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Background: Antimicrobial resistance has become an urgent global health priority. Basic hygiene practices and cleaning and disinfection of the hospital environment are key in preventing pathogen cross-transmission.Aim: To our knowledge no studies have assessed the worldwide differences in cleaning and disinfection practices in healthcare facilities. The electronic survey described here was developed in order to evaluate differences in healthcare facility cleaning practices around the world.Methods: The International Society of Antimicrobial Chemotherapy (ISAC, formerly ISC), Infection Prevention and Control work group developed a survey with 30 multiple-choice questions. The questions were designed to assess the current cleaning practices in healthcare settings around the world.Findings: A total of 110 healthcare professionals, representing 23 countries, participated in the online survey. In 96% of the facilities a written cleaning policy was present. Training of cleaning staff occurred in 70% of the facilities at the start of employment. Cleaning practices and monitoring of these practices varied.Conclusions: The survey enabled assessment and recognition of widely differing global practices in approaches to environmental cleaning and disinfection. Development of guideline recommendations for cleaning and disinfection could improve practices and set minimum standards worldwide. [ABSTRACT FROM AUTHOR]

Objective: The skin disinfectant '0.5% chlorhexidine gluconate in 70% alcohol' (0.5% CHG-70% alc) may cause skin lesions in extremely preterm infants (gestational age <26 weeks). In April 2013, 0.2% chlorhexidine gluconate solution in acetate (0.2% CHG-acetate) was introduced as skin disinfectant for extremely preterm infants in our neonatal intensive care units. We aimed to compare the incidence of skin lesions and central line-associated bloodstream infection (CLABSI) among extremely preterm infants when using 0.5% CHG-70% alc and 0.2% CHG-acetate.Design: Retrospective pre-post comparison cohort study.Patients: All electronic patient records of extremely preterm infants born between January 2011-March 2013 ('0.5% CHG-70% alc' cohort) and April 2013-October 2015 ('0.2% CHG-acetate' cohort) were reviewed.Main Outcome Measures: The incidence of skin lesions and CLABSI. Skin lesions were defined as the presence of erythema, blisters, excoriation, oedema or induration. CLABSI was defined according to the definition of the US Centers for Disease Control and Prevention.Results: The incidence of skin lesions was 22% (95% CI 11% to 37%) in the '0.5% CHG-70% alc' cohort (n=41) and 5% (95% CI 1% to 15%; p=0.02) in the '0.2% CHG-acetate' cohort (n=41). The incidence of CLABSI was the same in both groups (28%; 95% CI 14% to 46% in '0.5% CHG-70% alc' vs 27%; 95% CI 14% to 44% in '0.2% CHG-acetate'; p=0.98).Conclusions: Using 0.2% CHG-acetate as skin disinfectant in extremely preterm infants resulted in statistically significant reduction of skin lesions, without increasing the risk of CLABSI as compared with 0.5% CHG-70% alc. [ABSTRACT FROM AUTHOR]

The emergence of Carbapenem-resistant Acinetobacter baumannii is a threat to modern medicine and has been recognised globally. Epidemic clones of A.baumannii are associated with hospital epidemics throughout the world causing serious ramifications. There are number of molecular typing techniques used for molecular characterisation, however, due to lack of resources molecular epidemiology remains unfledged in developing countries. In this study a total number of 205 carbapenem-resistant Acinetobacter species were collected and compared with European Clone I, II and III. PCR for and blaOXA-51-like was performed for confirmation and multiplex PCR was performed for blaOXA-23-like, blaOXA- 24-like and blaOXA-58-like genes. Isolates harbouring carbapenemases were selected for molecular typing using PFGE, RAPD-PCR and REP-PCR and discriminatory index was performed. The cost of all molecular typing methods was calculated. The blaOXA-51-like gene was present in 188 (91.7%), and within these 188 isolates; blaOXA-23-like 36(19%), blaOXA-24-like 62(33%), 30(16%) carried blaOXA-58-like genes. PFGE typing revealed 13 clusters and 15 unique types, RAPD-PCR, 11 clusters and 23 unique types and REP-PCR, 8 clusters and no unique types. With 80% similarity cut-off value, 11 isolates were similar to EU clone I, 5 isolates were similar to EU II and 3 isolates were similar to EU III. Cost of molecular methods was compared between PFGE, RAPD-PCR and REP-PCR. PFGE was found to have high discriminatory power and RAPD-PCR was economical. [ABSTRACT FROM AUTHOR]

The current COVID-19 pandemic has led to a worldwide shortage of respiratory protective equipment. In order to offer maximum protection against infection for all healthcare workers, we need to optimise our use of the available equipment. This article provides practical advice on which type of mask is indicated in what specific situation, what requirements the mask should meet and how to optimise the local workflow, including the re-use of masks after decontamination.

Healthcare workers (n = 803) with mild symptoms were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 90 positive) and asked to complete a symptom questionnaire. Anosmia, muscle ache, ocular pain, general malaise, headache, extreme tiredness and fever were associated with positivity. A predictive model based on these symptoms showed moderate discriminative value (sensitivity: 91.2%; specificity: 55.6%). While our models would not justify presumptive SARS-CoV-2 diagnosis without molecular confirmation, it can contribute to targeted screening strategies.

Background: The full-length (L-) variant of caspase-12 is believed to predispose to sepsis. It has been replaced in the genome of most human populations by the (S-) variant, which leads to premature termination of translation. Strikingly, the L-allele is still widely prevalent in African populations, presumably due to a counterbalancing selective force specific to this continent, for which malaria is a prime candidate., Methods: We investigated associations between caspase-12 genotype and malarial parameters in three West-African populations, in studies encompassing immunological, clinical and obstetric data., Results: The caspase-12 L-allele was found at frequencies of 11-34%. Plasmodium falciparum-stimulated mononuclear cells from S/L heterozygote donors produced stronger interferon-gamma and interleukin-10 responses than S/S homozygotes (p = 0.011 and p = 0.023 in uninfected and infected donors respectively). Nevertheless, we found no association between caspase-12 genotype and either the presentation of severe malaria or individual clinical parameters in sick children. Amongst pregnant women, the caspase-12 genotype did not influence peripheral or placental malaria infection, or basic obstetric parameters. Interestingly, perinatal mortality was more frequent in children of both S/S and L/L than S/L mothers, independent of placental P. falciparum-infection., Conclusion: We find little clinical or epidemiological evidence that malaria has contributed to the persistence of functional caspase-12 in Africa, suggesting either that alternative selective forces are at work or that genetic drift underlies its current global distribution.