Journal articles on the topic 'Association for Practitioners in Infection Control'
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White, Mary Castle, and Joseph J. Klimek. "Association for practitioners in infection control and the American Journal of Infection Control after twenty years: A review." American Journal of Infection Control 20, no. 1 (February 1992): 1–3. http://dx.doi.org/10.1016/s0196-6553(05)80116-6.
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Horan, Teresa C., Robert P. Gaynes, William J. Martone, William R. Jarvis, and T. Grace Emori. "CDC Definitions of Nosocomial Surgical Site Infections, 1992: A Modification of CDC Definitions of Surgical Wound Infections." Infection Control & Hospital Epidemiology 13, no. 10 (October 1992): 606–8. http://dx.doi.org/10.1017/s0195941700015241.
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In 1988, the Centers for Disease Control (CDC) published definitions of nosocomial infections However, because of journalistic style and space constraints, these definitions lacked some of the detail provided to National Nosocomial Infections Surveillance (NNIS) System hospitals in the NNIS Manual (unpublished). After the NNIS System hospitals had had considerable experience with the definitions and in response to a request for review by The Surgical Wound Infection Task Force, a group composed of members of The Society for Hospital Epidemiology of America, the Association for Practitioners in Infection Control, the Surgical Infection Society, and the CDC, we slightly modified the definition of surgical wound infection and changed the name to surgical site infection (SSI).
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Denton, Andrea, Carole Fry, Helen O’Connor, and Jude Robinson. "Revised Infection Prevention Society (IPS) Competences 2018." Journal of Infection Prevention 20, no. 1 (January 2019): 18–24. http://dx.doi.org/10.1177/1757177418798908.
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Competences for infection prevention and control (IPC) practitioners were first introduced by the Infection Control Nurses Association (ICNA) in 2000. In recent years, they have been revised by the Education and Professional Development Committee of the Infection Prevention Society (IPS). The competences are a multi-purpose tool to support and inform service and workforce development and management at an operational and strategic level. They can assist in designing education programmes, help with staff appraisal, personal development plans and support revalidation alongside developing team structures and requirements. They enable the practitioner to review their own current position of progression and clinical standing from the position of assisted, supervised and independent. These terms are designed to assist the user to express the level of competence at which they work. This may differ depending on the competences that are being explored. This current version of the IPS competences (2018) have been designed to reflect the current structures and practices within the health and social care economy. They have been redeveloped within an electronic interactive framework to encourage usability and assist with manageability and record keeping. The competency framework tool is intended as a guide; the idea is for the practitioner to focus on relevant aspects of the competences and combine with organisational and individual goals and revalidation where applicable.
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Saguil, Esther, Amiel Nazer Bermudez, Carl Abelardo Antonio, and Kim Cochon. "Consensus Recommendations on the Prevention and Management of Surgical Site Infections (SSI) in the Philippine Setting." Philippine Journal of Surgical Specialties 72, no. 2 (December 1, 2017): 70–80. http://dx.doi.org/10.61662/pcs_lpwy9819.
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Over the years, strategies in the prevention and management of surgical site infections (SSI) of patients in the Philippines have never been standardized. Several guidelines released by international foreign bodies have been found to be either conflicting or inappropriate for adaptation in the local context. To address these issues, the Philippine College of Surgeons (PCS), in collaboration with the Philippine Hospital Infection Control Society (PHICS), Philippine Hospital Infection Control Nurses Association (PHICNA) and Operating Room Nurses Association of the Philippines, Inc. (ORNAP), initiated the development and adaptation of country-specific SSI guidelines in 2017. The new recommendations are based on the latest clinical practice guidelines released for the past five years and consensus by a panel of experts in the Philippines, through the assistance of a guideline development team engaged by PCS. Thirty-six (36) recommendations on different aspects of care were outlined. Implementation of an SSI surveillance program was also advised for health facilities. The new guidelines are intended to serve as the local benchmark for the prevention and management of SSI for surgeons and practitioners, taking into account their situation and experience in the Philippines. It is expected to improve the standard of care provided by health facilities and contribute to the reduction of the prevalence and incidence of SSI in the country. Key words: Surgical site infection, surgical wound infection, postoperative wound infection, infection control
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Robb, Kylie. "Utilizing a Risk-Based Criteria Framework to Identify Infection Prevention and Control Risks in Australian Dental Settings." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s427. http://dx.doi.org/10.1017/ice.2020.1087.
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Background: A dental practitioner must comply with the Dental Board of Australia’s guidelines on infection control. In this project, we developed a risk-based criteria framework to assess a practitioner’s infection prevention and control (IPC) systems and processes. This project allowed for the provision of the highest standard of infection control continuing education and advice relevant to the needs of members of the Australian Dental Association (NSW Branch). Methods: A review of 1,050 continuing professional development (CPD) IPC course evaluation forms was conducted to determine the key IPC areas that participants have the most difficulty with. All core IPC documents that practitioners are expected to understand and comply with were determined and any regulator- and profession-led compliance checklists were collated. These data were consolidated to generate a risk-based criteria framework that was then applied to 99 private, office-based, dental practices to determine IPC compliance. Results: After the review of 99 dental practices, the total aggregate compliance score was 78%, and the 15 key IPC areas were ranked from highest to lowest. These data assisted with the development of a full-day IPC course focusing on the top 5 risks in each category. The five areas of opportunity identified were Hand Hygiene (52%), Surgical Procedures and Aseptic Technique (59%), Documentation, Policy and Knowledge (61%), Sharps (72%), Steam Sterilisers (72%). Conclusions: This project identified key IPC risks for office-based dental practices from the capture of performance-based data. This data formed a targeted education framework that prioritized areas of opportunity to improve IPC standards in Australian dental practices.Funding: NoneDisclosures: None
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Azhar, Ramsha, Syed Hammad Ahsan, Salik Rasool, Shahnawaz Jamali, and Bilal Hussain. "Knowledge, Attitude and Practices Regarding Infection Control Protocol amongst Dental Professionals – A Cross-Sectional Study." Journal of the Pakistan Dental Association 31, no. 01 (April 7, 2022): 21–26. http://dx.doi.org/10.25301/jpda.311.21.
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OBJECTIVE: The objectives are: (1) to assess and compare the knowledge, attitude and practices regarding infection control protocols and (2) to identify the factor(s) that might influence the implementation of these protocols amongst dental professionals in all three dental campuses of a public sector university, Karachi. METHODOLOGY: A cross-sectional, observational study was conducted in the three dental campuses of a public sector university, Karachi, for a period of three months from February to April 2019. The study participants consisted of dental and paradental professionals treating patients. A self-administered, structured, validated questionnaire was distributed among 285 participants, out of which 268 participants correctly filled and submitted back the questionnaire. Frequency distribution and Chi square test were performed. RESULTS: Campus A, covering areas of Mehmoodabad town, Karachi comprising 63 participants; Campus B, covering areas of Saddar town, Karachi comprising 68 participants; and Campus C, covering areas of Gulshan and Johar, Karachi comprising 129 participants, respectively. Statistically significant association was found between eyewear utilization among the designation of the practitioner, dental departments and dental campuses. Correspondingly, significant association was observed between awareness regarding needle stick injury protocol implementation with designation of the practitioner and dental campuses. Likewise, a significant association was found between utilization of rubber dams for maintenance of isolation with the age and designation of the practitioner, dental departments and dental campuses. CONCLUSION: The study highlighted the shortcomings of infection control protocol implementation in three dental campuses of a premier healthcare university of Pakistan. The results of this study may be utilized provincially and nationally for the construction and effective implementation of infection control policies. KEYWORDS: AIDS, Disinfection, Hepatitis B, Hepatitis C, Tuberculosis, Needle stick injury.
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O'Grady, Naomi P., Mary Alexander, E. Patchen Dellinger, Julie L. Gerberding, Stephen O. Heard, Dennis G. Maki, Henry Masur, et al. "Guidelines for the Prevention of Intravascular Catheter–Related Infections." Clinical Infectious Diseases 35, no. 11 (December 1, 2002): 1281–307. http://dx.doi.org/10.1086/344188.
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Abstract These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicine (SCCM), in collaboration with the Infectious Disease Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), Surgical Infection Society (SIS), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), American Society of Critical Care Anesthesiologists (ASCCA), Association for Professionals in Infection Control and Epidemiology (APIC), Infusion Nurses Society (INS), Oncology Nursing Society (ONS), Society of Cardiovascular and Interventional Radiology (SCVIR), American Academy of Pediatrics (AAP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) and is intended to replace the Guideline for Prevention of Intravascular Device–Related Infections published in 1996. These guidelines are intended to provide evidence-based recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.
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Scheckler, William E., and Patty J. Peterson. "Nosocomial Infection Prevalence, Risk and Control in Small Community and Rural Hospitals." Infection Control & Hospital Epidemiology 7, S2 (February 1986): 144–48. http://dx.doi.org/10.1017/s0195941700065711.
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Between 1972 and 1973, Britt and colleagues conducted 1-day infection prevalence surveys in 18 hospitals each with fewer than 75 beds and all located in the rural intermountain west. The lessons learned from that study were incorporated into a book chapter entitled “Infection Control in Small Hospitals” by Dr. Britt. Since that study no substantial nor systematic review of nosocomial infections in small community or rural hospitals has been reported. A recent editorial in Infection Control posed four questions that still needed to be answered for the smaller (less than 100-bed) hospital:1. Given the statistical realities of small hospitals, what types of surveillance methods—periodic prevalence surveys, general surveillance, focused surveillance, etc.—are the most reliable? Are any of them necessary?2. Which of the many infection control practices recommended by the CDC, the Joint Commission on Accreditation of Hospitals, and others are applicable to small hospitals?3. What resource sharing of existing expertise, from larger hospitals, health departments, groups such as the Association of Practitioners of Infection Control and the Society of Hospital Epidemiologists of America, and others can be developed for smaller hospitals in cost effective and realistic ways?4. Should smaller hospitals be required to have the same type of multidisciplinary infection control committees required of larger hospitals or can the responsibilities of the committee be delegated to a smaller group such as one nurse and one staff physician?The purpose of this report is to provide detailed infection control information obtained from 15 hospitals located in rural areas of Southwestern Wisconsin. This article will focus on data derived from an initial comprehensive prevalence survey that replicated the Britt study in the Wisconsin sites in 1983. Additional data were derived from ongoing bi-monthly prevalence studies done over 6 consecutive months in each of the 15 rural hospitals. Data from 6 months of ongoing comprehensive surveillance from each of the 15 hospitals and final conclusions from the project will be the subject of a subsequent paper.
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Kellesarian, Sergio Varela, Michael Yunker, Hans Malmstrom, Khalid Almas, Georgios E. Romanos, and Fawad Javed. "Male Infertility and Dental Health Status: A Systematic Review." American Journal of Men's Health 12, no. 6 (June 23, 2016): 1976–84. http://dx.doi.org/10.1177/1557988316655529.
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A limited number of studies have reported an association between male factor infertility (MFI) and dental health status (DHS). The aim of the present study was to assess the association between DHS and MFI through a systematic review of indexed literature. To address the focused question—“Is there a relationship between DHS and MFI?”—indexed databases were searched up to March 2016 using various key words “infertility,” “periodontal disease,” “periodontitis,” “dental infection,” “caries,” and “odontogenic infection.” Letters to the editor, case reports, commentaries, historic reviews, and experimental studies were excluded. In total seven studies were included in the present systematic review and processed for data extraction. All the studies reported a positive association between MFI and DHS. The number of study participants ranged between 18 and 360 individuals. Results from six studies showed a positive association between chronic periodontitis and MFI. Three studies reported a positive relationship between MFI and odontogenic infections associated to necrotic pulp, chronic apical osteitis, and radicular cysts. One study reported a relationship between caries index and MFI. From the literature reviewed, there seems to be a positive association between MFI and DHS; however, further longitudinal studies and randomized control trials assessing confounders are needed to establish real correlation. Dentists and general practitioners should be aware that oral diseases can influence the systemic health. Andrological examination should include comprehensive oral evaluation, and physicians detecting oral diseases should refer the patient to a dentist for further evaluation.
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Dias, Natasha M., Jaime O. Moreno, Flávio RF Alves, Lucio S. Gonçalves, and José C. Provenzano. "Antibiotic indication in endodontics by Colombian dentists with different levels of training: a survey." Acta Odontológica Latinoamericana 35, no. 3 (December 19, 2022): 198–205. http://dx.doi.org/10.54589/aol.35/3/198.
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Aim: This study investigated how Colombian dentists with different academic levels indicate antibiotics with therapeutic purposes in endodontics. Materials and method: A cross-sectional survey was conducted among 559 dentists in the form of an online questionnaire. Results: Three hundred and twenty questionnaires were answered (57.2%). There were significant differences among respondents. For irreversible pulpitis, 140 dentists (43.7%) said they prescribe antibiotics (57.5% of general practitioners, 20.1% of specialists and 38.9% of those with Master’s and/or PhD degrees), while for symptomatic apical periodontitis, 183 (57.2%) did so (74.1% of general practitioners, 28.4% of specialists and 50.0% of those with Master’s and/or PhD degrees) (p < 0.05). Amoxicillin was the most frequently prescribed antibiotic, and its association with clavulanic acid was the most often cited for acute periradicular abscess with systemic involvement. Conclusions: The greatest misunderstandings in prescribing antibiotics occurred among general practitioners. Considering all clinical conditions that do not require antibiotics, 60% of general practitioners and 34% of specialists, on average, indicated antibiotics. Keywords: antimicrobial stewardship - dental pulp disease - bacteria - dental infection control - antibacterial drug resistance
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Nikiphorou, Elena, Simon de Lusignan, Christian Mallen, Kaivan Khavandi, Jacqueline Roberts, Christopher D. Buckley, James Galloway, and Karim Raza. "Haematological abnormalities in new-onset rheumatoid arthritis and risk of common infections: a population-based study." Rheumatology 59, no. 5 (September 9, 2019): 997–1005. http://dx.doi.org/10.1093/rheumatology/kez344.
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Abstract Objectives To describe the prevalence of haematological abnormalities in individuals with RA at the point of diagnosis in primary care and the associations between haematological abnormalities, vaccinations and subsequent risk of common infections. Methods We studied 6591 individuals with newly diagnosed RA between 2004 and 2016 inclusive using the UK Royal College of General Practitioners Research and Surveillance Centre primary care database. The prevalence of haematological abnormalities at diagnosis (anaemia, neutropenia and lymphopenia) was established. Cox proportional hazards models were used to evaluate the association between each haematological abnormality and time to common infections and the influence of vaccination status (influenza and pneumococcal vaccine) on time to common infections in individuals with RA compared with a matched cohort of individuals without RA. Results Anaemia was common at RA diagnosis (16.1% of individuals), with neutropenia (0.6%) and lymphopenia (1.4%) less so. Lymphopenia and anaemia were associated with increased infection risk [hazard ratio (HR) 1.18 (95% CI 1.08, 1.29) and HR 1.37 (95% CI 1.08, 1.73), respectively]. There was no evidence of an association between neutropenia and infection risk [HR 0.94 (95% CI 0.60, 1.47)]. Pneumonia was much more common in individuals with early RA compared with controls. Influenza vaccination was associated with reduced risk of influenza-like illness only for individuals with RA [HR 0.58 (95% CI 0.37, 0.90)]. Conclusion At diagnosis, anaemia and lymphopenia, but not neutropenia, increase the risk of common infections in individuals with RA. Our data support the effectiveness of the influenza vaccination in individuals with RA.
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Andersen, Philip R., and Phyllis Tyrrell. "Feline immunodeficiency virus diagnosis after vaccination." Animal Health Research Reviews 5, no. 2 (December 2004): 327–30. http://dx.doi.org/10.1079/ahr200493.
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AbstractPrior to the widespread use of vaccination for the control of feline immunodeficiency virus (FIV) infection, diagnosis was made by the detection of antibodies against FIV. A number of commercial animal side tests perform quite well for this determination, with positive predictive values between 91 and 100% and negative predictive values between 96 and 100%. Furthermore, results of these tests could be confirmed by western blot analysis of FIV test-positive sera. Currently, a killed whole virus FIV vaccine has been made available to practitioners. Vaccinated cats seroconvert by ELISA and western blot, making presently available diagnostic tests, which rely on antibody detection, useless in cats after vaccination. The advisory panels of the American Association of Feline Practitioners and Academy of Feline Medicine both recommend testing for feline leukemia virus antigen and FIV antibody before vaccination.
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Caroff, Daniel A., Paul M. Szumita, and Michael Klompas. "The Relationship Between Sedatives, Sedative Strategy, and Healthcare-Associated Infection: A Systematic Review." Infection Control & Hospital Epidemiology 37, no. 10 (June 20, 2016): 1234–42. http://dx.doi.org/10.1017/ice.2016.129.
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BACKGROUNDHealthcare-associated infections (HAIs) cause significant morbidity in critically ill patients. An underappreciated but potentially modifiable risk factor for infection is sedation strategy. Recent trials suggest that choice of sedative agent, depth of sedation, and sedative management can influence HAI risk in mechanically ventilated patients.OBJECTIVETo better characterize the relationships between sedation strategies and infection.METHODSSystematic literature review.RESULTSWe found 500 articles and accepted 70 for review. The 3 most common sedatives for mechanically ventilated patients (benzodiazepines, propofol, and dexmedetomidine) have different pharmacologic and immunomodulatory effects that may impact infection risk. Clinical data are limited but retrospective observational series have found associations between sedative use and pneumonia whereas prospective studies of sedative interruptions have reported possible decreases in bloodstream infections, pneumonia, and ventilator-associated events.CONCLUSIONInfection rates appear to be highest with benzodiazepines, intermediate with propofol, and lowest with dexmedetomidine. More data are needed but studies thus far suggest that a better understanding of sedation practices and infection risk may help hospital epidemiologists and critical care practitioners find new ways to mitigate infection risk in critically ill patients.Infect Control Hosp Epidemiol 2016;1–9
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Goetz, Angella, Victor L. Yu, and Walter F. O'Donnell. "Surgical Complications Related to Insertion of Penile Prostheses with Emphasis on Infection and Cost." Infection Control & Hospital Epidemiology 9, no. 6 (June 1988): 250–54. http://dx.doi.org/10.1086/645847.
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AbstractWe initiated a prospective study of penile prosthesis implant surgery to evaluate risk factors for infection and other complications. Twenty-one patients admitted for surgery or related complications were evaluated over a seven-month period. The two types of penile prostheses implanted were (1) inflatable and (2) semirigid. Nine of 21 patients (43%) developed postoperative complications. Although cephapirin and gentamicin were given prophylactically, four of nine patients had four wound infections and one case of pneumonia. One case of Bacteroides fragilis bacteremia was due to stool incontinency during surgery. In two of the wound infections, removal and reinsertion of the prosthesis was necessary. Other complications included hypotension during surgery, prosthesis malfunction and malposition, and urethral tears. There were no significant associations between infection and age, length of surgery, or type of prosthesis used. These complications contributed to prolonged hospital stay and readmission (87 extra days for the infected patients at a cost of $44,000). Antibiotic costs to treat the infections totaled $1,900. Prospective evaluation by infection control practitioners of various elective surgeries can be useful in quantitating the complication rate and targeting patients at risk, with the goal of minimizing hospital costs.
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DREESMAN, J. M., A. BAILLOT, L. HAMSCHMIDT, M. MONAZAHIAN, U. C. WEND, and W. H. GERLICH. "Outbreak of hepatitis B in a nursing home associated with capillary blood sampling." Epidemiology and Infection 134, no. 5 (January 26, 2006): 1102–13. http://dx.doi.org/10.1017/s0950268806005942.
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In 2001, two residents of a nursing home in Lower Saxony, Germany, were diagnosed with acute hepatitis B virus (HBV) infection. A systematic contact investigation of 188 residents yielded 19 confirmed or probable cases of acute or recent HBV infection and three persistent asymptomatic HBsAg carriers. Sequence analysis revealed that one carrier had high viraemia (109 genomes/ml), HBV genotype A2, and the same S gene and/or X gene sequence as 16 acutely infected persons. An unmatched case-control study was conducted with the 17 cases that had sequence identity together with 26 controls. The strongest association was found for treatment by a particular general practitioner (GP) (OR>11, P<0·001) and blood sampling for glucose monitoring on a particular day by the GP's staff (OR 13·6, P<0·001, adjusted OR 8·5, P=0·017). Control measures were implemented. Serological controls after 6 and 18 months revealed that the outbreak was brought under control.
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Savor, Connie, Michael A. Pfaller, Julie A. Kruszynski, Richard J. Hollis, Gary A. Noskin, and Lance R. Peterson. "Comparison of Genomic Methods for Differentiating Strains of Enterococcus faecium: Assessment Using Clinical Epidemiologic Data." Journal of Clinical Microbiology 36, no. 11 (1998): 3327–31. http://dx.doi.org/10.1128/jcm.36.11.3327-3331.1998.
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Genomic DNA extracted from 45 vancomycin-resistantEnterococcus faecium (VRE) isolates was cleaved withHindIII and HaeIII and subjected to agarose gel electrophoresis. The ability of this method (restriction endonuclease analysis [REA]) to distinguish strains at the subspecies level was compared with results previously determined by pulsed-field gel electrophoresis (PFGE). Chart reviews were performed to provide a clinical correlation of possible epidemiologic relatedness. A likely clinical association was found for 29 patients as part of two outbreaks. REA found 21 of 21 isolates were the same type in the first outbreak, with PFGE calling 19 strains the same type. In the second outbreak with eight patient isolates, HindIII found six were the same type and two were unique types. HaeIII found three strains were the same type, two strains were a separate type, and three more strains were unique types, while PFGE found three were the same type and five were unique types. No single “ideal” method can be used without clinical epidemiologic investigation, but any of these techniques is helpful in providing focus to infection control practitioners assessing possible outbreaks of nosocomial infection.
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Ekpenyong, Bernadine, Chukwuemeka J. Obinwanne, Godwin Ovenseri-Ogbomo, Kelechukwu Ahaiwe, Okonokhua O. Lewis, Damian C. Echendu, and Uchechukwu L. Osuagwu. "Assessment of Knowledge, Practice and Guidelines towards the Novel COVID-19 among Eye Care Practitioners in Nigeria–A Survey-Based Study." International Journal of Environmental Research and Public Health 17, no. 14 (July 16, 2020): 5141. http://dx.doi.org/10.3390/ijerph17145141.
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The aim of this study was to explore knowledge, practice of risk and guidelines of the novel corona virus disease (COVID-19) infection among the eye care practitioners and the potential associated factors. A cross-sectional self-administered online survey was distributed via emails and social media networks between 2nd and 18th May 2020 corresponding to the week of the lockdown in Nigeria to eye care practitioners (ECPs). Data for 823 respondents were analyzed. Knowledge and risk practice were categorized as binary outcome and univariate and multivariate linear regression were used to examine the associated factors. The mean score for COVID-19-related knowledge of public health guidelines was high and varied across the ECPs. Ophthalmic Nurses, Ophthalmologists and Optometrists showed higher COVID-19-related knowledge than other ECPs (p < 0.001), particularly those working in the private sector. More than 50% of ECPs stated they provided essential services during the COVID-19 lockdown via physical consultation, particularly the Ophthalmologists. Most respondents reported that the guidelines provided by their Association were useful but expressed their lack of confidence in attending to patients during and after the COVID-19 lockdown. Compared to other ECPs in Nigeria, more Ophthalmic Nurses received training in the use of Personal Protective Equipment (PPE). This survey is the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Nigeria. ECPs in Nigeria displayed good knowledge about COVID-19 and provided eye care services during the COVID-19 lockdown in Nigeria, despite the majority not receiving any training on the use of PPEs with concerns over attending to patients. There is need for the government to strengthen health systems by improving and extending training on standard infection prevention and control measures to ECPs for effective control of the pandemic and in the future as essential health workers.
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Sokil, Laura E., Liam H. Wong, Bopha Chrea, James E. Meeker, Jung Yoo, and Lara C. Atwater. "A Large Database Evaluation of Infection and Nonunion Following Ankle Arthrodesis: Does Pain Regimen Matter?" Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0094. http://dx.doi.org/10.1177/2473011421s00947.
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Category: Ankle Arthritis; Ankle Introduction/Purpose: Multimodal therapies are critical for limiting use of opioids for postoperative pain control after orthopaedic procedures. Though NSAIDs and COX-2 inhibitors are effective non-opioid adjuncts for postoperative pain, animal models have demonstrated increased rates of nonunion or delayed union in the presence of NSAIDs. Nonunion or delayed union results in a protracted postoperative course that may warrant longer duration of surveillance or revision procedures. Retrospective studies and meta-analyses investigating NSAID use and bone healing have conflicting findings. Additionally, there are few studies investigating NSAID use and other adverse events such as postoperative infection. Improved understanding of the impact of NSAID use on union rates and infection after ankle arthrodesis will allow practitioners to optimize safe, effective pain control while limiting risk of nonunion. Methods: This large retrospective database study queried a national insurance claims database (PearlDiver Technologies) for patients undergoing ankle arthrodesis from 2015 through 2019 as identified by ICD-10 codes. Patients prescribed NSAIDs or COX-2 inhibitors within six weeks following ankle arthrodesis were identified. Patients with any operation one year prior to or following ankle arthrodesis were excluded from analysis to prevent attributing complications to another operation. Association between NSAID or COX-2 inhibitor use and infection or nonunion following ankle arthrodesis were analyzed using multivariable logistic regression analyses. To adjust for comorbid conditions, multivariable models included age at time of operation, sex, obesity, tobacco use, and diabetes. Results: Our query yielded 2,355 patients in the five-year period who underwent ankle arthrodesis. 257 (11%) patients were prescribed NSAIDs following surgery and 56 (2.4%) patients were prescribed COX-2 inhibitors. Infection risk was similar between patients not prescribed either medication (n=92, 4.5%) and those treated with NSAIDs (n=14, 5.4%; P=0.60) or COX-2 inhibitors (n=2, 3.5%; P=0.99). The nonunion rate between patients not prescribed either medication (n=232, 11%) was similar to those treated with COX-2 inhibitors (n=8, 14%; P=0.64), but increased in patients treated with NSAIDs (n=45, 18%; P=0.006). On multivariable analysis, tobacco use (OR, 1.46; 95% CI, 1.09-1.94), obesity (OR, 2.08; 95% CI, 1.57-2.76), and NSAID use (OR, 1.53; 95% CI, 1.06-2.17) were associated with increased odds of nonunion after ankle arthrodesis (all P<0.02) (Table). Conclusion: Analysis of the PearlDiver database, the largest available administrative claims database, for 2,355 patients undergoing ankle arthrodesis demonstrated an 11% risk of nonunion and 4.5% risk of infection. The risk of nonunion is increased in patients prescribed NSAIDs within six weeks postoperatively (18%). After adjusting for comorbid conditions associated with nonunion, such as tobacco use and obesity, NSAID use increased risk of nonunion whereas COX-2 inhibitor use did not. Prospective investigation is necessary to better understand these relationships, however, our analysis suggests practitioners should judiciously utilize NSAIDs and consider use of COX-2 inhibitors for pain control after ankle arthrodesis surgery.
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Muntean, Andrei-Alexandru, Mădălina-Maria Muntean, and Gabriela-Loredana Popa. ""ANTIBIOGRAM PICTURE GUIDE FOR THE MEDICAL MICROBIOLOGY PRACTITIONER - PART 1: EXTENDED-SPECTRUM BETA-LACTAMASES (ESBLS) AND CEPHALOSPORINASES (AMPCS) IN ENTEROBACTERALES"." Romanian Archives of Microbiology and Immunology 80, no. 4 (December 31, 2021): 312–19. http://dx.doi.org/10.54044/rami.2021.04.02.
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Antibiotic resistance is a global, far-reaching phenomenon. Natural resistance to antibiotics, expressed or inducible, is common in Enterobacterales and can occur through the production of different enzymes such as penicillinases, ESBLs or cephalosporinases. In association with other resistance mechanisms, strains that lead to untreatable infections can emerge. Improper infection control measures are responsible for the selection and spread of these strains. The dissemination of acquired Extended-Spectrum Beta-Lactamases (ESBLs) across the globe is well known, a wide spectrum of enzymes being responsible for their different hydrolytic activity. Another important set of enzymes, the cephalosporinases (with the chromosomal cephalosporinase AmpC as the most important), are also concerning as their hyper-expression can alter wide spectrum beta-lactams, like carbapenems. These mechanisms can be readily observed through phenotypic tests, like antibiotic interactions on the disk diffusion antibiogram, or derepression / inhibition of enzymes using key antibiotics. Keywords: ESBL, cephalosporinase, AmpC, carbapenemase, cloxacillin, oxacillin, antibiotic resistance, antibiogram, Enterobacterales
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Beatty, Julia A., Claire R. Sharp, W. Paul Duprex, and John S. Munday. "Novel feline viruses: Emerging significance of gammaherpesvirus and morbillivirus infections." Journal of Feline Medicine and Surgery 21, no. 1 (November 26, 2018): 5–11. http://dx.doi.org/10.1177/1098612x18808102.
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Practical relevance: New technologies capable of sequencing the genetic material in any given biological sample, combined with computer-based algorithms for sequence assembly and analysis, have revolutionised infectious disease research. The rate at which novel viruses are being discovered now exceeds our understanding of their clinical relevance. Novel viruses may contribute to diseases that are major causes of feline morbidity and mortality, including cancer and chronic kidney disease. The identification of new viral pathogens raises the prospect of not only improved patient outcomes through specific treatment but even disease prevention through viral control measures. Clinical challenges: It can be difficult to determine the role of a novel virus in disease development. Disease may be an occasional outcome, often years after infection. A high prevalence of infection in the general population can make disease associations harder to identify and almost impossible to rule out. Host cofactors such as immune dysfunction, genetic background or coinfections may be required for manifestation of disease, and one virus species may be linked to a range of pathological sequelae. Establishing causality relies on evaluating accumulating evidence from multiple investigations, which is often hard to access by practitioners. Global importance: The worldwide distribution of gammaherpesvirus and morbillivirus infections in domestic cats underlines the potential of these viruses to negatively impact feline health and welfare globally. Evidence base: This review relies on grade Ia–III evidence.
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Akunne, Maureen Ogochukwu, Uchechukwu Chris Chukwueke, and Chibueze Anosike. "ASSESSMENT OF KNOWLEDGE OF ZIKA VIRUS INFECTION AMONG HEALTH CARE PROFESSIONALS IN A SOUTHEASTERN STATE OF NIGERIA." International Journal of Pharmacy and Pharmaceutical Sciences 10, no. 2 (February 1, 2018): 56. http://dx.doi.org/10.22159/ijpps.2018v10i2.22634.
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Objective: Zika virus infection is fast becoming a major public health concern in both developed and developing countries of the world because of its association with microcephaly and Guillain Barre Syndrome. Assessment of its knowledge and understanding among different healthcare practitioners are essential for prevention and control especially in developing countries such as Nigeria. Our aim was to assess the knowledge of the virus and its associated factors among healthcare professionals (HCPs).Methods: A cross-sectional study was conducted from June 10 to August 28, 2016, among health care professionals who were selected by non-probability convenience sampling technique. The respondents were selected from various practice settings including academic institution, private and government hospitals in Enugu State, Nigeria. A validated and pilot tested 15 item questionnaire was used to evaluate respondents’ knowledge of ZIKV infection. Descriptive statistics and chi-square were used to analyze respondents’ level of knowledge and its associated factors using SPSS version 16.Results: Two hundred (200) respondents participated in this study with more than half (53.0%) being male, and most were either Physician or Pharmacist (59.5%). Our results also showed that most of the respondents (128, 64.0%) had poor knowledge of ZIKV infection. However, among the respondents assessed, the Pharmacists and the Physicians had better knowledge of the disease as the test statistics were statistically significant at X2=16.722, p=0.033. HCPs in the academia had better knowledge compared to those that are self-employed or practicing in private or government hospitals (X2=17.178, p=0.028).Conclusion: Our findings suggest that most of the HCPs assessed in this study had poor knowledge of ZIKV infection. However, professional status, place of service, and study site were found to be associated with the respondents’ level of knowledge. Hence, through sensitization and awareness campaigns through the media, seminars, and workshops aimed at educating HCPs on the disease should be encouraged.
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Vasilevska, Lidushka, Elena Kjosevska, and Tanja Lekovska-Stoicovska. "Prevention of Coronavirus infections SARS-CoV-2 in dental practice." Archives of Public Health 13, no. 1 (March 15, 2021): 1–18. http://dx.doi.org/10.3889/aph.2021.5992.
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The COVID-19 pandemic is an unprecedented global crisis in public health. Professionals in dental institutions, dental associations and regulatory bodies face various challenges in providing dental care and prevention of oral health of the population, as well as protection of patients and practitioners from the health threat of SARS-CoV-2 virus. The aim of this paper is to present the current findings and views regarding the information on the epidemiological and clinical characteristics of the SARS-CoV-2 virus and the need to implement protocols to protect patients and dental practitioners from the health threat posed by the virus, in compliance with medically relevant regulations.Material and methods: References from WHO, FDI and published papers in international scientific journals in this relatively short period were consulted and they presented: updated epidemiological and seroepidemiological information, review of response measures implemented in EU countries / EEA, UK and countries around the world and response options to minimize the risk of recurrence of COVID-19. Results: Viral pneumonia that appeared on February 11, 2020, was named "Coronavirus (COVID 19)" by the WHO, while the International Committee on Taxonomy of Viruses (ICTV) proposed the name "SARS-CoV-2" for phylogenetic and taxonomic analysis of this corona virus. Dentists/doctors of dental medicine should be familiar with transmission of SARS-CoV-2, how to identify patients with SARS-CoV-2 infection and what measures should be taken for protection during the intervention in order to prevent its transmission. There are recommendations for infection control measures that should be followed by the dentists/doctors of dental medicine. The fact that aerosols and drops have been considered for major SARS-CoV-2 propagation routes has been emphasized. If these measures are not undertaken, then the dental office can potentially expose patients to cross-infection.
Conclusion: The epidemiological situation around the world is changing dynamically, but patients should not be left without urgent medical help. Oral health team members are required to update their knowledge and skills regarding the prevention, diagnosis and management of communicable diseases that can be transmitted in a clinical setting and to stick to the standard precautions to protect patients from infections as well as protect themselves.
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Kathree, Bashier Ahmed, Saadika B. Khan, Rukshana Ahmed, Ronel Maart, Nazreen Layloo, and Winifred Asia-Michaels. "COVID-19 and its impact in the dental setting: A scoping review." PLOS ONE 15, no. 12 (December 18, 2020): e0244352. http://dx.doi.org/10.1371/journal.pone.0244352.
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Introduction The scoping review examined the evidence related to infection control and transmission measures of the SARS-CoV-2 virus in a dental setting during this pandemic. Dental practitioners are normally guided in practice by set ethical principles, thus the researchers wanted to determine how these rules are managed during this pandemic. Methods A protocol specific for the objectives of this study was developed according to the criteria for a scoping review. Relevant databases (Pubmed, Scopus, Elsevier, Science Direct, Wiley), including online access to health/ dental organizations (World Health Organization/ American Dental Association), were searched to identify evidence which was restricted to the English language for the period 2015–2020. Predetermined eligibility criteria were applied, evidence was assessed and data extracted for each included article. Relevant outcomes assessed were: infection control measures, transmission of the SARS-CoV-2 virus, such as modes and sources of transmission and the ethical principles related to the dental setting with a focus on the COVID-19 pandemic. Results Searches yielded a total of 402 articles: 387 from electronic databases and 15 from other sources. Of these, 231 were unrelated to the objectives of the current scoping review. The full text of 69 studies was assessed for eligibility, of which 26 were finalized for inclusion following the objectives and inclusion criteria set for the scoping review. Most of the included articles were reviews, recommendations and guidelines for dentists. A narrative explanation of the pre-specified outcomes is reported for the 3 areas covered for this review. There is no clinical evidence available that can support the recommendations by individuals, dental organizations or health authorities related to the objectives of this review, but these may be considered as the much needed guidelines during the unprecedented COVID-19 pandemic. A different ethical framework is required during a pandemic and these must be informed by evidence.
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Panchaud, Alice, Miloš Stojanov, Anne Ammerdorffer, Manon Vouga, and David Baud. "Emerging Role of Zika Virus in Adverse Fetal and Neonatal Outcomes." Clinical Microbiology Reviews 29, no. 3 (June 8, 2016): 659–94. http://dx.doi.org/10.1128/cmr.00014-16.
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SUMMARYThe rapid spread of the Zika virus (ZIKV) in the Americas and its potential association with thousands of suspected cases of microcephaly in Brazil and higher rates of Guillain-Barré syndrome meet the conditions for a Public Health Emergency of International Concern, as stated by the World Health Organization in February 2016. Two months later, the Centers for Disease Control and Prevention (CDC) announced that the current available evidence supports the existence of a causal relationship between prenatal Zika virus infection and microcephaly and other serious brain anomalies. Microcephaly can be caused by several factors, and its clinical course and prognosis are difficult to predict. Other pathogens with proven teratogenicity have been identified long before the current ZIKV epidemic. Despite the growing number of cases with maternal signs of infection and/or presence of ZIKV in tissues of affected newborns or fetuses, it is currently difficult to assess the magnitude of increase of microcephaly prevalence in Brazil, as well as the role of other factors in the development of congenital neurological conditions. Meanwhile, health agencies and medical organizations have issued cautious guidelines advising health care practitioners and expectant couples traveling to, returning from, or living in affected areas. Analogous to dengue virus (DENV) epidemics, ZIKV has the potential to become endemic in all countries infested byAedesmosquitoes, while new mutations could impact viral replication in humans, leading to increased virulence and consequently heightened chances of viral transmission to additional naive mosquito vectors. Studies are urgently needed to answer the questions surrounding ZIKV and its role in congenital neurological conditions.
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Garcia, Diana G., Donnell P. Ewert, and Laurene Mascola. "A Survey of Hospital Postpartum and Postabortion Rubella Vaccination Policies in Los Angeles County, 1992." Infection Control & Hospital Epidemiology 14, no. 9 (September 1993): 513–16. http://dx.doi.org/10.1086/646795.
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AbstractObjective:To determine the proportion of Los Angeles County (LAC) hospitals offering obstetrical services that have postpartum and postabortion rubella vaccination policies.Design:A survey was sent to the infection control practitioners (ICPs) of all operational acute care hospitals (N = 133) in LAC in 1992. A reminder and second survey was mailed to ICPs who did not respond to the first mailing.Results:Of 75 hospitals with obstetrical departments, 56 (75%) responded. Thirty-four (61%) of the 56 respondent hospitals had postpartum rubella vaccination policies. Of the 34 hospitals with policies, 30 (88%) accepted only a written record of rubella seropositivity as proof of immunity, 30 (88%) screened women with unknown immunity status before hospital discharge, and 32 (94%) vaccinated susceptible women before hospital discharge. Of the 32 hospitals that performed induced abortions, only two (6%) provided screening and vaccination services for these women.Conclusion:Only 61% of hospitals in LAC offering obstetrical services had postpartum rubella vaccination policies while only minimal screening and vaccination occurred in association with abortion services. Widespread implementation of postabortion screening and vaccination, and more stringent compliance with Advisory Committee on Immunization Practices recommendations for postpartum screening and vaccination in hospitals offering obstetrical services would reduce the number of rubella-susceptible women who have been missed by other prevention strategies.
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North, Arlene, Jean Stratton, David Moore, and Margaret McCann. "DRY GAUZE AND IODINE TULLE DRESSINGS FOR THE PREVENTION OF INFECTION IN PATIENTS WITH A LOWER LIMB EXTERNAL FIXATOR: A RETROSPECTIVE OBSERVATIONAL STUDY." Orthopaedic Proceedings 105-B, SUPP_10 (June 1, 2023): 22. http://dx.doi.org/10.1302/1358-992x.2023.10.022.
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IntroductionExternal fixators are attached to bones with percutaneous pins and wires inserted through soft tissues and bone increasing the risk of infections. Such infections compromise patient outcomes e.g., through pin loosening or loss, failure of fixator to stabilise the fracture, additional surgery, increased pain, and delayed mobilisation. These infections also impact the healthcare system for example, increased OPD visits, hospitalisations, treatments, surgeries and costs. Nurses have a responsibility in the care and management of patients with external fixators and ultimately in the prevention of pin-site infection. Yet, evidence on best practices in the prevention of pin-site infection is limited and variation in pin-site management practices is evident. Various strategies are used for the prevention of pin-site infection including the use of different types of non-medicated and medicated wound dressings. The aim of this retrospective study was to investigate the use of dry gauze or iodine tulle dressings for the prevention of pin-site infections in patients with lower limb external fixators.MethodologyA retrospective study of patients with lower limb external fixators who attended the research site between 2015–2022. Setting & Sample: The setting was the outpatient's (OPD) orthopaedic clinic in a University Teaching Hospital in Dublin, Ireland. Eligibility Criteria:Over the age of 16, treated with an Ilizarov, Taylor Spatial frame (TSF) or Limb Reconstruction System (LRS) external fixators on lower limbs,Pin-sites dressed with dry gauze or iodine tulle,Those with pre-existing infected wounds close to the pin site and/or were on long term antibiotics were excluded.Follow Up Period: From time of external fixator application to first pin-site infection or removal of external fixator. Outcome Assessment: The primary outcome was pin-site infection, secondary outcomes included but were not limited to frequency of pin-site infection according to types of bone fixation, frequency of pin/wire removal and hospitalisation due to infection. Data analysis: IBM SPSS Version 25 was used for statistical analysis. Descriptive and inferential statistics were conducted as appropriate. Categorical data were analysed by counting the frequencies (number and percentages) of participants with an event as opposed to counting the number of episodes for each event. Differences between groups were analysed using Chi-square test or Fisher's exact test, where appropriate. Continuous variables were reported using mean and standard deviations and difference analysed using a two-sample independent t-test or non-parametric test (Mann-Whitney), where appropriate. Using Kaplan-Meier, survival analysis explored time to development of infection. Ethical approval: granted by local institute Research Ethics Committee on 12th March 2018.ResultsDuring the study period, 97 lower limb external fixators were applied with 43 patients meeting the study eligibility criteria. The mean age was 38 (SD 14.1; median 37) and the majority male (n=32, 74%). At least 50% (n=25) of participants had an IIizarov fixator, with 56% (n=24) of all fixators applied to the tibia and fibula. Pin/wire sites were dressed using iodine (n=26, 61%) or dry gauze dressings (n=15, 35%). The mean age of participants in the iodine group was significantly higher than the dry gauze group (p=.012). The only significant difference between the iodine and dry gauze dressing groups at baseline was age. A total of 30 (70%) participants developed a pin-site infection with 26% (n=11) classified as grade 2 infection. Clinical presentation included redness (n=18, 42%), discharge (n=16, 37%) and pain (n=15, 35%). Over half of participants were prescribed oral antibiotics (n=28, 65%); one required intravenous antibiotics and hospitalization due to pin-site infection. Ten (23%) participants required removal of pin/wires; two due to pin-site infection. There was no association between baseline data and pin-site infection. The median time to developing an infection was 7 weeks (95%, CI 2.7 to 11.29). Overall, there were 21 (81%, n=26) pin-site infections in the iodine group and nine (60%, n=15) in the dry gauze group, difference in proportion and relative risk between the dressing groups were not statistically significant (RR 1.35, 95% CI 0.86–2.12; p= .272). There was no association between baseline data, pin-site infection, and type of dressingConclusionsAt the research site, patients are referred to the OPD orthopaedic clinic from internal and external clinical sites e.g., from Hospital Consultants, General Practitioners and occasionally from multidisciplinary teams, throughout Ireland. Our retrospective observation study found that 97 lower limb external fixators were applied over a seven-year period which is lower than that reported in the literature. However, the study period included the COVID pandemic years (2020 and 2021) which saw a lower number of external fixators applied due to lack of theatre availability, cancelled admissions and social/travel restrictions that resulted in fewer accidents and lower limb trauma cases requiring external fixator application. The study highlighted a high infection rate with 70% of participants developing pin-site infection which is in keeping with findings reporting in other studies. Our study showed that neither an iodine nor dry gauze dressing was successful in preventing pin-site infection. In the iodine group 81% of participants developed infection compared to 60% in the dry gauze group. Given the lack of difference between the two groups consideration needs to be given to the continued use of iodine dressings in the prevention of pin-site infection. Pin-site infections result in a high portion of participants being prescribed antibiotics and, in an era, that stresses the importance of antimicrobial stewardship there is a need to implement effective infection prevention and control strategies that minimise infection. Further research is therefore needed to investigate more innovative medicated dressings such as those that contain anti-microbial or anti-bacterial agents.
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Lindley, Megan C., Juliet Yonek, Faruque Ahmed, Joseph F. Perz, and Gretchen Williams Torres. "Measurement of Influenza Vaccination Coverage among Healthcare Personnel in US Hospitals." Infection Control & Hospital Epidemiology 30, no. 12 (December 2009): 1150–57. http://dx.doi.org/10.1086/648086.
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Objective.To characterize practices related to measuring influenza vaccination rates among healthcare personnel in US hospitals.Design.Descriptive survey.Setting.Nonfederal, short-stay hospitals that provide general medical and surgical services, identified by use of the 2004 American Hospital Association Annual Survey Database.Participants.Healthcare personnel from 996 randomly sampled US hospitals stratified by region and bed size.Methods.A self-administered questionnaire was distributed in 2006 to infection control coordinators to gather data on policies and practices related to the provision of the influenza vaccine and on the measurement and reporting of influenza vaccination rates. Descriptive statistics and associations were calculated, and logistic regression was conducted.Results.The response rate was 56% (ie, 555 of 996 US hospitals responded to the questionnaire). Weighting accounted for sampling design and nonresponse. Most hospitals provided the influenza vaccine to employees (100%), credentialed medical staff (ie, independent practitioners; 94%), volunteers (86%), and contract staff (83%); provision for students and residents was less frequent (58%). Only 69% of hospitals measured vaccination rates (mean coverage rate, 55%). Most hospitals that measured coverage included employees (98%) in the vaccination rates, whereas contract staff (53%), credentialed medical staff (56%), volunteers (56%), and students and residents (30%) were less commonly included. Among hospitals measuring coverage, 44% included persons for which vaccine was contraindicated, and 51% included persons who refused vaccination. After adjustment for region and size, hospitals with vaccination plans written into policy (odds ratio, 2.0 [95% confidence interval, 1.22–7.67]) or that addressed internally reporting coverage (odds ratio, 4.8 [95% confidence interval, 2.97–7.66]) were more likely to measure coverage than were hospitals without such plans.Conclusions.Hospitals vary in terms of the groups of individuals included in influenza vaccination coverage measurements. Standardized measures may improve comparability of hospital-reported vaccination rates. Measuring coverage in a manner that facilitates identification of occupational groups with low vaccination rates may inform development of targeted interventions.
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Arykan, N. G., A. E. Shestopalov, E. E. Khvorostinina, A. O. Alekseeva, and K. S. Asaturyan. "Selecting anticoagulant therapy in patients with cirrhosis." Russian Medical Inquiry 6, no. 5 (2022): 286–92. http://dx.doi.org/10.32364/2587-6821-2022-6-5-286-292.
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Patients with liver diseases have a higher risk of hemostatic disorders. Meanwhile, despite a well-established opinion on a low risk of thromboses in cirrhosis, thromboembolic events cannot be totally ruled out in these patients. Increased risks of thrombotic events and venous thromboembolism in cirrhosis are accounted for by external (immobilization, surgeries, infections, comorbidities) and internal factors (reduced synthesis of anticoagulants, increased levels of estrogens). Practically, the selection of anticoagulant therapy in cirrhosis is difficult because of divergent hemostatic disorders and requires continuous and careful monitoring of hemostasis. In 2019, the American Gastroenterological Association (AGA) released guidelines on anticoagulant therapy in patients with cirrhosis and pulmonary embolism. We describe a patient with cirrhosis and pulmonary embolism. A management strategy was tailored to the AGA guidelines, the Russian Society on Liver Research guidelines, and the Russian Gastroenterological Association on Fibrosis and Cirrhosis and Complication Diagnosis and Treatment guidelines. This example of successful selection of anticoagulant therapy, multidisciplinary approach, and dynamic evaluation of all available methods of hemostasis control will be useful for practitioners. KEYWORDS: cirrhosis, hemostasis, thrombosis, hemorrhage, venous thromboembolism, pulmonary embolism, thromboelastometry, anticoagulant, low-molecular-weight heparin. FOR CITATION: Arykan N.G., Shestopalov A.E., Khvorostinina E.E. et al. Selecting anticoagulant therapy in patients with cirrhosis. Russian Medical Inquiry. 2022;6(5):286–292 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-286-292.
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Harvey, John B., Jacqueline M. Roberts, and Peter M. Schantz. "Survey of veterinarians’ recommendations for treatment and control of intestinal parasites in dogs: Public health implications." Journal of the American Veterinary Medical Association 199, no. 6 (September 15, 1991): 702–7. http://dx.doi.org/10.2460/javma.1991.199.06.702.
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Summary A systematic, random sample of 450 small and mixed-animal practitioners was selected from the client list of a prominent veterinary pharmaceutical and animal health company. A telephone survey was conducted, using a standard questionnaire, to assess whether current veterinary practices concerning prophylaxis and treatment of canine roundworm (Toxocara canis) and hookworm (Ancylostoma spp) infections are adequate to prevent transmission to human beings. Analysis of results focused on 3 questions related to prevention: practitioner's frequency of client education regarding zoonotic potential of roundworms and hookworms, pup age at which veterinarian recommends first anthelmintic treatments, and proportion of veterinarians recommending prophylactic drug administration for pups and nursing bitches. Despite the proven association of household pet dogs and human toxocariasis, only a third (148/450) of veterinarian respondents routinely discussed the potential zoonotic hazards of canine roundworms with their clients. A total of 29% (130/450) of veterinarians surveyed either never discussed these potential hazards or discussed them only when asked by their clients. With regard to anthelmintic treatment practices, 31% (140/450) of veterinarians surveyed recommended that pups first be examined and treated for intestinal parasites within 4 weeks of age. Thirty-three percent (163/450) recommended first examination and deworming at 5 to 6 weeks of age, and 36% (163/450) suggested that it be done at or after 7 weeks of age. Less than half (208/450) of veterinarians administered anthelmintics prophylactically to at least some pups and dogs. Sixty-four percent (287/450) of respondents recommended routine testing and treatment of nursing bitches. Because of the low frequency of direct client education regarding the potential zoonotic hazards of roundworms and hookworms in pets and the wide disparity in methods of treatment, we conclude that current veterinary practices are inadequate for maximal prevention of environmental contamination with eggs of these intestinal helminths. Systematic anthelmintic treatment and simple hygienic practices are necessary to avoid the risk of zoonotic transmission. We recommend that prophylactic deworming programs be initiated 2 to 3 weeks after pups are whelped, and that these programs include the nursing bitch. Treatment should be repeated every 2 to 3 weeks until 3 months after birth. Dog breeders and pet store owners, as well as private pet owners, need to be educated regarding the time to begin deworming the pups and bitch to effectively reduce environmental contamination with eggs of roundworms and hookworms.
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Gugliotti, Ron. "Infection control practitioners." American Journal of Infection Control 16, no. 1 (February 1988): 34. http://dx.doi.org/10.1016/0196-6553(88)90009-0.
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Dys, Sarah, Jaclyn Winfree, Paula Carder, Kaylin Dugle, Sheryl Zimmerman, and Kali Thomas. "“Doing the Impossible with the Inadequate”: COVID-19 Response in U.S. Assisted Living Settings." Innovation in Aging 4, Supplement_1 (December 1, 2020): 930–31. http://dx.doi.org/10.1093/geroni/igaa057.3412.
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Abstract The COVID-19 pandemic has disproportionately affected long-term care operators, staff, residents and their families; although much attention has been given to nursing homes, largely lost in the discourse are assisted living, residential care, and dementia care (AL) communities. As part of a broader, ongoing study assessing states’ AL regulations regarding medical and mental health care for residents with Alzheimer’s and related dementias (ADRD), stakeholders across the United States were recruited in July and August 2020 for semi-structured interviews to provide their perspectives on AL policies and practices specific to COVID-19 response. Stakeholders (n=32) consisted of state healthcare and trade association representatives, clinical practitioners, operators, researchers, and dementia care experts experienced in AL-related operational, healthcare, and regulatory affairs. Using thematic analysis, we describe several emerging topics regarding the opportunities, challenges, and innovations of responding to COVID-19 within the unique context of AL. States’ public health responses to COVID-19 lacked an understanding of the broader long-term care system, especially AL’s scope and purpose, workforce, capacity to implement infection control practices and policies, and unintended consequences of social isolation for older adults, specifically residents living in dementia care units. Despite these challenges, stakeholders described opportunities to expand telehealth infrastructure, communication and collaboration across states and among operators, and several innovations to mitigate the effects of social isolation. It is imperative for policymakers to understand the nuances of the AL context and design regulations and public health responses grounded in a whole-person perspective and in partnership with operators during, and beyond, pandemic circumstances.
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Sara, Toema, Ogwo Chukwuebuka, Patel Nikita, Fritz Caileigh, Catalano Alexandria, Saclayan Angelica, and Mekled Salwa. "The impact of the COVID-19 pandemic on parents seeking dental care for their children." Open Journal of Pediatrics and Child Health 8, no. 1 (June 13, 2023): 015–23. http://dx.doi.org/10.17352/ojpch.000047.
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Many changes in routine dental care were implemented to protect dentists and patients during the COVID-19 pandemic. Pediatric dentists face unique challenges in dealing with parental fears and behavioral changes in pediatric patients. Despite the meticulous infection control protocols that dental offices have implemented during the pandemic, they experienced significant reductions in routine recall. The aim of this study is to assess the impact of the SARS-CoV-2 pandemic on parents seeking dental care for their children at the Temple Kornberg School of Dentistry (TUKSoD). Parents who currently have their children treated at the TUKSoD were invited to participate in a questionnaire. One hundred and six parents completed the survey anonymously on paper. The survey focused on parents’ attitude changes towards dental care for their children post-pandemic. Bivariate analysis followed by a Two-way ANOVA test was used to calculate the association between the effect of the COVID-19 pandemic on parents of pediatric patients’ decision to seek dental care versus the age of the child. Our results showed that improved dental protocols increased the likelihood of parents bringing their children to the dentist during the COVID pandemic (p < 0.001). The results help pediatric dentists to build trust among their patients during the pandemic. It will also help policymakers understand the pediatric patients’ parents’ concerns and assess their current safety measures. Ultimately, this study will give practitioners more insight into how to handle outbreaks of new COVID-19 variants that may present in the future.
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Lejeune, Manigandan, Sabine Mann, Holly White, Danielle Maguire, Jaime Hazard, Rebecca Young, Charles Stone, Doug Antczak, and Dwight Bowman. "Evaluation of Fecal Egg Count Tests for Effective Control of Equine Intestinal Strongyles." Pathogens 12, no. 11 (October 26, 2023): 1283. http://dx.doi.org/10.3390/pathogens12111283.
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The American Association of Equine Practitioners strongly advocates evidence-based intestinal strongyle control in horses. It recommends targeted treatment of all heavy egg shedders (>500 eggs per gram (EPG) of feces), while the low shedders (0–200 EPG) are left untreated. As 50–75% of adult horses in a herd are low shedders, preventing them from unnecessary anthelmintic exposure is critical for tackling resistance. There are various fecal egg count (FEC) techniques with many modifications and variations in use, but none is identified as a gold standard. The hypothesis of the study was that the diagnostic performance of 12 commonly used quantitation methodologies (three techniques with four variants) differs. In this regard, method comparison studies were performed using polystyrene beads as proxy for intestinal strongyle eggs. Mini-FLOTAC-based variants had the lowest coefficient of variation (CV%) in bead recovery, whereas McMaster variants had the highest. All four variants of Mini-FLOTAC and the NaNO3 1.33 specific gravity variant of modified Wisconsin followed a linear fit with R2 > 0.95. In contrast, the bead standard replicates for modified McMaster variants dispersed from the regression curve, causing a lower R2. The Mini-FLOTAC method seems less influenced by the choice of floatation solution and has better repeatability parameters and linearity for bead standard recovery. For FEC tests with high R2 (>0.95) but that underestimated the true bead count, a correction factor (CF) was determined to estimate the true count. Finally, the validity of CF was analyzed for 5 tests with R2 > 0.95 to accurately quantify intestinal strongyle eggs from 40 different horses. Overall, this study identified FEC methodologies with the highest diagnostic performance. The limitations in standardizing routine FEC tests are highlighted, and the importance of equalization of FEC results is emphasized for promoting uniformity in the implementation of parasite control guidelines.
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McIntyre, Kirsty Marie, Frederick J. Bolton, Rob M. Christley, Paul Cleary, Elizabeth Deja, Ann E. Durie, Peter J. Diggle, et al. "A Fully Integrated Real-Time Detection, Diagnosis, and Control of Community Diarrheal Disease Clusters and Outbreaks (the INTEGRATE Project): Protocol for an Enhanced Surveillance System." JMIR Research Protocols 8, no. 9 (September 26, 2019): e13941. http://dx.doi.org/10.2196/13941.
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Background Diarrheal disease, which affects 1 in 4 people in the United Kingdom annually, is the most common cause of outbreaks in community and health care settings. Traditional surveillance methods tend to detect point-source outbreaks of diarrhea and vomiting; they are less effective at identifying low-level and intermittent food supply contamination. Furthermore, it can take up to 9 weeks for infections to be confirmed, reducing slow-burn outbreak recognition, potentially impacting hundreds or thousands of people over wide geographical areas. There is a need to address fundamental problems in traditional diarrheal disease surveillance because of underreporting and subsequent unconfirmed infection by patients and general practitioners (GPs); varying submission practices and selective testing of samples in laboratories; limitations in traditional microbiological diagnostics, meaning that the timeliness of sample testing and etiology of most cases remains unknown; and poorly integrated human and animal surveillance systems, meaning that identification of zoonoses is delayed or missed. Objective This study aims to detect anomalous patterns in the incidence of gastrointestinal disease in the (human) community; to target sampling; to test traditional diagnostic methods against rapid, modern, and sensitive molecular and genomic microbiology methods that identify and characterize responsible pathogens rapidly and more completely; and to determine the cost-effectiveness of rapid, modern, sensitive molecular and genomic microbiology methods. Methods Syndromic surveillance will be used to aid identification of anomalous patterns in microbiological events based on temporal associations, demographic similarities among patients and animals, and changes in trends in acute gastroenteritis cases using a point process statistical model. Stool samples will be obtained from patients’ consulting GPs, to improve the timeliness of cluster detection and characterize the pathogens responsible, allowing health protection professionals to investigate and control outbreaks quickly, limiting their size and impact. The cost-effectiveness of the proposed system will be examined using formal cost-utility analysis to inform decisions on national implementation. Results The project commenced on April 1, 2013. Favorable approval was obtained from the Research Ethics Committee on June 15, 2015, and the first patient was recruited on October 13, 2015, with 1407 patients recruited and samples processed using traditional laboratory techniques as of March 2017. Conclusions The overall aim of this study is to create a new One Health paradigm for detecting and investigating diarrhea and vomiting in the community in near-real time, shifting from passive human surveillance and management of laboratory-confirmed infection toward an integrated, interdisciplinary enhanced surveillance system including management of people with symptoms. International Registered Report Identifier (IRRID) DERR1-10.2196/13941
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Venyo, Anthony Kodzo-Grey. "Schistosomiasis Associated Glomerulopathy (Glomerulonephristis / Nephrotic Syndrome): A review and Update of the Literature." General Medicine and Clinical Practice 3, no. 4 (December 14, 2020): 01–19. http://dx.doi.org/10.31579/2639-4162/037.
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Schistosomiasis may affect a number of organs within the human body. Schistosomiasis may also be associated with glomerular disease of the kidney in the form of glomerulonephritis and nephrotic syndrome. The association between Schistosomiasis and glomerulopathy may not be well known by a number of practitioners and its pathophysiology may not be very well understood and this could be due to the underdiagnosis of the disease due to the possibility of lack of facilities within the Schistosomiasis endemic areas of the world especially within tropical Africa. Nevertheless, there are a number of patterns of renal involvement in Schistosomiasis which include (a) upper urinary tract sequelae of lower urinary tract Schistosomiasis pathology, (b) immune-related glomerulonephritis, (c) as well as oxidant-stress-mediated renal tubular glomerulonephritis. The renal involvement by Schistosomiasis does tend to be ensued by the development of Schistosomiasis-associated Glomerulopathy (Glomerulonephritis / Nephrotic Syndrome) of varying severity. Individuals affected by Schistosomiasis-associated kidney disease may develop (a) asymptomatic disease which tends to related to self-limited and asymptomatic glomerular disease (b) symptomatic disease which most commonly would tend to present with nephrotic syndrome most often in patients who develop hepato-splenic schistosomiasis with liver fibrosis associated with Schistosoma mansoni infection. Symptomatic patients tend to develop severe hypo-proteinemia, half of the patients tend to have elevated blood pressure. In the absence of nephrotic syndrome, patients who have Schistosomiasis-associated glomerulopathy may manifest with: (a) isolated non-nephrotic syndrome proteinuria (b) acute glomerulonephritis associated with haematuria and heavy proteinuria, (c) Nephrotic syndrome together with systemic manifestations of co-infection with salmonella (class II) or hepatitis C virus (Class I), (d) End stage renal disease (ESRD). Some of the patients who have Schistosomiasis of the kidney may present with Haematuria, Hypertension, Hepato-splenic Schistosomiasis. The diagnosis should be suspected with regard to the following scenarios: (a) clinical suspicion in a patient with kidney disease who is known or has been known to have Schistosoma mansoni; (b) exposure to an endemic area, (c) clinical evidence / demonstration of chronic hepatosplenic schistosomiasis, (d) if the patient has not been diagnosed as having been afflicted with schistosomiasis, then schistosomal infection should be documented, (e) majority of patients with schistosomiasis and kidney disease should have kidney biopsy. (f) The patients should be evaluated for co-infection with salmonella, hepatitis C virus, and hepatitis B virus in order to ensure adequate treatment of the disease. Schistosomiasis is the second most devastating tropical parasitic disease globally which tends to be responsible for many urological complications. Nevertheless, glomerular injury is an uncommon complication which has mainly or most often described with Schistosoma Mansoni. When patients who have Schistosomiasis-associated Kidney disease are managed and followed-up on long-term basis with renal end points, one third of the patients independent of the histopathology examination features of the kidney biopsies would tend to progress dialysis. Membranoproliferative glomerulonephritis (MPGN) is an uncommon complication associated with Schistosoma Haematobium infection which tends to be associated with potentially poor prognosis. MPGN could lead quickly to End Stage Renal Disease (ESRD). Anti-helminthic and immunosuppressive medicaments tend not to be effective at advanced stages of the disease and hence efforts need to be focused upon the prevention, early detection, as well as treatment of Schistosoma infections among at-risk groups of individuals. In order to reduce morbidity related to Schistosoma-associated nephropathy, public health policy, should be concentrated upon the prevention of the disease by the control of snail, improved sanitation, and health education, as well as by the implementation, and sustenance of chemotherapy-based control strategies. Considering that many individuals are found yearly to be inflicted by Schistosomiasis who tend to dwell in more rural parts of their countries where facilities for the undertaking of renal function tests and biopsies of the kidney tend not to be readily available, there is the likelihood that Schistosomiasis-associated nephropathies may be highly underdiagnosed globally.
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Chalder, T., J. Neeleman, S. E. Reme, M. Power, and S. Wessely. "Factors associated with acute fatigue in primary care." Psychological Medicine 40, no. 8 (January 27, 2010): 1289–95. http://dx.doi.org/10.1017/s0033291709992327.
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BackgroundTo examine the role of psychological distress, negative life events, social support and lack of fitness (using breathlessness on exertion as a proxy) in the development of new onset fatigue in a primary care population.MethodAdults between the ages of 18 and 45 years who were registered with five general practices in South East England were asked to complete a fatigue questionnaire and the 12-item General Health Questionnaire. Between 1 and 12 months later, subjects who visited the general practitioner (GP) with a suspected viral infection were recruited to the study and asked to complete measures of fatigue, psychological distress, life events, social support and allergies (stage 2). The next person to present to the GP with a complaint other than a viral illness was recruited as a control. Factors assessed at stage 2 that were associated with the development of fatigue were examined with stepwise logistic regression.ResultsAcute fatigue was not associated with a viral illness. Negative life events and breathlessness on exertion (interpreted as lack of fitness) were associated with incident cases of fatigue. However, when controlling for concurrent psychological distress, the independent association of negative life events disappeared.ConclusionsPsychological distress was strongly associated with new onset fatigue and hence emphasizes the significance of psychological distress as a concomitant complaint in fatigue. Further, the salient association between breathlessness and fatigue may indicate the need to recommend exercise as a therapeutic strategy to improve physical fitness in the primary care setting.
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Fernández-de-las-Peñas, César, Jorge Rodríguez-Jiménez, Ignacio Cancela-Cilleruelo, Angel Guerrero-Peral, José D. Martín-Guerrero, David García-Azorín, Ana Cornejo-Mazzuchelli, Valentín Hernández-Barrera, and Oscar J. Pellicer-Valero. "Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients." JAMA Network Open 5, no. 11 (November 15, 2022): e2242106. http://dx.doi.org/10.1001/jamanetworkopen.2022.42106.
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ImportanceIdentification of long-term post–COVID-19 symptoms among hospitalized and nonhospitalized patients is needed.ObjectiveTo compare the presence of post–COVID-19 symptoms 2 years after acute SARS-CoV-2 infection between hospitalized and nonhospitalized patients.Design, Setting, and ParticipantsA cross-sectional cohort study was conducted at 2 urban hospitals and general practitioner centers from March 20 to April 30, 2020, among 360 hospitalized patients and 308 nonhospitalized patients with acute SARS-CoV-2 infection during the first wave of the pandemic. Follow-up was conducted 2 years later.Main Outcomes and MeasuresParticipants were scheduled for a telephone interview 2 years after acute infection. The presence of post–COVID-19 symptoms was systematically assessed, with particular attention to symptoms starting after infection. Hospitalization and clinical data were collected from medical records. Between-group comparisons and multivariate logistic regressions were conducted.ResultsA total of 360 hospitalized patients (162 women [45.0%]; mean [SD] age, 60.7 [16.1] years) and 308 nonhospitalized patients (183 women [59.4%]; mean [SD] age, 56.7 [14.7] years) were included. Dyspnea was more prevalent at the onset of illness among hospitalized than among nonhospitalized patients (112 [31.1%] vs 36 [11.7%]; P &lt; .001), whereas anosmia was more prevalent among nonhospitalized than among hospitalized patients (66 [21.4%] vs 36 [10.0%]; P = .003). Hospitalized patients were assessed at a mean (SD) of 23.8 (0.6) months after hospital discharge, and nonhospitalized patients were assessed at a mean (SD) of 23.4 (0.7) months after the onset of symptoms. The number of patients who exhibited at least 1 post–COVID-19 symptom 2 years after infection was 215 (59.7%) among hospitalized patients and 208 (67.5%) among nonhospitalized patients (P = .01). Among hospitalized and nonhospitalized patients, fatigue (161 [44.7%] vs 147 [47.7%]), pain (129 [35.8%] vs 92 [29.9%]), and memory loss (72 [20.0%] vs 49 [15.9%]) were the most prevalent post–COVID-19 symptoms 2 years after SARS-CoV-2 infection. No significant differences in post–COVID-19 symptoms were observed between hospitalized and nonhospitalized patients. The number of preexisting medical comorbidities was associated with post–COVID-19 fatigue (odds ratio [OR], 1.93; 95% CI, 1.09-3.42; P = .02) and dyspnea (OR, 1.91; 95% CI, 1.04-3.48; P = .03) among hospitalized patients. The number of preexisting medical comorbidities (OR, 3.75; 95% CI, 1.67-8.42; P = .001) and the number of symptoms at the onset of illness (OR, 3.84; 95% CI, 1.33-11.05; P = .01) were associated with post–COVID-19 fatigue among nonhospitalized patients.Conclusions and RelevanceThis cross-sectional study suggested the presence of at least 1 post–COVID-19 symptom in 59.7% of hospitalized patients and 67.5% of nonhospitalized patients 2 years after infection. Small differences in symptoms at onset of COVID-19 were identified between hospitalized and nonhospitalized patients. Post–COVID-19 symptoms were similar between hospitalized and nonhospitalized patients; however, lack of inclusion of uninfected controls limits the ability to assess the association of SARS-CoV-2 infection with overall and specific post–COVID-19 symptoms 2 years after acute infection. Future studies should include uninfected control populations.
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Panico, Ginger, and Julie Louise Gerberding. "Responsibilities of Infection Control Practitioners." Infection Control and Hospital Epidemiology 14, no. 4 (April 1993): 193. http://dx.doi.org/10.2307/30149726.
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Panico, Ginger, and Julie Louise Gerberding. "Responsibilities of Infection Control Practitioners." Infection Control and Hospital Epidemiology 14, no. 4 (April 1993): 193. http://dx.doi.org/10.1086/646713.
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Weinstein, Robert A. "Job Board-Infection Control Practitioners." Infection Control & Hospital Epidemiology 12, no. 5 (May 1991): 328. http://dx.doi.org/10.1017/s0899823x0008538x.
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Rearick, Terri. "Infection Control Practitioners and AIDS." Infection Control 8, no. 10 (October 1987): 403. http://dx.doi.org/10.1017/s0195941700066558.
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Newlin, B. "HIV infection control for podiatric practitioners." Journal of the American Podiatric Medical Association 80, no. 1 (January 1, 1990): 21–25. http://dx.doi.org/10.7547/87507315-80-1-21.
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Although significant advances have been made in the treatment of acquired immunodeficiency syndrome (AIDS), neither a curative therapy nor a vaccine is available. Protecting practitioners, medical staff members, and patients from infection with human immunodeficiency virus (HIV) remains a particularly important issue. Fortunately, this virus is not readily transmitted in the health care setting. Adequate protection can be accomplished through the strict implementation of universal infection control policies in the treatment of all patients. Understanding these procedures, providing access to necessary equipment and supplies, and monitoring adherence to universal infection control measures will minimize the risk of exposure.
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Mason, Jonathan. "What are infection control practitioners for?" Nursing Standard 15, no. 46 (August 2001): 31. http://dx.doi.org/10.7748/ns.15.46.31.s55.
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Gugliotti, Ron. "Infection control practitioners: Who are we?" American Journal of Infection Control 13, no. 5 (October 1985): 236–37. http://dx.doi.org/10.1016/0196-6553(85)90065-3.
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Van Gessel, Helen, Thomas Riley, and Alistair McGregor. "Clostridium difficile infection: an update for infection control practitioners." Healthcare infection 14, no. 3 (September 2009): 115–18. http://dx.doi.org/10.1071/hi09105.
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Wang, Annie, Nick Daneman, Charlie Tan, John S. Brownstein, and Derek R. MacFadden. "Evaluating the Relationship Between Hospital Antibiotic Use and Antibiotic Resistance in Common Nosocomial Pathogens." Infection Control & Hospital Epidemiology 38, no. 12 (October 26, 2017): 1457–63. http://dx.doi.org/10.1017/ice.2017.222.
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OBJECTIVEThe relationship between hospital antibiotic use and antibiotic resistance is poorly understood. We evaluated the association between antibiotic utilization and resistance in academic and community hospitals in Ontario, Canada.METHODSWe conducted a multicenter observational ecological study of 37 hospitals in 2014. Hospital antibiotic purchasing data were used as an indicator of antibiotic use, whereas antibiotic resistance data were extracted from hospital indexes of resistance. Multivariate regression was performed, with antibiotic susceptibility as the primary outcome, antibiotic consumption as the main predictor, and additional covariates of interest (ie, hospital type, laboratory standards, and patient days).RESULTSWith resistance data representing more than 90,000 isolates, we found the increased antibiotic consumption in defined daily doses per 1,000 patient days (DDDs/1,000 PD) was associated with decreased antibiotic susceptibility forPseudomonas aeruginosa(−0.162% per DDD/1,000 PD;P=.119). However, increased antibiotic consumption predicted increased antibiotic susceptibility significantly forEscherichia coli(0.173% per DDD/1,000 PD;P=.005),Klebsiellaspp (0.124% per DDD/1,000 PD;P=.004),Enterobacterspp (0.194% per DDD/1,000 PD;P=.003), andEnterococcusspp (0.309% per DDD/1,000 PD;P=.001), and nonsignificantly forStaphylococcus aureus(0.012% per DDD/1,000 PD;P=.878). Hospital type (P=.797) and laboratory standard (P=.394) did not significantly predict antibiotic susceptibility, while increased hospital patient days generally predicted increased organism susceptibility (0.728% per 10,000 PD;P<.001).CONCLUSIONSWe found that hospital-specific antibiotic usage was generally associated with increased, rather than decreased hospital antibiotic susceptibility. These findings may be explained by community origins for many hospital-diagnosed infections and practitioners choosing agents based on local antibiotic resistance patterns.Infect Control Hosp Epidemiol2017;38:1457–1463
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Shields, Jack W. "Infection Control Practices of General Dental Practitioners." Infection Control & Hospital Epidemiology 20, no. 6 (June 1999): 389. http://dx.doi.org/10.1086/503134.
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Aziz, Ann-Marie. "Infection prevention and control practitioners: improving engagement." British Journal of Nursing 25, no. 6 (March 24, 2016): 297–302. http://dx.doi.org/10.12968/bjon.2016.25.6.297.
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Min, Jeong Eun, Brenda Carolina Guerra-Alejos, Ruyu Yan, Heather Palis, Brittany Barker, Karen Urbanoski, Bernie Pauly, et al. "Opioid Coprescription Through Risk Mitigation Guidance and Opioid Agonist Treatment Receipt." JAMA Network Open 7, no. 5 (May 15, 2024): e2411389. http://dx.doi.org/10.1001/jamanetworkopen.2024.11389.
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ImportanceAt the onset of the COVID-19 pandemic, the government of British Columbia, Canada, released clinical guidance to support physicians and nurse practitioners in prescribing pharmaceutical alternatives to the toxic drug supply. These alternatives included opioids and other medications under the risk mitigation guidance (RMG), a limited form of prescribed safer supply, designed to reduce the risk of SARS-CoV-2 infection and harms associated with illicit drug use. Many clinicians chose to coprescribe opioid medications under RMG alongside opioid agonist treatment (OAT).ObjectiveTo examine whether prescription of hydromorphone tablets or sustained-release oral morphine (opioid RMG) and OAT coprescription compared with OAT alone is associated with subsequent OAT receipt.Design, Setting, and ParticipantsThis population-based, retrospective cohort study was conducted from March 27, 2020, to August 31, 2021, included individuals from 10 linked health administrative databases from British Columbia, Canada. Individuals who were receiving OAT at opioid RMG initiation and individuals who were receiving OAT and eligible but unexposed to opioid RMG were propensity score matched at opioid RMG initiation on sociodemographic and clinical variables. Data were analyzed between January 2023 and February 2024.ExposureOpioid RMG receipt (≥4 days, 1-3 days, or 0 days of opioid RMG dispensed) in a given week.Main Outcome and MeasuresThe main outcome was OAT receipt, defined as at least 1 dispensed dose of OAT in the subsequent week. A marginal structural modeling approach was used to control for potential time-varying confounding.ResultsA total of 4636 individuals (2955 [64%] male; median age, 38 [31-47] years after matching) were receiving OAT at the time of first opioid RMG dispensation (2281 receiving ongoing OAT and 2352 initiating RMG and OAT concurrently). Opioid RMG receipt of 1 to 3 days in a given week increased the probability of OAT receipt by 27% in the subsequent week (adjusted risk ratio, 1.27; 95% CI, 1.25-1.30), whereas receipt of opioid RMG for 4 days or more resulted in a 46% increase in the probability of OAT receipt in the subsequent week (adjusted risk ratio, 1.46; 95% CI, 1.43-1.49) compared with those not receiving opioid RMG. The biological gradient was robust to different exposure classifications, and the association was stronger among those initiating opioid RMG and OAT concurrently.Conclusions and RelevanceThis cohort study, which acknowledged the intermittent use of both medications, demonstrated that individuals who were coprescribed opioid RMG had higher adjusted probability of continued OAT receipt or reengagement compared with those not receiving opioid RMG.
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Butt, Hira, Hira Sheikh, Syed Ghyour Ali Mohsin, Nauman Rauf Khan, Tajwar Jafar, Taimur Hassan Shah, and Maria Jabbar. "Barriers to the Maintenance of COVID 19 Cross Infection Control Protocols among Medical and Dental Practitioners." Pakistan Journal of Medical and Health Sciences 16, no. 10 (October 30, 2022): 708–10. http://dx.doi.org/10.53350/pjmhs221610708.
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Objective: To determine the barriers to the maintenance of COVID 19 cross infection control protocols among medical and dental practitioners Methodology: A cross sectional study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore from July 2021 to July 2022 on medical and dental practitioners. The sampling technique employed was convenient sampling. Medical and dental practitioners irrespective of their age, gender and specialty of practice were included in the study. Data was collected using a pre-validated questionnaire with a Cronbach alpha value of 0.7. Results: There was s statistically significant difference in the scores of barriers to maintenance of COVID 19 cross infection control protocols of overcrowding in the hospital (p= ≤0.001), limitation of infection control material (p=≤0.001), insufficient training in infection control (p=0.05), lack of handwashing (p=0.022), not wearing a mask while examining the patient (p=≤0.001) and lack of knowledge about mode of transmission of COVID 19 (P=0.036) Conclusion: The barriers faced to maintenance of cross infection control protocols pertaining to the hospital administration were reported to be higher for medical practitioners in comparison to the dental practitioners. The barriers faced to maintenance of cross infection control protocols pertaining to the attitude and practices of health care workers were also higher for medical practitioners in comparison to the dental practitioners. Keywords: Cross infection control, COVID 19 pandemic, medical practitioners, dental practitioners