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7. Infection prevention and control risk factors for SARS-CoV-2 infection in health workers: a global, multi-centre, case–control study

Author

Pejic, Aleksandra, Turmukhambetova, Anar, Omarkulov, Bauyrzhan, Carevic, Biljana, Mdziniso, Bawinile, Ebrahim, Faiqa Kassim, Habebe, Shambel, Conly, John, Tsekrekos, Stephen, Pinchera, Biagio, Gentile, Ivan, Villari, Paolo, Poscia, Roberto, Lia, Lorenza, Falasconi, Giuseppe, Torre, Giuseppe La, Filon, Francesca Larese, Porru, Stefano, Spiteri, Gianluca, Vatcheva-Dobrevska, Rossitza, Stefanowa, Petya, Dicheva, Violeta, Markovic-Denic, Ljiljana, Akhmaltdinova, Lyudmila, Ciofi degli Atti, Marta Luisa, Marusic, Vuk, Nikolic, Vladimir, Mioljevic, Vesna, Okwor, Tochi, Akande, Tosin, Ogboghodo, Esohe Olivia, Tyszkiewicz, Jerzy, Placha, Grzegorz, Alrstom, Ali, Abouharb, Raed, Hasan alzuhaily, Tarif, Ala bin, Bellizzi, Saverio, Ramadan, Mohannad, Tsereteli, David, Chakhunashvili, Giorgi, Pashalishvili, Mariam, Raka, Lul, Aregey, Aron, Verovchuk, Bohdan, Stetsyk, Vitalii, Novak, Tetiana, Hakim, Ferdous, Mostafa, Zaman, Shirin, Tahmina, Adsul, Balkrishna Bandu, Ahmad, Mohammed, Bhansali, Suman, Bilimale, Anil, Das, Pritimoy, Rahman, Mahbubur, Garat, Vaibhav G., Kaur, Ravneet, Kant, Shashi, Khapre, Meenakshi, George, Leyanna Susan, Narlawar, Uday, Rathod, Pragati, Rathod, Shyam, Retnakumar, Charutha, Patel, Prakash B., Sharma, Sarita, Saxena, Vartika, Tomy, Chitra, Wadhava, Sarita, Berba, Regina P., Therese G. Virata, Ma. Patricia, Sandejas, Joanne Carmela M., Cassini, A., Yin, M., Simniceanu, A., Gon, G., Cowling, B.J., and Allegranzi, B.

Published
2024
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8. Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis

Author

Fleischmann-Struzek, C., Mellhammar, L., Rose, N., Cassini, A., Rudd, K. E., Schlattmann, P., and Allegranzi, B.

Subjects
Mortality -- Germany -- Rwanda, Medical colleges -- Health aspects -- Analysis, Infection -- Health aspects -- Analysis, Health care industry, World Health Organization
Abstract

Purpose To investigate the global burden of sepsis in hospitalized adults by updating and expanding a systematic review and meta-analysis and to compare findings with recent Institute for Health Metrics and Evaluation (IHME) sepsis estimates. Methods Thirteen electronic databases were searched for studies on population-level sepsis incidence defined according to clinical criteria (Sepsis-1, -2: severe sepsis criteria, or sepsis-3: sepsis criteria) or relevant ICD-codes. The search of the original systematic review was updated for studies published 05/2015-02/2019 and complemented by a search targeting low- or middle-income-country (LMIC) studies published 01/1979-02/2019. We performed a random-effects meta-analysis with incidence of hospital- and ICU-treated sepsis and proportion of deaths among these sepsis cases as outcomes. Results Of 4746 results, 28 met the inclusion criteria. 21 studies contributed data for the meta-analysis and were pooled with 30 studies from the original meta-analysis. Pooled incidence was 189 [95% CI 133, 267] hospital-treated sepsis cases per 100,000 person-years. An estimated 26.7% [22.9, 30.7] of sepsis patients died. Estimated incidence of ICU-treated sepsis was 58 [42, 81] per 100,000 person-years, of which 41.9% [95% CI 36.2, 47.7] died prior to hospital discharge. There was a considerably higher incidence of hospital-treated sepsis observed after 2008 (+ 46% compared to the overall time frame). Conclusions Compared to results from the IHME study, we found an approximately 50% lower incidence of hospital-treated sepsis. The majority of studies included were based on administrative data, thus limiting our ability to assess temporal trends and regional differences. The incidence of sepsis remains unknown for the vast majority of LMICs, highlighting the urgent need for improved epidemiological sepsis surveillance., Author(s): C. Fleischmann-Struzek [sup.1], L. Mellhammar [sup.2], N. Rose [sup.1], A. Cassini [sup.3], K. E. Rudd [sup.4], P. Schlattmann [sup.5], B. Allegranzi [sup.3], K. Reinhart [sup.6] [sup.7] [sup.8] Author Affiliations: [...]

Published
2020
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16. Broadening the infection prevention and control network globally; 2017 Geneva IPC-think tank (part 3)

Author

Zingg, W, Storr, J, Park, BJ, Jernigan, JA, Harbarth, S, Grayson, ML, Tacconelli, E, Allegranzi, B, Cardo, D, Pittet, D, Abbas, M, Ahmad, R, Ailegranzi, B, Andremont, A, Bell, M, Borg, M, Carmeli, Y, Castro-Sanchez, E, Conly, J, Eggimann, P, Gastmeier, P, Hernandez, M, Hetwaldt, L, Holmes, A, Kilpatrick, C, Kolwaite, A, Krause, K-H, Larson, E, Masson-Roy, S, Mehtar, S, Mendelson, M, Lin, LM, Moldovan, A, Monnet, D, Ndoye, B, Nthumba, P, Ogunsola, F, Park, B, Perencevich, E, Samore, M, Seto, WH, Srinivasan, A, Tarrant, C, Tomczyk, S, Talaat, M, Villegas, MV, Voss, A, Walsh, T, Widmer, A, 2017 Geneva-IPC Think Tank, Abbas, M., Ahmad, R., Allegranzi, B., Andremont, A., Bell, M., Borg, M., Cardo, D., Carmeli, Y., Castro-Sanchez, E., Conly, J., Eggimann, P., Gastmeier, P., Grayson, M.L., Harbarth, S., Hernandez, M., Herwaldt, L., Holmes, A., Jernigan, J.A., Kilpatrick, C., Kolwaite, A., Krause, K.H., Larson, E., Masson-Roy, S., Mehtar, S., Mendelson, M., Lin, L.M., Moldovan, A., Monnet, D., Ndoye, B., Nthumba, P., Ogunsola, F., Park, B., Perencevich, E., Pittet, D., Samore, M., Seto, W.H., Srinivasan, A., Storr, J., Tacconelli, E., Tarrant, C., Tomczyk, S., Talaat, M., Villegas, M.V., Voss, A., Walsh, T., Widmer, A., Zingg, W., Abbas, Mohamed, Conly, John, Eggimann, Philippe, Krause, Karl-Heinz, Moldovan, Andréea Anamaria, Monnet, Dominique Ndiouga, Ndoye, Babacar, Tomczyk, Sara Marie, Widmer, Andréas, NIHR knowledge mobilisation fellowship, and National Institute for Health Research

Subjects
0301 basic medicine, Biomedical Research, Global Health, Antimicrobial Stewardship, WHO, 0302 clinical medicine, ECDC, Drug Resistance, Multiple, Bacterial, Infection control, Antimicrobial stewardship, Hand Hygiene, Pharmacology (medical), 030212 general & internal medicine, Pharmacology & Pharmacy, Intersectoral Collaboration, health care economics and organizations, Public, Environmental & Occupational Health, ddc:616, Cross Infection, Public relations, National, Institutional, Anti-Bacterial Agents, Infectious Diseases, International, Public Health, Life Sciences & Biomedicine, Switzerland, Microbiology (medical), medicine.medical_specialty, Infection prevention and control, 030106 microbiology, Control (management), 2017 Geneva-IPC Think Tank, Change, World Health Organization, Microbiology, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Patient safety, CDC, Collaboration, Networks, parasitic diseases, Control network, medicine, Humans, lcsh:RC109-216, cardiovascular diseases, Infection Control, Science & Technology, business.industry, Public health, Research, Public Health, Environmental and Occupational Health, International health, United States, Group Processes, QR, Stewardship, Centers for Disease Control and Prevention, U.S, business, RA
Abstract

Background Healthcare-associated infection (HAI) is a major challenge for patient safety worldwide, and is further complicated by antimicrobial resistance (AMR) due to excessive antimicrobial use in both humans and animals. Existing infection prevention and control (IPC) networks must be strengthened and adapted to better address the global challenges presented by emerging AMR. Methods In June 2017, 42 international experts convened in Geneva, Switzerland, to discuss two key areas for strengthening the global IPC network: 1) broadening collaboration in IPC; and 2) how to bring the fields IPC and AMR control together. Results The US Centers for Disease Prevention and Control, the European Centre for Disease Prevention and Control, and the World Health Organization (WHO) convened together with international experts to discuss collaboration and networks, demonstrating the participating organizations’ commitment to close collaboration in IPC. The challenge of emerging AMR can only be addressed by strengthening this collaboration across international organisations and between public health and academia. The WHO SAVE LIVES: Clean Your Hands initiative is an example of a successful collaboration between multiple global stakeholders including academia and international public health organisations; it can be used as a model. IPC-strategies are included within the four pillars to combat AMR: surveillance, IPC, antimicrobial and diagnostic stewardship, research and development. The prevention of transmission of multidrug-resistant microorganisms is a patient safety issue, and must be strengthened in the fight against AMR. Conclusions The working group determined that international organisations should take the lead in creating new networks, which will in turn attract academia and other stakeholders to join. At the same time, they should invest in bringing existing IPC and AMR networks under one umbrella. Transmission of multidrug-resistant microorganisms in hospitals and in the community threatens the success of antimicrobial stewardship programmes, and thus, research and development in IPC should be addressed as an enhanced global priority.

Published
2019

21. Technology for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva IPC-Think Tank (Part 2)

Author

Zingg, W., Park, B. J., Storr, J., Ahmad, R., Tarrant, C., Castro-Sanchez, E., Perencevich, E., Widmer, A., Krause, K-H., Kilpatrick, C., Tomczyk, S., Allegranzi, B., Cardo, D., Pittet, D., Abbas, M., Andremont, A., Bell, M., Borg, M., Carmeli, Y., Conly, J., Eggimann, P., Gastmeier, P., Grayson, M. L., Harbarth, S., Hernandez, M., Herwaldt, L., Holmes, A., Jernigan, J. A., Kolwaite, A., Larson, E., Masson-Roy, S., Mehtar, S., Mendelson, M., Lin, L. M., Moldovan, A., Monnet, D., Ndoye, B., Nthumba, P., Ogunsola, F., Samore, M., Seto, W. H., Srinivasan, A., Tacconelli, E., Talaat, M., Villegas, M. V., Voss, A., Walsh, T., NIHR knowledge mobilisation fellowship, Zingg, Walter, Cardo, Denise, Abbas, Mohamed, Conly, John, Eggimann, Philippe, Moldovan, Andréea Anamaria, Monnet, Dominique Ndiouga, Ndoye, Babacar, 2017 Geneva IPC-Think Tank, Abbas, M., Ahmad, R., Allegranzi, B., Andremont, A., Bell, M., Borg, M., Cardo, D., Carmeli, Y., Castro-Sanchez, E., Conly, J., Eggimann, P., Gastmeier, P., Grayson, M.L., Harbarth, S., Hernandez, M., Herwaldt, L., Holmes, A., Jernigan, J.A., Kilpatrick, C., Kolwaite, A., Krause, K.H., Larson, E., Masson-Roy, S., Mehtar, S., Mendelson, M., Lin, L.M., Moldovan, A., Monnet, D., Ndoye, B., Nthumba, P., Ogunsola, F., Park, B., Perencevich, E., Pittet, D., Samore, M., Seto, W.H., Srinivasan, A., Storr, J., Tacconelli, E., Tarrant, C., Talaat, M., Tomczyk, S., Villegas, M.V., Voss, A., Walsh, T., Widmer, A., and Zingg, W.

Subjects
Microbiology (medical), Technology, medicine.medical_specialty, Internationality, Infection prevention and control, Health Personnel, Best practice, media_common.quotation_subject, lcsh:Infectious and parasitic diseases, WHO, Antibiotic resistance, Medical microbiology, ddc:590, ECDC, Hygiene, Drug Resistance, Bacterial, Humans, Medicine, Infection control, lcsh:RC109-216, Pharmacology (medical), Microbiome, 2017 Geneva IPC-Think Tank, media_common, ddc:616, Cross Infection, Infection Control, Bacteria, business.industry, Research, Microbiota, Public health, Public Health, Environmental and Occupational Health, CDC, Copper, Hand hygiene, Whole genome sequencing, Antimicrobial, Anti-Bacterial Agents, Group Processes, QR, Infectious Diseases, Risk analysis (engineering), business, Switzerland
Abstract

Background The high burden of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) is partially due to excessive antimicrobial use both in human and animal medicine worldwide. How can technology help to overcome challenges in infection prevention and control (IPC) and to prevent HAI and emerging AMR? Methods In June 2017, 42 international experts convened in Geneva, Switzerland to discuss four potential domains of technology in IPC and AMR: 1) role and potential contribution of microbiome research; 2) whole genome sequencing; 3) effectiveness and benefit of antimicrobial environmental surfaces; and 4) future research in hand hygiene. Results Research on the microbiome could expand understanding of antimicrobial use and also the role of probiotics or even faecal transplantation for therapeutic purposes. Whole genome sequencing will provide new insights in modes of transmission of infectious diseases. Although it is a powerful tool for public health epidemiology, some challenges with interpretation and costs still need to be addressed. The effectiveness and cost-effectiveness of antimicrobially coated or treated environmental high-touch surfaces requires further research before they can be recommended for routine use. Hand hygiene implementation can be advanced, where technological enhancement of surveillance, technique and compliance are coupled with reminders for healthcare professionals. Conclusions The four domains of technological innovation contribute to the prevention of HAI and AMR at different levels. Microbiome research may offer innovative concepts for future prevention, whole genome sequencing could detect new modes of transmission and become an additional tool for effective public health epidemiology, antimicrobial surfaces might help to decrease the environment as source of transmission but continue to raise more questions than answers, and technological innovation may have a role in improving surveillance approaches and supporting best practice in hand hygiene.

Published
2019

33. Human factors design

Author

Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Clack, L; https://orcid.org/0000-0002-5162-5188, Sax, H, Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Clack, L; https://orcid.org/0000-0002-5162-5188, and Sax, H

Published
2017

34. Behavior and Hand Hygiene

Author

Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), McLaws, M L, Sax, H, Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), McLaws, M L, and Sax, H

Published
2017

35. Performance feedback

Author

Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Stewardson, Andrew James, Sax, Hugo, Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Stewardson, Andrew James, and Sax, Hugo

Published
2017

36. Monitoring hand hygiene performance

Author

Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Sax, H, Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), and Sax, H

Published
2017

37. Marketing hand hygiene

Author

Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Storr, J, Sax, H, Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Storr, J, and Sax, H

Published
2017

38. My Five Moments for Hand Hygiene

Author

Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), Sax, H, Pittet, D, Boyce, J M, Allegranzi, B, Pittet, D ( D ), Boyce, J M ( J M ), Allegranzi, B ( B ), and Sax, H

Published
2017

40. Control of Carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa in Healthcare Facilities: A Systematic Review and Reanalysis of Quasi-experimental Studies

Author

Tomczyk, S, Zanichelli, V, Grayson, ML, Twyman, A, Abbas, M, Pires, D, Allegranzi, B, Harbarth, S, Tomczyk, S, Zanichelli, V, Grayson, ML, Twyman, A, Abbas, M, Pires, D, Allegranzi, B, and Harbarth, S

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPsA) are a serious cause of healthcare-associated infections, although the evidence for their control remains uncertain. We conducted a systematic review and reanalysis to assess infection prevention and control (IPC) interventions on CRE-CRAB-CRPsA in inpatient healthcare facilities to inform World Health Organization guidelines. Six major databases and conference abstracts were searched. Before-and-after studies were reanalyzed as interrupted time series if possible. Effective practice and organization of care (EPOC) quality criteria were used. Seventy-six studies were identified, of which 17 (22%) were EPOC-compatible and interrupted time series analyses, assessing CRE (n = 11; 65%), CRAB (n = 5; 29%) and CRPsA (n = 3; 18%). IPC measures were often implemented using a multimodal approach (CRE: 10/11; CRAB: 4/5; CRPsA: 3/3). Among all CRE-CRAB-CRPsA EPOC studies, the most frequent intervention components included contact precautions (90%), active surveillance cultures (80%), monitoring, audit and feedback of measures (80%), patient isolation or cohorting (70%), hand hygiene (50%), and environmental cleaning (40%); nearly all studies with these interventions reported a significant reduction in slope and/or level. The quality of EPOC studies was very low to low.

Published
2019

45. Implementing infection prevention practices across European hospitals: an in-depth qualitative assessment

Author

Clack, Lauren, Zingg, Walter, Saint, Sanjay, Casillas, Alejandra, Touveneau, Sylvie, Jantarada, Fabrico, Willi, Ursina, van der Kooi, Tjallie, Damschroder, Laura, Forman, Jane, Harrod, Molly, Krein, Sarah, Pittet, Didier, Sax, Hugo, Ahmad, Raheelah, Allegranzi, B, Cookson, Bary, Dettenkofer, M, Gastmeier, Petra, Grundmann, H, Hansen, Sonia, Heczko, P, Holmes, Alison, Kyratsis, Yiannis, Magiorakos, A, Martin, M, Richet, H, Szilágyi, E, van Benthem, B, Wu, Albert, Organization Sciences, Organization & Processes of Organizing in Society (OPOS), Network Institute, University of Zurich, and Sax, Hugo

Subjects
Male, medicine.medical_specialty, Infection Prevention and Control, Attitude of Health Personnel, 610 Medicine & health, Complex interventions, Infection Prevention and Control, Implementation, Hospitals, Europe, Organization, Complex Interventions, Interviews as Topic, 10234 Clinic for Infectious Diseases, 03 medical and health sciences, 0302 clinical medicine, Complex Interventions, Intervention (counseling), Bloodstream infection, Acute care, Humans, Infection control, Stepped wedge, Medicine, 030212 general & internal medicine, Qualitative Research, Original Research, ddc:616, implementation science, Cross Infection, business.industry, 030503 health policy & services, Health Policy, infection control, 2719 Health Policy, Hospitals, 3. Good health, Hospital medicine, hospital medicine, Europe, Knowledge, Family medicine, Implementation, Communicable Disease Control, HD28, Female, 0305 other medical science, business, RA, Organization, Qualitative research
Abstract

ObjectiveThe Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project included a cluster-randomised, stepped wedge, controlled study to evaluate multiple strategies to prevent catheter-related bloodstream infection. We report an in-depth investigation of the main barriers, facilitators and contextual factors relevant to successfully implementing these strategies in European acute care hospitals.MethodsQualitative comparative case study in 6 of the 14 European PROHIBIT hospitals. Data were collected through interviews with key stakeholders and ethnographic observations conducted during 2-day site visits, before and 1 year into the PROHIBIT intervention. Qualitative measures of implementation success included intervention fidelity, adaptation to local context and satisfaction with the intervention programme.ResultsThree meta-themes emerged related to implementation success: ‘implementation agendas’, ‘resources’ and ‘boundary-spanning’. Hospitals established unique implementation agendas that, while not always aligned with the project goals, shaped subsequent actions. Successful implementation required having sufficient human and material resources and dedicated change agents who helped make the intervention an institutional priority. The salary provided for a dedicated study nurse was a key facilitator. Personal commitment of influential individuals and boundary spanners helped overcome resource restrictions and intrainstitutional segregation.ConclusionThis qualitative study revealed patterns across cases that were associated with successful implementation. Consideration of the intervention–context relation was indispensable to understanding the observed outcomes.

Published
2018

46. Educating healthcare workers to optimal hand hygiene practices: addressing the need

Author

Mathai, E., Allegranzi, B., Seto, W., Chraïti, M.-N, Sax, H., Larson, E., and Pittet, D.

Abstract

The education of healthcare workers is essential to improve practices and is an integral part of hand hygiene promotional strategies. According to the evidence reviewed here, healthcare worker education has a positive impact on improving hand hygiene and reducing healthcare-associated infection. Detailed practical guidance on steps for the organization of education programmes in healthcare facilities and teaching-learning strategies are provided using the World Health Organization (WHO) Guidelines for Hand Hygiene in Health Care as the basis for recommendations. Several key elements for a successful educational programme are also identified. A particular emphasis is placed on concepts included in the tools developed by WHO for education, monitoring and performance feedback

Published
2018

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