Contact precautions are required to prevent transmission of multi-drug-resistant organisms; however, reports on adherence rates vary. This study used video monitoring to evaluate adherence to the use ...of personal protective equipment (PPE) by different types of healthcare workers.
This observational study was conducted in a 781-bed tertiary hospital from July 2016 to March 2017. Cameras were installed in areas where staff don PPE. Infection control teams observed the videos and assessed adherence rates.
In total, 1097 opportunities for donning PPE were observed. Most staff observed were nurses and nursing assistants (Ns/Nsas) (880/1097, 80.2%). Overall, the adherence rate to appropriate PPE use was 34.0%. The adherence rate among Ns/Nsas was lower (239/858, 27.9%) compared with infectious disease doctors (18/18, 100%) and cleaning staff (42/49, 85.7%). The adherence rate for PPE use for Clostridium difficile infection (CDI) with toxin detection was significantly higher than that for CDI without toxin detection and multi-drug-resistant organisms (P<0.001 for both). The adherence rate for patients with an independent functional status was higher than that for patients with a dependent functional status (P=0.018). The adherence rate was lower in the intensive care unit (ICU) than in non-ICU wards (27.6% vs 36.5%; P=0.006).
Video monitoring is a useful tool for monitoring adherence to PPE use, facilitating observation of more PPE opportunities than direct observation. Adherence to contact precautions varied by occupation; however, overall adherence was insufficient. The lower adherence rate in nurses might be due to more frequent care visits.
The aim of this study was to investigate the epidemiology of post-COVID conditions beyond 12 months and identify factors associated with the persistence of each condition.
This was a cross-sectional ...questionnaire-based survey.
We conducted the survey among patients who had recovered from COVID-19 and visited our institute between February 2020 and November 2021. Demographic and clinical data and data regarding the presence and duration of post-COVID conditions were obtained. We identified factors associated with the persistence of post-COVID conditions using multivariable linear regression analyses.
Of 1148 surveyed patients, 502 completed the survey (response rate, 43.7%). Of these, 393 patients (86.4%) had mild disease in the acute phase. The proportion of participants with at least one symptom at 6, 12, 18, and 24 months after symptom onset or COVID-19 diagnosis was 32.3% (124/384), 30.5% (71/233), 25.8% (24/93), and 33.3% (2/6), respectively. The observed associations were as follows: fatigue persistence with moderate or severe COVID-19 (β = 0.53, 95% confidence interval CI = 0.06–0.99); shortness of breath with moderate or severe COVID-19 (β = 1.39, 95% CI = 0.91–1.87); cough with moderate or severe COVID-19 (β = 0.84, 95% CI = 0.40–1.29); dysosmia with being female (β = −0.57, 95% CI = −0.97 to −0.18) and absence of underlying medical conditions (β = −0.43, 95% CI = −0.82 to −0.05); hair loss with being female (β = −0.61, 95% CI = −1.00 to −0.22), absence of underlying medical conditions (β = −0.42, 95% CI = −0.80 to 0.04), and moderate or severe COVID-19 (β = 0.97, 95% CI = 0.41–1.54); depressed mood with younger age (β = −0.02, 95% CI = −0.04 to −0.004); and loss of concentration with being female (β = −0.51, 95% CI = −0.94 to −0.09).
More than one-fourth of patients after recovery from COVID-19, most of whom had had mild disease in the acute phase, had at least one symptom at 6, 12, 18, and 24 months after onset of COVID-19, indicating that not a few patients with COVID-19 suffer from long-term residual symptoms, even in mild cases.
We analysed associations between exposure to nightlife businesses and severe acute respiratory syndrome coronavirus 2 PCR test results at a tertiary hospital in Tokyo between March and April 2020. A ...nightlife group was defined as those who had worked at or visited the businesses. We included 1517 individuals; 196 (12.9%) were categorised as the nightlife group. After propensity score matching, the proportion of positive PCR tests in the nightlife group was significantly higher than that in the non-nightlife group (nightlife, 63.8%; non-nightlife, 23.0%; P < 0.001). An inclusive approach to mitigate risks related to the businesses needs to be identified.
The purpose of this investigation was to elucidate the impact of prompt intervention for patients whose blood culture results became positive during weekends, as this is not standard care in some ...countries. A retrospective cohort study was conducted in a tertiary referral hospital. From June 2015, results of positive blood cultures became available during weekends. If infectious disease specialists identified cases of bacteremia on suboptimal antimicrobial coverage, they contacted the primary team for modification of antibiotic treatment. We reviewed patients whose blood culture results became positive during weekends, comparing the pre-intervention (September 2014 to May 2015) and post-intervention (June 2015 to February 2016) periods. In total, 1081 (post-intervention 568 52.5%) bacteremia episodes were included (median patient age interquartile range, IQR: 72 60–82 years; men: 625 57.8%). During the post-intervention period, 187 (32.9%) bacteremia episodes were detected during weekends. Infectious disease specialists evaluated the positive blood culture results 1, 2, and ≥3 days prior in 77 (13.6%), 88 (15.5%), and 22 (3.9%) cases, respectively. Although the 7- and 30-day mortality did not significantly improve after the intervention, the length of hospital stay (LOS) in the hospital-acquired bacteremia group was significantly reduced during the post-intervention period after controlling for confounders (post- vs. pre-intervention: median days IQR: 37 19–63 vs. 46.5 24.8–86.3,
p
= 0.030). Blood culture results became positive during weekends in one-third of bacteremia cases. The LOS was shortened after the intervention in the hospital-acquired bacteremia group. This could be an important antimicrobial stewardship target.
The kinetics and mechanism of oxidation of CF3CHFOCH3 was studied using an 11.5-dm3 environmental reaction chamber. OH radicals were produced by UV photolysis of an O3−H2O−He mixture at an initial ...pressure of 200 Torr in the chamber. The rate constant of the reaction of CF3CHFOCH3 with OH radicals (k 1) was determined to be (1.77 ± 0.69) × 10-12 exp(−720 ± 110)/T cm3 molecule-1 s-1 by means of a relative rate method at 253−328 K. The mechanism of the reaction was investigated by FT-IR spectroscopy at 298 K. CF3CHFOC(O)H, FC(O)OCH3, and COF2 were determined to be the major products. The branching ratio (k 1a/k 1b) for the reactions CF3CHFOCH3 + OH → CF3CHFOCH2 • + H2O (k 1a) and CF3CHFOCH3 + OH → CF3CF•OCH3 + H2O (k 1b) was estimated to be 4.2:1 at 298 K from the yields of CF3CHFOC(O)H, FC(O)OCH3, and COF2. The rate constants of the reactions of CF3CHFOC(O)H (k 2) and FC(O)OCH3 (k 3) with OH radicals were determined to be (9.14 ± 2.78) × 10-13 exp(−1190 ± 90)/T and (2.10 ± 0.65) × 10-13 exp(−630 ± 90)/T cm3 molecule-1 s-1, respectively, by means of a relative rate method at 253−328 K. The rate constants at 298 K were as follows: k 1 = (1.56 ± 0.06) × 10-13, k 2 = (1.67 ± 0.05) × 10-14, and k 3 = (2.53 ± 0.07) × 10-14 cm3 molecule-1 s-1. The tropospheric lifetimes of CF3CHFOCH3, CF3CHFOC(O)H, and FC(O)OCH3 with respect to reaction with OH radicals were estimated to be 0.29, 3.2, and 1.8 years, respectively.
Gas-to-water equilibrium coefficients, KeqS (in M atm−1), of difluoromethane (CH2F2), a hydrofluorocarbon refrigerant (HFC-32), in aqueous salt solutions relevant to seawater were determined over a ...temperature (T) range from 276 to 313 K and a salinity (S) range up to 51 ‰ by means of an inert-gas stripping method. From the van't Hoff equation, the KeqS value in water, which corresponds to the Henry's law constant (KH), at 298 K was determined to be 0.065 M atm−1. The salinity dependence of KeqS (the salting-out effect), ln(KH∕KeqS), did not obey the Sechenov equation but was proportional to S0. 5. Overall, the KeqS(T) value was expressed by ln(KeqS(T)) = −49.71 + (77.70 − 0.134 × S0. 5) × (100∕T) + 19.14 × ln(T∕100). By using this equation in a lower-tropospheric semi-hemisphere (30–90 °S) of the Advanced Global Atmospheric Gases Experiment (AGAGE) 12-box model, we estimated that 1 to 4 % of the atmospheric burden of CH2F2 resided in the ocean mixed layer and that this percentage was at least 4 % in the winter; dissolution of CH2F2 in the ocean may partially influence estimates of CH2F2 emissions from long-term observational data of atmospheric CH2F2 concentrations.
Emerging drug resistance in Salmonella Typhi and S. Paratyphi is a substantial public health concern. We report what appears to be the first case and isolation of multidrug resistant S. Paratyphi A ...carrying CTXM-15-type extended-spectrum beta-lactamase from a Japanese traveller returning from India.
The atmospheric chemistry of (CF3)2CHOCH3, a possible HCFC/HFC alternative, was studied using a smog chamber/FT-IR technique. OH radicals were prepared by the photolysis of ozone in a 200-Torr ...H2O/O3/O2 gas mixture held in an 11.5-dm3 temperature-controlled chamber. The rate constant, k 1, for the reaction of (CF3)2CHOCH3 with OH radicals was determined to be (1.40 ± 0.28) × 10-12 exp(−550 ± 60)/T cm3 molecule-1 s-1 by means of a relative rate method at 253−328 K. The value of k 1 at 298 K was (2.25 ± 0.04) × 10-13 cm3 molecule-1 s-1. The random errors are reported with ±2 standard deviations, and potential systematic errors of 15% could increase k 1. In considering OH-radical reactions, we estimated the tropospheric lifetime of (CF3)2CHOCH3 to be 2.0 months using the rate constant at 288 K. The degradation mechanism of (CF3)2CHOCH3 initiated by OH radicals was also investigated using FT-IR spectroscopy at 298 K. Products (CF3)2CHOC(O)H, CF3C(OH)2CF3, CF3C(O)OCH3, and COF2 were identified and quantified. The branching ratio, k 1a/k 1b, was estimated to be 2.1:1 for reactions (CF3)2CHOCH3 + OH → (CF3)2CHOCH2 •+ H2O (k 1a) and (CF3)2CHOCH3 + OH → (CF3)2C•OCH3 + H2O (k 1b).
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