Impact of the "Guidelines for infection prevention in dentistry" (2006) by the Commission of Hospital Hygiene and Infection Prevention at the Robert Koch-Institute (KRINKO) on hygiene management in dental practices – analysis of a survey from 2009

Aim: To assess trends in hygiene management in dental practices in comparison to an earlier survey in 2002/2003 and to point out key aspects for future efforts

Occurrence of methicillin-resistant Staphylococcus aureus in farm workers and the livestock environment in Mecklenburg-Western Pomerania, Germany

Background: Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) has a wide host range and is transmissible to humans, especially to those with close contact to colonized animals. This study presents the first data on the occurrence of MRSA in farm workers and livestock farms (pig, cattle and poultry) in the federal state of Mecklenburg-Western Pomerania in northeast Germany. 78 farm workers at pig farms, cattle farms and poultry farms were tested for MRSA via pooled nasal and pharyngeal swabs. Additionally, from each of the 34 participating farms (17 pig farms, 11 cattle farms, 6 poultry farms) five dust samples were taken from the direct surroundings of the animals. Furthermore, oropharyngeal swabs were additionally taken from 10 animals per poultry farm. Isolated MRSA strains were characterized and confirmed using PCR and spa typing. Resistance patterns were obtained using the broth microdilution assay. Results: In total, 20 of 78 (25.6%; 95% CI:17.3-36.3) farm workers were positive for MRSA. All MRSA-positive workers were employed at pig farms. Six of 17 (35.3%; 95% CI:17.3-58.7) pooled dust samples from pig farms were also positive. Overall, six spa types were identified, of which t034 predominated. All strains belonged to LA-MRSA CC398 and were resistant to tetracycline. Resistance to lincosamides, macrolides, fluoroquinolones and aminoglycosides was present in some strains. Three farm workers harbored the identical spa type and antimicrobial resistance pattern found in the corresponding dust sample. Neither workers, dust samples from cattle and poultry farms, nor oropharyngeal poultry swabs tested positive for MRSA. Conclusions: The present study emphasizes the importance of MRSA on pig farms and pig-farm workers in the rural region of Mecklenburg-Western Pomerania, whereas LA-MRSA could not be isolated from cattle and poultry farms

Uniform documentation of measures in cases of MRSA – an important step towards improving the quality of treatment

The basis for the management and documentation of multiresistant organisms (MRO) in medical facilities in Germany are the Infection Protection Act (IPA) and the recommendations given by the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO)

Sichere Aufbereitung von Transfer- und Lagerungshilfen

In der Pflege und Betreuung von pflegebedürftigen und behinderten Menschen werden zunehmend Transfer- und Lagerungshilfen (TLH) genutzt. Diese Hilfsmittel erfüllen eine Dreifachfunktion, da sie die Eigenaktivität und Mobilität der Pflegebedürftigen unterstützen, die Dekubitusprophylaxe verbessern und den pflegerischen Umgang mit den Patienten erleichtern. Dadurch kann auch die körperliche Belastung für das Pflegepersonal verringert werden. Obwohl von vielen Herstellern die Anwendung von TLH vorrangig im häuslichen Bereich, d.h. patientenbezogen, propagiert wird, ist die Anwendung aus Sicht der Arbeitsmedizin auch in Pflegeeinrichtungen und Krankenhäusern sinnvoll. Hier erfolgt die Anwendung häufig jedoch nicht patientenbezogen. Damit gewinnt die sichere Aufbereitung dieser Medizinprodukte an Bedeutung. Ziel dieses Beitrags ist es, die Problematik der Aufbereitung dieser passiven, mobilen TLH in der Praxis darzustellen. Ausgehend von einer Risikoanalyse werden die Vorteile, die möglichen hygienischen Probleme sowie die Aufbereitungsmöglichkeiten beim Einsatz von TLH aufgezeigt. An Beispielen aus der konkreten Praxis wird gezeigt, dass in vielen Fällen Herstellerangaben zur Aufbereitung sehr ungenau sind oder keine dem Infektionsrisiko angemessene Aufbereitung erlauben. Besonders komplex aufgebaute TLH, die verschiedene Materialien kombinieren und mit Schlaufen, Bändern und Bezügen versehen sind, können ggf. bei der Aufbereitung problematisch sein. Für die Betreiber ist zu bedenken, dass die Folgekosten von schlecht oder nicht aufzubereitenden Hilfsmitteln die Anschaffungskosten um ein Vielfaches übersteigen können. Daher sollte die Aufbereitbarkeit ein wichtiges Kriterium beim Einkauf vom TLH sein. Diese sollte möglichst einfach, sicher und kostengünstig durchzuführen sein. Gleichzeitig mit dem Einkauf von Hilfsmitteln muss die entsprechende Logistik zur Aufbereitung und Lagerung zur Verfügung stehen. Die Hersteller der TLH sind dringend aufgefordert, die Produkte hinsichtlich der Anforderungen an die Reinigung und Desinfektion zu optimieren.Transfer and repositioning aids are increasingly used in nursing of disabled as well as people in need of care. These tools encourage the physical activity and mobility of patients, assist with decubitus prophylaxis and make it easier nurse with patients. In this way their use reduces the physical burden on nursing staff. While many manufactures propagate these aids for domestic use in the fist line, their use in hospitals or LTCF is encouraged by occupational medicine. This raises the issue of safe reprocessing of these medical products. This manuscript aims to show the problems with safe reprocessing of transfer and repositioning aids. These transfer and repositioning aids are sometimes made of a mix of materials. Some come with loops, straps and covers. In many cases the manufacturer’s cleaning and handling instructions are very imprecise. Examples show that proper hygienic handling in accordance with the manufacturer’s instructions is either not always possible or possible only at great effort or expense. The Recommendations of the Commission on Hospital Hygiene and Prevention of Infection at the Robert Koch Institute and the Federal Institute for Drugs and Medical Devices on Hygiene Requirements in the Handling of Medical Devices propose an interim solution for proper hygienic handling that may in certain circumstances cause damage to the material and forfeiture of the manufacturer’s guarantee. Before such products are purchased, the hygiene specialists should check the options for hygienic handling as described in the concrete instructions from the manufacturer. If the options are not considered practicable, we recommend that the hygiene specialists appeal to the manufacturers to produce more suitable aids. Manufacturers of these transfer and repositioning aids are urgently called upon to optimise their products taking hygienic handling requirements into account

Review of indicators for cross-sectoral optimization of nosocomial infection prophylaxis – a perspective from structurally- and process-oriented hygiene

In the care of patients, the prevention of nosocomial infections is crucial. For it to be successful, cross-sectoral, interface-oriented hygiene quality management is necessary. The goal is to apply the HACCP (Hazard Assessment and Critical Control Points) concept to hospital hygiene, in order to create a multi-dimensional hygiene control system based on hygiene indicators that will overcome the limitations of a procedurally non-integrated and non-cross-sectoral view of hygiene

Practices of skin care among nurses in medical and surgical intensive care units: results of a self-administered questionnaire

Dermatitis of hands is a problem among nurses. The aim of this prospective questionnaire based survey was to analyze practice and knowledge of skin care of medical and surgical nurses

Pilot-study on the influence of carrier gas and plasma application (open resp. delimited) modifications on physical plasma and its antimicrobial effect against Pseudomonas aeruginosa and Staphylococcus aureus

Introduction: Physical plasma is a promising new technology regarding its antimicrobial effects. This is especially accounting for treatment of bacterial infection of chronic wounds. Plasma can be generated with different carrier gases causing various biological effects. Screening of different carrier gases and plasma generation setups is therefore needed to find suitable compositions for highly effective antimicrobial plasma treatments and other applications

One-day point prevalence of emerging bacterial pathogens in four secondary and five tertiary care German hospitals – results from a pilot study of the German Society for Hospital Hygiene (Deutsche Gesellschaft für Krankenhaushygiene, DGKH)

Objective: Data on the prevalence of emerging bacterial pathogens like extended-spectrum-lactamase-building (ESBL) Gram negative organisms, multiresistant Pseudomonas and Acinetobacter species or toxin-building Clostridium difficile in German hospitals are sparse. To provide data for different regions in Germany, a one-day point prevalence study with five tertiary care hospitals and four secondary care hospitals was conducted on the 10th of February 2010

Minimum inhibitory (MIC) and minimum microbicidal concentration (MMC) of polihexanide and triclosan against antibiotic sensitive and resistant Staphylococcus aureus and Escherichia coli strains

Background: An in-vitro study was conducted investigating the antimicrobial efficacy of polihexanide and triclosan against clinical isolates and reference laboratory strains of Staphylococcus aureus and Escherichia coli