To evaluate the effects of a hand hygiene-focused educational program on hand hygiene compliance and infection morbidity in older adults care facilities in Japan, hand hygiene compliance was observed at three time points and residents' infection morbidity was calculated at two time points. Results showed that participants' hand hygiene compliance was 75 (19.7%), 213 (57.0%), and 210 (55.1%) before, 1 month, and 8 months after the intervention, respectively (p<.001). Infection rates were 1.84 and 0.81 before and after the intervention, respectively. Findings indicate that a nurse-led multimodal hand hygiene education program for staff working in geriatric facilities improves hand hygiene compliance and reduces infection morbidity.

In the 2022 revision of medical service fees, responding to the emerging infectious diseases such as COVID-19-based on the experience of the explosive infection of COVID-19 in the Amami archipelago-coordinated intervention in remote island areas in emergencies has been particularly difficult than inland areas due to human resources and geographical barriers. Multicenter cooperation with the support of public health centers and medical associations is vital for remote island emergencies. The construction of an external evaluation system through environmental rounds in normal times is for emergencies. To deepen ICT activities, administrative departments must participate in regional cooperation.

[Background] Contaminated healthcare environments are potential sources of infection spread, necessitating regular cleaning and disinfection. Recently, there has been a growing interest in environmental disinfection through indoor sterilization devices. Herein, we compared the sterilization effectiveness of two indoor sterilization devices: the Pulsed Xenon Ultraviolet (PX-UV) irradiation device and the ozone and hydrogen peroxide indoor sterilization device (Ozone-H₂O₂).

[Methods] We adjusted the inoculum concentration of seven pathogenic microorganisms, including spore-forming and multidrug-resistant bacteria relevant in healthcare settings, between 10⁴ and 10⁸ CFU/mL. We inoculated 10 μL of the microbial suspension onto Mueller-Hinton (MH) agar. The inoculated agar plates were tilted at a 45#176; angle, and we subjected them to 5 and 10-min PX-UV irradiation. Further, we conducted environmental sterilization using ozone-H₂O₂. The inoculated agar plates treated with PX-UV and ozone-H₂O₂ were incubated, and bacterial growth was assessed using a five-point scale.

[Results] After 5 min of PX-UV irradiation, bacterial growth was observed for Bacillus cereus and Candida parapsilosis. Following 10 min of PX-UV irradiation, minimal bacterial growth was observed for B. cereus. However, no bacteria were detected for all tested bacterial species after exposure to ozone-H₂O₂.

[Conclusion] In the case of PX-UV indoor sterilization, there was a tendency for spore-forming bacteria and Candida species to be less effectively sterilized.

Severe biliary tract infections can lead to sepsis, organ failure, and even death. At Sagamihara National Hospital, tazobactam/piperacillin (TAZ/PIPC), a broad-spectrum antimicrobial agent, is widely used as an initial treatment for community-onset non-severe biliary tract infections, and the antimicrobial stewardship team and the Department of Gastroenterology discussed the establishment of recommended antimicrobial agents and clinical pathways (CP), based on severity. Herein, we compared the initial antimicrobial use before and after CP creation in patients hospitalized with community-onset non-severe biliary tract infections between September 2020 and August 2023. Moreover, we compared patient backgrounds and treatment statuses between the CP- and non-CP-created groups according to disease severity. A total of 114 patients (68 and 46 with mild and moderate diseases) were included in this study. The use of cefmetazole increased significantly (p<0.001) from 1 (3.8%) to 17 (40.5%) after CP preparation for mild disease. The usage of sulbactam/cefoperazone in moderate disease increased from 12 (54.5%) to 19 (79.2%) posttreatment (p=0.12); however, the difference was not significant. The use of TAZ/PIPC decreased significantly in patients with mild and moderate disease (p<0.05), and no mortalities or relapses within 30 days of admission and completion of antimicrobial therapy were observed, regardless of CP use. Results suggest that the use of recommended antimicrobial agents according to the severity of non-severe biliary tract infection may increase the use of recommended antimicrobial agents and lead to the conservation of broad-spectrum antimicrobial agents such as TAZ/PIPC.