An evaluation of the efficacy of Aqualox for microbiological control of industrial cooling tower systems

A comprehensive sampling protocol was employed to evaluate the efficacy of Aqualox, a biocide based on electrochemically activated water, against legionellae and heterotrophic bacteria in two industrial cooling tower systems. Both of the towers in the study remained free from evidence of Legionella spp. contamination throughout a five-month evaluation period, despite the previously demonstrated presence of legionellae in one of the test towers, and in two other towers on the same site, at levels well in excess of UK Health and Safety Commission (HSC) Approved Code of Practice and Guidance (ACOP) upper action limits. Levels of heterotrophic bacteria were controlled below 10(4) cfu/mL in both towers throughout most of the trial. Results also provided indirect evidence of significant activity against biofilm bacteria, with biofilm removal beginning almost immediately after commissioning of the Aqualox treatment systems. The results were particularly encouraging as the two towers studied had a long history of poor microbiological control using conventional bromine-based biocide products. Significant differences were observed between laboratory measurements of total viable counts on frequent liquid samples and those obtained from dip slides following HSC recommendations.     

加强临床微生物检验促进医院感染控制

随着医学科学技术的发展,临床微生物检验已日益成为疾病诊断、抗生素合理使用、医院感染控制等非常重要的手段.微生物检验水平直接关系到感染性疾病的诊治水平和医院感染控制水平.然而,国内临床微生物实验室普遍存在仪器设备简陋、检验技术落后、检验速度慢、专职人员少（基层医院细菌室只配备1人,有的还是兼职）等问题,这些现状与当今感染性疾病的严峻形势很不协调.     

某市46所医疗机构医院感染管理专职人员现状

目的 调查某市二级及以上医疗机构医院感染管理部门的设置及其感控专职人员的配备现状。方法 采用问卷调查的方式,于2021年3月对全市46所二级及以上医疗机构的基本情况及其感控专职人员的基本情况进行调查。结果 46所医疗机构均设立医院感染管理部门,73.91%医疗机构感控专职人员的配备符合要求,配备不达标的医疗机构主要是编制床位数高于600张的医疗机构,三级医疗机构的达标率(40.00%)低于二级医疗机构的达标率(78.05%)。87名感控专职人员的年龄主要集中在40～50岁,从事医院感染管理的工作年限主要集中在1～5年,主要为本科学历,中级职称,护理专业,二级和三级医院感控专职人员在专业方面的差异具有统计学意义。结论 整体上该市医院感染管理部门的设置及其感控专职人员的配备量较合理,但高学历感控专职人员匮乏,专业结构单一,人员流动性较大,有待进一步优化。     

电力企业灭鼠技术及效果观察

目的为电力企业的灭鼠探索有效控制方法与技术。方法采用敌鼠钠盐稻谷毒饵饱和投药和生态防制相结合的方法。结果灭前鼠密度为:夹夜法14.64%,粉迹法49.46%;灭后鼠密度为:夹夜法0%,密度下降100%;粉迹法0.47%,密度下降99.05%,且鼠密度长时间保持在较低水平。结论0.03%敌鼠钠盐稻谷毒饵与生态防制相结合的综合方法可收到明显而持久的灭鼠效果。     

感染控制的经济评价

随着医疗费用的不断提高，决策在进行卫生保健决策时，对临床有效性和经济效益的依赖越来越大。有充分的理由进行经济学分析：在资源不足的情况下，对如何使用这些资源的问题，必须做出选择。     

医院感染管理专职人员专业胜任力评价体系的构建

目的 构建医院感染管理专职人员专业胜任力量化评价体系,通过科学评价为专职人员培养提供科学依据。方法 利用文献资料和经验总结构建评价要点,通过专家咨询法筛选评价要点并计算评价要点的权重系数,由专家组为各评估要点设计等级化的评价内容选项并赋予分值。每项评价要点得分与权重的乘积即为此要点得分,所有评价要点得分合计计算被评价者总得分。结果 评价体系包括“基础条件”“医院感染识别能力”“医院感染监测能力”“医院感染防控技术应用能力”,“应急处置能力”“组织协调能力”“质量改进能力”“教育培训能力”和“感染防控专业科研能力”共9个维度,25项评价要点,每项评价要点包含3项等级量化评分内容。专家问卷咨询的内部一致性信度Cronbach’s α系数为0.873,总内容效度指数(S-CVI)为0.868,条目内容效度(I-CVI)范围为0.71～1。结论 本研究构建的量化评价体系信度、效度结果满足要求,评价体系科学可行,用于医院感染管理专职人员专业胜任力的科学评价,可以有效识别能力短板,确定培养方向和重点,为医疗机构医院感染管理专职人员的人才培养和梯队建设提供科学依据,促进医院高质量发展。     

Use and efficacy of tuberculosis infection control practices at hospitals with previous outbreaks of multidrug-resistant tuberculosis.

OBJECTIVE: To evaluate the implementation and efficacy of selected Centers for Disease Control and Prevention guidelines for preventing spread of Mycobacterium tuberculosis. DESIGN: Analysis of prospective observational data. SETTING: Two medical centers where outbreaks of multidrug-resistant tuberculosis (TB) had occurred. PARTICIPANTS: All hospital inpatients who had active TB or who were placed in TB isolation and healthcare workers who were assigned to selected wards on which TB patients were treated. METHODS: During 1995 to 1997, study personnel prospectively recorded information on patients who had TB or were in TB isolation, performed observations of TB isolation rooms, and recorded tuberculin skin-test results of healthcare workers. Genetic typing of M tuberculosis isolates was performed by restriction fragment-length polymorphism analysis. RESULTS: We found that only 8.6% of patients placed in TB isolation proved to have TB; yet, 19% of patients with pulmonary TB were not isolated on the first day of hospital admission. Specimens were ordered for acid-fast bacillus smear and results received promptly, and most TB isolation rooms were under negative pressure. Among persons entering TB isolation rooms, 44.2% to 97.1% used an appropriate (particulate, high-efficiency particulate air or N95) respirator, depending on the hospital and year; others entering the rooms used a surgical mask or nothing. We did not find evidence of transmission of TB among healthcare workers (based on tuberculin skin-test results) or patients (based on epidemiological investigation and genetic typing). CONCLUSIONS: We found problems in implementation of some TB infection control measures, but no evidence of healthcare-associated transmission, possibly in part because of limitations in the number of patients and workers studied. Similar evaluations should be performed at hospitals treating TB patients to find inadequacies and guide improvements in infection control.     

Rates of surgical-site infection: an international comparison.

OBJECTIVES: To quantify the occurrence of surgical-site infections (SSIs) in an Italian region and to estimate the proportion of potentially avoidable infections through benchmarking comparison. DESIGN: Prospective study during 1 month based on a convenience sample of surgical patients admitted to 31 public hospitals. All of the patients undergoing an intervention included among the 44 operative procedures of the National Nosocomial Infections Surveillance (NNIS) System were enrolled. Ninety-five percent of the patients were actively observed after discharge for up to 30 days for all of the operations and for up to 1 year for operations involving implantation. RESULTS: Among the 6,167 operative procedures studied, 290 infections were recorded (4.7 per 100 procedures), 206 (71%) of which were SSIs (3.3 per 100 procedures; 95% confidence interval, 2.9-3.9). One hundred thirty-five SSIs (65.5%) were superficial infections, 53 (25.7%) were deep infections, and 12 (5.8%) were organ-space infections; in 6 cases (2.9%), the type of SSI was not recorded. The frequency of SSIs observed in this study was significantly higher for several procedures than that expected when the NNIS System rates (standardized infection ratio [SIR] ranging from 1.77 to 6.42) or the Hungarian rates (SIR ranging from 1.28 to 3.04) were applied to the study population. CONCLUSIONS: The high intensity of postdischarge surveillance can in part explain the differences observed. To allow for meaningful benchmarking comparison, in addition to intrinsic patient risk, data on the intensity of postdischarge surveillance should be included in published reports.     

Collaboration between infection control and occupational health in three continents: a success story with international impact

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work.The products developed have been widely heralded as innovative and interactive, leading to their inclusion into "toolkits" used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.     

Shaping the new generation of microbiological food safety professionals: Attitudes,education and training

The development of proactive risk management approaches in pursuit of microbiologically safe food is a direct consequence of the ineffectiveness of traditional retrospective strategies. This review catalogues some of the more important observations and insights which have brought about such a change in strategy. By any interpretation the reaction of the scientific community to change has been, in some quarters, as trenchant as it is unwarranted. The anatomy of this opposition and the psychological determinants underpinning it are examined and challenged. The need for an amended perception of the role of monitoring and of microbiological standards in the validation of proactive risk management is explored. Particular attention is given to the importance of accurate analytical methods and to the advantages which derive from the adoption of microbiological reference ranges as opposed to single numerical limits. The need to assess attainable ranges with reference to the intrinsic characteristics of the food under consideration and its mode of transport and distribution is also highlighted. Implications of the change in strategy aimed at consumer protection for education and training of food safety professionals with particular reference to food microbiologists, are considered.     

军队小规模医院医院感染管理专职人员职业危害因素与对策

目的探讨军队小规模医院医院感染管理专职人员的职业危害因素。方法分析某军队医院医院感染管理专职人员的职业危害因素并采取相应的防护措施。结果医院感染管理专职人员工作面广,容易遭受各种职业危害,如心理压力大（专业跨度大、工作负荷重、成就感低等）、物理因素伤害（接触紫外线、臭氧、酒精灯,有灼伤和烧伤风险）、化学因素伤害（接触化学消毒剂等）以及生物性因素伤害（污水、污物的病原菌及接触特殊感染和传染病患者的潜在威胁）。结论应从改善专职人员工作环境、增加医院感染管理经费、配备必要的防护设施及采取积极有效的防护措施入手,提高医院感染管理专职人员职业安全保障。     

Women in chronic pain: sense of control and encounters with health professionals

An evolving theory on "women's sense of control while in chronic pain and the results of the quality of their encounters with health professionals" is introduced in this article. According to the theory, the main challenge of women in chronic pain is to maintain a sense of control of self and the pain to avoid demoralization, which is seen as a potential threat for all women in chronic pain. To retain a sense of control, women are challenged to learn to live with the pain and cope with the unpredictability and incurability of the pain. They are challenged to find meaning in their suffering, to create personal space, and to be self-protective as well as to keep a positive self-image and self-esteem while trying to live a "normal" life in dignity in spite of the pain and warding off isolation and demoralization. Health professionals are seen as potentially powerful people in the lives of women in chronic pain. Empowerment or disempowerment from them greatly influences whether women in chronic pain are demoralized or not.     

Fibre-optic sigmoidoscopy compared with the Kato technique in diagnosis and evaluation of the intensity of Schistosoma mansoni infection.

450 patients in Riyadh, Saudi Arabia, complaining of chronic abdominal pain and, coming from different countries endemic for schistosomiasis, were examined endoscopically using fibre-optic colono- or sigmoidoscopes, and rectal biopsies were examined for Schistosoma mansoni ova. After a preliminary study showed that more than 6 biopsies did not increase the positivity rate, 6 biopsies were taken from the rectum and examined by transparency technique. 280 were positive for S. mansoni, 9 of them having in addition S. haematobium. 4 patients had polyps in the sigmoid colon and rectum. When these positive cases were examined using duplicate 50 mg Kato smears, only 160 (57.1%) were positive. There was a highly positive correlation between the intensity of infection as graded by the 2 techniques. We recommend examination of 6 rectal biopsies using fibre-optic sigmoidoscopy when available in small communities with a patchy distribution of schistosomiasis like Saudi Arabia. The method could also be used to exclude schistosomiasis in persons who have moved from rural to urban or non-endemic areas and are unlikely to be re-exposed to infection.     

An evaluation of satisfaction with telemedicine among health-care professionals

A survey was conducted among non-doctor health-care professionals in six rural counties in Missouri. The purpose of the survey was to establish baseline data to evaluate the effect of changes in the health-care sector, especially technology changes, on the job satisfaction, career satisfaction, relationships and communication activities of health professionals. The survey included three rural counties in which integrated telecommunication and interactive video telemedicine services were being installed, but before significant activities had begun, and three comparator counties without substantial integrated telecommunications infrastructure and telemedicine services. During a one-month study period, 1108 questionnaires were distributed. The total response rate was 50.1% (n = 555). Of the respondents, 30.3% indicated that technology in health-care was having a large effect on their work, although only 18.2% indicated that telemedicine and telecommunications were having a large effect. No systematic differences were found among the health professionals in the two communities at the time telemedicine equipment was being installed.     

An audit of the use of manual handling equipment and their microbiological flora--implications for infection control

A review of the use of manual handling aids in two hospitals found equipment was employed on a multi-patient basis with inadequate cleaning. Sampling with a Casella slit sampler demonstrated frequent contamination by methicillin-resistant Staphylococcus aureus and Clostridium difficile of fabric aids. Recommendations for care of equipment are made.