# pos

id: cord-278618-7tu5c7m1
pos: NNP
token:
  https://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implicationsfor-ipc-precaution-recommendations

lemma:
  https://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implicationsfor-ipc-precaution-recommendations


# ent

id: cord-275696-xag08e8h
type: CHEMICAL
entity:
  R E E N I N G T O O L C L I N I C A L N O T E S A N D A C O D E B L U E R E S U S R E C O R D I N A P L A S T I C C O V E R 1 L N S I V A N D B L O O D W O R


id: cord-263016-28znb322
type: DISEASE
entity:
  influenza A B parainfluenza 1e4 RSV A B human metapneumovirus enterovirus rhinovirus adenovirus human bocavirus


id: cord-267132-nb0j6k3h
type: ORG
entity:
  Healthcare Infection Control Practices Advisory Committee Society for Healthcare Epidemiology of America Association for Professionals in Infection Control Infectious Diseases Society of America Hand Hygiene Task Force Guideline


id: cord-267132-nb0j6k3h
type: WORK_OF_ART
entity:
  Prolonged Antimicrobial Activity of a Catheter Containing Chlorhexidine Silver Sulfadiazine Extends Protection against Catheter Infections


id: cord-265820-xfq2s412
type: DISEASE
entity:
  respiratory viruses influenza B virus respiratory syncytial virus parainfluenza virus types 1 2 and 3 and adenovirus and reverse transcriptionepolymerase chain reaction RT


id: cord-269408-6qncy0nd
type: PROTEIN
entity:
  HA COVID 19 and late indeterminate cases If an index case patient was found in the same ward as a HA COVID 19 case


id: cord-269408-6qncy0nd
type: PROTEIN
entity:
  HA COVID 19 and late indeterminate infections could be traced back to cases where the acquisition was


id: cord-274368-s1h3p5s9
type: ORG
entity:
  World Health Organisation Department of Communicable Disease Surveillance and Response Prevention of hospital


id: cord-288483-y9fyslgo
type: ORG
entity:
  Disease Control and Prevention Interim Infection Prevention and Control Recommendations for Patients with Suspected


id: cord-288483-y9fyslgo
type: ORG
entity:
  Recent Public Health Emergency Responses Health Secur Hospital Preparedness for Severe Acute Respiratory Syndrome


id: cord-288483-y9fyslgo
type: ORG
entity:
  Centers for Disease Control and Prevention Strategies for Optimizing the Supply of Facemasks Sourcing Personal Protective Equipment


id: cord-314449-ukqux772
type: PROTEIN
entity:
  staphylococci Corynbacterium diphtheriae Neisseria meningitidis Bordetella pertussis Acinetobacter and Pseudomonas 15e20 A mouse study


id: cord-314963-sk8pqjrh
type: CHEBI
entity:
  hydrogen peroxide 7 9 11 19 20 and liquid protocols e g hydrogen peroxide sodium hypochlorite 7 9 11 12 13 18 19 21 22 The CDC recently released crisis standards of care decontamination recommendations


id: cord-314963-sk8pqjrh
type: ORG
entity:
  Surgical Facemask Decontamination and Reuse A Scoping Review Protocol Aerosolized Hydrogen Peroxide Decontamination


id: cord-314963-sk8pqjrh
type: LAW
entity:
  the COVID 19 Pandemic An Efficient Ethanol Vacuum Method for the Decontamination and Restoration of Polypropylene Microfiber Medical Masks Respirators Analysis


id: cord-314963-sk8pqjrh
type: ORG
entity:
  a High Level Disinfection Cabinet for Decontamination of N95 Respirators Effects of Sterilization With Hydrogen Peroxide and Chlorine Dioxide


id: cord-290305-8u2zxsam
type: ORG
entity:
  the Australian National Hand Hygiene Initiative National Program for Prevention of Healthcare Associated Infections and Antimicrobial Resistance


id: cord-311012-wyglrpqh
type: ORG
entity:
  Effective Virucidal Activity of Povidone Iodine Products Against Middle East Respiratory Syndrome Coronavirus MERS CoV


id: cord-311012-wyglrpqh
type: ORG
entity:
  Virucidal Activity of World Health Organization Recommended Formulations Against Enveloped Viruses Including


id: cord-336259-gtb8ictv
type: ORG
entity:
  an Influenza Pandemic Hospital Acceptance Study of Filtering Facepiece Respirator Decontamination Using Ultraviolet Germicidal Irradiation Disinfection


id: cord-320454-dhfl92et
type: ORG
entity:
  the National Nosocomial Infections Surveillance System NNIS of the Centers for Disease Control and Prevention CDC USA


id: cord-303966-z6u3d2ec
type: ORG
entity:
  the Commission on International Development Achieving the Millennium Development Goals Report of a WHO International Study Team Ebola


id: cord-347351-emdj66vj
type: ORG
entity:
  First Global Patient Safety Challenge Clean Care is Safer Care Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2


# url

id: cord-278618-7tu5c7m1
domain: www.who.int
url:
  http://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implicationsfor-ipc-precaution-recommendations


# bib

id: cord-007545-oguse5gt
title: The effectiveness of training and taste testing when using respirator masks
author: Kelly, L.
date: 2004-10-01
txt: ./txt/cord-007545-oguse5gt.txt
cache: ./cache/cord-007545-oguse5gt.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118845/
doi: 10.1016/j.jhin.2004.07.009
abstract: nan
summary:
  title: The effectiveness of training and taste testing when using respirator masks The nursing staff swirl screening swabs from various sites into a single SMB that is labelled with the patient''s identification details. We conclude that swirling of screening swabs directly into SMB is a sensitive, cost-effective and convenient method to screen for ciprofloxacinresistant MRSA in hospitals. The effectiveness of training and taste testing when using respirator masks Using the test hoods, we also looked at staff in the accident and emergency department and the intensive care unit who had not received any formal training in mask fitting but who were expected to follow the manufacturer''s instructions. We have changed our practice and now recommend that staff working in high-risk areas receive training on mask fitting at induction and pass a fit test. Briefly, since January 2004, laboratories have been asked to test all diarrhoeal specimens from patients aged 65 years and over for C.


id: cord-007554-1nz6wdlo
title: Laboratory evaluation of selective mannitol broth for MRSA screening
author: Kelly, S.
date: 2004-10-01
txt: ./txt/cord-007554-1nz6wdlo.txt
cache: ./cache/cord-007554-1nz6wdlo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118990/
doi: 10.1016/j.jhin.2004.07.012
abstract: nan
summary:
  title: Laboratory evaluation of selective mannitol broth for MRSA screening Laboratory evaluation of selective mannitol broth for MRSA screening Screening for methicillin-resistant Staphylococcus aureus (MRSA) carriage in patients admitted to hospital features prominently in strategies for control of MRSA. 5 This letter describes our evaluation and use of a recently described selective mannitol broth (SMB) for rapid ciprofloxacin-resistant MRSA screening. Ten-fold serial dilutions (range 10 K1 -10 K8 ) of an overnight broth culture of MRSA (NCTC 13143, ciprofloxacin resistant) were made. Material and labour costs of screening using the conventional method of salt broth enrichment followed by subculture were compared with those using SMB. Our results show that SMB can detect 1-2 cfu/mL of MRSA (Table I) and that it has a shelf life of three We conclude that swirling of screening swabs directly into SMB is a sensitive, cost-effective and convenient method to screen for ciprofloxacinresistant MRSA in hospitals.


id: cord-010154-99j5t7ha
title: Seasonal respiratory virus testing in management of adult cystic fibrosis patients
author: Gohil, S.
date: 2019-07-04
txt: ./txt/cord-010154-99j5t7ha.txt
cache: ./cache/cord-010154-99j5t7ha.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172063/
doi: 10.1016/j.jhin.2019.07.001
abstract: nan
summary:
  Sir, Testing for respiratory virus infections (RVIs) is performed less frequently in patients with cystic fibrosis (CF), although they are known to contribute to bacterial infections and exacerbations by various mechanisms [1e3] . This prompted a PDSA (Plan, Do, Study, Act) quality service improvement evaluation to assess the utility of routine respiratory virus testing in the management of adult CF patients during a respiratory exacerbation. This had several aims, including: earlier RVI detection, early targeted antiviral treatment (for influenza alone), checking vaccination history and correlation with the test result (for influenza alone), and exploring the possible role of occupation in the exposure and acquisition of RVIs. Routine screening for seasonal RVIs for all adult CF patients took place between November 2017 and April 2018. Following this service evaluation (PDSA Cycle 1), routine RVI testing is now being considered for all adult CF patients presenting with an exacerbation during the annual influenza season.


id: cord-034481-zi9q96lj
title: Stability of SARS-CoV-2 on environmental surfaces and in human excreta
author: Liu, Yongjian
date: 2020-11-01
txt: ./txt/cord-034481-zi9q96lj.txt
cache: ./cache/cord-034481-zi9q96lj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603996/
doi: 10.1016/j.jhin.2020.10.021
abstract: nan
summary:
  Although close exposure to respiratory droplets from an infected patient is the main transmission route of SARS-CoV-2, touching contaminated surfaces and objects might also contribute to transmission of this virus. Here, we provide a report of our study of the stability of SARS-CoV-2 on various environmental surfaces and in human excreta (feces and urine). SARS-CoV-2 was more stable in urine than in feces, and infectious virus was detected up to 3 days in two adult urine and 4 days in one child urine. Prior to our study, two research teams had just reported the stability of SARS-CoV-2 on different material surfaces [4, 5] . In comparison with the above two studies, our data displayed a prolonged survival time of this virus on environmental surfaces. In Chin''s study, a five microliters of virus stock with the infectious titer of 10 6.8 TCID 50 /ml was deposited on the surface.


id: cord-252730-ihpden9q
title: Observations on disinfectant performance
author: Glasbey, T.
date: 2020-04-28
txt: ./txt/cord-252730-ihpden9q.txt
cache: ./cache/cord-252730-ihpden9q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.04.034
doi: 10.1016/j.jhin.2020.04.034
abstract: nan
summary:
  In the recent review article ''Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents'' [1] , the authors claim that "data obtained with benzalkonium chloride at reasonable contact times were conflicting. In that paper [2] , a disinfectant solution having an active ingredient concentration of 0.2% appeared to show no efficacy against the enveloped human coronavirus, whereas it showed remarkable activity (>5.12 log reduction) against a non-enveloped coxsackie virus. A second study cited by the authors, this time dating from 1998, showed a >3.7 log reduction of coronavirus in 10 minutes, used a 0.05% solution of a pharmacopeial grade of benzalkonium chloride (i.e. not a formulated disinfectant product) [3] . In another paper cited by the authors, a more contemporary formulated benzalkonium chloride disinfectant, when tested at a 0.5% concentration, gave a >6.13 log reduction of coronavirus in 30 minutes in both clean and dirty conditions [4] .


id: cord-256135-v75qvb1i
author: Persoon, Ilona F.
date: 2020-07-30
txt: ./txt/cord-256135-v75qvb1i.txt
cache: ./cache/cord-256135-v75qvb1i.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120303583
doi: 10.1016/j.jhin.2020.07.027
abstract: nan
summary:
  authors: Persoon, Ilona F.; Stankiewicz, Nikolai; Smith, Andrew; de Soet, Hans (J.J.); Volgenant, Catherine M.C. title: A review of respiratory protection measures recommended in Europe for dental procedures during the COVID-19 pandemic During the COVID-19 pandemic period, the World Health Organisation (WHO) recommends wearing respiratory protection when undertaking aerosol generating procedures (AGP) to reduce the risks of cross-infection between patients and healthcare worker (HCW) and vice versa 2 . When patients do not show symptoms of COVID-19, 54% of countries recommend respiratory protection FFP2 / FFP3 when performing AGP. A considerable number of countries also recommend respiratory protection FFP2 / FFP3 when performing non AGPs, both in patients with (63%) and without symptoms of COVID-19 (33%). However, the effectiveness of these respirators to prevent transmission of pathogens highly depends on proper fit and use of the equipment 9 In conclusion, the recommendations on respiratory protection when undertaking dental healthcare in European countries vary considerably.

title:
  A review of respiratory protection measures recommended in Europe for dental procedures during the COVID-19 pandemic


id: cord-256705-gexh2wtd
title: COVID-19: how prepared are front-line healthcare workers in England?
author: Prescott, K.
date: 2020-04-24
txt: ./txt/cord-256705-gexh2wtd.txt
cache: ./cache/cord-256705-gexh2wtd.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120302061
doi: 10.1016/j.jhin.2020.04.031
summary:
  In view of this, a cross-sectional survey of front-line healthcare workers (HCWs) at two large acute NHS hospital trusts in England was undertaken to assess their confidence and perceived level of preparedness for the virus. As such we carried out an online cross sectional questionnaire based survey of front line HCW at two large acute NHS hospital Trusts in England to ascertain how prepared they felt to manage COVID-19. We designed an online cross-sectional questionnaire-based survey using Online Surveys (formerly BOS) to ascertain how confident and prepared front line HCW felt in managing potential COVID-19 cases. At the time the survey went live work in both hospital Trusts had already begun to prepare front line HCW for COVID-19. As the threat of COVID-19 grows, we wanted to assess how confident our front line HCW felt to manage possible cases.

abstract:
  National efforts are underway to prepare the UK National Health Service (NHS) for the COVID-19 pandemic; however, the efficacy of these interventions is unknown. In view of this, a cross-sectional survey of front-line healthcare workers (HCWs) at two large acute NHS hospital trusts in England was undertaken to assess their confidence and perceived level of preparedness for the virus. The survey found that there has been moderate success in readying HCWs to manage COVID-19, but that more still needs to be done, particularly in relation to educating HCWs about laboratory diagnostics.


id: cord-257468-woyycghi
title: Transmission of infection from non-isolated patients with COVID-19 to health care workers
author: Basso, Trude
date: 2020-08-20
txt: ./txt/cord-257468-woyycghi.txt
cache: ./cache/cord-257468-woyycghi.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120304023
doi: 10.1016/j.jhin.2020.08.015
summary:
  This study evaluated transmission of infection from a symptomatic patient with COVID-19 to 60 HCWs exposed ≤2 m for ≥15 minutes, or during aerosol generating procedures. Following ≥106 unique high-risk contacts, none of the HCWs tested positive for SARS-CoV-2 RNA or had developed antibodies. These results were in accordance with other reports and should reassure HCWs and further stimulate a broader evaluation of the foundation for the current practice of home-quarantine of non-symptomatic HCWs. During the Coronavirus Disease-19 (COVID-19) pandemic, the proportion of health care workers (HCWs) amongst verified, infected individuals, has been reported somewhere between 10 and 20 % [1, 2] . In this study we found that ≥106 unique close contact exposures, including 12 contacts during AGPs with a nonisolated patient with COVID-19, resulted in no SARS-CoV-2 transmissions from patient to HCWs. With one exception, all included HCWs were certain or quite certain that their adherence to the hand hygiene procedure had been proper at the time of exposure.

abstract:
  Insufficiently protected health care workers (HCWs) defined as high-risk contacts of patients with COVID-19 are routinely quarantined. This study evaluated transmission of infection from a symptomatic patient with COVID-19 to 60 HCWs exposed ≤2 m for ≥15 minutes, or during aerosol generating procedures. Following ≥106 unique high-risk contacts, none of the HCWs tested positive for SARS-CoV-2 RNA or had developed antibodies. The HCWs reported adherence to basic infection control procedures. These results were in accordance with other reports and should reassure HCWs and further stimulate a broader evaluation of the foundation for the current practice of home-quarantine of non-symptomatic HCWs.


id: cord-259855-7sn2coni
author: Singh, Rajinder Pal
date: 2020-10-03
txt: ./txt/cord-259855-7sn2coni.txt
cache: ./cache/cord-259855-7sn2coni.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019567012030459X?v=s5
doi: 10.1016/j.jhin.2020.09.034
summary:
  Tight-fitting FFP3 facemasks are ideal respiratory protective equipment during aerosol generating procedures in Covid-19 environment, and require a Fit Test (FT) to assess mask-face seal competency. Tight-fitting respirator facemasks such as N95 or FFP3 masks are considered to be the gold standard respiratory protective equipment (RPE) for healthcare workers (HCW) working in aerosol generating procedure (AGP) environments 1 involving Covid-19. The purpose of the study is to describe an innovative potential solution called ''Singh Thattha'' technique, where we have used an under-mask beard cover to overcome the facial hair factor for wearing a respirator mask in bearded individuals. A. Singh Thattha technique was adopted by 27 male bearded Sikh dentists in the UK who subjected themselves to Bitrex QFT conducted by certified fit testers to existing industry standards set by British Safety Industry Federation. Tight-fitting respirator masks, which depend on a seal of the mask with the wearer''s face, are considered as ideal protective RPE for HCWs working in AGP environment involving Covid-19.

title:
  Bearded individuals can use an under-mask beard cover ‘Singh Thattha’ for donning respirator masks in Covid-19 patient care

abstract:
  Tight-fitting FFP3 facemasks are ideal respiratory protective equipment during aerosol generating procedures in Covid-19 environment, and require a Fit Test (FT) to assess mask-face seal competency. Facial hair is considered to be an impediment for achieving a competent seal. We are describing an under-mask beard cover called Singh Thattha technique which obtained a pass rate of 25/27 (92.6%) by qualitative and 5/5 (100%) by quantitative FT in full-bearded individuals. Sturdier versions of FFP3 were more effective. Individuals for whom shaving is not possible, the Singh Thattha technique could offer an effective solution to safely don respirator masks.


id: cord-260024-yrhlg6wm
title: A lesson learned from the MERS outbreak in South Korea in 2015
author: Ha, Kyoo-Man
date: 2015-10-24
txt: ./txt/cord-260024-yrhlg6wm.txt
cache: ./cache/cord-260024-yrhlg6wm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26601605/
doi: 10.1016/j.jhin.2015.10.004
abstract: nan
summary:
  The Korea Centers for Disease Control and Prevention (KCDC) under the Ministry of Health and Welfare (MW) insisted on not sharing MERS information from the hospitals with the public at the initial stage of the outbreak under the pretext of hospital protection, although in reality this decision may have been based on nepotism. Considering that the MERS outbreak was not only a health issue but also an emergency management issue, the model for controlling similar epidemics or pandemics in the future-oriented model should involve all stakeholders in an early and co-ordinated response. Although many stakeholders tried to play their own roles during the MERS outbreak in Korea, their responses were somewhat late and unco-ordinated, and thus contributed to the national crisis. The key tenet is that Korea must not consider the MERS outbreak to be a hospital infection control issue.


id: cord-262027-z90wujlo
author: Cheng, V.C.C.
date: 2020-04-08
txt: ./txt/cord-262027-z90wujlo.txt
cache: ./cache/cord-262027-z90wujlo.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019567012030178X
doi: 10.1016/j.jhin.2020.04.003
abstract: nan
summary:
  title: Disinfection of N95 respirators by ionized hydrogen peroxide during pandemic coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 Letter to the Editor Disinfection of N95 respirators by ionized hydrogen peroxide during pandemic coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 has been spreading globally, and the World Health Organization declared a pandemic on 11 th March 2020 [1] . Therefore, we attempted to disinfect N95 respirators using SteraMist Binary Ionization Technology solution delivered through a SteraMist Surface Unit, registered with the US Environmental Protection Agency [5] . N95 respirators inoculated with influenza A virus without disinfection were used as the positive control. Reuse of N95 respirators has been proposed by CDC [4] , but this carries a risk of contamination and infection of HCWs. Disinfection of N95 respirators may provide an alternative option. Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong

title:
  Disinfection of N95 respirators by ionized hydrogen peroxide during pandemic coronavirus disease 2019 (COVID-19) due to SARS-CoV-2


id: cord-263016-28znb322
title: Middle East respiratory syndrome coronavirus (MERS-CoV): what lessons can we learn?
author: Omrani, A.S.
date: 2015-08-22
txt: ./txt/cord-263016-28znb322.txt
cache: ./cache/cord-263016-28znb322.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26452615/
doi: 10.1016/j.jhin.2015.08.002
summary:
  Infection prevention/control and management guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection Infection prevention and control guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection Revised interim case definition for reporting to WHO e Middle East respiratory syndrome coronavirus (MERS-CoV) Revised interim case definition for reporting to WHO e Middle East respiratory syndrome coronavirus (MERS-CoV) Investigation of cases of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV); interim guidance updated 3 Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia Investigation of an imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in

abstract:
  The Middle East Respiratory Coronavirus (MERS-CoV) was first isolated from a patient who died with severe pneumonia in June 2012. As of 19 June 2015, a total of 1,338 MERS-CoV infections have been notified to the World Health Organization (WHO). Clinical illness associated with MERS-CoV ranges from mild upper respiratory symptoms to rapidly progressive pneumonia and multi-organ failure. A significant proportion of patients present with non-respiratory symptoms such as headache, myalgia, vomiting and diarrhoea. A few potential therapeutic agents have been identified but none have been conclusively shown to be clinically effective. Human to human transmission is well documented, but the epidemic potential of MERS-CoV remains limited at present. Healthcare-associated clusters of MERS-CoV have been responsible for the majority of reported cases. The largest outbreaks have been driven by delayed diagnosis, overcrowding and poor infection control practices. However, chains of MERS-CoV transmission can be readily interrupted with implementation of appropriate control measures. As with any emerging infectious disease, guidelines for MERS-CoV case identification and surveillance evolved as new data became available. Sound clinical judgment is required to identify unusual presentations and trigger appropriate control precautions. Evidence from multiple sources implicates dromedary camels as natural hosts of MERS-CoV. Camel to human transmission has been demonstrated, but the exact mechanism of infection remains uncertain. The ubiquitously available social media have facilitated communication and networking amongst healthcare professionals and eventually proved to be important channels for presenting the public with factual material, timely updates and relevant advice.


id: cord-264057-z5arb1k5
author: Goel, S.
date: 2007-05-18
txt: ./txt/cord-264057-z5arb1k5.txt
cache: ./cache/cord-264057-z5arb1k5.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019567010700062X
doi: 10.1016/j.jhin.2007.02.015
summary:
  This short-term observational study of infection control practice was performed in the medical emergency outpatient department (EMOPD) of a tertiary-care hospital in India when threatened by an outbreak of severe acute respiratory syndrome (SARS). Infection control measures such as fumigation and cleaning were noted, as was the EMOPD laboratory function, use of personnel protection and display of information on infectious diseases. The EMOPDs in key hospitals need be able to screen for infectious diseases, especially in view of the threats from SARS and Avian influenza. The need to screen all patients with suspected infectious disease in the medical emergency outpatient department (EMOPD), and for control and prevention of infection, was recognized. In addition, the patient/attendant load, patient flow, and medical staff practice were observed, and information displayed on SARS or other infectious diseases was noted.

title:
  Preparations and limitations for prevention of severe acute respiratory syndrome in a tertiary care centre of India

abstract:
  This short-term observational study of infection control practice was performed in the medical emergency outpatient department (EMOPD) of a tertiary-care hospital in India when threatened by an outbreak of severe acute respiratory syndrome (SARS). An investigator attended the lobby daily to screen patients with symptoms for SARS. Patient/attendant load, patient flow, medical staff working practices and position in the EMOPD were observed. Infection control measures such as fumigation and cleaning were noted, as was the EMOPD laboratory function, use of personnel protection and display of information on infectious diseases. A total of 162 (7.4%) of the 2165 patients surveyed had respiratory symptoms but no cases of SARS were found. The flow of patients and their attendants was not systematic. No laboratory tests for SARS were available, and no educational material on SARS was displayed. The EMOPDs in key hospitals need be able to screen for infectious diseases, especially in view of the threats from SARS and Avian influenza.


id: cord-265820-xfq2s412
author: Cheng, V.C.C.
date: 2010-01-12
txt: ./txt/cord-265820-xfq2s412.txt
cache: ./cache/cord-265820-xfq2s412.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670109004034
doi: 10.1016/j.jhin.2009.09.009
summary:
  Not wearing a surgical mask either by the exposed persons during contact with the index cases (4/4 vs 264/832, P = 0.010) or vice versa (4/4 vs 300/832, P = 0.017, Fisher''s exact test) were found to be significant risk factors for nosocomial acquisition of S-OIV. This included repeated open staff forum achieving high attendance; early recognition of index cases among inpatients by liberal testing; early relief of sick staff from work; directly observed hand hygiene practice during outbreaks; and monitoring of compliance with infection control practice. Not wearing surgical mask by the exposed persons during contact with the index cases (4/4 vs 264/832, P ¼ 0.010) or vice versa (4/4 vs 300/832, P ¼ 0.017, Fisher''s exact test) was found to be a significant risk factor for nosocomial infection of S-OIV (Table I) .

title:
  Prevention of nosocomial transmission of swine-origin pandemic influenza virus A/H1N1 by infection control bundle

abstract:
  After the outbreak of severe acute respiratory syndrome in Hong Kong, the importance of preventing nosocomial transmission of respiratory viruses has become a top priority in infection control. During the containment and early mitigation phases of the swine-origin influenza virus (S-OIV) A H1N1 pandemic, an infection control bundle consisting of multiple coherent measures was organised by our infection control team to minimise nosocomial transmission. This included repeated open staff forum achieving high attendance; early recognition of index cases among inpatients by liberal testing; early relief of sick staff from work; directly observed hand hygiene practice during outbreaks; and monitoring of compliance with infection control practice. During the first 100 days (from 1 May to 8 August 2009) when the first 100 laboratory-confirmed patients with S-OIV and 12 infected healthcare workers (HCWs) were identified, a total of 836 asymptomatic exposed persons (184 patients and 652 HCWs) were required to undergo a seven-day medical surveillance. The infection control nurses monitored them for the onset of symptoms. Four (0.48%) exposed persons (one house officer, two non-clinical staff, and one patient) were virologically confirmed with S-OIV. Not wearing a surgical mask either by the exposed persons during contact with the index cases (4/4 vs 264/832, P = 0.010) or vice versa (4/4 vs 300/832, P = 0.017, Fisher's exact test) were found to be significant risk factors for nosocomial acquisition of S-OIV.


id: cord-266977-5swwc6kr
author: Secker, Thomas.J.
date: 2020-09-19
txt: ./txt/cord-266977-5swwc6kr.txt
cache: ./cache/cord-266977-5swwc6kr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32956784/
doi: 10.1016/j.jhin.2020.09.021
summary:
  authors: Secker, Thomas.J.; Leighton, Timothy.G.; Offin, Douglas.G.; Birkin, Peter.R.; Hervé, Rodolphe.C.; Keevil, Charles.W. title: Journal of Hospital Infection A cold water, ultrasonic activated stream efficiently removes proteins and prion-associated amyloid from surgical stainless steel Aim: To test the efficacy of an ultrasonically activated stream for the removal of tissue 27 proteins, including prion-associated amyloid, from surgical stainless steel (SS) surfaces. This study has tested the efficacy of UAS technology for the removal of 239 total protein and prion-amyloid from stainless steel, which is considered the most difficult 240 contaminant to decontaminate in the surgical field. 335 J o u r n a l P r e -p r o o f Tissue protein (Dark grey bars) and prion-associated amyloid (light grey bars) attachment 545 from different prion-infected brain homogenates (22L, ME7 and 263K) to surgical stainless 546 steel pre and post treatment with an ultrasonically activated stream (UAS) (Graph A).

title:
  Journal of Hospital Infection A cold water, ultrasonic activated stream efficiently removes proteins and prion-associated amyloid from surgical stainless steel

abstract:
  BACKGROUND: Sterile Service Department decontamination procedures for surgical instruments struggle to demonstrate efficient removal of the hardiest infectious contaminants, such as prion proteins. A recently designed novel system, which utilises a low pressure ultrasonic activated, cold water stream, has previously demonstrated efficient hard surface cleaning of several biological contaminants. AIM: To test the efficacy of an ultrasonically activated stream for the removal of tissue proteins, including prion-associated amyloid, from surgical stainless steel (SS) surfaces. METHODS: Test surfaces were contaminated with 22L, ME7 or 263K prion infected brain homogenates. The surfaces were treated with the ultrasonically activated water stream for contact times of 5 and 10 seconds. Residual proteinaceous and amyloid contamination were quantified using sensitive microscopic analysis, and immunoblotting was used to characterize the eluted prion residues before and after treatment with the ultrasonically activated stream. FINDINGS: Efficient removal of the different prion strains from the surgical SS surfaces was observed, and reduced levels of protease sensitive and resistant prion protein was detected in recovered supernatant. CONCLUSIONS: This study demonstrated that an ultrasonically activated stream has the potential to be a cost-effective solution to improve current decontamination practices and has the potential to reduce hospital acquired infections.


id: cord-267132-nb0j6k3h
author: Loveday, H.P.
date: 2013-12-10
txt: ./txt/cord-267132-nb0j6k3h.txt
cache: ./cache/cord-267132-nb0j6k3h.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/s0195-6701(13)60012-2
doi: 10.1016/s0195-6701(13)60012-2
summary:
  Clinical effectiveness (i.e. using prevention measures that are based on reliable evidence of efÀ cacy) is a core component of an effective strategy designed to protect patients from the risk of infection, and when combined with quality improvement methods can account for signiÀ cant reductions in HCAI such as meticillin-resistant Staphylococcus aureus (MRSA) and Clostridium difÀ cile. Full text conÀ rms that the article: relates to infections associated with hospital hygiene; is written in English; is primary research (randomised controlled trials, prospective cohort, interrupted time series, controlled before-after, quasi-experimental, experimental studies answering speciÀ c questions), a systematic review or a meta-analysis including the above designs; and informs one or more of the review questions. 334 In a prospective cohort study using data from two randomised trials and a systematic review to estimate rates of PICC-related bloodstream infection in hospitalised patients, the author concluded that PICCs used in high-risk hospitalised patients are associated with a rate of CR-BSI similar to conventional CVCs placed in the internal jugular or subclavian veins (two to À ve per 1000 catheter-days).

title:
  epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

abstract:
  National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998–2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.


id: cord-267570-e58jrxaj
author: Wu, X.
date: 2020-03-20
txt: ./txt/cord-267570-e58jrxaj.txt
cache: ./cache/cord-267570-e58jrxaj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.03.021
doi: 10.1016/j.jhin.2020.03.021
abstract: nan
summary:
  title: Strategies for qualified triage stations and fever clinics during the outbreak of COVID-2019 in the county hospitals of Western Chongqing Here we report the strategies of makeshift for qualified triage stations and fever clinics during the outbreak of COVID-2019 in the 37 county hospitals of Western Chongqing. In the tent, a second time temperature measurement using a more precise infrared thermometer is undertaken, to further assess suspected patients and to minimize the risk of contact transmission to medical staff. [3, [5] [6] One cannot overemphasize the importance of the triage station and fever clinic during the contagious disease outbreak in terms of timely patient management and minimizing the risk of nosocomial transmission. Thus, thanks to qualified triage station and fever clinics altogether with community isolation, quarantine, medical support, COVID-2019 has been rapidly and well controlled in all of the counties in Western Chongqing. Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics

title:
  Strategies for qualified triage stations and fever clinics during the outbreak of COVID-2019 in the county hospitals of Western Chongqing


id: cord-267917-belkwihy
title: Putting some context to the aerosolization debate around SARS-CoV-2
author: Peters, Alexandra
date: 2020-04-30
txt: ./txt/cord-267917-belkwihy.txt
cache: ./cache/cord-267917-belkwihy.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120302255
doi: 10.1016/j.jhin.2020.04.040
abstract: nan
summary:
  1 The experiments reported in this letter compared the stability of SARS-CoV-2 and SARS-CoV-1 in aerosols and on a number of different surfaces. The work showed that "SARS-CoV-2 remained viable in aerosols throughout the duration of (the) experiment (3 hours), with a reduction in infectious titer from 10 3.5 to 10 2.7 TCID50 per liter of air. [2] [3] [4] These media articles'' assertions include that SARS-Co V-2 can last "three hours after being coughed out into the air", 4 and that the van Doremalen et al. 2 The media even went as far as suggesting that the aerosols generated by the three-jet Collison nebulizer "duplicated the microscopic droplets created in a cough or a sneeze". It is for these reasons that the WHO and infection prevention specialists continue to support assertion that transmission of SARS-CoV-2 is primarily through droplets and contact (including indirect contact with contaminated surfaces).


id: cord-269408-6qncy0nd
author: Khonyongwa, Kirstin
date: 2020-10-13
txt: ./txt/cord-269408-6qncy0nd.txt
cache: ./cache/cord-269408-6qncy0nd.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120304667?v=s5
doi: 10.1016/j.jhin.2020.10.006
summary:
  AIMS: This study was performed to evaluate the prevalence and clinical outcomes of Healthcare-associated COVID-19 infections (HA-COVID-19) during the 2020 epidemic and study factors which may promote or correlate with its incidence and transmission in a Teaching Hospital NHS Trust in London, England. Factors studied included the utility of a single combined throat and nose swab (CTNS) for patient placement, delayed RNA positivity (DRP), selfreported COVID-19 sickness absence among hospital staff, total hospital bed occupancy, community incidence of COVID-19 (CIC19) and the change in incidence of other significant hospital-acquired bacterial infections (HAB). When a HA-COVID-19 case was identified, actions included staff refresher training for correct PPE usage, rapid transfer of patients to a COVID-19 positive cohort ward, deep cleaning (washing walls and carpets) followed by increasing the cleaning frequency until no further transmission was seen (defined as no new symptom onset within 2 weeks of last known case and in haematology and geriatrics a CNTS was tested for SARS-CoV-2 RNA twice weekly for all contacts up to 2 weeks from last positive case regardless of symptoms).

title:
  Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

abstract:
  BACKGROUND: The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV2 pandemic of 2020 led to onward transmissions among vulnerable inpatients. AIMS: This study was performed to evaluate the prevalence and clinical outcomes of Healthcare-associated COVID-19 infections (HA-COVID-19) during the 2020 epidemic and study factors which may promote or correlate with its incidence and transmission in a Teaching Hospital NHS Trust in London, England. METHODS: Electronic laboratory, patient and staff self-reported sickness records were interrogated from 1(st) March to 18(th) April 2020. HA-COVID-19 was defined as COVID-19 with symptom onset >14 days of admission. Test performance of a single combined throat and nose swab (CTNS) for patient placement was calculated. The effect of delayed RNA positivity (DRP, defined as >48h delay), staff self-reported COVID-19 sickness absence, hospital bed occupancy, and community incidence of COVID-19 was compared for HA-COVID-19. The incidence of other significant hospital-acquired bacterial infections (HAB) was compared to previous years. RESULTS: 58 HA-COVID-19 (7.1%) cases were identified. When compared to community-acquired admitted cases (CA-COVID-19), significant differences were observed in age (p=0.018), ethnicity (p<0.001) and comorbidity burden (p<0.001) but not in 30 d mortality. CTNS negative predictive value was 60.3%. DRP was associated with greater mortality (p=0.034) and incidence of HA-COVID-19 correlated positively with DRP (R=0.7108) and staff sickness absence (R=0.7815). For the study period HAB rates were similar to previous 2 years. CONCLUSION: Early diagnosis and isolation of COVID-19 patients would help reduce transmission. A single CTNS has limited value in segregating patients into positive and negative pathways.


id: cord-272904-4iv8ezg7
title: Hospital factors associated with SARS-CoV-2 infection among healthcare personnel in Greece
author: Maltezou, Helena C.
date: 2020-10-22
txt: ./txt/cord-272904-4iv8ezg7.txt
cache: ./cache/cord-272904-4iv8ezg7.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120304916?v=s5
doi: 10.1016/j.jhin.2020.10.010
summary:
  Healthcare personnel (HCP) constitute a high-risk group for SARS-CoV-2 infection. Factors significantly associated with an increased risk for SARS-CoV-2 infection were: working in a non-referral hospital compared to a COVID-19 referral hospital, working in a hospital with a high number of employees, and working in a hospital with an increased number of COVID-19 patients. These findings underscore the need for continuous education of HCP in order to achieve high compliance rates with infection control guidelines, regardless of direct care of COVID-19 patients. In conclusion, our study confirms that HCP constitute a high-risk group for SARS-CoV-2 infection. SARS-CoV-2 infection in healthcare personnel with high-risk occupational exposure: evaluation of seven-day exclusion from work policy Transmission of COVID-19 to health care personnel during exposures to a hospitalized patient

abstract:
  Healthcare personnel (HCP) constitute a high-risk group for SARS-CoV-2 infection. We estimated their risk of infection per hospital characteristics. Factors significantly associated with an increased risk for SARS-CoV-2 infection were: working in a non-referral hospital compared to a COVID-19 referral hospital, working in a hospital with a high number of employees, and working in a hospital with an increased number of COVID-19 patients. Our study revealed gaps in infection control in the non-referral hospitals. There is an urgent need for continuous training in infection control practices. Compliance of HCP with the use of personal protective equipment should also be addressed.


id: cord-274119-jjiox4it
title: Does hospital work constitute a risk factor for Helicobacter pylori infection?
author: Mastromarino, P.
date: 2005-04-20
txt: ./txt/cord-274119-jjiox4it.txt
cache: ./cache/cord-274119-jjiox4it.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019567010500040X
doi: 10.1016/j.jhin.2004.12.019
summary:
  pylori infection rate among patients undergoing endoscopy for upper gastrointestinal symptoms in Italy is as high as 71.3%; 28 therefore, medical and nursing staff involved in endoscopic procedures could have a high risk of occupational exposure. The purpose of this study was to determine whether different staff groups of healthcare workers, either with or without direct patient contact, are at equal risk of acquiring H. 28, 29 An inverse relationship between educational attainment and infection in the overall population was seen in univariate analysis, showing more risk for healthcare personnel with %8 years of education compared with staff with a university education (Table II) . pylori prevalence in endoscopy personnel and general medical staff by age group (!40 vs R40 years old). pylori infection rate has been reported frequently in gastrointestinal endoscopy personnel, very few studies have been carried out on the prevalence of infection in different groups of hospital employees.

abstract:
  The aim of this study was to assess whether clinical work constitutes a risk factor for Helicobacter pylori infection among employees in hospitals. The prevalence of H. pylori infection was analysed in 249 individuals employed in a university teaching hospital according to three categories of hospital workers: (A) personnel from gastrointestinal endoscopy units (N=92); (B) personnel from other hospital units with direct patient contact (N=105); and (C) staff from laboratories and other units with no direct patient contact (N=52). Stool samples from each subject were examined with a validated enzyme-linked immunosorbent assay for the presence of H. pylori antigens. A questionnaire inquiring about sociodemographic and occupational characteristics was completed by each participant. The prevalence of H. pylori infection was 37.0% in group A, 35.2% in group B and 19.2% in group C (P<0.05). Among the different healthcare categories, nurses had a significant higher prevalence of H. pylori infection (P<0.01). No significant association was found between the length of employment or exposure to oral and faecal secretions, and H. pylori infection. Hospital work involving direct patient contact seems to constitute a major risk factor for H. pylori infection compared with hospital work not involving direct patient contact.


id: cord-274368-s1h3p5s9
author: Carter, B.
date: 2020-07-21
txt: ./txt/cord-274368-s1h3p5s9.txt
cache: ./cache/cord-274368-s1h3p5s9.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120303443?v=s5
doi: 10.1016/j.jhin.2020.07.013
summary:
  Nosocomial infection is defined as an infection that is acquired in hospital by a patient who was admitted for a reason other than that infection (at least 15 days prior to a positive COVID-19 diagnosis), and in whom the pathogen was not incubating at the time of admission. However, a large study in the United States reported that non-ventilator associated nosocomial pneumonia occurred in 2.1% of all hospital admissions, with a mortality rate of 13.1% (12) . There is no current published data for nosocomial versus community acquired COVID-19 in UK hospitals, leaving uncertainty around morbidity or mortality and heightened public anxiety. Clinical teams at each site screened in-patient admission lists for eligibility and had access to infection control records of positive COVID-19 laboratory testing. Since hospital workers or patient visitors with COVID-19 were not included in the definition of NC infection, or were patients with a positive diagnosis less than 15 days prior to their admission.

title:
  Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial study (COVID in Older PEople).

abstract:
  INTRODUCTION: Hospital admissions for non-COVID-19 pathology have significantly reduced. It is believed that this may be due to public anxiety about acquiring COVID-19 infection in hospital and the subsequent risk of mortality. There is an urgent need for clarity regarding patients who acquire COVID-19 in hospital (nosocomial COVID-19 infection [NC]), their risk of mortality, compared to those with community acquired COVID-19 (CAC) infection. METHODS: The COPE-Nosocomial Study was an observational cohort study. The primary outcome was the time to all-cause mortality (estimated with an adjusted hazards ratio [aHR]), and secondary outcomes were Day-7 mortality and the time-to-discharge. A mixed-effects multivariable Cox’s proportional hazards model was used, adjusted for demographics and comorbidities. RESULTS: Our study included 1564 patients from 10 hospital sites throughout the UK, and one in Italy, and collected outcomes on patients admitted up to 28(th) April, 2020. 12.5% of COVID-19 infections were acquired in hospital. 425 (27.2%) patients with COVID died. The median survival time in NC patients was 14 days, which compared to 10 days in CAC patients. In the primary analysis, NC infection was associated with reduced mortality (aHR=0.71, 95%CI 0.51-0.99). Secondary outcomes found no difference in Day-7 mortality (aOR=0.79, 95%CI 0.47-1.31), but NC patients required longer time in hospital during convalescence (aHR=0.49, 95%CI 0.37-0.66). CONCLUSION: The minority of COVID-19 cases were the result of NC transmission. Whilst no COVID-19 infection comes without risk, patients with NC had a reduced risk of mortality compared to CAC infection, however, caution should be taken when interpreting this finding. In the United Kingdom, authority to conduct the study was granted by the Health Research Authority (20/HRA/1898), and in Italy by the Ethics Committee of Policlinico Hospital Modena (Reference 369/2020/OSS/AOUMO). Cardiff University was the study sponsor.


id: cord-274562-0mtwbwkk
author: Olesen, Bente
date: 2020-04-24
txt: ./txt/cord-274562-0mtwbwkk.txt
cache: ./cache/cord-274562-0mtwbwkk.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120302085?v=s5
doi: 10.1016/j.jhin.2020.04.033
abstract: nan
summary:
  title: Infection prevention partners up with psychology in a Danish Hospital successfully addressing staffs fear during the COVID-19 pandemic We have worked hard at NOH hard to prepare for the pandemic building COVID-19 cohort isolation wards using existing wards, creating new workflows, tripling the available number of intensive care beds, and initiating intensive education of literally all groups of staff. We pride ourselves to be used to a high standard regarding hand hygiene [2] , we are well familiar with the occasional seasonal occurrence of influenza, norovirus, CDIFF and VRE [3] ; However, COVID19 is a new virus and reports of deaths among healthcare staff from Italy, China and Spain are scary reading, especially for front line healthcare personal. Recently the mental health care for medical staff in China during the COVID-19 outbreak including various remedial actions was reported [4, 5] . Mental health care for medical staff in China during the COVID-19 outbreak

title:
  Infection prevention partners up with psychology in a Danish Hospital successfully addressing staffs fear during the COVID-19 pandemic


id: cord-275696-xag08e8h
title: Enhancing departmental preparedness for COVID-19 using rapid cycle in situ simulation
author: Dharamsi, A.
date: 2020-06-13
txt: ./txt/cord-275696-xag08e8h.txt
cache: ./cache/cord-275696-xag08e8h.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120303054?v=s5
doi: 10.1016/j.jhin.2020.06.020
summary:
  In response to COVID-19, we developed a rapid-cycle in situ simulation (ISS) programme to facilitate identification and resolution of systems-based latent safety threats. Rapid cycle simulation has been described previously in medical education as a way of providing real time feedback and opportunities for learners to practice [7] , and there are examples of in situ simulation being used in an iterative fashion to find solutions to latent safety threats over months to years [7, 8] . Given our experience from SARS, our ISS team understood that the highest risk of this emerging respiratory pathogen would be in the case of a critically-ill patient presenting to triage and ultimately requiring aerosol-generating procedures in the ED [8, 9] . The rapid-cycle ISS programme was created to identify latent safety threats (LST) to staff and mitigate these with innovative solutions that could subsequently be tested in the next simulation. This rapid-cycle ISS programme provides an opportunity to identify and iteratively address latent safety threats in caring for patients with possible COVID-19 in a time-sensitive fashion.

abstract:
  In response to COVID-19, we developed a rapid-cycle in situ simulation (ISS) programme to facilitate identification and resolution of systems-based latent safety threats. The simulation involved a possible COVID-19 case in respiratory failure, using a manikin modified to aerosolize phosphorescent secretions. 36 individuals participated in and 20 observed five ISS sessions over six weeks. Debriefing identified latent safety threats from four domains: personnel, PPE, supply/environment, and communication. These threats were addressed and resolved in later iterations. 94% of participants felt more prepared to care for a potential COVID-19 patient after the ISS.


id: cord-278618-7tu5c7m1
title: Sustainability of SARS-CoV-2 in aerosols: Should we worry about airborne transmission?
author: Romano-Bertrand, Sara
date: 2020-06-12
txt: ./txt/cord-278618-7tu5c7m1.txt
cache: ./cache/cord-278618-7tu5c7m1.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120303030?v=s5
doi: 10.1016/j.jhin.2020.06.018
abstract: nan
summary:
  This is based on previous knowledge [1] and the doctrine that: a patient positive for SARS-CoV-2 is contagious by respiratory secretions (>10μm in size) that disseminate only on short distance (<1m); SARS-CoV-2 carried on large droplets settles onto local surfaces and is not stable in the air; SARS-CoV-2 aerosol dispersion is possible during AGPs which extensively expose HCWs and therefore HCWs need to wear a respirator for a higher respiratory protection during AGPs. However, an experimental study of van Doremalen et al, [2] assessed the sustainability of SARS-CoV-2 in aerosols (<5μm at 65% of hygrometry (expressed in %RH for relative humidity)) performed using a high-powered machine that does not reflect normal cough conditions (https://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implicationsfor-ipc-precaution-recommendations). They showed that SARS-CoV-2 remained viable and infective at least 3 hours in aerosols, which opened the debate on SARS-CoV-2 transmission through longdistance aerosols (>1m), and questioned the appropriateness of respiratory protection for HCWs. An individual who is well, emits 10 to 10 4 particles per liter of expired air, including 95% of <1μm-size particles [3] .


id: cord-278723-rirmvf3l
author: Gray, S.
date: 2020-08-05
txt: ./txt/cord-278723-rirmvf3l.txt
cache: ./cache/cord-278723-rirmvf3l.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.07.030
doi: 10.1016/j.jhin.2020.07.030
abstract: nan
summary:
  This observation highlights the need to evaluate the existing Public Health England PPE guidance [4] in HD units that recommends fluid repellent surgical masks and plastic aprons in conjunction with bare below the elbows policy in HCWs treating COVID-19-suspected or -confirmed patients not involved in aerosol-generating procedures [5] instead of ECDC [2] and CDC [6] recommended FFP2/3 masks and long-sleeved gowns in similar clinical settings. At the beginning of the COVID-19 pandemic in the North West of England initially one shift (19 th March 2020) and subsequently the whole main hospital HD unit (6 th April 2020) was designated for treatment of suspected or confirmed COVID-19 patients receiving HD. Public Health England PPE guidance [5] was followed for staff caring for suspected and confirmed COVID-19 patients including surgical masks, plastic aprons, protective eyewear and gloves and there were no issues with PPE supplies.

title:
  Increased risk of COVID-19 in haemodialysis healthcare workers in a tertiary centre in the North West of England


id: cord-279436-kftdqzg0
author: Au, S.S.W.
date: 2010-03-31
txt: ./txt/cord-279436-kftdqzg0.txt
cache: ./cache/cord-279436-kftdqzg0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/20359769/
doi: 10.1016/j.jhin.2010.01.017
summary:
  authors: Au, S.S.W.; Gomersall, C.D.; Leung, P.; Li, P.T.Y. title: A randomised controlled pilot study to compare filtration factor of a novel non-fit-tested high-efficiency particulate air (HEPA) filtering facemask with a fit-tested N95 mask We carried out a randomised controlled cross-over study to compare the efficacy of such a mask (Totobobo, Dream Lab One Pte Ltd, Singapore) with fit-tested N95 masks (1860 or 1860s or 1862; 3M, St Paul, MN, USA) in 22 healthy volunteers. In view of the potential benefits of this new mask, we carried out a controlled cross-over pilot study to compare the in-vivo filtration capacity of trimmed but non-fittested Totobobo masks with a fit-tested N95 mask (1860 or 1860s or 1862; 3 M, St Paul, MN, USA). This was a prospective unblinded study of healthy Chinese volunteers using two different protective devices: a Totobobo mask (Dream Lab One Pte. Ltd, Singapore) and a fitted N95 filtering facepiece respirator (1860 or 1860s or 1862, 3M, St Paul, MN, USA).

title:
  A randomised controlled pilot study to compare filtration factor of a novel non-fit-tested high-efficiency particulate air (HEPA) filtering facemask with a fit-tested N95 mask

abstract:
  Use of a fit-tested N95 or FFP2 mask is recommended to protect against transmission of airborne pathogens. This poses considerable logistic problems when preparing for, or dealing with, an epidemic. Some of these problems might be overcome by use of a compact reusable high-efficiency particulate air filtering mask that can be cut to size. We carried out a randomised controlled cross-over study to compare the efficacy of such a mask (Totobobo, Dream Lab One Pte Ltd, Singapore) with fit-tested N95 masks (1860 or 1860s or 1862; 3M, St Paul, MN, USA) in 22 healthy volunteers. The median (interquartile range) reduction in airborne particle counts was significantly higher [193-fold (145–200)] for N95 masks than for Totobobo masks [135-fold (83–184)] (P < 0.05). There was no statistically significant difference between the proportion of subjects achieving a reduction of ≥100-fold between N95 (19/22) and Totobobo (16/22) masks. We conclude that use of the Totobobo mask without fit testing cannot be recommended, but its performance is sufficiently promising to warrant further investigation.


id: cord-280285-mwuix1tv
author: Inkster, T.
date: 2017-05-06
txt: ./txt/cord-280285-mwuix1tv.txt
cache: ./cache/cord-280285-mwuix1tv.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2017.05.002
doi: 10.1016/j.jhin.2017.05.002
summary:
  title: Consecutive yearly outbreaks of respiratory syncytial virus in a haemato-oncology ward and efficacy of infection control measures In December 2015 three patients on the haematology ward with respiratory symptoms tested positive for RSV in a 24 h period. On the day of ward closure a fourth patient with respiratory symptoms tested positive for RSV and was isolated with precautions in place. Confirmed case of RSV Any patient or staff member with respiratory symptoms and a positive respiratory sample for RSV Probable case of RSV Any patient or staff member with respiratory symptoms Asymptomatic carrier Any patient or staff member in whom RSV was detected on screening in the absence of respiratory symptoms or fever measuring both standard and transmission-based infection control precautions at the time of ward reopening, and a training package was put in place for ward staff.

title:
  Consecutive yearly outbreaks of respiratory syncytial virus in a haemato-oncology ward and efficacy of infection control measures

abstract:
  BACKGROUND: Respiratory syncytial virus (RSV) causes significant respiratory tract infection in immunosuppressed patients. AIM: To describe two consecutive yearly outbreaks of RSV in our haemato-oncology ward. METHODS: Haematology patients presenting with respiratory symptoms were screened by polymerase chain reaction for viral respiratory pathogens using a saline gargle. FINDINGS: None of our patients had undergone bone marrow transplant but all had underlying haematological malignancies. Eight patients were affected in the first outbreak (mortality rate: 37.5%) and 12 patients were affected in the second (mortality rate: 8.3%). Extensive infection control measures were implemented in both outbreaks and were successful in preventing further cross-transmission. CONCLUSION: There was significant learning from both outbreaks and actions implemented with the aim of reducing the likelihood and impact of future outbreaks.


id: cord-280419-odqo3o4w
title: Custom solution for PPE in the orthopaedic setting: retrofitting Stryker Flyte T5® PPE system
author: Gibbons, John P.
date: 2020-10-26
txt: ./txt/cord-280419-odqo3o4w.txt
cache: ./cache/cord-280419-odqo3o4w.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120304977?v=s5
doi: 10.1016/j.jhin.2020.10.016
summary:
  In this study the authors made modifications to two different SS systems to incorporate high-efficiency particulate air (HEPA) filters to the inlets to the fan to assess their potential as a method of providing a reusable system for PPE for the surgeon with regard to protection from a respiratory droplet spread virus. The results show that using a layer of HEPA filter cut to size, and sealed to the inlet for the fan in the helmet will reduce the downstream particulate at the user''s mouth by over 99.5% which is equivalent to that of a respirator mask. With the modification of the HEPA filter to the inlet of the T5 helmet as described, the downstream penetration was reduced to 0.46% (σ = 0.24%) which is significantly better than all other test configurations and offers a particulate filtration similar to FFP3 and N99 or other equivalent respirator mask.

abstract:
  The COVID-19 pandemic has meant that there is growing pressure on hospital resources not least the availability of appropriate personal protective equipment (PPE), specifically, facemasks and respirator masks. Within the field of orthopaedic surgery, it is a common sight to see orthopaedic surgery carried out in “space suits” (SS) which comprise of a helmet, hood and surgical gown. In this study the authors made modifications to two different SS systems to incorporate high-efficiency particulate air (HEPA) filters to the inlets to the fan to assess their potential as a method of providing a reusable system for PPE for the surgeon with regard to protection from a respiratory droplet spread virus. The testing was carried out using particle counter upstream and downstream on a manikin wearing two different SS systems with and without modifications to the inlet. The results show that using a layer of HEPA filter cut to size, and sealed to the inlet for the fan in the helmet will reduce the downstream particulate at the user’s mouth by over 99.5% which is equivalent to that of a respirator mask. HEPA filter material is relatively cheap and can be used repeatedly making this a viable alternative to disposable, and even re-sterilized, respirator masks in the setting of a respiratory droplet spread viral pandemic.


id: cord-283165-mdkr9qo0
title: Diagnosis and features of hospital-acquired pneumonia: a retrospective cohort study
author: Russell, C.D.
date: 2015-12-15
txt: ./txt/cord-283165-mdkr9qo0.txt
cache: ./cache/cord-283165-mdkr9qo0.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670115004934
doi: 10.1016/j.jhin.2015.11.013
summary:
  The aim of this study was to retrospectively evaluate the accuracy of the diagnosis of HAP in inpatients on acute internal medicine and general surgical wards receiving intravenous antimicrobials for a clinical diagnosis of HAP made by the patient''s team. This was a retrospective observational cohort study of medical and surgical inpatients receiving intravenous antimicrobials for a clinical diagnosis of HAP at a tertiary care hospital in Edinburgh, UK. To be classified as radiologically confirmed HAP in this study, chest X-ray evidence of a new or progressive lung infiltrate was required (reported by a radiologist), consistent with the 2005 ATS/IDSA guidelines. In comparison to community-acquired pneumonia, where the culture-positive rate of sputum samples at our institution has been reported as 30%, a bacterial pathogen was identified from 17 of 35 (48.6%) samples from patients with radiologically confirmed HAP and therefore has greater potential to influence management.

abstract:
  BACKGROUND: Hospital-acquired pneumonia (HAP) is defined as radiologically confirmed pneumonia occurring ≥48 h after hospitalization, in non-intubated patients. Empirical treatment regimens use broad-spectrum antimicrobials. AIM: To evaluate the accuracy of the diagnosis of HAP and to describe the demographic and microbiological features of patients with HAP. METHODS: Medical and surgical inpatients receiving intravenous antimicrobials for a clinical diagnosis of HAP at a UK tertiary care hospital between April 2013 and 2014 were identified. Demographic and clinical details were recorded. FINDINGS: A total of 166 adult patients with a clinical diagnosis of HAP were identified. Broad-spectrum antimicrobials were prescribed, primarily piperacillin–tazobactam (57.2%) and co-amoxiclav (12.5%). Sputum from 24.7% of patients was obtained for culture. Sixty-five percent of patients had radiological evidence of new/progressive infiltrate at the time of HAP treatment, therefore meeting HAP diagnostic criteria (2005 American Thoracic Society/Infectious Diseases Society of America guidelines). Radiologically confirmed HAP was associated with higher levels of inflammatory markers and sputum culture positivity. Previous surgery and/or endotracheal intubation were associated with radiologically confirmed HAP. A bacterial pathogen was identified from 17/35 sputum samples from radiologically confirmed HAP patients. These were Gram-negative bacilli (N = 11) or Staphylococcus aureus (N = 6). Gram-negative bacteria tended to be resistant to co-amoxiclav, but susceptible to ciprofloxacin, piperacillin–tazobactam and meropenem. Five of the six S. aureus isolates were meticillin susceptible and all were susceptible to doxycycline. CONCLUSION: In ward-level hospital practice ‘HAP’ is an over-used diagnosis that may be inaccurate in 35% of cases when objective radiological criteria are applied. Radiologically confirmed HAP represents a distinct clinical and microbiological phenotype. Potential risk factors were identified that could represent targets for preventive interventions.


id: cord-284532-b6tsjmfs
author: Thampi, N.
date: 2020-05-06
txt: ./txt/cord-284532-b6tsjmfs.txt
cache: ./cache/cord-284532-b6tsjmfs.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120302346?v=s5
doi: 10.1016/j.jhin.2020.05.003
abstract: nan
summary:
  A prominent strategy to improve hand hygiene, developed by the World Health Organization (WHO), includes an effective six-step handwashing technique and has led to broad uptake through the use of a multimodal approach; however encouraging consistent compliance can be challenging [1] . In addition to needing to remember all six steps of the technique and needing to wash hands for the required duration of time, there can be a lack of awareness regarding the importance of handwashing technique on reducing the microbial burden on hands. In the context of the 3/6 evolving COVID-19 pandemic, the near-ubiquitous melody of Brother John provided an opportunity for international, interdisciplinary collaboration to translate and rapidly disseminate the musical mnemonic globally. A clear advantage of this six-step handwashing song is that it highlights the importance of correct technique, in addition to the recommended 20-second duration (such as singing "happy birthday" twice, another popular approach). Figure 1: WHO six-step handwashing technique 1 and handwashing song lyrics, set to the tune of Brother John.

title:
  It’s in our hands: a rapid, international initiative to translate a hand hygiene song during the COVID-19 pandemic


id: cord-286062-gzntdlp8
author: Paul, S.P.
date: 2017-05-03
txt: ./txt/cord-286062-gzntdlp8.txt
cache: ./cache/cord-286062-gzntdlp8.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670117302396
doi: 10.1016/j.jhin.2017.04.023
summary:
  METHODS: Children aged less than two years admitted to hospital with a clinical diagnosis of bronchiolitis with positive results for either RSV or RV were included in this study. The aim of this study was to determine the clinicopathological outcomes in a cohort of infants and young children aged less than two years admitted with bronchiolitis, where the presence of either RSV or RV as a single pathogen was detected on analysis of NPA samples. Data were collected on median age at presentation, sex, associated risk factors (chronic lung disease, prematurity, congenital heart disease, genetic conditions), therapeutic interventions (intravenous fluids, intravenous antibiotics, chest X-ray), need for respiratory support (high flow oxygen, continuous positive airway pressure, ventilation), management in high-dependency unit (HDU)/paediatric intensive care unit (PICU) and outcome [length of stay (LOS) and any deaths].

title:
  Respiratory-syncytial-virus- and rhinovirus-related bronchiolitis in children aged <2 years in an English district general hospital

abstract:
  BACKGROUND: Bronchiolitis is the most common reason for hospitalization in young children. In addition to respiratory syncytial virus (RSV), other viruses have been increasingly implicated. Guidance on testing has also changed. AIMS: To compare clinicopathological outcomes in young children admitted with bronchiolitis due to RSV in comparison with rhinovirus (RV), and identify associated risk/epidemiological factors. METHODS: Children aged less than two years admitted to hospital with a clinical diagnosis of bronchiolitis with positive results for either RSV or RV were included in this study. Polymerase-chain-reaction-negative cases using an extended respiratory virus panel served as a control group. Retrospective data were collected on sex, risk factors, respiratory support, intravenous fluids and antibiotics. Outcomes such as length of stay (LOS) and need for transfer to the high-dependency unit/paediatric intensive care unit were included. FINDINGS: Two hundred and twenty-seven out of 437 nasopharyngeal aspirate samples were positive for either RSV (N = 162) or RV (N = 65). The median age of cases was three months and 75% had at least one risk factor. Risk factors were higher in the RV group (P = 0.004). RV accounted for the majority of cases outside the RSV season (P < 0.01). RV-associated bronchiolitis had a longer LOS (more than seven days) (P < 0.05) and increased need for chest X-rays and/or antibiotics (P < 0.05). Use of intravenous fluids and respiratory support were higher in the RV group, but the difference was not significant. CONCLUSIONS: RV is the second most common pathogen associated with bronchiolitis and is isolated all year round. This may be important in those with risk factors resulting in prolonged LOS. Further research is necessary to establish the exact role of RV in this common condition, particularly outside the traditional RSV season.


id: cord-288483-y9fyslgo
author: Zorko, David J.
date: 2020-07-10
txt: ./txt/cord-288483-y9fyslgo.txt
cache: ./cache/cord-288483-y9fyslgo.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120303376?v=s5
doi: 10.1016/j.jhin.2020.07.007
summary:
  Studies were eligible for inclusion if the following criteria were met: 1) The study was original research, including systematic reviews; 2) The study evaluated surgical facemask PPE or their components; 3) The study evaluated any intervention(s) to decontaminate, sterilize or treat surgical masks (applied either before or after their use) for the purposes of reuse as PPE; 4) At least one of the following efficacy or safety outcomes of interest was reported: a) mask performance (i.e. filtration efficiency and airflow resistance); b) reduction in pathogen load; c) in vivo infection rates following use of decontaminated masks; d) changes in physical appearance (i.e. mask appearance or physical degradation); e) adverse effects experienced by the wearer (e.g. skin irritation); or f) feasibility of the intervention (e.g. time, cost, resource utilization).

title:
  DECONTAMINATION INTERVENTIONS FOR THE REUSE OF SURGICAL MASK PERSONAL PROTECTIVE EQUIPMENT: A SYSTEMATIC REVIEW

abstract:
  BACKGROUND: The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination interventions to allow for surgical mask reuse. AIM: Identify and synthesize data from original research evaluating interventions to decontaminate surgical masks for the purpose of reuse. METHODS: We searched MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8, 2020 for prospective original research on decontamination interventions for surgical masks. Citation screening was conducted independently in duplicate. Study characteristics, interventions, and outcomes were extracted from included studies by two independent reviewers. Outcomes of interest included impact of decontamination interventions on surgical mask performance and germicidal effects. FINDINGS: Seven studies met eligibility criteria: one evaluated the effects of heat and chemical interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were evaluated with heterogenous test conditions. Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticle-coated masks. CONCLUSION: There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogenous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks.


id: cord-288553-fez60jyn
author: Colaneri, Marta
date: 2020-03-19
txt: ./txt/cord-288553-fez60jyn.txt
cache: ./cache/cord-288553-fez60jyn.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120301171?v=s5
doi: 10.1016/j.jhin.2020.03.018
abstract: nan
summary:
  title: Lack of SARS-CoV-2 RNA environmental contamination in a tertiary referral hospital for infectious diseases in Northern Italy. Health care workers are at increased risk of acquiring COVID-19 infection, possibly due to direct contact with the patients. In this regard, studies suggest that surfaces and suspensions can carry HCoVs, increasing the risk of contact transmission that could lead to hospital acquired HCoVs infections [4, 5] Since February 21, 2020, when the first autochthonous case in Italy was confirmed, an overwhelming number of SARS-CoV-2 infections is continuously being detected, exceeding 8,000 cases at the time of writing. Fondazione IRCCS Policlinico San Matteo, Pavia, is a 1,300-bed tertiary teaching hospital in Northern Italy and a national SARS-CoV-2 referral center. Survival of human coronaviruses 229E and OC43 in suspension and after drying on surfaces: A possible source of hospital-acquired infections Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination

title:
  Lack of SARS-CoV-2 RNA environmental contamination in a tertiary referral hospital for infectious diseases in Northern Italy.


id: cord-288859-19jwawrm
author: Choi, S.
date: 2017-09-25
txt: ./txt/cord-288859-19jwawrm.txt
cache: ./cache/cord-288859-19jwawrm.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670117305261
doi: 10.1016/j.jhin.2017.09.017
summary:
  title: High reproduction number of Middle East respiratory syndrome coronavirus in nosocomial outbreaks: mathematical modelling in Saudi Arabia and South Korea Therefore, the IDEA model was used to evaluate and compare the MERS R 0 values from the outbreaks in both KSA and South Korean hospitals. Since the IDEA model is parameterized using epidemic generation time, incidence case counts were aggregated at serial intervals of six, seven and eight days in the present study [10] . The IDEA model was fitted to the daily KSA and Korea MERS-CoV case data according to the onset date. Figure 3 shows that the IDEA model provided well-fitted curves for the cumulative data regarding South Korean MERS symptom-onset dates for all cases. The present study used the IDEA model to estimate R 0 values from the MERS outbreaks in KSA and South Korea. Best-fit reproduction number (R 0 ) by serial intervals of Middle East respiratory syndrome in South Korea, 2015, using the incidence decay with exponential adjustment model.

title:
  High reproduction number of Middle East respiratory syndrome coronavirus in nosocomial outbreaks: mathematical modelling in Saudi Arabia and South Korea

abstract:
  BACKGROUND: Effective countermeasures against emerging infectious diseases require an understanding of transmission rate and basic reproduction number (R(0)). R(0) for severe acute respiratory syndrome is generally considered to be >1, whereas that for Middle East respiratory syndrome (MERS) is considered to be <1. However, this does not explain the large-scale outbreaks of MERS that occurred in Kingdom of Saudi Arabia (KSA) and South Korean hospitals. Aim: To estimate R(0) in nosocomial outbreaks of MERS. METHODS: R(0) was estimated using the incidence decay with an exponential adjustment model. The KSA and Korean outbreaks were compared using a line listing of MERS cases compiled using publicly available sources. Serial intervals to estimate R(0) were assumed to be six to eight days. Study parameters [R(0) and countermeasures (d)] were estimated by fitting a model to the cumulative incidence epidemic curves using Matlab. FINDINGS: The estimated R(0) in Korea was 3.9 in the best-fit model, with a serial interval of six days. The first outbreak cluster in a hospital in Pyeongtaek had an R(0) of 4.04, and the largest outbreak cluster in a hospital in Samsung had an R(0) of 5.0. Assuming a six-day serial interval, the KSA outbreaks in Jeddah and Riyadh had R(0) values of 3.9 and 1.9, respectively. CONCLUSION: R(0) for the nosocomial MERS outbreaks in KSA and South Korea was estimated to be in the range of 2–5, which is significantly higher than the previous estimate of <1. Therefore, more comprehensive countermeasures are needed to address these infections.


id: cord-288980-kig6xnkb
author: Donà, Daniele
date: 2020-05-17
txt: ./txt/cord-288980-kig6xnkb.txt
cache: ./cache/cord-288980-kig6xnkb.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120302516?v=s5
doi: 10.1016/j.jhin.2020.05.020
abstract: nan
summary:
  title: Multidrug resistant infections in the COVID-19 era, a framework for considering the potential impact The recent report by Jolivet et al highlights the progress being made on Multidrug-resistant (MDR) infections [1] . However, this report predates the COVID-19 pandemic and it is unclear what the impact will be on MDR infections globally. There are reports of a high use of broad-spectrum antibiotics in the hospital setting, recognised as a risk factor for hospital-acquired infections (HAI) with MDR organisms [2] [3] [4] . Equally, wider recognition of the importance of nosocomial infections, with stricter hygiene policies, high use of PPE, and patients being cared for in new temporary hospitals, could all mitigate against this threat [2, 3] . Impact of colonisation pressure on acquisition of extendedspectrum β-lactamase-producing Enterobacteriaceae and meticillin-resistant Staphylococcus aureus in two intensive care units: a 19-year retrospective surveillance Management of multidrug-resistant organisms in health care settings Bed occupancy rates and hospital-acquired infections--should beds be kept empty

title:
  Multidrug resistant infections in the COVID-19 era, a framework for considering the potential impact


id: cord-290305-8u2zxsam
author: Fisher, D.
date: 2013-09-05
txt: ./txt/cord-290305-8u2zxsam.txt
cache: ./cache/cord-290305-8u2zxsam.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2013.07.005
doi: 10.1016/j.jhin.2013.07.005
summary:
  METHODS: The bundle included active surveillance on admission and transfer/discharge to identify ward-based acquisition of MRSA, isolation and cohorting of MRSA-infected patients, enhanced hand hygiene initiatives, and publicly displayed feedback of MRSA acquisition and hand hygiene compliance rates. 6e9 Effective interventions for controlling MRSA transmission in a hospital setting are well known and include active surveillance, improving hand hygiene compliance, and isolating all MRSA cases, whereas general strategies such as obtaining focused and committed hospital leadership are critical towards lowering implementation barriers and improving sustainability. À Other measures included a bare-below-the-elbows policy for all clinical staff, coloured bracelets to identify all colonized and infected patients, and cash rewards (of around US$250) for exemplary performances by wards or departments with regards to hand hygiene compliance and MRSA transmission rates to enjoy a celebratory lunch or similar.

title:
  Sustained meticillin-resistant Staphylococcus aureus control in a hyper-endemic tertiary acute care hospital with infrastructure challenges in Singapore

abstract:
  BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA) has been entrenched in Singapore hospitals since the 1980s, with an excess of 600 non-duplicate cases of infections (120 bacteraemia episodes) each year in our 995-bed university hospital. Approximately 5% of our hospital beds are used as isolation facilities. AIM: To study the impact of an MRSA control bundle that was implemented via gradual geographic extension across hospital wards. METHODS: The bundle included active surveillance on admission and transfer/discharge to identify ward-based acquisition of MRSA, isolation and cohorting of MRSA-infected patients, enhanced hand hygiene initiatives, and publicly displayed feedback of MRSA acquisition and hand hygiene compliance rates. Implementation was between October 2006 and June 2010 in order to provide lead-time for the incremental development of infrastructural capacity, and to develop an ethic of infection prevention among staff. Results were analysed via interrupted time-series analysis. FINDINGS: MRSA infections fell midway through the implementation, with MRSA bacteraemia declining from 0.26 [95% confidence interval (CI): 0.18–0.34] cases per 1000 inpatient-days in the first quarter of 2004 to 0.11 (95% CI: 0.07–0.19) cases per 1000 inpatient-days in the first quarter of 2012. MRSA acquisition rates fell a year after the programme had been fully implemented, whereas hand hygiene compliance rose significantly from 47% (95% CI: 44–49) in the first quarter of 2009 to 69% (95% CI: 68–71) in the first quarter of 2012. CONCLUSION: Successful staged implementation of an MRSA bundle in a hyper-endemic setting is sustainable and represents a model that may be adapted for similar settings.


id: cord-294839-qxn22td0
author: Ibfelt, T.
date: 2014-12-01
txt: ./txt/cord-294839-qxn22td0.txt
cache: ./cache/cord-294839-qxn22td0.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670114003429
doi: 10.1016/j.jhin.2014.10.007
summary:
  The intervention reduced the presence of adenovirus [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.1–5.0], rhinovirus (OR 5.3, 95% CI 2.3–12.4) and respiratory syncytial virus (OR 4.1, 95% CI 1.5–11.2) compared with the control group, but the intervention had no effect on sickness absence or disease patterns in the nurseries. The aim of this study was to determine whether regular systematic cleaning and disinfection of toys would decrease the prevalence of bacteria and respiratory viruses in the nursery environment, and reduce sickness absence in Danish nurseries. Nurseries were questioned about their policies and procedures for hygiene and cleaning of toys before commencement of the study, and randomized to intervention (N ¼ 6) and control (N ¼ 6) groups. Fortnightly cleaning and disinfection of toys reduced the frequency of detection of some respiratory viruses, but not the bacterial load, and did not reduce the number of days of absence due to respiratory infection or sickness as a whole.

title:
  Effect of cleaning and disinfection of toys on infectious diseases and micro-organisms in daycare nurseries

abstract:
  BACKGROUND: The rising number of children in daycare nurseries increases opportunities for the transmission of infectious diseases. Pathogens may be transmitted directly from child to child via sneezing, coughing and touching, or indirectly via the environment. Toys are among the fomites with the highest pathogen load, but their role in disease transmission is unknown. AIM: To determine if washing and disinfection of toys can reduce sickness absence and microbial pathogen load in the nursery environment. METHODS: Twelve nurseries (caring for 587 children) were randomized to intervention and control groups. The intervention consisted of washing and disinfection of toys and linen every two weeks for three months by a commercial cleaning company. The extent and causes of sickness absence among the children were recorded in both groups before and after introduction of the intervention. Ten sampling points in each nursery were examined for bacteria and respiratory viruses. RESULTS: The presence of respiratory virus DNA/RNA was widespread, but very few pathogenic bacteria were found in the environment. The intervention reduced the presence of adenovirus [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.1–5.0], rhinovirus (OR 5.3, 95% CI 2.3–12.4) and respiratory syncytial virus (OR 4.1, 95% CI 1.5–11.2) compared with the control group, but the intervention had no effect on sickness absence or disease patterns in the nurseries. CONCLUSION: Although cleaning and disinfection of toys every two weeks can decrease the microbial load in nurseries, it does not appear to reduce sickness absence among nursery children.


id: cord-295322-9kye4w9g
author: Kumar, Parmeshwar
date: 2020-05-22
txt: ./txt/cord-295322-9kye4w9g.txt
cache: ./cache/cord-295322-9kye4w9g.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.05.029
doi: 10.1016/j.jhin.2020.05.029
abstract: nan
summary:
  title: Adaptation of the ''Assembly Line'' and ''Brick System'' techniques for hospital resource management of personal protective equipment, as preparedness for mitigating the impact of the COVID-19 pandemic in a large public hospital in India An assembly line was put in place where components of the PPE kit were added in sequence until the final completed product was packed and ready for distribution. It is typically used inventory management of the personal kit issued to each fighting unit and also used by the United Nations Peace Keeping Forces (The UN Brick) [1] . The requisite number of in-house PPE kits for the various wards were then assembled into one brick(a carton) and supplied to that unit on a daily basis. Bricks of varying sizes and levels help in rationing of PPE between different wards based on differentiating essential and elective patients.

title:
  Adaptation of the ‘Assembly Line’ and ‘Brick System’ techniques for hospital resource management of personal protective equipment, as preparedness for mitigating the impact of the COVID-19 pandemic in a large public hospital in India


id: cord-297023-0qlo0mun
title: Mass screening of healthcare personnel for SARS-CoV-2 in the northern emirates
author: Park, Sung‐Soo
date: 2020-10-17
txt: ./txt/cord-297023-0qlo0mun.txt
cache: ./cache/cord-297023-0qlo0mun.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.10.008
doi: 10.1016/j.jhin.2020.10.008
abstract: nan
summary:
  While healthcare personnel (HCP) potentially has an increased risk of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the era of the pandemic [1] , the approach to testing HCP for the virus has not been uniform [2] . Given the significant percentage of asymptomatic coronavirus disease 2019 (COVID-19) infection [3] , universal testing of HCP could allow infected workers to be identified and isolated early, reduce in-hospital transmission, mitigate potential workforce depletion, and enhance healthcare workers'' safety [4] . This study aimed to evaluate the effectiveness of the universal staff screening for COVID-19 and identify any risk factor for viral infection. The staff were encouraged to notify the occupational health nurse for SARS-CoV-2 test any time if they had any suspicious symptoms of COVID-19 or close contact with COVID-19 patients. Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19 COVID-19: the case for healthcare worker screening to prevent hospital transmission


id: cord-301299-flb5wwzg
title: SARS-CoV-2 infection among healthcare workers in a hospital in Madrid, Spain
author: García, Inés Suárez
date: 2020-07-21
txt: ./txt/cord-301299-flb5wwzg.txt
cache: ./cache/cord-301299-flb5wwzg.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120303510
doi: 10.1016/j.jhin.2020.07.020
summary:
  AIM: The aim of this study was to describe the epidemiological and clinical characteristics of COVID-19 among healthcare workers (HCWs) between February 24(th) to April 30(th), 2020 in a hospital in Madrid, Spain. Therefore, we designed a retrospective cohort study whose aim was to describe the epidemiological and clinical characteristics of SARS-CoV-2 infection among HCWs in a hospital in Madrid, Spain. During the study period, HCWs experiencing symptoms consistent with probable COVID-19 were instructed to present at the Occupational Health outpatient clinic, where they were managed according to the hospital protocol: a nasopharyngeal swab was collected and analysed with polymerase chain reaction (PCR) for SARS-CoV-2. A case of COVID-19 was defined as any HCW presenting to the Occupational Health outpatient clinic with symptoms consistent with COVID-19 and with positive SARS-CoV-2 PCR.

abstract:
  AIM: The aim of this study was to describe the epidemiological and clinical characteristics of COVID-19 among healthcare workers (HCWs) between February 24(th) to April 30(th), 2020 in a hospital in Madrid, Spain. METHODS: We designed a retrospective cohort study. Cumulative COVID-19 incidence was calculated for all HCWs and categorized according to presumed level of COVID-19 exposure (high, medium and low). RESULTS: Among 1,911 HCW, 213 (11.1%) had COVID-19 during the study period. Cases increased gradually from March 8(th), peaking in March 17(th) and declining thereafter. The peak of cases among HCWs was reached 14 days before the peak in admitted COVID-19 cases in the hospital. There were no significant differences in the proportion of COVID-19 cases according to level of occupational exposure (p=0.123). There were 5 departments and 2 professions in which more than 20% of the workers had confirmed COVID-19. We identified temporal clusters in three of these departments and one profession, with most of the cases occurring over a period of less than 5 days. The prevalence of comorbidities was low and 91.5% of patients had mild or moderate symptoms. Eleven patients were admitted to the hospital and 1 patient needed intensive care. None of the patients died. The median time of sick leave was 20 (IQR: 15 – 26) days. CONCLUSIONS: Our results suggest that HCW-to-HCW transmission accounted for part of the cases. In spite of a low prevalence of comorbidities and a mild clinical course in most cases, COVID-19 caused long periods of sick leave.


id: cord-303966-z6u3d2ec
author: Shears, P.
date: 2007-10-22
txt: ./txt/cord-303966-z6u3d2ec.txt
cache: ./cache/cord-303966-z6u3d2ec.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17945396/
doi: 10.1016/j.jhin.2007.08.016
summary:
  In many hospitals serving the poorest communities of Africa and other parts of the developing world, infection control activities are limited by poor infrastructure, overcrowding, inadequate hygiene and water supply, poorly functioning laboratory services and a shortage of trained staff. Summary In many hospitals serving the poorest communities of Africa and other parts of the developing world, infection control activities are limited by poor infrastructure, overcrowding, inadequate hygiene and water supply, poorly functioning laboratory services and a shortage of trained staff. Many medical journals are currently devoting part of their current issues to the themes of poverty and infection in the developing world, in recognition of the commitments made by the G8 Summit and the United Nations (UN) Millenium Development Goals (MDGs) to improve maternal healthcare, reduce childhood mortality and the impact of human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS), malaria and other communicable diseases.

title:
  Poverty and infection in the developing world: Healthcare-related infections and infection control in the tropics

abstract:
  In many hospitals serving the poorest communities of Africa and other parts of the developing world, infection control activities are limited by poor infrastructure, overcrowding, inadequate hygiene and water supply, poorly functioning laboratory services and a shortage of trained staff. Hospital transmission of communicable diseases, a high prevalence of human immunodeficiency virus and multidrug-resistant tuberculosis, lack of resources for isolation and disinfection, and widespread antimicrobial resistance create major risks for healthcare-related infections. Few data exist on the prevalence or impact of these infections in such environments. There is a need for interventions to reduce the burden of healthcare-related infections in the tropics and to set up effective surveillance programmes to determine their impact. Both the Global (G8) International Development Summit of 2005 and the United Nations Millennium Development Goals (MDGs) have committed major resources to alleviating poverty and poor health in the developing world over the next decade. Targeting resources specifically to infection control in low-resource settings must be a part of this effort, if the wider aims of the MDGs to improve healthcare are to be achieved.


id: cord-304170-cmeiqvnp
author: van Straten, B.
date: 2020-04-08
txt: ./txt/cord-304170-cmeiqvnp.txt
cache: ./cache/cord-304170-cmeiqvnp.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120301766?v=s5
doi: 10.1016/j.jhin.2020.04.001
abstract: nan
summary:
  authors: van Straten, B.; de Man, P.; van den Dobbelsteen, J.; Koeleman, H.; van der Eijk, A.; Horeman, T. title: Sterilization of disposable face masks by means of standardized dry and steam sterilization processes; an alternative in the fight against mask shortages due to COVID-19 In preparation for that scarcity we performed a study to investigate the possibility of reprocessing disposable FFP2 face masks in order to verify their re-usability with a method that could be applied in practice using already available equipment. The results of our experiences and experiments indicate that our sterilization process did not influence the functionality of the masks tested. The sterilization process of available standard autoclaves in hospitals may have to be adjusted in order to use this sterilization method. However, our method seems to be a potentially useful way to reuse mouth masks; other hospitals facing a shortage of masks may wish to test and validate this approach to reusing masks.

title:
  Sterilization of disposable face masks by means of standardized dry and steam sterilization processes; an alternative in the fight against mask shortages due to COVID-19


id: cord-309274-2npxrrhr
title: Prevalence of hospital infection and antibiotic use at a University Medical Center in Hong Kong
author: Lee, M.K.
date: 2007-02-02
txt: ./txt/cord-309274-2npxrrhr.txt
cache: ./cache/cord-309274-2npxrrhr.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670106005470
doi: 10.1016/j.jhin.2006.12.013
summary:
  authors: Lee, M.K.; Chiu, C.S.; Chow, V.C.; Lam, R.K.; Lai, R.W. title: Prevalence of hospital infection and antibiotic use at a University Medical Center in Hong Kong Hospital infection prevalence surveys were performed in our 1400-bed University medical centre in Hong Kong from 1985 to 1988. We investigated the rates of four major hospital-acquired infections (HAIs) (pneumonia, symptomatic urinary tract infection, surgical site infection and laboratory-confirmed bloodstream infection) in order to identify current distribution and any changes after 15 years. Demographic information, admission diagnosis, use of medical device and antibiotic were recorded by the ward nursing staff who had attended briefing sessions on each ward on the point prevalence survey with instructions on correct filling of a data collection form. The last survey in our hospital was performed over 15 years ago and some interesting changes in nosocomial infection rate and antibiotic use were found.

abstract:
  Hospital infection prevalence surveys were performed in our 1400-bed University medical centre in Hong Kong from 1985 to 1988. We investigated the rates of four major hospital-acquired infections (HAIs) (pneumonia, symptomatic urinary tract infection, surgical site infection and laboratory-confirmed bloodstream infection) in order to identify current distribution and any changes after 15 years. A one-day point prevalence study was performed on 7 September 2005. All inpatients were surveyed for HAIs, community-acquired infections (CAIs), risk factors, pathogenic isolates and antibiotics prescribed. Infections were diagnosed according to Centers for Disease Control and Prevention (CDC) criteria. In total, 1021 patients were surveyed; of these, 41 had 42 HAIs (4% prevalence) and 389 (38%) were receiving antibiotics. The commonest HAI was pneumonia (1.4%) followed by bloodstream infection (0.9%) and symptomatic urinary tract infection (0.8%). The prevalence of postoperative surgical site infection was 5.6%. The nosocomial prevalence rate was highest in the Intensive Care Unit, followed by the Pediatric and Neonatal Intensive Care Units, Children's Cancer Centre/Bone Marrow Transplant Unit and Orthopaedics with Traumatology. Meticillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa were the commonest pathogens. The rates are significantly lower than previously and reflect the increased resources for infection control made available following the outbreak of severe acute respiratory syndrome (SARS).


id: cord-311012-wyglrpqh
title: Ethanol and Isopropanol Inactivation of Human Coronavirus on Hard Surfaces
author: Meyers, Craig
date: 2020-09-28
txt: ./txt/cord-311012-wyglrpqh.txt
cache: ./cache/cord-311012-wyglrpqh.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120304515
doi: 10.1016/j.jhin.2020.09.026
summary:
  AIM: There are few data showing the efficacy of multiple concentrations of EtOH, IPA, and SH on a human coronavirus (HCoV) dried on surfaces using short contact times. FINDINGS: Concentrations of EtOH and IPA from 62% to 80% were very efficient at inactivating high numbers of HCoV dried on tile surfaces even with a 15 sec contact time. CONCLUSIONS: EtOH, IPA, and SH at multiple concentrations efficiently inactivated infectious virus on hard surfaces, typical of those found in public places. Interestingly, at the highest concentrations tested, 95% EtOH and 95% IPA, we observed significant reductions in inactivating, with some contact times producing less than a 2 log 10 reduction of infectious virus. Our studies demonstrate that EtOH and IPA at concentrations ranging from 62% to 80% are highly effective at inactivating HCoV on tile surfaces even with contact times as low as 15 sec.

abstract:
  BACKGROUND: The COVID-19 pandemic has greatly increased the frequency of disinfecting surfaces in public places causing a strain on the ability to obtain disinfectant solutions. An alternative is to supply plain alcohols (EtOH and IPA) or sodium hypochlorite (SH). AIM: There are few data showing the efficacy of multiple concentrations of EtOH, IPA, and SH on a human coronavirus (HCoV) dried on surfaces using short contact times. METHODS: Multiple concentrations of EtOH, IPA, and SH to inactivate high numbers of HCoV under real-life conditions were tested. High concentrations of infectious HCoV were dried on porcelain and ceramic tiles, then treated with multiple concentrations of the alcohols for contact times of 15 sec, 30 sec, and 1 min. Center for Disease Control (CDC) recommended three concentrations of SH were also tested. Reductions in titres were measured by using the tissue culture infectious dose 50 (TCID(50)) assay. FINDINGS: Concentrations of EtOH and IPA from 62% to 80% were very efficient at inactivating high numbers of HCoV dried on tile surfaces even with a 15 sec contact time. Concentrations of 95% dehydrated the virus, allowing infectious virus to survive. The CDC recommended 1/10 and 1/50 dilutions of SH were efficient at inactivating high numbers of HCoV dried on tile surfaces, whereas, a 1/100 dilution had substantially lower activity. CONCLUSIONS: EtOH, IPA, and SH at multiple concentrations efficiently inactivated infectious virus on hard surfaces, typical of those found in public places. Often no remaining infectious HCoV could be detected.


id: cord-314449-ukqux772
title: Prevention of hospital-acquired infections: review of non-pharmacological interventions
author: Curtis, L.T.
date: 2008-06-02
txt: ./txt/cord-314449-ukqux772.txt
cache: ./cache/cord-314449-ukqux772.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670108001503
doi: 10.1016/j.jhin.2008.03.018
summary:
  Interventions such as proper hand and surface cleaning, better nutrition, sufficient numbers of nurses, better ventilator management, use of coated urinary and central venous catheters and use of high-efficiency particulate air (HEPA) filters have all been associated with significantly lower nosocomial infection rates. This review is not exhaustive and will not attempt mathematical data analysis but will examine recent research that examines non-pharmacological interventions for reducing HAIs. It will also include a brief description of the morbidity, mortality and medical costs associated with nosocomial infections, along with a brief discussion of the routes by which HAIs spread. Many terms were used in the literature searches including nosocomial, hospital acquired, MRSA (meticillin-resistant Staphylococcus aureus), staphyloccoccus, streptococcus, VRE (vancomycinresistant enterococcus), Clostridium difficile, legionella, klebsiella, tuberculosis, airborne infection, waterborne infection, hand washing, hospital cleaning, urinary catheters, central catheters, haemodialysis, ultraviolet light, HEPA (high-efficiency particulate air) filtration and many others.

abstract:
  Hospital-acquired (nosocomial) infections (HAIs) increase morbidity, mortality and medical costs. In the USA alone, nosocomial infections cause about 1.7 million infections and 99 000 deaths per year. HAIs are spread by numerous routes including surfaces (especially hands), air, water, intravenous routes, oral routes and through surgery. Interventions such as proper hand and surface cleaning, better nutrition, sufficient numbers of nurses, better ventilator management, use of coated urinary and central venous catheters and use of high-efficiency particulate air (HEPA) filters have all been associated with significantly lower nosocomial infection rates. Multiple infection control techniques and strategies simultaneously (‘bundling’) may offer the best opportunity to reduce the morbidity and mortality toll of HAIs. Most of these infection control strategies will more than pay for themselves by saving the medical costs associated with nosocomial infections. Many non-pharmacological interventions to prevent many HAIs will also reduce the need for long or multiple-drug antibiotic courses for patients. Lower antibiotic drug usage will reduce risk of antibiotic-resistant organisms and should improve efficacy of antibiotics given to patients who do acquire infections.


id: cord-314554-ltej7wvo
author: Nakamura, Itaru
date: 2020-07-01
txt: ./txt/cord-314554-ltej7wvo.txt
cache: ./cache/cord-314554-ltej7wvo.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120303182?v=s5
doi: 10.1016/j.jhin.2020.06.033
abstract: nan
summary:
  key: cord-314554-ltej7wvo authors: Nakamura, Itaru; Watanabe, Hidehiro; Itoi, Takao title: Protective barrier box to mitigate exposure to airborne virus particles with minimum personal protective equipment when obtaining nasal PCR samples date: 2020-07-01 journal: J Hosp Infect cord_uid: ltej7wvo can be minimized to a gown, nonsterile gloves, and a medical mask, and only glove exchange is thought to be necessary to perform nasal sampling on the next patient. Although contamination after use was indicated as a disadvantage of the aerosol box 3 , this PCR box designed to be easily cleaned by wiping with a disinfectant after sampling. In preparation for the next epidemic, we must develop these types of protective devices, which can reduce the exposure risks and reduce the need for PPE. How to Obtain a Nasopharyngeal Swab Specimen More on Barrier Enclosure during Endotracheal Intubation More on Barrier Enclosure during Endotracheal Intubation The authors declare no conflict of interest

title:
  Protective barrier box to mitigate exposure to airborne virus particles with minimum personal protective equipment when obtaining nasal PCR samples


id: cord-314963-sk8pqjrh
author: O’Hearn, Katie
date: 2020-08-13
txt: ./txt/cord-314963-sk8pqjrh.txt
cache: ./cache/cord-314963-sk8pqjrh.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120303832
doi: 10.1016/j.jhin.2020.08.005
summary:
  Studies were eligible for inclusion in this systematic review if they satisfied all of the following criteria: (1) Original publication or systematic review; (2) Study reported on decontamination procedures for NIOSH-approved N95 (including SN95) FFRs or their components; (3) At least one of the decontamination procedures evaluated used one of the J o u r n a l P r e -p r o o f following chemical disinfectants: sodium hypochlorite; liquid hydrogen peroxide, vaporized hydrogen peroxide, hydrogen peroxide gas plasma, or ionized hydrogen peroxide; ethanol or isopropyl alcohol; (4) The study reported on at least one of the following outcomes of interest: (i) impact of the disinfectant on FFR performance, with a specific focus on aerosol penetration and airflow resistance (pressure drop); (ii) effectiveness of the disinfectant at removing viral or bacterial load; (iii) observations related to changes in physical traits following decontamination with a disinfectant; (iv) impact of each disinfectant on FFR fit; or (v) findings or observations related to user safety or irritation.

title:
  Efficacy and Safety of Disinfectants for Decontamination of N95 and SN95 Filtering Facepiece Respirators: A Systematic Review

abstract:
  BACKGROUND: Decontaminating and re-using filtering facepiece respirators (FFRs) for healthcare workers is a potential solution to address inadequate FFR supply during a global pandemic. AIM: The objective of this review was to synthesize existing data on the effectiveness and safety of using chemical disinfectants to decontaminate N95 FFRs. METHODS: We conducted a systematic review on disinfectants to decontaminate N95 FFRs using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined study eligibility and extracted predefined data fields. Original research reporting on N95 FFR function, decontamination, safety, or FFR fit following decontamination with a disinfectant was included. FINDINGS AND CONCLUSIONS: A single cycle of vaporized hydrogen peroxide (H(2)O(2)) successfully removes viral pathogens without affecting airflow resistance or fit, and maintains an initial filter penetration of <5%, with little change in FFR appearance. Residual hydrogen peroxide levels following decontamination were within safe limits. More than one decontamination cycle of vaporized H(2)O(2) may be possible but further information is required on how multiple cycles would affect FFR fit in a real world setting before the upper limit can be established. Although immersion in liquid H(2)O(2) does not appear to adversely affect FFR function, there is no available data on its ability to remove infectious pathogens from FFRs or its impact on FFR fit. Sodium hypochlorite, ethanol, isopropyl alcohol and ethylene oxide are not recommended due to safety concerns or negative effects on FFR function.


id: cord-320454-dhfl92et
title: Healthcare-associated infections in neonatal units: lessons from contrasting worlds
author: Srivastava, S.
date: 2007-03-12
txt: ./txt/cord-320454-dhfl92et.txt
cache: ./cache/cord-320454-dhfl92et.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670107000400
doi: 10.1016/j.jhin.2007.01.014
summary:
  Neonatal intensive care units are vulnerable to outbreaks and sporadic incidents of healthcare-associated infections (HAIs). Summary Neonatal intensive care units are vulnerable to outbreaks and sporadic incidents of healthcare-associated infections (HAIs). We reviewed 125 articles regarding HAIs from both advanced and resource-limited neonatal units in order to study risk factors, aetiological agents, antimicrobial susceptibility patterns and reported successes in infection control interventions. We reviewed 125 articles regarding HAIs from both advanced and resource-limited neonatal units in order to study risk factors, aetiological agents, antimicrobial susceptibility patterns and reported successes in infection control interventions. This review on healthcare-associated neonatal infections studies the definitions, associated risk factors and the aetiological agents involved with their antimicrobial susceptibility patterns in two contrasting worlds. Risk factors for hospital-acquired infections in the neonatal intensive care unit Outbreak of Candida bloodstream infections associated with retrograde medication administration in a neonatal intensive care unit

abstract:
  Neonatal intensive care units are vulnerable to outbreaks and sporadic incidents of healthcare-associated infections (HAIs). The incidence and outcome of these infections are determined by the degree of immaturity of the neonatal immune system, invasive procedures involved, the aetiological agent and its antimicrobial susceptibility pattern and, above all, infection control policies practised by the unit. It is important to raise awareness of infection control practices in resource-limited settings, since overdependence upon antimicrobial agents and co-existing lack of awareness of infection control is encouraging the emergence of multi-drug-resistant nosocomial pathogens. We reviewed 125 articles regarding HAIs from both advanced and resource-limited neonatal units in order to study risk factors, aetiological agents, antimicrobial susceptibility patterns and reported successes in infection control interventions. The articles include surveillance studies, outbreaks and sporadic incidents. Gram-positive cocci, viruses and fungi predominate in reports from the advanced units, while Gram-negative enteric rods, non-fermenters and fungi are commonly reported from resource-limited settings. Antimicrobial susceptibility patterns from surveillance studies determined the empirical therapy used in each neonatal unit. Most outbreaks, irrespective of the technical facilities available, were traced to specific lack of infection control practices. We discuss infection control interventions, with special emphasis on their applicability in resource-limited settings. Cost-effective measures for implementing these interventions, with particular reference to the recognition of the role of the microbiologist, the infection control team and antibiotic policies are presented.


id: cord-323732-7nzjrvla
author: Avo, Cameron
date: 2020-06-24
txt: ./txt/cord-323732-7nzjrvla.txt
cache: ./cache/cord-323732-7nzjrvla.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120303091
doi: 10.1016/j.jhin.2020.06.024
abstract: nan
summary:
  title: An Observational Study to Identify Types of Personal Protective Equipment Breaches on Inpatient Wards In response to the COVID-19 pandemic, UK Infection Prevention & Control (IP&C) guidelines have been published on using personal protective equipment (PPE) in various healthcare settings [1] . We conducted a behavioural observation study to investigate whether, based on national guidelines [1] , healthcare workers wear correct PPE, what breaches occur, and how frequently. ''All PPE'' zones require a fluid-resistant surgical face mask (FRSM), disposable apron, disposable gloves, and, subject to risk assessment, eye protection. Eye protection was not reported as part of the ''required'' PPE on non-COVID wards as this could not be objectively measured in the context of individual risk assessments. Eye protection was not counted as part of the ''required'' PPE on non-COVID wards as this could not be objectively measured in the context of individual risk assessments.

title:
  An Observational Study to Identify Types of Personal Protective Equipment Breaches on Inpatient Wards


id: cord-325612-a24qbiyd
author: Bae, Suyeon
date: 2020-06-23
txt: ./txt/cord-325612-a24qbiyd.txt
cache: ./cache/cord-325612-a24qbiyd.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.06.022
doi: 10.1016/j.jhin.2020.06.022
summary:
  METHOD: Observations measured different environmental features at three different departments and questionnaires asked HCP''s perception of safety from infectious diseases and coping behaviors (e.g., avoidance and disinfection). FINDINGS: This study has implications for potential interventions that enough HH stations at convenient locations would increase HH compliance rate from psychological perspectives, perception of safety from infectious diseases. The participants were asked to report the 12 degree of their perceptions of safety from infectious diseases at work (α = 0.92) and perceived 13 vulnerability on the 7-Likert scale (strongly disagree to strongly agree), the likelihoods of a 14 physical object being contaminated and causing infection (α = 0.94) on the 0-100 scale (not at all 15 to extremely likely), their behaviours (α = 0.94) on the 5-Likerts scale (never to always), and HH 16 compliance rates among the HCPs themselves.

title:
  The ways in which healthcare interior environments are associated with perception of safety from infectious diseases and coping behaviours

abstract:
  BACKGROUND: Global pandemic outbreaks often have people fear. Healthcare personnel (HCP), especially those fighting the pathogens at the front lines, encounter a higher risk of being infected, while they treat patients. In addition, a variety of environmental fomites in hospitals, which may contain infectious agents, can post a high risk of getting infectious diseases. AIM: Making HCP feel safe from infectious diseases is critical to delivering the best healthcare practice. Therefore, this study aims provide a better understanding of HCP’s HH behaviours and perceptions of infectious diseases from psychological perspectives. METHOD: Observations measured different environmental features at three different departments and questionnaires asked HCP’s perception of safety from infectious diseases and coping behaviors (e.g., avoidance and disinfection). FINDINGS: This study has implications for potential interventions that enough HH stations at convenient locations would increase HH compliance rate from psychological perspectives, perception of safety from infectious diseases. In response to the current research gap in psychological aspects associated with HH, this study also presents HCP’s coping behaviours (e.g., avoidance and disinfection) would be predicted by their perceived contamination likelihoods and their perceived vulnerability enhanced the associations. CONCLUSIONS: Nonetheless, due to several limitations, those findings should be carefully interpreted and further studies must be conducted with more solid academic rigor.


id: cord-328455-kg2pg8y2
title: Is it possible to achieve 100 percent hand hygiene compliance during the COVID-19 pandemic?
author: Wong, S.-C.
date: 2020-05-15
txt: ./txt/cord-328455-kg2pg8y2.txt
cache: ./cache/cord-328455-kg2pg8y2.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120302474
doi: 10.1016/j.jhin.2020.05.016
abstract: nan
summary:
  Since the SARS-CoV-2 is predominantly transmitted via droplet and contact routes, hand hygiene with appropriate PPE are key infection control measures to protect HCWs. 2 We therefore expected hand hygiene compliance among our HCWs to increase further during the COVID-19 pandemic. It is unexpected to observe relatively lower hand hygiene compliance among HCWs working in ward B, of which some of the beds are used for caring suspected or confirmed COVID-19 patients. Hand hygiene among HCWs has become even more important in the context of the COVID-19 pandemic, 6 especially with evidence of SARS-CoV-2 transmission while presymptomatic or asymptomatic. Absence of nosocomial transmission of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in the pre-pandemic phase in Hong Kong Hand hygiene compliance among healthcare workers in two paediatric units before and during COVID-19 pandemic All authors report no conflicts of interest relevant to this article.


id: cord-329135-g8fuax6p
title: Bioaerosol sampling: sampling mechanisms, bioefficiency and field studies
author: Haig, C.W.
date: 2016-04-01
txt: ./txt/cord-329135-g8fuax6p.txt
cache: ./cache/cord-329135-g8fuax6p.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670116300044
doi: 10.1016/j.jhin.2016.03.017
summary:
  Numerous successful studies are described that point to best practice in bioaerosol sampling, from the use of small personal samplers to monitor workers'' pathogen exposure through to large static samplers collecting airborne microbes in various healthcare settings. 11, 53 If the target microbe is unknown and a general assessment of bioaerosol particles present in an environment is sought, then the use of different types of sampling devices will mitigate the limitations of individual samplers, making a comprehensive study more likely. Correlation between active and passive sampling was also described during a study comparing different ventilation regimes in OTs. 12 Using a Surface Air System sampler (SAS, International Pbi, Milan, Italy) operating at 180 L/min and settle plates, both with tryptic soy agar, the study showed that unidirectional airflows within OTs did not guarantee low counts of airborne bacteria. Effect of sampling time and air humidity on the bioefficiency of filter samplers for bioaerosol collection

abstract:
  Investigations into the suspected airborne transmission of pathogens in healthcare environments have posed a challenge to researchers for more than a century. With each pathogen demonstrating a unique response to environmental conditions and the mechanical stresses it experiences, the choice of sampling device is not obvious. Our aim was to review bioaerosol sampling, sampling equipment, and methodology. A comprehensive literature search was performed, using electronic databases to retrieve English language papers on bioaerosol sampling. The review describes the mechanisms of popular bioaerosol sampling devices such as impingers, cyclones, impactors, and filters, explaining both their strengths and weaknesses, and the consequences for microbial bioefficiency. Numerous successful studies are described that point to best practice in bioaerosol sampling, from the use of small personal samplers to monitor workers' pathogen exposure through to large static samplers collecting airborne microbes in various healthcare settings. Of primary importance is the requirement that studies should commence by determining the bioefficiency of the chosen sampler and the pathogen under investigation within laboratory conditions. From such foundations, sampling for bioaerosol material in the complexity of the field holds greater certainty of successful capture of low-concentration airborne pathogens. From the laboratory to use in the field, this review enables the investigator to make informed decisions about the choice of bioaerosol sampler and its application.


id: cord-334738-k6002qzb
title: MERS-CoV in a healthcare worker in Jeddah, Saudi Arabia: an index case investigation
author: Shalhoub, S.
date: 2016-04-16
txt: ./txt/cord-334738-k6002qzb.txt
cache: ./cache/cord-334738-k6002qzb.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/27210272/
doi: 10.1016/j.jhin.2016.04.002
summary:
  In September 2015, a confirmed case of Middle East respiratory syndrome (MERS) was diagnosed in a healthcare worker in Jeddah, Saudi Arabia. The investigation identified a probable source of an index case who had been in hospital in Jordan in August 2015 while there was an ongoing MERS outbreak and who then subsequently sought medical care in Jeddah. Once the MERS-CoV diagnosis was confirmed, patient A was moved to a negative pressure isolation room in the intensive care unit (ICU). Infection control measures were taken as follows: all patients present in ED on the day of patient A''s diagnosis were screened for MERS-CoV using lower respiratory tract samples or NP samples using RTePCR. Patients who had fever, cough, leucopenia, hypo-oxygenation or infiltrates on chest X-ray were considered highly suspected MERS-CoV cases and were therefore moved to negative pressure isolation rooms while screening was undertaken.

abstract:
  In September 2015, a confirmed case of Middle East respiratory syndrome (MERS) was diagnosed in a healthcare worker in Jeddah, Saudi Arabia. Given the absence of confirmed MERS cases in Jeddah at the time, an epidemiological index case investigation took place. The investigation identified a probable source of an index case who had been in hospital in Jordan in August 2015 while there was an ongoing MERS outbreak and who then subsequently sought medical care in Jeddah.


id: cord-336259-gtb8ictv
title: Evidence for decontamination of single-use filtering facepiece respirators
author: Polkinghorne, A.
date: 2020-05-27
txt: ./txt/cord-336259-gtb8ictv.txt
cache: ./cache/cord-336259-gtb8ictv.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120302632
doi: 10.1016/j.jhin.2020.05.032
summary:
  Physical and chemical methods of decontamination have been tested for treatment of FFRs with ultraviolet germicidal irradiation, sterilization by steam, ethylene oxide and vaporous hydrogen peroxide, demonstrating the most promising results thus far. Decontamination of masks to facilitate safe re-use has been postulated as one, albeit controversial 8 , solution with a number of studies over the last 20 years investigating the effectiveness of different decontamination methods on the performance of the treated FFR in protecting the HCW and/or removing the potential of the FFR to act as a fomite [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] . Filter performance does not appear to be significantly impacted either with autoclave, oven and microwave-based methods demonstrated to have no significant effect on FFR particle filtration 10, 15, 17 , including after several cycles of exposure to steam decontamination 12 . A pandemic influenza preparedness study: use of energetic methods to decontaminate filtering facepiece respirators contaminated with H1N1 aerosols and droplets

abstract:
  Single-use filtering face respirators (FFRs) are critical pieces of personal protective equipment for healthcare workers treating patients with suspected upper respiratory tract pathogens. Experiences during pandemics in the 2000s, as well as the ongoing COVID-19 pandemic caused by the SARS-2-CoV2, have highlighted concerns over the pressures that sustained respiratory virus pandemics may have on supplies of FFRs globally. Decontamination of FFRs has been posited as one solution to support the re-use of FFRs with a growing body of literature over the last 10+ years beginning to examine both the efficacy of disinfection of contaminated FFRs but also the impact of the decontamination process on the FFR’s performance. Physical and chemical methods of decontamination have been tested for treatment of FFRs with ultraviolet germicidal irradiation, sterilization by steam, ethylene oxide and vaporous hydrogen peroxide, demonstrating the most promising results thus far. Many of these methods utilize existing equipment that may already be available in hospitals and could be re-purposed for FFR decontamination. Importantly, some methods may also be replicated on household equipment, broadening the utility of FFR decontamination across a range of healthcare settings. Utilizing techniques to experimentally contaminate FFRs with a range of microorganisms, most decontamination methods appear to reduce the risk of the mask as a source of infection to the wearer and others to negligible levels. The performance of the filter, especially the efficiency of particle penetration following treatment, varied greatly depending on the processing method as well as the model of the filter itself, however. Urgent regulatory body-supported research is required to endorse the routine decontamination of FFRs. In emergency settings, these methods should nevertheless be carefully considered as one strategy to address potential shortfalls in supplies of FFRs for healthcare workers.


id: cord-339203-5oextxkm
title: Preventing the Transmission of COVID-19 Amongst Healthcare Workers
author: Feng Tan, L.I.
date: 2020-04-09
txt: ./txt/cord-339203-5oextxkm.txt
cache: ./cache/cord-339203-5oextxkm.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120301833
doi: 10.1016/j.jhin.2020.04.008
abstract: nan
summary:
  To date, no healthcare worker has contracted COVID-19 in a Singapore healthcare institution. However, healthcare workers including non-clinical staff have contracted COVID-19 in the community and from overseas travel 6 . Whilst some had continued working for a short period prior to diagnosis, thus far there have been no cases of healthcare worker-to-patient COVID-SARS which was predominantly transmitted nosocomially in Singapore 5 , COVID-19 is predominantly acquired in the community. This presents a different challenge to preventing COVID-19 infection in healthcare workers. In Singapore, we have put in place strict staff management policies that have progressed as the infection continues its spread worldwide. All staff with travel to affected regions are placed on a 14-day compulsory leave of absence with overseas travel strongly discouraged as the infection has now spread across the globe. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China Beyond the assistance: additional exposure situations to COVID-19 for healthcare workers


id: cord-341069-kngf6qpe
title: Factors affecting stability and infectivity of SARS-CoV-2
author: Chan, Kwok-Hung
date: 2020-07-09
txt: ./txt/cord-341069-kngf6qpe.txt
cache: ./cache/cord-341069-kngf6qpe.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019567012030339X?v=s5
doi: 10.1016/j.jhin.2020.07.009
summary:
  AIM: The aim of this study was to investigate the infectivity of SARS-CoV-2 under various environmental factors, disinfectants and different pH conditions. The viability of virus was determined after treatment with different disinfectants and pH solutions at room temperature (20∼25(o)C). SARS-CoV-2 could be detected under a wide range of pH conditions from pH4 to pH11 for several days and 1 to 2 days in stool at room temperature but lost 5 logs of infectivity. One hundred microliters of SARS-CoV-2 with 114 10 6.5 TCID 50 /ml was added into each bottles of 0.9 ml VTM and incubated at room temperature 115 (20-25 o C). When SARS-CoV-2 was added in VTM with pH ranging from 2 to 13, the virus remained 163 viable up to 6 days but lost between 2.9 and 5.33 logs of infectivity from pH5 to pH9 and up 164 to 1~2 days in pH4 and pH11 ( Table 2) .

abstract:
  BACKGROUND: In late 2019, a novel human coronavirus, SARS-CoV-2, emerged in Wuhan, China. This virus has caused a global pandemic involving more than 200 countries. SARS-CoV-2 is highly adapted to humans and readily transmits from person-to-person. AIM: The aim of this study was to investigate the infectivity of SARS-CoV-2 under various environmental factors, disinfectants and different pH conditions. The efficacy of a variety of laboratory virus inactivation methods and home disinfectants against SARS-CoV-2 were investigated. METHODS: The residual virus in dried form or in solution was titrated on Vero E6 cell line at day 0, 1, 3, 5, and 7 after incubation at different temperatures. The viability of virus was determined after treatment with different disinfectants and pH solutions at room temperature (20∼25(o)C). FINDINGS: SARS-CoV-2 was able to retain viability for 3-5 days in dried form or 7 days in solution at room temperature. SARS-CoV-2 could be detected under a wide range of pH conditions from pH4 to pH11 for several days and 1 to 2 days in stool at room temperature but lost 5 logs of infectivity. A variety of commonly used disinfectants and laboratory inactivation procedures were found to reduce viral viability effectively. CONCLUSION: This study demonstrates the stability of SARS-CoV-2 on environmental surfaces and raises the possibility of faecal-oral transmission. Commonly used fixatives, nucleic acid extraction methods and heat inactivation were found to significantly reduce viral infectivity that could ensure hospital and laboratory safety during the COVID-19 pandemic.


id: cord-341462-gxpia9rs
title: Face Masks and Containment of Coronavirus Disease 2019 (COVID-19): Experience from South Korea
author: Lim, Soo
date: 2020-06-12
txt: ./txt/cord-341462-gxpia9rs.txt
cache: ./cache/cord-341462-gxpia9rs.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0195670120303029
doi: 10.1016/j.jhin.2020.06.017
abstract: nan
summary:
  title: Face Masks and Containment of Coronavirus Disease 2019 (COVID-19): Experience from South Korea The professional medical societies in South Korea have warned about health hazards from impaired infant health to increased adult mortality rate, and people are advised to wear a facial mask when PM level is very high (6) (7) (8) (9) (10) . This increasing public concern regarding PM has made wearing a face mask a matter of everyday life during epidemics of respiratory diseases in South Korea. A recently published article clearly showed the effectiveness of surgical face masks in reducing respiratory viral shedding (17) To conclude, considering the relatively low incidences of severe cases or mortality and good control of COVID-19 in several countries where self-quarantine principles are well established, wearing protective masks is an important strategy to stop the spread of respiratory viruses such as SARS-CoV-2. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis


id: cord-342277-v6310fjh
title: Environmental survey to assess viral contamination of air and surfaces in hospital settings
author: Carducci, A.
date: 2011-01-31
txt: ./txt/cord-342277-v6310fjh.txt
cache: ./cache/cord-342277-v6310fjh.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2010.10.010
doi: 10.1016/j.jhin.2010.10.010
summary:
  The aim of this study was to monitor surfaces and air in hospital settings to reveal the presence of hepatitis C virus, human adenovirus, norovirus, human rotavirus and torque teno virus by nucleic acid assays, in parallel with measurements of total bacterial count and haemoglobin presence. Moreover, viral agents transmitted via the faecaleoral route, such as rotavirus, human adenovirus 40 and 41 and norovirus, are frequently associated with healthcare setting infections spread by air, hand and surface contamination. The nucleic acids extracted from samples were analysed according to published protocols of nested (RT)ePCR to detect and distinguish the target viruses: the primers, virus genome regions and reaction conditions are reported in Table I . Although this is particularly true for viruses, where detection on surfaces and in air is very difficult, the low reliability of bacterial counts as indicators of viral contamination, suggests studying alternative parameters for assessing virological safety.

abstract:
  The presence of pathogenic viruses in healthcare settings represents a serious risk for both staff and patients. Direct viral detection in the environment poses significant technical problems and the indirect indicators currently in use suffer from serious limitations. The aim of this study was to monitor surfaces and air in hospital settings to reveal the presence of hepatitis C virus, human adenovirus, norovirus, human rotavirus and torque teno virus by nucleic acid assays, in parallel with measurements of total bacterial count and haemoglobin presence. In total, 114 surface and 62 air samples were collected. Bacterial contamination was very low (<1 cfu/cm(2)) on surfaces, whereas the ‘medium’ detected value in air was 282 cfu/m(3). Overall, 19 (16.7%) surface samples tested positive for viral nucleic acids: one for norovirus, one for human adenovirus and 17 (14.9%) for torque teno virus (TTV). Only this latter virus was directly detected in 10 air samples (16.1%). Haemoglobin was found on two surfaces. No relationship was found between viral, biochemical or bacterial indicators. The data obtained confirm the difficulty of assessing viral contamination using bacterial indicators. The frequent detection of TTV suggests its possible use as an indicator for general viral contamination of the environment.


id: cord-344468-ocrhgoba
title: When weighing universal precautions, filtration efficiency is not universal
author: Chen, V.
date: 2020-04-24
txt: ./txt/cord-344468-ocrhgoba.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32339617/
doi: 10.1016/j.jhin.2020.04.032
abstract: nan
summary:
  Most existing studies investigate masks made of cotton, but there are many promising materials that have not been formally tested, ranging from medical textiles like surgical wrap to consumer goods like non-woven polypropylene shopping bags. This innovation was publicized in the media before it was noted that the 99% efficiency of the surgical wrap refers to a measure called the bacterial filtration efficiency (BFE), and thus could not be meaningfully compared with N95 masks that are tested on their ability to remove much smaller particles. Other FDA-recognized filtration tests measure PFE, BFE, and viral filtration efficiency (VFE) using transmission of 0.1 micron polystyrene latex particles, S. Because each method uses different sized particles to test filtration, the significance of different metrics varies greatly and meaningful conclusions cannot be drawn by comparing, say, a standalone BFE to an N95 efficiency.


id: cord-346745-wowihqea
author: Tang, J.W.
date: 2005-10-25
txt: ./txt/cord-346745-wowihqea.txt
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extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/16253388/
doi: 10.1016/j.jhin.2005.05.017
summary:
  The simple water tank and food dye model shows that movement of air from opening the door could have resulted in the exposure of the susceptible nurse to airborne VZV from the patient in the isolation room ( Figure 1 ). 7,8 Therefore, there is a distinct possibility that despite the negative pressure inside the room, transmission of VZV may have occurred via infectious aerosol as the nurse stood at the door. In summary, we report a case of nosocomial transmission of VZV to a nurse that may have occurred via aerosol transmission, despite negative-pressure isolation of the infected patient. Thus, this case report recommends that susceptible personnel should not stand at the entrances of isolation rooms containing patients with respiratory infections since, despite negative pressure, nosocomial transmission via an airborne route may still be possible.

title:
  Door-opening motion can potentially lead to a transient breakdown in negative-pressure isolation conditions: the importance of vorticity and buoyancy airflows

abstract:
  A patient with severe chickenpox was admitted to a negative-pressure isolation room. He remained sedated, intubated and mechanically ventilated throughout his admission. He was managed only by nurses immune to chickenpox. A non-immune male nurse occasionally handed equipment through the doorway, without entering the room. Ten days later, he also developed chickenpox. Sequencing of viruses from the patient and nurse showed the same rare genotype, indicating nosocomial transmission. An experimental model demonstrated that, despite negative pressure, opening the door could have resulted in transport of infectious air out of the isolation room, leading to a breakdown in isolation conditions.


id: cord-347351-emdj66vj
author: Kampf, Günter
date: 2020-09-18
txt: ./txt/cord-347351-emdj66vj.txt
cache: ./cache/cord-347351-emdj66vj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jhin.2020.09.022
doi: 10.1016/j.jhin.2020.09.022
summary:
  Originating from a single travel-associated primary case from China, the first documented chain of multiple human-to-human transmissions of SARS-CoV-2 outside of Asia allowed a detailed study of transmission events and identified several factors (e.g. cumulative face-toface contact, direct contact with secretions or body fluids of a patient, personal protective equipment) to classify contacts as low or high risk [32] . In the close surrounding of COVID-19 patients in hospitals SARS-CoV-2 RNA is detected more frequently compared to surfaces outside the patient rooms but samples were so far consistently negative for infectious virus. General disinfection of frequently touched surfaces in the public such as shopping carts or door handles is, however, unlikely to add any protective value because even in COVID-19 wards inanimate surfaces were mainly contaminated in the permanent and immediate surrounding of symptomatic patients (detection of viral RNA, not of infectious virus) and only rarely one room away [138] suggesting that the risk to find SARS-CoV-2 on frequently touched surfaces in the public is low.

title:
  Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

abstract:
  During the current SARS-CoV-2 pandemic new studies are emerging daily providing novel information about sources, transmission risks and possible prevention measures. In this review, we aimed to comprehensively summarize the current evidence on possible sources for SARS-CoV-2, including evaluation of transmission risks and effectiveness of applied prevention measures. Next to symptomatic patients, asymptomatic or pre-symptomatic carriers are a possible source with respiratory secretions as the most likely cause for viral transmission. Air and inanimate surfaces may be sources; however, viral RNA has been inconsistently detected. Similarly, even though SARS-CoV-2 RNA has been detected on or in personnel protective equipment, blood, urine, eyes, the gastrointestinal tract and pets, these sources are currently thought to play a negligible role for transmission. Finally, various prevention measures such as hand washing, hand disinfection, face masks, gloves, surface disinfection or physical distancing for the healthcare setting and public are analysed for their expected protective effect.


