This study aimed to gain insight into how to better educate nurses and improve their clinical practice on antimicrobial therapy through a survey of their relevant educational and clinical experiences. A questionnaire survey was conducted on 681 ward nurses at 173 hospitals nationwide, including regional medical care support hospitals with 300 or more beds, advanced treatment hospitals, and designated cancer hospitals. The survey inquired about the respondents' educational experience in 17 areas of antimicrobial therapy, their knowledge of time- and concentration-dependent antimicrobial agents, their awareness and practice of intravenous antimicrobial administration, and prescription orders by physicians.

The number of completed questionnaires that we received back was 381 (response rate: 55.9%). There were only four aspects of antimicrobial therapy in which 70% or more respondents received education. Of the respondents, 9.6% were educated in the PK-PD theory and 36.6% in the assessment of stool properties using the Bristol stool scale. The rates of those who received education regarding time- and concentration-dependent antimicrobial agents were 42.9% and 37.3%, respectively, and 51.9% of the respondents were found to "successfully" administer time-dependent agents at equal intervals. In addition, 90% or more of the respondents were either "aware" or "somewhat aware" of the need to assess side effects. Among them, 62.0% collected information on diarrhea, and 28.3% employed the Bristol stool scale. Less than 50% of the respondents were found to "always" receive prescription orders from physicians.

Nurses tend to have less educational experience in the areas of antimicrobial therapy which requires practical improvement. The results indicate the need for appropriate continuing education, enhanced on-the-job training, and clear and specific prescription orders by physicians.

This study conducted a survey on healthcare workers (HCWs) who received two doses of the BNT162b2 coronavirus disease 2019 (COVID-19) vaccine. It aimed to determine their postvaccination severe acute respiratory syndrome 2 (SARS-CoV-2) antibody status.

The study enrolled a total of 307 HCWs. Blood samples, which were obtained 2 weeks after receiving the second vaccination dose, were analyzed using a lateral flow test, the Wondfo SARS-CoV-2 antibody test, which outputs results in the form of lines. We developed a visual scoring system for the quantification of test line intensity, with scores ranging from 0 to 5.

Among individuals with a history of previous SARS-CoV-2 infection, 85.7% (12/14) scored 5 (strongly positive) in comparison with 22.9% (67/293) of individuals with no history of previous SARS-CoV-2 infection. A score of 5 was associated with prior SARS-CoV-2 infection and postvaccination fever (adjusted odds ratios, 19.6 and 2.6; 95% confidence intervals, 5.0-131 and 1.3-4.9, respectively). In addition, we conducted an enzyme-linked immunosorbent assay on some of the blood samples to evaluate the anti-spike protein antibody levels. Anti-SARS-CoV-2 antibodies were identified in 99.7% (306/307) of fully vaccinated HCWs. The final analysis included the results of previous antibody tests conducted before and after the initial vaccine dose of the HCWs. We confirmed that a higher score in the quantifying test corresponds to higher antibody titers. The average anti-spike protein antibody levels before and after the vaccination showed the following results: 1132±1007 AU/mL in previously infected HCWs before vaccination; 18070±4183 AU/mL in previously infected HCWs after the first vaccination; 7819±3822 AU/mL in previously uninfected HCWs after the second vaccination; and 30206±9740 AU/mL in previously infected HCWs after the second vaccination. Significant differences were observed between each group (P < 0.01).

It has been reported that the improved compliance with standard precautions and hand hygiene reduced the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in neonatal intensive care units (NICUs). However, the inhospital transmission of MRSA has not been completely prevented. This study aimed to identify issues that need to be considered in the future, which was a systematic scoping review of preventive measures of MRSA infections in the medical treatment environment in NICU. Using the Japanese (Igakuchuozasshi) and English (Pubmed) database, we searched for articles published between January 1, 1950, and October 31, 2019. The inclusion criteria of the articles were as follows: reporting the incidence rate of MRSA in the NICU and describing measures for medical treatment environment. Ultimately, 22 articles were selected. The measures for the medical treatment environment were implemented primarily to reduce the inhospital transmission of MRSA and to control outbreaks. These measures were classified into the following three categories: environmental hygiene management, allocations of infants and staffs, and hospital equipment. Among the 22 articles, some demonstrated that changes in cleaning procedures or facility renovation resulted in the reduction of MRSA colonization and/or infection rates. Other studies reported that bed placement, isolation of colonized/infected infants, and workflow of nurses in charge of colonized infants increased the risk of MRSA transmission. The boundaries of the patient's area may elucidate the workflow line of the healthcare personnel and timing of hand hygiene and medical/care equipment sanitation. The effectiveness of infection prevention measures, such as clear boundaries between patient areas and/or distances between the patients' beds, have not yet been elucidated.

Herein, we report five cases of adult varicella in foreign workers who were diagnosed at Kaga Medical Center between April 2016 and May 2019. We conducted epidemiological investigations of the sample by age distribution and monthly distribution of the onset for the five foreign cases, five cases of varicella in Japanese adults, and all cases of varicella and herpes zoster diagnosed during this period. All the five foreign workers who were diagnosed with adult varicella were Vietnamese, and their mean age was 22.6±0.8 years. The mean age of the five Japanese adults was 64.6±21.2 years, which indicates a wide variation. A total of 54 patients had varicella, of whom 41 (75%) were children below 10 years old. Among the patients who had zoster, 73 were Japanese, and 21 (28.8%) of them were in their 70s. The comparison of the distribution of varicella and herpes zoster cases by month of onset revealed that herpes zoster occurred throughout the year, most commonly in February and August. On the contrary, varicella was not found to occur during the summer, and it had a bimodal distribution peaking from March to May and November to January. The cases of adult varicella in foreign workers occurred in January, May, and November, coinciding with the varicella season in Japan. Moreover, four of the foreign workers developed varicella more than 3 weeks after arriving in Japan, indicating that they were likely exposed to the virus after entering the country. Conclusively, it is important that we enlighten clinicians with regard to the necessity of varicella vaccination for foreign workers who have no immunity against varicella zoster virus.