Psychosocial determinants associated with healthcare workers' self-reported compliance with infection prevention and control during the COVID-19 pandemic: a cross-sectional study in Dutch residential care facilities for people with intellectual and developmental disabilities.

BACKGROUND: Healthcare workers' (HCWs) compliance with infection prevention and control (IPC) is crucial to reduce the infection transmission risk. However, HCWs' compliance with IPC in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is known to be suboptimal. Therefore, this study examined sociodemographic and psychosocial determinants associated with IPC non-compliance in this setting, to inform IPC policy and promotion programmes for adequate IPC behaviour. METHODS: An online questionnaire was administered to 285 HCWs from 16 RCFs between March 2021 and March 2022. Determinants associated with IPC non-compliance were assessed using logistic regression analyses. RESULTS: Being a woman (OR: 3.57; 1.73-7.37), and being a non-medical professional were associated with increased odds of non-compliance (social workers, OR: 2.83; 1.65-4.85; behavioural specialists, OR: 6.09; 1.98-18.72). Perceived inadequate education/training (aOR: 1.62; 1.15-2.27) and perceived time constraints/competing priorities (aOR: 1.43; 1.03-1.98) were also associated with increased odds of non-compliance, independent of sociodemographic variables. In contrast, the belief that the supervisor complies with IPC (descriptive norm supervisor) was associated with decreased odds of non-compliance (aOR: 0.60; 0.41-0.88). CONCLUSIONS: To improve IPC in disability care settings, the implementation of tailored and structural IPC education and training programmes (e.g., on-the-job training) is recommended to increase HCWs' capabilities and bridge the IPC compliance gap between medical and non-medical professionals. In addition, role models, particularly supervisors, are crucial for promoting IPC behaviour. Facilities should create a culture of IPC compliance by norm setting, acting on, and modelling IPC behaviours at all levels of the organisation (management, medical, and non-medical staff).

Prevalencia de portadores nasales de Staphylococcus aureus y Streptococcus pneumoniae en atención primaria y factores asociados a la colonización / Prevalence of nasal carriage of Staphylococcus aureus and Streptococcus pneumoniae in Primary Care and factors associated with colonization

OBJETIVO: Determinar la prevalencia de portadores nasales de Staphylococcus aureus (S. aureus) y Streptococcus pneumoniae (S. pneumoniae) en personas atendidas en las consultas de Atención Primaria del área de Barcelona, así como los factores que se asocian a la condición de portador sano. MÉTODOS: Estudio transversal multicéntrico realizado entre 2010-2011, en el que participaron 27 profesionales de Atención Primaria. Se obtuvieron 3969 frotis nasales de población mayor de 4 años y sin signos de enfermedad infecciosa. Variables dependientes: ser portador de S.aureus y/o de S. pneumoniae. Variables independientes: características socio demográficas, estado de salud, estado vacunal, ocupación laboral y convivencia con niños. Se realizó el análisis descriptivo, cálculo de la prevalencia de portadores sanos de S.aureus y/o de S. pneumoniae y se ajustaron modelos de regresión logística según edad. RESULTADOS: En niños de 4 a 14 años, la prevalencia de portadores de S.aureus fue 35,7%, de S. pneumoniae del 27,1% y co-colonizados del 5,8%. En adultos mayores de 14 años fue del 17,8, del 3,5 y del 0,5% respectivamente. En niños, ser portador de S.aureus se asoció con no presentar S. pneumoniae, y ser portador de S. pneumoniae con no presentar S.aureus y menor edad. En adultos, ser portador de S.aureus se asoció con ser hombre, menor e dad y trabajar en sanidad, y ser portador de S. pneumoniae con convivir con menores de 6 años. La proporción de portadores co-colonizados es baja (1,0%). CONCLUSIONES: La prevalencia de portadores en niños es mayor que en los adultos. Salvo la edad, no se observan otros factores comunes que se asocien a la condición de portador sano de estas 2 bacterias por separado

OBJECTIVE: To determine (I) the prevalence of Staphylococcus aureus (S.aureus) and Streptococcus pneumoniae (S. pneumoniae) nasal carriage in Primary Health Care patients in area of Barcelona, and (II) the factors associated with S.aureus and S. pneumoniae colonization. METHODS: Multi-center cross-sectional study conducted in 2010-2011 with the participation of 27 Primary Health Care professionals. Nasopharyngeal swabs were obtained from 3,969 patients over 4 years of age who did not present with any sign of infection. Dependent variables: S.aureus and/or S. pneumoniae carrier state. Independent variables: socio-demographic characteristics, health status, vaccination status, occupation, and living with children. A descriptive analysis was performed. The prevalence of carriers of S.aureus and/or S. pneumoniae was calculated and logistic regression models were adjusted by age. RESULTS: In children from 4 to 14 years old, the prevalence of S.aureus carriers was 35.7%, of S.pneumoniae 27.1%, and 5.8% were co-colonized. In adults older than 14 years old, the prevalence was 17.8%, 3.5%, and 0.5%, respectively. In children, S.aureus carrier state was inversely associated with S. pneumoniae carrier state; S. pneumoniae was associated with younger age, and inversely associated with S.aureus carrier state. In adults, being a carrier of S.aureus was associated with male gender, younger age, and a health-related occupation, whereas S. pneumoniae carrier state was associated with living with children under 6 years of age. The proportion of co-colonized carriers was low (1.0%). CONCLUSIONS: The proportion of S.aureus and S. pneumoniae carriers was higher in children than in adults. Age was the only factor associated with healthy carrier status for S. aureus and for S. pneumoniae