Prevent Cross Infection Research Articles

Knowledge, attitudes and perceptions of occupational hazards and safety practices in Nigerian healthcare workers.

Background By profession, healthcare workers (HCWs) attend to clients and patients through a variety of preventive and curative services. However, while their attention is focused on providing care, they are vulnerable to hazards that could be detrimental to their health and well-being. This is especially true in developing countries where health service delivery is fraught with minimal protective precautions against exposures to numerous fomites and infectious agents. This study assessed the workplace hazards and safety practices by selected HCWs in a typical health care facility (HCF) in Nigeria.MethodsThe study utilized a descriptive cross-sectional design and stratified sampling technique to identify 290 respondents. The study used mixed methodology and collected data by validated instruments with resulting data analyzed by IBM-SPSS, version 20.ResultsThe results showed that over half of the respondents were registered nurses, female, married (61.7 %) with 5 years median work experience (70.3 %). Most respondents (89 %) were knowledgeable about hazards in HCFs, identified recapping used needles as a risky practice (70 %) and recognized that effective hand washing prior to, and after every clinical procedure in preventing cross infection (100 %). Also, most respondents (96.2 %) believed they were at risk of occupational hazards while about two-thirds perceived the risk as high. In addition, only 64.2 and 87.2 % had completed Hepatitis B and Tetanus immunizations, respectively. Only 52.1 % “always” complied with standard procedures and most (93.8 %) practice safe disposal of sharps (93.8 %) while those that did not (40 %) generally implicated lack of basic safety equipment. In this study, the practice of hand washing by respondents was not influenced by occupation and education.ConclusionsThe high level of knowledge demonstrated by respondents was at variance with practice, therefore, measures aimed at promoting safety practices and, minimizing exposure to hazards such as; provision of safety equipment, pre-placement and routine training of staff on safety practices and adequate reinforcement of staff capacity and capability through drills in all HCFs should be institutionalized and made mandatory. The protocol of the safety training and drills should be responsive to evidence-based emerging and sectoral safety challenges.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-1880-2) contains supplementary material, which is available to authorized users.

Toward improving the World Health Organization fifth moment for hand hygiene in the prevention of cross-infection

The World Health Organization describes that there are 5 moments during a health care encounter when hand hygiene should be performed. This research explores a number of explanatory hypotheses to inform future intervention development with regard to improving compliance with the fifth moment. A sequential, mixed-methods study was conducted using nonparticipant observation and a survey with focus groups informing the development of the questionnaire. A total of 484 participants were observed and 410 returned a postobservation questionnaire; a response rate of 85%. Analysis explored the role of organizational culture, professional culture/practice, and individual-level variables in explaining compliance with the fifth moment. Ninety-three percent of participants performed hand hygiene following the fifth moment. Compliance varied between regions, but not by professional group. More than 65% indicated that the fifth moment was clearly defined, achievable, valuable, encouraged, and widely known. However, 60% suggested that it was repetitive. There was a positive relationship between the performance of hand hygiene following the fifth moment and the perception that it was widely known. Interventions to improve compliance with the fifth moment should focus on promoting awareness of the fifth moment and how it should be implemented in practice. Mechanisms for raising awareness should include education and role modeling.

Prevention of cross infection with ultrasonic diagnostic equipment

Prevention of cross infection with ultrasonic diagnostic equipment

Prevention of cross infection in dentistry-A Review

Prevention of cross infection is a crucial aspect of dental practice therefore dentists must adopt certain basic routines while practising. Heightened awareness among dental practitioners of cross infection risks has meant that barrier procedures (gloves, mask, eye protection) and the use of autoclaves are now common place in the dental surgery.

Prevalence and Associations of Hepatitis B Seropositivity in a Rural African Ophthalmic Surgical Population

Objective: Globally, Hepatitis B virus (HBV) infection remains a public health issue. It is a major cause of morbidity and mortality, especially in developing countries. Working in a healthcare setting particularly in low resource area is a major risk factor for contracting HBV infection. Despite this, routine pre-operative screening for HBV infection has not yet practiced in many Nigerian hospitals. This study assessed the prevalence and associations of hepatitis B seropositivity in a rural south-eastern Nigerian population of ophthalmic surgical patients. Methods: This was a prospective cross-sectional survey of ophthalmic surgical patients at the Presbyterian Joint Hospital—a rural missionary eye care facility in south-eastern Nigeria, conducted between December 2012 and June 2013. Participant’s socio-demographic and clinical data and result of screening for hepatitis B surface antigen (HbSAg) were collected. Results: The participants (n = 100; males, 40; females, 50) were aged 52.9 SD ± 15.4 (range 1 - 88 years). They were predominantly farmers—45% and traders—26% who had cataract—58% and glaucoma—16% as their leading clinical diagnosis indicating ophthalmic surgical intervention. Of them only 2 (2.0%) were sero-positive for HbSAg. HBV seropositivity was not associated with age, gender or occupation. Conclusion: Though the prevalence of hepatitis B viral infection is low in this study, universal measures to prevent cross infection of the healthcare worker is indicated.

Infection control measures among dental practitioners in a Southern state of India: A cross-sectional study

Introduction: The identification of hepatitis B virus, human immunodeficiency virus as an occupational hazard in dentistry urged all practicing dentists, dental auxiliaries, and dental laboratories to employ appropriate infection control procedures. Aim: The aim of this study to investigate whether there is a scope for improvement in the practice of infection control measures. Materials and Methods: A cross-sectional study was conducted using self-administered questionnaire, to obtain information about procedures used for prevention of cross-infection in dental practices. The study subjects, dental practitioners in Guntur district, were obtained using snowball technique. Data were analyzed using SPSS version 19 software. Descriptive and inferential statistics were used to summarize the results and P < 0.05 was considered statistically significant. Results: The mean age of the study population was 36.48 ± 8.94 years. Of the 183 study subjects, 136 (74.3%) were males and 47 (25.7%) females. Of the total practitioners, 45% usually treated ≥10 patients per day, and 52% had the habit of taking medical history for all patients. Statistically significant difference had been found between the practitioners with Bachelor of Dental Surgery and Master of Dental Surgery as their highest qualification, regarding the method of sterilization of handpiece (P = 0.03). Conclusion: This study result suggests that there was a scope for improvement in the practice of infection control procedures among dental care professionals.

Outbreak of Extended Spectrum Beta Lactamase Producing Klebsiella Species Causing Neonatal Sepsis at Patan Hospital in Nepal

Introductions: Klebsiella sepsis is the most important nosocomial infection in neonates. The objectives of this study were to review an outbreak in a neonatal unit caused by Klebsiella species, to identify the source of the infections, and to identify infection control measures for eradication and prevention of these infections. Methods: The case notes and investigation reports of all sepsis cases admitted in neonatal units of Patan hospital from July to December 2011 caused by Klebsiella species were retrospectively reviewed. The demographic profile, risk factors along with clinical features and management of sepsis were reviewed. Results: Twenty three out of 37 neonatal blood cultures grew Klebsiella species. Thirty one were K. pneumoniae and six K. oxytoca. Seventeen of the 31 (55%) K. pneumoniae isolates were multidrug resistant and extended spectrum beta lactamase producers. Eighteen of 23 (78%) neonates with Klebsiella sepsis died. After extensive cleaning methods and identifying an intermittently leaking roof in one of the nurseries below a vescicovaginal fistula room of gynecological ward above, the infection outbreak was finally controlled. Conclusions: Infections with extended spectrum beta lactamase producing Klebsiella spp. are a threat in neonatal units because of limited treatment options for these multidrug resistant organisms. Identification of the source and control of the outbreak can be a challenge. Plain Language Summary: The study was done to review an outbreak caused by Klebsiella species, to identify the source of the infections along with infection control measures for eradication and prevention of these infections in neonate unit. Identification of the source and eradication of the outbreak of Klebsiella species can be a challenge. Hand washing remains one of the most important methods to prevent cross infections and nosocomial infections. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13011 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):20-25

Utilization of Signal-to-Cutoff Ratio of Hepatitis C Virus Antibody Assay in Predicting HCV Viremia among Hemodialysis Patients

Background: Hepatitis C virus (HCV) infection is a common cause of acute and chronic hepatitis among the hemodialysis population. To prevent cross infection between hemodialysis patients during the hemodialysis procedure, routine screening of anti-HCV antibody is recommended. However, a reactive anti-HCV EIA test is not equal to active HCV infection. An expensive RT-PCR study is required to confirm HCV viremia. This will significantly increase the cost burden because payment for each hemodialysis treatment is very low in Taiwan. Thus, it is useful to identify parameters that could predict HCV viremia among anti-HCV-reactive patients. In this study, we examined the usefulness of signal-to-cut (S/CO) ratio of anti-HCV antibody in discriminating HCV viremia from non-viremia among the anti-HCV-reactive hemodialysis population. Materials and Methods: In a cross-sectional measurement of anti-HCV antibody among 369 chronic hemodialysis patients, 44 showed reactive and 9 grey zone reaction for anti-HCV. These 53 patients underwent further blood tests for the measurement of AST, ALT and HCV RNA (by RT-PCR). The results of RT-PCR were used as a dependent variable. Then, S/CO ratios of anti-HCV, serum AST, ALT levels, age and duration of hemodialysis were used as independent variables to undergo ROC curve and logistic regression analysis. Results: Thirty-six of the 53 reactive and grey zone patients were positive for HCV RNA in the RT-PCR study. Patients who were positive for HCV RNA had a higher S/CO ratio (p < 0.01), higher AST and ALT levels (p < 0.01), and longer duration on hemodialysis (p < 0.05) than those negative for HCV RNA. Logistic regression revealed that only S/CO ratio was a significant predictor for HCV viremia (p = 0.004). ROC curve analysis showed that S/CO ratio had a highest area under curve (0.967, p < 0.001), followed by ALT (0.826, p < 0.001), AST (0.778, p = 0.001), duration on hemodialysis (0.606, p = 0.215) and age (0.426, p = 0.386) in discriminating HCV viremia from non-viremia. Using a cutoff S/CO ratio of 65, we can confirm HCV viremia with a diagnostic specificity of 100%, sensitivity of 80.1% and positive predictive value of 100%. Conclusion: S/CO ratio is a useful indicator in predicting HCV viremia among anti-HCV-reactive hemodialysis patients. Patients with an S/CO ratio >65 can be regarded as those with active HCV infection. Alternatively, patients with reactive anti-HCV but with an S/CO ratio <65 should receive further RT-PCR test.

Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in 3 cities in Brazil

Hand hygiene (HH) is the main tool for cross-infection prevention, but adherence to guidelines is low in limited-resource countries, and there are not available published data from Brazil. This is an observational, prospective, interventional, before-and-after study conducted in 4 intensive care units in 4 hospitals, which are members of the International Nosocomial Infection Control Consortium (INICC), from June 2006-April 2008. The study was divided into a 3-month baseline period and a follow-up period. A multidimensional HH approach was introduced, which included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Health care workers were observed for HH practices in each intensive care unit during randomly selected 30-minute periods. We recorded 4,837 opportunities for HH, with an overall HH compliance that increased from27%-58% (P<.01). Multivariate analysis showed that some variables were associated with poor HH compliance: men versus women (49% vs 38%, P<.001), nurses versus doctors (55% vs 48%, P<.02), among others. With the implementation of the INICC approach, adherence to HH was significantly increased. Programs should be aimed at improving HH in variables found to be predictors of poor HH compliance.

Occupational risk involving students of health

Objective: To analyze the social representations of occupational risks involving students in the area of health. Method: Exploratory research with 160 students from nursing, medicine and dentistry, through interviews. The data were processed in ALCESTE 4.8 and lexical analysis done by descending hierarchical classification. Results: In four semantic classes, namely: occupational risks involving students in the area of health, the work environment and occupational risks, exposure to accidents with sharps and adoption of standard precautions as biosecurity measures. Conclusion: Students healthcare represent occupational risks, such as a concern for the prevention of cross infection in the workplace, should both professionals and students of health, adopt standard precautions and biosecurity measures in the environment work.

Honey a sweet approach to alveolar osteitis: A study.

Background:Honey is one of the oldest known medicines. Its use has been rediscovered in later times by the medical profession, especially for dressing wounds. It has been reported from various clinical studies on the usages of honey as a dressing for infected wounds that the wound become sterile in 3-6 days, others have al so reported that the honey is effective in cleaning up infected wound.Materials and Methods:The 54 patients of dry socket were selected from the from the outpatient department of oral and maxillofacial surgery. A diagnosis of dry socket was made clinically. This study was under taken to evaluate the effect of honey dressing in management of dry socket.Results:In this study there was significant reduction if inflammation, hyperemia, edema and exudation after honey dressing that results in soothing effect and reduction in pain and discomfort. There was al so significant reduction in CRP level post operative days .There was side effect of honey was observed in our study, so it can be used as alternative for the management of dry socket.Discussion:It has al so been reported that the honey dressing halt advancing necrosis. It has al so been found to act as barrier preventing wounds from becoming infected, preventing cross infection, and allowing burn wound to heal rapidly.Conclusions:There are no side effects of honey. Excess use of euginol, can lead to necrosis of bone. The honey can be used as medicament for the management of dry socket.

Risk factors for hepatitis C virus sero-positivity among haemodialysis patients receiving care at kidney centre in a tertiary health facility in Maiduguri, Nigeria.

Hepatitis C virus (HCV) is an important health care problem in haemodialysis. Hepatitis C virus is both a cause and complication of kidney diseases. Yet there are limited information on antibody against HCV in patients on haemodialysis. The purpose of this study was to determine the prevalence of anti-HCV and the risk factors associated with HCV infection in a cohort of 100 participants on haemodialysis. They were consecutively recruited into the study, anti-HCV testing was made by the 3rd-generation ELISA System (C-100, C-33c, C-22). The prevalence of HCV antibody was 15%, risk factors associated with HCV antibody were history of blood transfusion and duration of session of haemodialysis; the risk increased with increased with the number of blood transfusion and seasons of haemodialysis. The observed high prevalence of HCV antibody among patients on haemodialysis reflect the quality of healthcare services and the standards of infection control practices in our haemodialysis units. Routine screening for HCV should be done before blood transfusion using third generation ELISA assays with high sensitivity and specificity. Safety measures should be taken in our haemodialysis units to prevent cross infection among patients and staffs. These safety measures include; discarding syringes, needles, gloves, bloodlines and dialysers after single use, and the use of sterile dressings on each patient visit.

Bamboo rayon–copper nanoparticle composites as durable antibacterial textile materials

Antibacterial textiles are gaining increasing importance due to consumer awareness of health and hygiene. Cellulose-containing polymers, like bamboo rayon, are prone to microbial attack which restricts their application in medical textiles. Metal nanoparticles are widely used for antibacterial modification of textile polymers; however, less durability to washing is considered to be a severe limitation. In the current study, bamboo rayon fabric grafted with acrylic acid was utilized as a backbone to immobilize copper nanoparticles. The modified product was characterized using Fourier transform infrared, thermo gravimetric analysis and scanning electron microscopy analysis. The change in appearance of the fabric was measured using a spectrophotometer. The grafted bamboo rayon–Cu nanoparticles composite fabric was then evaluated for antibacterial activity against both Gram positive and Gram negative bacteria and the durability of their antibacterial activity to washing. The product showed antibacterial activity against both types of bacteria which was found to be durable till 50 washings. The release study showed lower release of nanoparticles in aqueous media indicating better immobilization of nanoparticles on grafted bamboo rayon. The material can be claimed as suitable candidate for medical textile applications to prevent cross infections.

The effect of SOLO and sodium hypochlorite disinfectant on some properties of different types of dental stone

Background: Dental casts come into direct contact with impression materials and other items that are contaminated by saliva and blood from a patient's mouth, leaving the casts susceptible to cross-contamination. The disinfectant solutions of the impression materials cause various adverse reactions. Therefore, disinfection of dental casts may be effective in preventing cross infection. This study was carried out to evaluate the surface hardness, dimensional accuracy, reproduction of details and surface porosity of type III, type IV and type IV extra hard dental stone after immersion in and spray by using SOLO and Sodium hypochlorite disinfectant solutions. Materials and methods: 240 Stone samples were prepared in rubber rings, A total of 60 test block were prepared for each test (surface hardness, dimensional accuracy, reproduction of details and surface porosity).the samples were divided into three groups (20 for each type of stone) type (III, IV, IV extra hard); SOLO and Sodium hypochlorite disinfectant by 2 methods (immersion and spray) were used in each test. Results: the results of dimensional accuracy, reproduction of details, surface hardness and surface porosity revealed no significant difference for all types of tested stone samples after immersion or spraying in SOLO and NaOCl except the surface hardness of type IV extra hard showed significant difference after spray with SOLO and the surface porosity of type IV extra hard showed significant difference after immersed in both SOLO and NaOCl solutions. Conclusions: Based on the results of this study immersion in and spray by using SOLO and NaOCl disinfectant solutions produced no adverse effect on dimensional accuracy, reproduction of details, surface hardness and surface porosity for type III, type IV dental stone and for type IV extra hard dental stone except for the surface hardness for type IV extra hard when sprayed with SOLO and the surface porosity when type IV extra hard stone immersed in the SOLO and NaOCl solutions.

P111: It is not in your hands!

Hand hygiene (HH) is well-recognised as part of best practice in preventing cross infection. In light of the P.aeruginosa outbreak in neonatal units in the UK, it is recommended that healthcare workers (HCWs) should routinely use alcohol hand rub after hand washing in all augmented care areas. Since this practice may lead to dermatitis, we have conducted this study to assess whether use of alcohol hand rub was necessary after hand washing (HW) as we were unable to find any scientific papers to support this recommendation.

Efficacy of ATP Bioluminescence as an Evaluation Method of Endoscopic Disinfection

The endoscopy has a higher risk of cross infection and due to its delicate structure and the nature of the material, the cleaning and disinfection process requires careful reprocessing to prevent cross infection. Recently, the ATP bioluminescence has been used to monitor the cleaning management in the medical environment. The ATP bioluminescence, therefore, may have a potential role in monitoring the reprocessing of endoscopes. The purpose of this study is to evaluate efficacy of ATP tracer as the method in the management of the endoscope reprocessing.

Green synthesis of silver nanoparticles by Chrysanthemum morifolium Ramat. extract and their application in clinical ultrasound gel

Eco-friendly green synthesis with plant extracts plays a very important role in nanotechnology, without any harmful chemicals. In this report, the synthesis of water-soluble silver nanoparticles was developed by treating silver ions with Chrysanthemum morifolium Ramat. extract at room temperature. The effect of the extract on the formation of silver nanoparticles was characterized by ultraviolet and visible absorption spectroscopy, X-ray diffraction, transmission electron microscopy, and Fourier transform infrared spectroscopy. The ultraviolet and visible absorption spectroscopy results show a strong resonance centered on the surface of silver nanoparticles (AgNP) at 430 nm. The Fourier transform infrared spectroscopy spectral study demonstrates Chrysanthemum morifolium Ramat. extract acted as the reducing and stabilizing agent during the synthesis. The X-ray diffraction analysis confirmed that the synthesized AgNP are single crystallines, corresponding with the result of transmission electron microscopy. Water-soluble AgNP, with an approximate size of 20 nm–50 nm were also observed in the transmission electron microscopy image. The bactericidal properties of the synthesized AgNP were investigated using the agar-dilution method and the growth-inhibition test. The results show the AgNP had potent bactericidal activity on Staphylococcus aureus and Escherichia coli, as well as a strong antibacterial activity against gram-negative bacteria, as compared to gram-positive bacteria with a dose-dependent effect, thus providing a clinical ultrasound gel with bactericidal property for prevention of cross infections.

Changes of drug-resistance of Pseudomonas aeruginosa in pediatric intensive care unit

Pseudomonas aeruginosa is an important cause of nosocomial infection, severe sepsis and death which associated with a trends of rising rates of resistance to a broad array of antimicrobial agents. To explore a feasible treatment protocol for such patients, we analyzed the susceptibility patterns of Pseudomonas aeruginosa in pediatric intensive care unit (PICU). The age distribution, outcome of patients, sources of strains and susceptibility patterns of Pseudomonas aeruginosa in PICU from Jan 1, 2007 to Dec 31, 2011 were analyzed. Susceptibility to amikacin, piperacillin/tazobactam, aztreonam, ampicillin, ciprofloxacin, imipenem, meropenem, cefepime, cefoperazone, cefotaxime, ceftriaxone, ceftazidime, cefoperazone/sulbactam, cephazolin, cefuroxime, and polymyxin were determined by the disk-diffusion technique (K-B test method) and broth microdilution. P. aeruginosa ATCC 27853 was used as reference strain. Seventy-five patients were Pseudomonas aeruginosa positive. 26(34.7%) were < 6 m, 49 (65.4%) were < 2 y. The percentages of cases who were Pseudomonas aeruginosa positive in different age groups in the same time was basically similar; 18 (24.0%) cases died. Pseudomonas aeruginosa accounted for 10.9% of G(-) germs, 6.5% of all pathogens in 2010 - 2011. Of the 126 strains, 83 (65.9%) were from sputum sample, 31 (24.6%) were from catheter sample of tracheal cannula, 10 (7.9%) were from blood sample and 2 (1.6%) were from secretion sample. The sensitivity to antibiotics of Pseudomonas aeruginosa in pediatric common treatments was 72.4% to cefoperazone/sulbactam, 71.5% to meropenem, 48.4% to imipenem, 66.7% to ceftazidime, 49.2% to piperacillin/tazobactam. Absolute resistance to ampicillin, cephazolin, cefuroxime and cefotaxime. Multiple-drug resistance was still severe, but a decreasing tendency was observed, 90.5% in 2007, 81.3% in 2008, 51.1% in 2009, 53.8% in 2010, 33.3% in 2011. Pan-drug resistance in different years was similar, 12.5% in 2008, 2.2% in 2009, 7.7% in 2010, 6.7% in 2011. The condition of drug resistance of Pseudomonas aeruginosa was still rigorous, we should conduct surveillance and prevent abusing antibiotics in order to avoid exacerbating drug resistance. We should improve testing technique, early and appropriate empirical antibiotics therapy is crucial according to clinical experience and antibiotic sensitivity. The effective treatment of P. aeruginosa is paramount to prevent multidrug resistance. The use of combination therapies for P. aeruginosa infection has been a long-advocated practice. To prevent hospital acquired cross infection, health care workers must pay close attention to hand sanitation and sterile operation strictly.

Upaya pencegahan yang dilakukan oleh dokter gigi di Makassar terhadap bahaya akibat penggunaan amalgam Prevention of dentists in Makassar to the risk of amalgam

Makassar is a big city with the highest number of dentists in South Sulawesi. Currently there are many dentists in thecity of Makassar using amalgam as a filling material for cheaper and more durable, so it is preferred by patients.Generally, they have ignored the dangers of exposure to mercury in amalgam through breathing or skin contact. For itwas on this descriptive observational study noted the efforts of Makassar dentist to prevent hazards due to the use ofamalgam in practice. From the general population of dentists who were registered as members of the IndonesianDentists Association (IDA) branch Makassar as much as 258 people, based on the opinions of Gay and Diehl withanticipation drop out of 20%, was obtained a sample of 100 people, but only 67 respondents (male = 13, female = 54)uses amalgam. The results are efforts to prevent the danger of amalgam achieved 51-75% by 32 respondents (47.7%),76-100% by 25 respondents (37.3%), 26-50% by 10 respondents (15%), and no respondents who seek prevention ofcross infection hazard to the achievement of 0-25%. Efforts to prevent with the achievement of 51-75% (32respondents) and 76-100% (25 respondents), could be said to have met the standard, concluded that 85% of dentists inMakassar have good enough prevention efforts to amalgam while doing their practice.

"Life in a Germ-Free World": Isolating Life from the Laboratory Animal to the Bubble Boy

This article examines a specific technology, the germ-free "isolator," tracing its development across three sites: (1) the laboratory for the production of standard laboratory animals, (2) agriculture for the efficient production of farm animals, and (3) the hospital for the control and prevention of cross-infection and the protection of individuals from infection. Germ-free technology traveled across the laboratory sciences, clinical and veterinary medicine, and industry, yet failed to become institutionalized outside the laboratory. That germ-free technology worked was not at issue. Working, however, was not enough. Examining the history of a technology that failed to find widespread application reveals the labor involved in aligning cultural, societal, and material factors necessary for successful medical innovation.