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Fulltext 2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients

Sartelli M, Di Bella S, McFarland LV, Khanna S, Furuya-Kanamori L, Abuzeid N, et al.

World J Emerg Surg, 2019 02 28;14:8.
PMID: 30858872 DOI: 10.1186/s13017-019-0228-3

In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.

Matched MeSH terms: Infection Control/methods; Infection Control/trends
Environmental surface sampling of SARS-CoV-2 in selected hospitals in Malaysia

Rajendiran S, Thahir SSA, Veloo Y, Suppiah J, Pahrol MA, Shakor ASA, et al.

Trop Biomed, 2021 Sep 01;38(3):462-468.
PMID: 34608120 DOI: 10.47665/tb.38.3.089

COVID-19 has spread rapidly worldwide. The role of fomites in facilitating onward transmission is plausible. This study aimed to determine the presence of viable virus and its persistence on the surfaces of fomites in wards treating COVID-19 patients in Malaysia. This study was conducted in two stages. First, environmental sampling was performed on random days in the intensive care unit (ICU) and general wards. Then, in the second stage, samples were collected serially on alternate days for 7 days in two selected general wards. In Stage 1, a total of 104 samples were collected from the surfaces of highly touched and used areas by patients and healthcare workers. Only three samples were tested positive for SARS-COV-2. In Stage 2, three surface samples were detected positive, but no persistence of the virus was observed. However, none of the SARS-CoV-2 RNA was viable through tissue culture. Overall, the environmental contamination of SARS-CoV-2 was low in this hospital setting. Hospitals' strict infection control and the compliance of patients with wearing masks may have played a role in these findings, suggesting adherence to those measures to reduce occupational exposure of COVID-19 in hospital settings.

Matched MeSH terms: Infection Control/methods*
Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings

Rosenthal VD, Bat-Erdene I, Gupta D, Rajhans P, Myatra SN, Muralidharan S, et al.

J Vasc Access, 2021 Jan;22(1):34-41.
PMID: 32406328 DOI: 10.1177/1129729820917259

BACKGROUND: Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available.
METHODS: Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
RESULTS: We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%).
CONCLUSIONS: Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections.

Matched MeSH terms: Infection Control
Isoniazid preventive therapy in correctional facilities: a systematic review

Al-Darraji HA, Kamarulzaman A, Altice FL

Int J Tuberc Lung Dis, 2012 Jul;16(7):871-9.
PMID: 22410101 DOI: 10.5588/ijtld.11.0447

Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide and the main cause of death in correctional facilities in middle- and low-income countries. Due to the closed environment and the concentration of individuals with TB-related risk factors, effective measures are required to control TB in such settings. Isoniazid preventive therapy (IPT) represents an effective and cost-effective measure. Despite international recommendations that IPT be integral to TB control, it is seldom deployed. A systematic review of interventions used to assess IPT initiation and completion in correctional facilities was conducted using published studies from two biomedical databases and relevant keywords. Additional references were reviewed, resulting in 18 eligible studies. Most (72%) studies were conducted in the United States and in jail settings (60%), with the main objective of improving completion rates inside the facility or after release. Studies that provided data about initiation and completion rates showed poor success in correctional facilities. Adverse consequences and treatment interruption ranged from 1% to 55% (median 5%) in reported studies; hepatotoxicity was the most prevalent adverse reaction. Despite its accelerating effect on the development of active TB, information on human immunodeficiency virus (HIV) status was provided in only half of the studies. Among the four studies where IPT effectiveness was assessed, the results mirror those described in community settings. Future studies require thorough assessments of IPT initiation and completion rates and adverse effects, particularly in low- and middle-income countries and where comorbid viral hepatitis may contribute significantly to outcomes, and in settings where TB and HIV are more endemic.

Matched MeSH terms: Infection Control/methods*
Knowledge of blood-borne infectious diseases and the practice of universal precautions amongst health-care workers in a tertiary hospital in Malaysia

Hamid MZ, Aziz NA, Anita AR, Norlijah O

Southeast Asian J. Trop. Med. Public Health, 2010 Sep;41(5):1192-9.
PMID: 21073041

This study aimed to assess the knowledge of blood-borne diseases transmitted through needle stick injuries amongst health-care workers in a tertiary teaching hospital. We also aimed to assess the practices of universal precautions amongst these workers and its correlation with the facts. We carried out a cross-sectional study from January to July 2008 involving various levels of health-care workers in Serdang Hospital, Selangor, Malaysia. A self-administered questionnaire assessing knowledge of blood-borne diseases and universal precautions, and actual practice of universal precautions was used. Two hundred fifteen respondents participated in this study; 63.3% were staff nurses. The mean knowledge score was 31.84 (SD 4.30) and the mean universal practice score was 9.0 (SD 2.1). There was a small, positive correlation between knowledge and actual practice of universal precautions (r = 0.300, n = 206, p < 0.001) amongst the cohort studied. Factors such as age and years of experience did not contribute towards acquisition of knowledge about blood-borne illnesses or the practice of universal precautions.

Matched MeSH terms: Infection Control/methods*; Infection Control/standards
Disinfection: gaps between recommended and actual practice

Keah KC, Jegathesan M, Tan SC, Chan SH, Chee OM, Cheong YM, et al.

Southeast Asian J. Trop. Med. Public Health, 1995 Dec;26(4):795-8.
PMID: 9139397

Basic practices on disinfection was surveyed in 6 hospitals using an observation and interview checklist. Two surveys were done, one pre-(first survey) and one post-intervention (second survey). The disinfection and sterilization policy of the Ministry of Health was not available in 66 (70.2%) and 12 (13%) of the units in the first and second survey respectively. In the second survey, staff in all the units washed disinfectant containers before refilling compared with 41.5% of the units in the first survey. Dilution of disinfectants not recommended was found to be used in the first survey. Storing cleaned and sterile items in disinfectants, using disinfectant as a substitute for sterilization of autoclavable items and not decontaminating spillages were some of the wrong practices observed. Considerable improvements were made in the second survey. Improper usage of disinfectants was also indicated by failure of the in-use test. Rate of failure of disinfectants in-use decreased from 11.6% in the first survey to 5.0% in the second survey. To ensure proper disinfection practices, a comprehensive training program on disinfection is required for nurses and attendants.

Matched MeSH terms: Infection Control/methods*; Infection Control/standards
Space spraying of bacterial and chemical insecticides against Anopheles balabacensis Baisas for the control of malaria in Sabah, East Malaysia

Seleena P, Lee HL, Chooi KH, Junaidih S

Southeast Asian J. Trop. Med. Public Health, 2004 Mar;35(1):68-78.
PMID: 15272747

A pilot study was undertaken to determine the effectiveness of space application of insecticides for the control of malaria in Ranau, a district in Sabah. A village each was treated monthly: with chemical adulticide--alpha cypermethrin (Fendona SC(R)/10SC(R)) at 2 g a.i./10,000 m2 in Pahu; with biological larvicides--Bacillus thuringiensis israelensis (Vectobac 12AS(R)) at 500 ml/10,000 m2 or B. sphaericus (Vectolex WG(R)) at 500 g/10,000 m2 in Pinawantai; and with a mixture of chemical adulticide and biological larvicide in Togop Laut. All sprayings were conducted using a portable mist blower. During the study period all villages, including Tarawas the untreated village, received the conventional malaria control measures. Entomological and epidemiological surveillance was used to measure the effectiveness of the space application. The entomological surveillance indicated that the An. balabacensis population was significantly reduced by alpha cypermethrin in Pahu and Togop Laut and B. sphaericus in Pinawantai; but was not reduced by B.t.i. in Pinawantai. There was a significant reduction in the number of malaria cases and in the slide positivity rate in the treated villages during the study period. The pilot study does indicate that space application of larvicides/adulticides or a mixture of both is able to reduce the malaria vector population and the malaria transmission. A larger scale study needs to be undertaken in a malarious village/province to determine whether space application of insecticides together with other malaria control measures will be able to eradicate malaria.

Matched MeSH terms: Infection Control/methods*
Fulltext Risk of blood-borne infection among health care workers in two Kuala Lumpur hospitals

Hesham R, Tajunisah ME, Ilina I

Med J Malaysia, 2008 Aug;63(3):222-3.
PMID: 19248694

Health care workers (HCW) are at high risk of acquiring blood-borne diseases. This study compared the risk of infection among HCW in different hospital units and also between HCW and students in medical fields. This cross-sectional study involved pre-tested questionnaires that were completed by 625 HCW and undergraduate students undergoing clinical attachments from February to August 2001. The respondents were separated into two groups: i) HCW from Hospital Kuala Lumpur, HKL (n=241) and Hospital Universiti Kebangsaan Malaysia, HUKM (n=153) ii) Medical students from Universiti Kebangsaan Malaysia, UKM (n=171) and HUKM student nurses (n=60). The results obtained showed that the risk of transmission of blood-borne infections varied significantly according to professional ranks (p<0.05) and to hospital units (p<0.05). The medical intensive care (ICU), haemodialysis, and nephrology and urology units had the highest scores for the risk of infection while the diagnostic laboratory had the lowest risk of infection (p<0.05). Preventive measures taken by the subjects in this study were not satisfactory especially with reference to the use of personal protective equipment and the practice of universal precautions.

Matched MeSH terms: Infection Control
Fulltext Change in infection control practices and awareness of hospital medical staff in the aftermath of SARS

Loh LC, Chelliah A, Ang TH, Ali AM

Med J Malaysia, 2004 Dec;59(5):659-64.
PMID: 15889569 MyJurnal

Severe Acute Respiratory Syndrome (SARS) epidemic illustrated the crucial role of infection surveillance and control measures in the combat of any highly transmissible disease. We conducted an interview survey of 121 medical staff 145 doctors, 46 staff nurses and 30 medical assistants) in a state hospital in Malaysia three months after the end of SARS epidemic (from October to December 2003). Staff was grouped according to those directly involved in the care of suspected SARS patients [S+ group n=41] and those who were not [S- group; n=80]. On hand washing following sneezing, coughing and touching patients, the proportions of medical staff that reported an increase after the SARS crisis were 22.3%, 16.5% and 45.5% respectively. On wearing masks, gloves, and aprons when meeting potentially infectious patients, the proportions that reported an increase were 39.7%, 47.1% and 32.2% respectively. Significantly more staff in S+ than S- group reported these increases. Sixty percent of staff was aware of changes in hospital infection control policies after SARS; 93.4% was aware of notifying procedures, and 81.8% was aware of whom to notify in the hospital. Regarding infection isolation ward, Infectious Control Nurse and Infection Control Committee Chairman in the hospital, the proportions of staff that could correctly name them were 39.7%, 38.3% and 15.7% respectively. Significantly more in S+ than S- group could do so. However, more than half the staff claimed ignorance on the knowledge of infection isolation ward (56.2%), Infection Control Nurse (57.9%) and Chairman (65.3%). Our findings demonstrated that SARS crisis had some positive impact on the infection control practices and awareness of medical staff especially on those with direct SARS involvement. Implications for future control of infectious diseases are obvious.

Matched MeSH terms: Infection Control/methods*
Fulltext Handwashing at University Hospital

Yasmin AH, Yasmin MY

Med J Malaysia, 1993 Jun;48(2):251-2.
PMID: 8350809
Matched MeSH terms: Infection Control*
Fulltext Prelabour rupture of membranes and neonatal morbidity in level II nursery in Kelantan

Malik AS

Med J Malaysia, 1994 Mar;49(1):12-6.
PMID: 8057984

In view of controversial reports about the role of prelabour rupture of foetal membranes (PROM) in neonatal morbidity and to study the association of PROM with infections and meconium aspiration syndrome (MAS), a prospective case control study was conducted in a level II nursery of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan. Of the 111 neonates with PROM studied, 18 developed clinical problems (septicaemia and other specific problems such as pneumonia, omphalitis, skin infection and MAS) while 5/56 of the control group developed similar problems. The difference between the two groups was not significant (p < 0.30). There was no neonatal death. It is concluded that PROM is not associated with neonatal morbidity. Neonates with this problem alone do not need to be admitted to the neonatal nursery.

Matched MeSH terms: Infection Control
Fulltext Varicella in children with haematological malignancy--outcome of treatment and prevention

Ho CM, Khuzaiah R, Yasmin AM

Med J Malaysia, 1994 Mar;49(1):29-35.
PMID: 8057987

Primary varicella-zoster virus infection in children with haematological malignancy is a life threatening disease. In one year, there were 10 cases of varicella and 2 cases of zoster among these children as well as 5 mothers who were accompanying their children who developed varicella in the oncology ward. Two children died of fulminating disease despite aggressive antiviral and supportive treatment. Acyclovir can be used in treatment and prophylaxis in exposed susceptible children. Varicella -zoster immune globulin is not available in this country. Vaccination with live virus has been shown to be protective in immunocompromised children and needs consideration.

Matched MeSH terms: Infection 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: Infection Control
Fulltext Early onset neonatal septicaemia in a level II nursery

Malik AS, Pennie RA

Med J Malaysia, 1994 Mar;49(1):17-23.
PMID: 8057985

A prospective study of 486 high risk neonates admitted to a level II nursery in a relatively poor and rural area of Malaysia was carried out to determine the incidence, the spectrum of micro-organisms and predisposing factors in relation to early onset septicaemia. The incidence of proven or probable septicaemia was 57.61 per 1000 high risk newborns over 1.5 kg. The case fatality was 10.71 per cent. Coagulase negative staphylococci, Streptococcus Group B and Klebsiella species were the most commonly isolated organisms. Meconium staining of liquor was the most common risk factor for admission to the nursery, and prematurity was the most significant risk factor for early neonatal infection (P < 0.005) followed by small for gestational age (P < 0.04). Although the incidence of septicaemia was quite high in the level II nursery, the mortality rate was comparable to established figures.

Matched MeSH terms: Infection Control
Fulltext Evaluation of the bacteriological contamination of a closed feeding system for enteral nutrition

Chan L, Yasmin AH, Ngeow YF, Ong GS

Med J Malaysia, 1994 Mar;49(1):62-7.
PMID: 8057993

A closed enteral delivery system consisting of a cardboard tetrapack containing the sterile ready-to-use liquid feed and an independent sterile administration set, has been devised. We found bacterial contamination within 24 hours in this system in patients on ventilatory support in intensive care. This emphasises the need for meticulous care in handling enteral feeding systems to prevent environmental contamination.

Matched MeSH terms: Infection Control/methods
Fulltext Sepsis

Lim VKE

Med J Malaysia, 1996 Dec;51(4):494-8; quiz 499.
PMID: 10968044
Matched MeSH terms: Infection Control/methods
COVID-19 - How prepared are emergency departments in embracing the new norm?

Iqhbal KM, Ahmad NH

Med J Malaysia, 2020 09;75(5):585-586.
PMID: 32918431

No abstract provided.

Matched MeSH terms: Infection Control/organization & administration*
Emergency Laparotomy in a COVID-19 patient with acute abdomen

Hassan R, Johari M, Nijhar JS, Sharifah BSA, Low LL, Amri N

Med J Malaysia, 2021 03;76(2):254-257.
PMID: 33742640

We describe here the first laparotomy involving a COVID-19 patient in Malaysia. A 60-year-old man screened positive for SARS-CoV-2 in March 2020 and developed acute abdomen in the ward in Hospital Sultanah Bahiyah, Kedah. He underwent laparotomy and cholecystectomy for gangrenous cholecystitis. All personnel adhered to infectious control precautions, donning full personal protective equipment (PPE) throughout the surgery. Post-operatively, due to raised septic parameters, he was carefully diagnosed with and treated empirically for superimposed bacterial sepsis instead of cytokine release syndrome, with confirmed blood culture of Klebsiella pneumoniae. Patient was discharged well later. None of the staff involved in his care developed COVID-19 infection.

Matched MeSH terms: Infection Control
Discipline as complete mediation in the implementation of the Theory Planned Behaviour of nurse's handwashing compliance

Lenggono KA, Qomariyatus S, Gatot C, Sri A, Ahsan, Patria DKA, et al.

Med J Malaysia, 2023 May;78(3):296-300.
PMID: 37271838

INTRODUCTION: Hospital-acquired infection is still one of the health problems in the world that require infection control and prevention efforts, especially nurses' hand washing compliance. Various strategies and efforts to improve handwashing compliance include educational approaches, motivation and improvement of the health care system, one of which is through the use of The Theory Of Planned Behaviour application in solving handwashing compliance.
MATERIALS AND METHODS: Quantitative research with a survey approach and observation of hand washing compliance of all nurses N = 321 with a sample of n = 178 nurses. The research variables studied consisted of intention, discipline, self-assessment, opportunity compliance and implementation of the nurse's hand washing. Nurse handwashing compliance observations were made by Infection Prevention Control Link Nurse (IPCN) committee. Data analysis using structural equation modelling (SEM) with smart partial least square (SmartPLS 3.0) application.
RESULTS: The nurse's intention to apply the theory of planned behaviour has no significant effect on the implementation of hand washing with path coefficients of 0.104 and p-value 0.221 > 0.05. The effect of nurses' intentions on the implementation of nurse hand washing through discipline is significant with a value of variance accounted for (VAF) 0.8043 or 80.43 % of nurse discipline is a complete mediation variable.
CONCLUSION: Discipline as a complete meditation variable in the application of the theory of planned behaviour in the compliance of nurses' hand washing five moments six steps. Nurses are expected to continuously improve their discipline independently or be assisted by training activities facilitated by the hospital.

Matched MeSH terms: Infection Control
Fulltext Risk factors, prevention and communication strategy during Nipah virus outbreak in Malaysia

Chua KB

Malays J Pathol, 2010 Dec;32(2):75-80.
PMID: 21329177 MyJurnal

An outbreak of acute febrile encephalitis affecting pig-farm workers and owners was recognized in peninsular Malaysia as early as September 1998. The outbreak was initially thought to be due to Japanese encephalitis (JE) virus and thus very intensive prevention, control and communication strategies directed at JE virus were undertaken by the Ministry of Health and Ministry of Agriculture of Malaysia. There was an immediate change in the prevention, control and communication strategies with focus and strategies on infected pigs as the source of infections for humans and other animals following the discovery of Nipah virus. Information and understanding the risks of Nipah virus infections and modes of transmission strengthened the directions of prevention, control and communication strategies. A number of epidemiological surveillances and field investigations which were broadly divided into 3 groups covering human health sector, animal health sector and reservoir hosts were carried out as forms of risk assessment to determine and assess the factors and degree of risk of infections by the virus. Data showed that there was significant association between Nipah virus infection and performing activities involving close contact with pigs, such as processing of piglets, administering injection or medication to pigs, assisting in the birth of piglets, assisting in pig breeding, and handling of dead pigs in the affected farms. A complex process of anthropogenic driven deforestation, climatic changes brought on by El Niño-related drought, forest fire and severe haze, and ecological factors of mixed agro-pig farming practices and design of pig-sties led to the spillovers of the virus from its wildlife reservoir into pig population.

Matched MeSH terms: Infection Control/methods*

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