The Journal of hospital infection
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Multicenter Study
Detection of SARS-CoV-2 within the healthcare environment: a multi-centre study conducted during the first wave of the COVID-19 outbreak in England.
Understanding how severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spread within the hospital setting is essential in order to protect staff, implement effective infection control measures, and prevent nosocomial transmission. ⋯ Effective cleaning can reduce the risk of fomite (contact) transmission, but some surface types may facilitate the survival, persistence and/or dispersal of SARS-CoV-2. The presence of low or undetectable concentrations of viral RNA in the air supports current guidance on the use of specific personal protective equipment for aerosol-generating and non-aerosol-generating procedures.
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Randomized Controlled Trial Multicenter Study
Infectious complications in patients receiving ticagrelor or clopidogrel before coronary artery bypass grafting.
The antiplatelet agent ticagrelor has recently been found to have bactericidal activity, demonstrated in vitro and in an in vivo mouse model, which warrants further clinical investigations. The aim of this study was to evaluate infectious complications after coronary artery bypass grafting in patients pre-operatively treated with ticagrelor or clopidogrel. In a multi-centre trial, all adult patients who were pre-operatively treated with ticagrelor or clopidogrel prior to isolated primary coronary artery bypass grafting were eligible. ⋯ Of 2311 patients who were included, 1293 (55.9%) received clopidogrel and 1018 (44.1%) ticagrelor pre-operatively. In both overall and propensity score matched analyses, ticagrelor was associated with a similar incidence of infectious complications compared to clopidogrel. Our findings do not support a clinically relevant bactericidal effect of ticagrelor in patients undergoing coronary artery bypass grafting.
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Multicenter Study
Improving healthcare worker adherence to the use of transmission-based precautions through application of human factors design: a prospective multi-centre study.
A key component of transmission-based precautions (TBPs) is the use of personal protective equipment (PPE) but healthcare worker (HCW) adherence remains suboptimal. A human factors-based intervention was implemented to improve adherence to TBPs including (i) improved signage, (ii) standardized placement of signage, (iii) introduction of a mask with integrated face shield, and (iv) improvement in PPE availability. Donning of the correct PPE by HCWs improved significantly (79.7 vs 56.4%; P < 0.001). This approach may be more effective than education alone, but further study is required to determine sustainability and subsequent impact on transmission of healthcare-associated infections.
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Multicenter Study
Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study.
Staphylococcus aureus is the leading pathogen in surgical site infections (SSI). ⋯ SSI due to S. aureus are decreasing and becoming rare events in Switzerland. High-risk procedures that may benefit from specific preventive measures were identified. Unfortunately, many of the independent risk factors are not easily modifiable.
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Multicenter Study Observational Study
Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments.
The use of peripheral venous catheters (PVCs) has increased outside intensive care units, as has the rate of PVC-associated-bloodstream infection (PVC-BSI). PVCs are widely used in internal medicine departments (IMDs), but data on the incidence of PVC-BSI and its characteristics in IMDs are scarce. ⋯ PVCs carry a significant risk for bacteraemia in Spanish IMDs. Phlebitis is not always clinically evident in patients with bacteraemia in this population. The study findings support the need for educational and interventional preventive measures in both IMDs and emergency departments to reduce the rate of PVC-BSI and associated comorbidities, and costs.