Noch Steigerungsfähig? Die Compliance mit der Händehygiene unter psychologischen Gesichtspunkten

Die hygienische Händedesinfektion ist eine effektive und einfache Maßnahme zur Prävention von Infektionen im Gesundheitswesen. Am 5. Mai, dem von der WHO initiierten „Internationalen Tag der Händehygiene“, soll alljährlich die Aufmerksamkeit des Gesundheitspersonals auf dieses Thema gelenkt werden, denn oft lässt sich trotz regelmäßiger Schulungen und Kampagnen die Händehygiene-Compliance ab einem gewissen Punkt nicht weiter steigern. Im Beitrag wird das Potenzial zur weiteren Verbesserung der Compliance vor allem anhand psychologischer Aspekte erläutert, die neben der Ausstattung und der Wissensvermittlung einen wichtigen Teil der nachhaltigen Stärkung der Händehygiene ausmachen.Peer Reviewe

Noch Steigerungsfähig? Die Compliance mit der Händehygiene unter psychologischen Gesichtspunkten

Die hygienische Händedesinfektion ist eine effektive und einfache Maßnahme zur Prävention von Infektionen im Gesundheitswesen. Am 5. Mai, dem von der WHO initiierten „Internationalen Tag der Händehygiene“, soll alljährlich die Aufmerksamkeit des Gesundheitspersonals auf dieses Thema gelenkt werden, denn oft lässt sich trotz regelmäßiger Schulungen und Kampagnen die Händehygiene-Compliance ab einem gewissen Punkt nicht weiter steigern. Im Beitrag wird das Potenzial zur weiteren Verbesserung der Compliance vor allem anhand psychologischer Aspekte erläutert, die neben der Ausstattung und der Wissensvermittlung einen wichtigen Teil der nachhaltigen Stärkung der Händehygiene ausmachen.Peer Reviewe

Noch steigerungsfähig? Die Compliance mit der Händehygiene unter psychologischen Gesichtspunkten

Die hygienische Händedesinfektion ist eine effektive und einfache Maßnahme zur Prävention von Infektionen im Gesundheitswesen. Am 5. Mai, dem von der WHO initiierten „Internationalen Tag der Händehygiene“, soll alljährlich die Aufmerksamkeit des Gesundheitspersonals auf dieses Thema gelenkt werden, denn oft lässt sich trotz regelmäßiger Schulungen und Kampagnen die Händehygiene-Compliance ab einem gewissen Punkt nicht weiter steigern. Im Beitrag wird das Potenzial zur weiteren Verbesserung der Compliance vor allem anhand psychologischer Aspekte erläutert, die neben der Ausstattung und der Wissensvermittlung einen wichtigen Teil der nachhaltigen Stärkung der Händehygiene ausmachen.Peer Reviewe

Der indikationsgerechte Einsatz von medizinischen Einmalhandschuhen in der Krankenversorgung: Gibt es hier Handlungsbedarf

Der von der Weltgesundheitsorganisation initiierte „Internationale Tag der Händehygiene“ soll alljährlich am 5. Mai die Aufmerksamkeit auf die Händehygiene vor allem in medizinischen und pfle-gerischen Einrichtungen lenken. Aus diesem Anlass wird in diesem Jahr im Epidemiologischen Bulletin 18/2023 die indikationsgerechte Nutzung medizinischer Einmalhandschuhe in Einrichtungen des Gesundheitswesens thematisiert und auf bestehende Probleme bei der Händehygiene-Compliance hingewiesen.Peer Reviewe

The microbiological quality of air improves when using air conditioning systems in cars

<p>Abstract</p> <p>Background</p> <p>Because of better comfort, air conditioning systems are a common feature in automobiles these days. However, its impact on the number of particles and microorganisms inside the vehicle - and by this its impact on the risk of an allergic reaction - is yet unknown.</p> <p>Methods</p> <p>Over a time period of 30 months, the quality of air was investigated in three different types of cars (VW Passat, VW Polo FSI, Seat Alhambra) that were all equipped with a automatic air conditioning system. Operation modes using fresh air from outside the car as well as circulating air from inside the car were examined. The total number of microorganisms and the number of mold spores were measured by impaction in a high flow air sampler. Particles of 0.5 to 5.0 μm diameter were counted by a laser particle counter device.</p> <p>Results</p> <p>Overall 32 occasions of sampling were performed. The concentration of microorganisms outside the cars was always higher than it was inside the cars. Few minutes after starting the air conditioning system the total number of microorganisms was reduced by 81.7%, the number of mold spores was reduced by 83.3%, and the number of particles was reduced by 87.8%. There were no significant differences neither between the types of cars nor between the types of operation mode of the air conditioning system (fresh air vs. circulating air). All parameters that were looked for in this study improved during utilization of the car's air conditioning system.</p> <p>Conclusions</p> <p>We believe that the risk of an allergic reaction will be reduced during use also. Nevertheless, we recommend regular maintenance of the system and replacement of older filters after defined changing intervals.</p

Five-years surveillance of invasive aspergillosis in a university hospital

<p>Abstract</p> <p>Background</p> <p>As the most common invasive fungal infection, invasive aspergillosis (IA) remains a serious complication in immunocompromised patients, leading to increased mortality. Antifungal therapy is expensive and may result in severe adverse effects.</p> <p>The aim of this study was to determine the incidence of invasive aspergillosis (IA) cases in a tertiary care university hospital using a standardized surveillance method.</p> <p>Methods</p> <p>All inpatients at our facility were screened for presence of the following parameters: positive microbiological culture, pathologist's diagnosis and antifungal treatment as reported by the hospital pharmacy. Patients fulfilling one or more of these indicators were further reviewed and, if appropriate, classified according to international consensus criteria (EORTC).</p> <p>Results</p> <p>704 patients were positive for at least one of the indicators mentioned above. Applying the EORTC criteria, 214 IA cases were detected, of which 56 were proven, 25 probable and 133 possible. 44 of the 81 (54%) proven and probable cases were considered health-care associated. 37 of the proven/probable IA cases had received solid organ transplantation, an additional 8 had undergone stem cell transplantation, and 10 patients were suffering from some type of malignancy. All the other patients in this group were also suffering from severe organic diseases, required long treatment and experienced several clinical complications. 7 of the 56 proven cases would have been missed without autopsy. After the antimycotic prophylaxis regimen was altered, we noticed a significant decrease (p = 0.0004) of IA during the investigation period (2003-2007).</p> <p>Conclusion</p> <p>Solid organ and stem cell transplantation remain important risk factors for IA, but several other types of immunosuppression should also be kept in mind. Clinical diagnosis of IA may be difficult (in this study 13% of all proven cases were diagnosed by autopsy only). Thus, we confirm the importance of IA surveillance in all high-risk patients.</p

Quantitative Contributions of Target Alteration and Decreased Drug Accumulation to Pseudomonas aeruginosa Fluoroquinolone Resistance.

Quinolone antibiotics constitute a clinically successful and widely used class of broad-spectrum antibiotics; however, the emergence and spread of resistance increasingly limits the use of fluoroquinolones in the treatment and management of microbial disease. In this study, we evaluated the quantitative contributions of quinolone target alteration and efflux pump expression to fluoroquinolone resistance in Pseudomonas aeruginosa. We generated isogenic mutations in hot spots of the quinolone resistance-determining regions (QRDRs) of gyrA, gyrB, and parC and inactivated the efflux regulator genes so as to overexpress the corresponding multidrug resistance (MDR) efflux pumps. We then introduced the respective mutations into the reference strain PA14 singly and in various combinations. Whereas the combined inactivation of two efflux regulator-encoding genes did not lead to resistance levels higher than those obtained by inactivation of only one efflux regulator-encoding gene, the combination of mutations leading to increased efflux and target alteration clearly exhibited an additive effect. This combination of target alteration and overexpression of efflux pumps was commonly observed in clinical P. aeruginosa isolates; however, these two mechanisms were frequently found not to be sufficient to explain the level of fluoroquinolone resistance. Our results suggest that there are additional mechanisms, independent of the expression of the MexAB-OprM, MexCD-OprJ, MexEF-OprN, and/or MexXY-OprM efflux pump, that increase ciprofloxacin resistance in isolates with mutations in the QRDRs

Mechanical plus oral bowel preparation with paromomycin and metronidazole reduces infectious complications in elective colorectal surgery: a matched case-control study

Purpose!#!Infectious complications are as high as 30% in elective colorectal surgery. In recent years, several studies have discussed the topic of preoperative bowel decontamination prior to colorectal surgery in order to reduce postoperative infectious complications and have found significant effects of oral antibiotic administration with a large variety of drugs used. No study has evaluated the combination of oral paromomycin and metronidazole in this context.!##!Methods!#!We performed a prospective single-center study with a matched-pair retrospective cohort to evaluate postoperative infectious complications (superficial site infections, organ space abscess, anastomotic leakage) in elective colorectal surgery.!##!Patients!#!A total of 120 patients were available for study inclusion; 101 gave informed consent and were included. A total of 92 patients were matched and subsequently analyzed. We could show a reduction in overall infectious complications in the intervention group (15.2% vs 30.8%, p = 0.018; odds ratio 0.333, 95% CI 0.142-0.784) as well as a reduction in superficial surgical site infections (8.7 vs 19.6%, p = 0.041, OR 0.333, 95% CI 0.121-0.917). The frequency of the other infectious complications such as intraabdominal abscesses and anastomotic leakage showed a tendency towards decreased frequencies in the intervention group (OR 0.714, 95% CI 0.235-2.169 and OR 0.571; 95% CI 0.167-1.952, respectively). Finally, the oral antibiotic administration led to an almost significantly reduced length of stay (12.24 days vs 15.25 days; p = 0.057).!##!Conclusions!#!Oral paromomycin and metronidazole with intravenous ertapenem effectively reduce infectious complications in elective colorectal surgery.!##!Trial registration!#!The study was registered at Clinicaltrials.gov (NCT03759886) December 17, 2018