Central line-associated bloodstream infection (CLABSI) is an infection that is routinely observed and is a problem in the pain of the patients and medical care economy. In total, 278 cases were clinically judged as CLABSI during hospitalization for 3 years from January 2013 to December 2015. When CLABSI occurs, additional medical cost is incurred; however, as for by one, examines the additional treatment (antimicrobial agents, antifebriles, testing, and hospital charges). Also, we examined bacteria detected from catheter tip cultures and the infection related to the number of the lumen incidence of catheter. The mean days from CVC puncture to the infection onset were 20.1, and the additional days of hospitalization were an average of 7.4. The total cost was 49,933,000 yen, and the additional total medical expense for the 278 cases was an average of 179,000 yen; 35.0% of Staphylococcus aureus, coagulase-negative staphylococci infections 32.5%, number of the lumen were single; the tip culture detected bacteria was double, and a rate of infection was high in order of triple. Also, an estimated cost of 20 million yen was expected for 3 years when we considered replacing it before CLABSI onset as a supposition in PICC. An increase in CLABSI extends the length of hospital stay and increases the medical cost. Prevention is important, and we consider adaptation of the catheter custody sufficient and do it, and unnecessary catheter removes it early without detaining you. The associated medical staff needs prevention from CLABSI and education about infection measures. Of the medical person to "recover from CLABSI if catheter withdrawal" have an easy plan, but CLABSI can be fatal when aggravated.
The objectives of this study were to elucidate changes in the recognition and actions of nursing students regarding uniform care and to examine the degree of bacterial contamination of their uniforms by the number of days worn. In total, 199 nursing students participated in a questionnaire survey on uniform management. Bacterial specimens were collected from the uniforms of 19 nursing students using sterile cotton swabs both after the uniforms were worn and after they were laundered. The samples were subjected to aerobic culturing at 37°C for 48 h. The number of bacteria was counted, and the strains were identified. The antimicrobial susceptibility of Staphylococcus spp. was also evaluated. The number of uniform wearing days was the longest among the students of the higher grade. Most nursing students in the lower grade considered 1 day as the ideal number of one uniform-wearing day. The number of bacteria on the uniforms increased after they were worn in both the groups, i.e., among those who wore it for 1 day and those who wore it for ≥2 days. After laundering, the number of bacteria decreased in both the groups, but a larger number of bacteria survived on the uniform of those who wore it for ≥2 days. The commonly detected bacteria on the uniforms belonged to Staphylococcus spp., Micrococcus spp., and Moraxella spp. in both the groups. After laundering, Micrococcus spp. and S. hominis were detected more often on the uniform of those who wore it for ≥2 days. Among the 31 strains of Staphylococcus spp. observed, one strain of S. aureus was identified as methicillin-sensitive S. aureus. Among other CNS, the rate of antibiotic resistance was as follows: 100% for S. cohnii and 50% each for S. caprae, S. epidermidis, and S. haemolyticus. These findings suggest that it is necessary to reconsider uniform care and to longitudinally examine the rate of antibiotic resistance of Staphylococcus spp.
Multi-drug resistant Pseudomonas aeruginosa (MDRP) was detected in a patient hospitalized in the Department of Hematology and Oncology at the Tokai University Hachioji Hospital in July 2015. An infection control team (ICT) examined the nozzles of warm-water toilet seats that contributed to the widespread MDRP infection in this ward. A cleaning method used by the cleaning staff as an in-hospital infection prevention measure was improperly implemented and was identified as one factor causing the outbreak. The problems identified by the ICT revealed that warm-water toilet seats were being used daily but were not being appropriately cleaned, and the warm-water toilet seats were outdated in the hospital. Aggressive intervention by the ICT is necessary for the development of an effective cleaning regime for the equipment being used in the hospital.
Arthropods, such as mites and mosquitos, are widely known to transmit pathogens that are responsible for viral hemorrhagic, dengue, and Zika fevers. In addition, several other fly species have the potential to act as vectors for bacterial pathogens in hospitals. An infection control team (ICT) investigated the origin and breeding of small household flies and implemented measures to prevent the outbreak of flies in the operating ward of a Japanese hospital. The ICT placed six light traps in the operating ward and counted and identified trapped flies at monthly intervals from September 2015 to October 2016. Of the 344 flies that were captured in the first month, phorid flies (Phoridae) were the most abundant. Of these, 115 phorid flies were captured in the staff room of the ward. Moth flies (Psychodidae) were the most common around an unused bed washer in one of the rooms in the ward. The ICT considered that phorid flies were attracted by leftover food in the staff room, and moth flies were attracted to damp conditions around the bed washer.
The ICT instructed users of the staff room to clean leftover food, and they washed out the drain pipe of the bed washer before completely removing the bed washer from the operating ward. After implementing these measures, outbreaks of flies in the operating ward have decreased since October 2016. In addition, the ICT isolated and cultured bacteria from fly integuments and from homogenized flies; however, no antibiotic-resistant bacteria were detected. It is necessary to investigate the origin and breeding of small household flies in hospital settings at the earliest and to continue the implementation of fly-control interventions proposed by the ICT.