Health Vigilance Research Articles

Association of personal factors with increased risks of accidents in the workplace among health workers in nine Puskesmas in Kediri City, Indonesia

Public Health Center hereinafter referred to as the Puskesmas is a health service facility that organizes public health efforts and first-level individual health efforts by prioritizing promotive and preventive efforts in their work areas. If the results of the examination cannot be handled promotively and preventively, they will be referred to more complete health facilities such as hospitals. Standard action in Puskesmas is still high and often ignored, this is very dangerous if left unchecked it will have an impact on the safety and health of health workers, patients, and patients' families. The objective of this study is to analyze the correlation of personal factors with the unsafe actions of health workers in nine Puskesmas in Kediri City, Indonesia. The population for this study was health workers including nurses, midwives, laboratories, and cleaners, totaling 410. This study is analytical with a cross-sectional design, While statistical analysis consists of univariate, bivariate, and logistic regression. The results show a correlation between fatigue and unsafe actions of health workers Ignoring safety procedures, the knowledge of health workers, and unsafe actions of health workers Ignoring safety procedures, and not using personal protective equipment. There is a correlation between personal factors (knowledge, fatigue) and unsafe actions and strong correlation. The results of the analysis using logistic regression produced a significance value of 0.000, which means that there is an influence of the knowledge and fatigue variables on unsafe acts. It is recommended that a safety talk in the mornings on a regular basis would increase health vigilance at work.

Feline sporotrichosis: occurrence in the Metropolitan Region of the municipality of Recife and anatomical distribution of lesions on cats’ body

Sporotrichosis is a fungal infection of worldwide importance caused by a saprophyte fungus of the genus Sporothrix. The objective of this study was to report the occurrence of feline sporotrichosis in the Metropolitan Region of the city of Recife and the anatomical distribution of lesions on the bodies of cats. Stray cats (n=100) with suggestive sporotrichosis lesions were examined. Material from the lesion was collected from all patients using an imprint and/or sterile swab for cytology. The material was placed on a glass slide and stained using rapid panoptic staining. Data on the localization of each skin lesion were recorded, and cigar-shaped yeast structures were searched at the microscopical examination. A heat map graphically represented the anatomical distribution of each lesion. In 70% (70/100) of samples were visualized fungal structure compatible with Sporothrix spp. There was a predominance of positive males (?2=6.691; p=0.0097). Skin lesions related to Sporothrix spp. infections were unevenly distributed throughout the animal's body. Based on the interpolation of data, the chance for detecting lesions was higher on the nose, anterior paw, and ears than on other body sites (H=40.0043; p=0.0000). Because of the high positivity in these cats, measures of health vigilance are imperative to reduce the risk of animal and human infection.

Transmission of a human isolate of clade 2.3.4.4b A(H5N1) virus in ferrets.

Since 2020, there has been unprecedented global spread of highly pathogenic avian influenza A(H5N1) in wild bird populations with spillover into a variety of mammalian species and sporadically humans1. In March 2024, clade 2.3.4.4b A(H5N1) virus was first detected in dairy cattle in the U.S., with subsequent detection in numerous states2, leading to over a dozen confirmed human cases3,4. In this study, we employed the ferret model, a well-characterized species that permits concurrent investigation of viral pathogenicity and transmissibility5 in the evaluation of A/Texas/37/2024 (TX/37) A(H5N1) virus isolated from a dairy farm worker in Texas6. Here, we show that the virus has a remarkable ability for robust systemic infection in ferrets, leading to high levels of virus shedding and spread to naïve contacts. Ferrets inoculated with TX/37 rapidly exhibited a severe and fatal infection, characterized by viremia and extrapulmonary spread. The virus efficiently transmitted in a direct contact setting and was capable of indirect transmission via fomites. Airborne transmission was corroborated by the detection of infectious virus shed into the air by infected animals, albeit at lower levels compared to the highly transmissible human seasonal and swine-origin H1 subtype strains. Our results show that despite maintaining anavian-like receptor binding specificity, TX/37 displays heightened virulence, transmissibility, and airborne shedding relative to other clade 2.3.4.4b virus isolated prior to the 2024 cattle outbreaks7, underscoring the need for continued public health vigilance.

Fatalism or vigilance? Exposure to infant and maternal deaths and subsequent use of maternal health services in Malawi

In developing contexts, where formal health services are still expanding, understanding what factors discourage individuals from using health services is critical to advance population health. A long theorized, but rarely investigated, conjecture is that in high-mortality contexts, exposure to death can beget fatalism, or even foster distrust of formal healthcare, locking families into cycles of low use of health services. A counter perspective, however, suggests exposure to death can encourage individuals’ health vigilance, corresponding with their higher use of health services. We test these competing ideas by analyzing the associations between women’s intimate exposure to death in the context of pregnancy and delivery via (1) a sister’s maternal death and (2) an infant child’s neonatal death, and their subsequent use of maternal health services. We focus on the context of Malawi, a setting that features high maternal and infant mortality rates, similar to those observed across much of sub-Saharan Africa, as well as persistent gaps in service use. Specifically, we use Malawi Demographic and Health Survey (2015–16) data to examine if a sister’s maternal death or a child’s neonatal death corresponds with a woman’s odds of attending full antenatal care during a subsequent pregnancy or delivering the pregnancy at a formal health facility. Given the qualitatively distinct nature of losing one’s only or first child, we also assess if the effect of a child’s neonatal death varies by birth order. The results show that maternal and neonate death exposures correspond generally with women’s higher use of maternal health services, challenging the notion that exposure to death fosters fatalism or distrust. Although the results vary in significance, the nuanced findings highlight women’s vigilance in the face of health threats, emphasizing their resilience amid a high burden of familial loss.

Focus, vigilance, resilience: towards stronger infectious disease surveillance, threat detection and response in the EU/EEA.

This perspective summarises and explains the long-term surveillance framework 2021-2027 for infectious diseases in the European Union/European Economic Area (EU/EEA) published in April 2023. It shows how shortcomings in the areas of public health focus, vigilance and resilience will be addressed through specific strategies in the coming years and how these strategies will lead to stronger surveillance systems for early detection and monitoring of public health threats as well as informing their effective prevention and control. A sharper public health focus is expected from a more targeted list of notifiable diseases, strictly public-health-objective-driven surveillance standards, and consequently, leaner surveillance systems. Vigilance should improve through mandatory event reporting, more automated epidemic intelligence processing and increased use of genomic surveillance. Finally, EU/EEA surveillance systems should become more resilient by modernising the underlying information technology infrastructure, expanding the influenza sentinel surveillance system to other respiratory viruses for better pandemic preparedness, and increasingly exploiting potentially more robust alternative data sources, such as electronic health records and wastewater surveillance. Continued close collaboration across EU/EEA countries will be key to ensuring the full implementation of this surveillance framework and more effective disease prevention and control.

Genomic Characterization of a Clinical NDM-1-Producing Klebsiella michiganensis from Brazil.

Public health faces daily challenges due to increasing reports of pathogenic microorganisms with new antimicrobial resistance. Klebsiella michiganensis, an emerging pathogen, poses difficulty in its identification using conventional techniques. This study presents the first documented case of NDM-1-producing K. michiganensis in Brazil, identified as the new ST418. Initially, the isolate from a tracheal secretion was misidentified as K. oxytoca. However, accurate identification was achieved through ANI analyses. Whole-genome sequencing was conducted to characterize the genetic context of the resistance genes, to identify virulence factors, and to construct a phylogenetic tree. The blaNDM-1 gene was found to be harbored on an IncFIB plasmid approximately 112 kb in length, which was transferable in conjugation assays. The detection of carbapenem resistance genes in this species highlights the importance of public health vigilance, as it may serve as a reservoir and disseminator of significant resistance genes.

Wastewater threshold as an indicator of COVID-19 cases in correctional facilities for public health response: A modeling study

Although prison facilities are not fully isolated from the communities in which they are located, most of the population is confined and requires high levels of health vigilance and protection. This study aimed to examine the dynamic relationship between facility-level wastewater viral concentrations and the probability of at least one positive COVID-19 case within the facility. The study period was from January 11, 2021 to May 8, 2023. Wastewater samples were collected and analyzed for SARS-CoV-2 (N1) and pepper mild mottle virus (PMMoV) three times weekly across 14 prison facilities in Kentucky (USA). Positive clinical case reports were also provided. A hierarchical Bayesian facility-level temporal model with a latent lagged process was developed. We modeled facility-specific SARS-CoV-2 (N1) normalized by the PMMoV wastewater concentration ratio threshold associated with at least one COVID-19 clinical case at an 80 % probability. The threshold differed among facilities. Across the 14 facilities, our model demonstrates a mean capture rate of 94.95 % via the N1/PMMoV ratio threshold with pts≥0.5. However, as the pts threshold was set higher, such as at ≥0.9, the mean capture rate of the model was reduced to 60 %. This robust performance underscores the effectiveness of the model for accurately detecting the presence of positive COVID-19 cases among incarcerated people. The findings of this study provide a facility-specific threshold model for public health response based on frequent wastewater surveillance.

Widespread Circulation of Tick-Borne Viruses in Virginia-Evidence of Exposure to Heartland, Bourbon, and Powassan Viruses in Wildlife and Livestock.

Emerging tick-borne viruses such as Powassan virus (POWV), Bourbon virus (BRBV), and Heartland virus (HRTV), whilst rare, can cause severe health problems in humans. While limited clinical cases have been reported thus far in Virginia, the presence of tick-borne viruses poses a serious health threat, and the extent of their prevalence in Virginia is unknown. Here, we sought evidence of POWV, BRBV, and HRTV exposure in Virginia via a serological assessment of wildlife and livestock. Wildlife in Virginia were found to be seropositive against POWV (18%), BRBV (8%), and HRTV (5%), with western and northern regions of the state having a higher prevalence. Multiple wildlife species were shown to have been exposed to each virus examined. To a lesser extent, cattle also showed exposure to tick-borne viruses, with seroprevalences of 1%, 1.2%, and 8% detected in cattle against POWV, BRBV, and HRTV, respectively. Cross-reactivity against other known circulating mosquito-borne flaviviruses was ruled out. In conclusion, there is widespread exposure to tick-borne viruses in western and northern Virginia, with exposure to a diverse range of animal populations. Our study provides the first confirmation that HRTV is circulating in the Commonwealth. These findings strengthen the existing evidence of emerging tick-borne viruses in Virginia and highlight the need for public health vigilance to avoid tick bites.

An Overview of Pharmacovigilance Practice and Management in Sub-Saharan African Countries

Most sub-Sahara African countries faced with prolonged resource deficiencies suffers specific constraints in establishing a functional and operationally-free pharmacovigilance systems platforms which should guide and in facilitate the generation of vital data to reinforce health information policies and practices. Despite the commendable efforts invested by the different stake holders within such countries to harmonize pharmacovigilance guidelines and regulations, lack of integration and the dependence on pharmacovigilance systems remain major constrains. Other identified difficulties are those associated with the problem of translating data reporting tools into multiple communicable languages, and the inadequacy of the healthcare experts who translates with the patient’s population, the pressure imposed by the short consultation time between a patient and a health practitioner. To add to this, there exist issues of community concern like the increasing use of herbal traditional products with anecdotal therapeutic evidence, low quality, self-medication practices, counterfeit and roadside drugs use, substandard medications that are readily accessible to the population. Some prolonged problems are associated with social and political instability, territorial conflicts, little or no access to drug utilization data, which makes it difficult to reliably estimate the true risks of medication use. Pharmacovigilance activities are still at its infancy due to poor and less trained health personnel, lack of budget allocation for health vigilance from the State financial attributions. In addition to the limited investment in pharmacovigilance activities, there is little collaboration between public health programmes and National Medicines Regulatory Authorities (NMRA), especially during mass drug administration for neglected tropical diseases and mass vaccinations. Frequent spontaneous report in SSA is low and this can hinder robust signal detection analyses. This paper attempts to identify the challenges of the practice of pharmacovigilance in sub-Saharan African countries and its implication in health vigilance in the community. In this paper, we review the specific challenges and areas of progress in pharmacovigilance in SSA.

Health Vigilance and Risk Factors for Cervical Cancer: A Study in the State of Maranhão, Brazil

Health Vigilance and Risk Factors for Cervical Cancer: A Study in the State of Maranhão, Brazil

Contribution of medico-administrative databases to health vigilance: example of post-oocyte retrieval infections.

Can we monitor post-oocyte retrieval infections in the French national health data system to complement the French ART vigilance system? Medico-administrative databases provide a more comprehensive view of post-oocyte retrieval infections and can be used to detect abnormal increases in frequency and outlier ART centers as a complementary tool to the ART vigilance system. The various studies of ART complications are reassuring, showing relatively low overall complication rates. Nonetheless, the European Union has set up a vigilance system to monitor these complications. However, this system is not an exhaustive source of information and does not provide a complete overview of post-ART complications. The study population was identified from the comprehensive French national hospital discharge database. It included women under 46 years of age undergoing an oocyte retrieval in 2019, classified into three population subgroups according to the indication of oocyte retrieval: infertility (IF) , fertility preservation (FP), and oocyte donation (OD) . The study population included 52 098 women who had undergone 65 948 oocyte retrievals in 2019. Hospital stays and delivery of antibiotics within 31 days after oocyte retrieval were analyzed. Women and infections were characterized according to various characteristics (age, comorbidities, indication of oocyte retrieval, type of hospital stay, length of hospital stay, type of antibiotherapy, etc.). Multivariate analysis was performed to determine the relation between the occurrence of infection and women's characteristics, and results are expressed as odds ratios (ORs) and 95% CI. A funnel plot and a box plot were used to compare the infection rate per center with the national average and to detect outliers. Infections in the month following the oocyte retrieval represented 6.9% of the procedures in 2019 (n = 4522). Of these infections, 112 were hospitalized (0.2% of oocyte retrievals), and 4410 were non-hospitalized (6.7% of oocyte retrievals). The hospitalized infections were essentially gynecological infections (40.9%) and urinary tract infections (23.5%). In 87.9% of non-hospitalized infections, a single antibiotic therapy was prescribed. Mixed-effect model analysis showed that the risk of infection was significantly higher in women under 30 years of age, in the FP population, in supplementary universal health coverage (CMU-C) beneficiaries, and women with endometriosis. Funnel plot and box plot analysis showed that three ART centers have an infection rate significantly higher than the national average. In the three centers that stand out from all the others, the objective is to return to these centers to understand the possible reasons for this observed rate and to implement corrective measures. Despite all its advantages, the French national health data system presents some limitations, such as the risk of inappropriate coding. Another limitation of this study is that we cannot confirm an attributable relation between the infection and the ART procedure, even if the delay of 31 days after oocyte retrieval is consistent with the occurrence of a post-retrieval complication. In addition, antibiotics may be prescribed as a 'precautionary' measure in certain situations (women with a susceptibility to infection, complicated procedures), or as antibiotic prophylaxis for embryo transfer. Despite the limits in identifying post-ART infections in medico-administrative databases, this approach is a promising way to complement the ART vigilance reporting system. This concept developed for infections will also be generalized to other complications with regular feedback to professionals. No specific funding was sought for the study. The study was supported by the Agence de la biomédecine, France. The authors declare that they have no conflict of interest. N/A.

The Every Mind Matters campaign: changes in mental health literacy and its associations with campaign awareness.

The aim of this study is to investigate the effects on population level mental health literacy (MHL) of Every Mind Matters over 30 months following campaign launch. To observe changes in MHL over time, we conducted regression analyses on a nationally representative, repeated cross-sectional dataset of nine survey waves from September 2019 to March 2022 and an individual participant data meta-analysis with data from October 2019 to March 2021 to examine the association between campaign awareness and the outcomes. There were small improvements in knowledge of management of stress, depression and anxiety, mental health vigilance, sleep literacy and psychological wellbeing self-efficacy from September 2019 to March 2020 and a deterioration in most MHL outcomes from March 2020 compared with September 2019. Campaign awareness was positively associated with symptom management of depression and anxiety, help seeking self-efficacy, stigma related to mental disorders and mental health vigilance. There is little evidence that the campaign improved MHL in the general population beyond March 2020. Those who were aware of the campaign may have benefitted from its resources.

Oral lesions and monkeypox: increasing the need for prevention and access of a novel zoonotic disease – correspondence

Dear Editor: Monkeypox (MPOX), a novel zoonotic pox disease is a transmissible viral illness caused by the monkeypox virus that was first observed in humans in the 1970s. MPOX outbreaks have been documented in several countries, with the majority of cases restricted to endemic regions on the African continent1. However, the quick appearance of MPOX in a number of cities beyond the virus’s endemic territory in persons who were not necessarily connected or who had not gone to Africa, as well as new data showing human-to-human transmission, caused too much alarm for many health authorities2,3. The current MPOX epidemic has been classified as a public health emergency of international concern by the World Health Organization (WHO)4. An intense fever sickness with many skin lesions is the characteristic clinical presentation of newly developed MPOX. MPOX has a 1–2 weeks incubation period, although it can be as brief as 7–20 days on the face before spreading to other sections of the body5. Patients and doctors are concerned when a lesion in the mouth is discovered because a small number of instances can be caused by cancer or hazardous diseases. But, MPOX symptoms include mouth ulcers and oral lesions6. Mouth ulcers can impair a person’s ability to eat and drink, resulting in dehydration and malnutrition7. The latest MPOX epidemic originated with perioral papules that blistered and ulcerated. According to one research, over a quarter (24%) of MPOX patients had mouth ulcers. As a result, dentists in disease-endemic areas may be the first to notice MPOX precursor symptoms2,6. As a result, dental professionals working in locations where common or endemic illnesses are prevalent should exercise extreme caution, especially when examining patients with lymphadenopathy. In all patients, a thorough examination of the oral mucosa for macular and papular lesions is required. In healthy individuals, oral or cutaneous lesions emerge ~2 weeks after contact with the monkeypox virus while serum antibodies are often identified8,9. Since oral and perioral lesions are among the first to appear, the Oral Health Confraternity can help with case detection. Similarly, Indiana Dental Association (IDA) has issued an instructional brochure outlining the oral signs of monkeypox virus infection as well as the testing techniques that dentists can use to examine the virus in suspected patients10. Indeed, prior published research has revealed that oral ulcers were observed in infected patients during the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 infection, emphasizing the necessity of dental health screening11. A lesion in the mouth might become the predominant issue, resulting in an oral sore that is readily neglected. At this level, just one intraoral lesion in the oral cavity, tongue, or oropharynx should be considered and evaluated. In conclusion, the initial sign may be mouth sores, which may be the first indication of MPOX. All patients with unexplained oral sores need the most advanced diagnostic and treatment options. This would aid not only in quick containment but also in providing better medical treatment. Following reports of the monkeypox virus community spread, it is critical to enhance health vigilance in risk groups through clinical prediction, focused testing, and vulnerable population education. Ethical approval Not applicable as no animal study was conducted. Sources of funding No funding. Author contribution T.A.D.: conceptualization, data curation, writing – original draft preparation. M.Y.: data curation, writing – original draft preparation. M.S.: conceptualization, writing – reviewing and editing, visualization and supervision. Conflicts of interest Authors declare that they have no conflicts of interest. Research registration unique identifying number (UIN) None. Guarantor Tsehaye Asmelash Dejene. Data statement All data are available in the manuscript. Provenance and peer review Not commissioned, internally peer-reviewed.

The Association between Prematurity, Antibiotic Consumption, and Mother-Infant Attachment in the First Year of Life.

Antibiotics have individual and public-health drawbacks. Nevertheless, mother-infant attachment quality and maternal sensitivity are associated with antibiotic use. Ambivalent-attached infants are more likely to consume antibiotics than other infants. Conceivably, the emotional over-externalization of ambivalent-attached infants and maternal anxiety when infants are ill raise concerns in healthcare professionals, leading to antibiotic over-prescriptions. However, because infants prematurely born, particularly those with less than 32 weeks of gestation, are under more accurate health vigilance, the impact of infant and maternal behavior on antibiotic prescription may vanish in this sample. To test this hypothesis, we performed a longitudinal study to compare antibiotic use and the quality of mother-infant attachment in three groups: 86 infants born at full-term, 44 moderate-to-late preterm infants (32-36 gestation weeks), and 58 very-to-extreme preterm infants (<32 gestation weeks). Infants' attachment was observed with the Ainsworth Strange Situation's experimental paradigm at 12 months of corrected age. Findings indicate that infant attachment strategy is associated with antibiotics uptake, but results vary across samples. The proportion of infants that used antibiotics is highest among ambivalent-attached infants in the full-term sample but highest among avoidant-attached infants in the very-to-extreme premature sample. Moreover, higher infant gestational age and lower maternal sensitivity determine higher antibiotic use.

Rapid and Highly Sensitive Method for Evaluating Surface Coatings against an Enveloped RNA Virus.

The COVID-19 pandemic has increased public health vigilance worldwide. The coronavirus (SARS-CoV-2) can spread via aerosols, and droplet-borne viruses remain viable on nonliving surfaces for long duration. Hence, effective antiviral coatings are highly useful in eliminating viral persistence on nonliving surfaces. Although innovative antiviral coatings have been designed, conventional procedures for antiviral assays are generally laborious, time-consuming, and have a high limit of detection. In the present study, we report a rapid and highly sensitive method for evaluating antiviral coatings by measuring the luciferase activity derived from recombinant Sendai virus (SeV). The physicochemical characteristics of SeV, which has a single-stranded RNA genome encapsulated within a lipid envelope, allow us to exploit it as an indicator of the physicochemical potential of coating materials against enveloped RNA viruses in general. We demonstrate that SeV-based assay systems allow for the rapid and quantitative evaluation of the surface coatings composed of iodine solubilized in polyvinyl acetate. Additionally, we have investigated the effect of mucins, the dominant protein component of saliva, on the antiviral activity of surface coatings. The presence of mucins in the SeV suspension considerably rescues luciferase activity at the viral-surface interface, presumably due to mucin-mediated viral protection. Our findings provide insights into a procedure capable of the rapid evaluation and optimization of surface coatings, and suggest an important role of the mucin in the valid evaluation of antiviral agents.

Implementation of a Geographic Information System-Based Smartphone Application for Health Vigilance in Older Adults by Village Health Volunteers (OSOMO).

This paper mainly studies the smartphone application for health vigilance in elderly adults, based on geographic information system (GIS) for village health volunteers (OSOMO in Thai) to monitor elderly's health. Eight areas from 4 provinces of 7th health territory (Roi Et, Khon Kaen, Maha Sarakham, and Kalasin) were employed for research. The smartphone application called "OSOMO Prompt" was created for both iPhone (iOS) and Android devices for 1,246 OSOMOs. The comparison results of the difference of mean scores of knowledge of before and after using the "OSOMO Prompt" smartphone application, showed that the trial group, 240 elderly participants had the mean scores after smartphone application use of 1.69, higher than before use smartphone application. The results also indicated a statistically significant difference (p-value < .001) at 95%, confidence interval between 2.15-1.22. In conclusion, the "OSOMO Prompt" smartphone application was proved as a tool for village health volunteers to make health decision for the elderly persons. Moreover, the system was easy to use and could improve the quality of the elderly's healthcare.

Perfil demográfico e clínico de casos ocupacionais de sensibilização a metilisotiazolinona e Kathon CG: estudo seccional

Abstract Introduction: methylisothiazolinone alone or associated with methylchloroisothiazolinone (Kathon CG) is a preservative related to occupational allergic contact dermatitis. Objectives: to evaluate the demographic and clinical profile of occupational cases of sensitization to isothiazolinones in the city of Rio de Janeiro and to describe the presence of these preservatives in national paints. Methods: cross-sectional study based on information from medical records of workers who underwent patch testing between 2013-2017. The prevalence of clinical, demographic and occupational characteristics was described and an unadjusted model was used to investigate the association between variables. We sought the presence and concentration of isothiazolinones in the chemical composition sheets of national paints. Results: among the 768 workers submitted to the tests, 68 had occupational dermatosis with a positive result for sensitization to methylisothiazolinone/Kathon CG. The most affected occupations were those related to domestic activities and cleaning. There was a greater likelihood of sensitization to isothiazolinones in women and in those with involvement of the hands and legs. Among the 61 paints evaluated, 26 had some isothiazolinone, with methylchloroisothiazolinone being the most common. Conclusions: sensitization to isothiazolinones can impact workers’ health and demands greater vigilance on cleaning materials and cosmetics, as well as discussing the composition regulation of the paints sold in Brazil.

Health vigilance concerning Acinetobacter baumannii bacteremia at the mohammed VI university hospital of oujda (morocco): epidemiological profile and antibiotic resistance

The objective of this work is to determine the epidemiological profile of Acinetobacter b aumannii (A.baumannii ) bacteremia in the microbiology laboratory of CHU Mohammed VI of Oujda and its antibiotic resistance rates. This is a retrospective and descriptive study of 27 months from June 24, 2016to September 19, 2018 including all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology)and EUCAST(European Committee on Antimicrobial Susceptibility Testing). Contaminated blood cultures were excluded. As results we collected 863 positive blood cultures, A. baumannii accounted for 7.41% (n = 64). 67% (n =43) of the strains were isolated from patients hospitalized in intensive care (adults, children and newborns). The two main risk factors described in patients with our series were wearing of intravascular device in 55% (n=35) Immunosuppression in 22% n=14). A. baumannii bacteremia was associated with care in 37.5% (n=24). 75% (n=48) of A. baumannii isolates were resistant to carbapenems. No strain of A. baumannii was resistant to colistin. In light of these results strengthening the control and prevention measures for healthcare associated infections would be the most reliable way to limit the spread of A. baumannii in our establishment.

Health vigilance concerning female urinary tract infections: Epidemiological profile and antibiotic resistance

The objectives of our work were to establish the epidemiological and bacteriological profile of female urinary tract infection at the Mohammed VI University Hospital of Oujda (Morocco), and then to study the drug resistance of the bacterial strains isolated. This is a retrospective study over 36 months including urine samples from patients hospitalized or consulting at the CHU Mohamed VI of Oujda (Morocco). Urines were processed according to the recommendations of the Medical Microbiology Reference (REMIC) and the EUCAST (European Committee on Antimicrobial Susceptibility Testing). We collected 12556 requests for CBEU from different departments. At the top of the list was the emergency department with a rate of 37% (n= 4666) followed by outpatient clinics (33.1%; n=4226). 5% (n=630) of the CBEU were positive. Escherichia coli (E. coli ) dominated the epidemiological profile with a rate of 72.50% (n=482). E. coli was resistant to penicillins in 69.50% (n=299) of cases, protected penicillins in 34.80% (n=149), third generation cephalosporins (C3G) in 9% (n=38), fluoroquinolones in 17.5% (n=73), Trimethoprim-Sulfamethoxazole in 46% (n=196) of cases and gentamicin in 12% (n=51) of cases. None of the strains were resistant to carbapenems. Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.

Health vigilance concerning bacteremia in neonatology - neonatal intensive care unit at the Mohammed VI University Hospital of Oujda (Morocco): epidemiological profile and antibiotic resistance

The objective of our study was to describe the epidemiological profile of blood culture isolates in the neonatology - neonatal intensive care unit of the Mohammed VI University Hospital of Oujda (Morocco) and to specify the resistance profile of the main germs isolated to antibiotics .This is a retrospective and descriptive study of 21 months from December 14, 2016 to September 14, 2018 and covering all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology) and EUCAST (European Committee on Antimicrobial Susceptibility Testing).contaminated blood cultures were excluded. As results, we collected 275 positive blood cultures. They occurred in the context of intravascular device (IVD) use in 59% (n=162) of cases. The most isolated bacterial groups were coagulase-negative staphylococci (CNS) 41.45 %( n=114), followed by Enterobacteriaceae 32.36 %( n=89).CNS were resistant to all beta-lactams in 57.89 %( n=66), and to glycopeptides in 5.26 %( n=6). Enterobacteriaceae were producers of extended-spectrum betalactamases in 79.77% (n=71) and producers of carbapenemases in 13.48% (n=12) of cases. The alarming increase of enterobacteriaceae isolates and their antibiotic resistance rates should encourage the reinforcement of hygiene measures in our University Hospital.