Objectives: Environmental hygiene of patient zones in the wards of TTSH- a 1700 bedded hospital in Singapore is upkept through twice daily HTC. An outbreak in two wards end March 2023 with high levels of Adenosine Triphosphate (ATP) found on surfaces after cleaning corroborated that the cleaning process was ineffective [1]. Though operatives undergo on-job training (OJT), they expressed difficulty in understanding the purpose of such cleaning and remembering the steps. To address these gaps, a new training and competency framework was developed. We thus sought to evaluate its usefulness in improving compliance to HTC. Method: The framework, effected from May 2023, consisted of three domains: standardized education, competency assessment, and feedback mechanisms[2, 4]. Educational materials explaining the importance of HTC and overall infection prevention were developed in three common languages to facilitate understanding for operatives of different races. Under the framework, all existing and new operatives undertake a 2-day classroom teaching and OJT, before a competency check. Upon passing the first competency, they are given a two-week probation. Another assessment is done before certifying them competent. Operatives who fail twice are redeployed to non-clinical areas. The audit team gave direct feedback during monthly audits to evaluate performance and provide ongoing support and reinforcement. Results: The compliance of HTC in the patient zone picked up immediately from 71% in April to 92% in June. However, a decrease to 68% was observed between September to December 2023, but soon picked up to 82% in February 2024 after retraining was conducted. Decrease in ATP levels after cleaning further validated increase efficiency of HTC. Conclusions: These results highlight that structured learning rapidly improves the thoroughness of cleaning [2, 3]. Ongoing assessment and feedback are essential to address subsequent deficiencies and for corrective actions to be taken promptly [2, 4]. This framework may be useful for teams seeking to optimize strategies in environmental hygiene.

Acknowledgments: The authors thank the frontline environmental services teams for conducting and providing results of the HTC audits.

This paper investigates the time N until a random walk first exceeds some specified barrier. Letting $X_i, i \geq 1,$ be a sequence of independent, identically distributed random variables with a log-concave density or probability mass function, we derive both lower and upper bounds on the probability $P(N \gt n),$ as well as bounds on the expected value $E[N].$ On barriers of the form $a + b \sqrt{k},$ where a is nonnegative, b is positive, and k is the number of steps, we provide additional bounds on $E[N].$

Objectives: Periprosthetic joint infection (PJI) is one of the most serious and debilitating complications that can occur after total joint arthroplasty. Therefore, early diagnosis and appropriate treatment are important for a good prognosis. Recently, molecular diagnostic methods have been widely used to detect the causative microorganisms of PJI sensitively and rapidly. The Multiplex Loop- Mediated Isothermal Amplification (LAMP) method is faster and easier to perform compared to polymerase chain reaction (PCR)-based assays. Therefore, this study developed a multiplex LAMP assay for diagnosing bacterial PJI using LAMP technology and evaluated its analytical and clinical performance. Methods: We developed a multiplex LAMP assay for the detection of five bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Pseudomonas aeruginosa, and Escherichia coli, frequently observed to be the causative agents of PJI. The method limit of detection (LOD) and cross-reactivity were determined by spiking standard strains into the joint synovial fluid. The LOD of the multiplex LAMP assay was compared with that of a quantitative real-time PCR (qPCR) assay. Clinical performance was evaluated using 20 joint synovial fluid samples collected from patients suspected of having bacterial PJI. Results: The LOD of the gram-positive bacterial multiplex LAMP assay and qPCR were 105/104 CFU/mL, 103/103 CFU/mL, and 105/104 CFU/mL against S. agalactiae, S. epidermidis, and S. aureus, respectively. For P. aeruginosa and E. coli, the LOD of the multiplex LAMP and qPCR assays were 105/104 and 106/104 CFU/mL, respectively. The multiplex LAMP assay detects target bacteria without cross-reacting with other bacteria, and exhibited 100% sensitivity and specificity in clinical performance evaluation. Conclusions: This multiplex LAMP assay can rapidly detect five high-prevalence bacterial species causing bacterial PJI, with excellent sensitivity and specificity, in less than 1 h, and it may be useful for the early diagnosis of PJI.

Background: Throughout healthcare, the physical environment presents an important source of pathogens that can cause healthcare associated infections (HAIs) To keep patients safe, hospitals must maintain a clean environment and minimize the presence of pathogens. Objectives: 1. To identify through environmental monitoring the level of cleanliness in area of pediatrics isolation ward. 2.To assessments of environmental cleaning practice of environmental service (EVS) staff, and healthcare worker. Methodology: This retrospective study was done in pediatrics isolation ward, tertiary hospital. Sample sizes were 1 EVS staff, 3 nurses aid, and 102 environmental sites. Data were collected from database of infection control program between February 29, to March 2, 2024 via Infection control assessment and response (ICAR: tool for assessing cleaning practice of EVS staff, personnel by direct performance observations), visual assessment, and monitored the residual bioburden by adenosine tri phosphate (ATP) tests, and swab culture of the surface. Data were analyzed by using descriptive statistics. Results: The results of this study revealed that level of cleanliness in area of ward by ATP test found, contaminated spots were highest (61.76%, 21/34) and clean spots were lowest (38.24%, 13/34), while swab culture method found contaminated spots were higher (55.88%, 19/34), clean spots were lower (44.12%, 15/34), and visual monitoring found contaminated and clean spots were 35.29%, 12/5 and 64.71%, 22/34 respectively. The most of contaminated sites were bed rails, toilet sink, Treatment and IV care car, door handle, mop, Light scope & blade (5.88%, 6/102). As the results proved the most organisms were Acinetobacter spp., Escherichia coli, and Pseudomonas spp., respectively. Conclusion: This study suggests that the environmental cleaning in specialized area must be monitored continuous with standard methods. It is necessary to promote education and training staffs follow update practice guidelines, especially the participation of disciplinary team motivated effective activities in reducing the microbial contamination.

Objectives: Energy devices (EDs), such as Harmonic, Ligasure, Thunderbeat and Trocar are widely used in Minimally Invasive Surgeries. They are expensive and designed for single use. However, due to the limitation of resources, they have been reused in some cases. Therefore, we aimed to assess the efficacy of EDs reprocessing by Adenosine Triphosphate (ATP) method. Methods: This was a cross-sectional description study. After first clinical using, EDs were taken to cleaning. Every ED was cleaned three times. Efficacy cleaning was assessed after each cleaning procedure by ATP method. ATP <200 RLUs (Relative Light Units) was benchmark as efficient cleaning process. Results: A total of 611 EDs were studied, including 269 of Harmonic, Ligasure, Thunderbeat, 298 of Trocar, and 44 other types. Detachable devices accounted for about 32.7%. Overall, after three consecutive cleanings, the median ATP values were decreased dramatically (957 RLUs, 160 RLUs, and 62 RLUs, respectively). This was a significant reduction in ATP levels between three stages (p < 0.05). There were 63.5%, 84.3%, and 92.8% EDs that had ATP < 200 RLUs after first, second, third cleaning respectively. Approximately 90% of EDs were still functional after three cleaning times. Nondetachable items were to be more difficult to clean than detachable ones (p = 0.0003, OR 1.3 [1.1 – 1.5]). Conclusions: Our data suggest that monitoring efficacy cleaning of surgical instruments in general and single-use energy devices in particular with ATP can identify a number of different influence factors, like the instrument condition, reprocessing procedure, or especially their structure. ATP measurement seems to be a valid technique that allows an immediate repeat of the manual cleaning if the results exceed the established cutoff of 200 RLUs.

Deliberative mini-publics are decision-making bodies that provide technical instruction to a set of randomly-selected citizens, who then deliberate over public policies. Mini-publics have long seen use across a range of policy areas globally. The appeal of using mini-publics lies in their integration of democratic and deliberative inputs, which can enhance the legitimacy of policy decisions and may even help to settle deeply divisive public debates. Yet whether mini-publics can be adapted to the adjudication of human rights remains an open question. This article provides the first general empirical evaluation of this question. It finds, first, an expanding set of bona fide deliberative mini-publics adjudicating rights disputes, on subjects from hate speech to Covid-19. However, a second and more complex analysis considers whether mini-publics can conduct the deliberations necessary to adjudicate rights disputes. Some theoretical commentary assumes that they can, given that rights adjudication requires factual or value-based analyses, to which lay citizens seem well suited. The article indeed finds evidence to support this conclusion, providing proof-of-concept that mini-publics can adjudicate rights disputes effectively. However, support for the conclusion is conditional: how well mini-publics invoke key rights doctrines depends on the nature of support and information provided to lay participants.

Introduction: Razors were being used for pre-operative hair removal in our Institute. As per international guidelines recommending the use of surgical clippers, we opted to study the effects of two pre-operative skin preparations in our Neurosurgical centre Objectives: Primary; Pre auditing period -Assess knowledge and skill in usage of Razor/Clipper as preoperative skin preparation methods, Provide training on Clipper method and assess the knowledge /awareness on merits and demerits of both methods, To implement the Clipper method as against Shaving Secondary ; Post auditing period -Investigate the efficacy and safety of clippers versus razors, on variety of biophysical parameters and Surgical Site Infection (SSI) Methods : PICO questions ; Population: Adult patients undergoing any type of surgical procedure, Intervention: Hair removal, Comparator: Different methods of Hair removal, Outcomes: Biophysical parameters and SSI •Target population: Sixty adult patients undergoing neurosurgical procedures. •Subjects: 30 each subjected to shaving and clipper methods •Pre and Post assessment of on 25 parameters /sub-parameters •Analysis by MS-Excel and SPSS. Results:•Preoperative -Prior skin injuries and/or reactions; adequacy of hair removal •Complete hair removal : 30 (100%) in the clipper group versus 3 (10%) by shaving (p = 0.0001). •30 mins after hair removal ; significantly less skin issues in the clipper group •Post operative - Skin injuries in 20 (66.6%) of the razor and none in the clipper group. •SSI - Two (6.6%) in the razor and none in the clipper group. Conclusions: The assessment showed that shaving leads to partial hair removal increasing the scores for skin issues, significant association between preoperative skin injuries and SSI, implying inverse correlation with the clipper method. This study provides insights into significance of among other biophysical parameters underscoring adoption of clipper as the standard practice for preoperative hair removal, in our setting thus enhancing patient safety.

Objectives: Neonatal intensive care unit (NICU) admits premature babies and neonates with acute illness who are under high infection risk due to immature immune response system. Infections caused by carbapenem- resistant Enterobacterales (CRE) is a serious threat to such patient population. A single case of CRE infection occurred in 36-bed NICU on July 2023. Infection control measures were put in place to prevent further CRE infection within the NICU. Methods: A neonate delivered at gestational age of 23 weeks and 6 days with birth weight of 650g was under mechanical ventilator care. On 35th day of life, CRE (Escherichia coli, New Delhi metallo-beta- lactamase-1 positive) was isolated from this neonate’s endotracheal suction material. After discussion with infection control physician, the bacterial culture was determined to have been resulted from colonization or localized infection, rather than invasive infection. Five measures were taken to prevent additional infection within the NICU. One, contact precaution was issued for CRE-infected baby, and an isolation ward and a designated nurse was assigned for the baby to prevent cross infection. Two, adherence to hand hygiene and personal protective equipment (PPE) application was monitored for medical personnel and visitors entering the NICU. Three, a checklist was designed specifically for disinfection of NICU isolation ward, and the designated cleaner and assistants were educated on the checklist. Four, testing with fluorescent markers was performed to validate cleaning. Five, the infectious disease specialist and the pharmacy analyzed the prescription pattern of broad-spectrum antibiotic among patients in NICU for systematic antibiotic regulation. Results: The following results were obtained after 2 weeks of infection control measures. 57 subjects underwent hand hygiene monitoring, on which 15.8%(9 case) of the subjects unadequately passed. Immediate feedback was provided upon these detections. Cleaning validation detected a single cases of inadequate disinfection (door to isolation ward), for which re-cleaning and education was performed. An increasing trend in consumption of 3rd generation cephalosporin (8.96% in April 2023 to 21.21% in June 2023) was found, and the neonatology department was advised to be more selective in prescription of broad- spectrum antibiotics. Conclusions: There was no CRE infection for 6 months following infection control measures. This case was determined to be an isolated case of CRE infection, and no further surveillance culture was obtained. Proactive infection control measures, including contact isolation, hand hygiene, environment cleaning, and regulation of broad-spectrum antibiotics, are necessary to prevent secondary infections that may follow an index CRE infection in the NICU.

How can a single-day cluster of public learning activities contribute to a larger ongoing public humanities agenda? This essay’s co-authors—facilitators of a public lecture and associated activities sponsored by a university academic department—revisit their strategic efforts to provide leadership for the one-day series of interconnected events, anchored in a Native scholar’s public lecture on sovereignty and citizenship. We write from a predominantly white university geographically removed from Native nations’ reservations and lacking a full-fledged curriculum in Indigenous studies. Yet we also write as members of a consortium committed to enhancing reciprocal learning with Indigenous peoples. Thus, we aimed to set this one-day program within our local collaborative’s sustained work to develop curriculum; engage multiple audiences in topics important to Native studies; and foster networks linking students, faculty, and staff with Native community members. In making visible aspects of “doing” public humanities that often remain unrecorded, this case study will assist others interested in taking on public humanities work, whether a small-scale, single-day program or initiatives extended across a long-term calendar. After describing the ongoing work, one university and Native community partners have been carrying out through a Native and Indigenous Peoples Initiative, and situating those efforts in connection with our collaborative’s shared values for community building, the essay revisits event management steps taken to tap into and support that endeavor. Acknowledging successful elements alongside challenges and opportunities not fully achieved, our case study also offers approaches for collaborative evaluation of public humanities programming.

Ultraviolet (UV) floral reflectance plays a crucial role in pollinator attraction and foraging behavior. Turf protection products could alter the UV reflectance of weedy flowers and potentially deter pollinators from visiting treated flowers. This study evaluated the effects of optical brightener, pigmented fungicide, commercially available sunscreen, and turf colorant on the reflectance of three different UV floral classes of weeds and subsequent pollinator visitation. Reflectance of petal apices in the ranges of UV-A, UV-B, and UV-C, as well as digitally assessed UV-reflecting area, was reduced 47% to 66% by optical brightener at 30 g L−1 and equivalent to sunscreen for all species having UV-reflecting petals with bullseye patterns, including dandelion (Taraxacum officinale F.H. Wigg.) and bulbous buttercup (Ranunculus bulbosus L.), or with contrasting reproductive parts, such as foxglove beardtongue (Penstemon digitalis Nutt. ex Sims). These UV-reflectance reductions were greater than those of pigmented fungicide or turf colorants (≤38%) but less than that of sunscreen applied via atomizer (≥73%). Pollinator visitation to flowers having UV-reflecting petals with bullseye patterns was 61% correlated to radiometric UV reflectance at 1 d posttreatment. Thus, impacts on UV reflectance can have a powerful influence on foraging cues, but other factors such as flower color, nectar rewards, and scent may also contribute. Pollinators visited bullseye-pattern flowers 40%, 34%, and 10% as often as nontreated flowers 1 d after optical brightener, sunscreen, and atomized sunscreen treatments, respectively, with foraging typically reduced up to 2 d posttreatment. Only slight changes were noted in posttreatment pollinator foraging on the UV-absorbing inflorescences of white clover (Trifolium repens L.). Despite transient impacts to floral reflectance and pollinator foraging visits, treatments did not affect floral density or quality, preserving long-term pollinator food resources. Our findings suggest that multiple bioactive residues could be employed in turfgrass management practices to potentially safeguard pollinators from harmful products.

While most Conditional Cash Transfer programs in Latin America expanded from rural to national coverage, Peru’s Juntos program maintained a strict rural focus for 15 years, systematically excluding poor urban households. This article examines the Peruvian paradox: why, despite regional trends and internal efforts to broaden coverage, Juntos remained territorially constrained. Using process tracing and semi-structured interviews with policymakers, senior bureaucrats, former congress members, and policy experts, the study identifies two institutional legacies rooted in the neoliberal reforms of the Fujimori era. First, the institutional consolidation of the Ministry of Economy and Finance (MEF) as a powerful veto player with control over public spending; and second, the diffusion of an ideational framework centered on fiscal austerity, efficiency, and aversion to clientelism. These legacies gave rise to two policy locks, a persistent rural bias and a regime of horizontal and fiscal control, that have limited the program’s adaptability to shifting poverty dynamics and urban demands.

Objectives: Hospital networks can significantly improve healthcare-associated infection (HAI) prevention and management through quality improvement and standardization. Since 2017, the Korea Disease Control and Prevention Agency (KDCA) has coordinated a network project involving a central hospital and participating community hospitals nationwide. This paper shares our experience as one of the central hospital operating the program for seven years (2017-2023). Methods: Our network comprised one central tertiary-care hospital and 12 community hospitals. Activities focused on education, consultation, and quality improvement (QI). QI activities analyzed hand hygiene (HH) practices, alcohol-based hand rub consumption, and the World Health Organization’s HH Self- Assessment Framework (HHSAF) results. We provided educational resources for personal protective equipment (PPE) training, particularly during the COVID-19 pandemic. Annual workshops facilitated the sharing of specialized infection control programs from each hospital. Results: The project conducted 19 training sessions on topics like multidrug-resistant organism (MDRO) infection control, with 1,435 participants. We offered consultations for 41 cases (paper, phone, and 8 on-site visits) and shared consultation details through regular meetings. QI activities resulted in most hospitals maintaining a HH practice rate above 90%. All eight hospitals that consistently participated in the program saw improvements in their HHSAF scores compared to baseline. Notably, two hospitals achieved an “Advanced” level, having previously been at an “Intermediate” level. PPE training for 12,762 healthcare workers across 13 hospitals strengthened their response capabilities during COVID- 19 and reduced occupational infection risks. Conclusions: Frequent patient transfers and rising HAI rates highlight the limitations of individual hospitals in preventing and managing HAIs. The community hospital network establishes a government-led infection prevention response system. This model fosters enhanced infection control capabilities across network hospitals by offering technical support to resource-constrained facilities and implementing effective infection prevention initiatives that address ongoing challenges.

Background: With the increasing cases of multi-resistant organism infection, Antimicrobial Stewardship Programs (ASP) is an important tool in combating this rising challenges. The objective of this study is to review whether the approach of the reduction in usage of second and third generation cephalosporin group antibiotics reduces the incidence of ESBL E.coli and ESBL Klebsiella pneumoniae (KP) cases in Sabah Women and Children Hospital (SWACH) from 2021 until 2023. Methods: After discussion with the head of clinical services, the preferred empirical antibiotic of respective unit was switched to ampicilin-sulbactam or amoxicillin clavulanic acid instead of second or third generation cephalosporin. ASP team actively surveillant and monitored the above mentioned antibiotic, cephalosporin usage would be prescribed only to pre-determined indications, while others will be actively switched to ampicilin-sulbactam and amoxicilin- clavulanic acid. This study summarized the usage of Injection second and third generation of cephalosporin group antibiotics from year 2021 to year 2023 and compare with the incidence of ESBL cases per 100 patients admission during the same period. Usage of pediatric antibiotic described in number of vials over total number of admission, while adult antibiotic usage described in Defined daily dose (DDD). Occurrence of ESBL cases described in total number of cases/100 patient admission. The trend will then compared to the baseline ESBL E coli and KP in SWACH in the year prior this intervention. Results: For pediatric and adult O&G populations, we observed that the usage of overall cephalosporin group antibiotics showed a decreasing trend since year 2021 till year 2023 and a slight reduction in ESBL E coli and KP was observed at the same period. However, in adult oncology group, despite overall reduction in usage of cephalosporin group antibiotic except injection cefepime, the rate of ESBL E coli showed a slight increase. Conclusion: Coordinated efforts between stewardship programs and infection control are essential for reversing conditions that favor the emergence and dissemination of multidrug resistant gram negative bacteria within hospital.

This article concerns opportunities for improving systems for processing public finds through digital technology and citizen science, taking England, Estonia, and Finland as case studies. These three countries have differing legislation, but all face a significant growth in hobby metal detecting and consequent increase in archaeological finds being reported, which places pressure on existing resources for recording them. While archaeologists in the different countries all value public finds as items that add to public collections, provide information about sites at risk, and can advance research, their priorities vary. This has an impact on approaches to processing finds, but offers the chance to embrace digital technology and involve the public. This article shows how digital technology and public involvement in archaeology have already facilitated change in all three countries and highlights further opportunities these might provide, given a growing desire to democratize archaeology and share public finds data as widely as possible.

Background: The risk of respiratory infection varies on the degree of the fit of N95 masks, so education and training of appropriate wearing methods are required. This study was conducted to investigate whether there are differences in the fit of N95 masks among healthcare workers(HCWs) with education and experience in N95 mask-wearing and to assess the effectiveness of N95 mask-wearing training through fit tests. Methods: From October 2023 to February 2024, training on the wearing of N95 masks was conducted through fit tests for 195 high-risk department HCWs and new HCWs at a tertiary hospital. Fit tests was conducted before and after the training. Previous experiences of N95 mask-wearing education were investigated using questionnaires. The fit test was measured using QNFT (Quantitative Fit Test). Data was analyzed using percentages and a chi-square test. Result: Out of the 195 participants, 44 HCWs had experience by group or rote learning. The fit test pass rate in the group with education experience was 45.5%, which was higher than the 32.9% in the group without education experience; however, there was no statistically significant difference (P=0.293). The fit test pass rate for N95 mask-wearing training increased significantly from 35.8% (70 HCWs) before training to 98.5% (192 HCWs) after training (p=0.000). The three HCWs who failed the first test all passed the fit test after retraining using N95 masks of different shapes and sizes. Discussion: It was confirmed that N95 mask-wearing training through fit tests was effective in increasing fit, whereas group or rote learning was not effective. N95 mask-wearing training through fit tests is an effective method to enhance N95 mask fitting. It is essential to explore diverse approaches to sustain the training impact.

Objective: Open surgical wound is prone to surgical site infection due to contamination of surrounding environment. Therefore, routine air sampling and culture of two operating rooms (OR) was performed from 2018 to 2023 to monitor and evaluate air quality and provide appropriate infection control measures. Method: 2 OR regularly performing prosthetic insertion were selected for routine air sampling every 6 months due to high risk of surgical infection associated with the procedure. Air sampling was performed by collecting 1000 litre of air over 10 minutes using air sampler (MAS-100 Eco, Merck). Collected air was cultured on blood agar plate and Sabourand dextrose agar for 30 days, and pathogen identification and quantification was performed upon positive culture result. This study employed a cut-off point of 17.6 colony forming unit (CFU) as specified by federal standards on biological particles published by National Aeronautics and Space Administration. Results: 12 air samplings was performed from 2018 to 2023. A single case of positive bacterial air culture was reported (20 CFU, coagulase-negative Staphylococcus). Infection control measures were provided upon reporting of positive bacterial air culture, including inspection of positive pressure ventilation system and high efficiency particulate air filter, disinfection of OR and the equipment, and more strict regulation of temperature and humidity. Air sampling was repeated after imposing the measures to evaluate their effectiveness. Cases of surgical site infection caused by the identified pathogen were monitored for 90 days, after which it was determined that there was no surgical site infection related to positive air culture. Conclusion: The six-year monitoring of OR air sampling confirmed that detection of positive air culture in routine sampling was not associated with surgical site infection. Based on this result, the hospital decided to conduct air sampling and culture only in outbreak of surgical site infection as part of epidemiologic evaluation.

Objectives: Japan is becoming a super-aging society, with people aged over 65 years old accounting for 28.9% of the total population. Therefore, nursing care facilities have significant implications in contemporary Japanese society. In those facilities, it is important to clean and disinfect the environment in order to prevent the spread of infection to the residents. Thus, the aim of this study was to verify the disinfection effect of atomizing IONLESSTM hypochlorous acid water (CLFineTM) as a newly efficient disinfection method of environment by evaluating its antimicrobial effect against Staphylococcus aureus in two nursing care facilities and one facility shuttle vehicle. Methods: The bacterial suspension of Staphylococcus aureus was dripped onto petri dishes, and they were used as test carriers after drying. The test carriers were allocated in the area of interest (six sites for Facility A and B, two sites for shuttle vehicle), and then CLFineTM was atomized by ultrasonic humidifier so as to adjust the atmospherically available chlorine concentration to 0.03 ppm. The test carriers were collected 3 and 5 hours after atomization of CLFineTM followed by evaluation of the viable bacterial counts. Results: In Facility A and B, antimicrobial effect of 1.68 to 3.79 LogR and 0.98 to 2.76 LogR were observed 5 hours after atomization, respectively. In shuttle vehicle, antimicrobial effect of 2.70 to 6.32 LogR were observed 5 hours after atomization. Conclusions: The atomization of CLFineTM has also been suggested to be useful as a control measure against aerosol infections. Therefore, it is expected to be applied as a non-touch disinfection method in addition to regular wet cleaning in nursing care facilities.

Objectives: Central Line-Associated Bloodstream Infections (CLABSIs) are associated with prolonged hospitalization, increased healthcare costs. It is important to reduce CLABSI rates through interventions. This study investigated the current status of CLABSI rates among hospitalized patients to gather foundational data for implementing CLABSI intervention measures. Methods: During a month from June 1st to 30th, 2023, a retrospective investigation of CLABSI rates was conducted among patients hospitalized at a tertiary hospital in South Korea. Psychiatric and obstetric, hospice, emergency, neonatal wards, and delivery rooms were excluded from the study. CLABSI was defined according to NHSN and Korean National Healthcare-associated Infections Surveillance System. Results: A total of 48 CLABSIs were identified, with mucosal barrier injury laboratory-comfirmed bloodstream infection (MBI-LCBI) accounting for 29 (60.4%) and non-MBI-LCBI for 19 (39.6%). Among MBI-LCBI, 28 (96.6%) occurred in hematology wards, while among non-MBI-LCBI cases, 9 (47.4%) occurred in general wards, 9 (47.4%) in hematology wards, and 1 (5.3%) in the intensive care units (ICUs). Overall CLABSI rates was 2.75 per 1,000 catheter days, with 1.66 for MBI-LCBI and 1.09 for non-MBI-LCBI. By department, the CLABSI rates per 1,000 catheter days were 6.11 in hematology wards, 1.02 in general wards, and 0.63 in the ICUs. A total of 58 organisms were isolated, with gram- negative bacteria (78.8%) predominating in MBI-LCBI and gram-positive bacteria (56.0%) in non- MBI-LCBI. Among MBI-LCBI, Klebsiella pneumoniae (30.3%), Escherichia coli (27.3%) were the most frequently isolated organisms, whereas among non-MBI-LCBI, coagulase-negative staphylococci (16.0%) and E. coli (16.0%) were the most frequently isolated organisms. Conclusions: The CLABSI rates among hospitalized patients at a tertiary hospital in South Korea was higher for MBI-LCBI than non-MBI-LCBI, with the majority occurring in hematology wards. Since the departments and causative organisms are different depending on MBI-LCBI and non-MBI-LCBI, it is necessary to individualize the CLABSI surveillance policy based on this.