Infection Control Committee Research Articles

Ten Practice Changes in COVID-19 Intensive Care Unit of a Tertiary Care Teaching Hospital in India during the Peak of Pandemic: Adapt and Improve.

During the peak of the coronavirus disease-2019 (COVID-19) pandemic, 10 practice-changing decisions were adopted which led to an improved standard of clinical care in the face of overwhelming burden to the healthcare setup. Formation of a control unit with the piggyback team, briefing before donning, replacement of personal protective equipment (PPE) with impermeable surgical gowns, a dedicated prone team and the prone bundle of care, weaning-extubation and tracheostomy protocol, online audiovisual family-patient meet, daily rounds by hospital infection control committee member, each one clean one policy, focused onsite training of healthcare support staff and discharge policy with post-discharge follow-up were the 10 important changes adopted.How to cite this articleSoni L, Pangasa N, Baidya DK, Subramaniam R. Ten Practice Changes in COVID-19 Intensive Care Unit of a Tertiary Care Teaching Hospital in India during the Peak of Pandemic: Adapt and Improve. Indian J Crit Care Med 2022;26(6):710–711.

Committee report: Questionnaire survey on the treatment of COVID-19 in patients receiving dialysis therapy

BackgroundPatients with coronavirus disease 2019 (COVID-19) who receive dialysis therapy develop more severe disease and have a poorer prognosis than patients who do not. Although various data on the treatment of patients not receiving dialysis therapy have been reported, clinical practice for patients on dialysis is challenging as data is limited. The Infection Control Committee of the Japanese Society for Dialysis Therapy decided to clarify the status of treatment in COVID-19 patients on dialysis.MethodsA questionnaire survey of 105 centers that had treated at least five COVID-19 patients on dialysis was conducted in August 2021.ResultsSixty-six centers (62.9%) responded to the questionnaire. Antivirals were administered in 27.7% of facilities treating mild disease (most patients received favipiravir) and 66.7% of facilities treating moderate disease (most patients with moderate or more severe conditions received remdesivir). Whether and how remdesivir is administered varies between centers. Steroids were initiated most frequently in moderate II disease (50.8%), while 43.1% of the facilities initiated steroids in mild or moderate I disease. The type of steroid, dose, and the duration of administration were generally consistent, with most facilities administering dexamethasone 6 mg orally or 6.6 mg intravenously for 10 days. Steroid pulse therapy was administered in 48.5% of the facilities, and tocilizumab was administered in 25.8% of the facilities, mainly to patients on ventilators or equivalent medications, or to the cases of exacerbations. Furthermore, some facilities used a polymethylmethacrylate membrane during dialysis, nafamostat as an anticoagulant, and continuous hemodiafiltration in severe cases. There was limited experience of polymyxin B-immobilized fiber column-direct hemoperfusion and extracorporeal membrane oxygenation. The discharge criteria for patients receiving dialysis therapy were longer than those set by the Ministry of Health, Labor and Welfare in 22.7% of the facilities.ConclusionsOur survey revealed a variety of treatment practices in each facility. Further evidence and innovations are required to improve the prognosis of patients with COVID-19 receiving dialysis therapy.

Rates of underreported needlestick and sharps injuries among healthcare workers in Turkey: in the light of Infection Control Committee data.

Doctors and nurses are frequently exposed to needlestick and sharps injuries (NSIs) because of their work. It is estimated that NSIs are more common than the rates reported to Infection Control Committee. The purpose of this study was to determine the incidence and reporting rates of NSIs in our hospital. After their consent forms were obtained for the questionnaire, 670 doctors and nurses were interviewed face-to-face by the Infection Control Committee nurse. The questionnaire consisted of 22 questions, and the answers were recorded. The questions were on demographic data and injuries. The data of NSIs, whose active surveillance was made in our hospital since 2005 and in the last 1 year, were also analyzed retrospectively. A total of 119 (17%) people out of 670 people who participated in the study had at least one NSI; 43 (36%) people of the 119 people were doctors and 76 (63.9%) people were nurses. The most common injuries among doctors were found in assistant doctors (60%). No statistically significant differences were detected between the doctors and nurses in terms of injury status (P = 0.398). The most common injuries were found in surgical clinics, and a significant difference was detected here when compared to other clinics. The data that 20 (17%) people of the 118 people who were injured by the NSIs reported the injury were obtained from the Infection Control Committee database. It is seen that injuries are high in surgical clinics and assistant doctors who have high work stress and workload. There were more injuries with sharp objects than the expected rates in our hospital although the reports were made very rarely. First of all, we should determine strategies, especially education, to reduce injuries, and then remove the obstacles to unreported injuries. The methods of clinics with a high rates of reporting needlestick and sharps injuries to the infection control committee should be examined and tried to be applied in our own clinics.

An Epidemiological Study of Nosocomial Infection in Post-Operative Patients.

A Nosocomial infection-also called” hospital acquired infection” can be defined as “An infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission.” The term Nosocomial infection is applied to any clinical infection that was neither present nor was in its incubation period, when the patient entered the hospital. Nosocomial infections are one of the most common adverse events during healthcare delivery and a major public health issue affecting morbidity, mortality, and quality of life. At any time, up to 7% of patients in developed and 10% in developing countries will acquire at least one Healthcare-associated infection (HAI), causing a considerable economic burden to the society. It is evident that HAIs result in prolonged hospital stays, long-term disability, increased resistance of microorganisms to antimicrobials, additional cost on health systems, high cost for patients and their family, and preventable deaths. The objective of the study was to find out the morbidity pattern in post-surgical wound infections and suggested measures to minimize exogenous and endogenous sources of Nosocomial infections. Out of total 300 patient's details collected, 98 patients were affected by surgical site nosocomial infection. Staphylococcus aureus is found to be the leading pathogens in post-surgical wound infection. In this study, we also found that reducing preoperative stay can reduce the postoperative surgical site infection. In conclusion, we should clearly understand and identify the nosocomial infections and device a system to track, analyse, monitor prevent and treat. Hospital infection control committee should meet regularly and make recommendations at all levels for prevention of Nosocomial infections. Total prevention may not be possible but can be minimized to significant extent by implementing the guidelines developed during the present study.

Surveillance of hospital acquired infections in veterinary practices

The importance of surveillance of hospital-acquired infections (HAI) is often overlooked within the veterinary community, with limited research available, resulting in this vital step being overlooked. When carried out correctly, it allows a practice to accumulate data on the rates of HAIs and ascertain when further action is required. Without these data, practices are often unaware of the severity of their problem. All practices should have an infection control ambassador or committee appointed to ensure these statistics are used correctly and shared with all team members. This article will examine current literature available and determine the pros and cons of each surveillance method and how they may be implemented.

Preparation of operating room for COVID-19 suspects at a tertiary care teaching hospital in New Delhi, India

The continuous rise in the number of cases of COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), generated an urgent need to transform the facilities of our existing operating rooms (OR) to cater for emergency surgeries for patients with suspected COVID-19. The aim was to minimise the spread of infection and to achieve the lowest risk for patients and staff while caring for COVID-19 suspects undergoing surgery. We devised a protocol in our hospital to prepare OR for patients suspected to be suffering from COVID-19 but in whom the surgical intervention could not be deferred until the result of the COVID-19 test was obtained. The key consideration was that we cater to suspected and confirmed COVID-19 patients who required emergency surgery while adhering to strict infection control measures. The study was undertaken as a pilot exercise in consultation with treating surgeons, hospital infection control committee members, hospital administrators, and engineers, along with a literature review, to transform the design and functioning of existing facilities to prepare for emergency surgeries of COVID-19 suspects at the beginning of the pandemic. While this required significant planning on paper and onsite by members of the OR staff, hospital infection control committee, administration, and engineers, the creation of a safe operating environment was possible within a 48-h period with minimal structural alterations.

Determination of post-traumatic growth status of frontline infection control nurses in the COVID-19 pandemic – a cross-sectional study

Introduction and aim. It is very important for nurses to experience post-traumatic growth in order to protect their mental health after traumatic events such as a pandemic. The aim of this study is to determine the post traumatic growth status of infection control nurses, who play an important role in health services in the COVID-19 pandemic. Material and methods. This study is a cross-sectional, descriptive study. The study was conducted with 170 infection control nurses working in infection control committees of hospitals in Turkey. “Nurse Descriptive Information Form” and “Post Traumatic Growth Inventory (PTGI)” were used as data collection tools in this study. Results. As a result of this research, the mean PTGI total score of the infection control nurses was 70.73±23.03, and it was determined that they experienced moderate growth from the sub-dimensions of the scale. Also it was determined that there was a statistically significant difference between the changes in philosophy of life sub-dimension scores of PTGI according to the age and marital status of the nurses. In addition, it was determined that there was a significant difference between the total PTGI scores according to the year of working as an infection control nurse and the loss of a relative of the healthcare worker due to the COVID-19 disease. Conclusion. In this study, it can be said that infection control nurses experienced a moderate post-traumatic growth after the COVID-19 pandemic. Age, marital status, working year and loss of a healthcare worker friend during the pandemic period seem to affect nurses’ post-traumatic growth. It is very important to determine the mental health of infection control nurses working on the front lines in the pandemic.

Profile of health care workers infected with SARS-CoV-2 infection in a central district in Kerala with focus on infection control practices.

There were reports of severe acute respiratory syndrome coronavirus 2 infection cases among health-care workers from all around the world. We did a cross sectional study among 533 COVID19 affected health-care workers. About 87.43% of participants were involved in duties not directly related to COVID-19 management. About 19.6% contracted the disease from their colleagues. About 15% of the affected health-care workers had at least one comorbidity and diabetes mellitus was the most common (5%). 57% of participants presented with fever followed by body ache in 40%. Only 0.4% of the participants needed ventilator support during treatment. 36% of the participants reported household transmission from them. Adequate personal protective equipment (PPE) usage and functioning infection control committee in their hospital were reported by most of the participants. The study points towards the need of adequate PPE use in the nonCOVID settings and the need for periodical assessment of infection control practices.

810. Cardiac Pacemaker Implantation Surgery: Automated Prediction of Surgical Site Infection

BackgroundA research focused on surgical site infection (SSI) was performed in patients undergoing cardiac pacemaker implantation surgery. The main objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI through pattern recognition algorithms, in this case the Multilayer Perceptron (MLP).MethodsData were collected from five hospitals in the city of Belo Horizonte (more than 3,000,000 inhabitants), between July 2016 and June 2018, on SSI by the Hospital Infection Control Committees (CCIH) of the hospitals involved in the search. All data used in the analysis during their routine SSI surveillance procedures were collected. So, three procedures were performed: a treatment of the collected database for use of intact samples; a statistical analysis on the profile of the hospitals collected and; an assessment of the predictive power of five types of MLP (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay, and Quick Propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% and 75% for testing, 35% and 25% for validation). They were compared by measuring AUC (Area Under the Curve - from 0 to 1) presented for each of the configurations.ResultsFrom 1394, 572 records were: 21% of deaths and 2.4% patients had SSI; from the confirmed SSI cases, approximately 64.3% had sites classified as “clean”; length of hospital stay ranged from 0 to 175 days (from 1 to 70 days); the average age is 67 years. The prediction power of SSI, the experiments achieved from 0.409 to 0.722.ConclusionDespite the considerable loss rate of more than 65% of the database samples due to the presence of noise, it was possible to have a relevant sampling for the profile evaluation of Belo Horizonte hospitals. Moreover, for the predictive process, although some configurations reached 0.722. To optimize data collection and enable other hospitals to use the SSI prediction tool (available in www.nois.org.br ), two mobile application were developed: one for monitoring the patient in the hospital and the other for monitoring after hospital discharge.Disclosures All Authors: No reported disclosures

The Prevalence of blaNDM-1 in Clinical Isolates of Carbapenem-resistant Pseudomonas Aeruginosa: A Systematic Review

Background: Pseudomonas aeruginosa (P. aeruginosa) is a gram negative bacteria that is known to cause nosocomial infections. Carbapenem is used to treat the damage caused by P. aeruginosa, however it is becoming resistant to carbapenems because of the production of β-lactamases. The objectives of the study were to systematically review the prevalence of blaNDM-1 in carbapenem-resistant Pseudomonas aeruginosa (CRPA) and to review and analyze the clinical sources as well as the antibiotic resistance profile of CRPA carrying blaNDM-1. Methods: The researchers systematically searched PubMed, ScienceDirect, and Google Scholar. Studies that met the inclusion criteria were included in the review. In assessing the methodological quality of the included studies, the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and the JBI Critical Appraisal Checklist for Case Reports were used. Results: A total of nine studies were included in which eight were cross-sectional studies and one was a case report. The highest prevalence rate reported was 54.55% in blaNDM-1 positive CRPA isolates among the cross-sectional studies. The three most frequent sources of clinical isolates of CRPA carrying blaNDM-1 include urine, wound discharge, and tissue, among the included studies. Lastly, this review showed that among the included studies, CRPA isolates carrying blaNDM-1 were most resistant to ceftazidime and gentamicin. Conclusions: There is varying prevalence of blaNDM-1 in CRPA in different countries. Urine, wound discharge, and tissue specimens being the most frequent sources of CRPA isolates carrying blaNDM-1 poses a challenge that must be given attention by the infection control committee, thus the need for proper handling and processing of clinical specimens. Resistance to ceftazidime and gentamicin among the CRPA isolates carrying blaNDM-1highlights the growing challenge of successfully treating infections caused by this bacteria. This challenge reminds us of the importance and purpose of antibiotic stewardship that emphasizes the improvement of proper antibiotic prescription by the physicians and proper antibiotic use by the patients that can help in preventing harm and antibiotic resistance. Doi: 10.28991/SciMedJ-2021-0304-9 Full Text: PDF

Device-Associated Hospital-Acquired Infections: Does Active Surveillance With Bundle Care Offer a Pathway to Minimize Them?

Background and objectiveThe prevalence of hospital-acquired infections (HAIs) is underreported in developing nations due to a lack of systematic active surveillance. This study reports the burden of device-associated HAIs (DA-HAIs) based on two years of active surveillance with in situ bundle care in closed intensive care units (ICUs) of a tertiary care hospital.Materials and methodsA prospective surveillance study was carried out in 140-bedded ICUs (2,100-bed hospital) of a tertiary care private medical college hospital. Daily active surveillance for catheter-associated urinary tract infection (CAUTI), ventilator-associated event (VAE), and central line-associated bloodstream infection (CLABSI) was done by trained infection control nurses (ICNs) along with quality champion nurses with HAI surveillance forms with bundle care auditing, which was attached to the case sheets of all patients on devices. The surveillance definitions of DA-HAIs were adapted from the Centers for Disease Control and Prevention (CDC)’s National Healthcare Safety Network (CDC-NHSN) 2017 surveillance criteria. Data were analyzed at the end of every month to generate the cumulative device-associated infection (DAI) rates and device utilization ratio (DUR). These data were compared with NHSN and International Nosocomial Infection Control Consortium (INICC) - India HAI rates and communicated to corresponding ICUs and also presented at the hospital infection control committee (HICC) meeting.ResultsThe surveillance data were reported over 71,877 patient days during the study period. The DUR of urinary catheters, ventilator, and central line were 0.53, 0.16, and 0.22, respectively. CAUTI, VAE, and CLABSI rates were 0.97, 10.5, and 0.43 per 1,000 device days, respectively. Among 166 DA-HAIs reported, 182 pathogens were identified. Klebsiella pneumoniae was the most common organism isolated, accounting for 37.4% of all DA-HAI cases, followed by Acinetobacter baumanii (30.8%). Most of the Gram-negative organisms were carbapenem-resistant (153/175; 87.4%). Vancomycin resistance rate in Enterococcus was 28.5% (2/7).ConclusionDUR and CAUTI, VAE, CLABSI rates were less/on par with the benchmarks of INICC and CDC-NHSN in almost all ICUs of our tertiary care unit. Gram-negative pathogen with 87.4% carbapenem resistance worsened the scenario. Proper active surveillance with bundle care and training by ICNs made a significant difference in all DA-HAI rates, especially VAE, which decreased to 10.5 from 23.6 per 1,000 ventilator days. Sustained active surveillance of HAI and bundle care auditing by a trained infection prevention team with a stringent antibiotic policy are the need of the hour to combat DAIs.

Impact of COVID -19 Pandemic on Plastic Surgery Practices in a Tertiary Care Set Up in Southern India.

The COVID-19 pandemic has modified the way, plastic surgeons treat their patients. This article depicts how we as a plastic surgery department in a tertiary care setup handled the pandemic with an emphasis on infection control policy. Data was collected from hospital records and quality assurance cell from March 21, 2020 to June 19, 2020 in terms of patient triaging, consultations, perioperative protocols, duty rosters, and academic activities. The changes on these with the impact of COVID-19 were studied with the same period of previous year. Outpatient clinics were closed and emergency consultations were reduced. Number of consultations reduced from 2591 to 75 and surgeries from 320 to 46 during the same period in 2019 and 2020 respectively. Though tele-consultations were helpful, the overall benefits were subpar. Emergency services continued with the guidelines of institute's infection control committee, such as area specific personal protective equipment, allotment of operating rooms, minimizing the crowd in operating room. There was some compromise in using accessories for microsurgical procedures. Duty rosters were designed to maintain uninterrupted services. Academic activities were continued with virtual platforms. Adequate preparation of health care setup and nation-wide lockdown has helped to handle emergency cases and in reduction of trauma-surgeries respectively. Though there were obstacles for some patients in accessing health care, our institutional response made us to render maximum possible care. Advancements in virtual platform helped in consultations and academics. Delayed conservative approach was used in most cases at the expense of cosmetic compromise.

Infection control standards and its benefits on operative theater safety management

Working in the operating room (OR) is a very demanding job, it needs very skillful persons working in harmony to give the patient undergoing surgery the care he deserves. The OR staff should react to any abrupt situation very fast and pay attention to each detail to carry out surgical operations safely. Working in the operating room (OR) is a very demanding job, it need very skillful persons working in harmony to give the patient undergoing a surgery the care he deserves. The OR staff should react to any abrupt situation very fast and pay attention to each detail to carry out surgical operations safely. Operating Room Protocol includes Hand hygiene and wearing personal barriers. Various methods of getting rid of contamination of surgical instruments include cleaning, purification of the water used, ultrasonic removal of derbies, disinfection and sterilization. Recommendations include the formation of an infection control committee, Create, apply and follow up an annual strategy to ensure medical safety measures and continuous learning for medical staff.

Co-infection of ST2IP carbapenem-resistant Acinetobacter baumannii with SARS-CoV-2 in the patients admitted to a Tehran tertiary referral hospital

BackgroundCarbapenem-resistant Acinetobacter baumannii (CRAB) is among the most concerning cause of healthcare-associated infections (HAI) due to its high level of antibiotic resistance and high mortality. In the era of the COVID-19 pandemic, the key priority of infection control committees is to contain the dissemination of antibiotic resistant Gram-negative bacteria. Here, we aimed to timely recognize the emergence of CRAB in COVID-19 cases admitted to the wards of a tertiary referral hospital and to identify the genetic relatedness of the isolates.MethodsFrom 30 March to 30 May 2020, a total of 242 clinical samples from COVID-19 cases were screened for CRAB isolates using standard microbiologic and antibiotic susceptibility tests. The PCRs targeting oxa23, oxa24, oxa58, blaTEM and blaNDM-1 genes were performed. Two multiplex PCRs for identifying the global clones (GC) of A. baumannii were also performed. The sequence type of CRABs was determined using Institut Pasteur (IP) multilocus sequence typing (MLST) scheme.ResultsEighteen CRAB isolates were recovered from COVID-19 patients with the mean age of 63.94 ± 13.8 years. All but 4 COVID-19 patients co-infected with CRAB were suffering from an underlying disease. Death was recorded as the outcome in ICUs for 9 (50%) COVID-19 patients co-infected with CRAB. The CRAB isolates belong to GC2 and ST2IP and carried the oxa23 carbapenem resistance gene.ConclusionThis study demonstrated the co-infection of CRAB isolates and SARS-CoV-2 in the patients admitted to different ICUs at a referral hospital in Tehran. The CRAB isolates were found to belong to ST2IP, share the oxa23 gene and to have caused several outbreaks in the wards admitting COVID-19 patients.

Covid-19 pandemic: chronicle of responses and experiences of the infection prevention and control committee at a tertiary hospital in southwest Nigeria.

Since the advent of 2019-Corona virus Disease (COVID-19) in Nigeria in February 2020, the number of confirmed cases has risen astronomically to over 61,307 cases within 8 months with more than 812 healthcare workers infected and some recorded deaths within their ranks. Infection prevention and control is a key component in ensuring safety of healthcare workers in the hospital as healthcare-associated infection is one of the most common complications of healthcare management. Unbridled transmission of infection can lead to shortage of healthcare personnel, reduced system efficiency, increased morbidity and mortality among patients and in some instances, total collapse of healthcare delivery services. The Infection Prevention and Control Committee is a recognised group by the Centre for Disease Control and Prevention with their core programmes including drawing up activities, procedures and policies designed to achieve above-stated objectives before, during and after any disease outbreak, especially emerging and re-emerging ones such as the 2019 Coronavirus Disease. In this report, we highlight the roles played by the Infection Prevention and Control Committee of the University of Medical Sciences Teaching Hospital to prevent the spread of COVID-19 within and outside the hospital community and the lessons learned to date.

Developing an Infection Prevention and Control Educational Program for Critical Care Nurses:Intervention Mapping Protocol and Social Cognitive Theory

Aim: This study aims to apply the Intervention Mapping protocol and Social Cognitive Theory in thedevelopment of an infection prevention and control education program aimed at critical care nurses.Background:Education programs have been widely used to improve awareness toward infection preventionand control, but the development of an integrated theory- and evidence-based education program tailored tocritical care nurses has not yet been discussed.Subject and Methods: Data are from the Hospital Universiti Sains Malaysia infection control records. The6-step Intervention Mapping protocol and the Social Cognitive Theory were used to develop an infectionprevention and control education material tailored to critical care nurses. The educational material was alsoinfluenced by Previous literature, hospital infection control committee, and in-charge nurses of intensivecare unit.Results: The educational material was tailored to target knowledge, self-efficacy, and risk perception thatidentified as the individual determinants of critical care nurses health behavior during assessment phase. Inaddition to physical environment and organizational support that determined as external determinants. Amatrix of change objectives was mapped out for each health behavior determinant, teaching methods, andtheir practical applications.Conclusion: Applying the Intervention Mapping protocol and the Social Cognitive Theory is effective indeveloping educational material tailored to critical care nurses to improve their self-confidence and promoteknowledge-based practice in infection prevention and control.

Adherence to Infection Prevention and Control Practices among Health Care Workers and its Outcome in Non-COVID Areas in a Tertiary Care Hospital

International Journal of Medicine and Public Health,2021,11,3,146-149.DOI:10.5530/ijmedph.2021.3.26Published:August 2021Type:Original ArticleAdherence to Infection Prevention and Control Practices among Health Care Workers and its Outcome in Non-COVID Areas in a Tertiary Care HospitalMini Palathingal Narayanan, Anuja Mohan, Priya Chandran, Durga Neelakandan, and Beena Philomina Jose Mini Palathingal Narayanan1,*, Anuja Mohan1, Priya Chandran2, Durga Neelakandan1, Beena Philomina Jose1 1Department of Microbiology, Government Medical College Kozhikode, Kerala, INDIA. 2Department of Community Medicine, Government Medical College Kozhikode, Kerala, INDIA. Abstract:Aim and Objective: 1. To study the adherence to Infection Prevention and Control (IPC) practices by health care workers in Non-COVID areas. 2. To compare the proportion of COVID affected health care workers among those adhering to proper IPC and those with non-adherence. Background: Hospitals serve as frontline health care institutions caring for the increased number of COVID-19 patients. The health care personnel working in hospitals are at increased risk of acquiring the disease during the pandemic. It is the prime responsibility of the Hospital Infection Control Committee to protect the health care workers (HCW) and prevent nosocomial transmission. Materials and Methods: In the cross sectional study,all health care workers from non-COVID areas of the hospital who were exposed to COVID-19 patient during the study period were assessed according to the risk assessment criteria. Results: A total of 1049 health care workers had contact with COVID-19 patients. Of this only 6 health care workers were diagnosed with COVID-19. Conclusion: The HCW diagnosed with COVID-19 was less than one percentage of exposed. This implies the impact that the IPC training had on the HCW which made them ensure their own safety and prevent the nosocomial spread of SARS-CoV-2 within the hospital. Keywords:Adherence, Frontline health care workers, Nosocomial infectionView:PDF (150.3 KB)

Prevalence of Nosocomial Infection Microorganisms and the Presence of Antimicrobial Multi-Resistance

BACKGROUND AND OBJECTIVES: hospitals represent the place where multidrug-resistant bacteria are concentrated and from where they spread within the institution and to the community. Thus, this research aimed to verify the profile of microorganisms related to nosocomial infection and to analyze the existence of multidrug-resistant bacteria at the Hospital de Caridade de Santo Ângelo/RS, the largest hospital in the city. METHODS: hospital infection data from 100 medical records, from August/2016 to March/2017, maintained by the Hospital Infection Control Committee were used. Bacterial identification was carried out by the Microbiology Laboratory of the hospital using morpho-tinting and biochemical methods; and antimicrobial susceptibility was determined by the disk diffusion method. Bacterial multidrug-resistance was considered based on resistance to three or more classes of antimicrobials. RESULTS: the three most prevalent microorganisms were Acinetobacter baumannii (17%), Escherichia coli (16%), and Staphylococcus aureus (8%). The hospital unit with the highest number of isolates was the adult Intensive Care Unit, with 41% of the cases. Tracheal secretion, urine, and wound secretion samples provided the highest number of isolates. Sixteen different species/groups of multidrug-resistant bacteria were identified, as follows: Morganella morganii (100%), Hafnia alvei (100%), Enterobacter sakazaki (100%), Serratia spp. (100%), Enterobacter aerogenes (100%), Proteus vulgaris (100%), Acinetobacter baumannii (100%), Klebsiella pneumoniae (83%), Enterobacter spp. (75%), Klebsiella ozaenae (66%), coagulase-negative Staphylococcus (66%), Escherichia coli (56%), Serratia rubidaea (50%), Serratia marcensces (50%), Staphylococcus aureus (37%) e Pseudomonas aeruginosa (28%). CONCLUSION: the large number of multidrug-resistant isolates reinforces the importance of isolation and restriction strategies to avoid cross-contamination to inside and outside the hospital.

Prevalence of COVID19 infection in health care workers in first wave of pandemic and role of hospital infection control committee in subsequent waves of pandemic

: Corona virus disease 2019 (COVID-19) is a new emerging infectious disease, first identified in China in December 2019, caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). : To study and analyze the prevalence, demographic characteristics of healthcare workers (HCWs) who tested positive for COVID-19 in a dedicated Covid hospital in Mumbai.This was a retrospective observational study of HCWs with COVID-19 in a dedicated Covid Hospital, Mumbai from April to October 2020.HCW tested positive for COVID-19 was 55 from April to October 2020.The percentage of infected hospital staff was 9.8%. Most of the infected HCWs were in the age group of 51 to 60. Mean age was 42 years. Mortality was 0.1%. Majority HCWs (70.9%) acquired infection from community; 20% acquired from the hospital and 9.1% acquired infection from infected coworkers. Majority of the affected HCWs were nurses followed by doctors. Comorbidities were reported in 23.6% of infected HCWs. 5.4% of infected HCWs received infection because of aerosol generated procedures. 58.1% of HCWs got infection despite receiving prophylaxis like HCQ, Arsenicumalbicum.HCWs are at an increased risk of COVID-19 in the workplace. Preparedness of HICC (Hospital Infection Control Committee), frequent training sessions and mock drills are of paramount importance in preventing spread of infectious disease. Coordination between Hospital Administrators, Public Health Officials of national and international organizations, Engineering Department, Occupational Health and Safety staff is essential in combating pandemic.

Device associated and surgical site infections, quality indicators in a tertiary care hospital: A 5 year study

Purpose: In the present study, an attempt is made to understand the pattern of HAIs (Healthcare Associated Infections) [device associated infections such as Catheter Associated Urinary Tract Infection (CAUTI), Ventilator Associated Event (VAE), Central Line-Associated Bloodstream Infection (CLABSI) & Surgical Site Infection (SSI) by analyzing statistical tool of quality indicators] and to establish a bench mark for HAIs in a single hospital for a period of 5 years. Methods: The Microbiologist & ICN’s conduct rounds in ICU’s & wards and collect data for active surveillance. The details of culture positive samples are collected by Microbiologist from the laboratory for passive surveillance. The surveillance forms (active & passive) capture details of individual patients. The data collection forms are prepared and updated as per Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN) guidelines. The data is analyzed and presented in the meeting of Hospital Infection Control Committee meeting & discussed with clinicians. Results: The cumulative (5 years) CAUTI rate is 0.45, VAE is 2.42, CLABSI is 1.35 & SSI is 0.21. HAI rates were highest for VAE (2.42/1000 ventilator days), the next was CLABSI (1.35/1000 central line days), followed by CAUTI (0.45/1000 urinary catheter days). SSI rate was 0.21/ 100 surgeries. Conclusions: Before the study was started, the benchmark were 2 for CAUTI, 5.5 for VAE, 3 for CLABSI and 2 for SSI. We could able to reduce the baseline benchmark and established our new benchmark as 1 for CAUTI, 3 for VAE, 2 for CLABSI and 1 for SSI that can be used in developing HAI prevention policies by the institution.