Association between excreta management and incidence of extended-spectrum β-lactamase-producing Enterobacteriaceae: role of healthcare workers' knowledge and practices.
Disease Transmission, Infectious
/ prevention & control
Enterobacteriaceae
/ enzymology
Enterobacteriaceae Infections
/ epidemiology
Health Knowledge, Attitudes, Practice
Health Personnel
/ psychology
Health Services Research
Humans
Infection Control
/ methods
Models, Statistical
Surveys and Questionnaires
beta-Lactamases
/ metabolism
ESBL-PE
Excreta
Hospital practices
Infection control
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
13
08
2018
accepted:
10
12
2018
pubmed:
18
12
2018
medline:
14
6
2019
entrez:
18
12
2018
Statut:
ppublish
Résumé
The spread of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in healthcare environments has become a major public health threat in recent years. To assess how healthcare workers (HCWs) manage excreta and the possible association with the incidence of ESBL-PE. Eight hundred HCWs and 74 nurse-supervisors were questioned through two self-report questionnaires in order to assess their knowledge and practices, and to determine the equipment utilized for excreta management in 74 healthcare departments. Performance on equipment utilized, knowledge and practices were scored as good (score of 1), intermediate (score of 2) or poor (score of 3) on the basis of pre-established thresholds. Linear regression was performed to evaluate the association between HCWs' knowledge/practices and the incidence of ESBL-PE. Six hundred and eighty-eight HCWs (86%) and all nurse-supervisors participated in the survey. The proportions of respondents scoring 1, 2 and 3 were: 14.8%, 71.6% and 17.6% for equipment; 30.1%, 40.6 % and 29.3% for knowledge; and 2.0%, 71.9% and 26.1% for practices, respectively. The single regression mathematic model highlighted that poor practices (score of 3) among HCWs was significantly associated with increased incidence of ESBL-PE (P = 0.002). A positive correlation was found between HCWs' practices for managing excreta and the incidence of ESBL-PE, especially in surgical units. There is an urgent need for development of public health efforts to enhance knowledge and practices of HCWs to better control the spread of multi-drug-resistant bacteria, and these should be integrated within infection control programmes.
Sections du résumé
BACKGROUND
BACKGROUND
The spread of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in healthcare environments has become a major public health threat in recent years.
AIM
OBJECTIVE
To assess how healthcare workers (HCWs) manage excreta and the possible association with the incidence of ESBL-PE.
METHODS
METHODS
Eight hundred HCWs and 74 nurse-supervisors were questioned through two self-report questionnaires in order to assess their knowledge and practices, and to determine the equipment utilized for excreta management in 74 healthcare departments. Performance on equipment utilized, knowledge and practices were scored as good (score of 1), intermediate (score of 2) or poor (score of 3) on the basis of pre-established thresholds. Linear regression was performed to evaluate the association between HCWs' knowledge/practices and the incidence of ESBL-PE.
FINDINGS
RESULTS
Six hundred and eighty-eight HCWs (86%) and all nurse-supervisors participated in the survey. The proportions of respondents scoring 1, 2 and 3 were: 14.8%, 71.6% and 17.6% for equipment; 30.1%, 40.6 % and 29.3% for knowledge; and 2.0%, 71.9% and 26.1% for practices, respectively. The single regression mathematic model highlighted that poor practices (score of 3) among HCWs was significantly associated with increased incidence of ESBL-PE (P = 0.002).
CONCLUSIONS
CONCLUSIONS
A positive correlation was found between HCWs' practices for managing excreta and the incidence of ESBL-PE, especially in surgical units. There is an urgent need for development of public health efforts to enhance knowledge and practices of HCWs to better control the spread of multi-drug-resistant bacteria, and these should be integrated within infection control programmes.
Identifiants
pubmed: 30557588
pii: S0195-6701(18)30710-2
doi: 10.1016/j.jhin.2018.12.006
pii:
doi:
Substances chimiques
beta-Lactamases
EC 3.5.2.6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
31-36Informations de copyright
Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.