Distribution of Aspergillus species and prevalence of azole resistance in clinical and environmental samples from a Spanish hospital during a three-year study period.

BACKGROUND: Surveillance studies are crucial for updating trends in Aspergillus species and antifungal susceptibility information. OBJECTIVES: Determine the Aspergillus species distribution and azole resistance prevalence during this 3-year prospective surveillance study in a Spanish hospital. MATERIALS AND METHODS: Three hundred thirty-five Aspergillus spp. clinical and environmental isolates were collected during a 3-year study. All isolates were screened for azole resistance using an agar-based screening method and resistance was confirmed by EUCAST antifungal susceptibility testing. The azole resistance mechanism was confirmed by sequencing the cyp51A gene and its promoter. All Aspergillus fumigatus strains were genotyped using TRESPERG analysis. RESULTS: Aspergillus fumigatus was the predominant species recovered with a total of 174 strains (51.94%). The rest of Aspergillus spp. were less frequent: Aspergillus niger (14.93%), Aspergillus terreus (9.55%), Aspergillus flavus (8.36%), Aspergillus nidulans (5.37%) and Aspergillus lentulus (3.28%), among other Aspergillus species (6.57%). TRESPERG analysis showed 99 different genotypes, with 72.73% of the strains being represented as a single genotype. Some genotypes were common among clinical and environmental A. fumigatus azole-susceptible strains, even when isolated months apart. We describe the occurrence of two azole-resistant A. fumigatus strains, one clinical and another environmental, that were genotypically different and did not share genotypes with any of the azole-susceptible strains. CONCLUSIONS: Aspergillus fumigatus strains showed a very diverse population although several genotypes were shared among clinical and environmental strains. The isolation of azole-resistant strains from both settings suggest that an efficient analysis of clinical and environmental sources must be done to detect azole resistance in A. fumigatus.

Metabarcoding approach to identify bacterial community profiling related to nosocomial infection and bacterial trafficking-routes in hospital environments.

Nosocomial infections (NIs) appear in patients under medical care in the hospital. The surveillance of the bacterial communities employing high-resolution 16S rRNA profiling, known as metabarcoding, represents a reliable method to establish factors that may influence the composition of the bacterial population during NIs. The present study aimed to utilize high-resolution 16S rRNA profiling to identify high bacterial diversity by analyzing 11 inside and 10 outside environments from the General Hospital of Ribeirão Preto Medical School, Brazil. Our results identified a high bacterial diversity, and among these, the most abundant bacterial genera linked to NIs were Cutibacterium, Streptococcus, Staphylococcus, and Corynebacterium. A Acinetobacter was detected in cafeterias, bus stops, and adult and pediatric intensive care units (ICUs). Data suggest an association between transport and alimentation areas proximal to the hospital ICU environment. Interestingly, the correlation and clusterization analysis showed the potential of the external areas to directly influence the ICU pediatric department microbial community, including the outpatient's clinic, visitor halls, patient reception, and the closest cafeterias. Our results demonstrate that high-resolution 16S rRNA profiling is a robust and reliable tool for bacterial genomic surveillance. In addition, the metabarcoding approach might help elaborate decontamination policies, and consequently reduce NIs.

Molecular Characterization of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Isolates Collected from Inanimate Hospital Environments in Addis Ababa, Ethiopia.

INTRODUCTION: The hospital environment contributes to the spread of Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE), which are contributing to increased morbidity and mortality rates. The present study was carried out to detect environmental contamination, antimicrobial susceptibility testing of ESBL-PE, and to explore molecular characterization of ESBL encoding genes. METHODS: A cross-sectional study was conducted within the intensive care units (ICUs) of Tikur Anbessa Specialized Hospital from June to July 2018. A total of 97 swabs were taken from high-contact inanimate surfaces near immediate patient environments. All isolates were cultured by using ESBL ChromoSelect Agar and identified with conventional bacteriological methods. Antimicrobial susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute. Combination disk test was used to confirm ESBL production, while molecular characterizations of ESBL genes were performed by polymerase chain reaction. RESULTS: Out of 97 swabbed sample, 24 (24.7%) were confirmed as ESBL-PE. The most predominant ESBL-PE was from E. coli (41.7%) and K. pneumoniae (25%). The Pediatrics and Neonatal ICU (29.2%, 7/24) exhibited highest ESBL-PE. The most contaminated materials were bed linens (33.3%). Most of ESBL-PE isolates were resistant to ampicillin (100%) and ceftriaxone (91.7%). A low resistance level was recorded for amikacin (25%). Among ESBL-producing genes, blaCTX-M (35.7%) was the most prevalent, followed by blaTEM and blaSHV gene 32.1% for each. CONCLUSIONS: Appearance of ESBL-PE in ICUs environment is posing a serious threat to control healthcare associated infections. The high level of resistance shows the need of policies for devising infection control procedures and detection of ESBL-PE.

Pseudomonas aeruginosa countrywide outbreak in hospitals linked to pre-moistened non-sterile washcloths, Norway, October 2021 to April 2022.

In November 2021, a clonal outbreak of Pseudomonas aeruginosa of novel sequence type ST3875 was detected in three patients who died of bloodstream infections in one hospital. By 25 April 2022, the outbreak included 339 cases from 38 hospitals across Norway. Initial hospital reports indicate Pseudomonas infection as the main contributing cause in seven deaths. In March 2022, the outbreak strain was identified in non-sterile pre-moistened disposable washcloths, used to clean patients, from three lots from the same international manufacturer.

Detection of Clostridioides difficile in hospital environment by using C diff Banana Broth™.

116 environmental samples from a 504 bed clinical hospital obtained in 2017/19 were inoculated into C diff Banana Broth™. Six C. difficile and 12 C. pefringens strains were isolated. Antibiotic-resistant Clostridium spp. dominated in hospital environment. To determine Clostridium spp. in hospital environment suitable medium like C diff Banana Broth™ should be used.

OCCUPATIONAL SAFETY AND HYGIENE OF HEALTHCARE PROFESSIONALS IN THE CONTEXT OF HOSPITAL ENVIRONMENT SAFETY.

OBJECTIVE: The aim: This study was conducted to carry out a comprehensive assessment of the occupational safety and health of medical workers. PATIENTS AND METHODS: Materials and methods: The study involved a questionnaire survey and full-scale physiological and hygienic research using bibliosemantic, questionnaire, hygienic, and statistical methods. RESULTS: Results: In the course of research it was recorded that the work of surgeons (according to the criteria of the current "Hygienic classification of work") is characterized by high intensity (class 3.2), high probability of exposure to infectious agents (class 3.3, and 4), harmful effects of physical factors (class 3.1 ), which according to the criteria of the general hygienic assessment of working conditions according to the degree of harmfulness and danger allows being assigned to class 3.3 ("harmful") and 4 ("dangerous"), respectively. Such working conditions provoke an increase in chronic morbidity (industrial and temporary disability), lead to the development of occupational diseases, and can pose a threat to the lives of workers. The need to focus attention on assessing the safety of hospitals in emergencies not only on issues of occupational safety and health but also on the stability and reliability of hospitals in such extreme conditions. CONCLUSION: Conclusions: The work process of doctors is characterized by the impact on their body of a complex of unfavorable production factors of psycho-physiological, biological, physical, and chemical nature, among which the leaders are high labor intensity due to intellectual and emotional load, irrational mode of work and rest, and biological factors.

One year later: The effect of changing azole-treated bulbs for organic tulips bulbs in hospital environment on the azole-resistant Aspergillus fumigatus rate.

Azole-treated plant bulbs have already been evoked as a potential explanation of the worldwide spread of azole-resistant Aspergillus fumigatus (ARAf). We previously pointed out the presence of a high rate of ARAf (71% of A. fumigatus detected on azole-supplemented media) in flower beds containing azole-treated bulbs at the hospital's surroundings. We show here that planting organic bulbs can be a solution to reduce ARAf burden (from 71% rate to below 3%). The results suggest that replacing treated bulbs with organic bulbs may be sufficient to regain a population that is predominantly susceptible in just 1 year. LAY SUMMARY: Antifungal resistance is increasingly observed in fungal pathogens. This study argues that planting organic bulbs in hospitals' outdoor surroundings could be a good alternative to continue to beautify green spaces, without the risk of dissipating antifungal-resistant fungal pathogens.

Rapid screening and characterization of bacteria associated with hospital cockroaches (Blattella germanica L.) using MALDI-TOF mass spectrometry.

AIMS: The study aimed to explore the diversity of culturable microbiota colonizing the alimentary tract and outer surfaces of German cockroaches (Blattella germanica) captured in a health care facility. METHODS AND RESULTS: Microbial identification was conducted using Matrix Assisted Laser Desorption-Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) Biotyper and 16S rRNA sequencing. A total of 181 bacteria strains were isolated from 25 cockroach specimens and the MALDI-TOF MS-based assay yielded direct identification of 96·5% (175 out of 181) of the strains at the species level. The proteomic fingerprinting mainly revealed strains belonged to Gram-negative Enterobacteria (103) with six different genera that were characterized including Citrobacter, Klebsiella, Kluyevera, Leclercia, Morganella and Serratia. In addition, Pseudomonas sp. strains ranked in second with 29·8% (54 strains) followed by Staphylococcus sp. (6·62%) and Enterococcus sp. (1·65%). A large number of these bacteria (n = 90, 49·72%) was found in cockroaches captured in the maternity ward, whereas 45 strains (24·8%) were recovered in the paediatric ward. Altogether, 24 bacterial species were identified from both the external surface and digestive tract of the insect, of which Serratia marcescens presented the major group (n = 80, 44·19%) followed by Pseudomonas aeruginosa (n = 53, 29·28%) and Klebsiella oxytoca (n = 9, 4·94%). CONCLUSION: The findings showed a high prevalence of bacterial pathogens harboured in the body and alimentary tract of B. germanica captured in a health care facility. SIGNIFICANCE AND IMPACT OF THE STUDY: This investigation shows the possible role of German cockroaches as a source for bacterial pathogens, increasing the likelihood of direct transmission of healthcare associated infections, and thereby representing a public health risk. In addition, the present study revealed a high discriminatory power of the mass spectra investigation and a competent bacterial typing tool that extends phenotypic and genotypic approaches, which allows new possibilities for fast and accurate diagnosis in medical entomology.

Can person-centred care for people living with dementia be delivered in the acute care setting?

The need to improve care for people living with dementia in the hospital setting has long been recognised. Person-centred care has the potential to improve the experience of care for persons living with dementia and their carers, and has been shown to improve the experiences of hospital staff caring for the persons living with dementia, however it remains challenging to deliver in a time- and task-focussed acute care setting. This commentary suggests that to embed person-centred care across the hospital environment, cultural changes are needed at organisational and ward levels. In particular there needs to be: leadership that supports and advocates for workforce capacity to recognise and meet both psychological and physical needs of people living with dementia, promotion of physical environments that support familiarisation and social interactions, an inclusive approach to carers and the development of a culture of sharing knowledge and information across hierarchies and roles. An evidence-based set of pointers for service change are described which highlight institutional and environmental practices and processes that need to be addressed in order for person-centred care to become part of routine care.

What is the relationship between indoor air quality parameters and airborne microorganisms in hospital environments? A systematic review and meta-analysis.

Airborne microorganisms in hospitals have been associated with several hospital-acquired infections (HAIs), and various measures of indoor air quality (IAQ) parameters such as temperature, relative humidity, carbon dioxide (CO2 ), particle mass concentration, and particle size have been linked to pathogen survival or mitigation of pathogen spread. To investigate whether there are quantitative relationships between the concentration of airborne microorganisms and the IAQ in the hospital environment. Web of Science, Scopus and PubMed databases were searched for studies reporting airborne microbial levels and any IAQ parameter(s) in hospital environments, from database inception to October 2020. Pooled effect estimates were determined via random-effects models. Seventeen of 654 studies were eligible for the meta-analysis. The concentration of airborne microbial measured as aerobic colony count (ACC) was significantly correlated with temperature (r = 0.25 [95% CI = 0.06-0.42], p = 0.01), CO2 concentration (r = 0.53 [95% CI = 0.40-0.64], p Ë‚ 0.001), particle mass concentration (≤5 µg/m3 ; r = 0.40 [95% CI = 0.04-0.66], p = 0.03), and particle size (≤5 and ˃5 µm), (r = 0.51 [95% CI = 0.12-0.77], p = 0.01 and r = 0.55 [95% CI = 0.20-0.78], p = 0.003), respectively, while not being significantly correlated with relative humidity or particulate matter of size >5 µm. Conversely, airborne total fungi (TF) were not significantly correlated with temperature, relative humidity, or CO2 level. However, there was a significant weak correlation between ACC and TF (r = 0.31 [95% CI = 0.07-0.52], p = 0.013). Although significant correlations exist between ACC and IAQ parameters, the relationship is not definitive; the IAQ parameters may affect the microorganisms but are not responsible for the presence of airborne microorganisms. Environmental parameters could be related to the generating source, survival, dispersion, and deposition rate of microorganisms. Future studies should record IAQ parameters and factors such as healthcare worker presence and the activities carried out such as cleaning, sanitizing, and disinfection protocols. Foot traffic would influence both the generation of microorganisms and their deposition rate onto surfaces in the hospital environment. These data would inform models to improve the understanding of the likely concentration of airborne microorganisms and provide an alternative approach for real-time monitoring of the healthcare environment.

Greek Nurses' Perception of Hospital Ethical Climate: A Cross-Sectional Study.

This study aimed to examine Greek nurses' perceptions about hospital ethical climate and to investigate the possible difference of those perceptions regarding their demographic and work-related characteristics. The cross-sectional study design was employed in this study in which 286 nurses and nurse assistants participated. Data were collected by a sheet containing demographic and work-related characteristics and the Greek version of the Oslons' Hospital Ethical Climate Scale. IBM Statistical Package for Social Sciences 25 was used in data analysis. Frequencies, means, percentages, and standard deviations summarized the data. For the statistical differences, parametric tests were performed. Independent Samples t and Pearson correlation analysis were used to determine the relationship between the ethical climate of the hospital and the nurses' characteristics. The p-values 0.05 were considered statistically significant. The mean age of the nurses was 44 years (SD: 8.5 years; range 24-66 years). The majority of them were women (77.3%). A percent of 57.7% of the sample was married. Most positive perceptions were concerning managers (4.01) following by peers (3.82), patients (3.69), hospitals (3.29) while the least positive perceptions of the ethical climate were concerning the physicians (3.16). The factors associated with hospital ethical perception were: working experience and responsible position. The highest score of ethical climate reported to managers subscale, while the minimum score was related to physicians. In general, Greek nurses reported positive perceptions regarding hospital ethical climate. The positive ethical climate is associated with a better working environment, fewer nurses' experience of moral distress, fewer chances for nursing turnover, high quality of nursing care, and fewer errors in nursing practice.

COVID-19 AS A STRESS TEST OF HEALTHCARE ESTABLISHMENTS EFFECTIVENESS AND RELIABILITY MEASURED NATIONALLY AND GLOBALLY.

OBJECTIVE: The aim: The authors aimed to estimate the healthcare environment risks and safety problems of the medical staff and patients, methods of neutralizing the negative public health effects and to suggest the new approaches to improved effectiveness and reliability of the healthcare establishments functioning under the emergencies. PATIENTS AND METHODS: Materials and methods: The study includes data of questioning of 163 healthcare workers of certain institutions in Ukraine using the questionnaire of the Agency for Healthcare Research and Quality ( the USA) on adherence to the patients' safety culture. In this study only the data on the patients' safety culture "response to mistakes" are represented. The more positive answers the respondents gave, the less they are aware that their mistakes and reports do not influence them negatively. RESULTS: Results: Hospital environment reprsents a complex multi-component system, in which specific medical and social tasks are executed, with their fulfillment accompanied with hazardous and unsafe biological, psycho-physiological, chemical, physical and social effects on the staff, patients and the environment. The joined effect of the hospital environment negative factors on the staff is stipulated for the stress and functional tiredness accumulation; it leads to increase in medical mistakes occurrence, which, in its turn, increases probability of occupational catching COVID-19, thus, raising the hospital environment risks under the COVID-19 circumstances both for the medical staff and the patients. CONCLUSION: Conclusions: The COVID-19 pandemics turned to be a helpful factor to define critical issues in the hospital environment safety, proving the necessity of further studies, aimed at transforming the safe hospital environment notion from its theoretical meaning into the working paradigm, minimizing practical risk in hospital establishments.

Impact of a Novel Antimicrobial Surface Coating on Health Care-Associated Infections and Environmental Bioburden at 2 Urban Hospitals.

BACKGROUND: Approximately 1 in 25 people admitted to a hospital in the United States will suffer a health care-associated infection (HAI). Environmental contamination of hospital surfaces contributes to HAI transmission. We investigated the impact of an antimicrobial surface coating on HAIs and environmental bioburdens at 2 urban hospitals. METHODS: A transparent antimicrobial surface coating was applied to patient rooms and common areas in 3 units at each hospital. Longitudinal regression models were used to compare changes in hospital-onset multidrug-resistant organism bloodstream infection (MDRO-BSI) and Clostridium difficile infection (CDI) rates in the 12 months before and after application of the surface coating. Incidence rate ratios (IRRs) were compared for units receiving the surface coating application and for contemporaneous control units. Environmental samples were collected pre- and post-application to identify bacterial colony forming units (CFUs) and the percent of sites positive for select, clinically relevant pathogens. RESULTS: Across both hospitals, there was a 36% decline in pooled HAIs (combined MDRO-BSIs and CDIs) in units receiving the surface coating application (IRR, 0.64; 95% confidence interval [CI], .44-.91), and no decline in the control units (IRR, 1.20; 95% CI, .92-1.55). Following the surface application, the total bacterial CFUs at Hospitals A and B declined by 79% and 75%, respectively; the percentages of environmental samples positive for clinically relevant pathogens also declined significantly for both hospitals. CONCLUSIONS: Statistically significant reductions in HAIs and environmental bioburdens occurred in the units receiving the antimicrobial surface coating, suggesting the potential for improved patient outcomes and persistent reductions in environmental contamination. Future studies should assess optimal implementation methods and long-term impacts.

Parents of extremely and moderately preterm children reported long-lasting impressions of medical care and the hospital environment.

AIM: Few studies have examined the parents of moderately preterm children. The aim of this study was to investigate the experiences of parents of both extremely and moderately preterm children. METHODS: Qualitative telephone interviews were conducted in 2013-2014 with 13 mothers and 10 fathers of extremely preterm children and with 11 mothers and seven fathers of moderately preterm children. The children were born between 2000 and 2003. Data were analysed with a narrative approach. RESULTS: Parents of extremely preterm children recounted dramatic birth stories that, for most, ended positively. Parents of moderately preterm children presented more neutral birth stories, and most recounted that their children did not receive attention for prematurity from medical staff. Parents from both groups described staff members' treatment in terms of long-lasting impressions, and they were deeply affected by the hospital environment and the other parents and children admitted. Parents whose children died or were disabled recounted dramatic stories and endless fights for support. CONCLUSION: Parents from both groups reported long-lasting impressions of the medical staff and the hospital environment, which they found important to talk about, even a decade after the birth of their child/children.

Fear of Hospital-Acquired Infections: The Combined Impact of Patient's Hygiene Sensitivity and Perceived Staff Preventive Behavior.

Over the years, the public has paid growing attention to hospital-acquired infections (HAIs). Currently, infection prevention and control are considered a number one national priority in leading developed countries. However, while some hospital visitors are knowledgeable of the topic, others may be ignorant or careless as regards sterility and hygiene-related matters. This study, conducted in Israel, compared people cognizant of hygiene-related issues to those who are less so, in an attempt to account for differences in terms of attitudes and perceptions regarding the hospital environment. Based on Endsley's (in: Proceedings of the IEEE 1988 national aerospace and electronics conference, IEEE, 1988, 1995) situation awareness concept, we hypothesized that people attending the hospital with different hygiene schema would react differently when faced with HAI-related triggers. Based on a survey of 208 respondents, the results support the hypotheses, and showed a significant moderating effect of hygiene-sensitivity on the relationship between the staffs' hospital acquired infection-related proactive behavior and avoidance tendencies among hospital visitors. Theoretical as well as practical recommendations are discussed.

Application of nutrient profile models to compare products offered in 'healthy' vs 'conventional' vending machines in a Spanish hospital environment.

INTRODUCTION: Vending machines promote easy access to food with low nutritional value. 'Healthy' vending machines (HVM) have been introduced as a means to improve the availability and accessibility of healthy food options, and the healthiness of the foods, however, has not been evaluated. OBJECTIVE: Our aim was to assess the healthiness of the products offered in HVM and 'conventional' vending machines (CVM), located in the Catalan Institute of Oncology. STUDY DESIGN AND METHODS: All products available in vending machines (HVM (n = 33) and CVM (n = 62) were evaluate during three nutrient profile models (NPMs): the World Health Organization's European Regional Office model (WHO), Nutrient Profile Model UK (NPM-UK), and Australian Health Star Rating system (HSR). RESULTS: Regardless of the NPM used, significant differences found in the proportion of healthy products among HVM and CVM (WHO: P-value = 0.005, NPM-UK: P value < 0.001, HSR: P-value < 0.001). The healthy products offered in HVM accounted for 30%, 73%, and 52% of the total content, while CVM offered 6%, 32%, and 15% of the content, as assessed by WHO, NPM-UK, and HSR, respectively. The WHO model was the most restrictive model, and the NPM-UK was the most permissible one. CONCLUSIONS: Although not all products in HVM are rated as healthy by the different NPMs, the percentage of healthy products was significantly higher than those in CVM.

Factors influencing sleep quality among Jordanian intensive care patients.

Sleep disturbance is common in patients in the intensive care unit (ICU). Numerous factors can contribute to this. High noise and light levels, nursing interventions and medication administration are major factors. This study investigated the demographic and environmental factors that might adversely affect ICU patients' quality of sleep. Data were collected from 103 patients using a demographic data sheet, the Freedman Quality of Sleep Scale and the Richards-Campbell Sleep Scale. Patients' demographic characteristics were found to have no significant effects on their perceived quality of sleep. Environmental factors, including noise, light, nursing interventions, diagnostic testing, the administration of medication, talking and phones ringing, were significantly related to the patients' perceived quality of sleep.

Healthcare-associated infections: bacteriological characterization of the hospital surfaces in the University Hospital of Abomey-Calavi/so-ava in South Benin (West Africa).

BACKGROUND: Healthcare-associated infections have become a public health problem, creating a new burden on medical care in hospitals. The emergence of multidrug-resistant bacteria poses a difficult task for physicians, who have limited therapeutic options. The dissemination of pathogens depends on "reservoirs", the different transmission pathways of the infectious agents and the factors favouring them. Contaminated environmental surfaces are an important potential reservoir for the transmission of many healthcare-associated pathogens. Pathogens can survive or persist in the environment for months and be a source of infection transmission when appropriate hygiene and disinfection procedures are inefficient. The aim of this study was to identify bacterial species from hospital surfaces in order to effectively prevent healthcare-associated infections. METHODS: Samples were taken from surfaces at the University Hospital of Abomey-Calavi/So-Ava in South Benin (West Africa). To achieve the objective of this study, 160 swab samples of hospital surfaces were taken as recommended by the International Organization for Standardization (ISO 14698-1). These samples were analysed in the bacteriology section of the National Laboratory for Biomedical Analysis. All statistical analyses were performed using SPSS Statistics 21 software. A Chi Square Test was used to test the association between the Results of culture samples and different care units. RESULTS: Of the 160 surface samples, 65% were positive for bacteria. The frequency of isolation was predominant in Paediatrics (87.5%). The positive samples were 64.2% Gram-positive bacteria and 35.8% of Gram-negative bacteria. Staphylococcus aureus predominated (27.3%), followed by Bacillus spp. (23.3%). The proportion of other microorganisms was negligible. S. aureus and Staphylococcus spp. were present in all care units. There was a statistically significant association between the Results of culture samples and different care units (χ2 = 12.732; p = 0.048). CONCLUSION: The bacteria found on the surfaces of the University Hospital of Abomey-Calavi/So-Ava's care environment suggest a risk of healthcare-associated infections. Adequate hospital hygiene measures are required. Patient safety in this environment must become a training priority for all caregivers.

Elimination of Klebsiella pneumoniae NDM from the air and selected surfaces in hospital using radiant catalytic ionization.

Due to increasing antibiotic resistance Klebsiella pneumoniae is a serious threat for the hospitalized patients. The aim of this study was the assessment of radiant catalytic ionization (RCI) efficacy on K. pneumoniae reduction in the air and on selected surfaces. Four K. pneumoniae NDM and ESBLs-producing strains were included in the study. Three types of surface were tested: cotton-polyester, terry and PVC. It was found that RCI significantly reduced the number of bacteria from all types of surface (terry: 0·56-1·22 log CFU m2 , cotton-polyester: 2·15-3·71 log CFU per m2 , PVC: 4·45-4·92 log CFU per m2 ) as well as from the air (1·80 log CFU per m3 ). The RCI technology may be a useful disinfection method in hospitals. SIGNIFICANCE AND IMPACT OF THE STUDY: Microbial contamination of air and surfaces in hospitals play an important role in healthcare-associated infections. The aim was the assessment of Klebsiella pneumoniae elimination using radiant catalytic ionization (RCI). K. pneumoniae are aetiological agent of nosocomial infections, such as: pneumonia, infections of urinary tract, blood, e.t.c. The strains producing the New Delhi metallo-ß-lactamases are one of the greatest epidemiological threat. The use of RCI eliminate the tested bacteria from the hospital environment, but can also be effective in food processing plants or public facilities, ensuring the safety of people and products. This research is scarce in references and has a large innovation and application potential.

What do patients really want? An in-depth examination of patient experience in four Australian hospitals.

BACKGROUND: Patient satisfaction is an important outcome measure guiding quality improvement in the healthcare setting while the patient-centred care movement places increasing importance on patient engagement in clinical decision-making. However, the concept of patient satisfaction is not clearly defined, and beliefs of patients are not always evident in health surveys. Researchers rarely follow up on surveys to explore patient views and what they mean in greater depth. This study set out to examine perceptions of hospital care, through in-depth, qualitative data capture and as a result, to gather rich, patient-driven information on user experience and satisfaction in the Australian healthcare setting; and identify influencing factors. METHODS: Focus groups were undertaken in four St Vincent's Health Australia (SVHA) hospitals in 2017 where participants discussed responses to eight questions from the Press Ganey Patient Experience Survey. Thirty people who were inpatients at SVHA. RESULTS: Good communication and high-quality information at arrival and discharge were found to be important to patients. Communication breakdown was also evident, further exacerbated by a range of environmental factors such as sharing a room with others. Overall, patients' felt that while their spiritual needs were well-supported by the hospital staff at all SVHA hospitals, it was the clinical teams prioritised their emotional needs. Good communication and environments can improve patient experience and follow-up at home is vital. CONCLUSIONS: Patient-centred care needs careful planning with patients involved at entry and exit from hospital. Focused communication, environmental changes, attending to complaints, and clearer discharge strategies are recommended.