Infektioiden torjunnan henkilöstö ikääntyneiden ympärivuorokautisessa pitkäaikaishoidossa

Hoitoon liittyvien infektioiden torjunta on tärkeä osa potilas- ja asiakasturvallisuutta. Tutkimuksen tarkoituksena oli kuvata ikääntyneiden ympärivuorokautisen pitkäaikaishoidon toimintayksiköissä infektioiden torjuntaan osallistuvan henkilöstön saatavuutta sekä hygieniayhdyshenkilötoiminnan ja infektioiden torjunnan alueellisen yhteistyön toteutumista. Poikkileikkaustutkimus sisälsi kaksi erillistä kyselyaineistoa Manner-Suomessa sijaitsevista pitkäaikaishoidon toimintayksiköistä. Ensimmäinen kysely (n=167 toimintayksikköä) toteutettiin syksyllä 2017 osana Euroopan pitkäaikaishoitolaitosten hoitoon liittyvien infektioiden ja mikrobilääkkeiden käytön prevalenssitutkimusta (HALT-3). Toinen aineisto (n=41) kerättiin syksyllä 2018 ja 2019. Aineistojen analysoinnissa käytettiin kuvailevia tilastollisia menetelmiä. Toimintayksiköistä valtaosalla oli infektioiden torjuntakoulutusta saanut työntekijä käytettävissä, ja kaikilla oli mahdollisuus ulkopuoliseen konsultaatioapuun. Yksiköistä suurimmassa osassa oli vähintään yksi hygieniayhdyshenkilö, joista enemmistö oli osallistunut edeltävän vuoden aikana infektioiden torjuntakoulutukseen. Harvalla oli kirjallinen työnkuva tai varattu erikseen työaikaa infektioiden torjunnan tehtäviin. Lähes kaikki toimintayksiköt tekivät yhteistyötä alueellisten infektioasiantuntijoiden kanssa

Molecular epidemiology of carbapenemase-producing Enterobacterales in Finland, 2012-2018

Carbapenemase-producing Enterobacterales (CPE) pose an increasing threat to patient safety and healthcare systems globally. We present molecular epidemiology of CPE in Finland during 2012-2018 with detailed characteristics of CPE strains causing clusters during the same time period. All Finnish clinical microbiology laboratories send Enterobacterales isolates with reduced susceptibility to carbapenems or isolates producing carbapenemase to the reference laboratory for further characterization by whole genome sequencing (WGS). In total, 231 CPE strains from 202 patients were identified during 2012-2018. Of the strains, 59% were found by screening and 32% from clinical specimens, the latter were most commonly urine. Travel and/or hospitalization history abroad was reported for 108/171 strains (63%). The most common species were Klebsiella pneumoniae (45%), Escherichia coli (40%), and Citrobacter freundii (6%), and the most common carbapenemase genes bla(NDM-like) (35%), bla(OXA-48-like) (33%), and bla(KPC-like) (31%). During 2012-2018, the annual number of CPE strains increased from 9 to 70 and different sequence types from 7 to 33, and bla(OXA-48-like) genes became the most prevalent. Of the clusters, 3/8 were linked to traveling or hospitalization abroad and 5/8 were caused by K. pneumoniae clone clonal complex 258. Most of the clusters were caused by K. pneumoniae producing KPC. High variety among different sequence types indicates that majority of CPE cases detected in Finland are likely imported from foreign countries. Nearly one-third of the cases are not found by screening suggesting that there is hidden transmission occurring in the healthcare settings.Peer reviewe

Molecular epidemiology of carbapenemase-producing Enterobacterales in Finland, 2012-2018

Carbapenemase-producing Enterobacterales (CPE) pose an increasing threat to patient safety and healthcare systems globally. We present molecular epidemiology of CPE in Finland during 2012-2018 with detailed characteristics of CPE strains causing clusters during the same time period. All Finnish clinical microbiology laboratories send Enterobacterales isolates with reduced susceptibility to carbapenems or isolates producing carbapenemase to the reference laboratory for further characterization by whole genome sequencing (WGS). In total, 231 CPE strains from 202 patients were identified during 2012-2018. Of the strains, 59% were found by screening and 32% from clinical specimens, the latter were most commonly urine. Travel and/or hospitalization history abroad was reported for 108/171 strains (63%). The most common species were Klebsiella pneumoniae (45%), Escherichia coli (40%), and Citrobacter freundii (6%), and the most common carbapenemase genes bla(NDM-like) (35%), bla(OXA-48-like) (33%), and bla(KPC-like) (31%). During 2012-2018, the annual number of CPE strains increased from 9 to 70 and different sequence types from 7 to 33, and bla(OXA-48-like) genes became the most prevalent. Of the clusters, 3/8 were linked to traveling or hospitalization abroad and 5/8 were caused by K. pneumoniae clone clonal complex 258. Most of the clusters were caused by K. pneumoniae producing KPC. High variety among different sequence types indicates that majority of CPE cases detected in Finland are likely imported from foreign countries. Nearly one-third of the cases are not found by screening suggesting that there is hidden transmission occurring in the healthcare settings

High influenza vaccination coverage among healthcare workers in acute care hospitals in Finland, seasons 2017/18, 2018/19 and 2019/20.

BackgroundInfluenza vaccination is widely recommended for healthcare workers (HCWs) in European countries, but the coverage is not always satisfactory. In Finland, a new act was introduced in March 2017, according to which it is the employer's responsibility to appoint only vaccinated HCWs for servicing vulnerable patients.AimWe determined the influenza vaccination coverage among HCWs in Finnish acute care hospitals in three influenza seasons after introduction of the act.MethodsWe analysed data collected by an internet-based survey sent annually to all Finnish acute care hospitals and described the influenza vaccination coverage among HCWs during seasons 2017/18, 2018/19 and 2019/20. We calculated mean coverage per healthcare district and season.ResultsIn season 2017/18, 38 of 39 hospitals, in 2018/19, 35 of 36 hospitals and in 2018/19 31 of 33 hospitals provided data. The mean influenza vaccination coverage was 83.7% (SD: 12.3) in season 2017/18, 90.8% (SD: 8.7) in 2018/19 and 87.6% (SD: 10.9) in season 2019/20. There was no significant increase or decrease in the mean coverage across the three seasons. The differences between districts were only significant in 2018/19 (p < 0.005).ConclusionsThe coverage of influenza-vaccinated HCWs in Finnish hospitals was high in all three seasons and the current legal situation (semi-mandatory system) in Finland seems to provide a good background for this. Data collection should be maintained and improved for further monitoring