Search

Widespread use of antimicrobials in human and veterinary medicine drives the emergence and dissemination of resistant bacteria in human, animal, and environmental reservoirs. The AVMA and FDA Center for Veterinary Medicine have both taken public positions emphasizing the importance of incorporating antimicrobial stewardship in veterinary clinical settings; however, a model for implementing a comprehensive antimicrobial stewardship program in veterinary practice is not readily available. In 2015, The Ohio State University College of Veterinary Medicine began developing a veterinary antimicrobial stewardship program modeled on existing programs in human health-care institutions and the 7 core elements of a successful hospital antimicrobial stewardship program, as defined by the CDC. The program includes comprehensive antimicrobial use guidelines, active environmental surveillance, and enhanced infection control procedures in The Ohio State University Veterinary Medical Center, along with routine monitoring and reporting of antimicrobial prescribing practices and antimicrobial susceptibility patterns of common pathogens isolated from patients and the hospital environment. Finally, programs have been developed to educate clinicians, staff, and students on antimicrobial resistance and appropriate antimicrobial prescribing practices. The antimicrobial stewardship program has been designed to help clinicians and students confidently make judicious antimicrobial use decisions and provide them with actionable steps that can help them act as strong stewards while providing the best care for their patients. This report describes our program and the process involved in developing it, with the intent that the program could serve as a potential model for other veterinary medical institutions.

Aims and objectives: Infection control is an essential part in dental practices. Potential disease transmission in the dental lab is well documented. Dental technicians should strictly adhere to the standard precautions in order to prevent potential risks of cross-contamination, thereby producing a safe environment for patients and staff. The aim of this study was to evaluate the knowledge, attitude, and practice among dental lab technicians toward infection control protocols at the dental laboratories of Riyadh. Materials and methods: A self-administered questionnaire will be distributed to dental lab technicians working at both private and governmental laboratories in Riyadh, Saudi Arabia. Data were collected from one hundred and twenty-one dental laboratory technicians. Results: According to the findings, only 42.9% had an infection control manual display in the dental lab, 43.8% had received infection control training courses as part of their orientation, 40.4% of the technicians had a valid hepatitis B vaccination. Dental technicians are exposed to high risk of injuries, 72.7% of respondents answered Yes, when they were asked about reporting sharp injuries to laboratory administration. Conclusion: There was poor compliance to infection control procedures, dental techniques are at increased risk of cross-contamination and infection, they have limited orientation and knowledge on the infection control guideline and policy.

Background: Dental clinic is an environment which poses potential risk for disease transmission both for dentists and their patients. Hence a study was planned to assess knowledge and attitude of undergraduate dental students in Davangere city about infection control in dental practice.Methods: A descriptive cross-sectional survey was conducted among 258 undergraduate dental students in Davangere city. A 21-item prevalidated structured close ended questionnaire was administered to the participants. Data was analyzed using chi-square test. Statistical significance was set at p ≤ 0.05.Results: Out of 258 participants, 62% were females and belonged to third year (54%). Majority of them had good knowledge (>90%) about infection control in dental practice and more than 90% believed that dentists had a risk of acquiring HIV and Hepatitis infection and felt hepatitis vaccination was mandatory. More than 80% of them used gloves, face masks, head cap and gown, washed hands before and after examining patient and were willing to implement and follow the infection control procedures in clinical practice. However, majority did not wear eye protective glasses (>80%) and 90% had experienced non-sterile occupational percutaneous injury which was a cause of concern.Conclusion: The knowledge of dental undergraduate students about infection control measures in dental practice was good. However, many reported non-sterile occupational injuries during clinical practice.

Jenny Nixon explains why informing your patients about infection control procedures will reassure them it's safe to visit

Besides its effects on physical health, the coronavirus disease 2019 (COVID-19) pandemic has resulted in adverse consequences on mental health of health-care workers. Several factors such as safety concerns and fear of infecting self or family members, social isolation measures, strict infection control procedures, lack of protective measures, exhaustion due to increased duration of working, and seeing patients die or colleagues infected can contribute to the development of mental health problems in health-care workers during the current COVID-19 pandemic. Some health-care staff including nurses, advanced practice providers, frontline health-care workers, and health-care workers who have children are more vulnerable to these mental health problems. Prevention of infection and staff burnout in health-care workers, provision of a timely mental health care, and social support are among the most important measures to provide a mental health care for health-care workers during the current COVID-19 pandemic.

Insufficiently protected healthcare workers (HCWs), defined as high-risk contacts of patients with coronavirus disease 2019 (COVID-19), are routinely quarantined. This study evaluated the transmission of infection from a symptomatic patient with COVID-19 to 60 HCWs exposed at ≤2 m for ≥15 min or during aerosol-generating procedures. Following ≥106 unique high-risk contacts, none of the HCWs tested positive for severe acute respiratory syndrome coronavirus-2 RNA or developed antibodies. The HCWs reported adherence to basic infection control procedures. These results are in accordance with other reports, and should reassure HCWs and further stimulate broader evaluation of the foundation for the current practice of home quarantining non-symptomatic HCWs.

Background COVID-19 required rapid innovation in health systems, in the context of an infection which placed healthcare professionals at high risk; general practice has been a key component of that innovative response. In Ireland, GPs were asked to work in a network of community assessment hubs. A focused training programme in infection control procedures/clinical use of personal protective equipment (PPE) was rapidly developed in advance. University departments of general practice were asked to develop and deliver that training. Aim The aim of this article is to describe infection control procedure training in Ireland, the uptake by GPs and the initial experience of GPs working in this unusual environment. Design and setting Two anonymous cross-sectional online surveys are sent to participants in training courses. Method Survey 1 followed completion of training; survey 2 followed establishment of the hubs. Results Six hundred seventy-five participants (including 439 GPs, 156 GP registrars) took part in the training. Two hundred thirty-nine (50.3%) out of four hundred seventy-five responded to Survey 1-over 95% reported an increase in confidence in the use of PPE. Two hundred ten (44.2%) out of four hundred seventy-five participants responded to Survey 2; 195 had completed hub shifts. Younger, female GPs predominated. Very high levels of infection control procedures were reported. Participants commented positively on teamworking, environment and systems. However, 'real-time' ambulance service data suggest the peak of the surge may have passed by the time the hubs were established. Conclusion Academic departments, GPs and the Irish health system collaborated effectively to respond to the need for community assessment of COVID-19 patients.

The Nasometer is a popular instrument for the acoustic assessment of nasality. In light of the currently ongoing COVID-19 global pandemic, clinicians may have wondered about the infection control procedures for the Nasometer. The current research investigated whether nasalance scores are affected if the Nasometer 6450 microphone casings are covered with a material such as rolled polyvinyl chloride household wrap. For the experiment, pre-recorded sound files from two speakers were played back through a set of small loudspeakers. Nasalance scores from two baselines and three wrap cover conditions were compared. While there was no statistically significant condition effect in a repeated-measures analysis of variance, the within-condition cumulative differences in nasalance scores were 2 for the initial baseline, 42 for wrap cover 1, 24 for wrap cover 2, 78 for wrap cover 3, and 8 for the final baseline. Mean differences between the wrap cover and the baseline conditions were 8.2 to 15.3 times larger, and cumulative differences were 8.3 to 16.6 times larger than between the two baselines. Based on the higher cumulative and mean differences observed, clinicians should not cover Nasometer microphones with household wrap as this increases variability of nasalance scores. Since there is evidence that the COVID-19 virus can survive for some time on metal surfaces, clinicians should be mindful of the fact that the Nasometer microphone housings can only be cleaned superficially and should be handled with gloves to minimize any possible risk of touch transfer of pathogens to the next speaker or the clinician.

Background A variety of public health measures have been implemented during the COVID-19 pandemic in Canada to reduce contact between individuals. The objective of this study was to provide empirical contact pattern data to evaluate the impact of public health measures, the degree to which social contacts rebounded to normal levels, as well as direct public health efforts toward age- and location-specific settings. Methods Four population-based cross-sectional surveys were administered to members of a paid panel representative of Canadian adults by age, gender, official language, and region of residence during May (Survey 1), July (Survey 2), September (Survey 3), and December (Survey 4) 2020. A total of 4981 (Survey 1), 2493 (Survey 2), 2495 (Survey 3), and 2491 (Survey 4) respondents provided information about the age and setting for each direct contact made in a 24-h period. Contact matrices were constructed and contacts for those under the age of 18 years imputed. The next generation matrix approach was used to estimate the reproduction number (Rt) for each survey. Respondents with children under 18 years estimated the number of contacts their children made in school and extracurricular settings. Results Estimated Rt values were 0.49 (95% CI: 0.29–0.69) for May, 0.48 (95% CI: 0.29–0.68) for July, 1.06 (95% CI: 0.63–1.52) for September, and 0.81 (0.47–1.17) for December. The highest proportion of reported contacts occurred within the home (51.3% in May), in ‘other’ locations (49.2% in July) and at work (66.3 and 65.4% in September and December). Respondents with children reported an average of 22.7 (95% CI: 21.1–24.3) (September) and 19.0 (95% CI 17.7–20.4) (December) contacts at school per day per child in attendance. Conclusion The skewed distribution of reported contacts toward workplace settings in September and December combined with the number of reported school-related contacts suggest that these settings represent important opportunities for transmission emphasizing the need to support and ensure infection control procedures in both workplaces and schools.

Background Safety of care is an essential aim of a healthcare system, even during a pandemic. Incident reporting (IR) is an important safety tool to identify system failures. This study evaluates the impact of SARS-COV-2 pandemic on IR trend in the COVID-19 wards of an Italian Academic Hospital (AH) in Italy. Methods The study analyzed the IR submitted by the wards of Infectious Diseases (ID), Intensive Care Unit (ICU), Pneumology (P) and Emergency Room (ER) of the AH of Udine from 2016 to 2020. For each ward, IR of 2020 were compared to IR of 2016-2019 period, expressed as the mean value. The IR's topics of ER unit, classified according to the International Standards of Patient Safety, were compared between 2019 and 2020. Variation in reporting was assessed using Chi-square tests. Results During 2020, 180 incidents were reported, 81.7% of which submitted by ER unit. Three wards showed a decrease in reporting compared to 2016-2019 period: -18% (7vs8,5) for ID unit, -26% (16v21,7) for ICU and -44% (10vs18) for P unit. ER unit, instead, showed a great IR increase (147vs49; +200%). Considering the reporting from 2016 to 2019, 196 out of 389 (50.4%) of IR came from ER unit. Analyzing the difference in reporting in ER unit between 2019 and 2020, the IR topics regarding “Delay in execution and reporting exams” increase from 2 to 21 (p < 0,05), “Lack of human and/or instrumental resources” from 4 to 29 (p < 0,05) and “Prevention and Control of Hospital Infectious” from 0 to 13 (p < 0,05). Conclusions ER unit showed a higher attitude in reporting than the other considered wards, especially during the COVID-19 period, recognizing IR as an important tool to highlight critical issues. This aspect may reflect the stronger safety culture already present in this unit. SARS-COV-2 pandemic stressed in ER needs of human resources to cope with reorganization determined by COVID-19, rapid covid-test results for the patient's care path definition, implementation of infection control procedures. Key messages A solid safety culture may contribute to maintain high levels of IR even while during challenging times for healthcare systems. Difference in reporting among Covid wards could be explained by a different level of Safety Culture.

Because severe acute respiratory coronavirus virus 2 (SARS-CoV-2) spreads easily and healthcare workers are at increased risk of both acquiring and transmitting infection, all healthcare facilities must rapidly and rigorously implement the full hierarchy of established infection controls: source control (removal or mitigation of infection sources), engineering and environmental controls, administrative controls, and personal protective equipment.

Severe acute respiratory syndrome coronavirus (SARS-CoV), emerged from China and rapidly spread worldwide. Over 8098 people fell ill and 774 died before the epidemic ended in July 2003. Bats are likely an important reservoir for SARS-CoV. SARS-like CoVs have been detected in horseshoe bats and civet cats. The main mode of transmission of SARS-CoV is through inhalation of respiratory droplets. Faeco-oral transmission has been recorded. Strict infection control procedures with respiratory and contact precautions are essential. Fever and respiratory symptoms predominate, and diarrhea is common. Treatment involves supportive care. There are no specific antiviral treatments or vaccines available.

Aim: Infection control is crucial in any clinical setting. It is vital that all dentists must follow the infection control protocols in their clinics to prevent cross-infection. In a dental clinic, even simple dental procedures including extractions, scaling and root planning, dental crown preparations and root canal treatment, have a high risk of exposure to blood, which may cause transmission blood-borne diseases. Dentist’s compliance with these guidelines and recommendations have been recently studied in different parts of the world. Hence this study was performed to evaluate the knowledge, attitude, and practice regarding infection control measures among private dental practioners in Karachi, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: This study was conducted for a period of four months in Karachi, Pakistan. Materials and Methods: Present cross–sectional study was performed by interviewing 234 dentists via a questionnaire based upon various questions regarding infection control. Sample were collected using convenience sampling, from private dental clinics in Karachi, Pakistan. Setting: Questionnaire were sent to 400 general dentist in Karachi, out of which 234 replied. Results: Mostly (69%) dentists who took part in the study were males. Regarding infection control, most of the individuals had a comprehensive understanding of infection control techniques. Isolation was considered to play a vital role in cross-infection prevention by 97.3% of the dentists. 93.2% used autoclave for sterilization and majority had thorough knowledge of the process involved. Regarding preventive measures, 66.7% of the dentists were vaccinated against major infectious agents in our society and 92.2% took protective measures required to prevent cross-infection. Conclusion: Knowledge, attitudes and practices regarding infection control of dentists in private clinic of Karachi, Pakistan are satisfactory.

Background: Patients admitted to intensive care units (ICUs) are at a greatest risk of health care associated infections (HAIs). Adherence to infection control (IC) precautions helps to prevent HAIs. Objective(s): To assess the infection control (IC) procedures and practices in intensive care units (ICUs). Methods: A cross sectional survey was conducted in ICUs of Althawra General Hospital in Sana'a, Republic of Yemen. All ICUs and their managers (n=12) and health care workers (n=200) made the target of the study. Data were collected using the IC assessment tool designed by the United States Agency for International Development (US-AID). It comprises modules for IC procedures and observation checklists for IC practices. Results: The IC procedures were poor regarding hand hygiene practices (49.1%), injection practices (25%), and type of catheters used in ICUs (16.7%). The IC practices of HCWs were poor regarding hand hygiene practices (30.2% in 46% of the ICUs), injection administration practices (35.7% in 34.5% of the ICUs) and waste disposal practices (23.5% in 92.5% of the ICUs). Conclusion: Infection control procedures and practices in ICUs of Althawra General Hospital were poor with respect to injection practices, type of catheters used in ICUs, hand hygiene practices, injection administration, and waste disposal. Recommendations: Improving the IC procedures regarding hand hygiene practices, injection practices, and type of catheters used in ICUs and addressing the IC practices of HCWs is a necessity.

Introduction: Endoscopy is a diagnostic procedure in which a flexible fiber optic tube passed into the esophagus, stomach and upper small intestine depending on the level at which lesions are anticipated. Because flexible endoscopes enter body cavities, they may acquire high levels of microbial contamination. Organic material (eg, blood, feces, and respiratory secretions) that collects in the channels and parts of the endoscope can be difficult to be removed. Aim of work: To assess nurses’ knowledge and practice regarding infection control procedures during GIT endoscopies, to assess nurses’ knowledge and practice regarding universal precautions during reprocessing techniques of GIT endoscopies, to evaluate the effect of training program on nurses’ knowledge and practice regarding infection control procedures and endoscopies reprocessing procedures. Materials and methods: An experimental study (pre-post test) was conducted in GIT endoscopy unit in General Surgery department, Zagazig University Hospitals. All endoscopy nursing staff (38 nurses) who is dealing with endoscopies reprocessing were included in the study. First tool was questionnaire sheet, to assess nurses’ knowledge. The second tool was observational checklist to assess nurses’ practice. The study was carried out on 3 stages: I- pre-intervention stage, II- Intervention stage (by implementation of the educational program), III- Post-intervention stage. Results: The study sample of nurses consisted of 38 female nurses with mean age 36.8 ± 6.1 years. There was an improvement in total level of nurses’ knowledge and practice regarding infection control with highly statistically significant difference before and after implementation of the educational program as regarding infection control, precautions post endoscopy procedures (endoscopy reprocessing). Conclusion: The study concludes that relatively short-term in-service training can significantly improve nurses’ knowledge and practice concerning infection control procedures and endoscopies reprocessing techniques in GIT endoscopy unit. It is a must to keep reinforcing the knowledge and practice regarding infection control.

Purpose of review The purpose of the review is to provide an update on control measures for norovirus (NoV), which is the most commonly implicated pathogen in acute gastroenteritis and outbreaks, causing major disruption in nurseries, schools, hospitals and care homes. Recent findings Important developments include the discovery that virus particles, previously considered to be the infectious unit, also occur in clusters, which appear to be more virulent than individual virus particles; a working culture system using human stem-cell derived enteroids; promising results from early phase clinical trials of candidate NoV vaccines, which appear to be safe and immunogenic; chronic NoV affects patients with primary and secondary immune deficiencies. Although several treatments have been used none are supported by well designed clinical trials; infection control procedures are effective if properly implemented. Summary NoV remains an important cause of morbidity and mortality. Although there are exciting developments on the vaccine front, the mainstay of control remains good hand hygiene, adherence to infection control procedures and limiting contamination of food, water and the wider environment. Once vaccines are available there will be important decisions to be made about how best to implement them.

Synthetic textiles such as polyester could potentially act as fomites of human coronaviruses, indicating the importance of infection control procedures during handling of contaminated textiles prior to laundering. This study provides novel evidence that human coronaviruses can persist on textiles for up to 3 days and are readily transferred from polyester textile to other surfaces after 72 h of incubation., Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persists on stainless steel and plastic for up to 7 days, suggesting that coronavirus disease 2019 (COVID-19) could be spread by fomite transmission. There is limited research on the stability of SARS-CoV-2 on textiles, with the risk of textiles acting as fomites not being well understood. To date, there does not appear to be any published research on the stability of coronaviruses during laundering, which is required to determine the efficacy of current laundering policies in the decontamination of health care textiles. The aim of this study was to investigate the environmental stability of human coronaviruses HCoV-OC43 and HCoV-229E on different textile fiber types and the persistence of HCoV-OC43 on textiles during domestic and industrial laundering. This study demonstrated that human coronaviruses (5 log10 50% tissue culture infective doses [TCID50]) remain infectious on polyester for ≥72 h, cotton for ≥24 h, and polycotton for ≥6 h; HCoV-OC43 was also able to transfer from polyester to PVC or polyester after 72 h. Under clean conditions, HCoV-OC43 was not detectable on cotton swatches laundered with industrial and domestic wash cycles without temperature and detergent (≥4.57-log10-TCID50 reduction), suggesting that the dilution and agitation of wash cycles are sufficient to remove human coronaviruses from textiles. In the presence of interfering substances (artificial saliva), ≤1.78 log10 TCID50 HCoV-OC43 was detected after washing domestically without temperature and detergent, unlike industrial laundering, where the virus was completely removed. However, no infectious HCoV-OC43 was detected when washed domestically with detergent. IMPORTANCE Synthetic textiles such as polyester could potentially act as fomites of human coronaviruses, indicating the importance of infection control procedures during handling of contaminated textiles prior to laundering. This study provides novel evidence that human coronaviruses can persist on textiles for up to 3 days and are readily transferred from polyester textile to other surfaces after 72 h of incubation. This is of particular importance for the domestic laundering of contaminated textiles such as health care uniforms in the United Kingdom and United States, where there may be a risk of cross-contaminating the domestic environment. It was demonstrated that human coronaviruses are removed from contaminated textiles by typical domestic and commercial wash cycles, even at low temperatures without detergent, indicating that current health care laundering policies are likely sufficient in the decontamination of SARS-CoV-2 from textiles.

While the effects of cleaning and disinfection practices on the reduction of environmental nosocomial bacteria are well-established in human and large animal veterinary hospitals, how animal movements within animal health care facilities influence environmental bacterial recovery is poorly understood. During three consecutive weeks, 155 electrostatic wipes were collected from the environment pre- and post-cleaning only or following disinfection from seven target locations within an animal shelter. All samples were cultured, and isolates were identified using a matrix-assisted laser desorption ionization—time of flight mass spectrometry. Social network analysis of animal movements during the sampling period was performed to estimate the level of connectivity of the seven target locations. The relationship between bacterial levels and connectivity estimates of the target locations were investigated using a negative binomial regression model with a random effect of sampling areas. Overall, our results indicate a significant reduction in the total bacterial contamination with disinfection when compared to cleaning only [Coefficient (Coef.) = −1.72, 95% Confidence Interval (CI) = −3.09, −0.34, P = 0.015]. Higher total bacterial contamination was significantly more likely in sampled areas with less animal movement connectivity (Coef. = −0.32, 95% CI = −0.49, −0.15, P ≤ 0.001). Pseudomonas aeruginosa and ampicillin resistant Enterobacteriaceae (Escherichia coli, Enterobacter spp. and Klebsiella spp.) were present in the animal holdings and in the shelters' veterinary clinic environment at all sampling times. Our findings demonstrate that cleaning followed by disinfection practices are effective at reducing environmental bacterial levels. Areas with less animal connectivity are more likely to have a higher bacterial contamination. These areas could represent environmental reservoirs for bacterial infection and should be targeted with effective cleaning and disinfection protocols.

The importance of infection control procedures in hospital radiology departments has become increasingly apparent in recent months as the impact of COVID-19 has spread across the world. Existing disinfectant procedures that rely on the manual application of chemical-based disinfectants are time consuming, resource intensive and prone to high degrees of human error. Alternative non-touch disinfection methods, such as Ultraviolet Germicidal Irradiation (UVGI), have the potential to overcome many of the limitations of existing approaches while significantly improving workflow and equipment utilization. The aim of this research was to investigate the germicidal effectiveness and the practical feasibility of using a robotic UVGI device for disinfecting surfaces in a radiology setting. We present the design of a robotic UVGI platform that can be deployed alongside human workers and can operate autonomously within cramped rooms, thereby addressing two important requirements necessary for integrating the technology within radiology settings. In one hospital, we conducted experiments in a CT and X-ray room. In a second hospital, we investigated the germicidal performance of the robot when deployed to disinfect a CT room in

Background As frontline providers of care, nurses and midwives play a critical role in controlling infections such as COVID-19, influenza, multi-drug resistant organisms and health care associated infections. Improved cleaning can reduce the incidence of infection and is cost effective but relies on healthcare personnel to correctly apply cleaning measures. As nurses and midwives have the most contact with patients and as an important first step in improving compliance, this study sought to explore nurses' and midwives’ knowledge on the role of the environment in infection prevention and control and identify challenges in maintaining clean patient environments. Methods Cross-sectional online survey of 96 nurses (RN/EN) and midwives (RW) employed in clinical settings (e.g. hospital, aged care, medical centre, clinic) in Australia. Results Nurses and midwives broadly stated that they understood the importance of cleaning. However, cleaning responsibilities varied and there was confusion regarding the application of different disinfectants when cleaning after patients with a suspected or diagnosed infection post-discharge. Most would not be confident being placed in a room where a previous patient had a diagnosed infection such as multi-drug resistant organism. Conclusion Greater organisational support and improving applied knowledge about infection control procedures is needed. This includes correct use of disinfectants, which disinfectant to use for various situations, and cleaning effectively following discharge of a patient with known infection. The cleanliness of shared medical equipment may also pose current risk due to lack of cleaning., Highlights • Improved cleaning reduces incidence of healthcare associated infection but relies on correct application. • Nurses and midwives expressed confusion regarding disinfectant use and cleaning responsibility. • Most would not be confident being placed in a room where a previous patient had a diagnosed infection.

Introduction COVID-19 has impacted dentistry in unprecedented ways. Objective The following research aimed to investigate the impact of the COVID-19 pandemic on periodontal practice in the United Kingdom using the COM-B (Capability Opportunity Motivation-Behaviour) model as the basis for a questionnaire. Basic research design An online survey link was sent to all members of the British Society of Periodontology and Implant Dentistry. A total of 358 responses were received and analysed. Results The great majority of participants thought that the pandemic had an impact on their profession, while only 4.7 % had no concerns. The main worries related to financial concerns and ability to provide appropriate levels of care. More than 80 % of respondents agreed that their establishment was compliant with infection control procedures. Some participants felt benefits mainly in terms of more time for CPD activities. It was felt that some of the changes needed will need to be sustained long-term. Conclusions Respondents were generally worried. However, they perceived they had the physical and psychological ability to effect changes to their practice, higher than the physical and social opportunities that they were afforded. Although the COVID-19 pandemic is causing profound changes and worries for the profession of Periodontology, clinicians are clear about their capability to control the situation and feel they have the motivation to make the required changes. Clinical significance COVID-19 has presented clinicians with novel challenges. Investigating the professional response to change and expected impact is of interest in the current climate as we navigate the ‘new normal’. Assessing the results could be useful in informing support strategies moving forward.

Early identification of imported cases, prevention of family clustering transmission, preventive measures in public areas and strict infection control procedures in hospitals were crucial for successful prevention of COVID-19 in Shenzhen, Chinahttps://bit.ly/2UDb5JA

Many dental procedures use modern devices like an air rotor and ultrasonic scaler, which generate aerosols and droplets. The dental procedures cannot be performed without the above devices. The ways commonly available today to control aerosols are suction, saliva ejectors, but it does little to control aerosols. The expensive filters like High-Efficiency Particulate Air (HEPA) are available but they are not easily available in rural set-up and economical for everyone. There are many diseases, for example- severe acute respiratory syndrome, tuberculosis, influenza and viral infections, which spread through droplets, so management of the infection control procedures for aerosols is mandatory in dental clinics. A novel human coronavirus-that is, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) also can be transferred through droplets and splatter. The COVID-19 pandemic has led to the manufacturing of novel devices to protect the dentist from the risk of transmission. The “Pravara tent” (the name Pravara was given to the tent by the authors as it was invented at the place called Pravara) is one of the examples of a protective (box) device, which can be used to control aerosols generated from air rotor and an ultrasonic scaler to reduce transmission of diseases between clinicians, and the patients. So, this tent is a simple, modified, and economical innovative protective device working with high efficacy by creating a barrier between patient and dentist to minimise aerosols during dental procedures.

Antimicrobial resistance is an ever-increasing global concern, with the era of untreatable infection becoming a reality. Wound care is no exception, with increasing issues of antibiotic-resistant infections across different wound types and care settings. Antibiotic resistance and stewardship have been the priority for most strategic interventions so far; however, in wound care, alternative or supplementary strategies using antiseptics should be considered. Antiseptics such as silver can provide effective cidal activity across a broad range of wound pathogens, assuming they are used at the correct level for an appropriate duration. Evidence summarised in this manuscript suggests that effective antiseptics, such as nanocrystalline silver, have an increasing body of evidence in support of their use to minimise transmission of antibiotic-resistant organisms as part of institutional infection control procedures and, in addition, through appropriate early use and stewardship on local wound infections, in conjunction with local procedures, to minimise the need for systemic antibiotic therapy. Engagement, alignment, and collaboration between wound care professionals and wider related teams and governments on antimicrobial stewardship, and the potential role of antiseptics within this, will help to generate further evidence for such interventions in the fight against antimicrobial-resistant infections in wound care.

Introduction: Disease transmission can occur through direct contact, blood, oral fluids, or other secretions and indirect contact with contaminated instruments, operatory equipment, or objects. Prevention of cross contamination helps in reducing the infection. The level of education of the students, and their knowledge about the infection control directly relates to the patient care. The current study aims to determine the level of knowledge and infection control procedures among dental students in a clihnical practice. Methods: This was a cross-sectional study with a self-administered questionnaire comprised of 18 open and close-ended questions related to infection control and prevention. Answers of the questions were analysed by SPSS version 20. Results: Among the students included, 53 (36.8%) participants were intern, 31 (21.5%) from fifth year, 31 (21.5) from fourth year and 29 (20.1) were third year. Performance satisfaction shows that the students were fairly satisfied with their performance. When students were asked to rate the implementation of infection control policy in their clinical practice 1 (0.7%) were very good, 74 (51.4%) were fair, 44 (30.6%) were good are while 25 (17.4%) were poor to implement infection control policy in their practice. Conclusions: The level of knowledge and practice of infection control measures was poor among dental students. The attitude towards infections control measures was positive, but a greater compliance was needed. Formal class and examination may help improve knowledge and clinical practices.

Highlights • Comparison of Dual Priming Oligonucleotide vs. Liquid Bead Suspension Array vs. Tagged Oligo Cleavage Extension chemistry for the detection of respiratory viruses from adult and pediatric populations. • Co-infections are detected frequently with these multiplex assays, especially in children, that it may impact current policies to cohort patients based on the result of a single virus. • All 3 commercial assays are based on different chemistries and are statistically non-inferior to each other in terms of sensitivity and specificity, both on prospective and retrospective samples. • Choice of assay by a clinical lab depends on volumes, cost, and work-flow considerations., Background Timely identification of respiratory virus infection is essential to mitigate inappropriate antibiotic use and to implement appropriate treatment and/or infection control procedures. As such, multiplexed PCR assays have become standard in many virology laboratories. Objectives To compare the Seeplex RV15 (test of record) with two newer generation multiplex assays, the Anyplex II RV16 and the xTAG respiratory virus panels. Study design Two hundred and three retrospective and 36 prospective respiratory samples were tested by all three assays. Samples were deemed to be positive if they tested positive for a virus by at least two of the three respective assays. Negative samples also had to test negative by at least two of the three assays. Inconclusive samples were those that showed band signal intensity between 0 and 100 on the RV15, but had not been previously tested on the RV16 or xTAG. Results and conclusions Overall sensitivity and specificity of all three assays were similar (∼85% and 100%, respectively). Given each assay can identify multiple different viruses, the targets reported by one assay did not always agree with each target from another assay. Partial discordant rates were 47% and 21% for positive and negative samples, respectively. These higher than expected partial discordant rates may be due to primer or chemistry differences amongst the three multiplex assays.

Universal precautions and general infection control measures needs to be considered when undertaking any clinical procedure. When administering intravenous (IV) therapy (medicines and/or maintenance fluids), specific measures need to be considered. This is especially important in elderly patients or if administering IV therapy to those with compromised immunity. There are many reasons why patients may need to receive IV therapy and these will all present with potential problems. This article will discuss IV therapy and some of the infection control procedures one must undertake when administering it.

Highly pathogenic avian influenza (HPAI) H5N1 and low pathogenic avian influenza (LPAI) H9N2 viruses have been recognized as threats to public health in Bangladesh since 2007. Although live bird markets (LBMs) have been implicated in the transmission, dissemination, and circulation of these viruses, an in-depth analysis of the dynamics of avian transmission of H5N1 and H9N2 viruses at the human-animal interface has been lacking. Here we present and evaluate epidemiological findings from active surveillance conducted among poultry in various production sectors in Bangladesh from 2008 to 2016. Overall, the prevalence of avian influenza viruses (AIVs) in collected samples was 24%. Our data show that AIVs are more prevalent in domestic birds within LBMs (30.4%) than in farms (9.6%). Quail, chickens and ducks showed a high prevalence of AIVs (>20%). The vast majority of AIVs detected (99.7%) have come from apparently healthy birds and poultry drinking water served as a reservoir of AIVs with a prevalence of 32.5% in collected samples. HPAI H5N1 was more frequently detected in ducks while H9N2 was more common in chickens and quail. LBMs, particularly wholesale markets, have become a potential reservoir for various types of AIVs, including HPAI H5N1 and LPAI H9N2. The persistence of AIVs in LBMs is of great concern to public health, and this study highlights the importance of regularly reviewing and implementing infection control procedures as a means of reducing the exposure of the general public to AIVs.Emerging Microbes & Infections (2017) 6, e12; doi:10.1038/emi.2016.142; published online 8 March 2017.

Objective The purpose of this study was to investigate compliance, awareness and practices of infection control procedures among dental students at colleges of dentistry, Al-Qassim Region in the Saudi Arabia. Materials and methods This study was conducted at college of dentistry of 50 of dental students. The questionnaire was formed by the authors. It was a self-administered questionnaire consisted of 14 closed-ended questions related to barrier techniques, vaccination status, percutaneous and mucous membrane exposures in addition to the dental treatment of infected patients, infection control practices and awareness. Results The questionnaire was distributed among 100 senior dental students at the Qassim Region of which only 50 students (50%) responded. Compliance with the use of protective barriers was high with the exception of protective eye wear, utilized by a mere20% of students. Regarding the treatment of patients with infectious diseases, 50% students did not mind treating patients with infectious diseases. Students suffered from non-sterile percutaneous and mucous membrane exposures compared withThe maximum number of reported exposures was related to the use of local anesthesia needles. Conclusions Efforts are needed to improve attitudes, implement information and motivate students in the correct and routine use of infection control measures, with all infection control protocols already implemented in dental schools, the challenge remains on improving compliance with infection control recommendations.

Graphical abstract, Highlights • The existing DWTPs are able to reduce the coronavirus, to date, the drinking water is safe. • The coronaviruses shed in the faeces and urine of infected individuals and then entered wastewater. • SARS-CoV-2 has been detected in a few standard WWTPs and they seem to be enough for removing the virus. • Wastewater monitoring could be a strategic tool for the epidemy evolution in communities. • Intensive studies for SARS-CoV-2 behavior in water and wastewater treatment are highly desirable., By 17 October 2020, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has caused confirmed infection of more than 39,000,000 people in 217 countries and territories globally and still continues to grow. As environmental professionals, understanding how SARS-CoV-2 can be transmitted via water and air environment is a concern. We have to be ready for focusing our attention to the prompt diagnosis and potential infection control procedures of the virus in integrated water and air system. This paper reviews the state-of-the-art information from available sources of published papers, newsletters and large number of scientific websites aimed to provide a comprehensive profile on the transmission characteristics of the coronaviruses in water, sludge, and air environment, especially the water and wastewater treatment systems. The review also focused on proposing the possible curb strategies to monitor and eventually cut off the coronaviruses under the authors’ knowledge and understanding.

Healthcare workers (HWs) perform a critical role not only in the clinical management of patients but also in providing adequate infection control and prevention measures and waste management procedures to be implemented in healthcare facilities. The aim of this study was to evaluate the awareness and knowledge of COVID-19 infection control precautions and waste management procedures among HWs in Saudi Arabian hospitals.This was a descriptive, cross-sectional study. Information on knowledge, awareness, and practice of infection control and waste management procedures were obtained from the HWs using a structured questionnaire. A thematic analysis was used to analyze the data.Our findings indicated that most of the study participants were knowledgeable, with a mean score of 78.3%. In total, 92.5%, 90.3%, and 91.7% of the participants were aware of the infection control precautions, COVID-19 waste management procedures, the availability of infection control supplies, respectively. HWs' Knowledge regarding waste management and infection control procedures correlated significantly with sex (P ≤ .001 and

To explore the phenomenon of tongue piercing in Klang Valley. Semi-structured in-depth interviews were conducted with piercers and those who had their tongue pierced (“piercees”) in Klang Valley. Five piercers and eight piercees were interviewed. Piercees had their tongue pierced at age 16-25 years. Three mainreasons for tongue piercing were to enhance appearance, express their individuality, and out of curiosity. They reported that they experienced various immediate and late complications. However, most were aware of and expected the complications. The majority of piercers reported adequate infection control procedures and enquired about the client’s health prior to piercing. Although some clients reported problems, such reports were rare. Tongue piercing is an invasive procedure with some risks, but precautions such as proper infection control procedures minimize the likelihood of encountering serious problems. The reasons for tongue piercing varied between individuals. Although the majority of the interviewed piercers reported cross-infection control, their knowledge of the medical risks associated with tongue piercing varied widely.

Opinion statement The concept of clinical biocontainment, otherwise known as high-level containment care (HLCC), had its birth among a confluence of near-simultaneous events in 1969. The U.S. Army’s Medical Research Institute of Infectious Diseases (USAMRIID) began construction of the first modern biocontainment unit that year, and opened the two-bed facility, often referred to as “the Slammer” in 1971. Over its 41-year existence, 21 persons exposed to highly hazardous infectious diseases were admitted to the Slammer, but none ever contracted the disease to which they had been exposed. Owing, in part, to this underutilization, some questioned the utility of HLCC units. This concern notwithstanding, Emory University and the University of Nebraska opened HLCC units in civilian academic medical centers in 2004 and 2005, respectively. These units, distinct from conventional infectious disease isolation wards found in most major medical centers, proved their worth during the West African Ebola Virus Disease (EVD) outbreak of 2014–2015. It is our opinion that such units, as well as the parallel high-level containment transport systems necessary to move patients to them, will continue to play an important role in the global response to emerging and highly hazardous contagious pathogens. Moreover, we feel that the lessons derived from their successful operation will lead to improvements in infection control procedures and practices throughout the healthcare system.

The narrative of Ebola's arrival in the United States has been overwhelmed by our fear of a West African-style epidemic. The real story of Ebola's arrival is about our healthcare system's failure to identify, treat, and contain healthcare associated infections. Having long been willfully ignorant of the path of fatal infectious diseases through our healthcare facilities, this paper considers why our reimbursement and quality reporting systems made it easy for this to be so. West Africa's challenges in controlling Ebola resonate with our own struggles to standardize, centralize, and enforce infection control procedures in American healthcare facilities.

Aim of Study: The aim of this review was to determine the precautions to be taken by dental surgeons and auxiliaries. Methodology: Literature review was conducted from 1966 to 2015 about Middle East respiratory syndrome coronavirus (MERS-CoV). Information on the transmission, laboratory findings, treatment options and precautionary measures were analysed. Results: No evidence suggested that animal livestock were a direct or intermediate source of MERS-CoV. Contrasting reports showed infection in a hospital with history of contact with camels. During community outbreaks, spread of the virus among close family members have been reported. Of greater concern was the outbreak in 2013 where a number of healthcare professionals were infected. Conclusion: Preventing the spread of MERS-CoV through strict infection control procedures is crucial due to the high mortality rate and lack of available vaccination or treatment.

Background Anesthesia providers commonly cross-contaminate their workspace and subsequently put patients at risk for a health care–acquired infection. The primary objective of this project was to determine if education and implementation of standardized infection control guidelines that address evidence-based best practices would improve compliance with infection control procedures in the anesthesia workspace. Methods Patient care–related hand hygiene of nurse anesthetists was observed in 3 areas of anesthesia practice before and 3 weeks and 3 months after staff education, placement of visual reminders, and the implementation of infection control guidelines. After the observation periods, the percent compliance on the part of the providers was calculated for each of the 3 areas of anesthesia practice, and the results were compared using the Fisher exact test. Results There were a total of 95 observations performed during the 3 observation periods. When compared with preimplementation baseline data, there was a 26.2% increase in the number of providers compliant with hand hygiene practices after airway instrumentation (P = .029) and a 71.9% increase in the number of providers who separated clean from contaminated items in the workspace (P = .0001). Conclusions Education, visual reminders, and standardized infection control guidelines were shown to improve compliance with infection control best practices in a group of nurse anesthetists.

Needlestick and sharp instrument injuries are common in dental practice and present the risk of direct exposure to blood-borne pathogens, including hepatitis B virus. This cross-sectional study was carried out to determine the risk factors of injury and infection in three types of dental clinic in Riyadh, Saudi Arabia. A total of 274 male and 241 female dentists completed a structured questionnaire on demographic factors, compliance with infection control practices, and past exposure to injury and infection hazards. Dentists with more years of professional experience were significantly less likely to report having had an injury in the past (unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 0.48, 0.27–0.87 and 0.38, 0.16–0.89 for dentists with 10–20 years and for those with over 20 years of experience, respectively). Greater compliance with infection control procedures was associated with significantly fewer reports of previous infection (OR 0.31, 95% CI 0.12–0.84). Experience of occupational safety training was not associated with a lower rate of injury or infection. Greater occupational safety knowledge and compliance with infection control management practices contribute to a reduced risk of injury and infection among dentists. More focused and specialized training on infection control and occupational safety is needed for all practicing dentists and dental students.

Patients with ESKD treated with hemodialysis (HD) are at substantially increased risk of life-threatening infections. A majority of bloodstream infections are related to vascular access, of which 70% are associated with the use of a central venous catheter (CVC) ([1][1]). Infections result in

Antibiotic resistance is an important issue in all aspects of health care, not just in veterinary medicine. Responsible use of antibiotics is vital in order to preserve their use for the future. Any new antibiotics will be reserved for the human. There are many aspects (strategies and practises) that can be adapted into veterinary practice to help preserve these drugs, such as infection control procedures.

Pulmonary function testing plays a crucial role in the diagnostic evaluation of patients with lung diseases. Cases of cross infection acquired from the pulmonary function laboratory, although rare, have been reported from various countries. It is therefore imperative to identify the risks and potential organisms implicated in cross infections in a pulmonary function test (PFT) laboratory and implement better and more effective infection control procedures, which will help in preventing cross infections. The infrastructure, the daily patient flow, and the prevalent disinfection techniques used in a PFT laboratory, all play a significant role in transmission of infections. Simple measures to tackle the cross infection potential in a PFT laboratory can help reduce this risk to a bare minimum. Use of specialized techniques and equipment can also be of much use in a set up that has a high turnover of patients. This review aims at creating awareness about the possible pathogens and situations commonly encountered in a PFT laboratory. We have attempted to suggest some relevant and useful infection control measures with regard to disinfection, sterilization, and patient planning and segregation to help minimize the risk of cross infections in a PFT laboratory. The review also highlights the lacuna in the current scenario of PFT laboratories in India and the need to develop newer and better methods of infection control, which will be more user-friendly and cost effective. Further studies to study the possible pathogens in a PFT laboratory and evaluate the prevalent infection control strategies will be needed to enable us to draw more precious conclusions, which can lead to more relevant, contextual recommendations for cross infections control in PFT lab in India.

BackgroundOutbreaks linked to cosmetic piercing are rare, but can cause significant illness. We report the investigation and management of a point-source outbreak that occurred during a “Black Friday” event in North West England.MethodsOutbreak investigation was led by Public Health England, and included active case finding among individuals pierced at a piercing premises between 25/11/2016 (“Black Friday”) and 7/12/2016. Detailed epidemiological, environmental (including inspection and sampling), and microbiological investigation was undertaken.ResultsDuring the “Black Friday” event (25/11/2016), 45 people were pierced (13 by a newly-appointed practitioner). Eleven cases were identified (7 microbiologically-confirmed, 2 probable, and 2 possible). All cases had clinical signs of infection around piercing sites, and five required surgical intervention, with varying degrees of post-operative disfigurement. All confirmed and probable cases had a “scaffold piercing” placed with a guide bar by the newly-appointed practitioner. Pseudomonas aeruginosa, indistinguishable at nine-locus variable-number tandem repeat loci, was isolated from four of the confirmed cases, and from pre- and post-flush samples from five separate water taps (three sinks) in the premises. Water samples taken after remedial plumbing work confirmed elimination of Pseudomonas contamination.ConclusionsAlthough high levels of Pseudomonas water contamination and some poor infection control procedures were identified, infection appeared to require additional exposure to an inexperienced practitioner, and the more invasive scaffold piercing. A proactive collaborative approach between piercers and health and environmental officials is required to reduce outbreak risk, particularly when unusually large events are planned.

Background The operating room (OR) of the hospital is a special unit that requires a relatively clean environment. The microbial concentration of an indoor OR extrinsically influences surgical site infection rates. The aim of this study was to use active sampling methods to assess microbial colony counts in working ORs and to determine the factors affecting air contamination in a tertiary referral medical center. Methods This study was conducted in 28 operating rooms located in a 3000-bed medical center in northern Taiwan. The microbiologic air counts were measured using an impactor air sampler from May to August 2015. Information about the procedure-related operative characteristics and surgical environment (environmental- and personnel-related factors) characteristics was collected. Results A total of 250 air samples were collected during surgical procedures. The overall mean number of bacterial colonies in the ORs was 78 ± 47 cfu/m3. The mean number of colonies was the highest for transplant surgery (123 ± 60 cfu/m3), followed by pediatric surgery (115 ± 30.3 cfu/m3). A total of 25 samples (10%) contained pathogens; Coagulase-negative staphylococcus (n = 12, 4.8%) was the most common pathogen. After controlling for potentially confounding factors by a multiple regression analysis, the surgical stage had the significantly highest correlation with bacterial counts (r = 0.346, p