Management Of Nosocomial Infections Research Articles

Knowledge, attitudes and practices of health care workers regarding the prevention of nosocomial infections in the ICU

Background: The aim of this study was to evaluate the knowledge, attitudes and practices of health care personnel regarding the prevention of nosocomial infections in the ICU. Methods: This was a cross-sectional, descriptive, study that took place in the intensive care units of two university hospitals of Yaoundé. Our study was conducted in two phases: the first phase consisted of the administration of an anonymous, self-administered questionnaire to the health care personnel who agreed to participate in the study, and the second phase permitted us to evaluate the personnel’s’ practices using the WHO model observation form. Data analysis was done using CS-Pro version 7.5, Microsoft® Office Excel 2013 and S.P.S.S. 21.0. Results: Our sample consisted of 60 practitioners. The sex-ratio was 0.54. The mean age was 38.35 ± 8.86 years. Most of the staff had been in the ICU for less than 5 years and only 35% of the staff had received at least one continuing education course on infection control measures. Good knowledge was found in 70% of the staff assessed, 60% had incorrect attitudes, and 63% had inadequate practices. The rate of compliance with good hygiene practices was 55.2%. Conclusion: Knowledge were mean, attitudes were wrong and practices were inadequate regarding the management of nosocomial infections in the ICU.

Potential Synergistic Effect of F.carica Against P. aeruginosa Intended for the Management of Nosocomial Infection

Background: Multi-drug resistance of Pseudomonas aeruginosa comprises the most vital obstacles in the antibacterial fight worldwide. The innovation of novel and effective antibacterial and/or resistance modulators is crucial to variance the extent of resistance or to reverse multidrug resistance. Objective: This study aimed to determine the in vitro antibacterial activity of the F.carica against the Pseudomonas aeruginosa associated with nosocomial infection. Methods: We studied different extracts of F.carica in methanol, benzene and water with antibiotics and their synergistic effect against P. aeruginosa using minimum inhibitory concentration and fraction inhibitory concentration index. Results: Our results revealed that the methanol extract of leaves possessed maximum phyto constituents and were active against P. aeruginosa. Methanol extracts of leaves alone and in combination with antibiotics showed a higher zone of inhibition and were synergistic <0.5) compared to other extracts. Moreover, the combination of ofloxacin with all solvent extracts enhanced the synergistic antibacterial activity with respect to other antibiotics used. Conclusion: We explored the synergistic effects of F. carica methanol extracts alone and with antibiotics was the most potential against P. aeruginosa.

Clinical significance of negative fluid balance and infection management in the treatment of acute respiratory distress syndrome caused by severe novel coronavirus infection

To explore the clinical significance of negative fluid balance and infection management in the treatment of acute respiratory distress syndrome (ARDS) caused by severe novel coronavirus infection. A retrospective survey was conducted. Patients with ARDS caused by severe novel coronavirus infection who were hospitalized in the department of critical care medicine of the Third Affiliated Hospital of Gansu University of Chinese Medicine and received non-invasive ventilator assisted ventilation were selected as the research objects. The fluid intake and output of all patients were accurately counted every day, and the fluid intake of the next day was adjusted according to the output of the previous day. According to the fluid negative balance, and whether the hospital infection management measures were complied with during the treatment and inspection of the patients, 45 patients with a negative fluid balance of more than 200 mL/d and strict management of nosocomial infection were taken as the observation group, and 48 patients with a negative fluid balance of less than 200 mL/d and no strict management of nosocomial infection were taken as the control group. The general data, weaning success rate, endotracheal intubation rate, mortality, as well as laboratory indicators such as white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP) after treatment were compared between the two groups. There were no significant differences in gender (male: 51.1% vs. 52.1%), age (years old: 66.31±15.92 vs. 67.50±13.59), acute physiology and chronic health evaluation II (APACHE II: 18.98±4.81 vs. 18.54±4.35) between the observation group and the control group (all P > 0.05), indicating that the baseline data were balanced and comparable. Compared with the control group, the weaning success rate of the observation group significantly increased [53.3% (24/45) vs. 31.2% (15/48), P = 0.031], endotracheal intubation rate significantly decreased [22.2% (10/45) vs. 43.8% (21/48), P = 0.028], mortality significantly reduced [20.0% (9/45) vs. 41.7% (20/48), P = 0.024], laboratory indicators WBC, PCT and CRP levels were significantly reduced [WBC (×109/L): 8.085±4.136 vs. 16.898±7.733, CRP (mg/L): 82.827±52.680 vs. 150.679±74.625, PCT (μg/L): 3.142±2.323 vs. 7.539±5.939, all P < 0.01]. Fluid negative balance and infection management have significant clinical significance in the treatment of severe novel coronavirus infection with ARDS.

A qualitative study of the factors impacting implementation of the national action plan to contain antimicrobial resistance (2016-2020) in medical institutions.

Antimicrobial resistance (AMR) has emerged as a serious global public health crisis. In response, 2016, 14 ministries in China, under the leadership of the National Health Commission, collaboratively issued the National Action Plan (NAP) to Contain Antibacterial Resistance (2016-2020). The NAP outlines strategies for medical institutions to adopt stewardship and implement AMR control. The purpose of this study was to comprehend stakeholders' perceptions of the NAP and explore the factors that influence its implementation in medical institutions. Semi-structured interviews were conducted with practitioners from medical institution in March and April 2021. Interviews were audio-recorded, transcribed and analyzed using thematic analysis via the framework approach. Twenty practitioners, representing diverse roles (4 administrators, 7 clinicians, 3 microbiologists, 3 pharmacists, 3 nosocomial infection management personnel) from seven institutions, participated in the study. Substantial efforts have been undertaken to regulate the rational use of antibiotics and enhance the management of hospital infections. Participants demonstrated awareness and concern regarding antimicrobial resistance, with widespread support expressed for the NAP. Among all professions, there were varying opinions on whether they felt restricted in their daily work. The tertiary hospitals have established multidisciplinary cooperation mechanisms. Six main themes were identified as both barriers and facilitators to the implementation of the NAP in the medical institutions: individual factors, leadership, multidisciplinary collaboration, patient factors, trainingand culture. The capacity for administrative attention is constrained or limited, poor enforcement of guidelines, insufficient specialist staff and the liability pressure on clinicians were perceived barriers. To containing AMR in medical institutions, management of hospital infections, the public's knowledge of antibiotics' usage, routine education and multidisciplinary support would be facilitators. Practitioners from medical institutions were highly supportive for the NAP. Consideration of practitioners' perceived barriers and facilitators might enhance implementation of the NAP to contain antimicrobial resistance.

Effect of cefazolin sodium and amoxicillin sodium/clavulanate potassium on postoperative infection, pain and expression of inflammatory factors in patients undergoing orthopedic surgery

Purpose: To investigate the comparative effect of two antibacterial treatments in orthopedic surgery.&#x0D; Methods: A total of 96 patients who had undergone orthopedic surgery in Department of Nosocomial Infection Management, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, China from January 2021 to December 2022 were retrospectively analyzed and equally divided into two groups based on the postoperative medications administered to prevent infection. The control group was treated with amoxicillin sodium/clavulanate potassium while the study group was treated with cefazolin sodium. The incidence of postoperative infection, pain score, inflammatory factors and quality of life were determined and compared between both groups.&#x0D; Results: The incidence of postoperative infection in the study group was lower than in the control group (p &lt; 0.05). Prior to intervention, the visual analogue scale (VAS) scores of the two groups were similar (p &gt; 0.05), but decreased significantly after intervention (p &lt; 0.05), with the score of the former after intervention lower than that of the latter (p &lt; 0.05). Prior to intervention, the inflammatory factor levels in both groups were identical (p &gt; 0.05); however, the levels fell significantly in both groups after intervention (p &lt; 0.05), but the levels in the study group were lower than in the control group (p &lt; 0.05). The quality of life scores were also higher for both groups after intervention (p &lt; 0.05), but higher for the study group than for the control group (p &lt; 0.05).&#x0D; Conclusion: Cefazolin sodium is more effective than amoxicillin sodium/clavulanate potassium in preventing infection in orthopedic patients after orthopedic surgery. However, there is a need to extend this treatment strategy to other clinical sites in order to validate these findings.

Factors Affecting the Qualification Rate of Hand Disinfection Among Physicians: A Cross-Sectional Survey.

The objective of this study is to examine the qualification rate of hand disinfection in the surgical department wards and analyze the influencing factors. A surprise assessment was carried out to evaluate the daily adherence to hand hygiene protocols in the surgical department wards. We aimed to investigate the factors that impact the qualification rate of hand disinfection. In this study, the qualification rate of hand disinfection was determined to be 64.38%. Notably, this rate exhibited significant variations based on gender, age, surgical site, and department category. Specifically, the qualification rate of hand disinfection among female participants stood at 82.35%, surpassing the qualification rate observed among male counterparts of 52.83%. Furthermore, doctors in the age group of 41-50 years demonstrated the highest qualification rate, and the abdominal surgical site exhibited the most noteworthy qualification rate, reaching 79.49%. The outcomes of the multiple logistic regression analysis highlighted the significance of age and gender as influential factors impacting the qualification rate. Specifically, doctors aged 51 years or older exhibited the lowest hand hygiene compliance, whereas female doctors demonstrated a notably higher qualification rate compared to their male counterparts. The disheartening qualification rate of hand disinfection highlights a concerning lack of awareness regarding hand hygiene among surgeons in their professional duties. Consequently, targeted interventions are imperative, focusing on intensified training, educational initiatives, enhanced supervision, and internal performance evaluations for key groups. The findings not only serve as a valuable database but also offer a viable roadmap for similar hospitals to reinforce the management of nosocomial infections.

Effects of refined nursing interventions in the operating room on surgical-site wound infection in patients with lung cancer: A meta-analysis.

In this study, a meta-analysis was conducted to assess the effect of refined nursing interventions in the operating room on the incidence of surgical-site wound infections in patients undergoing lung cancer surgery to provide an evidence base for the prevention and management of nosocomial infections. A computerised literature search was used to identify randomised controlled trials (RCTs) on the application of refined nursing interventions in the operating room in patients undergoing lung cancer surgery published in the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang databases from their inception until July 2023. The literature screening, data extraction and quality assessment of the included studies were performed independently by two researchers. RevMan 5.4 software was used for the meta-analysis. Twenty-eight studies were included in the analysis, with a total of 2406 patients, including 1210 patients in the refined nursing intervention group and 1196 patients in the control group. The results of the meta-analysis showed that the refined nursing interventions in the operating room significantly reduced the incidence of surgical-site wound infections in patients undergoing lung cancer surgery, compared with the control group (1.82% vs. 6.52%, odds ratio: 0.30, 95% CI: 0.19-0.47, p < 0.001), and shortened the length of hospital stay (standardised mean difference: -1.51 days, 95% CI: -1.92 to -1.11 days, p < 0.001). Current evidence suggests that the application of refined nursing interventions in the operating room is effective at reducing the incidence of surgical-site wound infections and shortening the length of hospital stay in patients undergoing lung cancer surgery. However, owing to the small number and low quality of the studies, more high-quality RCTs with large sample sizes are needed to confirm these results.

Evaluation of ICUs and weight of quality control indicators: an exploratory study based on Chinese ICU quality data from 2015 to 2020.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.

Contribution to the Personalized Management of the Nosocomial Infections: A New Paradigm Regarding the Influence of the Community Microbial Environment on the Incidence of the Healthcare-Associated Infections (HAI) in Emergency Hospital Surgical Departments.

Background: The management of acute surgical pathology implies not only the diagnosis-treatment sequence but also an important preventive component. In the surgical hospital department, wound infection is one of the most frequent complications which must be managed both in a preventive and a personalized manner. To achieve this goal, several factors of negative local evolution, contributing to the slowdown of the healing processes, such as the colonization and contamination of the wounds, need to be emphasized and controlled from the first moment. In this context, knowing the bacteriological status at admission ensures the distinction between the colonization and infection processes and could help to manage in an efficient way the fight against bacterial pathogen infections from the beginning. Methods: A prospective study was performed for 21 months on 973 patients hospitalized as emergencies in the Plastic and Reconstructive Surgery Department within the Emergency University County Hospital of Brasov, Romania. We analyzed the bacteriological profile of the patients from admission to discharge and the bidirectional and cyclic microorganism dynamics both in the hospital and the community microbial environment. Results: Of the 973 samples collected at admission, 702 were positive, with 17 bacterial species and one fungal, with a predominance of Gram-positive cocci at 74,85%. The most frequently isolated strains were Staphylococcus species (86.51% of the Gram-positive/64.7% of the total isolated strains), while Klebsiella at 8.16% and Pseudomonas aeruginosa species at 5.63% were mainly emphasized in the case of Gram-negative bacilli. Two to seven pathogens were introduced after admission, suggesting that the community microbial environment is in a process of evolution and enrichment with hospital pathogens. Conclusions: The high level of positive bacteriological samples and the complex associations of the pathogens found at the admission bacteriological screening sustain the new idea that the pathogenic microorganisms existing in the community microbial environment have started to increasingly influence the hospital microbial environment, in contrast with the previous consideration, which emphasized only the unidirectional relationship between hospital infections and the changing bacteriological characteristics of the community environment. This modified paradigm must become the basis of a new personalized approach to the management of nosocomial infections.

Preventive Measures and Management of Nosocomial Infections in Ultrasonography Treatment

Preventive Measures and Management of Nosocomial Infections in Ultrasonography Treatment

A Phage Cocktail To Control Surface Colonization by Proteus mirabilis in Catheter-Associated Urinary Tract Infections.

ABSTRACTProteus mirabilis is a biofilm-forming bacterium and one of the most common causes of catheter-associated urinary tract infections (CAUTIs). The rapid spread of multidrug-resistant P. mirabilis represents a severe threat to management of nosocomial infections. This study aimed to isolate a potent phage cocktail and assess its potential to control urinary tract infections caused by biofilm-forming P. mirabilis. Two lytic phages, Isf-Pm1 and Isf-Pm2, were isolated and characterized by proteome analysis, transmission electron microscopy, and whole-genome sequencing. The host range and effect of the phage cocktail to reduce the biofilm formation were assessed by a cell adhesion assay in Vero cells and a phantom bladder model. The samples treated with the phage cocktail showed a significant reduction (65%) in the biofilm mass. Anti-quorum sensing and quantitative real-time PCR assays were also used to assess the amounts of transcription of genes involved in quorum sensing and biofilm formation. Furthermore, the phage-treated samples showed a downregulation of genes involved in the biofilm formation. In conclusion, these results highlight the efficacy of two isolated phages to control the biofilms produced by P. mirabilis CAUTIs.IMPORTANCE The rapid spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial strains and biofilm formation of bacteria have severely restricted the use of antibiotics and become a challenging issue in hospitals. Therefore, there is a necessity for alternative or complementary treatment measures, such as the use of virulent bacteriophages (phages), as effective therapeutic strategies.

Research progress on healthcare-associated infection in patients with extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO), as an effecitive life support technique, is widely used in patients with respiratory and/or cardiac failure. Infection, with a prevalence of approximately 21% in adult patients with ECMO, is one of the most common complications and has a significant impact on mortality. Early identification of infections, and accurate prevention and anti-infective therapies for ECMO patients can improve their survival, but there is a lack of standardized protocols for recognition, diagnosis, management, prevention and treatment of the infections. By analyzing a series of literatures on healthcare-associated infections in patients with ECMO, the epidemiology, pathogens, risk factors, diagnosis, prevention and treatment were summarized to provide a theoretical background for the early identification, diagnosis and patient management of nosocomial infections.

Impact of Molecular Syndromic Diagnosis of Severe Pneumonia in the Management of Critically Ill Patients.

ABSTRACTThe impact of syndromic molecular diagnosis in the management of nosocomial infections caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) pathogens has been incompletely characterized. We evaluated the performance of a molecular syndromic platform (BioFire FilmArray-Pneumonia plus Panel) in patients with pneumonia in the intensive care unit (ICU) of a University Hospital in Greece over a 2-year period. We evaluated 79 consecutive patients diagnosed with pneumonia in the ICU (2018–2020), including 55 patients with ventilator associated pneumonia (VAP). We included 40 control patients diagnosed with pneumonia in the ICU the year before the study (2017–2018). We identified 16 cases of VAP due to XDR bacterial pathogens. We found an excellent agreement (89.4% 76/85 reported results) between the results of syndromic platform and conventional cultures of tracheal aspirates. The molecular syndromic test significantly improved time to diagnosis versus conventional culture (3.5 h vs 72 h, P < 0.0001), and identified new pathogens not detected by cultures in 49% of the cases. However, three cases of pneumonia with targets not included in the molecular platform, were not detected. Implementation of the molecular syndromic facilitated treatment modification from broad to narrow spectrum antimicrobial therapy, resulting in significant reductions in antibiotic consumption in the study group compared to the control group, without a negative impact in patient outcome. The implementation of syndromic molecular diagnosis in critically ill patients with pneumonia is associated with timely and improved diagnosis and has significant impact on reduction of antibiotic consumption.IMPORTANCE The impact of syndromic molecular diagnosis in the management of nosocomial infections caused by MDR/XDR pathogens has been incompletely characterized. We evaluated the performance of a molecular syndromic platform (BioFire FilmArray -Pneumonia plus Panel) in 79 patients with pneumonia in the intensive care unit (ICU) of a University Hospital in Greece over a 2-year period (2018–2020) compared to 40 control patients diagnosed with pneumonia in the ICU the year before the study (2017–2018). Importantly, implementation of syndromic pneumonia panel improved time to diagnosis, identified new pathogens not detected by cultures in 49% of the cases and resulted in a significant reduction in antibiotic consumption compared to the year before initiation of the study without a negative impact in mortality of patients. Collectively, our study demonstrates the positive value of PCR syndromic testing in the management of pneumonia in ICUs high rates of MDR/XDR nosocomial pathogens.

Nosocomial Extracardiac Infections After Cardiac Surgery.

Purpose of ReviewNosocomial extracardiac infections after cardiac surgery are a major public health issue affecting 3–8.2% of patients within 30–60 days following the intervention.Recent FindingsHere, we have considered the most important postoperative infective complications that, in order of frequency, are pneumonia, surgical site infection, urinary tract infection, and bloodstream infection. The overall picture that emerges shows that they cause a greater perioperative morbidity and mortality with a longer hospitalization time and excess costs. Preventive interventions and corrective measures, diminishing the burden of nosocomial extracardiac infections, may reduce the global costs. A multidisciplinary team may assure a more appropriate management of nosocomial extracardiac infections leading to a reduction of hospitalization time and mortality rate.SummaryThe main and most current data on epidemiology, prevention, microbiology, diagnosis, and management for each one of the most important postoperative infective complications are reported. The establishment of an antimicrobial stewardship in each hospital seems to be, at the moment, the more valid strategy to counteract the challenging problems.

Prevalence incidence and clinical outcome of Klebsiella and Acinetobacter ventilator-associated pneumonia

Introduction: Antimicrobial resistance identification for each hospital has benefits in management of nosocomial infections. Objectives: The aim of this study was to determine antimicrobial susceptibility of meropenem against Acinetobacter and Klebsiella strains in samples obtained from hospitalized patients with ventilator-associated pneumonia (VAP). Patients and Methods: In this cross-sectional study, 100 patients with VAP were selected from the intensive care unit (ICU) of Amin hospital in Isfahan. Lung secretions were collected and tested for bacterial infections. In samples with the positive bacterial infection, E-test and agar diffusion test were used to determine and compare the susceptibility of Acinetobacter and Klebsiella strains to meropenem. Results: The two susceptibility testing methods – E-test and agar diffusion test – showed similar results in 87 cases (87%) therefore, 84 cases were resistant and three cases were susceptible to meropenem. However, in 13 cases, the result of the agar diffusion test was resistant and the result of E-test was sensitive. According to the Kappa test, the agreement between the two tests was 0.87 and statistically significant (P &lt;0.001). Conclusion: Due to the high resistance of Klebsiella and Acinetobacter strains to meropenem, it should not be used as an experimental treatment in patients diagnosed with VAP caused by these strains. We recommend using meropenem for Acinetobacter and Klebsiella after susceptibility testing by E-test confirmed its efficacy.

Evaluation of microbial contamination in medical objects: A prospective observational cross-sectional study

Introduction: Healthcare-related infections (HCIs) include those that can be acquired as a result of any health care provided and may be caused by microorganisms present in various personal items of professionals during the provision of health care. The strains of microorganisms found in these personal items have shown high pathogenicity, ease of cross-transmission, and a reduced profile of sensitivity to different antibiotics. Objective: This study sought to assess the microbial contamination of lab coats and stethoscopes by health professionals at a private hospital in Sao Jose do Rio Preto-Sao Paulo, as well as bacterial resistance to antibiotics. This was done due to the complexity of bacterial resistance in the management of nosocomial infections. Methods: The method in which the samples were collected by swab, transferred to BHI broth for 24 hours at 370C, and sown on Mannitol, MacConkey, and Sabouraud. Bacteria with different morphologies were selected from Mannitol and MacConkey for the antibiotic sensitivity test. Bacteria with different morphologies were selected from Mannitol and MacConkey for the antibiotic susceptibility test. Results: The following microbes have been present in the objects: Staphylococcus aureus (48%), coagulase-negative Staphylococcus (37%), bacilli (7%), and Enterococcus sp and yeast fungi (4%). Regarding bacterial resistance to antibiotics, 92% of the bacteria were resistant to penicillin, 65% to erythromycin, 35% to oxacillin, 19% to norfloxacin, 19% to vancomycin, and 4% to gentamicin. Conclusion: This study consolidates to foster a widespread discussion about the role of lab coats and stethoscopes in the propagation of intra-hospital microorganisms to a community and from patient to patient. It has been found that the stethoscopes and lab coats of all health professionals contained microbial contamination, in addition to some multi-resistant antibiotic strains.

Knowledge, Attitude and Practice Toward COVID-19: A Cross-Sectional Study of Staff in China-Guinea Friendship Hospital, Guinea.

BackgroundThe purpose of this study was to assess the level of knowledge, attitude and practice of COVID-19 among staff in China-Guinea Friendship Hospital, and to confirm the effect of nosocomial infection management.MethodsThis cross-sectional study was conducted in December 2021. Information on socio demographic data, knowledge, attitude and practices related to COVID-19 was collected through a self-administered questionnaire.ResultsA total of 143 employees participated in the survey, with a response rate of 99.31% and a vaccination rate of 95.10%. The average knowledge score of COVID-19 was 8.39 ± 1.3 points (10 points in total), without significant differences between subgroups with different demographic variables (P > 0.05); more than 80% of the participants had a positive attitude, and 72.03–93.01% of the participants could take appropriate preventive practices in different environments such as hospital, outdoor or home.ConclusionThe staff of the China-Guinea Friendship Hospital has good knowledge of COVID-19, a positive attitude and appropriate preventive practices. It can be concluded that the current nosocomial infection management is active and effective. Therefore, this study suggests that comprehensive activities such as training, promotion and supervision of COVID-19-related knowledge and countermeasures should be widely and continuously implemented in healthcare facilities, which will continuously improve the overall KAP level of hospital staff and play an important role in curbing the COVID-19 pandemic.

Disinfection of Ultrasound Transducers Using Non-Sterile Tissue Paper in Some Low-Cost Private Ultrasound Centres in Nigeria – Implications for Nosocomial Infection Management

Background/Aims: The incidence of disease outbreaks in clinical settings arising from ultrasound examinations is well documented, and is a source of worry. The ultrasound transducers and the coupling gel are potential sources of these infections since they come in direct contact with the patient’s skin. In this study, we examine the efficacy of the widespread practice of the use of plain non-sterile tissue paper in some low cost private ultrasound centres in our locality as a method of disinfecting ultrasound transducers after each use. Its potential impact on nosocomial infection management in clinical practice is also examined. Methods: Swab samples from convex ultrasound transducers before and after transabdominal scanning of three consecutive patients were obtained from 10 different ultrasound centres in urban and rural areas of Enugu state. Ultrasound coupling gel samples were equally obtained, and all samples cultured for bacteria growth which was quantified in colony forming units per ml (cfu/ml) and reported in 1000/ml. Paired sampled t-test was used to check for significance in reduction in bacterial load before and after the transducer was cleaned.Results: Nine different bacterial strains were isolated. Staphylococcus aureus and Klebsiella spp had the highest percentage of occurrence in all centres. Significant bacteria growth was recorded in the morning before the examination, and plain tissue paper significantly reduced the bacteria load in the ultrasound transducer.Conclusion: Even though disinfecting ultrasound transducers with non-sterile plain tissue paper alone is statistically effective and has the potential to minimize nosocomial infection, it is however not clinically effective and hence not advised.

Management and Prevention of Nosocomial Urinary Tract Infections

BACKGROUND: Nosocomial infections are the leading cause of mortality, due to acquired nosocomial infections. Nosocomial urinary tract infections occur during or after hospitalization in patients who did not have an incubation phase of the infection at the time of admission to the hospital. AIM: In this study, we aim to define and manage nosocomial urinary tract infections in intensive care at University Hospital Center “Mother Teresa” Tirana. MATERIALS AND METHODS: 1350 patients were included in the study, of which 115 patients resulted in nosocomial nosocomial infections. The mean age of patients was 62 ± 16.6 years. RESULTS: Out of 1350 patients hospitalized in the Intensive Care during the period October 2019 - December 2020, 4% of patients result in urinary tract infections or 45% of the total for 115 cases of nosocomial infections. We see that men have a higher percentage than women of being affected by urinary tract infections, it is significant (p &lt; 0.001). The etiological cause of nosocomial urinary tract infections was Escherichia coli in 61.5% of cases. For nosocomial urinary tract infections, patients are monitored for fever, examination of urine complete, and uroculture. The mean hospital stay for patients without nosocomial infection of the urinary tract was 4 days, while that of those with urinary tract infection was 18.49 ± 27.68 (from 5 to 180 days). In comparison to the mean mentioned above, it is significant (p &lt; 0.0001). CONCLUSIONS: Nosocomial urinary tract infections are common in patients admitted to intensive care. Key recommendations should be given on diagnostic strategies, testing, selection of antibiotics as well as duration of treatment. We also need to collect data on how to prevent nosocomial infections in general and nosocomial urinary tract infections in particular.

The Economic Burden of Common Hospital Acquired Infections at Princes Bassma Hospital (PBH) in Jordan in 2019: A Review

Nosocomial infections (NIs) are hospital-acquired infections that occur after 48 hours of admission or discharge, which have ended up a major issue to the hospital industry. The purpose of this study was to examine the economic burden of Nosocomial infection at PBH. It was a retrospective study for the purpose of providing structured opportunities for PBH to reduce the economic burden, prevention, and management of NIs. To measure the cost of NI indorsed, a random sample of 700 patient records was considered in 2019 and retrospectively studied, coordinated with the essential highlights. The cost was estimated and calculated by using a step-down method, and the unit cost was measured in terms of additional hospitalization days. Among 22772 admissions to PBH in 2019, the distribution of 137 conceivable nosocomial contamination cases was found. The internal medicine and surgical wards were seen as the main host of NI in the hospital (medical ward 59.12% and 22.63% in the surgical ward). Escherichia coli was ranked the most prevalent infectious pathogen and discovered in 31 (22.63%); MRSA was found the least dominant (4.38%) of the infected patients. The evidence demonstrates obviously the economic burden of Jordanian Dinar JD10232.53 in PBH in Year 2019, the additional cost of NI in PBH annual budgeted financial requirements, which have to be considered avoidable cost in case of compelling infection control program worked successfully. Compliance with local and global standards for sanitization and sterilization to prevent the spread of hospital-acquired infections need to be investigated carefully.