Disinfectants are used to reduce the concentration of pathogenic microorganisms to a safe level and help to prevent the transmission of infectious diseases. However, bacteria have a tremendous ability to respond to chemical stress caused by biocides, where overuse and improper use of disinfectants can be reflected in a reduced susceptibility of microorganisms. This review aims to describe whether mutations and thus decreased susceptibility to disinfectants occur in bacteria during disinfectant exposure. A systematic literature review following PRISMA guidelines was conducted with the databases PubMed, Science Direct and Web of Science. For the final analysis, 28 sources that remained of interest were included. Articles describing reduced susceptibility or the resistance of bacteria against seven different disinfectants were identified. The important deviation of the minimum inhibitory concentration was observed in multiple studies for disinfectants based on triclosan and chlorhexidine. A reduced susceptibility to disinfectants and potentially related problems with antibiotic resistance in clinically important bacterial strains are increasing. Since the use of disinfectants in the community is rising, it is clear that reasonable use of available and effective disinfectants is needed. It is necessary to develop and adopt strategies to control disinfectant resistance.
14 February 2020 in Journal of Water, Sanitation and Hygiene for Development
Hospital wastewaters are highly complex effluents acting as a hotspot for antibiotic resistant bacteria. Especially, Gram-negative bacteria bearing multiple antibiotic resistant genes are increasingly found in hospital wastewaters. The aim of this study was to evaluate the presence of ESBL and Carbapenemase producing Enterobacteriaceae in hospital wastewaters from one Slovenian and two Austrian hospitals, as well as the occurrence of antibiotic resistant genes encoding for VIM, KPC, NDM, CTXM and OXA beta-lactamases in isolates from hospital wastewater. The results indicated high levels of extended-spectrum beta-lactamases (ESBL) producing Enterobacteriaceae in ranges up to 107 cfu/mL. Carbapenemase producing Enterobacteriaceae and OXA 48-type CPE were present in ranges up to 105 cfu/mL. Out of 89 multiplied PCR amplicons, only 36 were positive for different β-lactamase gene families, among those only three isolates were identified as multiresistant. The dominant ESBL family was CTXM in 19 different isolates. This was followed by 10 OXA-48 positive isolates and 10 VIM positive isolates. KPC or NDM carbapenemases were not identified with PCR screening of the isolates. Hospital wastewaters serve as a reservoir for nearly all clinically important antibiotic resistances. The importance of evaluating such potential environmental reservoirs is especially evident when outbreak cases could not be linked to an epidemiological source.
Objectives: The COVID-19 pandemic changed the use of antibiotics and had an impact on the development of antimicrobial resistance. The study aimed to examine the consumption of antibiotics and the occurrence of AMR infection and colonization in the selected general hospital.Methods: Data on antibiotic consumption and data on AMR infections and colonization were monitored in the period before the COVID-19 pandemic (2018, 2019) and during the COVID-19 pandemic (2020, 2021). Descriptive statistics, the Mann–Whitney U test, and the Pearson or Spearman correlation test were used.Results: The overall prescription of antibiotics stayed approximately the same, however, some important differences can be observed when analyzing specific groups of antibiotics (vancomycin, linezolid, piperacillin/tazobactam, meropenem, colistin). We did not observe the difference in the occurrence of AMR infections and colonizations before and during the pandemic. However, we did observe an alarming increase in CRaB, ESBL and VRE and highlighted the increase in all AMR groups between the first and second year of the pandemic.Conclusion: The connection between antibiotic consumption and the occurrence of AMR infections and colonization was confirmed.
2 July 2021 in Journal of Health, Population and Nutrition
Background: Vending machines represent one way of offering food, but they are overlooked in the efforts to improve people’s eating habits. The aim of our study was to analyse the variety and nutritional values of beverages offered in vending machines in social and health care institution in Slovenia. Methods: The available beverages were quantitatively assessed using traffic light profiling and the model for nutrient profiling used by Food Standards Australia New Zealand. Vending machines in 188 institutions were surveyed, resulting in 3046 different beverages consisting of 162 unique product labels. Results: Between 51 and 54% of beverages were categorised as unhealthy with regard to sugar content. Water accounted for only 13.7% of all beverages in vending machines. About 82% of beverages in vending machines were devoted to sugar-sweetened beverages, the majority (58.9%) presented in 500-ml bottles. The average sugar content and average calories in beverages sold in vending machines are slightly lower than in beverages sold in food stores. Conclusions: We suggest that regulatory guidelines should be included in the tender conditions for vending machines in health and social care institutions, to ensure healthy food and beverage choices.
The use of immersive technology in healthcare education is on the rise, yet its impact on learner engagement, knowledge retention, and specifically in areas like hand hygiene training, remains underexplored. The aim of this scoping review was to summarize the existing studies of immersive technology in hand hygiene training of healthcare providers and health professions students. A scoping review following the Levac et al. framework was conducted. The literature search was performed in databases PubMed, CINAHL Ultimate, ScienceDirect (Elsevier), Web of Science in addition to Google Scholar and ProQuest Dissertation & Theses. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews (PRIMSA-ScR) guideline was used to report the results. We analysed data using tabular and descriptive summary. In the final analysis 11 studies from seven countries were included. Most of the studies (n = 10, 90,91%) used virtual reality in hand hygiene training of healthcare providers and health professions students. Most studies have found that immersive technology is useful in teaching hand hygiene (n = 6, 54,55%). There are some theories and concepts that support the teaching of hand hygiene with immersive technology, but most of the research is not supported by them. Theories or concepts were included in two studies (18,18%). Immersive technology, especially virtual reality, enhances hand hygiene learning and engagement compared to traditional methods. However, most studies lack theoretical support. To advance this field, exploring immersive technology for further research and incorporating relevant theories is encouraged. Additionally, conducting a thorough cost-effectiveness analysis and establishing a robust evaluation framework, encompassing both short-term and long-term outcomes, will be beneficial for a comprehensive understanding of the impact of immersive technology in hand hygiene education.
Vending machines in health and social care facilities are often the only possible choice for a quick snack for workers and visitors, in many cases providing unhealthy dietary choices. Our study aimed to analyse the variety and nutritional quality of foods available in vending machines placed in social and health care institution in Slovenia. The available snacks were quantitatively assessed, using traffic light profiling. The model used for nutrient profiling was that of the Food Standards Australia New Zealand (FSANZ). Vending machines in 188 institutions were surveyed, resulting in 5625 food-items consisting of 267 unique product labels. Sweet products dominate in vending machines offers (about 70%), while nuts and seeds (8.4%), yoghurts (2.1%), fruits (1.4%) and milk (0.3%) are present in a very small proportion or are not available at all. According to FSANZ, 88.5% of all displayed food items in vending machines can be considered as lower nutritional quality or less healthy products. The authors’ future activities will be focused on ensuring wider availability of healthy dietary choices and on including official guidelines in tender conditions for vending machines in health and social care institutions in Slovenia.