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Objective To evaluate the electronic tracking system combined with paper records in quality control and management in the Sterilization and Supply Center (CSSD). Methods A electronic tracking system combined with paper records had been used in quality control of sterilizing instruments in CSSD since July 2018. The qualified rates of cleaning and sterilizing 328 sets of instruments collected before application of electronic tracking system (Jan to June 2016) and 345 sets of instruments collected after application of electronic tracking system (July to December 2018) were analyzed. The satisfactory degree of nurses on quality of service in CSSD was evaluated before and after application of electronic tracking system. Results There were significant increases in qualified rates of cleaning (91.77% vs. 95.65, P >0.05) and sterilizing (90.24% vs. 100.00%, P <0.01). There were 75nurses and 80 nurses who participated in the server before and after the application of electronic tracking system, respectively. Outcomes of the survey showed that nurses were satisfied with the packing system, quality of sterilizing, standard procedure, working efficacy in CSSD (P <0.01). Conclusion The electronic tracking system combined with paper records can effectively improve the quality of cleaning, disinfection and sterilization of medical instruments. [ABSTRACT FROM AUTHOR]

Nosocomial infections (hospital-acquired) has been an important public health problem, which may make those patients with infections or involved visitors and hospital personnel at higher risk of worse clinical outcomes or infection, and then consume more healthcare resources. Taking into account the stochasticity of the death and discharge rate of patients staying in hospitals, in this paper, we propose a stochastic dynamical model describing the transmission of nosocomial pathogens among patients admitted for hospital stays. The stochastic terms of the model are incorporated to capture the randomness arising from death and discharge processes of patients. Firstly, a sufficient condition is established for the stochastic extinction of disease. It shows that introducing randomness in the model will result in lower potential of nosocomial outbreaks. Further, we establish a threshold criterion on the existence of stationary distribution and ergodicity for any positive solution of the model. Particularly, the spectral radius form of stochastic threshold value is calculated in the special case. Moreover, the numerical simulations are conducted to both validate the theoretical results and investigate the effect of prevention and control strategies on the prevalence of nosocomial infection. We show that enhancing hygiene, targeting colonized and infected patients, improving antibiotic treatment accuracy, shortening treatment periods are all crucial factors to contain nosocomial infections. [ABSTRACT FROM AUTHOR]

AbstractCure rate models are mostly used to study data arising from cancer clinical trials. Its use in the context of infectious diseases has not been explored well. In 2008, Tournoud and Ecochard first proposed a mechanistic formulation of cure rate model in the context of infectious diseases with multiple exposures to infection. However, they assumed a simple Poisson distribution to capture the unobserved pathogens at each exposure time. In this paper, we propose a new cure rate model to study infectious diseases with discrete multiple exposures to infection. Our formulation captures both over-dispersion and under-dispersion with respect to the count on pathogens at each time of exposure. We also propose a new estimation method based on the expectation maximization algorithm to calculate the maximum likelihood estimates of the model parameters. We carry out a detailed Monte Carlo simulation study to demonstrate the performance of the proposed model and estimation algorithm. The flexibility of our proposed model also allows us to carry out a model discrimination. For this purpose, we use both likelihood ratio test and information-based criteria. Finally, we illustrate our proposed model using a recently collected data on COVID-19. [ABSTRACT FROM AUTHOR]

Background and Aim Nosocomial infection is a health problem in all countries. Considering the role of midwives in controlling nosocomial infection, the aim of this study was to determine the effect of an educational intervention based on model on preventive behaviors of nosocomial infection by Babol hospitals midwives was done. Methods & Materials The present study was a quasi-experimental study with intervention and control group. The interventions were performed in three 40-minute sessions in the Shahid Yahya Nejad Hospital in April and May 2017. The data collection tool was a structure Health Belief Model based(Awareness, structure Health Belief Model and behavior) on a questionnaire completed Its validity and reliability were assessed two months before and one month after Midwives who met the inclusion criteria education. Data were collected and analyzed by SPSS software v. 24 by Anova, T-test and ANCO one-way Covariance tests. Ethical Considerations This research paper has been approved by the ethics committee IR.IAU.TMU. REC.1398.068 and informed consent will be taken from the participants in the study the information will remain confidential. Results Before the intervention, the two groups did not differ significantly in terms of, mean scores of different model structures. After intervention, there was a significant difference in the mean and standard deviation of the effect of education on knowledge score (1.0±0.3), perceived sensitivity (2.8±1.5), perceived severity (3.6±1.7) Perceived barriers (-6.4±1.3), perceived benefits (5.1±4), self-efficacy (4.6 ± 2.6) and behavior( 3.1±1.1) was seen in the intervention group (P>0.05). Conclusion By increasing the scores obtained from the structures Especially self-efficacy and reduction of perceived barriers, designing and implementing an educational program based on model in midwives can increase their performance regarding the prevention of nosocomial infections. [ABSTRACT FROM AUTHOR]

In confronting the sudden epidemic of COVID-19, China and other countries have been under great deal of pressure to block virus transmission and reduce death cases. Fangcang shelter hospital, which is converted from large-scale public venue, is proposed and proven to be an effective way for administering medical care and social isolation. This paper presents the practice in information technology support for a Fangcang shelter hospital in Wuhan, China. The experiences include the deployment strategy of IT infrastructure, the redesign of function modules in the hospital information system (HIS), equipment maintenance and medical staff training. The deployment strategy and HIS modules have ensured smoothness and efficiency of clinical work. The team established a quick response mechanism and adhered to the principle of nosocomial infection control. Deployment of network and modification of HIS was finished in the 48 hours before patient admittance. A repair hotline and remote support for equipment and software were available whenever medical workers met with any questions. No engineer ever entered the contaminated areas and no one was infected by the coronavirus during the hospital operation. Up to now, Fangcang shelter hospital is adopted by many regions around the world facing the collapse of their medical systems. This valuable experience in informatization construction and service in Wuhan may help participators involving in Fangcang shelter hospital get better information technology support, and find more practical interventions to fight the epidemic. [ABSTRACT FROM AUTHOR]

Since the diagnosis of the first case of COVID-19 in December 2019, there have been reports of several healthcare workers infected with COVID- 19. It has changed the infection control practices of most ICUs all over the world. Prevention is better than cure is definitely proven true as there is no definite cure for COVID-19 yet. Personal protective equipment and hand hygiene are must while handling any suspected COVID-19 patient. Apart from that, there are several other things, which should be followed in ICU and specifically while caring for patient on ventilator. There are a large number of interventions done while treating any critically ill patient in ICU, which can generate aerosols and exaggerate spread of COVID-19, which include high-flow nasal cannula, NIV, nebulization, suctioning, bag and mask ventilation, endotracheal intubation, and bronchoscopy. We will be reviewing those things beyond PPE and hand hygiene along with the rationale of each of them, which can help to minimize the risk of exposure to healthcare workers and other patients in the surrounding. It will help not only to prevent COVID-19 transmission but also to reduce overall nosocomial infection rate. As per our knowledge, this will be the first paper reviewing innovative ideas to minimize the risk of infection in a comprehensive manner. [ABSTRACT FROM AUTHOR]

Background: The extended illness-death model is a useful tool to study the risks and consequences of hospital-acquired infections (HAIs). The statistical quantities of interest are the transition-specific hazard rates and the transition probabilities as well as attributable mortality (AM) and the population-attributable fraction (PAF). In the most general case calculation of these expressions is mathematically complex.Methods: When assuming time-constant hazards calculation of the quantities of interest is facilitated. In this situation the transition probabilities can be expressed in closed mathematical forms. The estimators for AM and PAF can be easily derived from these forms.Results: In this paper, we show how to explicitly calculate all the transition probabilities of an extended-illness model with constant hazards. Using a parametric model to estimate the time-constant transition specific hazard rates of a data example, the transition probabilities, AM and PAF can be directly calculated. With a publicly available data example, we show how the approach provides first insights into principle time-dynamics and data structure.Conclusion: Assuming constant hazards facilitates the understanding of multi-state processes. Even in a non-constant hazards setting, the approach is a helpful first step for a comprehensive investigation of complex data. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) susceptible to hepatitis B represent an important public health concern. National and international guidelines recommend assessing the hepatitis B immune status of all HCWs and possibly vaccinating those found to be seronegative (non-responders). We conducted a meta-analysis to estimate the rate of hepatitis B sero-susceptibility among HCWs in Italy and to explore possible options for the management of non-responders. Nineteen studies, selected from scientific articles available in the Scopus, MEDLINE/PubMed and ISI Web of Knowledge databases between 1 January 2016 and 22 April 2022, were included. The prevalence of HBV-susceptible HCWs was 27.1% (95%CI = 23.2–31.7%). In a comparison by sex (males vs. females) the RR was 1.16 (95%CI = 1.03–1.31), and by full-cycle vaccination period (adolescence vs. infancy) the RR was 0.30 (95%CI = 0.25–0.37). Occupational health screenings for hepatitis B, with subsequent vaccination of non-responders, and exclusion of susceptible HCWs from high-risk settings have been common management strategies. It is highly probable that a proportion of the next generation of medical students and HCWs will not show circulating IgG on serologic evaluation. Therefore, more targeted efforts are needed to identify these individuals and actively immunize them. [ABSTRACT FROM AUTHOR]

Background: Both long (> 30 days) and short-term (≤ 30 days) catheterisation has been associated with urinary tract infections (UTIs) due to the invasive nature of device insertion through the urethra. Catheter associated Urinary Tract Infections (CAUTIs) are common (prevalence of ~ 8.5%) infections which can be treated with antibiotics; however, CAUTIs are both expensive to treat and contributes to the antibiotic usage crisis. As catheters are unlikely be replaced for the management of patients' urination, ways of reducing CAUTIs are sought out, using the catheter device itself. The aim of this review is to assess the incidence of CAUTI and the causative micro-organisms when different urinary catheter devices have been used by humans, as reported in published research articles. Methods: A Systematic Literature Review was conducted in Ovid Medline, Web of Science and PubMed, to identify studies which investigated the incidence of UTI and the causative micro-organisms, in patients with different urinary catheter devices. The articles were selected based on a strict set of inclusion and exclusion criteria. The data regarding UTI incidence was extracted and calculated odds ratio were compared across studies and pooled when types of catheters were compared. CAUTI causative micro-organisms, if stated within the research pieces, were also gathered. Results: A total of 890 articles were identified, but only 26 unique articles met the inclusion/exclusion criteria for this review. Amongst the large cohort there were catheters of materials silicone, latex and PVC and catheter modifications of silver nanoparticles and nitrofurantoin antibiotics. The meta-analysis did not provide a clear choice towards a single catheter against another although silver-based catheters, and silver alloy, appeared to statistically reduce the OR of developing CAUTIs. At genus level the three commonest bacteria identified across the cohort were E. coli, Enterococcus spp. and Pseudomonas spp. whilst considering only at the genus level, with E. coli, Klebsiella pneumonia and Enterococcus faecalis most common at the species-specific level. Conclusions: There does not appear to be a catheter type, which can significantly reduce the incidence of CAUTI's in patients requiring catheterisation. Ultimately, this warrants further research to identify and develop a catheter device material that will reduce the incidence for CAUTIs. [ABSTRACT FROM AUTHOR]

The use of antibiotics to treat bacterial infections often imposes strong selection for antibiotic resistance. However, the prevalence of antibiotic resistance varies greatly across different combinations of pathogens and drugs. What underlies this variation? Systematic reviews, meta-analyses, and literature surveys capable of integrating data across many studies have tried to answer this question, but the vast majority of these studies have focused only on cases where resistance is common or problematic. Yet much could presumably be learned from the cases where resistance is infrequent or absent. Here we conducted a literature survey and a systematic review to study the evolution of antibiotic resistance across a wide range of pathogen-by-drug combinations (57 pathogens and 53 antibiotics from 15 drug classes). Using Akaike information criterion-based model selection and model-averaged parameter estimation we explored 14 different factors posited to be associated with resistance evolution. We find that the most robust predictors of high resistance are nosocomial transmission (i.e. hospital-acquired pathogens) and indirect transmission (e.g. vector-, water-, air-, or vehicle-borne pathogens). While the former was to be expected based on prior studies, the positive correlation between high resistance frequencies and indirect transmission is, to our knowledge, a novel insight. The most robust predictor of low resistance is zoonosis from wild animal reservoirs. We also found partial support that resistance was associated with pathogen type, horizontal gene transfer, commensalism, and human-to-human transmission. We did not find support for correlations between resistance and environmental reservoirs, mechanisms of drug action, and global drug use. This work explores the relative explanatory power of various pathogen and drug factors on resistance evolution, which is necessary to identify priority targets of stewardship efforts to slow the spread of drug-resistant pathogens. [ABSTRACT FROM AUTHOR]

Introduction: Nosocomial infections are infections occurring after patients get admitted in hospitals. The common nosocomial infections being surgical site infections(SSI), urinary tract infections(UTI), upper urespiratory tract infections(URTI), thrombophlebitis (IV line) and systemic infection with positive blood culture (blood) Method: This study was conducted in Obstetrics And Gynaecology Department Of Government Medical College, Bhavnagar From January 2015 To December 2015 to determine the incidence of surgical site infections and associated infections and the pathogens responsible for it. It is a retrospective descriptive study as data were collected from case papers, registers etc. Result: The surgical site infection rate in our study in obstretic ward was 5.5% in cases of LSCS and 0.3% in episiotomy case and in gynaec ward was 2.5% in cases of Abdominal hysterectomy and 0.6% in cases vaginal hysterectomy. The common associated infection in obstetrics ward was UTI: 1.39%, IV line 0.27%, Blood 0.08% and URTI 0.14% while in gyneac ward, UTI: 1.26%, IV line 0.96%, Blood 0% and URTI 0.11%. [ABSTRACT FROM AUTHOR]

Rapid transmission of infectious microorganisms such as viruses and bacteria through person-to-person contact has contributed significantly to global health issues. The high survivability of these microorganisms on the material surface enumerates their transmissibility to the susceptible patient. The antimicrobial coating has emerged as one of the most interesting technologies to prevent growth and subsequently kill disease-causing microorganisms. It offers an effective solution a non-invasive, low-cost, easy-in-use, side-effect-free, and environmentally friendly method to prevent nosocomial infection. Among antimicrobial coating, zinc oxide (ZnO) stands as one of the excellent materials owing to zero toxicity, high biocompatibility to human organs, good stability, high abundancy, affordability, and high photocatalytic performance to kill various infectious pathogens. Therefore, this review provides the latest research progress on advanced applications of ZnO nanostructure-based antibacterial coatings for medical devices, biomedical applications, and health care facilities. Finally, future challenges and clinical practices of ZnO-based antibacterial coating are addressed. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To analyze the pathogen strains and drug resistance of 862 patients with nosocomial infection, and to provide scientific data for the control of nosocomial infection. Methods Samples of respiratory tract, urinary tract and blood were collected from 862 patients with nosocomial infection in our hospital, and strain culture and AGAR paper diffusion were used to detect drug resistance. Results The infection sites of 862 patients mainly included 58 cases of upper respiratory tract infection, 304 cases of lower respiratory tract infection, 121 cases of bacteremia, 150 cases of intrapelvic tissue infection, 36 cases of ascites infection, and 76 cases of urinary tract infection. A total of 582 strains of pathogenic bacteria were isolated from 862 patients. Among the 582 pathogenic bacteria, there were 400 strains of gram-negative bacteria, including 96 strains of Klebsiella pneumoniae, 105 strains of Escherichia coli and 75 strains of Acinetobacter baumannii; there were 148 gram-positive strains, including 35 strains of Staphylococcus aureus and 58 strains of Coagulasenegative staphylococci; there were 32 strains of fungi, mainly including 16 strains of Candida albicans, and 2 strains of Mycoplasma. Gram-negative bacteria had higher resistance to cefuroxime and ampicillin, and lower drug resistance rate to imipenem, meropenem, tegacycline and polymyxin B. The drug resistance rates of Escherichia coli and Klebsiella pneumoniae to cefuroxime, ampicillin, ciprofloxacin and minocycline were high, all of which were close to or > 30%. The drug resistance rate of pseudomonas aeruginosa to ticacillin, gentamicin, minocycline and furantoin was high, with the drug resistance rate of > 30%. Acinetobacter baumannii was extensively resistant to most commonly used clinical antibiotics, and had a low resistance rate to minocycline, cefoperazone sulbactam, tegacycline and polymyxin B. The resistance rate of Gram-positive bacteria to ampicillin, erythromycin and ciprofloxacin was higher than that of Gram-positive bacteria. There were 11 strains of methicillin-sensitive staphylococcus aureus (MSSA), 24 strains of methicillin-resistant staphylococcus aureus (MRSA), 13 strains of methicillin-positive staphylococcus aureus (MSCNS), and 45 strains of methicillin-negative staphylococcus aureus (MR CNS). MSSA had a high resistance rate to penicillin, erythromycin and tetracycline, MSC NS was sensitive to vancomycin, tigacycline and linezolid, and the resistance rate to erythromycin and gentamicin was > 40%. The resistance rate of MRSA to erythromycin, ciprofloxacin, tetracycline, clindamycin and trimethoprim was all > 50%, and the resistance rate to vancomycin, tegacycline, linezolid, furantoin and rifampin was all < 30%. The resistance rate of MRCNS to vancomycin, tigacycline, linezolid, furantoin and rifampicin were all <30%. Conclusions The main pathogenic bacteria are Gram-negative bacteria, mainly Klebsiella pneumoniae and Escherichia coli. The resistance to cefuroxime, ampicillin and other drugs is relatively high, while the resistance to imipenem is relatively low. The Gram-positive bacteria are mainly Staphylococcus aureus and Coagulase-negative staphylococci, which have higher resistance to ampicillin, erythromycin and ciprofloxacin, and lower resistance to vancomycin, linezolid and tegacycline. [ABSTRACT FROM AUTHOR]

Ventilator-associated pneumonia (VAP), a hospital acquired pneumonia that occurs more than 48 h after mechanical ventilation, is a common complication of mechanical ventilation with a high mortality rate. VAP can cause patients to have difficulty weaning off the ventilator and to stay in the hospital longer, which results in a huge financial burden to patients and a huge demand for medical resources. Several strategies, such as drugs including chlorhexidine, β-lactam antibiotics and probiotics, have been used to prevent VAP in clinic. The incidence and the mortality rate of VAP have been decreased with the development of preventative strategies in the past decades, but VAP remains one of the most common causes of nosocomial infections and death in the intensive care unit. Current challenges in the management of VAP involved the lack of a gold standard for diagnosis, the absence of effective preventative strategies, and the rise in antibiotic resistance. Therefore, in order to reduce the incidence of VAP and improve the outcome of patients with mechanical ventilation, it is necessary to clarify the risk factors of VAP for clinical prevention and control of VAP. This paper reviews the international risk factors of VAP occurrence reported in recent years, including patient characteristics, increased mechanical ventilation time and prolonged length of hospital stay, disorders of consciousness, burns, comorbidities, prior antibiotic therapy, invasive operations, gene polymorphisms, and mentions the corresponding preventive measures. Each factor is not only an independent risk factor of VAP, but also has an influence on each other. A better understanding of risk factors for VAP is helpful for predicting the occurrence of VAP, improving the prevention and control of VAP, and reducing the morbidity and mortality rates of patients with VAP. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between various prevention and control measures for nosocomial infections (NIs) in psychiatric hospitals and patients with mental disorders. This study aimed to determine the characteristics of NIs in psychiatric hospitals and provide a reference for infection prevention and control in this setting. Data from the NI monitoring system of a psychiatric hospital in southeastern China were analysed. Patients who were hospitalized for mental disorders from January 1, 2016, to November 30, 2019, were classified into the non-COVID-19 containment group (NC19C group, n = 898), while those who were hospitalized from January 25, 2020, to November 30, 2022, were classified into the COVID-19 containment group (C19C group, n = 840). The data were analysed using SPSS version 22.0, and independent sample t tests, chi-square tests, correlation analyses, and multivariate logistic regression analyses were performed. A significance level of P < 0.0024 was applied. The incidence rate of NIs was higher in autumn in the NC19C group, while no seasonal difference was detected in the C19C group (P < 0.0024). Further analysis revealed that in the C19C group, the risk of hospitalized patients with mental disorders developing hospital-acquired pneumonia in spring was 0.362 times that in winter (OR = 0.362, 95% CI = 0.200 ~ 0.656, P = 0.001), and in summer, the risk was 0.342 times that in winter (OR = 0.342, 95% CI = 0.185 ~ 0.633 P = 0.001). Patients aged 18–44 years had a 4.260 times higher risk of developing hospital-acquired upper respiratory tract infections than did those aged 60 years and older (OR = 4.260, 95% CI = 2.143 ~ 8.470; P = 0.000). The risk of acquiring urinary tract infections in the hospital was 0.324 times greater among patients aged 18–44 years than for patients aged 60 years and older (OR = 0.324, 95% CI = 0.171–0.613; P = 0.001). The NC19C group did not exhibit the aforementioned differences. During the NC19C period, differences were observed in the diagnosis of hospital-acquired infections and sex (all P = 0.000). Psychiatric hospitals exhibit distinct nosocomial infection characteristics under the context of various infection control measures. Against the backdrop of strengthened infection control, the nosocomial infection characteristics of psychiatric hospitals may be associated with the features of mental disorders. [ABSTRACT FROM AUTHOR]

Background: The human oral and nasal cavities can act as reservoirs for opportunistic pathogens capable of causing acute infection. These microbes asymptomatically colonize the human oral and nasal cavities which facilitates transmission within human populations via the environment, and they routinely possess clinically significant antibiotic resistance genes. Among these opportunistic pathogens, the Klebsiella genus stands out as a notable example, with its members frequently linked to nosocomial infections and multidrug resistance. As with many colonizing opportunistic pathogens, the essential transmission factors influencing the spread of Klebsiella species among both healthy and diseased individuals remain unclear. Results: Here, we explored a possible explanation by investigating the ability of oral and nasal Klebsiella species to outcompete their native microbial community members under in vitro starvation conditions, which could be analogous to external hospital environments or the microenvironment of mechanical ventilators. When K. pneumoniae and K. aerogenes were present within a healthy human oral or nasal sample, the bacterial community composition shifted dramatically under starvation conditions and typically became enriched in Klebsiella species. Furthermore, introducing K. pneumoniae exogenously into a native microbial community lacking K. pneumoniae, even at low inoculum, led to repeated enrichment under starvation. Precise monitoring of K. pneumoniae within these communities undergoing starvation indicated rapid initial growth and prolonged viability compared to other members of the microbiome. K. pneumoniae strains isolated from healthy individuals' oral and nasal cavities also exhibited resistance to multiple classes of antibiotics and were genetically similar to clinical and gut isolates. In addition, we found that in the absence of Klebsiella species, other understudied opportunistic pathogens, such as Peptostreptococcus, increased in relative abundance under starvation conditions. Conclusions: Our findings establish an environmental and microbiome community circumstance that allows for the enrichment of Klebsiella species and other opportunistic pathogens. Klebsiella's enrichment may hinge on its ability to quickly outgrow other members of the microbiome. The ability to outcompete other commensal bacteria and to persist under harsh environmental conditions could be an important factor that contributes to enhanced transmission in both commensal and pathogenic contexts. 2NMbQE6jVjinwr48dC_rNo Video Abstract [ABSTRACT FROM AUTHOR]

Background: An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult. Methods: We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model. Results: Among the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14–38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74–0.96, P = 0.01) and 0.80 (95% CI 0.71–0.90, P < 0.001), respectively. Conclusion: Results showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI. [ABSTRACT FROM AUTHOR]

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Background/aim: Nosocomial infections occur worldwide and affect both developed and resource-poor countries. The aim of this paper was to determine the prevalence and risk factors for nosocomial infections in one Serbian hospital. Materials and methods: Three-point prevalence surveys were conducted in the Clinical Center of Kragujevac (1240 beds). The standard definitions for nosocomial infections of the Centers for Diseases Control and Prevention were used. The authors conducted surveys according to the same protocol. Results: The prevalence of infected patients and the overall prevalence of nosocomial infections was 6.2% and 7.1% in 2003, 4.6% and 4.6% in 2005, and 7.6% and 8.7% in 2009, respectively. In all three studies, the risk factors for nosocomial infections were older age, intravascular catheters, urinary catheters, longer hospital stays, hospitalization in an intensive care unit, and surgeries. According to the multivariate regression analysis, a prolonged hospitalization and use of a urinary catheter were independent risk factors for nosocomial infections in the first and second study. Conclusion: The overall healthcare-associated infection prevalence in our hospital increased from 2003 to 2009, and this was an incentive for a better definition of infection control priorities in high-risk departments. [ABSTRACT FROM AUTHOR]

This paper provides an analysis of the results of joint work of Russian and Congolese infectious disease specialists and epidemiologists to decipher the etiology and causes of the outbreak of intestinal infections in Dolisie (Republic of the Congo) in the summer of 2023. It has been found that the increase in the incidence of intestinal infections was caused mainly by the agents of typhoid fever and dysentery; tropical malaria was a combined pathology. No cases of cholera patient detection were registered. Failure of water supply system, domestic disrepair, and low public awareness about prevention of intestinal infections contributed to the active transmission of pathogens. The combination of epidemic process manifestations testified to the aquatic nature of the outbreak. Also, cases of pathogen transmission through contact household route were recorded, food transmission was not excluded. Patients with severe and complicated forms of typhoid fever and shigellosis accounted for 50 % of those hospitalized. There was delay in seeking medical care. The available regimens of antibacterial therapy were ineffective, since there was no possibility of laboratory confirmation of the diagnosis with determination of sensitivity to drugs. Uncontrolled treatment facilitated the emergence of antibiotic resistance in pathogens, prolonged bacterial release and subsequent spread of infection. Infectious disease specialists and epidemiologists of the Rospotrebnadzor provided consulting and practical assistance to Congolese colleagues, developed and presented recommendations for optimizing anti-epidemic and therapeutic measures, taking into account the results of assessment of the causes for onset and development of the outbreak.

Immunosuppression increases the risk of nosocomial infection in patients with chronic critical illness. This exploratory study aimed to determine the immunometabolic signature associated with nosocomial infection during chronic critical illness. We prospectively recruited patients who were admitted to the respiratory care center and who had received mechanical ventilator support for more than 10 days in the intensive care unit. The study subjects were followed for the occurrence of nosocomial infection until 6 weeks after admission, hospital discharge, or death. The cytokine levels in the plasma samples were measured. Single-cell immunometabolic regulome profiling by mass cytometry, which analyzed 16 metabolic regulators in 21 immune subsets, was performed to identify immunometabolic features associated with the risk of nosocomial infection. During the study period, 37 patients were enrolled, and 16 patients (43.2%) developed nosocomial infection. Unsupervised immunologic clustering using multidimensional scaling and logistic regression analyses revealed that expression of nuclear respiratory factor 1 (NRF1) and carnitine palmitoyltransferase 1a (CPT1a), key regulators of mitochondrial biogenesis and fatty acid transport, respectively, in natural killer (NK) cells was significantly associated with nosocomial infection. Downregulated NRF1 and upregulated CPT1a were found in all subsets of NK cells from patients who developed a nosocomial infection. The risk of nosocomial infection is significantly correlated with the predictive score developed by selecting NK cell-specific features using an elastic net algorithm. Findings were further examined in an independent cohort of COVID-19-infected patients, and the results confirm that COVID-19-related mortality is significantly associated with mitochondria biogenesis and fatty acid oxidation pathways in NK cells. In conclusion, this study uncovers that NK cell-specific immunometabolic features are significantly associated with the occurrence and fatal outcomes of infection in critically ill population, and provides mechanistic insights into NK cell-specific immunity against microbial invasion in critical illness. [ABSTRACT FROM AUTHOR]

During the Covid19 pandemic there has been much discussion about in-hospital procedures that may generate aerosols. One such procedure, that has led to confusion and concern, is nebulisation of children. In this paper, we discuss the evidence around whether nebulisation procedures generate aerosols, and offer strategies around nebulisation of children with asthma. [ABSTRACT FROM AUTHOR]

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Background and Aim: The variation of reported nosocomial infection is very high respectively. It seems review systematic and Meta analysis of related documents gives precise estimate of this subject for correct politisize. So tha aim of this study the review systematic and meta analysis of prevalence and causes of nosocomial infection in iran. Materials and Methods: For this study all articles published in Iranian journals and international journals, Final Report of Research Projects, related papers presented at congresses and thesis were reviewed with using standard and sensitive keywords. Then, all articles published between 1997-2010 years that had eligibility Inclusion criteria after quality control, using random model, intered to process of meta-analysis. Results: The finding show that the best estimate of total prevalence of nosocomial infection in Iran is 30.43% and the most common infections of nosocomial infection are respiratory infection 39.4%%, urinary infection 23.88%, bacteremia 21.98% and the most common factors of nosocomial infection are Pseudomonas aeroginosa 26.78%, klebsiella 31.42%, Staphylococcus 23.6% and E.coli 30.93%. The research also found a substantial heterogeneity that using meta regression method the main cause of produce of this heterogeneity, participants people, sample size, average age of the samples, time of study and gender were introduced. Conclusions: The simple review of studied documents in this survey show that prevalence rate of different nosocomial infection in Iran is high relatively. Hence make appropriate and evidence-based educational and control programs to reduce nosocomial infections prevalence rate in Iran should be considered by policy makers. [ABSTRACT FROM AUTHOR]

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The national and international guidelines recommend evaluating all healthcare workers (HCWs) for their measles immune status and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis in order to estimate the rate of measles susceptibility among HCWs in Italy and to explore possible options for the management of those found to be susceptible. Twenty-three studies were included in the meta-analysis. The prevalence of HCWs susceptible to measles was 11.5% (95%CI = 8.1–15.4%) and was higher in studies in which prevalence was evaluated by survey (16.7%; 95%CI = 8.9–26.3) than by the direct evaluation of blood specimens (9.1%; 95%CI = 6.2–12.5%). Occupational medicine examinations for measles screening with possible subsequent vaccination of seronegatives and the exclusion of susceptible HCWs from high-risk settings were common management strategies. HCWs susceptible to measles are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased. [ABSTRACT FROM AUTHOR]

Background: Hospital-acquired infections are recognized as a major risk factor in healthcare settings. Hand hygiene as the first stage of infection control plays an important role in reducing these infections. This study assesses the knowledge, attitudes, and practice regarding hand hygiene among nurses in intensive care units (ICUs) of Basrah City and Dhi Qar City, Iraq. Methods: This descriptive cross-sectional study targeted 231 ICU nursing staff working in hospitals of Al-Basra and Dhi-Qar in Iraq in 2022. The subjects were recruited through the census. To assess the nurses' hand hygiene knowledge, attitude, and practice, electronic questionnaires were administered via WhatsApp. The collected data were analyzed using descriptive statistics (absolute and relative frequency, Mean±SD) and inferential statistics (independent t-test, chisquare test, and Fisher test). The data analysis was performed using the SPSS software, version 22. Meanwhile, a significance level of <0.05 was considered for all statistical tests. Results: The mean scores (ranges) of nurses' hand hygiene knowledge, attitude, and practice were 4.74±1.82 (1-10), 77.25±7.89 (55-95), and 49.80±12.23 (21-70), respectively. There was a significant relationship between hand hygiene knowledge and gender, with female nurses' knowledge being higher compared to male nurses (P=0.03). Furthermore, nurses with less than 5 years of practical experience in the ICU had a higher mean score of attitudes toward hand hygiene compared to nurses with 5-10 years of practical experience (P=0.015). Additionally, nurses with less than 5 years of experience in the ICU showed a higher mean score of hand hygiene practice compared to nurses with more than 10 years of practical experience (P=0.028). Conclusion: According to the findings, the knowledge, attitude, and practice of ICU nurses about hand hygiene were inappropriate. It is necessary to implement educational programs to improve the knowledge, attitude, and practice of Iraqi ICU nurses in this area. [ABSTRACT FROM AUTHOR]

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This comprehensive review aims to provide a practical guide for intensivists, focusing on enhancing patient care associated with nosocomial peritonitis (NP). It explores the epidemiology, diagnosis, and management of NP, a significant contributor to the mortality of surgical patients worldwide. NP is, per definition, a hospital-acquired condition and a consequence of gastrointestinal surgery or a complication of other diseases. NP, one of the most prevalent causes of sepsis in surgical Intensive Care Units (ICUs), is often associated with multi-drug resistant (MDR) bacteria and high mortality rates. Early clinical suspicion and the utilization of various diagnostic tools like biomarkers and imaging are of great importance. Microbiology is often complex, with antimicrobial resistance escalating in many parts of the world. Fungal peritonitis and its risk factors, diagnostic hurdles, and effective management approaches are particularly relevant in patients with NP. Contemporary antimicrobial strategies for treating NP are discussed, including drug resistance challenges and empirical antibiotic regimens. The importance of source control in intra-abdominal infection management, including surgical and non-surgical interventions, is also emphasized. A deeper exploration into the role of open abdomen treatment as a potential option for selected patients is proposed, indicating an area for further investigation. This review underscores the need for more research to advance the best treatment strategies for NP. [ABSTRACT FROM AUTHOR]