Compliance with hand hygiene is important in infection control, and the rate of hand disinfectant application is rising in recent years. Therefore, we evaluated the qualitative evaluation system of hand hygiene by mechanically measuring hand disinfectants containing a fluorescence substance. We observed that the hospital staff and general population had a significantly higher application rate of hand disinfectant on the palm side than on the dorsal side (P < 0.05). Hospital staff had a significantly higher application rate compared to the general population (P < 0.05). Disinfectants on the bad hand hygiene area are distributed more on the dorsal side than on the palm side in both hospital staff and general population. Particularly, the bad hand hygiene area was around the thumb of both hands. Disinfectant distribution on the bad hand hygiene area was evaluated by GlitterBug, particularly on the fingertips, which was different from the evaluation using HandInScan. It was estimated that disinfectant distribution on the bad hand hygiene area is associated with hand hygiene techniques, amount of hand disinfectant applied, and other factors. Therefore, evaluation and appropriate instruction on hand hygiene methods is necessary. HandInScan and GlitterBug both had advantages, therefore it seemed useful to choose them as appropriate. In addition, the involvement of pharmacists in the evaluation of such systems is meaningful for contributing to more effective and appropriate use of hand disinfectants.
The technological trends in infection control were evaluated by analysis of intellectual property rights. The number of patent gazettes was 716 and the number of utility model gazettes was 80 during the period. In contrast to the increasing number of patent applications, utility model applications had decreased. The number of patent applications from the USA had been increasing in recent years, so developing technology in infection control is apparently more important even in the USA where many medical material suppliers are located. As a trend in technicalˆelds, conventional clinical tests and medicines have increased and involve may instruments and materials. This study suggests that more various technologies and products will be introduced into infection control in the near future, and analysis of intellectual property rights could also apply to theˆeld.
2013 年 1 月 29 日 受付・2013 年 5 月 13 日 受理) 要 旨 手指衛生手技としてのスクラブ法では流水下で手を擦り合わせることによる物理的除去効果が期 待され,その評価には蛍光物質を用いた目視確認が汎用されているが,洗い残しの定量的な把握は 困難であった.そこで,本研究では一定量の蛍光物質を手指に塗布して手洗いを行い,手洗いによ り水中に移行した蛍光物質を定量し,質量除去率を算出する手法について検討した.その結果,洗 い残し面積を目視して算出した面積除去率よりも質量除去率の方が有意に低かったとともに,面積 除去率と質量除去率の乖離の程度が被験者により大きく異なっており,目視確認による主観的評価 の問題点が明らかとなった.よって,手指衛生手技における物理的除去効果を定量的に把握するこ とは評価の客観性向上に資するものと考えられ,各種介入効果や手指衛生手技の具体的手順の検討 等に際し,質量除去率という指標が有用である可能性が示唆された. Key words感染制御,手指衛生,定量的評価,スクラブ法 図 質量除去率測定フロー-202 -
AbstractA physical removal eŠect can be expected by the scrub method used as a hand hygiene technique, but quantitative evaluation of the eŠect is di‹cult by visual inspection using ‰uorescent material. This study examined the mass extraction ratio by measurement of ‰uorescent material in the water after washing the hands with aˆxed quantity of ‰uorescent material. As a result, the mass extraction ratio was signiˆcantly lower than the area extraction ratio by visual inspection, and the deviation of the area extraction ratio and mass extraction ratio were signiˆcantly diŠerent from individual to individual, so that the problem with subjective evaluation by visual inspection was revealed. Therefore, the physical removal eŠect as the mass extraction ratio in hand hygiene techniques apparently improves the objectivity of evaluation, and the mass extraction ratio is a useful indicator to evaluate the eŠects of interventions and hand hygiene techniques.
Campylobacter spp. is a gram-negative bacillus that causes infectious enteritis and consists of several species, including Campylobacter jejuni, Campylobacter coli, and Campylobacter fetus. Although C. jejuni and C. coli cause infectious enteritis primarily in immunocompetent hosts, C. fetus causes extraintestinal infections such as septicemia, meningitis, and perinatal infections in immunocompromised hosts, as well as myopericarditis in rare cases. Only a few cases of infectious myo(peri)carditis associated with C. coli in immunocompetent hosts have been reported. These studies concentrated on antecedent C. coli enterocolitis and never demonstrated a positive culture in the pericardial fluid.A 72-year-old Japanese man presented with a 2-week fever, cough, and vomiting lasting. He was on hemodialysis for polycystic kidney disease, as well as medication for diabetes and hypertension. A chest computed tomography (CT) scan and a transthoracic echocardiogram revealed bilateral pleural fluid and large pericardial fluid at the time of admission. C. coli was identified from blood culture samples and blood-tinged pericardial fluid. He was successfully treated with antibacterial chemotherapy as well as pericardial fluid drainage and was discharged from the hospital with no complications.In this case, the presence of C. coli in the pericardial fluid confirmed the diagnosis of C. coli pericarditis. C. coli may cause septic pericarditis in immunocompromised hosts, despite typically causing only enteritis.