"Infection control refers to the policy and procedures implemented to control and minimize the dissemination of infections in hospitals and other healthcare settings with the main purpose of reducing infection rates." (Yacob Habboush, Infection Control, 2023)
Infection control and prevention is very important to the safety and well-being of our patients and caregivers at INTEGRIS Health. This subject guide has been designed to provide resources to our infection control caregivers and other caregivers wanting to gain further knowledge.
The focus of this subject guide is quality improvement and evidence based practice in the area of infection control and prevention.
The library staff is eager to assist you with any information needs and appreciates all comments and feedback regarding this subject guide: libsrv@integrishealth.org
Items of Interest and New Articles on Infection Control
PLoS One. 2025 Jun 18;20(6):e0325323. doi: 10.1371/journal.pone.0325323. eCollection 2025.
ABSTRACT
BACKGROUND: Healthcare-associated infections are a major complication of care for patients in intensive care, causing costs and additional mortality. Infection prevention practices, such as hand hygiene, have been suboptimal globally. This study aimed to explore the level of knowledge and perceptions of critical care staff regarding healthcare-associated infections as insufficient knowledge contributes to an increased burden of these infections.
METHODS: A nationwide survey of physicians and nurses working in intensive care units of Finnish tertiary care hospitals was conducted to gain knowledge and explore perceptions regarding the prevention of healthcare-associated infections in intensive care units. Descriptive statistics were used to describe the study data, and a mainly nonparametric method was used to compare the groups.
RESULTS: The respondents demonstrated moderately good knowledge of hand hygiene and infection prevention, with a median of 36 correct responses (Q1, Q3: 34, 37). However, there were notable gaps in their knowledge in infection prevention regarding the routes of infection transmission, with a median score of 4 (Q1, Q3: 4, 6). Conversely, perceptions of infection prevention were generally positive. The median score for perceptions was 51 (Q1, Q3: 47, 55), but no significant association was found between perceptions and knowledge levels.
CONCLUSIONS: The level of knowledge about healthcare-associated infections is not satisfactory. In particular, there is a lack of in-depth understanding of the mechanisms of infection transmission and prevention. Providing unit-tailored feedback on performance, along with education on the transmission mechanisms and infection prevention for healthcare workers is essential.
PMID:40531938 | PMC:PMC12176175 | DOI:10.1371/journal.pone.0325323
J Bone Joint Surg Am. 2025 Jun 18;107(Suppl 1):4-11. doi: 10.2106/JBJS.24.01244.
ABSTRACT
BACKGROUND: Skin antisepsis remains a vital component in prophylaxis against surgical site infection (SSI); however, for open fractures, it is unclear whether alcohol-based or aqueous solutions should be preferred. The purpose of this study was to compare the use of alcohol-based and aqueous skin antisepsis solutions, using data from the 2 PREP-IT trials, with respect to the risks of SSI and unplanned reoperation following surgery for an open fracture.
METHODS: Individual patient data from the 2 cluster-randomized, crossover clinical trials were combined to create a single data set of patients undergoing surgery for an open fracture. A regression model was used to analyze the effects of an alcohol-based versus an aqueous solution, as well as for potential interaction with the use of chlorhexidine or iodine as the primary agent. The primary outcome was SSI within 90 days.
RESULTS: A total of 3,338 participants undergoing surgery for an open fracture were included in the final analysis, with 1,700 receiving an alcohol-based solution and 1,638 receiving an aqueous solution. Overall, the use of an alcohol-based skin antiseptic solution, compared with an aqueous solution, did not reduce the risk of SSI at 90 days (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.66 to 1.48; p = 0.95), or the risk of unplanned reoperation at 1 year (OR, 0.98; 95% CI, 0.75 to 1.28; p = 0.88). Planned subgroup analyses also found no significant difference in the risk of SSI or unplanned reoperation when participants were stratified by Gustilo-Anderson type, fracture location, or the primary ingredient of the skin preparation solution (chlorhexidine versus iodophor).
CONCLUSIONS: This analysis found no difference in the risk of SSI or reoperation when comparing alcohol-based and aqueous skin preparation solutions. Furthermore, this analysis demonstrated no harm with use of an alcohol-based solution for open fractures, and the PREPARE trial found that skin preparation with 0.7% iodine povacrylex in 74% isopropyl alcohol was associated with a reduced risk of SSI for closed fractures. Given these findings, surgeons may wish to consider streamlining their policy by treating all fractures with a single skin antiseptic, 0.7% iodine povacrylex in 74% isopropyl alcohol.
LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
PMID:40531101 | DOI:10.2106/JBJS.24.01244
Antimicrob Resist Infect Control. 2025 Jun 17;14(1):69. doi: 10.1186/s13756-025-01593-8.
ABSTRACT
BACKGROUND: Unstandardised reprocessing procedures for flexible endoscopes can lead to infection outbreaks and threaten the lives of ICU patients. Despite recent updates to technical specification, there was a paucity of studies on the current status of flexible endoscopic reprocessing, particularly concerning flexible bronchoscopes (FB). This study aimed to assess the current practices of reprocessing FBs in ICUs in Hubei Province, China.
METHODS: A cross-sectional study was conducted utilizing convenience sampling from October 11, 2024, to December 6, 2024, in the ICUs of 216 hospitals in Hubei Province, China. A self-developed questionnaire was distributed through an online survey platform to either the person in charge of the ICU or the frontline technicians. The information regarding the reprocessing of FBs was collected, including general characteristics, personnel and training, layout and facilities, reprocessing operations, and reprocessing quality monitoring.
RESULTS: The content validity index of the questionnaire was 0.94. There were 202 valid questionnaires collected with a validity rate of 93.52%, including 158 ICUs in tertiary hospitals and 44 in secondary and primary hospitals. The ICUs of tertiary hospitals were better than the ICUs of secondary and primary hospitals in terms of the number of FBs available, the number of dedicated technicians, the opportunity for training, the availability of some equipment and facilities (ultrasonic cleaners, whole tube irrigators, etc.), and some reprocessing operations (FB sterilisation method and storage cabinet sterilisation frequency) (P < 0.05).
CONCLUSIONS: There were variations in FB reprocessing practices across ICUs in hospitals of all levels in Hubei, along with some common issues. Most ICUs were standardised in personnel training, operation, and recording, and ICUs in tertiary hospitals behaved better than in secondary and primary hospitals. However, there remained a need for improvement in the layout of the reprocessing environment, equipment configuration, and quality monitoring. Future research could apply implementation science to identify barriers and propose strategies to align practice with guidelines.
PMID:40528274 | PMC:PMC12175463 | DOI:10.1186/s13756-025-01593-8
Wiad Lek. 2025;78(5):1020-1025. doi: 10.36740/WLek/205362.
ABSTRACT
OBJECTIVE: Aim: To investigate the role and prospects of microbial environmental monitoring in a healthcare facility, to evaluate strategies for controlling microbial contamination, to identify the species composition of microorganisms and factors that pose a threat to creating a safe environment in the facility.
PATIENTS AND METHODS: Materials and Methods: A retrospective analysis of microbiological monitoring at a 200-bed healthcare facility (2020-2023) was conducted. Over 15,500 swab samples were collected from high-touch surfaces. Microorganism cultivation followed standard methods, with fungi grown on Sabouraud medium. Procedures complied with DSTU EN ISO 15189:2015 standards. The statistical reliability of relative indicators was calculated using a formula that included the standard error calculation.
RESULTS: Results: Microorganisms were detected in 0.8-1.9% of samples, with 162 positive environmental tests during the observation period. Staphylococcus aureus was the most common pathogen (37±3.5%), followed by Enterococcus spp. (28.4±3.2%) and Escherichia coli (16.1±2.8%). The surgical department showed the highest contamination rate (43.2±3.8%), with medical equipment in treatment rooms accounting for 61.8±3.8% of positive results.
CONCLUSION: Conclusions: The findings confirm that healthcare environments act as reservoirs for pathogens associated with healthcare-associated infections (HAIs). The surgical department exhibited the highest microbial burden, emphasizing the need for stricter infection control in high-risk areas. The predominance of Staphylococcus highlights its role in surgical site infections, with contaminated medical equipment serving as a key transmission factor. Strengthening disinfection protocols and routine monitoring is essential to mitigate microbial contamination risks. The implementation of microbial monitoring in Ukraine depends on national standards. Routine sampling is not mandatory, with most hospitals conducting surface monitoring only during outbreaks, limiting systematic infection control efforts.
PMID:40526653 | DOI:10.36740/WLek/205362
Front Public Health. 2025 May 30;13:1593114. doi: 10.3389/fpubh.2025.1593114. eCollection 2025.
ABSTRACT
BACKGROUND: Disinfectants have been extensively used in public environments since the COVID-19 outbreak to help control the spread of the virus. This study aims to investigate whether disinfectant use influences the structure of bacterial communities and contributes to bacterial resistance to disinfectants and antibiotics.
METHODS: Using molecular biology techniques-including metagenomic sequencing and quantitative PCR (qPCR)-we analyzed the bacterial communities on elevator button surfaces from two tertiary hospitals, one infectious disease hospital, two quarantine hotels (designated for COVID-19 control), and five general hotels in Nanjing, Jiangsu Province, during the COVID-19 pandemic. We focused on detecting disinfectant resistance genes (DRGs), antibiotic resistance genes (ARGs), and mobile genetic elements (MGEs).
RESULTS: Significant differences were observed in the bacterial community structures on elevator button surfaces across the four types of environments. Quarantine hotels, which implemented the most frequent disinfection protocols, exhibited distinct bacterial profiles at the phylum, genus, and species levels. Both α-diversity (within-sample diversity) and β-diversity (between-sample diversity) were lower and more distinct in quarantine hotels compared to the other environments. The abundance of DRGs, ARGs, and MGEs was also significantly higher on elevator button surfaces in quarantine hotels. Notably, antibiotic-resistant bacteria (ARBs), including Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa, were detected in all four settings.
CONCLUSION: The structure of bacterial communities on elevator button surfaces varies across different environments, likely influenced by the frequency of disinfectant use. Increased resistance gene abundance in quarantine hotels suggests that disinfection practices may contribute to the selection and spread of resistant bacteria. Enhanced monitoring of disinfection effectiveness and refinement of protocols in high-risk environments such as hospitals and hotels are essential to limit the spread of resistant pathogens.
PMID:40520307 | PMC:PMC12162647 | DOI:10.3389/fpubh.2025.1593114
Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Jun 6;59(6):933-941. doi: 10.3760/cma.j.cn112150-20241125-00946.
ABSTRACT
Objective: To develop a quality assessment index system for infection prevention and control in integrated medical and elderly care facilities, providing methods for assessing infection control quality and a theoretical basis for enhancing infection prevention and control capabilities. Methods: This study initially constructed a framework for the quality evaluation index system through literature reviews, work specifications and standards and expert interviews. The Delphi method was employed to conduct two rounds of consultations with 19 experts to evaluate the necessity, feasibility, stability, and sensitivity of the indicators. The expert's active coefficient, authority coefficient, degree of consensus, and coordination were statistically analyzed. The indicators were revised based on expert opinions to finalize the evaluation index system. The weights of the evaluation dimensions were determined using the Analytic Hierarchy Process (AHP), while the weights of the indicators were determined using the proportional allocation method. Reliability was assessed via Cronbach's α coefficient, and content validity was verified through the Content Validity Index (CVI). Results: After two rounds of expert consultation, the expert positive coefficient, expert authority coefficient (Cr) and expert coordination coefficient Kendall's W was 100%, 0.992 and 0.634 (P<0.001), indicating high expert authority, good concentration and coordination of opinions. The assessment index system for infection prevention and control quality in integrated medical and elderly care facilities was ultimately constructed, comprising three primary indicators, 18 secondary indicators and 68 tertiary indicators. Among the primary indicators, the process quality had the highest weight of 0.338. Within the process quality, the secondary indicators with the highest weights were infection control material allocation, hand hygiene quality and the management of cluster outbreaks. A total of 11 unique evaluation indicators for integrated medical and elderly care facilities were established, with the highest weighted indicator being the rate of standardized surveillance of infection-related risk factors. Reliability and validity analyses demonstrated that the overall Cronbach's α coefficient of the system was 0.991, and the Scale-level Content Validity Index was 0.936, confirming good reliability and validity. Conclusion: The evaluation index system constructed in this study can serve as an effective assessment tool for the quantitative evaluation of infection control quality in integrated medical and elderly care facilities. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.
PMID:40518427 | DOI:10.3760/cma.j.cn112150-20241125-00946
Microb Biotechnol. 2025 Jun;18(6):e70177. doi: 10.1111/1751-7915.70177.
ABSTRACT
The built environments of high-traffic areas can play a significant role in the transmission of microorganisms and associated infections, sometimes favouring the selection of multidrug-resistant (MDR) organisms due to the excessive use of conventional disinfectants. Probiotic-based sanitation (PBS) was suggested as a novel alternative approach to control the infectious risk in crowded community environments due to its effectiveness in reducing fungal, bacterial, and viral pathogens in sanitary settings. PBS may thus trigger a paradigm shift from chemical to biological strategies in cleaning environments with high human occupancy, offering an ecological and economically sustainable alternative to conventional chemical disinfection. Providing robust data supporting the results reported so far, it has the potential to optimise bioburden control and infection prevention in mass transportation spaces. This review brings together existing research on PBS in mass transportation areas, pinpoints areas of lack of information, and explores its potential future uses, including the creation of probiotic-based materials for sustainable biocontrol in high-traffic areas.
PMID:40515692 | PMC:PMC12166553 | DOI:10.1111/1751-7915.70177
Wounds. 2025 May;37(5):198-209.
ABSTRACT
Burn wounds are insults to the skin that can be caused by various sources, including thermal, electrical, or chemical sources, and even natural sources such as the sun. A burn wound is conventionally categorized into 3 distinct zones: (1) coagulation, (2) ischemia/stasis, and (3) hyperemia. In addition to the potential for physiological scarring, burn wounds can lead to microbial infections, such as pneumonia and methicillin-resistant Staphylococcus aureus, that are difficult to treat using conventional antimicrobial therapy. Patients whose burn wounds trigger a systemic inflammatory response experience further deterioration of their medical condition. Moreover, an increase in the incidence of antibiotic resistance poses a major challenge in the treatment of wounds. Researchers are shifting their focus to newer techniques, such as acellular fish skin, hydrogels, negative pressure wound therapy, nanotherapeutics, and stem cell therapy to counter the disadvantages associated with conventional therapy. This review provides an overview of burn wound causes, classifications, and treatments, and it discusses the healing phases of wounds, possible types of infections, the complexities associated with existing conventional treatments, and the advanced techniques currently used in burn wound management that have proven to reduce hospital stays and make treatment more cost-effective.
PMID:40512682