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.
ObjectiveTo evaluate the efficiency of hydrogen peroxide vapor (HPV) in disinfecting multidrug-resistant organisms (MDROs).MethodsWe searched Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database for before-after studies or case-control studies or cohort studies evaluating efficiency of HPV and published from January 2010 to December 2020 (the time range was from January 2000 to December 2020 in the snowball searching). RevMan 5.4 and R 4.0.2 softwares were used for meta-analysis.ResultsA total of 9 studies were included, consisting of 8 before-after studies and 1 cohort study. Six studies evaluated positive rate of environmental samplings, meta-analysis revealed that HPV combined with manual cleaning disinfected the environment efficiently [relative risk (RR)=0.03, 95% confidence interval (CI) (0.01, 0.08), P< 0.000 01] and HPV was more efficient than manual cleaning [RR=0.04, 95%CI (0.02, 0.10), P< 0.000 01]. Three studies evaluated the hospital-acquired MDROs colonization/infection rates, and the results of the 3 studies were consistent, revealing that HPV could reduce hospital-acquired MDROs colonization/infection rates.ConclusionHPV is efficient in reducing MDROs contaminated surfaces and hospital-acquired infection rate.
ObjectiveTo provide scientific evidence for the prevention and control of infectious diseases in hospitals through analyzing the data of notified infectious diseases collected in one general comprehensive hospital from 2009 to 2014. MethodsDescriptive method was used to analyze the data of infectious diseases reported through the reporting system in 6 years in the hospital, and then the incidence, diseases classification and transmission route were summarized. ResultsA total of 15 847 cases, covering 32 notified infectious diseases, were reported between 2009 and 2014, including 15 144 category-B (95.56%) and 703 category-C (4.44%) infectious disease cases, among which the top four were syphilis, hepatitis B, tuberculosis and acquired immune deficiency syndrome (AIDS), with AIDS showing upward trend year by year. There were also 38 H1N1 cases of emerging infectious disease cases. In the view of the trend, there was an upward trend from 2009 to 2012, while there was a downward trend from 2012 to 2014. There were cases for all age groups, and most cases occurred among patients at an age of 40 to 44, accounting for 11.25% of the total cases. Eighteen occupations were involved, and the top five in terms of the number of infections accounted for 63.96% of all the cases. ConclusionCategory-B infections have been the major diseases reported in our hospital from 2009 to 2014. Therefore, the priority of our job in the future should be focused on prevention and control of syphilis, hepatitis B, tuberculosis and AIDS.
Objective To optimize the report procedure of infectious diseases, solve the problems during routine surveillance such as incomplete report and incorrect report, in order to improve the report quality of infectious diseases. Methods Common problems in the report cards which were systematically collected in the infectious disease report management system were analyzed. Then, through negotiation with engineers of the information center, procedures which might easily lead to errors were deleted, report procedures were optimized. Furthermore, clinicians were also trained on infectious disease report from time to time. The entire study was divided into three periods, including baseline period (from October 1, 2012 to December 31, 2013), intervention period (from January 1, 2014 to December 31, 2014) and enhanced intervention period (from January 1, 2015 to December 31, 2015). The incorrect report rate and incomplete report rate were automatically calculated and compared among the three periods to evaluate the report quality. Results Compared with the baseline period, the total incomplete rate in the enhanced intervention period decreased from 8.21% to 3.19% (χ2=103.143,P<0.001), the incorrect report rate of hepatitis B virus decreased from 32.84% to 21.63% (χ2=19.002,P<0.001), and the incorrect report rate of syphilis decreased from 24.93% to 6.86% (χ2=90.416,P<0.001). respectively. Conclusion The infectious disease report system plays a very important role in timely identification of errors and improvement of incomplete and incorrect report, and is of great significance in the management of infectious diseases.
Objective To investigate the situation and related factors of influenza vaccination among healthcare workers in Sichuan, and provide a basis for the formulation of the strategy of influenza vaccination. Methods From August 1st to August 6th, 2022, healthcare workers from 21 prefectures and cities in Sichuan province were selected by the hospital infection quality control centers to conduct an online questionnaire survey for status and related factors of influenza vaccination. Single factor analysis of vaccination rate was carried out by χ2 test, and the related factors of influenza vaccination were analyzed by binary multiple logistic regression model. Results A total of 3264 copies of questionnaires were distributed, and 3244 valid copies were recovered, with an effective recovery rate of 99.4%. The vaccination rate of influenza vaccine in the surveyed healthcare workers was 56.9% (1846/3244). The gender, age, professional title, position, department, hospital type, hospital nature, hospital level, influenza awareness, and influenza vaccination willingness were the factors resulting in statistically significant differences in influenza vaccination rate among healthcare workers (P<0.05). Binary multiple logistic regression indicated that age≥35 years old [odds ratio (OR)=0.799, 95% confidence interval (CI) (0.681, 0.937), P=0.006], the educational background being bachelor degree or above [OR=1.221, 95%CI (1.036, 1.439), P=0.017], position [nurses vs. doctors: OR=1.339, 95%CI (1.112, 1.612), P=0.002; technicians vs. doctors: OR=1.849, 95%CI (1.278, 2.676), P=0.001], the hospital type being specialized hospital [OR=1.804, 95%CI (1.446, 2.251), P<0.001], hospital level [secondary vs. primary hospitals: OR=0.344, 95%CI (0.271, 0.437), P<0.001; tertiary vs. primary hospitals: OR=0.526, 95%CI (0.413, 0.671), P<0.001], influenza awareness [fair vs. poor: OR=1.262, 95%CI (1.057, 1.508), P=0.010; good vs. poor: OR=1.489, 95%CI (1.142, 1.940), P=0.003], vaccination willingness [OR=4.725, 95%CI (4.009, 5.569), P<0.001] were related factors of influenza vaccination in healthcare workers. The influenza awareness was good in 416 healthcare workers (12.8%), fair in 1989 (61.3%), and poor in 839 (25.9%). The correct rate of influenza vaccination frequency was the highest (82.7%), while the correct rate of influenza contraindication was the lowest (3.2%). Among the healthcare workers, 2206 (68.0%) were willing to be vaccinated, of whom 1548 (70.2%) believed that they could protect people with weak immune function around them after vaccination; 1038 were unwilling to be vaccinated with influenza vaccine in the near future, of whom 335 (32.3%) believed that they had strong immunity and did not need to be vaccinated. Conclusions The influenza vaccination rate of medical staff is related to a variety of factors. Strengthening the publicity and education, and encouraging hospitals to provide free influenza vaccination, especially the correct understanding of contraindications, may be helpful to improve the vaccination rate.