Patient perspectives on infection prevention and control in cancer care: a survey of knowledge and attitudes among persons with cancer and their next of kin.

BACKGROUND: With the growing prevalence of antimicrobial resistance, there may be a need to strengthen infection prevention and control (IPC) measures in cancer care. When developing clinical guidelines, it is important to incorporate patient perspectives. AIM: To determine the knowledge of, and attitudes towards, IPC among persons with cancer and their next of kin in Norway. METHODS: Through discussions in expert panels and a pilot study, a survey was developed consisting of 13 knowledge statements to be judged true/false and 40 attitude items to be judged using a Likert scale and was sent to a panel of people with cancer experience on August 22nd, 2023. The mean correct responses and attitude scores were reported. FINDINGS: Of 551 respondents, the mean correct response to IPC-related knowledge questions was 79% (95% confidence interval: 78-80). Respondents were most knowledgeable about hand hygiene (99%, 546/551), but least knowledgeable about its role in preventing antibiotic resistance (41%, 225/551). Strong support was noted for IPC, especially within the patient responsibilities theme, with a mean score of 4.83. However, there was a notable reluctance towards some selected intrusive IPC measures, such as reducing contact with close relations. CONCLUSION: This survey revealed a high level of knowledge and attitudes that support the importance of IPC among persons with cancer in Norway and their next of kin. We recommend including patient perspectives in future development of IPC guidelines.

Clusters of healthcare-associated SARS-CoV-2 infections in Norwegian hospitals detected by a fully automatic register-based surveillance system.

BACKGROUND: Notifications to the Norwegian Institute of Public Health of outbreaks in Norwegian healthcare institutions are mandatory by law, but under-reporting is suspected due to failure to identify clusters, or because of human or system-based factors. This study aimed to establish and describe a fully automatic, register-based surveillance system to identify clusters of healthcare-associated infections (HAIs) of SARS-CoV-2 in hospitals and compare these with outbreaks notified through the mandated outbreak system Vesuv. METHODS: We used linked data from the emergency preparedness register Beredt C19, based on the Norwegian Patient Registry and the Norwegian Surveillance System for Communicable Diseases. We tested two different algorithms for HAI clusters, described their size and compared them with outbreaks notified through Vesuv. RESULTS: A total of 5033 patients were registered with an indeterminate, probable, or definite HAI. Depending on the algorithm, our system detected 44 or 36 of the 56 officially notified outbreaks. Both algorithms detected more clusters then officially reported (301 and 206, respectively). CONCLUSIONS: It was possible to use existing data sources to establish a fully automatic surveillance system identifying clusters of SARS-CoV-2. Automatic surveillance can improve preparedness through earlier identification of clusters of HAIs, and by lowering the workloads of infection control specialists in hospitals.

Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography.

PURPOSE: To compare the distribution of mammographic features among women recalled for further assessment after screening with digital breast tomosynthesis (DBT) versus digital mammography (DM), and to assess associations between features and final outcome of the screening, including immunohistochemical subtypes of the tumour. METHODS: This randomized controlled trial was performed in Bergen, Norway, and included 28,749 women, of which 1015 were recalled due to mammographic findings. Mammographic features were classified according to a modified BI-RADS-scale. The distribution were compared using 95 % confidence intervals (CI). RESULTS: Asymmetry was the most common feature of all recalls, 24.3 % (108/444) for DBT and 38.9 % (222/571) for DM. Spiculated mass was most common for breast cancer after screening with DBT (36.8 %, 35/95, 95 %CI: 27.2-47.4) while calcifications (23.0 %, 20/87, 95 %CI: 14.6-33.2) was the most frequent after DM. Among women screened with DBT, 0.13 % (95 %CI: 0.08-0.21) had benign outcome after recall due to indistinct mass while the percentage was 0.28 % (95 %CI: 0.20-0.38) for DM. The distributions were 0.70 % (95 %CI: 0.57-0.85) versus 1.46 % (95 %CI: 1.27-1.67) for asymmetry and 0.24 % (95 %CI: 0.16-0.33) versus 0.54 % (95 %CI: 0.43-0.68) for obscured mass, among women screened with DBT versus DM, respectively. Spiculated mass was the most common feature among women diagnosed with non-luminal A-like cancer after DBT and after DM. CONCLUSIONS: Spiculated mass was the dominant feature for breast cancer among women screened with DBT while calcifications was the most frequent feature for DM. Further studies exploring the clinical relevance of mammographic features visible particularly on DBT are warranted.