The Impact of Infection Control Policies on Hospital Acquired Infections by MDROs from 2016 to 2023.

Purpose: Hospital-acquired infections (HAIs) caused by multidrug-resistant organisms (MDROs) pose a significant challenge to healthcare systems. The present study aimed to evaluate the impact of the infection policy to COVID-19 on the incidence of HAIs caused by MDROs. Methods: We conducted an eight-years retrospective analysis at a hospital in Shanghai, China. Bloodstream, sputum, and urinary tract cultures of MDROs obtained 48h after admission were collected monthly from January 2016 to Dec 2023. Occupied bed days (OBDs) were used to generate monthly HAI incidences per 10,000 OBDs. The study period was divided into pre-control, in-control, and post-control cohorts, in January 2020 and January 2022. The incidence was compared using interrupted time-series regression. Results: In total, 6763 MDRO cultures were identified, comprising 1058 bloodstream, 4581 sputum, and 1124 urine cultures derived from 4549 patients. The incidence rates of all HAIs were 8.68 per 10,000 OBDs in the pre-control cohort, 9.76 per 10,000 OBDs in the in-control cohort and 12.58 per 10,000 OBDs in the post-control cohorts, respectively. A downward trend in the incidence of HAI was observed in the post-control cohort (p<0.05). Conclusion: This study demonstrates that while the COVID-19 pandemic poses a significant challenge to infection control within hospitals, it provides a unique opportunity to enhance infection control measures and evaluate their effectiveness. In addition, these findings highlight the need for more targeted prevention and control strategies against different pathogens in future epidemics.

The interplay of skin architecture and cellular dynamics in wound healing: Insights and innovations in care strategies.

Wound healing involves complex interactions among skin layers: the epidermis, which epithelializes to cover wounds; the dermis, which supports granulation tissue and collagen production; and the hypodermis, which protects overall skin structure. Key factors include neutrophils, activated by platelet degranulation and cytokines, and fibroblasts, which aid in collagen production during proliferation. The healing process encompasses inflammation, proliferation, and remodeling, with angiogenesis, fibroplasia, and re-epithelialization crucial for wound closure. Angiogenesis is characterized by the creation of collateral veins, the proliferation of endothelial cells, and the recruitment of perivascular cells. Collagen is produced by fibroblasts in granulation tissue, aiding in the contraction of wounds. The immunological response is impacted by T cells and cytokines. External topical application of various formulations and dressings expedites healing and controls microbial contamination. Polymeric materials, both natural and synthetic, and advanced dressings enhance healing by providing biodegradability, biocompatibility, and infection control, thus addressing tissue regeneration challenges. Numerous dressings promote healing, including films, hydrocolloids, hydrogels, foams, alginates, and tissue-engineered substitutes. Wound dressings are treated with growth factors, particularly PDGF, and antibacterial drugs to prevent infection. The challenges of tissue regeneration and infection control are evolving along with the field of wound care.

Molecular epidemiological analysis of blaNDM-5-producing Klebsiella pneumoniae ST2407-K25 causing infection outbreaks in pediatric patients based on whole genome sequencing.

BACKGROUND: Pediatric patients are vulnerable to the threat of carbapenem-resistant Klebsiella pneumoniae (CRKP) due to their limited immunity and few available antibiotics. Especially when these pathogens exhibit hypervirulent phenotypes, they are often associated with poor clinical outcomes. METHODS: In this study, we investigated a CRKP outbreak in pediatric patients from 2019 to 2021 in a teaching hospital in China based on whole genome sequencing. We sequenced twenty-nine CRKP isolates isolated from unduplicated pediatric patients to understand their genetic relationships, virulence factors, resistance mechanisms, and transmission trajectories. Conjugation experiments were performed to evaluate the horizontal transfer ability of carbapenem resistance determinants in twenty-nine CRKP isolates. We then characterized these isolates for biofilm formation ability and serum resistance. Genetic relatedness, comparison of plasmids, and chromosomal locus variation of CRKP isolates were analyzed by bioinformatics. RESULTS: All the isolates were carbapenemase-producers harbouring blaNDM-5. Among them, twenty-eight isolates belonged to the ST2407 group, with the consistent capsular serotype K25. The virulence-related factors: ureA, fim, ybtA, irp1/irp2, and mrkA were prevalent in these isolates. Additionally, most CRKP isolates showed moderately adherent biofilm formation. Although the ST2407 clonal group did not exhibit serum resistance, the heterogeneous level of serum resistance was related to the disruption of oqxR. Conjugation and WGS revealed that the blaNDM-5 carried by the twenty-eight CRKP ST2407 isolates was located on nonconjugative IncX3 plasmids associated with deleting the T4SS-encoding genes. Clonal transmission of CRKP ST2407 in pediatric patients was suggested by the phylogenetic tree. CONCLUSIONS: Our study provides evidence of the clonal spread of blaNDM-5-producing K. pneumoniae in pediatric patients and the necessity for the T4SS system for horizontal transfer of the IncX3 plasmid carrying blaNDM-5. Additionally, the disruption of oqxR may have affected the serum resistance of CRKP. The results of this study emphasize the importance of continuously monitoring for CRKP infection in pediatric patients to prevent recurrent infections.

A Prospective Clinical Audit of Sterile Surgical Glove-Donning Practices Among Young Surgeons at a Tertiary Care Hospital in Sudan.

Background Adherence to aseptic protocols and proper sterilization is critical for optimal patient recovery post-surgery. The standard procedure for donning sterile surgical gloves helps manage infection risk and maintain surgical site cleanliness by following aseptic principles. This study evaluates adherence to these protocols among young surgeons at a tertiary care hospital in Sudan. Methods This prospective audit included 42 young residents and house officers at a tertiary care hospital in Sudan, following ethical clearance. Compliance with sterile surgical glove-donning practices was assessed using the World Health Organization (WHO) pre- and post-intervention criteria. Participants were observed in the operating room without prior notice. The intervention comprised a video presentation and a live demonstration. Results Pre-intervention adherence to standard criteria for donning sterile surgical gloves was 73.4% (n= 31). This rate increased significantly to 91.4% (n= 38) following the intervention and showed marked improvement. Conclusion The audit demonstrated a significant improvement in adherence to donning sterile surgical gloves practices after the intervention. Implementing WHO guidelines effectively enhances compliance, reduces infection risks, and increases awareness of aseptic practices.

WHO research agenda on the role of the institutional safety climate for hand hygiene improvement: a Delphi consensus-building study.

BACKGROUND: Creating and sustaining an institutional climate conducive to patient and health worker safety is a critical element of successful multimodal hand hygiene improvement strategies aimed at achieving best practices. Repeated WHO global surveys indicate that the institutional safety climate consistently ranks the lowest among various interventions. METHODS: To develop an international expert consensus on research agenda priorities related to the role of institutional safety climate within the context of a multimodal hand hygiene improvement strategy, we conducted a structured consensus process involving a purposive sample of international experts. A preliminary list of research priorities was formulated following evidence mapping, and subsequently refined through a modified Delphi consensus process involving two rounds. In round 1, survey respondents were asked to rate the importance of each research priority. In round 2, experts reviewed round 1 ratings to reach a consensus (defined as ≥70% agreement) on the final prioritised items to be included in the research agenda. The research priorities were then reviewed and finalised by members of the WHO Technical Advisory Group on Hand Hygiene Research in Healthcare. RESULTS: Of the 57 invited participants, 50 completed Delphi round 1 (88%), and 48 completed round 2 (96%). Thirty-six research priority statements were included in round 1 across five thematic categories: (1) safety climate; (2) personal accountability for hand hygiene; (3) leadership; (4) patient participation and empowerment and (5) religion and traditions. In round 1, 75% of the items achieved consensus, with 9 statements carried forward to round 2, leading to a final set of 31 prioritised research statements. CONCLUSION: This research agenda can be used by researchers, clinicians, policy-makers and funding bodies to address gaps in hand hygiene improvement within the context of an institutional safety climate, thereby enhancing patient and health worker safety globally.

Characterization of Chlorhexidine Resistance Among Clinical Isolates of Coagulase-Negative Staphylococcus Species in a Tertiary Care Center, Chennai.

Background Coagulase-negative Staphylococci (CoNS) are potential pathogens and are often associated with healthcare-associated infections (HAIs). Chlorhexidine (CHX) is the most widely used antiseptic to reduce colonization and infection by all Staphylococci, including CoNS. Resistance to CHX among CoNS has been observed over the past few years, consequent to its widespread use. Phenotypic tolerance or reduced susceptibility to CHX is conferred by plasmid-mediated qac group of genes, mainly qacA/B and smr, which cause activation of efflux pumps over the bacterial cell wall. This study aims to characterize the phenotypic and genotypic resistance exhibited by CoNS species against CHX. Methods After ethical approval, 148 consecutive, non-repetitive isolates of clinically significant CoNS species of hospitalized patients, isolated from blood samples and exudative specimens, were included in the study. Speciation was performed by conventional biochemical identification and automated methods. Antimicrobial susceptibility testing was performed by disc diffusion technique and for vancomycin by minimum inhibitory concentration (MIC) determination, as per Clinical Laboratory Standards Institute (CLSI) M-100 2023 guidelines. Methicillin resistance was detected using a cefoxitin disc. MIC for CHX was performed by agar dilution method; reduced susceptibility was considered when MIC to CHX ≥4 µg/mL. The simplex polymerase chain reaction (PCR) was carried out with suitable controls to detect qacA/B and smr. Statistical analysis was conducted to determine the association of qacA/B and smr genes with MIC of CHX in the study isolates. Results Fifteen different species of CoNS were obtained from clinical samples. A high percentage of resistance was observed against various classes of antibiotics. Methicillin resistance was observed in 69.6% (103/148) of isolates. Of 148 CoNS, 52.7% (78/148) of isolates exhibited reduced susceptibility to CHX with an MIC ≥4 µg/mL. These isolates exhibited a higher percentage of methicillin resistance (75.6%, 59/78). By PCR, 34.5% (51/148) of isolates carried either or both genes. Gene qacA/B was solely detected in 27.02% (40/148) of isolates, of which 14 were CHX-tolerant and the remaining 26 were CHX-susceptible. Gene smr was solely detected in 4.1% (6/148) of isolates comprising three isolates each in CHX-tolerant and susceptible categories. There were 3.4% (5/148) of isolates that harbored both genes, of which only one isolate was CHX-susceptible, while the other four were CHX-tolerant. A proportion of isolates that were phenotypically tolerant to CHX did not carry either or both genes. A significant statistical association was found between reduced susceptibility to CHX and the presence of antiseptic resistance genes in the study isolates (p-value=0.033942). Conclusion To our knowledge, this is the first study from South India to investigate CHX resistance among CoNS using phenotypic and genotypic methods. The rise of antiseptic resistance among CoNS is an emerging threat to current infection control practices. The presence of qacA/B and smr genes, especially in CHX susceptible isolates, is concerning since these resistance genes are located on transferable plasmids, and the isolates can develop resistance eventually upon exposure to CHX.

Impact of COVID-19 on Antibiotic Stewardship, Antimicrobial Resistance, and Prescribing Habits at Two General Hospitals in Abu Dhabi: A Retrospective Analysis.

Introduction The COVID-19 pandemic has overwhelmingly affected healthcare systems, particularly in the area of antibiotic management. The surge in antimicrobial use to address secondary bacterial infections in COVID-19 patients has heightened concerns about overuse and antimicrobial resistance (AMR). This study examined the pandemic's effect on the antibiotic stewardship program (ASP) at two general hospitals in Abu Dhabi, focusing on changes in prescribing practices, adherence to stewardship guidelines, resistance trends, and overall health system impact. The present retrospective study evaluated shifts in antibiotic consumption, compliance with stewardship practices, and broader healthcare implications. The aim is to assess the pandemic's impact, identify improvement areas, and provide insights to enhance the ASP in addressing the global AMR crisis. Methods This retrospective review assessed electronic medical records from two general hospitals in Abu Dhabi over a 24-month period, from January 2019 to December 2020. It included pre-COVID-19 data from 2019 and data from 2020 during the COVID-19 surge. The study focused on patients aged 25 to 40 years with respiratory tract infections, urinary tract infections, ventilator-associated pneumonia, and nosocomial infections, identified using predefined ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes. Patients with COVID-19 diagnoses and those undergoing surgical procedures were excluded. Key metrics compared data from 2019 and 2020 to assess changes in clinicians' prescribing practices, antibiotic usage, ASP interventions, and their impact on the healthcare system. Results The COVID-19 pandemic influenced antibiotic use and resistance trends, leading to longer hospital stays (3.86 days in 2019 vs. 4.29 days in 2020) and increased use of duplicate anaerobic therapy (4.58% in 2019 vs. 5.71% in 2020). From 2019 to 2020, the average duration of antibiotic therapy decreased from 6.23 days to 5.24 days, but empirical therapy without sufficient evidence rose. The average length of treatment increased (2.87 days in 2019 vs. 3.28 days in 2020), and there was a rise in the use of antibiotics for viral and fungal infections, with cases growing from 17.08% in 2019 to 22.38% in 2020. Despite modest improvements in stewardship practices in 2020, AMR challenges persisted. These results underscore the need for enhanced stewardship programs and continued research to address the ongoing impact on antibiotic prescribing and resistance. Conclusion The COVID-19 pandemic increased antibiotic use and altered resistance patterns. Although stewardship practices improved, AMR challenges remained. Enhanced stewardship programs and ongoing research are essential to mitigate these effects and improve antibiotic management. Recommendation To address changes in antibiotic use and resistance during the COVID-19 pandemic, it is recommended to strengthen ASPs to adapt to new prescribing trends, ensure adherence to evidence-based practices, provide ongoing education for clinicians, invest in research on long-term resistance impacts, and enhance data tracking and monitoring systems.

Retrospective Analysis of Antimicrobial Resistance Trends in Pseudomonas aeruginosa and Acinetobacter baumannii.

INTRODUCTION: The rise of antibiotic resistance poses a critical challenge to public health, particularly in managing infections caused by non-fermenting bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. This study aimed to determine the prevalent multi-drug resistance among non-fermentative Gram-negative bacteria isolated from hospitalized patients in a tertiary care center. MATERIAL AND METHODS: A retrospective analysis was undertaken using one year of data from 2022 to 2023 to evaluate the antimicrobial resistance (AMR) profiles of P. aeruginosa and A. baumannii. The study assessed antibiotic resistance patterns, including piperacillin/tazobactam, carbapenems (imipenem, meropenem), ciprofloxacin, and colistin. RESULTS: The analysis revealed resistance of P. aeruginosa to various antibiotics shows that piperacillin/tazobactam exhibited the highest resistance rate at 32% (181/565), while colistin exhibits the lowest at 5.6% (32/565). For A. baumannii, the resistance varies significantly among antibiotics, with piperacillin/tazobactam and ciprofloxacin showing the highest resistance rates at 56.8% (128/225) and 68% (153/225), respectively. In contrast, colistin is highly effective, with only 0.8% (2/225) resistance, and amikacin also demonstrates low resistance at 9.7% (22/225). CONCLUSION: The growing trend of multi-drug and extensive drug resistance among non-fermenters such as P. aeruginosa and A. baumannii necessitates urgent action. Establishing strict antibiotic policies, continuous monitoring of resistance patterns, and investment in antimicrobial research are imperative to combat the limited treatment options and manage these pathogens effectively.

Comparative analysis of personal protective equipment nonadherence detection: computer vision versus human observers.

OBJECTIVES: Human monitoring of personal protective equipment (PPE) adherence among healthcare providers has several limitations, including the need for additional personnel during staff shortages and decreased vigilance during prolonged tasks. To address these challenges, we developed an automated computer vision system for monitoring PPE adherence in healthcare settings. We assessed the system performance against human observers detecting nonadherence in a video surveillance experiment. MATERIALS AND METHODS: The automated system was trained to detect 15 classes of eyewear, masks, gloves, and gowns using an object detector and tracker. To assess how the system performs compared to human observers in detecting nonadherence, we designed a video surveillance experiment under 2 conditions: variations in video durations (20, 40, and 60 seconds) and the number of individuals in the videos (3 versus 6). Twelve nurses participated as human observers. Performance was assessed based on the number of detections of nonadherence. RESULTS: Human observers detected fewer instances of nonadherence than the system (parameter estimate -0.3, 95% CI -0.4 to -0.2, P < .001). Human observers detected more nonadherence during longer video durations (parameter estimate 0.7, 95% CI 0.4-1.0, P < .001). The system achieved a sensitivity of 0.86, specificity of 1, and Matthew's correlation coefficient of 0.82 for detecting PPE nonadherence. DISCUSSION: An automated system simultaneously tracks multiple objects and individuals. The system performance is also independent of observation duration, an improvement over human monitoring. CONCLUSION: The automated system presents a potential solution for scalable monitoring of hospital-wide infection control practices and improving PPE usage in healthcare settings.

Enhancing laboratory biosafety management: a comprehensive strategy from theory to practice.

Objective: This study examines biosafety management practices in a psychiatric hospital's laboratory in China, focusing on how outdated information technology impacts the hospital's ability to respond to public health emergencies. The goal is to enhance the hospital's emergency response capabilities by updating risk assessments, biosafety manuals, and implementing a comprehensive quality management system alongside a specialized infection control system for significant respiratory diseases. Methods: We utilized an integrated research approach, expanding the scope of risk assessments, updating the biosafety manual according to the latest international standards, and implementing a quality management system. A specialized infection control system for significant respiratory diseases was introduced to improve emergency response capabilities. Results: Updated risk assessments and a new biosafety manual have significantly improved the identification and management of biosafety threats. Implementing new quality management and infection control systems has enhanced response efficiency and operational standardization. Conclusion: The measures taken have strengthened the biosafety management and emergency response capabilities of the laboratory department, highlighting the importance of information technology in biosafety management and recommending similar strategies for other institutions.

Closing the gap on infection prevention staffing recommendations: Results from the beta version of the APIC staffing calculator.

BACKGROUND: Published literature suggests "one-size-fits-all" infection prevention and control (IPC) staffing recommendations do not sufficiently account for program complexity needs. This project's objective was to create and validate a calculator utilizing risk and complexity factors to generate individualized IPC staffing ratios. METHODS: An online survey-based calculator was created that incorporated factors intended to predict staffing needs and multiple investigative questions to allow for optimization of factors in the algorithm. Hospital characteristics, staffing ratios, staffing perception, and outcomes were analyzed to determine the optimal questions and benchmarks for future releases. RESULTS: The median infection preventionist full-time equivalent to bed ratio was 121.0 beds for 390 participating hospitals. The calculator deemed 79.2% of respondent staffing as below expected. Significant association existed between higher standard infection ratio ranges and staffing status for central line-associated bloodstream infection (P = .02), catheter-associated urinary tract infections (P = .001), Clostridioides difficile infections (P = .003), and colon surgical site infections (P = .0001). CONCLUSIONS: This novel approach allows facilities to staff their IPC program based on individual factors. Future versions of the calculator will be optimized based on the findings. Future research will clarify the impact of staffing on patient outcomes and staff retention.

Non-pharmaceutical infection prevention measures in nosocomial SARS-CoV-2 outbreaks: a retrospective multicentre cohort study.

Hospital severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks are relevant for patients and healthcare systems within and beyond the pandemic. We aimed to explore the characteristics of SARS-CoV-2 outbreaks and their infection prevention and control (IPC) measures during the different pandemic waves. A comprehensive structured template for SARS-CoV-2 outbreaks was developed and filled out by six university hospitals. The main outcome variable was outbreak size (OS). A total of 80 outbreaks and 734 infection cases were enrolled between 03/2020-02/2023. In the majority of outbreaks (85%) a contact tracing (CT) team was in place. In 13 (16%) outbreaks the CT team was exclusively responsible for CT, which was negatively linked to OS when adjusting for SARS-CoV-2 waves (Estimate (ß)=-1.350; Standard Error (SE) =.274; p<0 .0001). Patients as index had a greater association with OS than healthcare workers (HCWs) (ß=-0.29; SE=0.098; p=0.003). Additionally, the mandatory use of facemasks by patients in the presence of HCWs was negatively linked to OS (ß=-0.237; SE=0.08; p=0.003). The frequency of patient screening during outbreaks varied considerably, whereby higher frequency screenings for SARS-CoV-2 were negatively associated with OS (ß=-0.358; SE=0.109; p=0.001). Our data provides insights in non-pharmaceutical outbreak prevention and management revealing that the mandatory use of facemasks by patients in the presence of HCWs and a high patient screening frequency in ongoing outbreaks were significantly associated with smaller outbreaks. Further studies are required to allow for generalizability.

Risk factors for non-isolation of patients admitted for pulmonary tuberculosis in a high-incidence département: a single-center retrospective study.

Pulmonary tuberculosis (PT) is an airborne disease, justifying the identification of suspect patients on admission, and their hospitalization in individual rooms with the implementation of Airborne Supplementary Precautions (ASP). The aim of this study was to identify, in a high-prevalence hospital, the frequency of non-isolated PT and the factors associated with the delay in implementing ASP. This was a retrospective observational study, including patients with at least one Mycobacterium tuberculosis-positive specimen. Patient demographic and clinical data, as well as data related to the mode of admission, were collected. Univariate and multivariate statistical analyses were performed. During the study period, 256 patients were included. Among them 134 (52.3%) had PT. These included 100 (75%) men, median age 39, 70% foreign-born. Among these patients, 46 (34%) were isolated beyond the 24th hour of admission. The average time to implement ASP was 4.3 days, and 7 patients (5.2%) were not isolated throughout their stay. Three classes of factors were associated by multivariate analysis with isolation. Previous consultation with a general practitioner was protective whereas admission through emergency department was not. Presence of so-called cardinal clinical signs and a suggestive chest X-ray were protective factors. Finally, European patients were less frequently isolated. In our study, 34% of patients admitted with PT were not isolated on admission. The risk of non-isolation was 3 times higher in cases of admission via the emergency department, and European patients were less well isolated. The presence of cardinal signs and prior consultation with a general practitioner were associated with a higher frequency of isolation.

Icariin-loaded chitosan/ß-glycerophosphate thermosensitive hydrogel enhanced infection control and bone regeneration in canine with infectious bone defects.

Faced with infectious bone defects, the development of a thermosensitive hydrogel containing icariin (ICA) represents a promising therapeutic strategy targeting infection control and bone regeneration. In this study, we prepared and evaluated the physicochemical properties, in vitro and in vivo drug release, antimicrobial activity, anti-inflammatory properties, and bone repair effects of ICA/Chitosan/ß-Glycerophosphate (ICA/CTS/ß-GP) thermosensitive hydrogel. Our findings demonstrate that the ICA/CTS/ß-GP thermosensitive hydrogel undergoes a liquid-to-gel transition at body temperature, which is crucial for maintaining local drug release at the defect site. Additionally, the hydrogel exhibited sustained release of ICA over 28 days, showing high antimicrobial activity against Staphylococcus aureus and good biocompatibility in blood compatibility tests. In a canine model of infectious bone defects, the ICA/CTS/ß-GP thermosensitive hydrogel showed effective infection control and modulated inflammation, vascular formation, and bone factor expression, while also activating the Wnt/ß-catenin signaling pathway. In conclusion, the ICA/CTS/ß-GP thermosensitive hydrogel could control infection and repair bone tissue. Its antimicrobial and osteogenic properties provide hope for its clinical application.

Infection Control Nursing Competency Model for Nurses in Intensive Care Units: A Delphi Study.

BACKGROUND: Intensive care unit (ICU) nurses require advanced expertise and skills in critical care and need infection control nursing competency (ICNC). Given the lack of research on it, this study aimed to develop a model of ICU nurses' ICNC. METHODS: A Delphi panel consisting of experts in intensive care nursing and infection control was organized to provide discerning and professional perspective on ICNC. Approved by the Institutional Review Board, a three-round Delphi survey was conducted via email from July to December 2023. The content validity ratio (CVR) and the coefficient of variation were calculated for panel responses. RESULTS: Among 17, 15 nurses (88.2%) participated and completed the surveys. 80% were female, and the panel had an average working experience of 14.2 years specifically in ICUs and/or infection control departments at hospitals. After the initial round, a preliminary model was developed, consisting of 10 main components and 59 sub-elements. After eliminating five elements with CVR values below 0.49 in the second survey, the final model, consisting of 10 main components and 54 sub-elements, was confirmed in the third survey. CONCLUSIONS: ICU nurses' ICNC can be understood based on this study's results, and further research can be designed to improve this competency.

Development and Implementation of Learning Collaboratives for Infection Prevention and Control Education in Long-Term Care Facilities.

Infections in long-term care facilities (LTCFs) pose a critical challenge, with one to three million serious infections annually and up to 380,000 associated deaths. The vulnerability of aging populations and inadequate infection prevention and control (IPC) programs underscore the need for intervention. This initiative provided tailored continuing education through eight virtual learning collaboratives serving 541 infection preventionists. The project also developed nine IPC toolkits and a manual to further support LTCFs' infection prevention efforts.

Microbial laden mobile phones from international conference attendees pose potential risks to public health and biosecurity.

INTRODUCTION: Mobile phones, contaminated with pathogenic microorganisms, have the potential to act as "trojan horses". The microbial signatures present on their surfaces most probably vary across different geographical regions. As a result, mobile phones belonging to international conference attendees may serve as a model for global microbial dissemination, posing potential risks to public health and biosecurity. AIM: This study aimed to profile the microbes present on mobile phones belonging to delegates attending an international scientific conference through use of metagenomic shotgun DNA sequencing. METHODS: Twenty mobile phones, representing ten different geographical zones from around the world, were swabbed and pooled together into ten geographical-specific samples for high definition next-generation DNA sequencing. WONCA council members were invited to participate and provided verbal consent. Following DNA extraction, next generation sequencing, to a depth of approximately 10Gbp per sample, was undertaken on a v1.5 Illumina NovaSeq6000 system. Bioinformatic analysis was performed via the CosmosID platform. RESULTS: A total of 2204 microbial hits were accumulated across 20 mobile phones inclusive of 882 bacteria, 1229 viruses, 88 fungi and 5 protozoa. Of particular concern was the identification of 65 distinct antibiotic resistance genes and 86 virulence genes. Plant, animal and human pathogens, including ESKAPE and HACEK bacteria were found on mobile phones. DISCUSSION/CONCLUSION: Mobile phones of international attendees are contaminated with many & varied microorganisms. Further research is required to characterize the risks these devices pose for biosecurity and public health. Development of new policies which appropriately address and prevent such risks maybe warranted.

An Investigation of the Knowledge of Infection Control Practices Held by Healthcare Professionals.

Background: Healthcare-associated infections (HAIs), arising from inadequate hygiene practices, significantly increase morbidity and mortality rates in hospitalized patients. Materials and Methods: This descriptive study involved 350 healthcare workers from private hospitals in Wuhan, China. Participants responded to a questionnaire with close-ended questions, distributed physically and via email. Data were analyzed using SPSS version 25.0. Results: The analysis indicated a gap in healthcare workers' knowledge of infection control, affecting hospital hygiene standards. About 60% of respondents hold a diploma or higher qualification. Conclusion: The findings underscore the importance of targeted training and educational initiatives in infection control procedures. A significant factor in hospitals' inadequate hygiene practices is the gap in staff training and knowledge.

Study on Knowledge of Infection Control Practice of Healthcare Workers.

Background: Healthcare-associated infections (HAIs), also known as nosocomial infections, are a significant risk in hospitals, leading to increased morbidity and mortality among patients due to poor hygiene practices. Materials and Methods: This descriptive study involved 350 participants from Wuhan's private hospitals. Respondents answered a questionnaire distributed in person or via email, and data were analyzed using SPSS version 25.0. Results: Analysis revealed a knowledge gap among healthcare workers in infection control, affecting their ability to maintain hospital cleanliness. Education levels were assessed, showing that 60% of participants held diplomas or higher qualifications. Conclusion: The study highlights the urgent need for enhanced training and information dissemination on infection control practices among healthcare staff. Identifying this knowledge and practice gap is crucial for improving hospital hygiene and reducing HAI incidence.

Is Taurolidine Irrigation Effective in Preventing Surgical Site Infection during Fracture Surgery?

Taurolidine, known for its broad-spectrum antimicrobial properties and low toxicity, has shown promise in reducing infections in various surgical settings. However, it has not been extensively evaluated in orthopedic surgery. This study assessed the efficacy of taurolidine irrigation in reducing surgical site infections in patients undergoing ankle fracture surgery. A retrospective review was conducted for patients >20 years old who underwent ankle fracture surgery between March 2016 and March 2023, with follow-ups exceeding 6 months. Patients were classified into the following two groups: those who underwent normal saline (NS) irrigation and those who underwent taurolidine irrigation. Minor infections were defined as requiring additional oral antibiotics postoperatively, while major infections were characterized by hospitalization or reoperation due to infection within 3 months. Of 844 patients, 688 were included. The taurolidine group (n = 328) had a significant reduction in minor infections (7.3% vs. 22.5%, odds ratio = 0.410, p = 0.028) compared to the NS group (n = 360). Major infections were fewer in the NS group (1.2% vs. 0%, p = 0.051), but the number of cases was too small for reliable analysis. Taurolidine irrigation significantly reduces the occurrence of minor infections in ankle fracture surgeries when compared to normal saline irrigation.