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Background: Antimicrobial resistance has become an urgent global health priority. Basic hygiene practices and cleaning and disinfection of the hospital environment are key in preventing pathogen cross-transmission.Aim: To our knowledge no studies have assessed the worldwide differences in cleaning and disinfection practices in healthcare facilities. The electronic survey described here was developed in order to evaluate differences in healthcare facility cleaning practices around the world.Methods: The International Society of Antimicrobial Chemotherapy (ISAC, formerly ISC), Infection Prevention and Control work group developed a survey with 30 multiple-choice questions. The questions were designed to assess the current cleaning practices in healthcare settings around the world.Findings: A total of 110 healthcare professionals, representing 23 countries, participated in the online survey. In 96% of the facilities a written cleaning policy was present. Training of cleaning staff occurred in 70% of the facilities at the start of employment. Cleaning practices and monitoring of these practices varied.Conclusions: The survey enabled assessment and recognition of widely differing global practices in approaches to environmental cleaning and disinfection. Development of guideline recommendations for cleaning and disinfection could improve practices and set minimum standards worldwide. [ABSTRACT FROM AUTHOR]

Background Cardiac output (CO) monitoring remains complex in newborns as most of the current technologies fail to accurately measure systemic blood flow in the presence of shunts. We validated CO measurements using transpulmonary ultrasound dilution (TPUD) in a neonatal lamb model with a left-to-right shunt. Methods Regular arterial and central venous catheters were inserted into seven lambs (3.5–8.3 kg). A surgically constructed left-to-right aorto-pulmonary Gore-Tex® shunt was intermittently opened and closed, while CO was manipulated by creating haemorrhagic hypotension. CO measurements with TPUD (COtpud) were compared with those obtained by an ultrasonic transit-time flow probe positioned around the main pulmonary artery (COufp). Results We performed 72 sessions of three paired CO measurements. The mean COufp was 1.00 litre min−1 (range 0.47–1.75 litre min−1) and mean COtpud 1.05 litre min−1 (range 0.54–1.87 litre min−1). With an open shunt, the mean Qp/Qs ratio was 1.8 (range 1.3–2.6). A comparison between COufp and COtpud showed a mean bias (sd) of 0.03 (0.09) and 0.07 (0.10) litre min−1, respectively, for measurements with a closed and an open shunt. The percentage error was 18% and 20% for measurements with a closed and an open shunt. Polar plot analysis showed good trending ability for both closed and open shunt groups. Conclusions TPUD is a reliable technology to measure CO in the presence of a left-to-right shunt. [ABSTRACT FROM PUBLISHER]

Background The transpulmonary thermodilution (TPTD) technique for measuring cardiac output (CO) has never been validated in the presence of a left-to-right shunt. Methods In this experimental, paediatric animal model, nine lambs with a surgically constructed aorta-pulmonary left-to-right shunt were studied under various haemodynamic conditions. CO was measured with closed and open shunt using the TPTD technique (COTPTD) with central venous injections of ice-cold saline. An ultrasound transit time perivascular flow probe around the main pulmonary artery served as the standard reference measurement (COMPA). Results Seven lambs were eligible for further analysis. Mean (sd) weight was 6.6 (1.6) kg. The mean COMPA was 1.21 litre min–1 (range 0.61–2.06 l min–1) with closed shunt and 0.93 litre min−1 (range 0.48–1.45 litre min−1) with open shunt. The open shunt resulted in a mean Qp/Qs ratio of 1.8 (range 1.6–2.4). The bias between the two CO methods was 0.17 litre min−1 [limits of agreement (LOA) of 0.27 litre min−1] with closed shunt and 0.14 litre min–1 (LOA of 0.32 litre min−1) with open shunt. The percentage errors were 22% with closed shunt and 34% with open shunt. The correlation (r) between the two methods was 0.93 (P<0.001) with closed shunt and 0.86 (P<0.001) with open shunt. The correlation (r) between the two methods in tracking changes in CO (ΔCO) during the whole experiment was 0.94 (P<0.0001). Conclusions The TPTD technique is a feasible method of measuring CO in paediatric animals with a left-to-right shunt. [ABSTRACT FROM AUTHOR]