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Hospital-Acquired Infections: Risk Factors and Preventions

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A special issue of Pathogens (ISSN 2076-0817).

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 7274

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Special Issue Editors

Dr. Gabriele Messina

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Guest Editor

Department of Molecular and Developmental Medicine, Università degli Studi di Siena, Siena, Italy
Interests: technology; prevention; disinfection; UV radiation; LED; environmental hygiene; high touch; cross-contamination; stethoscopes; HAI
Special Issues, Collections and Topics in MDPI journals

Dr. Davide Amodeo

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Guest Editor

Department of Medical Biothecnologies, Università degli Studi di Siena, Siena, Italy
Interests: microbiology; environmental hygiene; disinfection; UV radiation; multidrug-resistant bacteria; HAI
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nosocomial infections, also known as hospital-acquired infections (HAIs), a term coined in the 1990s, have a significant public health impact in terms of morbidity, mortality, and care-related costs, despite continued advances in the areas of epidemiology and scientific research.

Risk factors and preventive actions compete for the challenge considering that more than half of HAIs are preventable, especially those associated with certain behaviours, through a multidisciplinary approach.

Interventions are needed at several levels to contain and avoid HAIs: education, adherence to good hygiene practices during care, hand hygiene, patient screening, surveillance, antibiotic stewardship, and guidelines.

Furthermore, an essential element is the environment, where microbes persist, and 'high touch' surfaces because of their role in cross-contamination. A holistic approach is the effective key to managing the problem.

The aim of this Special Issue is to bring together technological, structural, educational, and operational experiences for the prevention and management of HAIs.

Dr. Gabriele Messina
Dr. Davide Amodeo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

surgical site infection
dialysis infection
burn infection
bacterial infections: Legionella
Clostridium difficile
ventilator-associated pneumonia prevention
female urinary catheter in urinary tract infection prevention
endoscope sterilization and disinfection

Related Special Issue

Hospital-Acquired Infections: Risk Factors and Preventions—2nd Edition in Pathogens

Published Papers (5 papers)

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Research

13 pages, 543 KiB

Open AccessArticle

Clinical and Microbiological Risk Factors for 30-Day Mortality of Bloodstream Infections Caused by OXA-48-Producing Klebsiella pneumoniae

by Pilar Lumbreras-Iglesias, Edurne Rodrigo-Arrazola, Lucía López-Amor, Jonathan Fernández-Suárez, María Rosario Rodicio and Javier Fernández

Pathogens 2024, 13(1), 11; https://doi.org/10.3390/pathogens13010011 - 21 Dec 2023

Viewed by 1002

Abstract

Bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae are associated with high morbidity and mortality, and the therapy options available for their treatment are frequently scarce. The aim of this study was to analyze risk factors for 30-day mortality in patients with BSI caused by OXA-48-producing K. pneumoniae. The clinical and treatment features of the patients, who attended a single hospital over a five-year period, were retrospectively reviewed. The microbiological features, including the sequence types (ST) and the somatic (O) and capsular (K) antigens, as well as their resistance properties, comprising phenotypes and genetic background, were also considered. To identify the risk factors for 30-day mortality, uni- and multivariate statistical analyses were performed. The univariate analysis revealed statistically significant correlations for age, male gender, lower respiratory system infection, infection by ST147 isolates, and infection by isolates expressing the K64 antigen. The multivariate analysis, applied to variables yielding p-values close to or lower than 0.05 in the univariate analysis, confirmed gender, lower respiratory system infection, and infection with ST147 isolates, but not age or infection with K64 isolates, as risk factors for 30-day mortality. Moreover, the multivariate analysis showed that patients suffering from hematological malignancies or having been treated with inappropriate therapy, both having p-values slightly higher than 0.05 in the univariate analysis, exhibited significantly poorer outcomes in the multivariant analysis. The association of the ST147 clone with an increased risk of mortality is a novel finding that deserves further attention. Studies like the one presented here can certainly benefit the management of patients with nosocomial BSI caused by carbapenemase-producing K. pneumoniae. Full article

(This article belongs to the Special Issue Hospital-Acquired Infections: Risk Factors and Preventions)

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13 pages, 2667 KiB

Open AccessArticle

Efficacy of Violet-Blue (405 nm) LED Lamps for Disinfection of High-Environmental-Contact Surfaces in Healthcare Facilities: Leading to the Inactivation of Microorganisms and Reduction of MRSA Contamination

by Davide Amodeo, Pietro Manzi, Isa De Palma, Alessandro Puccio, Nicola Nante, Mariella Barcaccia, Daniele Marini and Donatella Pietrella

Pathogens 2023, 12(11), 1338; https://doi.org/10.3390/pathogens12111338 - 10 Nov 2023

Cited by 2 | Viewed by 1262

Abstract

Effective disinfection procedures in healthcare facilities are essential to prevent transmission. Chemical disinfectants, hydrogen peroxide vapour (HPV) systems and ultraviolet (UV) light are commonly used methods. An emerging method, violet-blue light at 405 nm, has shown promise for surface disinfection. Its antimicrobial properties are based on producing reactive oxygen species (ROS) that lead to the inactivation of pathogens. Studies have shown significant efficacy in reducing bacterial levels on surfaces and in the air, reducing nosocomial infections. The aim of this study was to evaluate the antimicrobial effectiveness of violet-blue (405 nm) LED lamps on high-contact surfaces in a hospital infection-control laboratory. High-contact surfaces were sampled before and after 7 days of exposure to violet-blue light. In addition, the effect of violet-blue light on MRSA-contaminated surfaces was investigated. Exposure to violet-blue light significantly reduced the number of bacteria, yeasts and moulds on the sampled surfaces. The incubator handle showed a low microbial load and no growth after irradiation. The worktable and sink showed an inconsistent reduction due to shaded areas. In the second experiment, violet-blue light significantly reduced the microbial load of MRSA on surfaces, with a greater reduction on steel surfaces than on plastic surfaces. Violet-blue light at 405 nm has proven to be an effective tool for pathogen inactivation in healthcare settings Violet-blue light shows promise as an additional and integrated tool to reduce microbial contamination in hospital environments but must be used in combination with standard cleaning practices and infection control protocols. Further research is needed to optimise the violet-blue, 405 nm disinfection method. Full article

(This article belongs to the Special Issue Hospital-Acquired Infections: Risk Factors and Preventions)

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9 pages, 1856 KiB

Open AccessArticle

The Effect of Subinhibitory Concentration of Metronidazole on the Growth and Biofilm Formation on Toxigenic Clostridioides difficile Strains Belonging to Different Ribotypes

by Dorota Wultańska, Paweł Karpiński, Michał Piotrowski and Hanna Pituch

Pathogens 2023, 12(10), 1244; https://doi.org/10.3390/pathogens12101244 - 14 Oct 2023

Viewed by 1008

Abstract

Clostridioides difficile is a predominant nosocomial pathogen within the healthcare setting able to produce biofilms. Sub-minimum inhibitory concentrations (sub-MICs) of antibiotics trigger mechanisms affecting bacterial virulence, including increased adhesion and biofilm formation. The aim of this study was to investigate how sub-MICs of metronidazole affect the biofilm formation of C. difficile strains. We tested 14 reference and clinical C. difficile strains, including hypervirulent strains of RT027. The MICs of metronidazole for the tested strains were determined using the broth microdilution method. Biofilm formation was evaluated using confocal laser scanning microscopy. The C. difficile strains belonging to RT027 produced the highest amounts of biofilm. The results of confocal laser scanning microscopy showed that all the tested C. difficile strains developed larger biofilms with diversified architectures upon exposure to sub-MICs of metronidazole. In our study, we reveal that sub-MIC concentrations of metronidazole affect the biofilm formation of clinical and reference strains of C. difficile. Importantly, metronidazole induces biofilm formation via hypervirulent RT027 strains. Full article

(This article belongs to the Special Issue Hospital-Acquired Infections: Risk Factors and Preventions)

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6 pages, 1715 KiB

Open AccessCommunication

Far-UVC Radiation for Disinfecting Hands or Gloves?

by Martin Hessling, Ben Sicks and Bernhard Lau

Pathogens 2023, 12(2), 213; https://doi.org/10.3390/pathogens12020213 - 29 Jan 2023

Cited by 2 | Viewed by 1857

Abstract

(1) Background: Far-UVC radiation in the spectral range 200–230 nm has, according to previous findings, a strong antimicrobial effect on pathogens, but exhibits hardly any harmful effect on human skin. Therefore, the present study will discuss whether such radiation could also be suitable for hand disinfection in the healthcare sector. (2) Methods: Hands and gloves were microbially contaminated and exposed to radiation from a 222 nm krypton-chloride-excimer lamp. The applied doses were 23 mJ/cm² and 100 mJ/cm², respectively. Irradiated and non-irradiated hands and gloves were pressed onto agar plates and colonies were counted and compared after 24 h of incubation. For comparison, we also treated hands and gloves with a commercial liquid alcohol-based disinfectant. (3) Results: On the hand, the 23 mJ/cm² resulted in the reduction of the observed colonies on the agar plates by one log level. For the gloves irradiated with 100 mJ/cm², a colony reduction of 1.3 log levels was recorded. In the comparative experiments with the commercial disinfectant, a colony reduction of 1.9 and approximately one log level was observed on hand and gloves, respectively. (4) Conclusion: In both cases, far-UVC radiation provided a considerable reduction in microorganisms. However, compared to published far-UVC irradiation results in suspensions, the disinfection success on hands and gloves was rather low. With regard to the irradiation limits currently existing in the European Union, multiple daily hand disinfection with far-UVC radiation is actually legally not possible at present, but the thresholds are currently under discussion and could change in the future. Far-UVC disinfection of hands in gloves seems theoretically possible if attention is paid to potential perforations in the gloves. Full article

(This article belongs to the Special Issue Hospital-Acquired Infections: Risk Factors and Preventions)

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12 pages, 2122 KiB

Open AccessArticle

Clinical Characteristics and Risk Factors for Intra-Abdominal Infection with Chryseobacterium indologenes after Orthotopic Liver Transplantation

by Yixin Zhang, Xiaoyu Zhao, Su Xu and Ying Li

Pathogens 2022, 11(10), 1126; https://doi.org/10.3390/pathogens11101126 - 29 Sep 2022

Cited by 2 | Viewed by 1463

Abstract

The incidence of hospital-acquired infections caused by Chryseobacterium indologenes (C. indologenes) is increasing. This study investigated the epidemiological and clinical features of C. indologenes intra-abdominal infections in patients who underwent orthotopic liver transplantation (OLT). In this retrospective study, 53 consecutive non-replicate clinical isolates of C. indologenes were collected and identified from the OLT patients at a tertiary care university hospital in Shanghai in 2017. Genetic relatedness of the isolates was determined by enterobacterial repetitive intergenic consensus polymerase chain reaction DNA fingerprinting. Antimicrobial susceptibility of the isolates was measured using the microdilution broth method. Nosocomial clonal transmission of C. indologenes was confirmed by bacterial homology analysis. All C. indologenes isolates were resistant to β-lactams, carbapenems, quinolones, and aminoglycosides, and showed susceptibility to trimethoprim–sulfamethoxazole and minocycline. Multivariate risk modelling revealed that ≥2 bed transfers and an operation time of ≥8 h were independent risk factors for C. indologenes intra-abdominal infection after OLT. A nomogram was constructed based on the screened risk factors, which showed good concordance and accuracy. Clonal dissemination of C. indologenes in OLT patients was demonstrated and several risk factors for intra-abdominal infections were identified. Epidemiological surveillance of this organism and extensive surveillance programs are imperative worldwide. Full article

(This article belongs to the Special Issue Hospital-Acquired Infections: Risk Factors and Preventions)

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