MyMedR

Physical methods of reducing the transmission of nosocomial infections via ultrasound and probe

Abdullah BJ, Mohd Yusof MY, Khoo BH

Clin Radiol, 1998 Mar;53(3):212-4.

Nosocomial infections are posing an increasingly serious problem in the hospital setting. With the increasing use of ultrasound in medical diagnosis, there is the potential for transmission of nosocomial infections via the ultrasound transducer and coupling gel. We evaluated the use of different membranes (three types of commercially available household cling film, condom, surgical glove and Opsite) applied over the ultrasound probe to determine if these were safe, convenient, cost-effective and did not impair the performance parameters of the ultrasound probe. None of the membranes impaired the physical scanning parameters using a Multi-Purpose Tissue/Cyst Phantom. The cling film was ideal for general use in terms of cost and convenience as well as safety. For sterile use the Opsite was better overall compared to the surgical glove, though it costs significantly more. The condom and surgical glove, though safe, were not very convenient to use for scanning.

Matched MeSH terms: Cross Infection/prevention & control*

Fulltext Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007

Al-Talib HI, Yean CY, Al-Jashamy K, Hasan H

Ann Saudi Med, 2010 Sep-Oct;30(5):358-63.

PMID: 20697171 DOI: 10.4103/0256-4947.67077

Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. The aim of the present study was to assess the burden of MRSA nosocomial infection, its association with factors of interest, and its antimicrobial susceptibility.

Matched MeSH terms: Cross Infection/prevention & control

Fulltext Strategies for radiology departments in handling the COVID-19 pandemic

Ashari MA, Zainal IA, Zaki FM

Diagn Interv Radiol, 2020 Jul;26(4):296-300.

PMID: 32352915 DOI: 10.5152/dir.2020.20232

The world is facing an unprecedented global pandemic in the form of the coronavirus disease 2019 (COVID-19) which has ravaged all aspects of life, especially health systems. Radiology services, in particular, are under threat of being overwhelmed by the sheer number of patients affected, unless drastic efforts are taken to contain and mitigate the spread of the virus. Proactive measures, therefore, must be taken to ensure the continuation of diagnostic and interventional support to clinicians, while minimizing the risk of nosocomial transmission among staff and other patients. This article aims to highlight several strategies to improve preparedness, readiness and response towards this pandemic, specific to the radiology department.

Matched MeSH terms: Cross Infection/prevention & control*

IMP-4-producing Pseudomonas aeruginosa in a French patient repatriated from Malaysia: impact of early detection and control measures

Bert F, Vanjak D, Leflon-Guibout V, Mrejen S, Delpierre S, Redondo A, et al.

Clin Infect Dis, 2007 Mar 1;44(5):764-5.

PMID: 17278079

Matched MeSH terms: Cross Infection/prevention & control*

Recovery of endoscopy services in the era of COVID-19: recommendations from an international Delphi consensus

Bhandari P, Subramaniam S, Bourke MJ, Alkandari A, Chiu PWY, Brown JF, et al.

Gut, 2020 11;69(11):1915-1924.

PMID: 32816921 DOI: 10.1136/gutjnl-2020-322329

The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.

Matched MeSH terms: Cross Infection/prevention & control*

Fulltext Use of negative pressure individual isolation system for CT scan of patients with suspected COVID-19

Cheah PK, Krisnan T, Abdul Kadir MH, Steven EM

Emerg Med J, 2020 Aug;37(8):467.

PMID: 32546476 DOI: 10.1136/emermed-2020-209851

Matched MeSH terms: Cross Infection/prevention & control

Fulltext Methicillin-resistant Staphylococcus aureus (mrsa) in a Malaysian hospital

Cheong I, Tan SC, Wong YH, Zainudin BM, Rahman MZ

Med J Malaysia, 1994 Mar;49(1):24-8.

PMID: 8057986

Between August 1990 to November 1991, 905 of 2583 (35.4%) isolates of Staphylococcus aureus were found to be methicillin-resistant in a general hospital in Malaysia. A detailed study of 539 of these isolates showed a high prevalence of methicillin resistant Staphylococcus aureus (MRSA) in the surgical/orthopaedic wards, paediatric wards and the special care unit. The yield of MRSA was highest from wounds/ulcers/skin swabs accounting for 64.2 per cent followed by 6.9 per cent in blood cultures. Vancomycin remains the drug of choice with no resistance detected. The resistance to ciprofloxacin was 6.7 per cent, rifampicin 4.5 per cent and fusidic acid 2.0 per cent. Most isolates were resistant to aminoglycosides. In view of the high prevalence of MRSA in this hospital, the authorities must introduce more effective measures to control its spread as a nosocomial pathogen. Otherwise it may seriously disrupt the efficient delivery of health care services in the country.

Matched MeSH terms: Cross Infection/prevention & control

COVID-19 testing strategy in response to infection among healthcare workers in a large non-COVID-designated hospital

Foo DHP, King TL, Lee HC, Santhramogan P, Ganasan V, Fong AYY, et al.

Hosp Pract (1995), 2021 Apr;49(2):110-118.

PMID: 33249880 DOI: 10.1080/21548331.2020.1857999

Sarawak General Hospital, which is the only public access tertiary referral center in Sarawak State for all clinical specialties, was designated a hybrid hospital to treat both COVID-19 and non-COVID-19 patients. During the initial surge of patients admitted with COVID-19, there was also a corresponding increase in health-care workers (HCWs) detected with COVID-19 infection. The latter being isolated, and the large number of staff members that had come into contact with COVID-19 being quarantined from work, placed further strain on the health-care services. The staff mass screening strategy was a policy decision made by the hospital in response to infection among HCWs, and it aimed to reduce in-hospital transmission (particularly among asymptomatic staff), mitigate workforce depletion due to quarantining, and protect the health-care workforce. In this study, we assessed the detection rate of COVID-19 infection from staff mass testing over a five-week period, and described our experience of adopting this surveillance screening strategy alongside ongoing contact tracing and symptomatic screening strategies. Although it was thought that such periodic staff surveillance might be helpful in protecting the health-care workforce within a short period, the long-term implications, especially in settings with limited resources, is significant and therefore explored in this paper. Our findings might provide an evidence-based reference for the future planning of an optimal strategy with the least compromise in care for a larger proportion of non-COVID-19 patients amid efforts against COVID-19 in a large non-COVID-designated hospital with hybrid status.

Matched MeSH terms: Cross Infection/prevention & control

Nosocomial outbreak of Enterobacter gergoviae bacteraemia in a neonatal intensive care unit

Ganeswire R, Thong KL, Puthucheary SD

J Hosp Infect, 2003 Apr;53(4):292-6.

PMID: 12660126

A nosocomial outbreak of bacteraemia, caused by Enterobacter gergoviae infected 11 babies, nine of whom were premature, and was investigated in the neonatal intensive care unit (NICU) of a general hospital in Johor Bahru, Malaysia. The strain that was isolated from the babies was also isolated from the dextrose saline used for the dilution of parenteral antibiotics and from the hands of a healthcare worker on duty in the nursery. Pulsed-field gel electrophoresis (PFGE) of Xba I-digested chromosomal DNA confirmed a possible cross-contamination of parenteral dextrose saline and the healthcare worker. Prompt and effective control measures were initiated within NICU and the nosocomial infection of E. gergoviae was brought to an abrupt end. To the best of our knowledge, this is the first documented outbreak of E. gergoviae in the NICU in a hospital in the state of Johor, Malaysia.

Matched MeSH terms: Cross Infection/prevention & control

Environmental contamination in the hospital as a possible source for nosocomial infection with methicillin-resistant Staphylococcus aureus

Ghaznavi-Rad E, Ghasemzadeh-Moghaddam H, Shamsudin MN, Hamat RA, Sekawi Z, Aziz MN, et al.

Infect Control Hosp Epidemiol, 2010 Dec;31(12):1302-3.

PMID: 21028965 DOI: 10.1086/657587

Matched MeSH terms: Cross Infection/prevention & control

Is reduced susceptibility to disinfectants and antiseptics a risk in healthcare settings? A point/counterpoint review

Harbarth S, Tuan Soh S, Horner C, Wilcox MH

J Hosp Infect, 2014 Aug;87(4):194-202.

PMID: 24996517 DOI: 10.1016/j.jhin.2014.04.012

Given the breadth and depth of antiseptic use, it is surprising how few large-scale studies have been undertaken into the consequences of their use, particularly in clinical practice. Depending on your point of view, this may either reflect an assurance that reduced susceptibility to antiseptics, and notably whether this confers cross-resistance to systemically administered antimicrobial agents, is not an issue of concern, or relative ignorance about the potential threat.

Matched MeSH terms: Cross Infection/prevention & control

Nurses compliance to hand hygiene practice and knowledge at Klang Valley hospital

Ho SE, Ho CC, Hng SH, Liu CY, Jaafar MZ, Lim B

Clin Ter, 2013;164(5):407-11.

PMID: 24217826 DOI: 10.7417/CT.2013.1604

Hand hygiene is the most important measure in the prevention of healthcare-associated infections (HCAI). Adherence to hand hygiene protocols in hospital by nurses enables in prevention and control the HCAI. The main aim of the present study was to assess nurses' compliance to hand hygiene practice and knowledge in a hospital.

Matched MeSH terms: Cross Infection/prevention & control

Evaluation of the efficacy of antibacterial medical gloves in the ICU setting

Kahar Bador M, Rai V, Yusof MY, Kwong WK, Assadian O

J Hosp Infect, 2015 Jul;90(3):248-52.

PMID: 25982193 DOI: 10.1016/j.jhin.2015.03.009

Inappropriate use of medical gloves may support microbial transmission. New strategies could increase the safety of medical gloves without the risk of patient and surface contamination.

Matched MeSH terms: Cross Infection/prevention & control

Prevention of hospital infection

Lam KL

Med J Malaysia, 1978 Dec;33(2):133-6.

PMID: 755163

Matched MeSH terms: Cross Infection/prevention & control*

Two outbreaks of Burkholderia cepacia nosocomial infection in a neonatal intensive care unit

Lee JK

J Paediatr Child Health, 2008 Jan;44(1-2):62-6.

PMID: 17640280

An outbreak of Burkholderia cepacia septicaemia occurred in our neonatal unit over a 9-week period in 2001, affecting 23 babies and two died. A second outbreak lasting 8 days occurred a year later, affecting five babies.

Matched MeSH terms: Cross Infection/prevention & control

Fulltext Hand hygiene - social network analysis of peer-identified and management-selected change agents

Lee YF, McLaws ML, Ong LM, Amir Husin S, Chua HH, Wong SY, et al.

Antimicrob Resist Infect Control, 2019;8:195.

PMID: 31798841 DOI: 10.1186/s13756-019-0644-x

Background: Hand hygiene compliance can be improved by strategies fostering collaborative efforts among healthcare workers (HCWs) through change agents. However, there is limited information about how change agents shape the social networks of work teams, and how this relates to organisational culture. The objectives of this study were to describe the influence of peer-identified change agents (PICAs) and management-selected change agents (MSCAs) on hand hygiene, perception of their leadership style by peers, and the role of the organisational culture in the process of hand hygiene promotion.

Methods: This study, stratified in pre-, during, and post-intervention periods, was conducted between February 2017 and March 2018 in two wards at a tertiary care hospital in Malaysia. Hand hygiene promotion was facilitated either by PICAs (study arm 1) or MSCAs (study arm 2), and the two wards were randomly allocated to one of the two interventions. Outcomes were: 1) perceived leadership styles of PICAs and MSCAs by staff, vocalised during question and answer sessions; 2) the social network connectedness and communication patterns between HCWs and change agents by applying social network analysis; and 3) hand hygiene leadership attributes obtained from HCWs in the post-intervention period by questionnaires.

Results: Hand hygiene compliance in study arm 1 and study arm 2 improved by from 48% (95% CI: 44-53%) to 66% (63-69%), and from 50% (44-55%) to 65% (60-69%), respectively. There was no significant difference between the two arms. Healthcare workers perceived that PICAs lead by example, while MSCAs applied an authoritarian top-down leadership style. The organisational culture of both wards was hierarchical, with little social interaction, but strong team cohesion. Position and networks of both PICAs and MSCAs were similar and generally weaker compared to the leaders who were nominated by HCWs in the post-intervention period. Healthcare workers on both wards perceived authoritative leadership to be the most desirable attribute for hand hygiene improvement.

Conclusion: Despite experiencing successful hand hygiene improvement from PICAs, HCWs expressed a preference for the existing top-down leadership structure. This highlights the limits of applying leadership models that are not supported by the local organisational culture.

Matched MeSH terms: Cross Infection/prevention & control*

Fulltext Recommendations for Essential Esophageal Physiologic Testing During the COVID-19 Pandemic

Lee YY, Bredenoord AJ, Gyawali CP

Clin Gastroenterol Hepatol, 2020 Aug;18(9):1906-1908.

PMID: 32371164 DOI: 10.1016/j.cgh.2020.04.075

Matched MeSH terms: Cross Infection/prevention & control*

Fulltext Risk of tuberculosis to healthcare workers

Liam CK

Med J Malaysia, 2001 Mar;56(1):107-11; quiz 112.

PMID: 11503290

Matched MeSH terms: Cross Infection/prevention & control

Fulltext Antibiotic use in residential aged care facilities

Lim CJ, Stuart RL, Kong DC

Aust Fam Physician, 2015 Apr;44(4):192-6.

PMID: 25901402

BACKGROUND: High infection burden among the residential aged care facility (RACF) population has long been recognised; however, existing infection prevention effort is often limited to infection surveillance activity. There is a scarcity of evidence to guide antimicrobial stewardship in the Australian RACF setting.
OBJECTIVE: This review summarises the current trends in antibiotic use and multi-drug resistant (MDR) organisms, challenges related to antibiotic prescribing and areas of suboptimal antibiotic prescribing for further improvement, particularly in the Australian RACF setting.
DISCUSSION: There is widespread antibiotic prescribing in RACF, which may lead to the emergence of antibiotic resistance. Accordingly, there is an immediate need for judicious antibiotic use in this high-risk population to curb the rapid emergence of MDR organisms and other adverse consequences associated with inappropriate antibiotic use, as well as to reduce healthcare costs.

Matched MeSH terms: Cross Infection/prevention & control*

Prevention of infection in the immunocompromised

Lim VK

Ann Acad Med Singap, 1997 May;26(3):331-5.

PMID: 9285028

Infection is an important cause of morbidity and mortality in immunocompromised patients. The high risk of infection is not only the consequence of the underlying disease but also the result of the diagnostic, monitoring and therapeutic procedures performed on these patients. Infections may be exogenous or endogenous in origin. The prevention of exogenous infections requires a high standard of hygiene. As many infections are acquired in hospitals, an effective control of nosocomial infection programme is crucial in preventing infections in the immunocompromised. Prevention of endogenous infections involves suppression of the aerobic bacterial flora (selective decontamination) and measures to maintain gastrointestinal epithelial integrity to reduce risk of translocation of intestinal flora. Boosting the host immunity through passive and active immunisation should also be considered. Prevention of infection in the immunocompromised is no easy task and requires a multidisciplinary approach.

Matched MeSH terms: Cross Infection/prevention & control*

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