Prevention Of Nosocomial Infections Research Articles

Lactobacillus rhamnosus GG treatment improves intestinal permeability and modulates microbiota dysbiosis in an experimental model of sepsis.

Decrease of 'health-benefiting' microbes and increase of pathogenic bacteria (a condition termed dysbiosis) in intensive care unit patients is considered to induce or aggravate sepsis (gut-origin sepsis). Orally administered probiotics have been effective in the prevention of nosocomial infections. However, the mechanisms of probiotic-induced anti-infection and anti-sepsis remain to be explored. In the present study, 4-week-old C57BL6 mice were orally administrated with Lactobacillus rhamnosus GG (LGG) or normal saline (control) 4 weeks prior to cecal ligation and puncture (CLP). A subset of the mice were sacrificed at 24 h post-CLP, and the others were used for survival studies. Ileum tissues, blood and fecal samples were collected. The survival rate of septic mice pretreated with LGG was significantly improved compared with untreated mice. The levels of inflammatory cytokines were reduced in LGG-pretreated septic mice. A decrease of colonic proliferation and epithelial tight junctions and an increase of colonic apoptosis were observed in control septic CLP+saline mice. LGG pretreatment reversed the colonic proliferation, apoptosis and expression of tight junction proteins to the levels of the sham group. LGG pretreatment improved the richness and diversity of intestinal microbiota in septic mice. The principal coordinates analysis clustering plots revealed a significant separate clustering in microbiota structure between three groups. Bacteria associated with energy consumption, including Bacteroidetes, with opportunistic infection, including Proteobacteria, Staphylococcaceae and Enterococcaceae, lipopolysaccharide producers, including Enterobacteriaceae, and facultative anaerobes, such as Bacteroidaceae and Erysipelotrichaceae, increased in septic mice. By contrast, bacteria associated with energy harvest, including Firmicutes, intestinal barrier function regulators, including Akkermansia, hepatic function regulators, including Coprococcus and Oscillospira, and obligate anaerobes, including Prevotellaceae, decreased in septic mice. With LGG pretreatment, the sepsis-induced microbiota dysbiosis was reversed. The present results elucidated the potential mechanism of LGG treatment in sepsis, by improving intestinal permeability and modulating microbiota dysbiosis.

Infection management strategy based on prevention and control of nosocomial infections in intensive care units.

Infection management strategy based on prevention and control of nosocomial infections in intensive care units.

THE RELATIONSHIP OF NURSING KNOWLEDGE REGARDING NOSOCOMIAL INFECTIONS ON PREVENTIVE BEHAVIORS OF NOSOCOMIAL INFECTIONS IN SALAK HOSPITAL OPERATING ROOM

Nosocomial infection or also called hospital-acquired infection occurs in patients who are hospitalized for at least 72 hours and the patient does not show symptoms of infection when admitted to hospital. Riskes data shows the level of nosocomial infection in Indonesia reaches 6-16% with an average of 9.8%. In 2006 Indonsia had the percentage of nosocomial infections was obtained in Lampung Province reached 4.3%, Jambi 2.8%, DKI Jakarta 0.9%, West Java 2.2%, then Central Java 0.5%, and Yogyakarta 0.8 %. Knowing the relationship between nurses' knowledge about nosocomial infections on the prevention behavior of nosocomial infections in the Salak hospital operating room Bogor in 2018 This type of research uses quantitative analytic descriptive study with Cross Sectional research design. The sampling method uses total sampling with the population are nurses in the operating room and data were obtained by 30 respondents. The data collection is obtained through questionnaires. The results showed that from a total of 30 respondents 17 respondents (56.7%) stated that nurses were well-informed, 18 respondents (60.0%) stated that nurses behaved positively. The results of the behavior of prevention of nosocomial infection there were 16 respondents (53.3%) nurses had knowledge with positive behavior. The results of statistical tests obtained p value = 0,000 which means that p value <0.05. At the conclusion of the statistical test, there was a relationship between nurses' knowledge about nosocomial infections on the prevention behavior of nosocomial infections in the operating room Salak hospital of Bogor in 2018

Screening and Prevention of Nosocomial Infections in Neonatal Intensive Care Unit (NICU)

Screening and Prevention of Nosocomial Infections in Neonatal Intensive Care Unit (NICU)

Factors Influencing Nurses’ Compliance Level in the Application of Hand Hygiene in Inpatient Wards of Muntilan General Hospital

Infectious diseases are still the leading cause of morbidity and mortality in the world. One of the infections was a nosocomial infection. Nurses have appreciable influence regarding nosocomial infection incident because nurses have a great deal of interaction with the patient during 24 hours. The prevention of nosocomial infection can be conducted by a nurse is with hand hygiene practice. The purpose of this research is to know factors influencing nurses ’ compliance level in the application of hand hygiene at in inpatient ward of Muntilan General Hospital. This was a quantitative research with research design cross-sectional. The sampling technique used was the Proportionate Stratified Random Sampling with t he number of respondents was 54 nurses. The instrument of the research applied a questionnaire and checklist. Analyses of the data used were the Chi-Square test. This research indicated there was a correlation between motivation with a compliance level of nurses in application of hand hygiene ( p-value 0.000 0,05 ).

Современные представления об эффективности и практические подходы к применению пробиотиков в клинической практике: фокус н Lactobacillus rhamnosus GG и Bifidobacterium lactis Вb-12

Over the last 20 years, there is an ever-increasing interest in the use of probiotics for the variety of health problems worldwide. However, the evidence base for various probiotic microorganisms differs significantly. This review provides data on the efficacy of the two best-studied probiotic strains with established positive effects on human health, namely *Lactobacillus rhamnosus* GG and *Bifidobacterium lactis* Bb-12. The efficacy of probiotics for the treatment of acute diarrhea, prevention of antibiotic-associated diarrhea and nosocomial infections, as adjuvant therapy in *H. pylori*-associated diseases was proven in numerous clinical studies. The evidence of positive effects of probiotics on the prevention of respiratory tract infections in children, in patients with atopic dermatitis and other medical conditions is also discussed. The practical guidelines of the international societies on the use of probiotics are reviewed. A particular attention is paid to dosing and safety issues in the use of *L. rhamnosus* GG and *B. lactis* Bb-12 in clinical practice, including vulnerable patient categories.

Integron Expression in Multidrug-Resistant Escherichia coli Isolated from House Flies within the Hospital

Escherichia coli is a serious cause of a variety of hospital-acquired infections and commonly contributes to the environment by house flies. Integrons, particularly class 1 integrons, are the genetic elements that play an important role in the horizontal transfer of antimicrobial resistance mechanism. This mechanism is commonly found in Enterobacteriaceae, especially E. coli. In this study, we aim to investigate the occurrence and antimicrobial resistance patterns of E. coli isolated from the house flies in Phayao hospital and to determine the gene expression of class 1 integrons in those isolates of E. coli. Totally, 70 isolates of E. coli were isolated from 60 house flies collected from the hospital. Fifty-seven of the isolates (81.43 %) were multidrug resistance (MDR) and highly resistant to b-lactams, tetracyclines, and sulfonamides. Of 57 isolates of MDR-E. coli, 20 isolates (35 %) were found to carry class 1 integron genes. Fifteen patterns of antimicrobial resistance occurred in the isolates of integron-positive E. coli. Most integron-positive E. coli isolates were resistant to 7 antimicrobials. Two isolates of these bacteria (10 %) were able to resist 13 out of 14 tested antimicrobials. Using PCR and sequencing analysis, an investigation showed that dfrA17-aadA5, dfrA12-aadA2 gene cassette was the most prevalent cassette (n = 10; 50 %) among the integron-positive E. coli isolates. Our results indicated that the presences of multidrug resistance and class 1 integrons were common in E. coli isolated from the houseflies in hospital. Therefore, screening for integron-positive E. coli from the hospital environment might be necessary for prevention of nosocomial infections.

Comparison of effect of propofol and sevoflurane on pulmonary function, inflammatory factors and postoperative pulmonary infection in elderly patients with esophageal carcinoma

Objective To explore the effect of propofol on pulmonary function, inflammatory factors and postoperative pulmonary infection in elderly patients with esophageal carcinoma, and to provide data for prevention and control of nosocomial infection. Methods From January 2011 to December 2015, 155 elderly patients with esophageal cancer in Lishui Central Hospital were selected and randomly divided into control group (C group, n=70) and observation group (O group, n=85) according to the digital table.In the maintenance of anesthesia, O group was given propofol, C group was given sevoflurane.The alveolar arterial oxygen partial pressure difference(PA-aO2), respiratory index(RI) and oxygenation index(OI) of the two groups were observed at different time points.The levels of IL-1, IL-6 and IL-10 in serum were measured at different time points, and the pulmonary infections were observed after operation. Results At 30min, 60min, 90min after ventilation in the two groups, the PA-aO2, RI were higher than the beginning of mechanical ventilation, OI were lower than the beginning of mechanical ventilation (t=7.266, 23.451, 9.572, 8.009, 30.836, 17.158, 4.908, 21.237, 21.350, 7.010, 23.644, 10.039, 9.099, 34.254, 16.679, 8.217, 35.434, 22.160, all P 0.05]. Conclusion Elderly patients with esophageal cancer undergoing radical operation of propofol, the effects of propofol on pulmonary function, inflammatory factors are less, the incidence of postoperative pulmonary infection is low, it has good clinical application value. Key words: Esophageal Neoplasms; Esophagectomy; Propofol; Sevoflurane; Aged

Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic Adjuvant Cancer Therapy, to Complement Immune Checkpoint Therapy and Other Traditional Cancer Therapies, with Least Auto-immune Side Effects through Eco-balance of Human Microbiome

This paper describes a novel serendipitous discovery to successfully treat cancer with improved efficiency emerged while using Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic Therapy (originally discovered to prevent or treat nosocomial infections) as an adjuvant therapy along with the immune checkpoint therapy and other conventional cancer therapies. This new discovery is named as “Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic Adjuvant Cancer Therapy”. Cancer is rising as a global epidemic, currently killing over 9 million people every year. This figure is supposed to get up to 13 million by the year 2030. The cancer epidemic is more prevalent in the Western countries than Eastern countries. The cost of treating cancer was $290 billion in the year 2010 and it is supposed to get up to $458 billion/year by the year 2030. Recently checkpoint immune therapy is showing great promise as a treatment tool. Yet the global success in treating the cancer is only 20% or slightly higher, with all the advancements and discoveries. A new paradigm shift in cancer treatment has been discovered as serendipitous discovery to enhance the efficiency of the existing cancer therapies significantly. This serendipitous discovery came as a surprise while running community based clinical trials using the novel discovery of Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic Therapy to prevent or cure the hospital acquired or nosocomial infections, which are affecting over six million people with severe mortality. Several physicians have observed that Dr. Reddy’s Probiotic therapy given for prevention or control of nosocomial infections significantly helped the recovery of cancer patients who were also receiving standard cancer therapies. This article outlines the mechanism by which Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic Therapy assist to cure cancer at a much faster pace, with the least side effects, when used as adjuvant therapy along with the immune checkpoint therapy, and other standard cancer therapies. Details are presented how the PD-1 and CTLA-4 blockade therapy works to reduce cancer and also the possible scientific explanations why such an immune checkpoint therapy only works on limited cancer cases. The effect of Multiple Mixed Strain Probiotics on establishing the immune tolerance through reduction of local or systemic inflammation is also outlined. The possible biological and immunological mechanisms of how Multiple Mixed Strain Probiotic Therapy significantly enhances the immune checkpoint therapy (PD-1 and CTLA-4 blockade) has been presented with explicit details. The details are also presented showing how Multiple Mixed Strain Adjuvant Therapy can minimize or significantly reduce the unpleasant side effects of the current conventional and immune checkpoint cancer therapies. Practical clinical and experimental data presented to show the significance of Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic Therapy, as an adjuvant therapy, along with the standard cancer therapies to improve the cancer treatment efficiencies by up to 60%. Evidence is presented to illustrate and point out that the current FDA regulations will allow the use of Dr. M.S. Reddy’s Multiple Mixed Strain Probiotic (Therapy) as nutritional supplement, since the probiotic strains used are categorized as food grade and GRAS (Generally Regarded as Safe), as per the 21 Code of Federal Regulations of the Food and Drug Administration. Details are presented with genus and species identification of individual probiotic strains used in the Multiple Mixed Strain Probiotic Therapy. Thus special and formal FDA approval is not required to use them as adjuvants to improve the efficiency of traditional cancer therapies. Finally the scientific reasoning is presented with evidence to illustrate the utmost urgency and necessity of using Dr. M.S. Reddy’s “Multiple Mixed Strain Probiotic Therapy” along with the immune checkpoint therapy and other traditional cancer therapies to protect the lives of millions of people dying with cancer annually.

Preliminary study on resistance mechanism and virulence features in carbapenems-resistant Klebsiella pneumoniae from burn patients

Objective: To investigate resistance mechanism and virulence features of carbapenems-resistant Klebsiella pneumoniae (CRKP) and to provide theoretical foundation for the prevention and control of nosocomial infections in burn wards as well as clinical therapy of CRKP. Methods: Strains of Klebsiella pneumoniae isolated from clinical samples of burn patients hospitalized in our unit from February to December 2016 were collected. The diameters of inhibition zone of imipemen or meropenem susceptibility disk of the above strains were≤22 mm. Kirby-Bauer disk diffusion method and automated instrument were applied to test drug resistance of the strains to 17 antibiotics of cephalosporins, aminoglycosides, sulfonamides, quinolones, and carbapenems. Pulsed-field gel electrophoresis (PFGE) was used to analyze homology of the strains. Crystal violet staining was applied to assess ability of biofilm formation of the strains. The hypermucoviscosity (HM) phenotype of the strains was determined by string test. Polymerase chain reaction was used to detect common carbapenemase genes of bla(KPC), bla(IMP), bla(OXA-48), and bla(NDM), capsular serotype genes of K1, K2, and K57, and virulence-associated gene of rmpA. Results: (1) A total of 29 CRKP strains were isolated. The 29 CRKP strains were with high drug resistance rate to carbapenems antibiotics of imipenen, meropenem, and ertapenem, and cephalosporins, aminoglycosides, and quinolones antibiotics, while the strains were with low drug resistance rate to sulfonamides antibiotics and tegafycline. (2) The 29 CRKP strains had 4 types of A, B, C, and D according to PFGE, with 11 strains of type A, 10 strains of type B, 6 strains of type C, and 2 strains of type D. (3) Among the 29 CRKP strains, 25 strains were positive in biofilm formation, with positive rate of 86.2%. (4) None of the 29 CRKP strains was positive in the string test with HM phenotype. (5) All the 29 CRKP strains carried carbapenemase genes. Among the 29 CRKP strains, 11 strains carried both bla(NDM-1) and bla(OXA-48) genes, 1 strain carried both bla(NDM-1) and bla(KPC-2) genes, 12 strains only carried bla(KPC-2) gene, and 5 strains only carried bla(NDM-1) gene. The 79.3% (23/29) strains were completely resistant to 3 kinds of carbapenems antibiotics. (6) Among the 29 CRKP strains, 3 strains carried K2 gene, 2 of which were completely resistant to 3 kinds of carbapenems antibiotics, 1 strain carried rmpA gene, and no strain carried K1 or K57 gene. Conclusions: The detection rate of CRKP isolated from burn patients hospitalized in our unit is high. The strains are mostly extensively drug-resistant bacteria, and the mechanism of drug resistance of which is complicated. There may have clonal spread of CRKP. And appropriate measures should be taken timely and effectively to prevent nosocomial spread of CRKP.

Use of Probiotics in the Prevention of Nosocomial Infections.

Nosocomial, hospital-acquired or health care-associated infections occur worldwide, affecting both developed and developing countries. This results in a prolonged hospital stay, increased antimicrobial resistance, increased mortality rate, and significant financial burden on the health care system. Routine preventive measures have led to the decrease in infection spreading; however, it cannot successfully prevent all of them, making a place for the development of new strategies, including probiotics. The aim of this review was to summarize available evidence of the role of probiotics in the prevention of nosocomial infections in children. Currently there is enough evidence showing that Lactobacillus rhamnosus GG administrated in a dose of at least 10 colony-forming units per day during the hospital stay can significantly reduce a risk for nosocomial diarrhea at regular pediatric ward. For other indications including the risk of respiratory tract infections at regular pediatric ward or risk of nosocomial infections at intensive care units we do not have enough evidence to give a recommendation. Therefore, additional research is needed to increase our knowledge and possibly further improve clinical practice.

Lactobacillus rhamnosus GG: clinical aspects of the use from the perspective of evidence-based medicine

This review provides information on the composition and functions of the intestinal microbiota, its role in the immune development. At present, prophylactic and therapeutic uses of probiotics are widely common for a variety of pathological conditions, however they have proven efficacy only in certain diseases. This review provides information on the efficacy of the use of probiotic microorganismL. rhamnosusGG in the paediatric practice as one of the most studied and tested strains. It summarized the currently available evidence on the efficacy of its use for the treatment of acute diarrhea, the prevention of antibiotic-associated diarrhoea and nosocomial infections, defined the role ofL. rhamnosusGG in the prevention of respiratory tract infections and gastrointestinal infections in children, considered its therapeutic and preventive use in allergic diseases and other nosological forms. Special attention was paid to the effect ofL. rhamnosusGG on the immune system functioning. The results of this strain test as adjuvant vaccines are also encouraging. The review describes the molecular mechanisms of action ofL. rhamnosusGG, which provide immunomodulating effect of this strain. In addition, it presents data on the clinical efficacy of Normobact L synbiotic comprising a combination of LGG (4 x 109) and fructooligosaccharides (800 mg), which is approved for use in children in Russia.

Risk factors associated with nosocomial infections in the Neonatal Intensive Care Unit at Mahatma Gandhi Memorial hospital between 2014 and 2015

Background: Nosocomial infections are one of the main causes of neonatal morbidity and mortality in low- and middle-income countries. The neonatal intensive care unit is a suitable environment for disseminating infections. The aim of this study was to identify risk factors associated with having a nosocomial infection in the neonatal intensive care unit at Mahatma Gandhi Memorial hospital between 2014 and 2015.Methods: An observational, analytical case-control study was conducted at the neonatal intensive care unit at Mahatma Gandhi Memorial hospital in 2017 following ethical approval (BE336/16). A retrospective review of medical records for a sample size of 144 cases and 144 matched controls from 2014 to 2015 was analysed. Descriptive statistics were presented and multivariate conditional logistic regression was used to determine associations between the independent variables and having a nosocomial infection.Results: A total of 144 neonates developed nosocomial infections as proven by positive cultures with Klebsiella pneumoniae being most frequent (n = 60; 41.67%). On multivariate logistic regression analysis, multiple deliveries, low birth weight, respiratory distress, prematurity, neonatal jaundice, hyaline membrane disease, the use of total parenteral nutrition, blood transfusion and surfactant administration, immediate use of oxygen and intravenous fluid and central line insertion were significantly associated with having a nosocomial infection (p ≤ 0.001).Conclusion: Neonatal-related factors and treatment modalities were identified as factors that increased the risk for nosocomial infections. A review of treatment modalities and related infection prevention and control in neonatal management are the key to prevention, early detection and management of nosocomial infections.

Safe and Effective Outpatient 2-Jaw Orthognathic Surgery

Orthognathic surgery has evolved significantly over the past 20 years. Advancements in surgical technique, rigid internal fixation, and virtual surgical planning have drastically improved the quality and efficiency of treatment. Due mostly to concerns about potential airway problems, orthognatic surgery has traditionally required inpatient management. As a major medical center in a large metropolitan area, we perform approximately 300 orthognathic surgeries per year. The rising cost of hospitalization, increased focus on prevention of nosocomial infections, and limited-bed availability have increased our organization’s focus on limiting hospital stays. Accordingly, with the help of our anesthesia colleagues, we have developed a safe and efficient protocol that allows us to perform 2-jaw orthognathic surgery on an outpatient basis.

Bacterial Distribution and Risk Factors of Nosocomial Blood Stream Infection in Neurologic Patients in the Intensive Care Unit.

To investigate the risk factors and analyze the distribution of pathogens to provide a basis for the prevention of nosocomial blood stream infections (BSI) and reduce the incidence and mortality of nosocomial BSI in neurologic patients. A retrospective chart review of neurologic patients admitted to an adult intensive care unit from January 2012 to December 2017 was conducted. Every positive blood culture, clinical demographic, microbiologic and laboratory result, as well as 28-day outcome data, were compiled on a data collection sheet. The clinical significance of each isolate was determined; in addition, the antimicrobial susceptibilities of causative pathogens and the most likely source were recorded. During the five-year study period, there were 121 nosocomial BSI yielding 151 isolates in 404 neurologic patients. Eighty-one percent of nosocomial BSI were monomicrobial. Gram-positive organisms caused 67.9% of these BSI, gram-negative organisms caused 32.1%, and fungi caused 0.8%. The crude incidence rate was approximately 29.9%, and the mortality of nosocomial BSI was as high as 29.8%. Intravascular lines were the most common source of nosocomial BSI (79.3%). The most common organisms causing BSI were coagulase-negative staphylococci (CoNS; 44.6% of isolates), Staphylococcus aureus (17.4%), Klebsiella species (11.5%), and Acinetobacter spp. (11.5%). Multivariable regression analysis revealed that the use of antibiotic agents in the 90 days prior (odds ratio [OR], 5.81; 95% confidence interval [CI], 3.18-10.62; p = 0.001), brain trauma (OR, 0.28; 95% CI, 0.15-0.51; p = 0.001), and transfusion (OR, 3.02; 95% CI, 1.45-6.29; p = 0.001) were significant predictors of nosocomial BSI. The incidence and mortality of nosocomial BSI were high in our neurologic patients. Strictly aseptic operations, hand hygiene, and reasonable use of transfusions and antibiotic agents are effective measures to prevent nosocomial BSI.

Prevention of Nosocomial Infections in Critically Ill Patients With Lactoferrin: A Randomized, Double-Blind, Placebo-Controlled Study

To obtain preliminary evidence for the efficacy of lactoferrin as a preventative measure for nosocomial infections and inform the conduct of a definitive study. Phase 2, multicenter, randomized, double-blind, placebo-controlled study. Medical-surgical ICUs. Adult, critically ill patients receiving invasive mechanical ventilation. Randomized, eligible, consenting patients expected to require invasive mechanical ventilation more than 48 hours received lactoferrin both enterally and via an oral swab or a placebo of sterile water for up to 28 days. Of the 214 patients who were randomized, 212 received at least one dose of the intervention and were analyzed (107 lactoferrin and 105 placebo). Protocol adherence was 87.5%. Patients receiving lactoferrin were older (mean [SD], 66.3 [13.5] vs 62.5 [16.2] yr), had a higher Acute Physiology and Chronic Health Evaluation II score (26.8 [7.8] vs 23.5 [7.9]), and need for vasopressors (79% vs 70%). Antibiotic-free days (17.3 [9.0] vs 18.5 [7.1]; p = 0.91) and nosocomial infections (0.3 [0.7] vs 0.4 [0.6] per patient; p = 0.48) did not differ between lactoferrin and placebo groups, respectively. Clinical outcomes for lactoferrin versus placebo were as follows: ICU length of stay (14.5 [18.0] vs 15.0 [37.3] d; p = 0.82), hospital length of stay (25.0 [25.9] vs 28.1 [44.6] d; p = 0.57), hospital mortality (41.1% vs 30.5%; p = 0.11), and 90-day mortality (44.9% vs 32.4%; p = 0.06). Biomarker levels did not differ between the groups. Lactoferrin did not improve the primary outcome of antibiotic-free days, nor any of the secondary outcomes. Our data do not support the conduct of a larger phase 3 trial.

Evaluation of the Cleaning Procedure Efficacy in Prevention of Nosocomial Infections in Healthcare Facilities Using Cultural Method Associated with High Sensitivity Luminometer for ATP Detection.

In healthcare facilities, environmental surfaces may be a reservoir of infectious agents even though cleaning and disinfection practices play a role in the control of healthcare-associated infections. In this study, the effectiveness of cleaning/disinfection procedures has been evaluated in two hospital areas, which have different risk category classifications. According to the contract with the cleaning service, after the daily ambulatory activities, the housekeeping staff apply an alcohol-based detergent followed by a chlorine-based disinfectant (2% Antisapril, Angelini; 540 mg/L active chlorine), properly diluted and sprayed. The contract provides for the use of disposable microfiber wipes which must be replaced with new ones in each health out-patient department. Surface contamination was analyzed using cultural methods and ATP detection, performed with a high-sensitivity luminometer. The values 100 CFU/cm2 and 40 RLU/cm2 were considered as the threshold values for medium-risk category areas, while 250 CFU/cm2 and 50 RLU/cm2 were defined for the low-risk category ones. Air quality was evaluated using active and passive sampling microbiological methods and particle count (0.3 μm–10 μm) detection. The cleaning/disinfection procedure reduced the medium bacterial counts from 32 ± 56 CFU/cm2 to 2 ± 3 CFU/cm2 in the low-risk area and from 25 ± 40 CFU/cm2 to 7 ± 11 CFU/cm2 in the medium-risk one. Sample numbers exceeding the threshold values decreased from 3% and 13% to 1% and 5%, respectively. RLU values also showed a reduction in the samples above the thresholds from 76% to 13% in the low-risk area. From the air samples collected using the active method, we observed a reduction of 60% in wound care and 53% in an ambulatory care visit. From the air samples collected using the passive method, we highlighted a 71.4% and 50% reduction in microbial contamination in the medium-risk area and in the low-risk one, respectively. The 10 μm size particle counts decreased by 52.7% in wound care and by 63% in the ambulatory care visit. Correct surface sanitation proved crucial for the reduction of microbial contamination in healthcare settings, and plays an important role in ensuring air quality in hospital settings.

Neonatal nosocomial infections-rates, characteristics and microbiological profile

Introduction The prevention and control of nosocomial infections (NI) is a real challenge for all the people, responsible for the hospital care of newborns. The clinical presentation and the outcome of those infections depend on the gestational age and the birthweight. Some organisational factors like overcrowding of the intensive units and the suboptimal proportion of medical staff can additionally contribute to an increase in the frequency of those infections. The aim of the present study is to analyse the main epidemiological characteristics of NI in the neonatology unit and to outline directions for future studies. Methods A retrospective epidemiologic study for the period 2012–2016 has been conducted in the Neonatology clinic of UMHAT St. George Plovdiv, Bulgaria. Information has been collected for 10,273 newborns (9166 full-term and 1107 premature). Data from 224 tracheal aspirates, 39 hemocultures and 55 mucous secretions (eye, nose and throat swabs) has been analysed. The methods used are conventional microbiological methods for identification of the isolated microorganisms and standard statistical methods for processing data. The rates of NI have been calculated per 100 newborns. Results For the period 2012–2016 the incidence of NI varies in the range of 3.92% for 2012 to 2.16% for 2016 with an average rate for the period of 3.03%. The prevailing type of NI registered are the ventilator-associated pneumonias (VAP) - 68.6%, followed by the bloodstream infections - 11.38%, (P Conclusion For the period 2012–2016 the incidence of NI in the neonatology clinic of UMHAT “St. George” is relatively low, in the reference ranges. VAP is the leading type of infection, followed by bloodstream infections. The Gram negative microorganisms are the prevailing type of microorganisms isolated with P. aeruginosa as a leading causative agent. The results from this study outline the necessity to direct the attention of the medical staff to the importance of observing and complying with the infection control practices when caring for newborns in the neonatology unit.

SMS - účinný nástroj v prevenci nozokomiálních nákaz

SMS - účinný nástroj v prevenci nozokomiálních nákaz

Investigation of the efficacy of alcohol-based solutions on adenovirus serotypes 8, 19 and 37, common causes of epidemic keratoconjunctivitis, after an adenovirus outbreak in hospital

Hand antiseptics are of great importance in the prevention of nosocomial infections. Due to the frequent occurrence of adenoviral epidemic keratoconjunctivitis outbreaks in the study hospital, it was necessary to investigate the efficiency of alcohol-based solutions on adenoviruses. To investigate the efficacy of alcohol-based solutions commonly found in hand antiseptics against adenovirus serotypes 8, 19 and 37. The efficacy of ethanol, isopropanol, chlorhexidine-digluconate, n-butanol and different combinations of these antiseptics on adenovirus serotypes that typically cause epidemic keratoconjunctivitis was investigated. The effect of antiseptic substances was investigated using a quantitative suspension test technique according to EN-14476. Antiseptics were prepared as follows: 70% ethanol, 70% isopropanol, 70% ethanol+0.5% chlorhexidine-digluconate, 70% isopropanol+0.5% chlorhexidine-digluconate, 60% ethanol+10% isopropanol, 60% ethanol+10% isopropanol+0.5% chlorhexidine-digluconate and 60% ethanol+10% isopropanol+1% n-butanol. The effect of antiseptics was evaluated at 30, 60 and 120 s. The highest reduction in virus titre was detected with 60% ethanol+10% isopropanol+1% n-butanol. This caused a reduction of 2.5log10, 3 log10 and 2.5log10 in adenovirus serotypes 8, 19 and 37, respectively. The lowest reduction in virus titre was detected with 70% ethanol+0.5% chlorhexidine-digluconate and 70% isopropanol+0.5% chlorhexidine-digluconate. These combinations caused a reduction of 1.62log10 in adenovirus serotypes 19 and 37. All antiseptics showed efficacy levels below 4log10 which is regarded as the efficiency limit by EN-14476. The alcohol-based solutions tested in this study were not found to be sufficiently effective against adenovirus serotypes. Further studies to investigate the efficiency of different alcohol-based solutions are required.