1,721,127 research outputs found
Multiresistant Pathogen Prevention and Diagnosis
No full textZusammenfassung Multiresistente Keime spielen im klinischen Alltag eine zunehmend bedeutsame Rolle. Dieses besonders auf Intensivstationen bzw. in Risikobereichen. Oftmals herrschen Unklarheiten bezuglich diagnostischer Screening-Indikationen und Strategien zur Vermeidung von ubertragungen mittels Hygiene- und Isolierungsma ss nahmen. Wir geben einen orientierenden uberblick uber die zur Zeit gangigen Empfehlungen und bewerten diese fur Methicillin-resistente Staphylococcusaureus-Stamme (MRSA) und multiresistente gramnegative Bakterien (MRGN). Abstract Multiresistant bacteria play an increasingly important role in everyday clinical practice. This is particularly the case in intensive care units and wards with critically ill patients. Often there is insufficient knowledge concerning diagnostic screening indications and strategies to avoid cross-transmission via infection control strategies. Hereby, we provide an orienting overview and assessment about current guidelines and recommendations with special focus on methicillin-resistant Staphylococcus aureus (MRSA) and multiresistantgramnegative bacteria (MRGN)
Prävention und Diagnostik multiresistenter Erreger
No full textAbstractPatients colonized or infected by multidrug-resistant bacteria (MDR) are entitled to the same medical treatment as other patients and infection control measures based on the current evidence are not in conflict with this aim. Recent studies indicate that the correct sampling technique is of utmost importance when screening for MRSA and usage of certain swabs might reduce the sensitivity considerably. Despite improvements in diagnostic strategies for direct MRSA detection by PCR, false positive results cannot be totally excluded. With regard to multidrug-resistant gramnegative bacteria differences between species should be emphasized to tailor infection control measures. E. g. easier transmissibility has been shown for K. pneumoniae compared to E. coli. Hospitals in Germany should strictly employ screening for carbapenemase-producing Enterobacterales as well as A. baumannii in all patients hospitalized abroad within the previous year. To avoid unnecessary social exclusion of MDR patients it must be emphasized that contact precautions are recommended for hospitals and not for long-time care facilities.</jats:p
Estimating the effect of practicing nursing professionals density on cumulative carbapenem-resistance prevalence in gram-negative invasive Isolates: a 30 European country observational modeling study
No full textBackground
The burden of antimicrobial-resistance, specifically carbapenem-resistance in gram-negative bacteria (CRGN), presents a serious public health threat worldwide. In Europe, Southern and Eastern countries (SEC) display a higher CRGN-prevalence as compared to Northern and Western countries (NWC). Since SEC also display lower nurse-density on average, we hypothesized that the occurrence of CRGN might correlate with nurse understaffing and therefore aimed at quantifying a potential independent effect of nurse-density on total CRGN in Europe.
Methods
A 30-country cross-sectional study was conducted. Cumulative six-year CRGN-prevalence (2011–2016) in four gram-negative bacterial species was determined based on > 700 k clinical invasive isolates (EARS-net). We performed multivariable log-linear regression to provide estimations of the effect of nurse-density while adjusting to various health-system variables.
Results
Multivariable analysis (adj.-R2 ~ 93%) suggested an average 0.4% [95%-CI 0.2–1.0%] CRGN-increase due to a decrement of one practicing nurse per week of hospital-stay of one population individual. Our modeling provided CRGN-estimations in two non-EARS-net countries (Switzerland and Turkey), which were almost equal to empirically estimated values (CAESAR-Network). Furthermore, a nurse-density-dependent moderation of the inter-species distribution balance was a likely pathway of the observed effect. These observations were specific for CRGN, in contrast to other resistance types in the same species.
Conclusions
This is the first attempt of quantifying potential nurse-density effects on antimicrobial-resistance at national level. Our results suggest an increase in CRGN by decreasing nurse-density. Nurse-density is thus a novel factor that might improve our understanding of the unbalanced CRGN-distribution among sub-European regions. Consequently, integrating nurse-density in future AMR-policies could be beneficial.Open-Access-Publikationsfonds 202
Thinking outside the box: Association of antimicrobial resistance with climate warming in Europe – A 30 country observational study
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COVID-19-Impfstrategien für Beschäftigte deutscher Kliniken: Ergebnisse einer Befragung von Leitungen der (Krankenhaus‑)Hygiene im Rahmen des B-FAST-Projektes
No full textBACKGROUND AND AIM: At the beginning of the COVID-19 vaccination campaign in Germany, employees in medical facilities were prioritised for vaccination against SARS-CoV‑2 due to the high risk of exposure and contact with vulnerable groups. Hospitals were therefore encouraged to organise and implement the vaccination of their employees as soon as possible. The aim of the study was to record the practice regarding the vaccination strategy for employees in German hospitals. METHODS: In a self-developed cross-sectional study, infection control practitioners of all German university hospitals as well as non-university hospitals in Lower Saxony and Bavaria were surveyed in March 2021. The data were stratified according to the characteristics of university hospitals and non-university hospitals. RESULTS: Of 416 invitations sent out, 100 questionnaires (university hospitals: 33; non-university hospitals: 67) were completed. University hospitals reported greater vaccination capacity than non-university hospitals, but a limiting factor was uncertain vaccine supply. Vaccination information campaigns were planned or had already been conducted in 89% of clinics. About two-thirds of the respondents (70%) said they did not plan to conduct antibody tests on vaccinated employees. A follow-up of vaccinated employees to detect possible SARS-CoV‑2 infections by PCR was planned by 41% of the respondents. In case of detection of SARS-CoV‑2 infection, 72% of the respondents had planned further diagnostic procedures. DISCUSSION: All hospitals were able to achieve rapid implementation of COVID-19 vaccination of their employees. At the time of the survey, there was also much uncertainty regarding the management of breakthrough infections as well as the need for booster vaccinations
Prevention of postoperative surgical site infections
No full textPostoperative wound infections represent a relevant complication of invasive interventions. Current European prevalence data show that for participating hospitals from Germany (n = 132) surgical site infections represent the most commonly occurring nosocomial infection with 24.3 %. This corresponds to a point prevalence of 1.31 %. It is assumed that approximately 25-33 % of all infections acquired in hospital could be prevented if all possible precautions would be taken. Recent studies have indicated that this rate might be even higher for individual infection entities. Infection control measures can be divided into general measures, which are valid for prevention in many fields and for many infection entities and into specific precautions related to hospital-specific circumstances or specific infection entities. In this article the various hygiene measures and recommendations are presented with respect to the level of evidence
Recommendations from the German Ophthalmological Society and the Professional Association of Ophthalmologists in Germany on perimetry during the SARS-CoV-2 pandemic : Status: 30 November 2020
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