Surgical site infections (SSIs) not only decrease patient satisfaction with surgery but also consume medical resources. Furthermore, they can affect not only hospital management but also the national health care budget. Preventive measures need to be taken to prevent the occurrence of SSIs as much as possible. Thus, scientifically based measures that are cost effective are needed. There are more than 3,000 articles on SSIs published annually, and it is physically impossible for medical professionals to study SSIs on their own. Thus, they need to refer to medical practice guidelines to develop countermeasures. Several guidelines have already been published, but the issue is which of them should be used for reference.

Among the issues to be addressed before surgery are the confirmation of nasal carriage of MRSA and its eradication. Before colorectal surgery, there is likely to be a discussion regarding bowel preparation. Regarding the measures to be taken during surgery, disinfectants used for the surgical site, additional intraoperative administration of prophylactic antibacterial agents, double-wearing of surgical gloves, use of antibacterial sutures, and prophylactic drains are to be addressed. Some institutions have not adapted the recommendations in the guidelines to clinical practice, and there is room for improvement in this area.

In this article, we first review the usefulness and limitations of the guidelines. Then, we examine the differences among the various guidelines and explain how to incorporate them into daily practice.

[Purpose] This study aimed to investigate infection prevention measures for Emergency Medical Technicians (EMTs) and to elucidate issues specific to fire departments.

[Target] Consent was obtained from 30 EMTs from three municipal fire departments that cooperated in this research.

[Method] At the target fire departments, the participants were directly interviewed, and the facility was inspected. Furthermore, the N95 mask-wearing procedure was evaluated, and a quantitative fit test was conducted.

[Results] The personal protective equipment worn by the EMTs was unique to the fire department in feature and handling. Zoning measures were established in the facility, but the boundaries were ambiguous. The shapes and sizes of the N95 masks the participants had were limited, and the participants were not able to freely choose N95 masks that fit their faces. In the evaluation of the N95 mask-wearing procedure, 20 participants did not check the user seal when wearing the N95 mask. In the quantitative fit test, three participants passed the total fit factor of 100 or more. The pass/fail result of the quantitative fit test was related to EMT affiliation (P < 0.05) but not to the presence or absence of paramedic qualifications or the evaluation of the wearing procedure.

[Conclusion] Protecting EMTs from infection is important for crisis management in fire departments; however, current fire departments have unique issues regarding infection control. For EMTs to safely perform missions in the field, the issues facing fire departments must be resolved, and systematic efforts for infection control must be continually supported.

In recent years, the use of vancomycin (VCM) in combination with tazobactam/piperacillin (TAZ/PIPC) has been reported to increase the incidence of acute kidney injury (AKI). However, reports on the use of teicoplanin (TEIC), a VCM analog, in combination with TAZ/PIPC are scarce. In this study, we investigated the influence of TEIC and TAZ/PIPC combination therapy on renal function.

We conducted a retrospective study to compare the TEIC and TAZ/PIPC combination therapy (TT) group with the TEIC and meropenem combination therapy (TM) group. We obtained data of patients treated between January 2018 and January 2022 and investigated changes in renal function.

We extracted 75 and 95 patients in the TT and TM groups, respectively. The incidence rates of AKI in the TT and TM groups were 16.0% (12 patients) and 14.7% (14 patients), respectively. Propensity score analysis using the inverse probability of treatment weighting method was conducted to adjust for background factors. The comparison revealed no significant differences (P = 0.56) among the treatment groups. In addition, there was no difference in the number of days to AKI onset. A multivariate analysis was also conducted to explore the risk factors associated with the development of AKI. Serum albumin level, quick sequential organ failure assessment score, duration of concomitant therapy, administration of loop diuretics, and administration of vasopressors were identified as the risk factors.

The results indicated that the incidence of AKI did not increase in the TT group compared with the TM group. Thus, TEIC, as an anti-methicillin-resistant Staphylococcus aureus agent, may be safer for kidney function than vancomycin when used in combination with TAZ/PIPC.

The third dose of COVID-19 vaccine has been administered in Japan since December 2021. In this study, we conducted a questionnaire survey on 539 employees of the Yamaguchi Red Cross Hospital regarding adverse reactions after the second and third doses of the vaccine. The results of the questionnaire survey indicated that fever (37.5°C or higher), fatigue, headache, chills, vomiting/nausea, diarrhea, myalgia, and joint pain) and local reactions (pain, redness, swelling, induration, scratchiness, and heat at the injection site) were significantly more likely to occur after the second dose and then after the third dose when adverse reactions were present. Based on adverse reactions after the second immunization, we believe that the occurrence of adverse reactions after the third immunization can be predicted.

[Background] Understanding the epidemiology of multidrug-resistant organisms (MDROs) and the state of infection control systems in healthcare institutions may contribute to the measures for combating MDROs and improving patient outcomes. Although Japan is a super-aged society unlike any other in the world, there have been only limited studies on long-term care hospitals, where 90% of beds are occupied by elderly patients.

[Materials/methods] We conducted a point prevalence survey on the status of infection prevention and control systems, and healthcare-associated infections at 1,032 healthcare institutions, stratified long-term care beds in Japanese long-term care facilities. Questionnaire forms were sent to the participating healthcare institutions and collected via mail from January to March 2020.

[Results] The response rate was 7.8% (80 centers). Of the responding institutions, 90% calculated "long-term care ward hospitalization fee 1, " which applies to hospitalization in wards that accommodate many patients with a high need for healthcare and assistance in daily living. At these institutions, 41.9% of patients were discharged home or to a care facility. Additional reimbursement for infection prevention 1 or 2 was calculated, and infection control teams had been set up at 63.8% of the institutions. For hand hygiene practice, some institutions reported the use of alcohol-based hand sanitizer, whereas other institutions did not. The antimicrobial use rate on point prevalence survey days was 9.4%. Of all patients who used antimicrobials, 28.6% had carried MDROs within the past year.

[Conclusions] The number of elderly people who go back and forth between healthcare institutions and the community is expected to continue increasing. If suitable measures are not taken to prevent and control the occurrence and spread of MDROs in long-term care hospitals, MDROs may spread from healthcare institutions to community-dwelling elderly people. Our survey results indicate that in long-term care hospitals, where human, physical, and financial resources are limited, it would be effective for all staff engaged in the care of patients to thoroughly implement standard infection prevention measures.

We investigated changes in antibody titers among staff members of a target hospital who had received the BNT162b2 vaccine. Blood samples were collected from 176 of the 599 staff members who received the first vaccination at the hospital, and antibody titers were measured using the CLEIA method. The mean antibody titer (standard deviation) immediately before the third vaccination was 17.5 u/mL (14.58), and that two weeks after the second vaccination was 233.6 u/mL (161.49), indicating a 13.2-fold increase. However, the mean antibody titer (standard deviation) immediately before the third vaccination was 15.3 m/uL (21.50), which was lower than that immediately before the second vaccination. These results indicated that antibody titers decreased with the passage of time after vaccination, similar to the findings of previous studies in Japan and overseas. Although individual differences in antibody titers were found in this study, we did not investigate factors that might affect antibody titers, such as the participant's underlying disease, lifestyle, and degree of adverse reactions following vaccination. The influence of these factors is a subject for future study.