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Article ; Online: The role of environmental and healthcare-associated infections in Asia: Lessons learned from the coronavirus disease 2019 (COVID-19) pandemic.

Apisarnthanarak, Anucha / Ling, Moi Lin / Weber, David J

Antimicrobial stewardship & healthcare epidemiology : ASHE

2023 Volume 3, Issue 1, Page(s) e100

Language	English
Publishing date	2023-06-15
Publishing country	England
Document type	Editorial
ISSN	2732-494X
ISSN (online)	2732-494X
DOI	10.1017/ash.2023.182
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: APSIC guide for prevention of catheter associated urinary tract infections (CAUTIs).

Ling, Moi Lin / Ching, P / Apisarnthanarak, A / Jaggi, N / Harrington, G / Fong, S M

Antimicrobial resistance and infection control

2023 Volume 12, Issue 1, Page(s) 52

Abstract: Background: The Asia Pacific Society of Infection Control launched the APSIC guide for prevention of catheter associated urinary tract infections in July 2022. It aims to highlight practical recommendations in a concise format designed to assist ... ...

Abstract	Background: The Asia Pacific Society of Infection Control launched the APSIC guide for prevention of catheter associated urinary tract infections in July 2022. It aims to highlight practical recommendations in a concise format designed to assist healthcare facilities in the Asia Pacific region to achieve high standards in infection prevention and control practices during the management and care of patients with a urinary catheter. Methods: The guidelines were developed by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published guidelines and recommendations relevant to each section. Results: It recommends that healthcare institutions have a catheter associated urinary tract infection prevention program that includes surveillance and the use of the insertion and maintenance bundles. Implementation of the bundles is best done using a quality improvement approach with a multidisciplinary team. Conclusions: Healthcare facilities should aim for excellence in care of patients with urinary catheters. It is recommended that healthcare facilities have a catheter associated urinary tract infection prevention program as part of their Infection Prevention and Control program.
MeSH term(s)	Humans ; Catheter-Related Infections/prevention & control ; Catheter-Related Infections/epidemiology ; Infection Control ; Urinary Catheterization/adverse effects ; Urinary Tract Infections/prevention & control ; Urinary Tract Infections/epidemiology ; Urinary Catheters/adverse effects
Language	English
Publishing date	2023-05-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-023-01254-8
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Article: Better hand hygiene means safer care.

Ling, Moi Lin

Annals of the Academy of Medicine, Singapore

2013 Volume 42, Issue 6, Page(s) 267–268

MeSH term(s)	Hand Disinfection/standards ; Hand Hygiene/methods ; Humans ; Infection Control/methods
Language	English
Publishing date	2013-09-05
Publishing country	Singapore
Document type	Editorial
ZDB-ID	604527-3
ISSN	0304-4602
ISSN	0304-4602
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Article ; Online: Ten years of hand hygiene excellence: a summary of outcomes, and a comparison of indicators, from award-winning hospitals worldwide.

Tartari, Ermira / Garlasco, Jacopo / Mezerville, Marcela Hernández-de / Ling, Moi Lin / Márquez-Villarreal, Hilda / Seto, Wing-Hong / Simon, Anne / Hennig, Thomas-Jörg / Pittet, Didier

Antimicrobial resistance and infection control

2024 Volume 13, Issue 1, Page(s) 45

Abstract: Background: Hand hygiene is a crucial measure for the prevention of healthcare-associated infections (HAIs). The Hand Hygiene Excellence Award (HHEA) is an international programme acknowledging healthcare facilities for their leadership in implementing ... ...

Abstract	Background: Hand hygiene is a crucial measure for the prevention of healthcare-associated infections (HAIs). The Hand Hygiene Excellence Award (HHEA) is an international programme acknowledging healthcare facilities for their leadership in implementing hand hygiene improvement programmes, including the World Health Organisation's Multimodal Improvement Strategy. This study aimed at summarising the results of the HHEA campaign between 2010 and 2021 and investigating the relationship between different hand hygiene parameters based on data from participating healthcare facilities. Methods: A retrospective analysis was performed on datasets from HHEA forms, including data on hand hygiene compliance, alcohol-based handrub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores. Descriptive statistics were reported for each variable. The correlation between variables was inspected through Kendall's test, while possible non-linear relationships between hand hygiene compliance, ABHR consumption and HHSAF scores were sought through the Locally Estimated Scatterplot Smoothing or logistic regression models. A tree-structured partitioning model was developed to further confirm the obtained findings. Results: Ninety-seven healthcare facilities from 28 countries in three world regions (Asia-Pacific, Europe, Latin America) were awarded the HHEA and thus included in the analysis. HHSAF scores indicated an advanced hand hygiene promotion level (median 445 points, IQR 395-480). System change (100 [95-100] points) and institutional safety climate (85 [70-95] points) showed the highest and lowest score, respectively. In most cases, hand hygiene compliance was above 70%, with heterogeneity between countries. ABHR consumption above 20 millilitres per patient-day (ml/PD) was widely reported, with overall increasing trends. HHSAF scores were positively correlated with hand hygiene compliance (τ = 0.211, p = 0.007). We observed a positive correlation between compliance rates and ABHR consumption (τ = 0.193, p < 0.001), although the average predicted consumption was stable around 55-60 ml/PD for compliance rates above 80-85%. Logistic regression and partitioning tree analyses revealed that higher HHSAF scores were more likely in the high-ABHR consumption group at cut-offs around 57-59 ml/PD. Conclusion: Ten years after its inception, the HHEA proves to be a valuable hand hygiene improvement programme in healthcare facilities worldwide. Consistent results were provided by the different hand hygiene indicators and the HHSAF score represents a valuable proxy measure of hand hygiene compliance.
MeSH term(s)	Humans ; Hand Hygiene/methods ; Retrospective Studies ; Cross Infection/prevention & control ; Hospitals ; Health Facilities
Language	English
Publishing date	2024-04-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-024-01399-0
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Article ; Online: SG-APSIC1055

Qinnan Liu / Kamini Devi / Ismail Bin Sazali / Tan Kwee Yuen / Shaiful Bahri Maroni / King Richard Jay Ganotisi / Quek Bak Siang / Ling Moi Lin

Antimicrobial Stewardship & Healthcare Epidemiology, Vol 3, Pp s15-s

Hand hygiene challenges among the ancillary team during the COVID-19 pandemic

2023 Volume 15

Abstract: Objectives: Ancillary staff members perform operational support functions and play an active role in enhancing the patient care experience. Infection prevention practices among ancillary staff play a critical role in preventing transmission of ... ...

Abstract	Objectives: Ancillary staff members perform operational support functions and play an active role in enhancing the patient care experience. Infection prevention practices among ancillary staff play a critical role in preventing transmission of microorganisms, which ensures the safety of patients. Low hand hygiene compliance was found among porters in a cross-institutional hand hygiene audit in 2021. A quality improvement team was formed to improve hand hygiene compliance, especially during the COVID-19 pandemic. Methods: A focus-group discussion and survey were conducted to understand hand hygiene knowledge and challenges among porters. Using the findings, the team initiated Glo–germ education tools, pocket alcohol hand-rub agents, pocket moisturizer, poster display, and a toolbox messaging system via conversion of group roll call to satellite-area roll call. Respective satellite teams were sent hand hygiene reminders, and prompt corrective action was taken following noncompliance events. Analytic comparisons of pre- and postsurvey data were performed using the χ2 test, and P < .05 was regarded as statistically significant. Results: In total, 572 ancillary staff participated in the survey. Knowledge of hand hygiene practices improved significantly following the interventions, as shown in the comparison of pre- and postintervention results: knowledge of the hand hygiene steps (P < .001), knowledge of the duration of hand rub (P < .001), and knowledge of duration of handwashing (P < .001). Also, 295 staff members (97.68%) stated that implementation measures increased their awareness of the importance of hand hygiene. Moreover, the hand hygiene compliance rate improved from 77.8% to 100%. There were no significant differences related to sex (P = .089), age group (P = .355), years of working (P = .359), education level (P = .268), or difficulty in reading English (P = .906). Conclusions: Evaluating staff hand hygiene knowledge and understanding the challenges faced among porters helped toward the ...
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Cambridge University Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: SG-APSIC1058

Zhimin Zhang / Molly How Kue Bien / Lee Lai Chee / Nenny Suzanah Binte Sellamat / Chua Puay Hoon / Lai Kai Mun / Ling Moi Lin

Antimicrobial Stewardship & Healthcare Epidemiology, Vol 3, Pp s31-s

Microbiological surveillance of endoscopes in a Singapore tertiary-care academic hospital: A retrospective study from 2018 to 2021

2023 Volume 31

Abstract: Objectives: Improper reprocessing of endoscopes may result in healthcare-associated infections. Regular microbiological surveillance is an important means of evaluating the quality of endoscope reprocessing. We evaluated the effectiveness of reprocessing ...

Abstract	Objectives: Improper reprocessing of endoscopes may result in healthcare-associated infections. Regular microbiological surveillance is an important means of evaluating the quality of endoscope reprocessing. We evaluated the effectiveness of reprocessing endoscopes (including the protocols on steps to be taken in the event of any positive microbiological results) in a sterile supply unit (SSU) and an endoscopy unit in a Singapore tertiary-care academic hospital. Methods: Singapore General Hospital (SGH) is a 1,750-bed, tertiary-care, academic medical center in Singapore with 2 main SSUs: 1 inpatient endoscopy unit and 1 outpatient endoscopy unit. We reviewed microbiological surveillance results from endoscopes following reprocessing from January 2018 to December 2021. In total, 160 endoscopes (27 bronchoscopes, 58 gastroscopes, 52 colonoscopes, 6 duodenoscopes, 5 echoscopes, 5 cystoscopes, 5 rhinolaryngoscopes, and 5 enteroscopes) and 15 automated endoscope reprocessors (AERs) were evaluated for the presence of microorganisms. Samples were obtained by swabbing the tip of the scope and the biopsy channel. Fluid was flushed from the biopsy channel after reprocessing, and this water from the AERs was sampled after waterline disinfection. Results: Of the 15,783 samples collected, 15,667 (99.3%) yielded no growth; 36 (0.2%) were positive for gut and environmental flora; and 80 (0.5%) were positive for low-concern organisms such as skin flora. Conclusions: Microbiological surveillance yielded a high percentage of negative results confirming the effectiveness of endoscope reprocessing. This quality-assurance process is necessary and beneficial in achieving patient safety.
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Cambridge University Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: SG-APSIC1076

Ismail Bin Sazali / Lee Lai Chee / May Kyawt Aung / Molly How Kue Bien / Tan Kwee Yuen / Hatijah Binti Tohid / Ling Moi Lin

Antimicrobial Stewardship & Healthcare Epidemiology, Vol 3, Pp s29-s

Bacteremia caused by Streptococcus mitis in a hematology unit

2023 Volume 29

Abstract: Objectives: Streptococcus mitis is a gram-positive coccus and is a common commensal found in the throat, nasopharynx, and mouth. In an immunocompromised host, S. mitis opportunistically multiplies and can translocate to other sites. At baseline, the ... ...

Abstract	Objectives: Streptococcus mitis is a gram-positive coccus and is a common commensal found in the throat, nasopharynx, and mouth. In an immunocompromised host, S. mitis opportunistically multiplies and can translocate to other sites. At baseline, the prevalence of S. mitis remained stable among hematological patients, averaging ~1 case monthly. However, in August–September 2020, 5 S. mitis cases were documented in a hematology ward and included overlapping inpatient stays. In this descriptive cluster report, we sought to identify the reasons for the increased prevalence of S. mitis in our institution. Methods: A literature review was undertaken to gain a better understanding of the bacteriology of S. mitis. Subsequently, geographical mapping was performed to identify epidemiological links. Further culture and sensitivity testing was requested. Hand hygiene compliance, environmental audit, and handling of central lines within the ward were examined for any lapses in practice. Results: Based on geographical mapping, no epidemiological linkages were established between patients; they were admitted to different rooms and did not share any equipment. Moreover, based on the antibiogram, different bacteria sensitivities were recorded across the isolates from these patients. A hand hygiene and environmental audit result showed 100% compliance. Nurses performed care of central lines in accordance with guidelines. However, an investigation of changes in practice revealed that the use of a toothbrush had only recently been permitted as part of streamlining oral care for hematology patients. Because toothbrushes were not provided by the hospital, patients were utilizing their personal toothbrushes with no direct supervision of their oral care regimen. Conclusions: The prevalence of S. mitis in hematological patients was likely due to the neutropenic condition of patients. This report provides valuable information supporting the optimization of oral hygiene in immunocompromised patients while minimizing the risk of ...
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Cambridge University Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Zero healthcare-associated respiratory viral infections amongst haematology inpatients: unexpected consequence of heightened infection control during COVID-19 outbreak

Wee, Liang En Conceicao Edwin Philip Tan Jing Yuan Venkatachalam Indumathi Ling Moi Lin

Journal of Hospital Infection

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #885340
Database	COVID19

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Article ; Online: Rapid Management of Serratia marcescens Outbreak in Neonatology Unit in Singapore: Risk factors and Infection Control Measures.

Arora, Shalvi / Oo, Aung Myat / Ismail, Bushra Binte Shaik / Poon, Woei Bing / Mun, Deborah Lai Chooi / Ki, Karrie Ko Kwan / Man, Wong Hei / Tan, Kwee Yuen / Aung, May Kyawt / Conceicao, Edwin Philip / Yong, Yang / Weng, Darius Chan Yak / Ying, Jean Sim Xiang / Venkatachalam, Indumathi / Lee, Lai Chee / Ling, Moi Lin

American journal of infection control

2024

Abstract: Background: To describe two consecutive Serratia marcescens outbreaks in neonatology unit of Singapore General hospital and determine risk factors associated with its acquisition in the second outbreak.: Methods: Epidemiological investigations, ... ...

Abstract	Background: To describe two consecutive Serratia marcescens outbreaks in neonatology unit of Singapore General hospital and determine risk factors associated with its acquisition in the second outbreak. Methods: Epidemiological investigations, environmental sampling and risk-factors analysis were used to guide infection control measures. Active surveillance sampling of nasopharyngeal aspirate and/or stool from neonates was conducted during both outbreaks. Whole-genome-sequencing was performed to determine clonal links. Retrospective case-control study was conducted in the second outbreak to identify risk factors for S. marcescens acquisition. Results: In the one-year period in 2022, two S. marcescens outbreaks were managed involving five neonates in March 2022 outbreak and eight neonates in November 2022 outbreak. Both outbreaks were caused by genetically unrelated S. marcescens clones, with a link to positive isolates from sinks in intensive care units and milk preparation room during outbreak 1. Neonatal jaundice(OR, 16.46; p-value= 0.023) and non-formula milk feeding(OR, 13.88; p-value= 0.02) were identified as independent risk factors during second outbreak. Multiple interventions adopted were cohorting of positive cases, carriage-screening, enhanced environmental cleaning, and emphasis on alcohol-based handrubs for hand-hygiene. Conclusion: The two outbreaks in our institution were likely due to infection prevention practices lapses and favourable environmental conditions. Nosocomial S. marcescens outbreaks in neonatology units are difficult to control and require multidisciplinary approach with strict infection prevention measures to mitigate infection risks.
Language	English
Publishing date	2024-05-16
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.2024.05.006
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Article ; Online: Zero healthcare-associated respiratory viral infections amongst haematology inpatients: unexpected consequence of heightened infection control during COVID-19 outbreak.

Wee, Liang En / Conceicao, Edwin Philip / Tan, Jing Yuan / Venkatachalam, Indumathi / Ling, Moi Lin

The Journal of hospital infection

2020

Language	English
Publishing date	2020-10-22
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2020.10.011
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