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1.
Breast Dis ; 41(1): 1-3, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34219707

RESUMO

During the first hit of SARS-COVID pandemic, an important reorganization of Healthcare Services has been done, and new protocols and pathways to protect frail patients like oncological patients were designed. The second hit of pandemic had stressed these new pathways and suggests to health-workers some improvements for safer management of patents.We reported our experience in organizing the clinical pathway of neoadjuvant therapy candidate patients based on the execution of sentinel lympho-node biopsy and the placement of implantable venous access port in the same access to operating room before neoadjuvant chemotherapy suggesting a possible organizational model. In the period October-December 2020 we have included in this new type of path twelve patients and we have not registered any cases of COVID among the patients included. We think this new path, adopted amid the second hit, will be useful for all Breast Units that are facing the challenge of guaranteeing the highest standards of care in a historical moment where the health emergency occupies the efforts of health workers and the economic resources of health systems.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , COVID-19/prevenção & controle , Cateterismo Venoso Central/métodos , Controle de Infecções/métodos , Segurança do Paciente , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/normas , Cateteres Venosos Centrais , Quimioterapia Adjuvante , Procedimentos Clínicos , Feminino , Humanos , Controle de Infecções/normas , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Biópsia de Linfonodo Sentinela/normas
2.
J Med Virol ; 94(1): 413-416, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34515998

RESUMO

In December 2020, Italy experienced the first case of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) B.1.1.7 lineage. In January 2021, we identified 21 cases of this variant in Corzano, defining the first outbreak of SARS-CoV-2 B.1.1.7 lineage in Italy. The high transmissibility of the B.1.1.7 variant represented an important benefit for the virus, which became rapidly dominant on the territory. Containment measures induced the epidemic curve onto a decreasing trajectory underlining the importance of appropriate control and surveillance for restraint of virus spread. Highlights The first Italian outbreak of SARS-CoV-2 B.1.1.7 lineage occurred in Lombardy in January 2021. The outbreak originated by a single introduction of the B.1.1.7 lineage. The genomic sequencing revealed, for the first time, the presence of the V551F mutation in the B.1.1.7 lineage in Italy. Surveillance, prompt sequencing and tracing efforts were fundamental to identify and to quickly contain the outbreak.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/epidemiologia , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Adolescente , Adulto , COVID-19/transmissão , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Feminino , Genoma Viral/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Controle de Infecções/métodos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Filogenia , Análise de Sequência de RNA , Sequenciamento Completo do Genoma , Adulto Jovem
3.
Crit Care Nurs Clin North Am ; 33(4): 419-429, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34742498

RESUMO

Currently, the Centers for Disease Control reports close to 40,000 central line-associated bloodstream infections (CLABSI) occur in acute care facilities in the United States each year. Most are considered preventable. Evidence-based practices such as the CLABSI bundle and central line maintenance bundles have demonstrated their effectiveness in reducing CLABSI. This article reviews these best practices and provides a framework for consistent implementation.


Assuntos
Infecções Relacionadas a Cateter , Cateterismo Venoso Central , Infecção Hospitalar , Pacotes de Assistência ao Paciente , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Cuidados Críticos , Infecção Hospitalar/prevenção & controle , Humanos , Controle de Infecções , Estados Unidos/epidemiologia
4.
BMC Health Serv Res ; 21(1): 1200, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34740361

RESUMO

BACKGROUND: Healthcare workers (HCW) are at higher risk of tuberculosis (TB) than the general population. We assessed healthcare facilities for their TB infection control standards and priorities. METHODS: A standardised tool was applied. The assessment was conducted by direct observation, documents review and interviews with the facility heads. RESULTS: Twenty healthcare facilities were assessed; 17 dispensaries, an HIV-clinic, a private not-for-profit hospital and a public regional hospital. In both hospitals, outpatient departments, internal medicine wards, paediatric wards, emergency departments; and the MDR-TB unit of the public regional hospital were assessed. In Gabon, there are currently no national guidelines for TB infection control (TBIC) in healthcare settings. Consequently, none of the facilities had an infection control plan or TBIC focal point. In three departments of two facilities (2/20 facilities), TB patients and presumed TB cases were observed to be consistently provided with surgical masks. One structure reported to regularly test some of its personnel for TB. Consultation rooms were adequately ventilated in six primary care level facilities (6/17 dispensaries) and in none of the hospitals, due to the use of air conditioning. Adequate personal protective equipment was not provided regularly by the facilities and was only found to be supplied in the MDR-TB unit and one of the paediatric wards. CONCLUSIONS: In Moyen-Ogooué province, implementation of TBIC in healthcare settings is generally low. Consequently, HCW are not sufficiently protected and therefore at risk for M. tuberculosis infection. There is an urgent need for national TBIC guidelines and training of health workers to safeguard implementation.


Assuntos
Infecção Hospitalar , Controle de Infecções , Tuberculose , Instituições de Assistência Ambulatorial , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Atenção à Saúde , Gabão/epidemiologia , Pessoal de Saúde , Humanos , Tuberculose/epidemiologia , Tuberculose/prevenção & controle
5.
Sci Rep ; 11(1): 21385, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725400

RESUMO

Shortages of reverse transcriptase (RT)-polymerase chain reaction (PCR) reagents and related equipment during the COVID-19 pandemic have demonstrated the need for alternative, high-throughput methods for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-mass screening in clinical diagnostic laboratories. A robust, SARS-CoV-2 RT-loop-mediated isothermal amplification (RT-LAMP) assay with high-throughput and short turnaround times in a clinical laboratory setting was established and compared to two conventional RT-PCR protocols using 323 samples of individuals with suspected SARS-CoV-2 infection. Limit of detection (LoD) and reproducibility of the isolation-free SARS-CoV-2 RT-LAMP test were determined. An almost perfect agreement (Cohen's kappa > 0.8) between the novel test and two classical RT-PCR protocols with no systematic difference (McNemar's test, P > 0.05) was observed. Sensitivity and specificity were in the range of 89.5 to 100% and 96.2 to 100% dependent on the reaction condition and the RT-PCR method used as reference. The isolation-free RT-LAMP assay showed high reproducibility (Tt intra-run coefficient of variation [CV] = 0.4%, Tt inter-run CV = 2.1%) with a LoD of 95 SARS-CoV-2 genome copies per reaction. The established SARS-CoV-2 RT-LAMP assay is a flexible and efficient alternative to conventional RT-PCR protocols, suitable for SARS-CoV-2 mass screening using existing laboratory infrastructure in clinical diagnostic laboratories.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , COVID-19/epidemiologia , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Pandemias , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , SARS-CoV-2/genética , COVID-19/virologia , Genoma Viral , Humanos , Controle de Infecções/métodos , Limite de Detecção , Programas de Rastreamento/métodos , RNA Viral/genética , RNA Viral/isolamento & purificação , DNA Polimerase Dirigida por RNA/genética , Reprodutibilidade dos Testes , Transcrição Reversa/genética , Sensibilidade e Especificidade
6.
J Korean Med Sci ; 36(42): e295, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725979

RESUMO

BACKGROUND: To minimize nosocomial infection against coronavirus disease 2019 (COVID-19), most hospitals conduct a prescreening process to evaluate the patient or guardian of any symptoms suggestive of COVID-19 or exposure to a COVID-19 patient at entrances of hospital buildings. In our hospital, we have implemented a two-level prescreening process in the outpatient clinic: an initial prescreening process at the entrance of the outpatient clinic (PPEO) and a second prescreening process is repeated in each department. If any symptoms or epidemiological history are identified at the second level, an emergency code is announced through the hospital's address system. The patient is then guided outside through a designated aisle. In this study, we analyze the cases missed in the PPEO that caused the emergency code to be applied. METHODS: All cases reported from March 2020 to April 2021 were analyzed retrospectively. We calculated the incidence of cases missed by the PPEO per 1,000 outpatients and compared the incidence between first-time hospital visitors and those visiting for the second time or more; morning and afternoon office hours; and days of the week. RESULTS: During the study period, the emergency code was applied to 449 cases missed by the PPEO. Among those cases, 20.7% were reported in otorhinolaryngology, followed by 11.6% in gastroenterology, 5.8% in urology, and 5.8% in dermatology. Fever was the most common symptom (59.9%), followed by cough (19.8%). The incidence of cases per 1,000 outpatients was significantly higher among first-time visitors than among those visiting for the second time or more (1.77 [confidence interval (CI), 1.44-2.10] vs. 0.59 [CI, 0.52-0.65], respectively) (P < 0.001). CONCLUSION: Fever was the most common symptom missed by the PPEO, and otorhinolaryngology and gastroenterology most frequently reported missed cases. Cases missed by the PPEO were more likely to occur among first-time visitors than returning visitors. The results obtained from this study can provide insights or recommendations to other healthcare facilities in operating prescreening processes during the COVID-19 pandemic.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/prevenção & controle , Tosse/etiologia , Febre/etiologia , Programas de Rastreamento/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial , COVID-19/epidemiologia , Criança , Feminino , Humanos , Incidência , Controle de Infecções , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
7.
Antimicrob Resist Infect Control ; 10(1): 159, 2021 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749807

RESUMO

BACKGROUND: In the COVID-19 pandemic context, a massive shortage of personal protective equipment occurred. To increase the available stocks, several countries appealed for donations from individuals or industries. While national and international standards to evaluate personal protective equipment exist, none of the previous research studied how to evaluate personal protective equipment coming from donations to healthcare establishments. Our aim was to evaluate the quality and possible use of the personal protective equipment donations delivered to our health care establishment in order to avoid a shortage and to protect health care workers throughout the COVID-19 crisis. METHODS: Our intervention focused on evaluation of the quality of donations for medical use through creation of a set of assessment criteria and analysis of the economic impact of these donations. RESULTS: Between 20th March 2020 and 11th May 2020, we received 239 donations including respirators, gloves, coveralls, face masks, gowns, hats, overshoes, alcohol-based hand rubs, face shields, goggles and aprons. A total of 448,666 (86.3%) products out of the 519,618 initially received were validated and distributed in health care units, equivalent to 126 (52.7%) donations out of the 239 received. The budgetary value of the validated donations was 32,872 euros according to the pre COVID-19 prices and 122,178 euros according to the current COVID-19 prices, representing an increase of 371.7%. CONCLUSIONS: By ensuring a constant influx of personal protective equipment and proper stock management, shortages were avoided. Procurement and distribution of controlled and validated personal protective equipment is the key to providing quality care while guaranteeing health care worker safety.


Assuntos
COVID-19/prevenção & controle , Dispositivos de Proteção dos Olhos/provisão & distribuição , Pessoal de Saúde/psicologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Máscaras/provisão & distribuição , Equipamento de Proteção Individual/provisão & distribuição , Roupa de Proteção/provisão & distribuição , Gestão da Segurança , COVID-19/epidemiologia , Humanos , Controle de Infecções , Pandemias , Equipamento de Proteção Individual/estatística & dados numéricos , Roupa de Proteção/estatística & dados numéricos , Melhoria de Qualidade , SARS-CoV-2
8.
Artigo em Inglês | MEDLINE | ID: mdl-34769694

RESUMO

BACKGROUND: Although COVID-19 has affected over 220 countries by October 2021, there is limited research examining the patterns and determinants of adherence to infection control measures over time. AIMS: Our study examines the sociodemographic factors associated with changes in the frequency of adherence to personal hygiene and social distancing behaviors in Hong Kong. METHODS: A serial cross-sectional telephone survey in the general population was conducted during the first (March 2020) (n = 765) and third wave (December 2020) (n = 651) of the local outbreak of the COVID-19 pandemic. Respondents were asked about their level of compliance with various personal hygiene and social distancing recommendations. RESULTS: By the third wave, mask use increased to 100%, and throughout the study periods, >90% practiced frequent hand hygiene. However, adherence to social distancing measures significantly waned over time: avoidance of social gatherings (80.5% to 72.0%), avoidance of public places/public transport (53.3% to 26.0%), avoidance of international travel (85.8% to 76.6%) (p < 0.05). The practice of ordering food takeout/home delivery, however, increased, particularly among high-income respondents. Higher education, female gender and employment status were the most consistently associated factors with adherence to COVID-19 preventive practices in the multivariable models. CONCLUSIONS: In urban areas of this region, interventions to improve personal hygiene in a prolonged pandemic should target males and those with low education. In addition to these groups, the working population needs to be targeted in order to improve adherence to social distancing guidelines.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , Feminino , Hong Kong/epidemiologia , Humanos , Controle de Infecções , Masculino , SARS-CoV-2 , Inquéritos e Questionários
9.
Infect Dis Clin North Am ; 35(4): 1027-1053, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34752219

RESUMO

Invasive fungal infections are an important cause of morbidity and mortality in hospitalized patients and in the immunocompromised population. This article reviews the current epidemiology of nosocomial fungal infections in adult patients, with an emphasis on invasive candidiasis (IC) and invasive aspergillosis (IA). Included are descriptions of nosocomial infections caused by Candida auris, an emerging pathogen, and IC- and IA-associated with coronavirus disease 2019. The characteristics and availability of newer nonculture-based tests for identification of nosocomial fungal pathogens are discussed. Recently published recommendations and guidelines for the control and prevention of these nosocomial fungal infections are summarized.


Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Micoses/epidemiologia , Micoses/prevenção & controle , Antifúngicos/uso terapêutico , COVID-19/complicações , COVID-19/epidemiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/etiologia , Fungos/classificação , Fungos/patogenicidade , Humanos , Hospedeiro Imunocomprometido , Controle de Infecções/normas , Micoses/diagnóstico , Micoses/etiologia , Fatores de Risco , SARS-CoV-2
10.
Infect Dis Clin North Am ; 35(4): 1055-1075, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34752220

RESUMO

Health care-acquired viral respiratory infections are common and cause increased patient morbidity and mortality. Although the threat of viral respiratory infection has been underscored by the coronavirus disease 2019 (COVID-19) pandemic, respiratory viruses have a significant impact in health care settings even under normal circumstances. Studies report decreased nosocomial transmission when aggressive infection control measures are implemented, with more success noted when using a multicomponent approach. Influenza vaccination of health care personnel furthers decrease rates of transmission; thus, mandatory vaccination is becoming more common. This article discusses the epidemiology, transmission, and control of health care-associated respiratory viral infections.


Assuntos
Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/transmissão , Fidelidade a Diretrizes , Pessoal de Saúde/normas , Humanos , Controle de Infecções/normas , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/transmissão , SARS-CoV-2/patogenicidade , Vacinação , Vírus/classificação , Vírus/patogenicidade
11.
Health Rep ; 32(11): 16-27, 2021 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-34787983

RESUMO

BACKGROUND: There are important information gaps concerning the prevalence and distribution of infection control practices (ICPs) within workplaces continuing to operate during the COVID-19 pandemic. DATA AND METHODS: To address these gaps, this paper examines the prevalence of workplace ICPs among employed respondents to Statistics Canada's Labour Force Survey in the months of July, August and September 2020 (n = 53,316). The article also seeks to identify sociodemographic, occupational and workplace factors associated with the level and type of workplace ICPs. ICPs included the reorganization of the workplace to allow for physical distancing, increased access to hand sanitizer or handwashing facilities, enhanced cleaning protocols and access to personal protective equipment. Multivariable regression models were used to examine the number of ICPs in place and the absence of specific ICPs. RESULTS: Generally high levels of reported protections among workers (15% of the sample had three ICPs and 72% had four or more ICPs) were observed. However, certain subgroups of workers were less likely to have ICPs in place. These included workers who were male; those with lower levels of education, shorter job tenure, or non-permanent work; and those working in the agricultural, construction, transportation and warehousing, and education industries. INTERPRETATION: In a large sample of Canadian employees, generally high levels of workplace ICPs to reduce the transmission of COVID-19 were observed. Groups with lower levels of ICPs included workers at the start of their employment, workers with low levels of education, and certain industry groups.


Assuntos
COVID-19 , Local de Trabalho , Canadá/epidemiologia , Humanos , Controle de Infecções , Masculino , Pandemias , Prevalência , SARS-CoV-2
12.
Respir Care ; 66(12): 1858-1865, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34789516

RESUMO

BACKGROUND: Methacholine bronchoprovocation or challenge testing (MCT) is commonly performed to assess airway hyper-responsiveness in the setting of suspected asthma. Nebulization is an aerosol-generating procedure, but little is known about the risks of MCT in the context of the ongoing coronavirus disease 2019 (COVID-19) pandemic. We aimed to quantify and characterize aerosol generation during MCT by using different delivery methods and to assess the impact of adding a viral filter. METHODS: Seven healthy subjects performed simulated MCT in a near particle-free laboratory space with 4 different nebulizers and with a dosimeter. Two devices continuously sampled the ambient air during the procedure, which detected ultrafine particles, from 0.02-1 µm, and particles of sizes 0.3, 0.5, 1.0, 2.0, 5.0, and 10 µm, respectively. Particle generation was compared among all the devices, with and without viral filter placement. RESULTS: Ultrafine-particle generation during simulated MCT was significant across all the devices. Ultrafine-particle (0.02-1 µm) concentrations decreased 77%-91% with the addition of a viral filter and varied significantly between unfiltered (P < .001) and filtered devices (P < .001). Ultrafine-particle generation was lowest when using the dosimeter with filtered Hudson nebulizer (1,258 ± 1,644 particle/mL). Ultrafine-particle concentrations with the filtered nebulizer devices using a compressor were higher than particle concentrations detected when using the dosimeter: Monaghan (3,472 ± 1,794 particles/mL), PARI (4,403 ± 2,948), Hudson (6,320 ± 1,787) and AirLife (9,523 ± 5,098). CONCLUSIONS: The high particle concentrations generated during MCT pose significant infection control concerns during the COVID-19 pandemic. Particle generation during MCT was significantly reduced by using breath-actuated delivery and a viral filter, which offers an effective mitigation strategy.


Assuntos
COVID-19 , Pandemias , Aerossóis , Humanos , Controle de Infecções , Cloreto de Metacolina , Nebulizadores e Vaporizadores , Tamanho da Partícula , SARS-CoV-2
13.
Isr Med Assoc J ; 23(11): 685-689, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34811981

RESUMO

BACKGROUND: Toward the end of 2019, the coronavirus disease-2019 (COVID-19) pandemic began to create turmoil for global health organizations. The illness, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), spreads by droplets and fomites and can rapidly lead to life-threatening lung disease, especially for the old and those with health co-morbidities. Treating orthopedic patients, who presented with COVID-19 while avoiding nosocomial transmission, became of paramount importance. OBJECTIVES: To present relevant methods for pandemic control and hospital accommodation with emphasis on orthopedic surgery. METHODS: We searched search PubMed and Google Scholar electronic databases using the following keywords: COVID-19, SARS-CoV-2, screening tools, personal protective equipment, and surgery triage. RESULTS: We included 25 records in our analysis. The recommendations from these records were divided into the following categories: COVID-19 disease, managing orthopedic surgery in the COVID-19 era, general institution precautions, triage of orthopedic surgeries, preoperative assessment, surgical room setting, personal protection equipment, anesthesia, orthopedic surgery technical precautions, and department stay and rehabilitation. CONCLUSIONS: Special accommodations tailored for each medical facility, based on disease burden and available resources can improve patient and staff safety and reduce elective surgery cancellations. This article will assist orthopedic surgeons during the COVID-19 medical crisis, and possibly for future pandemics.


Assuntos
COVID-19 , Controle de Infecções , Procedimentos Ortopédicos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Protocolos Clínicos , Transmissão de Doença Infecciosa/prevenção & controle , Saúde Global , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Salas Cirúrgicas/organização & administração , Inovação Organizacional , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/normas , Procedimentos Ortopédicos/tendências , Equipamento de Proteção Individual , SARS-CoV-2 , Triagem/organização & administração
14.
Isr Med Assoc J ; 23(11): 690-692, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34811982

RESUMO

BACKGROUND: Coronavirus disease-19 (COVID-19) impacted medical education and led to the significant modification or suspension of clinical clerkships and rotations. OBJECTIVES: To describe a revised surgery clerkship curriculum, in which we divided in-person clinical teaching into smaller groups of students and adopted online-based learning to foster student and patient safety while upholding program standards. METHODS: The third-year surgery core clerkship of a 4-year international English-language program at the Medical School for International Health at Ben Gurion University of the Negev, Beer Sheva, Israel, was adapted by dividing students into smaller capsules for in-person learning and incorporating online learning tools. Specifically, students were divided evenly throughout three surgical departments, each of which followed a different clinical schedule. RESULTS: National Board of Medical Examiners clerkship scores of third-year medical students who were returning to in-person clinical clerkships after transitioning from 8 weeks of online-based learning showed no significant difference from the previous 2 years. CONCLUSIONS: To manage with the restrictions caused by COVID-19 pandemic, we designed an alternative approach to a traditional surgical clerkship that minimized the risk of exposure and used online learning tools to navigate scheduling challenges. This curriculum enabled students to complete their clinical rotation objectives and outcomes while maintaining program standards. Furthermore, this approach provided a number of benefits, which medical schools should consider adopting the model into practice even in a post-pandemic setting.


Assuntos
COVID-19 , Estágio Clínico , Educação à Distância/métodos , Educação , Cirurgia Geral/educação , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estágio Clínico/organização & administração , Estágio Clínico/tendências , Currículo/tendências , Transmissão de Doença Infecciosa/prevenção & controle , Educação/métodos , Educação/organização & administração , Educação/tendências , Avaliação Educacional , Humanos , Controle de Infecções/métodos , Israel/epidemiologia , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2 , Estudantes de Medicina , Ensino
15.
BMC Infect Dis ; 21(1): 1196, 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34837973

RESUMO

BACKGROUND: Carbapenem resistant (CR) Klebsiella pneumoniae (Kp) and Acinetobacter baumannii (Ab) are emerging multidrug resistant bacteria with very limited treatment options in case of infection. Both are well-known causes of nosocomial infections and outbreaks in healthcare facilities. METHODS: A retrospective study was conducted to investigate the epidemiology of inpatients with CR Kp and CR Ab in a 1500-bed German university hospital from 2015 to 2019. We present our infection control concept including a weekly microbiologic screening for patients who shared the ward with a CR Kp or CR Ab index patient. RESULTS: Within 5 years, 141 CR Kp and 60 CR Ab cases were hospitalized corresponding to 118 unique patients (74 patients with CR Kp, 39 patients with CR Ab and 5 patients with both CR Ab and CR Kp). The mean incidence was 0.045 (CR Kp) and 0.019 (CR Ab) per 100 inpatient cases, respectively. Nosocomial acquisition occurred in 53 cases (37.6%) of the CR Kp group and in 12 cases (20.0%) of the CR Ab group. Clinical infection occurred in 24 cases (17.0%) of the CR Kp group and in 21 cases (35.0%) of the CR Ab group. 14 cases (9.9%) of the CR Kp group and 29 cases (48.3%) of the CR Ab group had a history of a hospital stay abroad within 12 months prior to admission to our hospital. The weekly microbiologic screening revealed 4 CR Kp cases caused by nosocomial transmission that would have been missed without repetitive screening. CONCLUSIONS: CR Kp and CR Ab cases occurred infrequently. A history of a hospital stay abroad, particularly in the CR Ab group, warrants pre-emptive infection control measures. The weekly microbiologic screening needs further evaluation in terms of its efficiency.


Assuntos
Acinetobacter baumannii , Infecções por Klebsiella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Hospitais Universitários , Humanos , Controle de Infecções , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae , Estudos Retrospectivos
17.
Radiol Technol ; 93(2): 141-149, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34728576

RESUMO

PURPOSE: To explore the level of bioburden and the effectiveness of the manufacturers' recommended cleaning methods on lead apparel in a radiology department. METHODS: A 2-phase experiment at a level II trauma center during a 2-year period assessed the level of bioburden on radiology lead apparel. Adenosine triphosphate swabs and a luminometer were used to measure cleanliness of high-touch areas. Cleanliness was measured before and after 3 cleaning methods were used: cleaning with a mild detergent and water; cleaning with a mild detergent, water, and then a disinfectant; and scrubbing with cleaning wipes. RESULTS: Average bioburden levels exceeded facility thresholds for all areas and types of lead apparel examined. All tested cleaning methods significantly reduced bioburden. DISCUSSION: Monthly cleaning of lead apparel provides improved cleanliness when compared with quarterly cleaning. Daily cleaning of lead apparel that will be used in a sterile environment is recommended. Future research might include examining other patient care and ancillary equipment found in the imaging department for potential bioburden and surveying technologists to examine practices for routine removal of bioburden from equipment. CONCLUSION: Health care professionals must be aware of the potential bioburden on clinical equipment and maintain an effective cleaning practice and schedule to reduce the possibility of spreading infection.


Assuntos
Infecção Hospitalar , Desinfecção , Trifosfato de Adenosina , Humanos , Controle de Infecções
18.
BMC Infect Dis ; 21(1): 1169, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34798820

RESUMO

BACKGROUND: SARS-CoV-2 stability and infection persistence has been studied on different surfaces, but scarce data exist related to personal protective equipment (PPE), moreover using realist viral loads for infection. Due to the importance for adequate PPE management to avoid risk of virus infection, RNA stability was evaluated on PPE. METHODS: Persistence of SARS-CoV-2 infection and detection of genomic RNA in PPE (gowns and face masks) were determined by in-vitro assays and RT-qPCR, respectively. Samples were infected with a clinical sample positive for SARS-CoV-2 (Clin-Inf), and with a heat-inactivated SARS-CoV-2 strain sample (Str-Inf) as a control. RESULTS: PPE samples infected with Clin-Inf were positive for the 3 viral genes on gowns up to 5 days post-infection, whereas these overall genes were detected up to 30 days in the case of face masks. However, gowns and FFP2 masks samples contaminated with Clin-Inf showed a cytopathic effect over VERO cells up to 5-7 days post-infection. CONCLUSIONS: SARS-CoV-2 RNA was detected on different PPE materials for 5 to 30 days, but PPE contaminated with the virus was infectious up to 5-7 days. These findings demonstrate the need to improve PPE management and to formulate strategies to introduce viricidal compounds in PPE fabrics.


Assuntos
COVID-19 , Equipamento de Proteção Individual , Animais , Chlorocebus aethiops , Pessoal de Saúde , Humanos , Controle de Infecções , RNA Viral/genética , SARS-CoV-2 , Células Vero
19.
Pediatr Ann ; 50(11): e454-e460, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34757874

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has brought to forefront the large morbidity, mortality, and complications that viral illnesses can cause. For athletes, viral illnesses can be disruptive toward their participation in youth sports. This article outlines the details of how the most common viral illnesses affect the youth athlete and youth sports, including COVID-19, non-COVID-19 upper respiratory infections, influenza, Epstein-Barr virus, varicella, herpes, and other dermatologic infections. In this article, we review current available guidelines and recommendations on how to handle these infections in athletes during sports as well as return-to-play recommendations. [Pediatr Ann. 2021;50(11):e454-e460.].


Assuntos
Atletas , COVID-19 , Viroses/prevenção & controle , Esportes Juvenis , Adolescente , Humanos , Controle de Infecções , SARS-CoV-2
20.
BMC Oral Health ; 21(1): 584, 2021 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-34798843

RESUMO

BACKGROUND: This study seeks to elucidate the impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists. METHODS: Changes in knowledge, attitude, and infection control behaviors reported in 2020 (COVID-19 period) were compared to the historical control of the non-COVID-19 period in 2018. A proportional random sampling method was used to select the study samples from 400 dental institutions. The response rate was 69% in 2018 and 62.8% in 2020. A total of 276 dentists in 2018 and 251 dentists in 2020 responded to this questionnaire. Multiple logistic regression was used to assess the associations between factors and recommended infection control practices. RESULTS: High rates of correct COVID-19 knowledge (94.76%), fears of being infected with the virus (94%) and use of personal protective equipment (mask, glove and protection gown; 95%) were reported. We found that knowledge regarding environmental infection control, HIV transmission, and the window of HIV transmission were significantly higher in the post-COVID-19 period compared with the pre-COVID-19 period. High compliance rates of wearing mask, gloves and protection were reported. The number of dentists wearing a hair cap and a protective eye mask/face shield during the pandemic significantly increased compared with that noted before the COVID-19 pandemic. Factors associated with the use of a hair cap and an eye mask/face shield differed between the pre- and post-COVID-19 periods. The factors associated with compliance regarding environment infection control also differed between the pre- and post-COVID-19 periods. CONCLUSION: The significant impact of COVID-19 on the knowledge, attitude, and infection control behaviors among dental care workers was observed in the current study. In particular, the use of hair caps and protective eye mask or face shields as well as environmental disinfection protocols has significantly improved. Trial registration TMU-JIRB: N201804006.


Assuntos
COVID-19 , Pandemias , Odontólogos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Controle de Infecções , SARS-CoV-2 , Inquéritos e Questionários
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