Hot topics in the prevention and control of healthcare-associated infections_West China Medical Journal

Authors：

LIN Ji , LI Jingwen , QIAO Fu ,  ZONG Zhiyong

Infection Prevention & Control Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZONG Zhiyong, Email: zongzhiy@scu.edu.cn

Keywords：

Healthcare-associated infection; Management; Research progress

DOI：

10.7507/1002-0179.201902051

Video：

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Healthcare-associated infection management has advanced rapidly in recent years. With the development of more standards and guidelines, infection control measures become more standardized and evidence-based. Evidence-based measures are increasingly applied in infection control, which promote more studies on the prevention and control of healthcare-associated infections. Furthermore, more new ideas of infection control have emerged, with old ones being challenged. The hand hygiene reform, multidrug-resistant organisms, and surgical site infections become the hot topics in recent years. In addition, whole-genome sequencing also provides more bases for understanding pathogen transmission in hospitals. Based on the high-quality studies published in recent years, this opinion review discusses these hot topics in the prevention and control of healthcare-associated infections.

Citation： LIN Ji, LI Jingwen, QIAO Fu, ZONG Zhiyong. Hot topics in the prevention and control of healthcare-associated infections. West China Medical Journal, 2019, 34(3): 251-255. doi: 10.7507/1002-0179.201902051 Copy

1.	Grayson ML, Stewardson AJ, Russo PL, et al. Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. Lancet Infect Dis, 2018, 18(11): 1269-1277.
2.	吴晓春, 曲秀娟, 陈苑利. 某三级综合教学医院手卫生暗访调查现状及对策研究. 中国感染控制杂志, 2018, 17(11): 1019-1021, 1025.
3.	Vikke HS, Vittinghus S, Giebner M, et al. Compliance with hand hygiene in emergency medical services: an international observational study. Emerg Med J, 2019, 36(3): 171-175.
4.	McLaws ML, Kwok YLA. Hand hygiene compliance rates: fact or fiction?. Am J Infect Control, 2018, 46(8): 876-880.
5.	Centers for Disease Control and Prevention. Healthcare providers. [2019-02-13]. https://www.cdc.gov/handhygiene/ providers/index.html.
6.	Reilly JS, Price L, Lang S, et al. A pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute hospital care in the United Kingdom. Infect Control Hosp Epidemiol, 2016, 37(6): 661-666.
7.	Pires D, Bellissimo-Rodrigues F, Soule H, et al. Revisiting the WHO " How to Handrub” hand hygiene technique: fingertips first?. Infect Control Hosp Epidemiol, 2017, 38(2): 230-233.
8.	Tschudin-Sutter S, Sepulcri D, Dange M, et al. Simplifying the WHO protocol: three steps versus six steps for performance of hand hygiene - a cluster-randomized trial. Clin Infect Dis, 2018.
9.	World Health Organization. World alliance for patient safety. WHO guidelines on hand hygiene in health care (advanced draft): a summary. Clean hands are safer hands. [2019-02-13]. https://www.who.int/patientsafety/events/05/HH_en.pdf.
10.	Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control, 1999, 27(2): 97-132.
11.	Bischoff P, Kubilay NZ, Allegranzi B, et al. Effect of laminar airflow ventilation on surgical site infections: a systematic review and meta-analysis. Lancet Infect Dis, 2017, 17(5): 553-561.
12.	Birgand G, Toupet G, Rukly S, et al. Air contamination for predicting wound contamination in clean surgery: a large multicenter study. Am J Infect Control, 2015, 43(5): 516-521.
13.	Roth JA, Juchler F, Dange M, et al. Frequent door openings during cardiac surgery are associated with increased risk for surgical site infection: a prospective observational study. Clin Infect Dis, 2018.
14.	Walker JT, Lamagni T, Chand M. Evidence that Mycobacterium chimaera aerosols penetrate laminar airflow and result in infections at the surgical field. Lancet Infect Dis, 2017, 17(10): 1019.
15.	乔甫, 林吉, 李婧闻, 等. 人工心肺机热交换水箱系统引起心脏手术患者奇美拉分枝杆菌的感染暴发. 中华医学杂志, 2017, 97(42): 3357-3360.
16.	胡国庆, 李晔, 高晓东, 等. 中国 2359 所医疗机构洁净手术室使用现状调查. 中华医院感染学杂志, 2018, 28(22): 3497-3500.
17.	CHINET 数据云. CPKP prevalence in China, 2017. [2019-02-13]. http://www.chinets.com/?type=login&returnUrl=http://www.chinets.com/Data/GermYear.
18.	Huang W, Qiao F, Zhang Y, et al. In-hospital medical costs of infections caused by carbapenem-resistant Klebsiella pneumoniae. Clin Infect Dis, 2018, 67(Suppl_2): S225-S230.
19.	Gu D, Dong N, Zheng Z, et al. A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study. Lancet Infect Dis, 2018, 18(1): 37-46.
20.	World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. (2017-11)[2019-02-13]. https://www.who.int/infection-prevention/publications/guidelines-cre/en/.
21.	Gysin DV, Cookson B, Saenz H, et al. Variability in contact precautions to control the nosocomial spread of multi-drug resistant organisms in the endemic setting: a multinational cross-sectional survey. Antimicrob Resist Infect Control, 2018, 7: 81.
22.	白艳玲, 杜明梅, 刘伯伟, 等. 感染/定植耐碳青霉烯类肺炎克雷伯菌住院患者周围环境中分离 CRKP 菌株的流行特征. 中华医院感染学杂志, 2018, 28(8): 1131-1134.
23.	Labricciosa FM, Sartelli M, Abbo LM, et al. Epidemiology and risk factors for isolation of multi-drug-resistant organisms in patients with complicated intra-abdominal infections. Surg Infect (Larchmt), 2018, 19(3): 264-272.
24.	Mills JP, Talati NJ, Alby K, et al. The epidemiology of carbapenem-resistant Klebsiella pneumoniae colonization and infection among long-term acute care hospital residents. Infect Control Hosp Epidemiol, 2016, 37(1): 55-60.
25.	Baur D, Gladstone BP, Burkert F, et al. Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis. Lancet Infect Dis, 2017, 17(9): 990-1001.
26.	Liu L, Feng Y, Tang G, et al. Carbapenem-resistant isolates of the Klebsiella pneumoniae complex in Western China: the common ST11 and the surprising hospital-specific types. Clin Infect Dis, 2018, 67(suppl_2): S263-S265.
27.	Shu LB, Lu Q, Sun RH, et al. Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province, China. Infect Drug Resist, 2018, 12: 11-18.
28.	Djibré M, Fedun S, Le Guen P, et al. Universal versus targeted additional contact precautions for multidrug-resistant organism carriage for patients admitted to an intensive care unit. Am J Infect Control, 2017, 45(7): 728-734.
29.	Li M, Wang X, Wang J, et al. Infection-prevention and control interventions to reduce colonisation and infection of intensive care unit-acquired carbapenem-resistant Klebsiella pneumoniae: a 4-year quasi-experimental before-and-after study. Antimicrob Resist Infect Control, 2019, 8: 8.
30.	Tacconelli E, Mazzaferri F, de Smet AM, et al. ESCMID-EUCIC clinical guidelines on decolonisation of multidrug-resistant Gram-negative bacteria carriers. Clin Microbiol Infect, 2019: S1198-743X(19)30025-4.
31.	Johnson RC, Deming C, Conlan S, et al. Investigation of a cluster of Sphingomonas koreensis infections. N Engl J Med, 2018, 379(26): 2529-2539.
32.	Regev-Yochay G, Smollan G, Tal I, et al. Sink traps as the source of transmission of OXA-48-producing serratia marcescens in an intensive care unit. Infect Control Hosp Epidemiol, 2018, 39(11): 1307-1315.
33.	Carling PC. Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks. Infect Control Hosp Epidemiol, 2018, 39(8): 972-979.
34.	Cantero M, Parra LM, Muñez E, et al. A cluster of Chryseobacterium indologenes cases related to drainage water in intensive care units. Infect Control Hosp Epidemiol, 2018, 39(8): 997-999.
35.	Tang P, Croxen MA, Hasan MR, et al. Infection control in the new age of genomic epidemiology. Am J Infect Control, 2017, 45(2): 170-179.
36.	王燕飞. 全基因组测序追踪医院内碳青霉烯耐药肺炎克雷伯菌的播散流行. 杭州: 浙江大学, 2017.
37.	Qi Y, Wei Z, Ji S, et al. ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China. J Antimicrob Chemother, 2011, 66(2): 307-312.

1. Grayson ML, Stewardson AJ, Russo PL, et al. Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. Lancet Infect Dis, 2018, 18(11): 1269-1277.
2. 吴晓春, 曲秀娟, 陈苑利. 某三级综合教学医院手卫生暗访调查现状及对策研究. 中国感染控制杂志, 2018, 17(11): 1019-1021, 1025.
3. Vikke HS, Vittinghus S, Giebner M, et al. Compliance with hand hygiene in emergency medical services: an international observational study. Emerg Med J, 2019, 36(3): 171-175.
4. McLaws ML, Kwok YLA. Hand hygiene compliance rates: fact or fiction?. Am J Infect Control, 2018, 46(8): 876-880.
5. Centers for Disease Control and Prevention. Healthcare providers. [2019-02-13]. https://www.cdc.gov/handhygiene/ providers/index.html.
6. Reilly JS, Price L, Lang S, et al. A pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute hospital care in the United Kingdom. Infect Control Hosp Epidemiol, 2016, 37(6): 661-666.
7. Pires D, Bellissimo-Rodrigues F, Soule H, et al. Revisiting the WHO " How to Handrub” hand hygiene technique: fingertips first?. Infect Control Hosp Epidemiol, 2017, 38(2): 230-233.
8. Tschudin-Sutter S, Sepulcri D, Dange M, et al. Simplifying the WHO protocol: three steps versus six steps for performance of hand hygiene - a cluster-randomized trial. Clin Infect Dis, 2018.
9. World Health Organization. World alliance for patient safety. WHO guidelines on hand hygiene in health care (advanced draft): a summary. Clean hands are safer hands. [2019-02-13]. https://www.who.int/patientsafety/events/05/HH_en.pdf.
10. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control, 1999, 27(2): 97-132.
11. Bischoff P, Kubilay NZ, Allegranzi B, et al. Effect of laminar airflow ventilation on surgical site infections: a systematic review and meta-analysis. Lancet Infect Dis, 2017, 17(5): 553-561.
12. Birgand G, Toupet G, Rukly S, et al. Air contamination for predicting wound contamination in clean surgery: a large multicenter study. Am J Infect Control, 2015, 43(5): 516-521.
13. Roth JA, Juchler F, Dange M, et al. Frequent door openings during cardiac surgery are associated with increased risk for surgical site infection: a prospective observational study. Clin Infect Dis, 2018.
14. Walker JT, Lamagni T, Chand M. Evidence that Mycobacterium chimaera aerosols penetrate laminar airflow and result in infections at the surgical field. Lancet Infect Dis, 2017, 17(10): 1019.
15. 乔甫, 林吉, 李婧闻, 等. 人工心肺机热交换水箱系统引起心脏手术患者奇美拉分枝杆菌的感染暴发. 中华医学杂志, 2017, 97(42): 3357-3360.
16. 胡国庆, 李晔, 高晓东, 等. 中国 2359 所医疗机构洁净手术室使用现状调查. 中华医院感染学杂志, 2018, 28(22): 3497-3500.
17. CHINET 数据云. CPKP prevalence in China, 2017. [2019-02-13]. http://www.chinets.com/?type=login&returnUrl=http://www.chinets.com/Data/GermYear.
18. Huang W, Qiao F, Zhang Y, et al. In-hospital medical costs of infections caused by carbapenem-resistant Klebsiella pneumoniae. Clin Infect Dis, 2018, 67(Suppl_2): S225-S230.
19. Gu D, Dong N, Zheng Z, et al. A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study. Lancet Infect Dis, 2018, 18(1): 37-46.
20. World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. (2017-11)[2019-02-13]. https://www.who.int/infection-prevention/publications/guidelines-cre/en/.
21. Gysin DV, Cookson B, Saenz H, et al. Variability in contact precautions to control the nosocomial spread of multi-drug resistant organisms in the endemic setting: a multinational cross-sectional survey. Antimicrob Resist Infect Control, 2018, 7: 81.
22. 白艳玲, 杜明梅, 刘伯伟, 等. 感染/定植耐碳青霉烯类肺炎克雷伯菌住院患者周围环境中分离 CRKP 菌株的流行特征. 中华医院感染学杂志, 2018, 28(8): 1131-1134.
23. Labricciosa FM, Sartelli M, Abbo LM, et al. Epidemiology and risk factors for isolation of multi-drug-resistant organisms in patients with complicated intra-abdominal infections. Surg Infect (Larchmt), 2018, 19(3): 264-272.
24. Mills JP, Talati NJ, Alby K, et al. The epidemiology of carbapenem-resistant Klebsiella pneumoniae colonization and infection among long-term acute care hospital residents. Infect Control Hosp Epidemiol, 2016, 37(1): 55-60.
25. Baur D, Gladstone BP, Burkert F, et al. Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis. Lancet Infect Dis, 2017, 17(9): 990-1001.
26. Liu L, Feng Y, Tang G, et al. Carbapenem-resistant isolates of the Klebsiella pneumoniae complex in Western China: the common ST11 and the surprising hospital-specific types. Clin Infect Dis, 2018, 67(suppl_2): S263-S265.
27. Shu LB, Lu Q, Sun RH, et al. Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province, China. Infect Drug Resist, 2018, 12: 11-18.
28. Djibré M, Fedun S, Le Guen P, et al. Universal versus targeted additional contact precautions for multidrug-resistant organism carriage for patients admitted to an intensive care unit. Am J Infect Control, 2017, 45(7): 728-734.
29. Li M, Wang X, Wang J, et al. Infection-prevention and control interventions to reduce colonisation and infection of intensive care unit-acquired carbapenem-resistant Klebsiella pneumoniae: a 4-year quasi-experimental before-and-after study. Antimicrob Resist Infect Control, 2019, 8: 8.
30. Tacconelli E, Mazzaferri F, de Smet AM, et al. ESCMID-EUCIC clinical guidelines on decolonisation of multidrug-resistant Gram-negative bacteria carriers. Clin Microbiol Infect, 2019: S1198-743X(19)30025-4.
31. Johnson RC, Deming C, Conlan S, et al. Investigation of a cluster of Sphingomonas koreensis infections. N Engl J Med, 2018, 379(26): 2529-2539.
32. Regev-Yochay G, Smollan G, Tal I, et al. Sink traps as the source of transmission of OXA-48-producing serratia marcescens in an intensive care unit. Infect Control Hosp Epidemiol, 2018, 39(11): 1307-1315.
33. Carling PC. Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks. Infect Control Hosp Epidemiol, 2018, 39(8): 972-979.
34. Cantero M, Parra LM, Muñez E, et al. A cluster of Chryseobacterium indologenes cases related to drainage water in intensive care units. Infect Control Hosp Epidemiol, 2018, 39(8): 997-999.
35. Tang P, Croxen MA, Hasan MR, et al. Infection control in the new age of genomic epidemiology. Am J Infect Control, 2017, 45(2): 170-179.
36. 王燕飞. 全基因组测序追踪医院内碳青霉烯耐药肺炎克雷伯菌的播散流行. 杭州: 浙江大学, 2017.
37. Qi Y, Wei Z, Ji S, et al. ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China. J Antimicrob Chemother, 2011, 66(2): 307-312.

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Hot topics in the prevention and control of healthcare-associated infections

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