Non-pharmaceutical infection prevention measures in nosocomial SARS-CoV-2 outbreaks: a retrospective multi-centre cohort study.

Background: Hospital severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks are relevant for patients and healthcare systems within and beyond the pandemic.

Aim: To explore the characteristics of SARS-CoV-2 outbreaks and their infection prevention and control (IPC) measures during the different pandemic waves.

Methods: A comprehensive structured template for SARS-CoV-2 outbreaks was developed and filled out by six university hospitals.

Assessing infection prevention and control structures in German hospitals after the COVID-19 pandemic using the WHO infection prevention and control assessment framework (IPCAF): results from 660 hospitals and comparison with a pre-pandemic survey.

Background: The WHO Infection Prevention and Control Assessment Framework (IPCAF) is a standardized tool to assess infection prevention and control (IPC) structures in healthcare facilities. The IPCAF reflects the eight WHO core components (CC) of IPC. Besides facility self-assessment, the IPCAF can be used for national surveys, and repeated usage can aid in describing trends concerning IPC structures.

The Use of Single-Use Medical Gloves in Doctors' Practices and Hospitals.

Background: Single-use medical gloves achieve their purpose only when properly used. Proper use also helps avoid undesired consequences such as excessive waste and CO2 emissions, as well as inadequate hand hygiene.

Methods: In this selective review of the primary scientific literature, we summarize the current state of knowledge on the use of single-use medical gloves in the health-care sector.

Surveillance of infections of surgical sites and lower respiratory tracts should be combined: experiences from the German surveillance module for operated patients (OP-KISS), 2018 to 2022.

BackgroundSurveillance of lower respiratory tract infections (LRTI) of operated patients conventionally focuses on intubated patients in intensive care units (ICU). Post-operative immobilisation increases the risk of LRTI not associated with ventilators. Operated patients, however, have thus far not been a primary target for LRTI surveillance.

Healthcare-Associated Infections and the Use of Antibiotics in German Hospitals—Results of the Point Prevalence Survey of 2022 and Comparison With Earlier Findings.

Background: A national point prevalence survey (PPS) of healthcare-associated infections (HAI) and antibiotic use (AU) was carried out in Germany in 2022 in the framework of the European PPS conducted by the European Centre for Disease Prevention and Control (ECDC). The objective was to determine the prevalence of HAI and AU in German hospitals and to compare the obtained values with those of the most recent previous PPS, which was carried out in 2016.

Methods: The German National Reference Center for the Surveillance of Nosocomial Infections was entrusted with the organization of the PPS of 2022.

Skin dysbiosis and loss of microbiome site specificity in critically ill patients.

An increasing amount of evidence has linked critical illness with dysbiotic microbiome signatures in different body sites. The disturbance of the indigenous microbiota structures has been further associated with disease severity and outcome and has been suggested to pose an additional risk for complications in intensive care units (ICUs), including hospital-acquired infections. A better understanding of the microbial dysbiosis in critical illness might thus help to develop strategies for the prevention of such complications.

Effect of a multimodal prevention strategy on dialysis-associated infection events in outpatients receiving haemodialysis: The DIPS stepped wedge, cluster-randomized trial.

Objectives: Patients with haemodialysis catheters are susceptible to dialysis-associated infections, particularly bloodstream infections. There have been few systematic attempts to reduce this burden. Our study aimed to investigate the effect of a multimodal prevention strategy on dialysis-associated infection events (DAIE) among haemodialysis outpatients.

Etiology of nosocomial infections in intensive care patients in German hospitals: An analysis of trends between 2008 and 2022.

Purpose: Data from the intensive care component of the German hospital infection surveillance system (KISS) was used to investigate the epidemiology of pathogens responsible for the most frequent device-associated infections and their development over time.

Method: The 10 most common pathogens were identified for ventilator-associated lower respiratory tract infections (VALRTI), catheter associated urinary tract infections (CAUTI), and central venous catheter associated bloodstream infections (CVC-BSI). The development over time was analyzed based on three five-year time periods: 2008-2012, 2013-2017, 2018-2022.

Implementation of a new surveillance system for dialysis-associated infection events in outpatient dialysis facilities in Germany.

Introduction: Patients receiving maintenance haemodialysis are at risk of catheter-related infections. Up to now, there has been no standardized surveillance tool in Germany to evaluate infection events in haemodialysis outpatients. As such, this study aimed to implement an online-based surveillance tool in outpatient dialysis facilities, and to report the first national surveillance data for haemodialysis patients in Germany from October 2019 until September 2021.

Sinks in patient rooms in ICUs are associated with higher rates of hospital-acquired infection: a retrospective analysis of 552 ICUs.

Background: Sinks in hospitals are a possible reservoir for healthcare-related pathogens. They have been identified as a source of nosocomial outbreaks in intensive care units (ICU); however, their role in non-outbreak settings remains unclear.

Aim: To investigate whether sinks in ICU patient rooms are associated with a higher incidence of hospital-acquired infection (HAI).

[The structural and spatial design of German intensive care units from the point of view of infection control measures : Survey among ICU-KISS participants].

Introduction: Intensive care unit (ICU) structural and spatial design may play a role in infection prevention and control.

Methods: Between 09/2021 and 11/2021 we performed an online survey among ICUs in Germany, Austria and Switzerland.

Results: A total of 597 (40%) of the invited ICUs answered the survey; 20% of the ICUs were built before 1990.

Central-line associated bloodstream infections in intensive care units before and after implementation of daily antiseptic bathing with chlorhexidine or octenidine: a post-hoc analysis of a cluster-randomised controlled trial.

Backgrounds: Antiseptic bathing did not reduce central-line (CL) associated bloodstream infection (CLABSI) rates in intensive care units (ICU) according to a recent cluster randomised controlled trial (cRCT). However, this analysis did not consider baseline infection rates. Our post-hoc analysis of this cRCT aimed to use a before-after comparison to examine the effect of daily bathing with chlorhexidine, octenidine or water and soap (control) on ICU-attributable CLABSI rates.

Surgical site infection surveillance in German hospitals: a national survey to determine the status quo of digitalization.

Background: Surveillance of surgical site infections (SSI) relies on access to data from various sources. Insights into the practices of German hospitals conducting SSI surveillance and their information technology (IT) infrastructures are scarce. The aim of this study was to evaluate current SSI surveillance practices in German hospitals with a focus on employed IT infrastructures.

Clinical Evidence for the Use of Octenidine Dihydrochloride to Prevent Healthcare-Associated Infections and Decrease Carriage or Transmission-A Review.

Background: The antiseptic agent octenidine dihydrochloride (OCT) is used for skin preparation, for decolonization, and within bundles for the prevention of catheter-related or surgical site infections (SSIs). Here, we review the evidence for the effects of OCT from clinical studies.

Methods: Review of studies published in the Medline, Scopus, and Cochrane databases until August 2022, performed in clinical settings and reporting on effects of OCT on carriage/transmission, SSI prevention, and prevention of intensive care unit (ICU)-related or catheter-related bloodstream and insertion site infections.

Age as a risk factor for surgical site infections: German surveillance data on total hip replacement and total knee replacement procedures 2009 to 2018.

BackgroundOlder age is frequently cited as a risk factor for healthcare-associated infections in general, and surgical site infections (SSIs) specifically.AimWe aimed to investigate the correlation between age and SSI occurrence.MethodsData on total hip replacement (THR) and total knee replacement (TKR) surgeries and resulting SSIs documented in the German national surveillance network from a 10-year period from 2009 to 2018 were selected for analysis.

SAPS2, APACHE2, SOFA, and Core-10-TISS upon admission as risk indicators for ICU-acquired infections: a retrospective cohort study.

Purpose: Early identification of high-risk patients is an important component in improving infection prevention. The SAPS2, APACHE2, Core-10-TISS, and SOFA scores are already widely used to estimate mortality, morbidity and nursing workload, but this study evaluated their usefulness in assessing a patient's risk of ICU-acquired infection.

Methods: We conducted a retrospective cohort study by analyzing all patient admissions to seven ICUs at Charité Berlin, Germany in 2017 and 2018.

The Clinical Importance of Preoperative Rectal Swabs in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Background: Surgical site infections are among the most common healthcare-associated infections, especially in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of this retrospective study was to examine postoperative infectious complications according to preoperative screening findings of nasal and rectal swabs.

Methods: Two hundred four consecutive patients received nasal and rectal swab examination for multidrug-resistant (MDR) bacteria within 30 days before the operation in patients where CRS and HIPEC were planned.

Chlorhexidine and octenidine susceptibility of bacterial isolates from clinical samples in a three-armed cluster randomised decolonisation trial.

Background: Routine use of chlorhexidine or octenidine for antiseptic bathing may have unintended consequences. Our analysis aimed to assess the phenotypic susceptibility of bacterial isolates from clinical samples to chlorhexidine and octenidine collected from intensive care units (ICU) that routinely used 2% chlorhexidine-impregnated wash cloths or 0.08% octenidine wash mitts (intervention) or water and soap (control) for daily patient care.

Reduction of antibacterial use in patients with very low birth weight on German NICUs after implementation of a mandatory surveillance system. A longitudinal study with national data from 2013 to 2019.

Objectives: To determine the influence of a national surveillance system for neonates (NEO-KISS) in neonatal intensive care units (NICUs) on consumption of antibacterial and to identify risk factors for prescriptions.

Methods: Data on antibacterial use between 2013 and 2019 from 231 NICUs in Germany was analyzed in this longitudinal study after introduction of a mandatory module for surveillance of antibacterial consumption in preterm infants. 59,411 newborns with a birth weight under 1500 gs were under surveillance in NEO-KISS during the study period.

No increase of device associated infections in German intensive care units during the start of the COVID-19 pandemic in 2020.

Background: The COVID-19 pandemic may have had a substantial impact on the incidence of device-associated healthcare-associated infections (HAI), in particular in intensive care units (ICU). A significant increase of HAI was reported by US hospitals when comparing incidence rates from 2019 and 2020. The objective of this study was to investigate the development of the most relevant device-associated HAI in German ICUs during the year 2020 as compared to 2019.

Successful control of Candida auris transmission in a German COVID-19 intensive care unit.

Background: Candida auris a frequently multidrug-resistant yeast species that poses a global health threat due to its high potential for hospital outbreaks. While C. auris has become endemic in parts of Asia and Africa, transmissions have so far rarely been reported in Western Europe except for Great Britain and Spain.

Corticosteroids as risk factor for COVID-19-associated pulmonary aspergillosis in intensive care patients.

Purpose: Corticosteroids, in particular dexamethasone, are one of the primary treatment options for critically ill COVID-19 patients. However, there are a growing number of cases that involve COVID-19-associated pulmonary aspergillosis (CAPA), and it is unclear whether dexamethasone represents a risk factor for CAPA. Our aim was to investigate a possible association of the recommended dexamethasone therapy with a risk of CAPA.

Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case-control study in a tertiary care university center.

Background: Factors contributing to the spread of SARS-CoV-2 outside the acute care hospital setting have been described in detail. However, data concerning risk factors for nosocomial SARS-CoV-2 infections in hospitalized patients remain scarce. To close this research gap and inform targeted measures for the prevention of nosocomial SARS-CoV-2 infections, we analyzed nosocomial SARS-CoV-2 cases in our hospital during a defined time period.