Application Of Infection Control Measures Research Articles

Surgical Site Bacterial Infection in a General Hospital, Al-Jouf Region, Saudi Arabia: A Retrospective Study.

Background Surgical site infection (SSI) is a major healthcare problem with a great impact on patient morbidity, mortality, and healthcare cost all over the world. It accounts for 20% of healthcare-associated infections (HAIs), with higher frequency in low- and middle-income countries where it affects about 30% of the patients undergoing surgery. Aim The current study aims to assess the prevalence of SSI in a general hospital in Sakaka, Al-Jouf region, Saudi Arabia. The types of bacteria causing SSI were also determined. Subjects and methods A retrospective cross-sectional study was done by reviewing the hospital records of patients who got SSI during the period between 2020 and 2022. Data collection was done during 2022 and 2023 after taking ethical approval and permission from the hospital management. Results The numberof patients who underwent surgical procedures during 2020, 2021, and 2022 were 689, 867, and 1119, respectively. Most of the cases were cholecystectomy and appendectomy. The cases that developed surgical site infection after cholecystectomy and/or appendectomy during 2021 and 2022 were 15.45% and 9.29% cases, respectively, and they were mainly associated with appendectomy. A culture and sensitivity test revealed methicillin-resistant Staphylococcus aureus (MRSA)and Klebsiella pneumonia. Nearly all patients have received ciprofloxacin for seven days and improved with treatment. Conclusion The number of cases that developed SSI has decreased gradually due to the application of infection control measures and strict follow-up.

A Measles Outbreak in a Local Children's Hospital in Korea, 2019.

A measles outbreak with 20 confirmed cases occurred at a local children's hospital in Daejeon from March 28 to April 21, 2019. The index patient was a 7-month-old girl with a recent history of travel to Vietnam. Contact tracing, active surveillance, and post-exposure prophylaxis were conducted by health authorities. Among the 20 patients, 11 (55%) were infants (0-11 months of age), three (15%) were aged 1-3 years, one (5%) was aged 4 years, and five (25%) were adults. Fifteen (75%) patients did not have a history of measles vaccination, and five (25%) had received only one vaccine dose. This study described the importance of prompt application of infection control measures in susceptible environments, including hospitals. Age-appropriate vaccination and providing information on infectious diseases to international travelers and multicultural families in Korea is vital.

A Study to Assess Knowledge, Attitude, and Practice of Dental Undergraduate Students toward Infection Control

Objective: This study aimed to assess the knowledge, attitude, and practice (KAP) of infection control among dental undergraduate students and explore the correlation between these variables. Materials and Methods: A cross-sectional study was conducted among 1000 dental undergraduate students from various dental colleges and universities. Participants were selected using a multistage random sampling method. Data were collected through a structured questionnaire, and mean scores for KAP were calculated. Correlation analysis was performed to examine the relationships between KAP scores. Results: The demographic characteristics of the participants were well distributed, with 45.0% of male and 55.0% of female students. Academic years and age groups were evenly represented. The mean knowledge score was 7.45 ± 1.82 out of 10, indicating a high level of knowledge. The attitude mean score was 4.63 ± 0.89 out of 5, reflecting a positive outlook toward infection control. However, the practice mean score was 2.79 ± 0.66 out of 4, suggesting room for improvement in translating knowledge and attitudes into clinical practice. Correlation analysis demonstrated significant positive associations between knowledge–attitude (r = 0.695, P < 0.001), knowledge–practice (r = 0.537, P < 0.001), and attitude–practice (r = 0.465, P < 0.001) scores. Conclusions: Dental undergraduate students exhibit a good level of knowledge and a positive attitude toward infection control. However, the practical application of infection control measures during clinical training requires further emphasis. Targeted educational interventions can bridge the gap between knowledge and practice, enhancing infection control practices among future dental professionals, and contributing to improved patient safety and health-care quality.

Phenotypic and genotypic detection of resistance mechanisms in carbapenem-resistant gram-negative bacteria isolated from Egyptian ICU patients with first emergence of NDM-1 producing Klebsiella oxytoca.

Carbapenems are considered the last resort to treat several infections, particularly in intensive care units (ICUs). However, increasing carbapenem resistance is problematic because it leads to high morbidity and mortality rates. This study aimed to determine the rate of carbapenem resistance among Gram-negative bacteria collected from patients in ICUs and to identify their resistance mechanisms using phenotypic and genotypic methods. Antimicrobial susceptibility testing was carried out using the disc diffusion method among 180 Gram-negative bacterial isolates. Productions of carbapenemases, metallo-beta-lactamases (MBLs) and the harboring of carbapenemase-encoding genes, were detected in 40 selected carbapenem-resistant Gram-negative bacteria (CR-GNB). Of 40 selected CR-GNB isolates, 28 (70%), and 20 (50%) isolates were phenotypically positive for carbapenemase, and MBL production, respectively. Furthermore, 22 (55%) showed amplification of one or more of the carbapenemase-encoding genes, including bla NDM-1, bla VIM-2, and bla OXA-48. This study described the first emergence of NDM-1 producing Klebsiella oxytoca in Egyptian ICUs. High incidence of CR-GNB detected in the ICUs in our study area may be attributed to the overuse of antibiotics, including carbapenems, and improper application of infection control measures. These findings confirm the need for the application of a strict antibiotic stewardship program.

Evaluation of Candida auris Colonization using Clinical Skin Swabs: A Single-Center Study in Isfahan, Iran

: The multidrug-resistant fungal pathogen Candida auris has been associated with healthcare. We need to address COVID-19 pandemic as well as the ongoing global fungal epidemic caused by C. auris, a multi-drug-resistant fungus spreading rapidly throughout the world. This study was conducted on patients admitted to an ICU in Isfahan, Iran, from November 2020 to February 2021 to determine the spectrum of C. auris colonization in immunocompromised patients hospitalized in an intensive care unit (ICU). Therefore, clinical swabs were collected from 32 immunocompromised patients for C. auris detection upon ICU admission after 7 to 14 days. A rich culture medium was used to evaluate C. auris growth at a higher temperature (40°C) and salinity (10% wt/vol) in Sabouraud dextrose agar, which can be used in combination with a C. auris-specific polymerase chain reaction method. C. auris was not isolated in the clinical samples of patients. The most common colonizer was Candida albicans, followed by C. glabrata, C. parapsilosis, and C. tropicalis. Candida glabrata was the only species with noticeable growth in the Salt SDA, with D-Mannitol as a carbon source. Currently, C. auris is not a common cause of systemic or superficial fungal infections in Iran. The screening of patients admitted to the ICU for C. auris could aid in the identification of colonized patients and could simplify the application of infection control measures.

Prevalence of human papilloma virus (HPV) genotypes between outpatients males and females referred to seven laboratories in Tehran, Iran

BackgroundHuman papilloma virus (HPV) causes the most common sexually-transmitted infection especially among sexually-active individuals. The aim of study was to characterize the molecular characterization of HPV genotypes between 5176 female and male patients.MethodsHPV DNA was extracted from genital swabs of the study participants and amplified by Real Time Polymerase Chain Reaction (PCR). Genotyping was performed for 2525 cases using REALQUALITY RQ-Multi HPV Detection Kit for the identification of 14 high risk (HR) and 2 low risk (LR) HPV genotypes. Demographic figures were analyzed in correlation with virological data statistically.ResultsOut of 5176 cases from 7 laboratories, 2727 (53%) were positive for HPV, of which. 2372(87%) women and 355 (13%) men were HPV positive. However, in an intra-gender analysis, positive rate was higher in men (355/637, 55.7%) than in women (2372/4539, 52%; P value 0.007). HPV positive patients were younger than negative individuals. Positive rate was higher among age categories 20–40. Genotyping was performed for 2525 cases. Out of 1219 (48%) patients who contained single genotypes, 566 (22%) and 653 (26%) harboured HR and LR genotypes, respectively. In females and males, 1189 (54%) and 117 (37%) contained multiple genotypes. No substantial associations were found between different age categories and HR/LR and multiple genotypes distribution.ConclusionThe prevalence of HPV infection in both genders was high. However, men had a higher rate of infection. These observations highlighted the necessity for a plan for targeted education to younger population in the society as well as application of infection control measures against HPV infection, especially in terms of general population mass HPV vaccination.

Phenotypic and molecular characterization of fluoroquinolone resistant Pseudomonas aeruginosa isolates in Palestine.

Fluoroquinolones are important antimicrobial agents for the treatment of Pseudomonas infections. A total of 11 isolates of P. aeruginosa were collected from different clinical samples from different medical centers in the North West Bank-Palestine during 2017. In this study, resistance to fluoroquinolones and secretions of β-lactamases were detected by phenotypic methods, while presence of β-lactamase gene sequences and other virulence factors were detected by PCR technique. PCR product for gyrA, parC and parE genes were sequenced for further analyses. The phylogenetic analyses, population diversity indices and haplotypes determination were conducted using computer programs MEGA version 6, DnaSP 5.1001 and median-joining algorithm in the program Network 5, respectively. Results of this study showed that the MIC for ciprofloxacin and norfloxacin had a range of 32-256 µg/ml. In addition, all isolates carried either exoT or exoT and exoY genes, different β-lactamase genes and 82% of these isolates harbored class 1 integrons. Analyses of the gyrA, parC and parE sequences were found to be polymorphic, had high haplotype diversity (0.945-0.982), low nucleotide diversity (0.01225-0.02001) and number of haplotypes were 9 for each gyrA and parE genes and 10 haplotypes for parC gene. The founder haplotypes being Hap-1 (18%), Hap-2 (27.3%) and Hap-6 (9.1%) for gyrA, parC and parE genes, respectively. Two of ParE haplotypes were detected as indel haplotypes. The Median-joining- (MJ) networks constructed from haplotypes of these genes showed a star-like expansion. The neutrality tests (Tajima's D test and Fu's Fs test) for these genes showed negative values. Palestinian fluoroquinolone resistant P. aeruginosa strains showed high MIC level for fluoroquinolones, β-lactamase producers, carried type III secretion exotoxin-encoding genes, most of them had integrase I gene and had high level of mutations in QRDR regions in gyrA, parC and parE genes. All these factors may play an important role in the invasiveness of these strains and make them difficult to treat. Isolation of these strains from different medical centers, indicate the need for a strict application of infection control measures in Medical centers in the North West Bank-Palestine that aim to reduce expense and damage caused by P. aeruginosa infections. Molecular analyses showed that Palestinian fluoroquinolone resistant P. aeruginosa haplotypes are not genetically differentiated; however, more mutations may exist in these strains.

Elimination of healthcare-associated Acinetobacter baumannii infection in a highly endemic region

This paper describes the elimination of healthcare-associated Acinetobacter baumannii infections in a highly endemic region. A prospective, observational study was performed between October 2012 and October 2017. Acinetobacter baumannii were isolated from 59 patients, and >95% similarity was demonstrated among isolates of seven patients (DiversiLab™, BioMérieux). Carbapenemase activity was detected in 15 of 17 (88%) isolates, and all were OXA-23 type. The control of Acinetobacter baumannii outbreaks can be achieved by close follow-up supported by molecular techniques, strict application of infection control measures, and isolation of transferred patients.

Infection Control Measures of COVID-19 at Endoscopy Units: Knowledge and ‎Practice of Gastrointestinal Endoscopists

Background and study aims:The health care workers at endoscopy units are at a high risk of COVID-19 infection. ‎Several guidelines for COVID-19 infection control measures at endoscopy units are ‎available. However, the knowledge and practice of endoscopists toward these measures are ‎not evaluated. We aimed to assess the level of knowledge and practice of Egyptian ‎gastrointestinal (GI) endoscopists for these measures‎‎. Patients and Method:‎An online questionnaire was filled by the GI endoscopists. It consisted of 4 sections; the ‎demographic features of the participants, pre-endoscopic infection control measures, during ‎endoscopy on COVID-19 patients measures and post-endoscopic measures. Each of the ‎last 3 sections contained questions assessing the knowledge and practices of the ‎endoscopists. The answers to some questions were set up as ‘yes’ or ‘no’ and the other ‎questions required selecting the appropriate answer‎‎.‎ Results: A total of 120 participants completed the questionnaire. About half had endoscopic ‎experience between 5 and 10 years. The overall correct answers regarding the knowledge ‎were 45.6% while 62.2% for the practice. Low percent of correct answers was related to ‎the personal protective equipment (PPE) use. About 56.7% and 58.3% found their level of ‎knowledge and practices to be fair, respectively‎‎‎‎‎. Conclusion: The knowledge of the infection control against COVID-19 was insufficient among GI ‎endoscopists particularly PPE use. Meanwhile, the practice was relatively adequate due to ‎hospital policies of strict application of infection control measures‎‎‎‎.

Preventive infection control in cardiac device implantation.

Cardiac implantable electronic devices have been increasingly used in recent years; as a result, there has been arise in device-related complications. Pacemaker-associated infection is challenging to manage, including system removal, antimicrobial therapy and reimplantation at another site. The aim of this study was to evaluate adherence to the steps in an infection control protocol in cardiac device implantation. A total of 100 patients referred for cardiac device implantation were enrolled in the study. They were evaluated with regard to the application of infection control measures during device implantation and followed-up for 6months to detect clinical signs of device-related infection (DRI). Asignificant correlation was found between the development of postoperative DRI and the presence or absence of the following factors: increasing patient age (p = 0.010), diabetes mellitus (p = 0.024), number of operators ≥4 (p = 0.001), implantation of abiventricular system (p = 0.025), duration of sterilization (p = 0.001), wearing double gloves (p < 0.001) and postoperative hematoma (p = 0.021). The study identified the following risk factors for DRI: age, diabetes mellitus and cardiac resynchronization therapy system implantation (p = 0.025). Antiseptic measures such as double-glove technique and duration of skin disinfection prior to the procedure, as well as environmental factors, also influenced device infection, as did the number of operators/staff and pocket hematoma.

The effect of nursing educational program on knowledge and practice of nurses regarding infection control measures for children under hemodialysis

Background/aim The aim of the present study was to assess the knowledge and practice of nurses regarding the prevention of infection for children under hemodialysis, and to evaluate the effect of an educational nursing program on nurses’ knowledge and practice regarding the prevention of infection among children undergoing hemodialysis. Patients and methods We chose a quasi-experimental research design for the present study. The study was conducted in the renal dialysis unit at Assiut Children University Hospital. A convenience sample of 32 nurses working in the pediatric renal dialysis unit, who accepted to participate in this study, were enrolled. Following tools were used in the study. Tool 1, which was a structured questionnaire sheet about nurses’ knowledge including sociodemographic data; and nurses’ knowledge about renal failure, renal dialysis, and general precautions during nursing care for children under hemodialysis. Tool 2, which was an observational checklist sheet developed by the researcher to assess nurses’ practice for children under hemodialysis. It was applied before and after 2 months of the implementation of the educational program. It consisted of general and specific precautions to be taken during care of children under hemodialysis and application of infection control measures. Results The levels of knowledge scores were satisfactory among 90.6% of the nurses. There was a highly significant improvement in the nurses’ practice scores regarding general precautions, hand-washing, wearing gloves, wearing mask, catheter insertion, skin preparation technique, taking care of patients’ equipment, dealing with sharp objects, dealing with blood, body secretions, and fluids, and maintaining clean environment and safe injection practices in addition to the total practice score. There were significant improvements in items of the nurses’ practice such as laboratory-style covering coats, full isolation, and catheter care. The practice score level was adequate among 68.7%, whereas inadequate among 31.3% of the nurses. There were significantly higher nurses’ knowledge score and levels of improvement of their knowledge score after the education program among older nurses and those with Bachelor of Nursing. Conclusion Nurses’ knowledge and practice regarding hemodialysis and infection control guidelines are inadequate. Carrying out nursing education programs about infection control measures when dealing with children under hemodialysis resulted in a significant improvement in nurse’s knowledge and practice. Recommendations Nurses should be encouraged to attend specific meetings such as workshops and seminars held for infectious diseases and infection control to be acquainted with the recent advances and skills in the hemodialysis unit.

Assessment of safety measures in hemodialysis units in Menoufia

Objective The aim of this study was to assess the safety measures for patients in hemodialysis units, aiming to improve the quality of medical services provided by the hemodialysis units in Menoufia Governorate and to evaluate hemodialysis units from the safety point of view. Background Hemodialysis is the most well-established form of treatment for end-stage renal failure. Standard precautions with additional measures are recommended specifically for dialysis centers to prevent transmission of bacteria and viruses from patient to patient. Patient and methods The study was conducted on 19 units of hemodialysis. All patients with end-stage renal disease under regular hemodialysis in these units were included. A questionnaire from the ministry of health and population was used. Results The percentage of working machines to total machines ranged from 77.4 to 100%. Practicing routine handwashing was 'good' in 60% of units, application of infection control measures was 'good' in half of the units, application of environmental infection control measures was 'good' in 12 units, and waste management was 'good' in 18 units. Workers were totally vaccinated against hepatitis B virus in eight units. Hepatitis B virus-positive patients had complete isolation. The level of safety in the studied units was 'good' in three units and 'fair' in 16 units. Conclusion More than 25% of the dialysis machines exceeded the recommended working hours/duration. Personal protective clothes and cleaning materials were available with shortage in usage. There was a shortage in the medical staff, especially in governmental hospitals. There was shortage in infrastructure of the most of dialysis units.

Prevalence of occult hepatitis C virus among hemodialysis patients in Tanta university hospitals: a single-center study.

Occult hepatitis C virus infection (OCI) is a newly defined type of infection by the chronic hepatitis virus (HCV) distinguished by the existence of HCV RNA in liver tissue and/or peripheral blood mononuclear cells (PBMCs) in patients whose plasma are devoid of both positive serology and RNA. Patients on maintenance hemodialysis evince a higher HCV prevalence than the general population due to high nosocomial transmission by the dialysis units. We investigated the prevalence of occult HCV infection in patients attending our university hemodialysis centers for maintenance hemodialysis. Sixty-two CHD patients negative for serum HCV tests were enrolled in the study. PMNCs were tested by real-time PCR for the presence of HCV RNA. For the 62 patients, the average duration since starting dialysis was 32.7months and the mean (SD) alanine transaminase and aspartate transaminase were 25.74 ± 9.75 and 28.81 ± 11.32IU/l, respectively. Out of the 62 CHD patients negative for serum anti-HCV and HCV RNA patients, only three (4.84%) were shown to have HCV RNA in their PBMCs implying the diagnosis of OCI; their viral load range was 1.24-4.15IU/ml. All three OCI-proven patients gave no history of hepatic disease. In this study, we found that patients considered to be free of HCV can have HCV replicating in their PBMCs. This awareness points to the possibility of HCV being transmitted from apparently uninfected persons. A positive HCV RNA detection in PBMCs is dependable in determining OCI among high-risk subjects particularly when a liver biopsy is not an option. HCV transmission can occur through hemodialysis units signaling incorrect application of infection control measures in our Egyptian dialysis units. Additional studies on hemodialysis patients are necessary to realize the true magnitude of OCI among this patient group and to highlight the importance of incorporating HCV viral assays in PBMCs into the diagnostic algorithm.

Risk Factors and Nursing Interventions for Ventilator-Associated Pneumonia in Pediatric Intensive Care Unit at Assiut University Children Hospital

Ventilator-associated pneumonia (VAP) is the second most common hospital-acquired infection in pediatric intensive care units (PICUs). It is linked to increased morbidity, mortality, and length of stay in the hospital and intensive care unit, adding tremendously to health care costs. Therefore prevention is the most appropriate intervention. The aim of this study is to (1) assess nursing interventions, (2) identify the risk factors for VAP in PICU at Assiut University Children Hospital. Subjects and Method: A prospective cohort study design was utilized during one year. The study included 65 pediatric patients were divided into two groups: group (I) pediatric patients developed VAP (20 cases) and group (II) pediatric patients who did not develop VAP (45 cases). Two tools were used, (1) questionnaire sheet and (2) observation checklist. Results: It was found that the risk factors associated with VAP were duration of mechanical ventilation and inadequate application of infection control policies and care for it. Conclusion and Recommendations: There were risk factors associated with VAP were duration of mechanical ventilation and inadequate application of infection control measures and hygienic care, which increase morbidity, mortality and hence the cost of VAP in the PICU.

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy.

Background Acinetobacter baumannii is an opportunistic pathogen that has become a major cause of concern, since it is a frequent cause of healthcare-associated infections (HAIs). The aim of the study was to describe the occurrence, the management and the control of an outbreak that occurred in an intensive care unit (ICU) of a teaching hospital in Southern Italy caused by multiple strains of extensively drug-resistant A. baumannii (XDRAB).MethodsCase-patient was defined as a patient with an healthcare-associated infection caused by an XDRAB isolate identified in a clinically significant culture. Environmental samples were collected from different surfaces. The isolates were identified by typical Gram stain morphology, using the Vitek 2 system (bioMérieux, France) and by MALDI-TOF MS mass spectrometry (bioMèrieux, France). Genotyping was performed through rep-PCR analysis.ResultsA patient presented an XDRAB ventilator-associated pneumonia at admission and was managed with strict isolation precautions until discharge. Five patients had a ventilator-associated pneumonia and two had a central line-associated bloodstream infection. Of the environmental samples, 1 sample obtained from the side of the bed of an infected patient yielded growth of XDRAB. Infection control measures were adopted. Rep-PCR analysis identified four patterns.ConclusionsThe integration of epidemiological and microbiological data and the application of infection control measures were crucial to bring such an outbreak to a rapid halt. The distinctive characteristic of this study was the complex molecular pattern of the outbreak, which subsided in a short period of time due to adherence to infection-control measures, confirming the fundamental role of molecular typing in the comprehension of outbreaks dynamics and of integrated control interventions for the interruption of epidemic events.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2036-7) contains supplementary material, which is available to authorized users.

Laboratory-acquired skin infections in a clinical microbiologist: Is wearing only gloves really safe?

Laboratory-acquired infection is one of the leading occupational health hazards. On a laboratory worker's hands, carbuncles occurred. Staphylococcus aureus was isolated from pus samples of the carbuncles, with the same pulsed field gel electrophoresis band pattern with one of the recently studied strains in the laboratory. Incorrect or inadequate application of infection control measures may result in pathogen acquisition from the clinical samples, and wearing only gloves is not sufficient for the biosafety of laboratory workers in clinical diagnostic laboratories.

Advancing Cryptosporidium Diagnostics from Bench to Bedside

Cryptosporidium is increasingly being recognized as an important cause of diarrhea worldwide. Although well known for its impact among HIV positive population, im- proved diagnostic tests have contributed to its emerging rec- ognition one among the most prevalent causes of early child- hood moderate to severe diarrhea, persistent diarrhea, and im- paired neurocognitive development. The diagnosis of Crypto- sporidiosis is generally carried out based on availability of skilled microscopist or advanced equipment for molecular- and immunologic-based assays. As an emerging enteric path- ogen of medical importance, the need for point-of-care tech- nology is deemed necessary for early identification of the pathogen and application of infection control measures for its potential risk of creating outbreaks. Current point-of-care technologies demonstrate varying sensitivities and specific- ities and may already address the present diagnostic need.

Prevalence of fecal carriage of extended-spectrum- and metallo-β-lactamase-producing gram-negative bacteria among neonates born in a hospital setting in central Saudi Arabia.

BACKGROUND AND OBJECTIVECommensal neonatal fecal flora constitute a reservoir of antibiotic resistance. The aim of this study was to characterize the prevalence of fecal carriage of extended spectrum beta-lactamases (ESBLs) and carbapenemase producing gram-negative bacteria among 150 neonates who were born in two hospitals in central Saudi Arabia.PATIENTS AND METHODSFrom June 2012 to Janauary 2013, 150 healthy neonates ≤7 days of age were screened for intestinal enteric bacteria colonization and the influence of age, mode of delivery, body weight and breast feeding of neonates on colonzation rates. The isolates were identified manually and by VITEK 2 and antibiotic susceptibility was tested. Phenotypic tests were performed to seek ESBL and metallo-β-lactamase (MBL) producers in recovered isolates.RESULTSAmong 150 fecal specimens, 188 gram-negative rods were recovered. E coli (n=130; 69.1%) was the commonest organism followed by Klebsiella pneumoniae (n=23; 12.2%), Pseudomonas aeuroginosa (n=14; 7.5%), Acinetobacter baumannii (n=9; 4.8%), Enterobacter spp. (n=9; 4.8%) and Morganella morganii (n=3; 1.6%). E coli colonization during the first day of life was 95.5% (n=43/45), which was relatively higher than in subsequent days. The colonization rate of E coli among low weight babies (≤3 kg) was significantly higher than fully grown neonates (≥4 kg)(P=.03). The prevalence of ESBL and MBL was 15.0% (n=28/188) and 1.6% (n=3/188). The prevalence rates of ESBL in E coli, K pneumoniae, E cloacae, M morganii and E aerogenes were 16.9% (n=22/130), 4.3 % (n=1/23), 60% (n=3/5), 33.3% (n=1/3), and 25% (n=1/4), respectively. All E cloacae with ESBLs and MBLs were resistant to all tested antibiotics including carbapenems.CONCLUSIONWithin the first week of life, the most important determinants of gut enteric bacteria composition in neonates were age in days, body weight, mode of delivery, and type of neonatal feeding. The findings of ESBLs- and MBLs-producing enteric bacteria as neonate-gut colonizers may have wider implication or linkage to prevention of nosocomial and community-acquired infections by these strains.

Seroprevalence of hepatitis B among pregnant women attending maternal and child health centres in Shebin El-Kom district (Menoufia governorate)

ObjectivesThis work aimed to determine the seroprevalence and the risk factors for acquiring hepatitis B virus (HBV) among pregnant women in Shebin El-Kom district, Menoufia governorate.BackgroundHBV infection is a major global health problem. Egypt is among the countries with an intermediate endemicity of hepatitis B surface antigen (HBsAg) (range 2-8%). In areas with high/intermediate endemicity, the most common route of infection is still the vertical transmission from mother to child. Passive immunoprophylaxis with hepatitis B immunoglobulin and active immunoprophylaxis with hepatitis B vaccine in the infants of HBV-positive carrier mothers are necessary for the protection of newborns.Participants and methodsA cross-sectional study was carried out on 397 pregnant women, who were randomly selected from pregnant women attending maternal and child health centres in Shebin El-Kom district, Menoufia governorate, and were subjected to a personal interview with a predesigned questionnaire and screened for HBsAg in the serum using enzyme-linked immunosorbent assay.ResultsThe seroprevalence of HBV among pregnant women in Shebin El-Kom district, Menoufia governorate, was 2.3%, and the main risk factors for acquiring infection were the habit of one-syringe multiple use [odds ratio (OR) = 12.03], a family history of HBV infection (OR = 8.73), and HBV infection in the husband (OR = 96.5).ConclusionHBV is of intermediate endemicity among pregnant women in Shebin El-Kom district, Menoufia governorate, and the Ministry of Health and Population should adopt a program for the screening of all pregnant women for HBsAg at maternal and child health centres and for health education of the public about the modes of transmission of HBV and the application of infection control measures at health facilities to control the spread of HBV.

Characterization of Methicillin Resistant Staphylococcus aureus from various clinical samples at tertiary care hospital of rural Gujarat

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an established pathogen in most health care facilities. MRSA strains are also important for their resistance to many other commonly used antibiotics. Objectives: To find out prevalence of MRSA strains and coproduction of β-lactamase and antibiotic sensitivity pattern of these strains. Materials and Methods: During the period of September 2009 to December 2010, a total of 200 strains of S. aureus were isolated from various specimens of different patients attending and admitted at C. U. Shah Medical College and Hospital, Surendranagar, Gujarat. Standard procedures were followed for isolation and identification of S. aureus isolates. Antibiotic susceptibility testing and detection of MRSA was done by Kirby Bauer disk diffusion method, as per Clinical and Laboratory Standards Institute (CLSI) guidelines. The production of β-lactamase was studied by the rapid method using nitrocefin disk. Results: Among 200 isolates of S. aureus, 117 (58.5 %) were methicillin-resistant, of which 110 (94.02%) were found to be multidrug-resistant. Among 117 MRSA strains, 86.59 % were resistant to ciprofloxacin, 81.71% were resistant to cephalexin, 80.49% were resistant to cefaclor and 79.27% were resistant to erythromycin. Vancomycin was the most effective drug as all MRSA isolates were sensitive to it. 93.90% MRSA isolates were sensitive to linezolid and 91.46% were sensitive to teicoplanin. 82.91% MRSA isolates were also co-producers of β-lactamase. Conclusions: The high incidence of MRSA in this hospital warrants for the judicial use of antibiotics and application of infection control measures to avoid therapeutic crisis resulting from multidrug-resistant MRSA. Key Words: MRSA, Staph aureus, Rural Gujarat