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Article ; Online: Sources of primary bloodstream infections in internal medicine patients - a cohort study.

Benenson, Shmuel / Ben-Yosef, Yonatan / Schwartz, Carmela / Cohen, Matan J / Oster, Yonatan

2023 Volume 113, Page(s) 69–74

Abstract: Purpose: To describe the sources of bloodstream infections (BSIs) in internal-medicine patients, on admission and during hospitalization, and to determine the proportion of BSIs in which no secondary cause could be defined (i.e., primary-BSI).: ... ...

Abstract	Purpose: To describe the sources of bloodstream infections (BSIs) in internal-medicine patients, on admission and during hospitalization, and to determine the proportion of BSIs in which no secondary cause could be defined (i.e., primary-BSI). Methods: We analyzed all BSIs at the internal-medicine wards of the two campuses of the Hadassah Hebrew-University Medical Center, during 2017-2018. We defined the BSI source of each event (secondary, Central-line associated BSI (CLABSI) or primary non-CLABSI) and compared BSIs present on admission (POA) to hospital acquired (HA). Results: There were 595 patient-unique BSI events, 316 (53.1%) POA-BSI and 279 (46.9%) HA-BSI. Overall, 309 (51.9%) were secondary, 194 (32.6%) primary non-CLABSI and 92 (15.5%) CLABSI. Primary non-CLABSI in the POA-BSI group was 20.6% vs. 46.2% in the HA-BSI group (p = 0.001). The length of hospital stay (LOS) of the HA-BSI group was longer than in the POA-BSI group (mean LOS, 19 days vs. 13.6 days, p = 0.01) and mortality rate was higher (48.7% vs. 19%, p = 0.001). Staphylococcus aureus was more common in primary non-CLABSI than in CLABSI and secondary BSI (29.5%, 12.8% and 16.2%, respectively). Conclusions: The proportion of primary non-CLABSI among HA-BSI events is very high (46.2%). The absence of any plausible source for these BSIs, and the fact that in our hospital more than 90% of patients in medicine wards have peripheral lines, suggests that these may be a possible source for primary non-CLABSIs. Measures to prevent peripheral-line associated BSI (PLABSI), like those implemented successfully for the prevention of CLABSI, should be considered.
MeSH term(s)	Humans ; Cross Infection/epidemiology ; Cohort Studies ; Bacteremia/epidemiology ; Sepsis/epidemiology ; Internal Medicine ; Retrospective Studies
Language	English
Publishing date	2023-04-26
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2023.04.018
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Zs.A 2608: Show issues

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Article ; Online: A feasibility study of the use of medical clowns as hand-hygiene promoters in hospitals.

Neumark, Yehuda / Bar-Lev, Adina / Barashi, David / Benenson, Shmuel

PloS one

2022 Volume 17, Issue 12, Page(s) e0279361

Abstract: Healthcare-acquired infections (HAI) pose vast health and economic burdens. Proper hand-hygiene is effective for reducing healthcare-acquired infections (HAI) incidence, yet staff compliance is generally low. This study assessed the feasibility, ... ...

Abstract	Healthcare-acquired infections (HAI) pose vast health and economic burdens. Proper hand-hygiene is effective for reducing healthcare-acquired infections (HAI) incidence, yet staff compliance is generally low. This study assessed the feasibility, acceptability and preliminary effect of employing medical clowns to enhance hand-hygiene among physicians and nurses. Staff perception of the intervention and its impact on hand-hygiene was assessed via self-report questionnaires. Nearly 1,500 hand-hygiene compliance observations were conducted in accordance with WHO guidelines before, during and after the intervention. In each of three hospitals in Israel, two departments were selected-one in which medical clowns routinely operate and one clown-naive department. Professional medical clowns acted as hand-hygiene promoters employing humorous tactics to encourage hand-sanitizing based on the WHO "5 Moments" model. The clown appeared in each department seven times during the 2-week intervention phase. Pre-intervention hand-hygiene compliance ranged from just over 50% to 80% across hospitals and departments. Overall, about 70% of nurses (N = 132) and 80% of physicians (N = 49) felt the intervention improved personal and departmental hand-hygiene, with large inter-department variation. Pre- to post-intervention hand-hygiene compliance increased by 4% -25% (3.5-14.8 percentage points) in four departments, three of which had low baseline compliance levels. Results of this feasibility study suggest that employing medical clowns as hand-hygiene promoters as a novel approach toward HAI prevention is feasible and welcome by hospital staff.
Language	English
Publishing date	2022-12-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0279361
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Article ; Online: Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children.

Kurd, Mohammad / Hashavya, Saar / Benenson, Shmuel / Gilboa, Tal

Seizure

2021 Volume 92, Page(s) 89–93

Abstract: Objectives: To explore the rate, characteristics, risk factors, and prognosis of children presenting with seizures as the main symptom of acute COVID-19 (coronavirus disease 2019).: Methods: We conducted a systematic retrospective study to identify ... ...

Abstract	Objectives: To explore the rate, characteristics, risk factors, and prognosis of children presenting with seizures as the main symptom of acute COVID-19 (coronavirus disease 2019). Methods: We conducted a systematic retrospective study to identify all children who presented to the emergency departments of a tertiary academic medical center between March 1st and December 31st 2020 and had a SARS-CoV-2 infection based on RT-PCR (reverse transcription-polymerase chain reaction) from nasopharyngeal swab. Clinical and demographic data were extracted from the electronic medical records and reviewed. Results: Total of 175 children were diagnosed with acute SARS-CoV-2 infection in the emergency departments during the study period. Of those, 11 presented with seizures. Age ranged from six months to 17 years and 4 were girls. Five presented with status epilepticus and responded to loading doses of anti-seizure medications. Six had fever. Seven had prior history of neurological disorder. Full recovery was the rule. Significance: Unlike in adults, seizures occur early and may be the main manifestation of acute COVID-19 in children. Seizures, including status epilepticus, may occur without fever even in children with no history of epilepsy and are not associated with severe disease. A high index of suspicion is required for early diagnosis thus infection control measures can be taken.
MeSH term(s)	Adult ; COVID-19 ; Child ; Female ; Humans ; Infant ; Retrospective Studies ; SARS-CoV-2 ; Seizures/diagnosis ; Seizures/drug therapy ; Seizures/epidemiology ; Status Epilepticus
Language	English
Publishing date	2021-08-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2021.08.017
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Zs.A 3573: Show issues

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Article ; Online: BNT162b2 mRNA Covid-19 Vaccine Effectiveness among Health Care Workers.

Benenson, Shmuel / Oster, Yonatan / Cohen, Matan J / Nir-Paz, Ran

The New England journal of medicine

2021 Volume 384, Issue 18, Page(s) 1775–1777

MeSH term(s)	BNT162 Vaccine ; COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Health Personnel ; Humans ; Immunogenicity, Vaccine ; Treatment Outcome ; Vaccines, Synthetic/immunology ; mRNA Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines, Synthetic ; BNT162 Vaccine (N38TVC63NU)
Language	English
Publishing date	2021-03-23
Publishing country	United States
Document type	Letter
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2101951
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Ua VI Zs.34: Show issues

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Article ; Online: High attack rate of COVID-19 in an organized tour group of vaccinated travellers to Iceland.

Benenson, Shmuel / Ottolenghi, Miriam / Cohen, Matan J / Nir-Paz, Ran / Oster, Yonatan

Journal of travel medicine

2021 Volume 28, Issue 8

MeSH term(s)	COVID-19 ; Humans ; Iceland ; Incidence ; SARS-CoV-2
Language	English
Publishing date	2021-10-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taab157
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Zs.A 4120: Show issues

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Article: A Dynamic Response to Exposures of Health Care Workers to Newly Diagnosed COVID-19 Patients or Hospital Personnel, in Order to Minimize Cross-Transmission and the Need for Suspension From Work During the Outbreak.

Schwartz, Carmela / Oster, Yonatan / Slama, Carole / Benenson, Shmuel

Open forum infectious diseases

2020 Volume 7, Issue 9, Page(s) ofaa384

Abstract: Background: During the coronavirus disease (COVID-19) epidemic, many health care workers (HCWs) have been exposed to infected persons, leading to suspension from work. We describe a dynamic response to exposures of HCWs at Hadassah Hospital, Jerusalem, ... ...

Abstract	Background: During the coronavirus disease (COVID-19) epidemic, many health care workers (HCWs) have been exposed to infected persons, leading to suspension from work. We describe a dynamic response to exposures of HCWs at Hadassah Hospital, Jerusalem, to minimize the need for suspension from work. Methods: We performed an epidemiological investigation following each exposure to a newly diagnosed COVID-19 patient or HCW; close contacts were suspended from work. During the course of the epidemic, we adjusted our isolation criteria according to the timing of exposure related to symptom onset, use of personal protective equipment, and duration of exposure. In parallel, we introduced universal masking and performed periodic severe acute respiratory syndrome coronavirus 2 screening for all hospital personnel. We analyzed the number of HCWs suspended weekly from work and those who subsequently acquired infection. Results: In the 51 investigations conducted during March-May 2020, we interviewed 1095 HCWs and suspended 400 (37%) from work, most of them, 251 (63%), during the first 2 weeks of the outbreak. The median duration of exposure (interquartile range) was 30 (15-120) minutes. Only 5/400 (1.3%) developed infection, all in the first 2 weeks of the epidemic. After introduction of universal masking and despite loosening the isolation criteria, none of the exposed HCWs developed COVID-19. Conclusions: Relatively short exposures of HCWs, even if only either the worker or the patient wears a mask, probably pose a very low risk for infection. This allowed us to perform strict follow-up of exposed HCWs in these exposures, combined with repeated testing, instead of suspension from work.
Keywords	covid19
Language	English
Publishing date	2020-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofaa384
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Article ; Online: Translating a theory-based positive deviance approach into an applied tool: Mitigating barriers among health professionals (HPs) regarding infection prevention and control (IPC) guidelines.

Cohen, Ricky / Gesser-Edelsburg, Anat / Singhal, Arvind / Benenson, Shmuel / Moses, Allon E

PloS one

2022 Volume 17, Issue 6, Page(s) e0269124

Abstract: Background: Although a wide range of intervention programs and methods have been implemented to increase health professionals' (HPs) adherence with infection prevention and control (IPC) guidelines and decrease the incidence of healthcare associated ... ...

Abstract	Background: Although a wide range of intervention programs and methods have been implemented to increase health professionals' (HPs) adherence with infection prevention and control (IPC) guidelines and decrease the incidence of healthcare associated infections (HAIs), a significant discrepancy remains between the guidelines and their implementation in practice. Objectives: This study proposes an applied tool based on the integrated theoretical framework of the positive deviance (PD) approach for developing more effective interventions to mitigate this discrepancy. Methods: A qualitative study guided by the PD approach based on data from two sources: (1) in-depth archival analysis of systematic review articles, and (2) integration and synthesis of findings based on an extensive empirical study we conducted, involving 250 HPs (nurses, physicians, support staff and cleaning staff) from three governmental hospitals in Israel, over 35 months (January 2017 to November 2020). Results: The barriers faced by HPs were classified into four main categories: (1) individual-motivational, (2) social-cultural, (3) organizational, and (4) work environment and resource-centered. For each barrier, we constructed a set of questions based on the PD approach. For each question, we adapted and applied methodological tools (e.g., in-depth interviews, focus groups, social network maps, video clips and simulations) to help solve the problem. Conclusion: Translating a theory-based approach into an applied tool that offers step-by-step actions can help researchers and practitioners adopt and implement the approach within intervention programs to mitigate barriers.
MeSH term(s)	Cross Infection/prevention & control ; Health Personnel ; Humans ; Infection Control/methods ; Motivation ; Qualitative Research
Language	English
Publishing date	2022-06-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0269124
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Article ; Online: The effect of a third BNT162b2 vaccine on breakthrough infections in health care workers: a cohort analysis.

Oster, Yonatan / Benenson, Shmuel / Nir-Paz, Ran / Buda, Inon / Cohen, Matan J

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2022 Volume 28, Issue 5, Page(s) 735.e1–735.e3

Abstract: Objectives: In August 2021, 6 months after mass vaccination of the Israeli population with the two-dose BNT162b2 mRNA vaccine, a surge of coronavirus disease 2019 infections, mostly from the delta variant, appeared also among the vaccinated. In response, ...

Abstract	Objectives: In August 2021, 6 months after mass vaccination of the Israeli population with the two-dose BNT162b2 mRNA vaccine, a surge of coronavirus disease 2019 infections, mostly from the delta variant, appeared also among the vaccinated. In response, the Israeli Ministry of Health initiated a booster (third dose) vaccination program. We assessed the protective effect of the third dose among health care workers (HCWs). Methods: Infections with severe acute respiratory syndrome coronavirus 2 are monitored systematically among HCWs at the Hadassah tertiary care medical centre in Jerusalem, Israel. In this cohort, we included breakthrough infections, defined as those occurring >180 days since the second vaccine dose. The follow-up period lasted 120 days. We compared infection rates between HCWs who received the booster dose and those who received only the two-dose regimen. Results: The rate of breakthrough infections among HCWs who received only the two-dose regimen was 21.4% (85 of 398). The rate in the boosted group was 0.7% (35/4973; relative risk 30, 95% CI 20-50). Those results were seen in all age groups. Discussion: The significantly lower rate of breakthrough infections in boosted HCWs indicates substantial protection by a third vaccine dose.
MeSH term(s)	BNT162 Vaccine ; COVID-19/prevention & control ; COVID-19 Vaccines ; Cohort Studies ; Health Personnel ; Humans ; SARS-CoV-2 ; Vaccines, Synthetic ; mRNA Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines, Synthetic ; mRNA Vaccines ; BNT162 Vaccine (N38TVC63NU)
Language	English
Publishing date	2022-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2022.01.019
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Zs.A 4541: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 284: Show issues

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Article ; Online: The Validity of Positive Coagulase-Negative Staphylococcus Cultures for the Diagnosis of Sepsis in the Neonatal Unit.

Benenson, Shmuel / Cohen, Matan J / Greenglick, Nofar / Schwartz, Carmela / Eventov-Friedman, Smadar / Ergaz, Zivanit

American journal of perinatology

2022

Abstract: Objective: Coagulase-negative : Study design: This historical cohort study was conducted in NICUs at the Hadassah-Hebrew University Medical Center of Jerusalem in Israel. Clinical and laboratory data in every CoNS bacteremia were collected and ... ...

Abstract	Objective: Coagulase-negative Study design: This historical cohort study was conducted in NICUs at the Hadassah-Hebrew University Medical Center of Jerusalem in Israel. Clinical and laboratory data in every CoNS bacteremia were collected and compared between bacteremia groups as follows: true positive, two positive BCs; contaminant, one positive BC out of two; undefined, one BC obtained and found positive. Results: For 3.5 years, CoNS was isolated in 139 episodes. True positive was identified in 44 of 139 (31.7%), contaminant in 42 of 139 (30.2%), and the event was undefined in 53 of 139 (38.1%). Vancomycin treatment was more frequent in the true positive and undefined groups than the contaminant group (100, 90.6, and 73.8% respectively, Conclusion: Diagnosis should definitely be based on at least two positive BCs, despite objective difficulties in obtaining BCs in neonates. Key points: · CoNS is a frequent pathogen causing LOS in neonates.. · Due to technical difficulties, often only one culture is collected prior to antibiotic therapy.. · No clinical/laboratory variables were associated with the diagnosis of true CoNS bacteremia.. · Diagnosis should definitely be based on at least two positive BCs..
Language	English
Publishing date	2022-05-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/a-1817-5698
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Zs.A 1929: Show issues

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Article ; Online: How effective are monthly departmental tracer surveys? A five-year retrospective study of 138 surveys in 96 departments.

Kopuit, Puah / Bier, Liora / Abu-Gush, Samar / Smadga, Hanna / David, Ruth / Shraga, Tova / Dery, Ilana / Ezagui, Bath Sheva / Yinnon, Amos M / Benenson, Shmuel

American journal of infection control

2024

Abstract: Background: Repeat departmental-wide surveys are commonly employed for infection-control. There remains debate concerning their cost-effectiveness.: Aim of the study: To measure the impact of repeat departmental-wide surveys in major in-patient ... ...

Abstract	Background: Repeat departmental-wide surveys are commonly employed for infection-control. There remains debate concerning their cost-effectiveness. Aim of the study: To measure the impact of repeat departmental-wide surveys in major in-patient departments (IPD) and ambulatory facilities (AF) in a tertiary care hospital. Design: Retrospective study of 138 surveys conducted in 96 departments over a five-year period. Methods: Two itemized questionnaires were designed to assess the most frequently inadequately-adhered-to infection control measures: one for IPD (with 21 items), the other for AF (with 17 items). Results: A total of 72 surveys were conducted in 49 IPDs, of which 39 (54%) were repeat surveys, and 66 surveys in 47 AFs, of which 33 (50%) were repeat surveys. The baseline rate of adherence/department was 71%±14 for the IPD, with an increase from the first to the last survey to 82%±13 (p=0.037). In 15/21 measured infection control items, adherence improved. Adherence to infection control items was lower at baseline in the AFs than in the IPDs (63±27), with an increase to 76±20 (NS). Although adherence improved for nine items, it deteriorated in another eight, producing an overall statistically unchanged outcome. Conclusion: Repeat whole-department surveys contribute moderately to increased adherence to infection control guidelines. Ambulatory facilities demonstrate lower rates of adherence to infection control guidelines and are less receptive to educational measures.
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2024.04.004
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