Carbapenem-Resistant Enterobacteriaceae Outbreak in a Medical Ward in Spain: Epidemiology, Control Strategy, and Importance of Environmental Disinfection.

Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) are a growing public health problem. We describe an outbreak by CRE and the measures to control it in a hospitalization unit in Spain. Methods: In June 2015, the system of prevention and control of CRE implemented in the hospital detected an increase in the incidence of patients with CRE in a mixed hospitalization facility (geriatrics, internal medicine, and pneumology), with the appearance of four related patients in 2 weeks, three of them being nosocomial cases. A multidisciplinary group was created and carried out: weekly screenings, general cleaning, four training sessions for personnel, two hand hygiene observation studies and environmental sampling. A higher incidence of new cases was detected in three adjoining rooms, in which environmental decontamination was performed with vaporized hydrogen peroxide. Results: In 5 months, a total of 18 cases were detected, 14 of them were nosocomial. Four different clones of Klebsiella pneumoniae OXA-48 were responsible for 83.3% of the cases. Adherence to hand hygiene increased from 36% to 85% after the training sessions. Seven percent of the environmental samples were positive for CRE in rooms with high incidence, moving to 0% after decontamination with hydrogen peroxide. Three patients died, one of them possibly associated with clinical infection due to CRE. Conclusions: Multidisciplinary information strategies, personnel training, and control of environmental reservoirs are effective to address outbreaks of CRE.

Mejora de los conocimientos sobre higiene de manos del personal sanitario tras un curso de formación del Hospital Universitario La Paz y sus percepciones sobre la higiene de manos / No disponible

OBJETIVOS: analizar el grado de conocimientos y las percepciones en higiene de manos de las personas involucradas en la asistencia sanitaria del Hospital Universitario La Paz. MATERIAL Y MÉTODOS: estudio cuasiexperimental. Durante el período 2016-2017 se empleó una encuesta de conocimientos y de percepciones en una muestra de 2614 sujetos, seguida de formación, tras la que se repitió la encuesta de conocimientos. Se realizaron las pruebas: ji-cuadrado y Test-T sobre los resultados de las encuestas de conocimientos, pre y post curso. Además, se realizó una regresión logística multivariante donde la variable dependiente era las puntuaciones excelentes (14-15 puntos) y las independientes el sexo, la edad y las categorías profesionales de mayor participación en la muestra. RESULTADOS: la puntuación media de la encuesta de conocimientos pre y post formación fue de 11,9 y 12,7 (p < 0,001), respectivamente. Ser mujer, tener entre 10 y 18 años de experiencia profesional y pertenecer a la categoría profesional de enfermería, se asoció a una mayor probabilidad de obtener una puntuación excelente (OR = 1,8 95%; IC = 1,3-2,4). Predominaron las percepciones favorables y la falta de tiempo se identificó como la principal causa de incumplimiento. «Descripción de un brote polimicrobiano en una unidad de cuidados intensivos durante la ola pandémica de COVID-19 de marzo 2020». CONCLUSIONES: el nivel de conocimientos en higiene de manos fue alto y mejoró mediante una actividad formativa en todo el personal. La sobrecarga laboral es un escollo importante para un buen cumplimiento de la higiene de manos

OBJECTIVES: to analyze the degree of knowledge and perceptions in hand hygiene of the people involved in health care at Hospital Universitario La Paz. MATERIAL AND METHODS: quasi-experimental study. During the period 2016-2017 a survey of knowledge and perceptions was carried out in a sample of 2,614 subjects. This was followed by training, after which the knowledge survey was repeated. The tests were performed: chi-square and Test-T on the results of the survey of knowledge, before and after the course. In addition, a multivariate logistic regression was performed and the dependent variable was excellent scores (14-15 points) and the independent variables were sex, age and the professional categories with the highest participation in the sample. RESULTS: the mean score of the pre and post training knowledge survey was 11.9 and 12.7 (p < 0.001), respectively. Being a woman, having between 10 and 18 years of professional experience and belonging to the professional category of nursing, was associated with a greater probability of obtaining an excellent score (OR = 1.8, 95%; IC 1,3-2,4). Favorable perceptions predominated and lack of time was identified as the main cause of noncompliance. CONCLUSIONS: the level of knowledge in hand hygiene was high and improved through a training activity for all staff. Work overload is a major stumbling block for good hand hygiene compliance