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This retrospective study aimed to assess and compare guideline adherence and treatment costs in the management of urinary tract infections (UTIs) and bloodstream infections (BSIs) in German tertiary hospitals from January 2019 to December 2020. The study analyzed 586 patient records, with 65% diagnosed with UTIs and 35% with BSIs. Antibiotic treatment was given to 98% of patients, but only 65% received microbiological diagnostics. Bacterial growth was observed in 86% of patients with cultures taken, with Escherichia coli being the leading pathogen. The treatment was intravenous in 63% of cases, with Ceftriaxone as the leading antibiotic agent. The guideline adherence was found to be low, at 33%. Multivariable logistic regression analysis revealed that patients with urogenital risk factors (OR = 1.589; p < 0.001) and increasing age (OR = 1.01; p = 0.007) were significantly more likely to receive guideline-concordant treatment for UTIs and BSIs. Additionally, complicating factors such as diabetes and renal dysfunction were associated with higher adherence rates, underscoring the importance of targeted antibiotic stewardship interventions.

In the context of the new socioeconomic reality, there is an urgent need for effective instruments for managing labor productivity, because measuring efficiency in order to respond in time and eliminate shortcomings is the basis of most processes. The aim of the article is to study the systems of personnel evaluation: OKR, МВО, KRI, based on the process of targeting; their delimitation, allocation of advantages and features of application. The necessity of transition to more effective instruments for managing labor productivity in the context of the new socioeconomic reality is substantiated. It is proposed to understand by OKR not just a method of evaluating the company’s staff, but rather a certain management system that allows to focus the team’s efforts on distinguishing and implementing the main and most significant individual goals through the prism of the strategic vision of the development plus the goals of the whole company. The main components of OKR are singled out and characterized: strategic vision, individual goals, action element or initiative and key results. The basic principles of the OKR system are formulated as follows: publicity and accessibility, ambition, concentration on the most important goals and objectives, quarterly basis, key results, systematic feedback, lack of attachment to motivation in the company. The advantages of OKR are distinguished from other staff evaluation systems.

Abstract Background Carbapenem resistant (CR) Klebsiella pneumoniae (Kp) and Acinetobacter baumannii (Ab) are emerging multidrug resistant bacteria with very limited treatment options in case of infection. Both are well-known causes of nosocomial infections and outbreaks in healthcare facilities. Methods A retrospective study was conducted to investigate the epidemiology of inpatients with CR Kp and CR Ab in a 1500-bed German university hospital from 2015 to 2019. We present our infection control concept including a weekly microbiologic screening for patients who shared the ward with a CR Kp or CR Ab index patient. Results Within 5 years, 141 CR Kp and 60 CR Ab cases were hospitalized corresponding to 118 unique patients (74 patients with CR Kp, 39 patients with CR Ab and 5 patients with both CR Ab and CR Kp). The mean incidence was 0.045 (CR Kp) and 0.019 (CR Ab) per 100 inpatient cases, respectively. Nosocomial acquisition occurred in 53 cases (37.6%) of the CR Kp group and in 12 cases (20.0%) of the CR Ab group. Clinical infection occurred in 24 cases (17.0%) of the CR Kp group and in 21 cases (35.0%) of the CR Ab group. 14 cases (9.9%) of the CR Kp group and 29 cases (48.3%) of the CR Ab group had a history of a hospital stay abroad within 12 months prior to admission to our hospital. The weekly microbiologic screening revealed 4 CR Kp cases caused by nosocomial transmission that would have been missed without repetitive screening. Conclusions CR Kp and CR Ab cases occurred infrequently. A history of a hospital stay abroad, particularly in the CR Ab group, warrants pre-emptive infection control measures. The weekly microbiologic screening needs further evaluation in terms of its efficiency.

The article is aimed at analyzing the motivational levers for effective work, which used to be effective before the beginning of the COVID-19 pandemic and became effective after it. The article substantiates the relevance of studying motivational factors and probable changes in the motivational components of employees that arose in response to the emergence of a new virus and the necessity to profoundly change the usual activity schemes. Having analyzed and summarized the research in the field of motivation and incentives to work effectively, the authors have found out that the issue of changing motivational levers during the pandemic remains greatly unsolved, despite numerous developments. The study makes it possible to draw certain conclusions, namely: the pandemic has clearly affected the employees’ motivation and productivity, but this effect remains rather insignificant. For example, with the beginning of the pandemic, the share of respondents experiencing an average level of satisfaction with their work decreased, while the share of both respondents experiencing the highest level of satisfaction and those who were dissatisfied with their work, increased. Also, with the onset of the pandemic, the share of productive respondents decreased, while the share of respondents showing high and low levels of productivity increased. The study shows that with the onset of a pandemic, stability, comfortable workplace conditions and the prospect of additional income have become more important; at the same time, such factors as competitive wages and career opportunities have gradually begun to lose their leadership in the list of important motivational components for productive work. The survey confirms that over the past year, employees have increasingly begun to value stability and socially responsible attitude demonstrated by employers; and more and more employees have begun to appreciate a company’s attitude to its personnel during the heyday of the pandemic, its willingness to change along with changes in the environment, its readiness to support its personnel and suggest help if need be.

Abstract Background and aims Bacterial infections are common in patients with decompensated liver cirrhosis and a leading cause of death. Reliable data on antibiotic resistance are required to initiate effective empiric therapy. We here aim to assess the antimicrobial resistance profile of bacteria among patients with liver cirrhosis and infection. Methods Overall, 666 cirrhotic patients admitted to Hannover Medical School between January 2012 and April 2018 with ascites were assessed for bacterial infection. In case of infection, bacteria cultured from microbiological specimens of ascites, blood or urine were identified and analyzed for resistances against common antibiotic agents. Furthermore, analyses compared two periods of time and community-acquired vs. nosocomial infections. Results In 281 patients with infection, microbiological sampling was performed and culture-positive results were obtained in 56.9%. Multidrug-resistant (MDR)-bacteria were found in 54 patients (19.2%). Gram-positive organisms were more common (n = 141/261, 54.0%) and detected in 116/192 culture-positive infections (60.4%). Comparing infections before and after 2015, a numerical decline for MDR-bacteria (23.8% vs. 15.6%, p = 0.08) was observed with a significant decline in meropenem resistance (34.9% vs. 19.5%, p = 0.03). MDR-bacteria were more frequent in the case of nosocomial infections. Of note, in ascites the majority of the tested bacteria were resistant against ceftriaxone (73.8%) whereas significantly less were resistant against meropenem (27.0%) and vancomycin (25.9%). Conclusions In our tertiary center, distinct ratios of gram-positive infection with overall low ratios of MDR-bacteria were found. Adequate gram-positive coverage in the empiric therapy should be considered. Carbapenem treatment may be omitted even in nosocomial infection. In contrast, 3rd generation cephalosporins cannot be recommended even in community-acquired infection in our cirrhotic population.

Abstract Objective Environmental surfaces may serve as potential reservoirs for nosocomial pathogens and facilitate transmissions via contact depending on its tenacity. This study provides data on survival kinetics of the most important nosocomial bacteria on a panel of commonly used surfaces. Type strains of S. aureus, K. pneumoniae, P. aeruginosa, A. baumannii, S. marcescens, E. faecium, E. coli, and E. cloacae were suspended in 0.9% NaCl solution at a McFarland of 1 and got then plated via cotton swabs either on glass, polyvinyl chloride, stainless steel, or aluminum. Surfaces were stored at regular ambient temperature and humidity to simulate routine daycare conditions. Sampling was performed by contact plates for a time period of four weeks. Results The longest survival was observed for A. baumannii and E. faecium on all materials (at least four weeks). S. aureus remained viable for at least one week. Gram negative species other than A. baumannii were usually inactivated in less than two days. Nosocomial transmission of the above mentioned bacteria may easily occur if no appropriate infection control measures are applied on a regular daily basis. This might be of particular importance when dealing with outbreaks of A. baumannii and E. faecium.

The article is aimed at studying the features of IT recruiting in modern operating conditions of the economy. The relevance of research of recruiting in IT companies is substantiated. The definition of the economic category of «IT recruiting», which is considered as a purposeful and structured process of providing IT company with the staff from the sphere of information technologies, with the knowledge, skills, competencies, qualities corresponding to vacant position and the needs of employer. It is determined that the issue of IT recruiting is not sufficiently covered in scientific sources. It is proved that a feature of IT recruiting are candidates, because each vacant position is essentially unique, and therefore requests an employee of the respective unique. The basic demands concerning the recruiter, looking for the candidates for the IT sphere, are formulated and substantiated. The techniques of IT personnel selection, including headhunting, recruiting and screening, are examined and characterized. It is determined that the headhunting technique is designed for employees of the level of middle+/senior/lead, recruiting technique is for the candidates of the junior/middle level, and screening – for the junior-level, i.e., practicians, probationers. The main channels of attracting candidates are characterized, which are chosen depending on the peculiarities of the company’s profile of future employee. IT is proved that the choice of the engagement channel is the most significant stage of the entire IT recruiting process. The authors consider the use of the IT-recruiting social network for business communication – LinkedIn, as well as specialized sites, services and such types of search as Boolean search and X-ray requests. The procedure of recruiting IT specialists is considered through the prism of search stages, a full cycle comprising 9 steps: request for opening a vacancy; selecting the search channels; searching for candidates; coming into contact; interview; testing; deciding as to filling a vacancy; employment and adaptation of the newly accepted employee.

The article is aimed at researching digital opportunities in the field of recruiting staff in the modern operating environment of the economy. The relevance of the transition to modern methods used in digital capabilities is substantiated. It is proved that the digital recruitment industry is not sufficiently disclosed in scientific sources, hence, as a result, low awareness of specialists in this sphere. This also leads to a low level of usage of modern instruments. It is specified that Ukrainian companies usually practice the already standardized elements of digitalization: search for candidates on job sites, posting job ads on social networks, etc. The key trending directions of digital recruitment are considered and characterized, in particular: use of artificial intelligence and robots; automation of processes; use of aggregation and uberization; use of social media; alternative ways to attract candidates; application of HR analytics. Based on the estimation of the existing and utilized digital capabilities of most typical Ukrainian companies, a number of measures are proposed to modernize the recruitment process and increase the profits of companies: development of a cloud network; launching an own ATS-system; increasing the use of targeted advertising on social networks and eliminating low-performance sources of job advertisements; automation and control of statistical information; launching an own HR bot. The proposed program of measures to improve recruitment of staff, taking into account the trending directions of digital recruitment, will significantly save the time of the recruiter at each stage, which in the future will significantly affect all indicators of performance of companies. It is proved that companies need to expand their digitalization horizons, because without this they can back down their positions in the market. Using digital instruments will allow recruiters to reach the market as quickly as possible and actively interact with candidates.

The article is aimed at researching remote employment in the new conditions of the State’s functioning. The author substantiates the relevance of transition to remote employment by the companies’ employees. Remote employment is defined as the only acceptable form of further functioning and possible development of companies under the quarantine conditions. Analyzing and generalizing scientific studies of scholars, the interdisciplinary relationships in researching remote employment are proved. The article allocates the main advantages for the employer when switching to remote employment. The main obstacles and risks on the way to a rapid transition to remote form in Ukraine are researched. Taking into account the importance of an urgent and mass transition to remote employment to be fulfilled in the State under quarantine conditions, a program to introduce this form of employment into the activities of companies is proposed. This program provides for the gradual implementation of the main stages of the introduction of remote employment, which are characterized by the author. Among the many steps towards the introduction of remote employment, the most important are the development and approval by the management of the program of actions, as well as bringing it to attention of the the company’s employees. At these stages occur most errors, which subsequently destroy the entire program. The program should be absolutely clear to all members of the team – from the average employee to the management of the company. The huge role of the HR manager in this process, in particular, with the support of the socio-psychological climate, establishing communications in working groups and the company in the conditions of remote employment, is emphasized. The importance of taking into account the risks associated with the company’s security is defined. Examples of a set of instruments for remote employment are provided in terms of the functional responsibilities of the employee, in particular, the Zoom software is defined to be the best in organizing video conferencing. Prospect for further research in this direction is development of an instrumentarium for improving the efficiency of remote employment and building up of a strong regulatory framework.

This retrospective study aimed to assess and compare guideline adherence and treatment costs in the management of urinary tract infections (UTIs) and bloodstream infections (BSIs) in German tertiary hospitals from January 2019 to December 2020. The study analyzed 586 patient records, with 65% diagnosed with UTIs and 35% with BSIs. Antibiotic treatment was given to 98% of patients, but only 65% received microbiological diagnostics. Bacterial growth was observed in 86% of patients with cultures taken, with Escherichia coli being the leading pathogen. The treatment was intravenous in 63% of cases, with Ceftriaxone as the leading antibiotic agent. The guideline adherence was found to be low, at 33%. Multivariable logistic regression analysis revealed that patients with urogenital risk factors (OR = 1.589; p < 0.001) and increasing age (OR = 1.01; p = 0.007) were significantly more likely to receive guideline-concordant treatment for UTIs and BSIs. Additionally, complicating factors such as diabetes and renal dysfunction were associated with higher adherence rates, underscoring the importance of targeted antibiotic stewardship interventions. [ABSTRACT FROM AUTHOR]

There is a lack of data on factors that contribute to the implementation of hygiene measures during nosocomial outbreaks (NO) caused by Methicillin-resistant Staphylococcus aureus (MRSA). Therefore, we first conducted a systematic literature analysis to identify MRSA outbreak reports. The expenditure for infection control in each outbreak was then evaluated by a weighted cumulative hygiene score (WCHS). Effects of factors on this score were determined by multivariable linear regression analysis. 104 NO got included, mostly from neonatology (n = 32), surgery (n = 27), internal medicine and burn units (n = 10 each), including 4,361 patients (thereof 657 infections and 73 deaths) and 279 employees. The outbreak sources remained unknown in 10 NO and were not reported from further 61 NO. The national MRSA prevalence did not correlate with the WCHS (p = .714). There were significant WCHS differences for internal medicine (p = 0.014), burn units (p

Antimicrobial resistance is a major public health issue caused by antibiotic overuse and misuse. Antimicrobial stewardship (AMS) has been increasingly endorsed worldwide, but its effect has been studied scarcely in urologic settings. A before-after study was performed from 2018 through 2020 to evaluate changes in antimicrobial prescription, resistance rates and clinical safety upon implementation of an AMS audit and feedback program in the Urology Department of a large German academic medical center. The primary endpoints were safety clinical outcomes: the rate of infection-related readmissions and of infectious complications after transrectal prostate biopsies. Resistance rates and antimicrobial consumption rates were the secondary endpoints. The AMS team reviewed 196 cases (12% of all admitted in the department). The overall antibiotic use dropped by 18.7%. Quinolone prescriptions sank by 78.8% (p = 0.02) and 69.8% (p > 0.05) for ciprofloxacin and levofloxacin, respectively. The resistance rate of E. coli isolates declined against ceftriaxone (−9%), ceftazidime (−12%) and quinolones (−25%) in the AMS period. No significant increase in infection-related readmissions or infectious complications after prostate biopsies was observed (p = 0.42). Due to the potential to reduce antibiotic use and resistance rates with no surge of infection-related complications, AMS programs should be widely implemented in urologic departments.

Abstract Background Identifying the source of an outbreak is the most crucial aspect of any outbreak investigation. In this review, we address the frequently discussed question of whether (rectal) screening of health care workers (HCWs) should be carried out when dealing with outbreaks caused by gram negative bacteria (GNB). A systematic search of the medical literature was performed, including the Worldwide Outbreak Database and PubMed. Outbreaks got included if a HCW was the source of the outbreak and the causative pathogen was an Escherichia coli, Klebsiella spp., Enterobacter spp., Serratia spp., Pseudomonas aeruginosa, or Acinetobacter baumannii. This was true for 25 articles in which there were 1196 (2.1%) outbreaks due to GNB, thereof 14 HCWs who were permanently colonized by the outbreak strain. Rectal screening of HCWs was helpful in only 2 of the 1196 (0.2%) outbreaks. Instead, the hands of HCWs served as a reservoir for the outbreak strain in at least 7 articles – especially when they suffered from onychomycosis or used artificial fingernails or rings. Conclusion Due to very weak evidence, we do not recommend rectal screening of HCWs in an outbreak situation with GNB. However, besides a critical review of hand hygiene habits, it might be useful to examine the hands of staff carefully. This measure is cheap, quick to perform, and seems to be quite effective.

Abstract Background Nosocomial infections due to vancomycin-resistant enterococci (VRE) have become a major problem during the last years. The purpose of this study was to investigate the economic burden of nosocomial VRE infections in a European university hospital. Methods A retrospective matched case-control study was performed including patients who acquired nosocomial infection with either VRE or vancomycin-susceptible enterococci (VSE) within a time period of 3 years. 42 cases with VRE infections and 42 controls with VSE infections were matched for age, gender, admission and discharge within the same year, time at risk for infection, Charlson comorbidity index (±1), stay on intensive care units and non-intensive care units as well as for the type of infection, using criteria of the Centers for Disease Control and Prevention. Results The median overall costs per case were significantly higher than for controls (EUR 57,675 vs. EUR 38,344; p = 0.030). Costs were similar between cases and controls before onset of infection (EUR 17,893 vs. EUR 16,600; p = 0.386), but higher after onset of infection (EUR 37,971 vs. EUR 23,025; p = 0.049). The median attributable costs per case for vancomycin-resistance were EUR 13,157 (p = 0.036). The most significant differences in costs between cases and controls turned out to be for pharmaceuticals (EUR 6030 vs. EUR 2801; p = 0.008) followed by nursing staff (EUR 8956 vs. EUR 4621; p = 0.032), medical products (EUR 3312 vs. EUR 1838; p = 0.020), and for assistant medical technicians (EUR 3766 vs. EUR 2474; p = 0.023). Furthermore, multivariate analysis revealed that costs were driven independently by vancomycin-resistance (1.4 fold; p = 0.034). Conclusions This analysis suggested that nosocomial VRE infections significantly increases hospital costs compared with VSE infections. Therefore, hospital personal should implement control measures to prevent VRE transmission.