce the air bioburden in an intensive care unit and the incidence of healthcare-associated infections. Aim: To explore whether this type of air purifying unit could reduce bacterial concentrations in the air of an operating room (OR) during orthopaedic surgery, thereby reducing the risk of surgical site infections. Methods: In this prospective experimental study, undertaken in 2018, three air purifying units were installed in an OR in a Swedish hospital in 2018. The air was actively sampled during 11 operations by a slit-to-slit agar impactor with the air purifying units either switched on or switched off. Air movements were visualized with the aid of smoke in mock-up studies. Findings: No significant difference in bacterial concentrations in air was found between the two conditions (air purifying units switched off or on) (P=0.54). Air movements around and above the surgical wound were disordered and resembled those of dilution mixing air. Conclusion: The three air purifying units installed in the OR did not reduce the airborne bacterial levels in the critical zone during orthopaedic surgery.
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