Background Pulmonary function test (PFT) rooms involve frequent patient turnover and can generate respiratory aerosols during forced expiratory maneuvers. This quality improvement (QI) project evaluated observed changes in culturable airborne bacteria (CAB, CFU/m3) under routine clinical operation when ultraviolet germicidal irradiation (UVGI)-related engineering controls were applied singly or in combination, to inform pragmatic infection-prevention options for PFT rooms. Methods CAB was sampled by impaction at two fixed locations in the PFT room using a consistent protocol with repeated measurements. The baseline/control condition was defined as routine operation with supplemental devices OFF (ceiling UV-C OFF and portable air-circulation UV sterilizer OFF) under the specified HVAC setting, and intervention conditions were assessed using the same protocol. Lobby measurements were used only as contextual building-environment comparators. Results The combined operation of ceiling UV-C, the portable air-circulation UV sterilizer, and HVAC yielded the lowest observed CAB, while ceiling UV-C alone produced the largest reduction among single interventions in this setting. Representative isolates included common skin/environmental taxa (e.g., Staphylococcus hominis), consistent with human occupancy and resuspension. Conclusions In this real-world QI evaluation, UV-C–containing interventions were associated with lower culturable airborne bacterial counts in the PFT room, with the lowest observed values under combined engineering controls. These findings should be interpreted as culture-based room-level observations under routine workflow conditions, not as evidence of complete air disinfection or respiratory pathogen reduction.
Clinical waste management is a central component to infection prevention and control (IPC) practice across the UK and Ireland, with effective implementation of waste management being critical to a functioning healthcare system. Healthcare organisations have a duty of care to provide a safe service that correctly manages potentially hazardous clinical waste for the safety of both staff and patients. Key guidance for best practice clinical waste management in the National Health Service (NHS) is outlined in the 'UK: Health Technical Memorandum 07-01: Safe and sustainable management of healthcare waste' and aligns with the NHS clinical waste strategy published in March 2023. Significant barriers to the successful implementation of these guidelines in the healthcare setting are often encountered. The infection prevention specialist plays an essential role in the education of healthcare staff to ensure the guidelines are adhered to at a practical level and to provide understanding of the waste management hierarchy. It is important to involve all key stakeholders to ensure the best chance of a positive outcome. Hospital management is responsible for ensuring there is a clear waste management policy and ensuring the engagement of competent, certified waste contractors. The IPC team members are key stakeholders with responsibility for setting and implementing standards on how waste is segregated to prevent infection spread. The hospital's Green Committee should also be involved to support delivery of a service with sustainability and costs to the forefront, in accordance with the 'Net Zero Carbon' targets.
Introduction Multidrug-resistant gram-negative bacteria (MDR-GNB) is a major healthcare challenge, particularly among patients admitted to intensive care units (ICU). The objective of the current study was to assess the risk of acquisition of MDR-GNB in ICU patients and its associated risk factors and outcomes. Methods A prospective cohort study among adult ICU patients was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia, between 2021 and 2022. Specimens were examined at admission, during stay, and before discharge for all patients. Acquisition of MDR-GNB was confirmed by a positive culture/PCR before discharge among patients who were negative at admission. Results A total of 307 patients were included. The mean age was 56.7±18.2 years and 62.2% were males. Out of 307, 82 (26.7%) patients acquired MDR-GNB during their ICU stay. The most common MDR-GNB pathogens were Klebsiella spp. (47.1%), Acinetobacter spp. (14.7%), Pseudomonas aeruginosa (12.7%), Enterobacter spp. (10.8%), and Escherichia coli (5.9%). Approximately 40.2% of MDR-GNB were presented as infection and 59.8% as colonization. In multivariate analysis, the following variables were independent predictors of MDR-GNB acquisition; pneumonia at admission, central line use, urinary catheter use, renal comorbidity, and prolonged hospitalization. Patients who acquired MDR-GNB had significantly higher mortality (34.1% versus 5.3%, p<0.001) and ICU length of stay (median of 26 versus 10 days, p<0.001). Conclusions The findings underscore the high risk and burden of MDR-GNB acquisition in ICU setting. There is urgent need for enhanced infection control strategies and antimicrobial stewardship activities to reduce the acquisition and its negative impact.
Introduction In healthcare, excessive glove use increases the risk of spreading microorganisms and amount of plastic waste. With no sustainable alternatives, reducing glove use is the primary mitigation strategy. This project aimed to understand healthcare workers’ (HCW) perspectives on glove use, to evaluate if a behaviour change was achieved through an intervention, and measure the reduction in glove use. Methods A multicentre before-after improvement project was conducted in the south-western region of the Netherlands. First, a regional policy on glove use was formulated. At baseline, a COM-B questionnaire on glove use was distributed among HCW. The intervention comprised a toolbox for healthcare facilities and observations of glove use. Additionally, glove procurement statistics were gathered, and interviews about the perceived usefulness of the intervention were conducted. Results The questionnaire had 1,111 participants. The COM-B theme Opportunity scored lowest, while Behaviour scored highest. At baseline, 1,550 observations were performed by 15 healthcare facilities, post-intervention 940 observations were performed by 6 healthcare facilities, showing a significant decrease in unnecessary glove use by HCW (42.3% vs. 25.9%, P<0.001). Glove procurement statistics showed a significant decrease in one healthcare facility (P<0.001). The overall grade of the intervention given by HCW was a 7.8 out of 10. Conclusion This project highlights the need for targeted interventions to improve issues related to the opportunity to correctly wear gloves. While the percentage of unnecessary use was notably high, interventions chosen by HCW can reduce this significantly, with potentially a positive impact on patient care and the environment.
Legionella species are environmental Gram-negative bacteria capable of colonising artificial water systems and causing Legionnaires’ disease, a severe form of atypical pneumonia. Healthcare facilities are particularly vulnerable to transmission because complex building water systems can support bacterial growth and aerosol generation, exposing highly susceptible patient populations.This article uses a case-based scenario to illustrate the investigation of suspected healthcare-associated Legionnaires’ disease on a haematology ward. The recognition of clustered pneumonia cases prompted multidisciplinary investigation involving infection prevention and control teams, clinical microbiologists, and estates engineers. The paper outlines the regulatory and technical frameworks that underpin Legionella risk management in healthcare facilities and the role of Water Safety Groups in coordinating environmental investigation.Key elements of laboratory diagnostics are described, as well as practical aspects of environmental sampling, including the use of pre-flush and post-flush samples to determine whether contamination is localised to outlets or reflects colonisation of the wider water distribution system. Interpretation of quantitative results is discussed alongside common engineering findings such as inadequate temperature control, stagnation, and redundant pipework. The article also outlines immediate precautionary measures and longer-term remediation strategies used to control Legionella in hospital water systems.Effective prevention of healthcare-associated Legionnaires’ disease requires close collaboration between infection prevention and control teams, microbiologists, and estates professionals to ensure safe design, monitoring, and management of healthcare water systems.
Background:Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia carries high mortality. At Yamanashi Prefectural Central Hospital, antimicrobial stewardship has focused on appropriate drug use. In 2022, a pharmacist-coordinated Infectious Disease Support Team (IDST) was established to optimize management, including diagnostics, dosing, and treatment duration. We evaluated the effects of IDST participation on the adherence to a predefined Staphylococcus aureus bacteraemia treatment bundle and mortality. Methods:We conducted a single-centre retrospective cohort study of adults with MRSA bacteraemia diagnosed between April 2020 and June 2025. Patients were categorized into IDST intervention or non-intervention groups. Bundle adherence (≥ 75% defined as ≥ 9/12 items) and 28- and 90-day mortality were analysed using Kaplan-Meier analysis with log-rank tests and Cox proportional-hazards models; two-sided P < 0.05 was considered significant. Results:Eighty-five patients were included in the present study. Overall, bundle adherence ≥75% occurred in 57.6%; adherence was higher with IDST than without (79.5% vs 39.1%); 28-day mortality occurred in 26 (30.6%) and 90-day mortality in 42 (49.4%), respectively. Survival analysis showed lower 28-day (log-rank P=0.031) and 90-day mortality (P=0.017) with IDST. In multi-variable models, IDST remained independently protective at 28 days (hazard ratio [HR] 0.328, 95% CI: 0.136-0.792; P=0.013) and 90 days (HR 0.427, 95% CI: 0.215-0.846; P=0.015). Conclusions:Pharmacist-coordinated IDST co-management significantly improved adherence to evidence-based care and was associated with reduced short- and intermediate-term mortality in patients with MRSA bacteraemia. This model may be applicable to hospitals with limited continuous on-site availability of infectious disease physicians, provided that specialist oversight remains accessible.
Background:Surgical site infections (SSIs) following caesarean section (CS) are a major cause of maternal morbidity in Sub-Saharan Africa. Limited evidence exists on the timing of symptom onset and clinician notification, which are critical for surveillance and early intervention. This study aimed to (i) identify risk factors for SSI following CS, (ii) assess the timing of symptom onset within 30 days, and (iii) examine the timing of clinician notification. Methods:A retrospective matched case-control study was conducted using post-CS SSI surveillance data from six tertiary hospitals in Nigeria. Cases (N = 51) were matched with controls (N = 153) at a 1:3 ratio based on maternal age, hospital, operating surgeon, and urgency of surgery. Associations were assessed using χ2 tests and conditional logistic regression. Symptom onset was evaluated over a four-week period, and Kaplan-Meier analysis was used to assess time to clinician notification. Results:Prolonged duration of surgery was the only factor significantly associated with SSI (P = 0.042); in conditional logistic regression, surgery exceeding 90 min was associated with SSI (odds ratio: 3.28, 95% confidence interval: 1.20-8.99). Most SSIs (72.1%) occurred within 1-14 days post surgery, and 77.5% were detected after discharge. Symptom onset peaked in the second postoperative week, with wound discharge and localized swelling most frequently reported. Nearly three-quarters of clinician notifications occurred within the first two weeks. Conclusion:SSIs following CS occurred predominantly within the first two postoperative weeks and were largely detected after discharge. Strengthening postdischarge surveillance, patient education, and early follow-up, particularly around two weeks postpartum, may improve SSI detection and maternal outcomes in Nigeria.
Introduction:The National Infection Prevention and Control Manual (NIPCM) is an online evidence-based resource developed by Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland (NHS Scotland). Following a 2022 evaluation and informed by lessons from the COVID-19 pandemic, the NIPCM guidance development process was reviewed to improve transparency and support auditable decision-making. Methods:The guidance development methodology, inclusive of the recommendation grading system, was assessed as part of an annual review process. Extant infection prevention and control (IPC) or public health guidance development frameworks of relevance were identified and appraised for potential integration into a new considered judgement form (CJF), which was piloted in practice with working groups. Results:Elements from the SIGN 50 and HICPAC methodologies were incorporated into ARHAI Scotland's new CJF with notable addition of a dedicated 'Expert opinion' section. The recommendation grading system was altered from a lettered system (A-C) to use of the terms 'recommendation' and 'good practice point'. Conclusion:By clearly documenting decision making, context and expert opinion, the new CJF improves transparency and supports guidance users with interpretation and implementation. The new grading system more adequately conveys the strength of supportive evidence and practical intent of recommendations.
Background:Healthcare-associated infections (HAIs) remain a major source of morbidity in solid organ transplant recipients, particularly in liver transplant (LT) intensive care units (ICUs), where profound immunosuppression and extensive antimicrobial exposure shape local microbial ecology. While reductions in overall infection incidence have been reported in structured surveillance programs, longitudinal changes in pathogen distribution and antimicrobial resistance (AMR) in transplant-specific ICUs remain insufficiently characterized. We aimed to evaluate pandemic-associated shifts in microbial ecology and AMR patterns across a 10-year surveillance period in a high-volume LT ICU. Methods:This retrospective analysis was based on prospectively collected surveillance data from adult LT recipients admitted between January 2015 and December 2024. The study period was categorized into prepandemic (2015-2019), pandemic (2020-2021), and postpandemic (2022-2024) phases. All analyses were performed at the HAI-episode level. Isolation density was calculated per 1000 patient-days. Incidence rate ratios were estimated using Poisson regression models with patient-days included as an offset. Period-related differences in AMR were evaluated using logistic regression. A two-sided P value <0.05 was considered statistically significant. Results:Among 7717 patients corresponding to 48,001 patient-days, 380 clinically significant isolates were analysed. Gram-negative organisms remained predominant throughout the study period, while Gram-positive isolates demonstrated a significant decreasing trend over time. Acinetobacter spp. (31.3%), Klebsiella spp. (25.8%), and Pseudomonas spp. (15.0%) were the leading pathogens. Isolation densities of Acinetobacter spp. and Escherichia coli were significantly higher in the prepandemic period than in the postpandemic period. In contrast, the pandemic and postpandemic phases were associated with significant increases in resistance probabilities among major Gram-negative pathogens. Acinetobacter spp. showed higher resistance to meropenem and amikacin, Klebsiella spp. demonstrated increased aminoglycoside and fluoroquinolone resistance, and Pseudomonas spp. exhibited increased ciprofloxacin resistance in 2020-2024 compared with 2015-2019. Conclusions:In this transplant-specific ICU, microbial ecology and resistance trajectories evolved independently of overall infection incidence trends. Pandemic-associated healthcare disruptions were accompanied by organism-specific resistance shifts rather than uniform ecological changes. Continuous surveillance and locally tailored antimicrobial stewardship strategies are essential to preserve therapeutic efficacy and mitigate the growing threat of multi-drug-resistant (MDR) pathogens in transplant ICUs.
Background:Surgical site infection (SSI) is common after emergency laparotomy (EL) due to contamination of the surgical field, yet most hospitals are unaware of their SSI rate. Most studies have focused on elective surgery where the surgical environment can be standardized easily. Methods:This prospective quality improvement study, with continuous SSI surveillance over 4 years, aimed to establish a reliable method for measuring post-EL SSI and to evaluate the impact of a care bundle (2% chlorhexidine skin preparation, second antibiotic dose after 4 h, use of a wound protector, antibacterial sutures, glove change and povidone iodine wound wash) to reduce SSI. Results:There were 176 patients pre intervention and 501 patients post intervention. The baseline SSI rate was 32.1%: 23.1% for clean wounds, 24.5% for clean-contaminated wounds, and 45.0% for dirty wounds. Post intervention, the overall SSI rate decreased to 18.1% (P=0.002): 11.8% for clean wounds (P=0.275), 15.1% for clean-contaminated wounds (P=0.121), and 25.6% for dirty wounds (P=0.021). Discussion:Patients undergoing EL are complex. Measuring SSI after EL is challenging due to high mortality, use of laparostomy, and longer length of stay, meaning in-hospital surveillance for patients staying >30 days is also required. Implementing behavioural change in a diverse group of surgeons in the emergency setting, during a pandemic in a National Health service hospital, was difficult. Conclusion:This study demonstrated a 44% reduction in post-EL SSI following introduction of a care bundle, highlighting the value of structured quality improvement in emergency surgery. SSI measurement following EL is challenging but feasible.
Background Surgical wound infections are a common healthcare-associated complication and are complicated by antimicrobial resistance, which limits empirical treatment options. Local pathogen and susceptibility data are needed to guide empirical therapy and stewardship in Azerbaijan. Aim To describe the microbiological profile of surgical wound cultures and the antimicrobial susceptibility patterns of recovered isolates in a tertiary hospital in Azerbaijan. Methods A retrospective laboratory-based study was conducted from August to December 2024 using surgical wound culture records and susceptibility data. Antimicrobial susceptibility testing was performed by disk diffusion and MIC-based methods and interpreted according to EUCAST criteria. Findings Out of 344 surgical wound culture records 45 had no microbial growth, 299 were analysed. The most frequent microorganisms were Staphylococcus aureus (84/299, 28.1%), Pseudomonas aeruginosa (54/299, 18.1%), Staphylococcus epidermidis (24/299, 8.0%), Klebsiella pneumoniae (22/299, 7.4%), and Escherichia coli (19/299, 6.4%). Among S. aureus isolates, 13/84 (15.5%) were MRSA. All tested S. aureus isolates were susceptible to vancomycin and linezolid. P. aeruginosa showed the highest susceptibility to meropenem (90.7%), amikacin (85.2%), and imipenem (82.7%). Among Enterobacterales, carbapenems showed the highest overall in vitro activity in the tested panels. Of 195 isolates eligible for MDR/XDR assessment, 93 (47.7%) were MDR, including 8 (4.1%) possible XDR, and 2 (1.0%) as confirmed XDR. Conclusion Surgical wound cultures were dominated by S. aureus and non-fermenting Gram-negative bacilli. Given increasing resistance, particularly among Gram-negative pathogens and persistent surveillance gaps, these findings support routine culture-based diagnosis and use of local susceptibility data to guide empirical therapy and antimicrobial stewardship.
Background:Effective public engagement in the challenges posed by antimicrobial resistance (AMR) is crucial to increase awareness and build positive behaviours relating to antimicrobials. Engaging children is essential in this, to shape their future perceptions of AMR and antimicrobial stewardship, and to influence their families and peers on the appropriate usage of antimicrobials. To achieve this, effective educational interventions must be developed, with clear assessments of their efficacy to improve their future development and reach. Aim:To evaluate the efficacy of an educational event linked to AMR on student and teacher awareness. Methods:A three-day educational event was performed with 405 student attendees, with ages ranging from 7 to 14 years. The event included a superbug exhibition, facilitator-led sessions, industry-led sessions and healthcare-led sessions. Qualitative opinions were captured using a notice board, and quantitative event effectiveness evaluations were captured both pre- and post-event. Results:Significant increases in self-described awareness of AMR were observed in both students and teachers following the event. Students had a lower self-assessed knowledge before the event, and exhibited a greater increase in knowledge compared with teachers. Qualitative findings showed themes of active change amongst the student cohort. Conclusion:The educational event was able to significantly increase the self-described awareness of AMR amongst the participants. Similar event formats should be considered for use when aiming to engage this demographic in the challenges posed by AMR.
Background:Linezolid-resistant Staphylococcus epidermidis (LRSE) outbreaks are increasingly recognized in hospital settings. Observing a rise in LRSE cases, the authors instituted surveillance to detect clonal spread, and evaluated the relationship between linezolid consumption and emergence of resistant. We illustrated transmission dynamics of LRESE by visualising patient movement and overlap. Methods:Clinical isolates of S. epidermidis were obtained from patient samples at the Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark. Species identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and linezolid resistance was determined by disc diffusion and gradient diffusion testing. All isolates underwent whole-genome sequencing (WGS) to assess genetic relatedness. Patient admission histories were mapped using EpiLinx, a digital platform for visualizing patient movement and overlap within the hospital. Linezolid consumption data were extracted from electronic health records and quantified in defined daily doses (DDD). Findings:In total, 24 patients with at least one clinical LRSE isolate were identified. WGS analysis confirmed that all isolates belonged to a single clone, exhibiting one to 50 single-nucleotide polymorphism differences over a 46-month period. EpiLinx revealed overlapping hospital admissions, facilitating direct transmission. All patients had invasive devices. The Department of Surgical Gastroenterology exhibited notably high linezolid usage than the hospital average at 144.3 DDD/month, accounting for 20% of total hospital consumption. Conclusion:The outbreak was characterized by clonal dissemination of LRSE, strongly associated with elevated linezolid usage in the Department of Surgical Gastroenterology. These findings underscore the critical impact of departmental antibiotic consumption on the emergence and spread of resistant organisms, and highlight the value of real-time genomic surveillance and digital epidemiological tools in outbreak management.
Introduction:Surgical site infection (SSI) surveillance is an essential element of an effective infection prevention and control programme. Ireland's national SSI surveillance programme is in its infancy, commencing in 2023 with surveillance data collected post hip fracture surgery. However, many hospitals have already implemented local SSI surveillance activities. The aim of this survey was to establish the extent and structure of these programmes. Methods:A cross-sectional online survey was distributed to consultant clinical microbiologists via the Irish Society of Clinical Microbiology mailing list (January-March 2025), including quantitative and optional qualitative components. Results:Responses were received from 37 hospitals, including both adult and paediatric centres and public (N = 32) and private institutions (N = 5). Public hospitals were well represented (32/47; 68% response rate). Twenty-one hospitals reported established SSI surveillance programmes. Commonly monitored procedures included elective hip and knee replacement surgery (N = 10), cholecystectomy (N = 8), cardiac surgery (N = 7), spinal surgery (N = 6), and hip fracture surgery (N = 6). Twelve sites employed dedicated SSI clinical nurse specialists. Where programmes existed, 48% had an SSI committee. The most common approach was prospective case surveillance (N = 14). Ten sites performed active postdischarge surveillance, using a combination of phone calls (N = 9), postdischarge patient questionnaires (N = 3), and text messages (N = 2). Challenges reported include provision of dedicated staff, Information Technology systems, governance structures, and postdischarge surveillance. Conclusion:SSI surveillance in Ireland is variable and resource-intensive, reflecting local adaptation without national standardisation. These findings highlight the need for co-ordinated national frameworks, investment in staffing and digital infrastructure, and integration of existing systems to support sustainable expansion of Ireland's national programme.
Urinary tract infections (UTIs) are common among nursing home (NH) residents and a leading cause of antibiotic use. NH staff members are key in recognizing suspected UTIs based on observed symptoms. This study surveyed 286 staff across eight European countries to identify which symptoms prompt UTI suspicion. While UTI-specific symptoms like painful and frequent urination were commonly cited, non-specific signs such as foul-smelling urine, confusion, and behavioural changes were also frequently reported. These findings reveal substantial cross-country variation and highlight the diagnostic challenges of UTIs in this population, emphasizing the need for improved training in evidence-based symptom recognition.
In this study, we report a case of decolonisation of a multi-drug-resistant extended spectrum beta-lactamase-producing Escherichia coli, and a vancomycin-resistant Enterococcus faecium after intervention with capsulated faecal microbiota transplantation (FMT). Following eradication, our patient acquired an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, which was subsequently eliminated after a second round of FMT capsules. Additionally, we report the detection of six distinct carbapenemase-producing organisms in this patient, who was evacuated from the war in Ukraine.
Background:Extended hospital stays, higher hospital costs, and increased mortality are common central line-associated bloodstream infection (CLABSI) outcomes. Nurses' roles in preventing CLABSI are vital. Improving patient outcomes requires action to ensure intensive care unit (ICU) nurses' strict adherence with nursing practice guidelines. Aim:The aim of this study was to develop and validate a nursing assessment tool to enhance CLABSI prevention and infection control in Chinese ICUs. Study design:We used an exploratory sequential mixed-method design using a three-stage sequential procedure: phase 1, an exploratory descriptive design involving interviews with 15 nurse experts and analysis using the Colaizzi method; phase 2, tool development and evaluation, including rigorous assessment of internal consistency and reliability using Cronbach's α and split-half test; and phase 3, a descriptive design applying the newly developed tool to 183 registered nurses in China. We evaluated demographic variable effects using one-way analysis of variance and independent samples t-tests. Results:The six themes of the CLABSI assessment tool covered the entire central venous catheter insertion and maintenance processes. The themes' weighted mean values were 4.57, 4.51, 4.49, 4.38, 4.37, and 3.86 for innovation for maintenance, innovation for replacement of infusion sets, innovation for cannulation procedure, internal environment, recipient, and external environment, respectively. The overall weighted mean of the tool was 4.43. Conclusions:The CLABSI assessment tool was highly accepted by ICU nurses. Most items align with current evidence-based guidelines. Some items reflect interventions proven effective in clinical practice, even exceeding guideline recommendations.
Background:Infections caused by Klebsiella pneumoniae producing the carbapenemases K. pneumoniae carbapenemase (KPC) and New Delhi metallo-β-lactamase (NDM) are a growing challenge in Latin America. These multi-drug-resistant strains have been associated with high morbidity and mortality rates. In Colombia, the spread of these infections has placed increasing pressure on healthcare systems. Objective:To describe the epidemiological characteristics and interventions implemented during an outbreak of co-producing KPC and NDM. Methods:A retrospective study of a KPC/NDM K. pneumoniae outbreak in a Colombian university hospital (July 2023-March 2024). Clinical and epidemiological variables were analysed. Outbreak control focused on active screening, patient cohorting, and hand hygiene reinforcement (>80% compliance). Results:Sixty-six cases were identified: 51.5% infections and 48.5% colonizations. Males predominated (56.1%) and the median age was 62 years. Bloodstream infections were the most common type of infection (17.6%), and the most affected service was general surgery (30.3%). The overall mortality rate was 13.6%, with no direct association with infection. Hand hygiene compliance exceeded 80% during the outbreak. Conclusions:The multi-disciplinary response proved instrumental in containing the outbreak, underscoring the significance of strict adherence to infection prevention measures and other measures not implemented previously.
