Lindblad Marie, Huss Fredrik, Tano Eva, Lytsy Birgitta, Sütterlin Susanne
Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden.
Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
Antimicrob Resist Infect Control. 2025 Jul 1;14(1):75. doi: 10.1186/s13756-025-01592-9.
To analyse observations of staff's hand hygiene, usage of gloves and plastic aprons, and dress code compliance at the Burn Centre, Uppsala University Hospital in Sweden, and to evaluate the association between hygiene non-compliance and outbreak periods. Furthermore, to explore the potential of using routine hygiene observations as an early warning tool for the risk of uncontrolled spread of (multidrug-resistant) bacteria.
Direct observations of the personnel's compliance with hand hygiene, usage of gloves and plastic aprons, and dress code were studied in relation to two A. baumannii outbreaks in 2014 and 2020. Interrupted time series analyses were conducted from 2013 to 2017 and 2018 to 2022 to evaluate outbreak intervention measures. Rolling sums of observed hygiene errors and 90th percentiles were calculated for four-, five-, and six-month periods.
During the study, 13,216 direct observations showed hygiene compliance ranging from 70 to 100% per category. Infection control interventions significantly reduced non-compliance after both outbreaks, with sustained improvements for two years following the first outbreak. Rolling four- to six-month sums, using 90th percentile thresholds of seven, nine, and eleven non-compliances predicted A. baumannii outbreaks.
In this setting, compliance levels above 97% were consistently observed during outbreak-free periods, suggesting a potential protective effect. Focus on non-compliance as a key metric and rolling sums of non-compliance, may support early detection of increased outbreak risk and guide preventive interventions.
分析瑞典乌普萨拉大学医院烧伤中心工作人员的手部卫生、手套和塑料围裙的使用情况以及着装规范的遵守情况，并评估卫生不达标与暴发期之间的关联。此外，探讨将常规卫生观察作为（多重耐药）细菌不受控制传播风险的早期预警工具的潜力。
针对2014年和2020年两次鲍曼不动杆菌暴发，研究了工作人员在手部卫生、手套和塑料围裙使用以及着装规范方面的合规情况。对2013年至2017年以及2018年至2022年进行中断时间序列分析，以评估暴发干预措施。计算了四个月、五个月和六个月期间观察到的卫生错误的滚动总和以及第90百分位数。
在研究期间，13216次直接观察显示，每个类别的卫生合规率在70%至100%之间。感染控制干预措施在两次暴发后均显著降低了不达标情况，首次暴发后持续改善了两年。使用七次、九次和十一次不达标情况的第90百分位数阈值预测鲍曼不动杆菌暴发的四至六个月滚动总和。
在这种情况下，在无暴发期持续观察到合规水平高于97%，表明可能具有保护作用。将重点放在不达标作为关键指标以及不达标情况的滚动总和上，可能有助于早期发现暴发风险增加，并指导预防干预措施。
