Transmitted Infection Risk Research Articles

Understanding the Effects of Trauma Exposure, Life Stress, Intimate Partner Violence, and Depression on Sexually Transmitted Infection Risk in Post-Conflict Liberia.

In sub-Saharan Africa, sexually transmitted infections (STIs) are a public health concern. The impact of STIs are exacerbated in post-conflict low- and middle-income countries, such as Liberia, where exposure to traumatic events is prevalent and access to mental health services are limited. Following a syndemics framework, this study used regression analyses to explore the independent, additive, and multiplicative effects of four psychosocial conditions (exposure to war-related traumatic events, intimate partner violence [IPV], stressful life events, and depressive symptoms) on self-reported STIs. Data were collected from 379 youth aged 18-30 years (n = 170 women; n = 179 men) in Montserrado County, Liberia. Results revealed that psychosocial variables correlated with each other and STI risk. In multivariable analysis, stressful life events, depressive symptoms, and IPV were statistically significant predictors of STI risk. We found support for an additive effect between the number of psychosocial conditions reported and STI risk, as well as a multiplicative effect (interaction) between IPV and depressive symptoms on STI risk. Our results suggest a synergy between experiencing psychosocial conditions and STI risk and point to the potential benefit of multi-level sexual health approaches that simultaneously address mental health and IPV among youth in Liberia.

Mini review on Artificial Blood Substitutes: Future perspective of Perfluorocarbon based oxygen carriers

The primary cause of death in the battle field and in civilian trauma is haemorrhagic shock. Around 50% combat deaths occur due to haemorrhage, depending on the severity of bleeding medical supervision can be provided like in catastrophic haemorrhage individual death occurs before providing the medical care and it is not a prehospital combat medical management problem during warfare scenario, even to transport wounded personnel to causality centre often takes 45 minutes to one hours. The hazardous nature of the forward combat areas and hostile operational environment frequently prevents medical personnel from quickly reaching the wounded even if the transport distances are small. Moreover, injuries with penetrating battlefield trauma often have only a "platinum 5 minutes." It is very important for military medical personnel to understand their options for treating haemorrhage quickly and efficiently during combat. Early intervention and definitive treatment could save up to 30% of soldier’s who die of action or of wounds. In view of this there is a requirement for the development of synthetic blood substitutes or oxygen therapeutic agents (OTA) in order to maintain the tissue oxygenation. Blood substitutes are the substances which mimic one of the physiological functions of the blood that is transportation of oxygen and carbon dioxide throughout the body. Blood substitutes or OTAs are being clinically tested as artificial oxygen carriers to improve tissue oxygenation and also to reduce allogenic blood transfusions. Two types of blood substitutes are reported so far: 1. Haemoglobin based oxygen carriers (HBOCs) and 2. Perfluorocarbon based oxygen carriers (PFOCs). PFOCs has huge advantages like universal compatibility, no requirement of cold storage, longer shelf life and no risk of infection transmission. These products have their own limitations and they have been withdrawn from international market for clinical use because of their side effects. It is a challenging task to the scientists to develop a safe, stable and biocompatible blood substitute for combat scenarios and also for civilian applications.

Predicting COVID-19 Outbreaks in Correctional Facilities Using Machine Learning.

The risk of infectious disease transmission, including COVID-19, is disproportionately high in correctional facilities.We used machine learning methods with data collected from 24 prison facilities in the Pennsylvania Department of Corrections to determine which sources of data best predict a coming COVID-19 outbreak in a prison facility.Key predictors included county-level measures of COVID-19, facility population, and the test positivity rate in a facility.Fortifying correctional facilities with the ability to monitor local community rates of infection (e.g., though improved interagency collaboration and data sharing) along with continued testing of incarcerated people and staff can help correctional facilities better predict-and respond to-future infectious disease outbreaks.

On the Ventilation Layout Pattern of Buildings to Reduce the Risk of Transmission of Respiratory Infectious Diseases from the Perspective of Healthy City: The case of Wuhan Community

This study focuses on the Wuhan community and examines the significance of architectural layout in the development of healthy cities. The aim is to establish an architectural ventilation layout model conducive to reducing the risk of respiratory infectious disease transmission. By amalgamating infection occurrence of illness data and simulating environmental conditions, the effectiveness of optimized ventilation layouts in reducing transmission rates was validated. Concurrently, in conjunction with simulation outcomes, a natural ventilation architectural layout scheme conducive to mitigating virus transmission was proposed. Grounded in the perspective of healthy urban development, this research employs computational simulations and other methodologies to propose a practical approach towards reducing transmission rates, specifically from the vantage point of ventilation layout.

Rocahepevirus ratti as an Emerging Cause of Acute Hepatitis Worldwide.

The hepatitis E virus (HEV) is a widespread human infection that causes mainly acute infection and can evolve to a chronic manifestation in immunocompromised individuals. In addition to the common strains of hepatitis E virus (HEV-A), known as Paslahepevirus balayani, pathogenic to humans, a genetically highly divergent rat origin hepevirus (RHEV) can cause hepatitis possessing a potential risk of cross-species infection and zoonotic transmission. Rocahepevirus ratti, formerly known as Orthohepevirus C, is a single-stranded RNA virus, recently reassigned to Rocahepevirus genus in the Hepeviridae family, including genotypes C1 and C2. RHEV primarily infects rats but has been identified as a rodent zoonotic virus capable of infecting humans through the consumption of contaminated food or water, causing both acute and chronic hepatitis cases in both animals and humans. This review compiles data concluding that 60% (295/489) of RHEV infections are found in Asia, being the continent with the highest zoonotic and transmission potential. Asia not only has the most animal cases but also 16 out of 21 human infections worldwide. Europe follows with 26% (128/489) of RHEV infections in animals, resulting in four human cases out of twenty-one globally. Phylogenetic analysis and genomic sequencing will be employed to gather global data, determine epidemiology, and assess geographical distribution. This information will enhance diagnostic accuracy, pathogenesis understanding, and help prevent cross-species transmission, particularly to humans.

The risk of COVID-19 infection among nurses working with COVID-19 patients.

Working with 2019 coronavirus disease (COVID-19) patients is currently considered one of the main fears and challenges that face healthcare workers (HCWs), especially nurses. This challenge can jeopardize the quality of health care services for those patients and cause a serious mental burden to HCWs. To understand and estimate the risk of COVID-19 infection among HCWs who directly serve COVID-19 patients. Before the community spread of the disease, 270 nurses who worked with COVID-19 wards were followed for 11 weeks to report the COVID-19 cases. On the other hand, during the community spread of the disease, 981 registered nurses (300 worked in COVID-19 wards and 681 worked in non-COVID wards) were followed for up to 16 weeks to report the COVID-19 cases. Before the community spread of COVID-19, none of the nurses who worked with the COVID-19 patients got the infection. On the other hand, during the community spread of the COVID-19 infection, 30% of the 300 nurses who worked in the COVID-19 wards got the COVID-19 infection, while 64% of the 681 HCWs who worked in the non-COVID wards got the infection. The relative risk of getting COVID-19 infection among HCWs who worked in the COVID-19 wards was reduced to about half in comparison to other HCWs who worked in the non-COVID wards (RR = 0.469). HCWs should not fear working with COVID-19 patients. Considering appropriate personal protective measures and infection control standards, the risk of infection transmission from the community is higher than that of COVID-19 patients, if any.

A statistical analysis of exhaled respiratory droplet trajectory distribution in view of assessing the risk of infectious disease transmission

In the present work an analytical model of exhaled droplet trajectory and evaporation is employed to perform a preliminary statistical analysis of the droplet spatial distribution. The analysis is carried out for a set of over twenty thousand droplets distributed in the range of diameters from 0.1 μm to 1 mm. The type of respiratory events modelled are mouth breathing and speaking. The analytical model employed has been recently developed by the authors. It implements the fundamental laws of fluid dynamics and convection-diffusion, and features a 2D empirical numerical model of buoyant intermittent jet modelling the exhaled breath cloud. A discrete random walk turbulent dispersion model is also included allowing statistical analysis of the droplet trajectory to be performed. With proper boundary conditions any type of respiratory event can be simulated making the model particularly versatile. From the analysis, spatial virus concentration maps are derived for the largest droplets falling to the ground, and for the smaller droplets remaining airborne in the area in front of an infected emitter and successively uniformly dispersed in the ambient. This allows to estimate the risk of infection by fomite, direct inhalation and indirect inhalation routes, and provide a better understanding of infectious disease transmission risks.

Review of strategies to prevent infections related to ultrasound-guided nerve blocks and vascular access

Ultrasound guidance has become ubiquitous in the clinical practice of regional anesthesia and vascular access. Because the ultrasound transducer and an acoustic coupling medium (e.g. ultrasound gel) are applied directly to the patient’s body, the contact of a non-sterile ultrasound transducer with the site of intervention during the breach of the skin integrity by the needle carries the risk of infection transmission. Surprisingly, however, recommendations on how to prevent ultrasound-related outbreaks are often conflicting. With the increasing use of ultrasound in interventional procedures, such as vascular access, regional anesthesia, and pain medicine, the development of clear guidelines on how to prevent infection from patient to patient is essential for patient and operator safety. This review aims to provide a current understanding of the mechanisms and prevalence of infection transmission and to summarize the current recommendations for infectious precautions with interventional ultrasound. We also provide practically implementable and pragmatic recommendations for infectious precautions, based on the available information.

Detection and molecular characterization of Cryptosporidium spp. in dairy calves in Lisbon and Tagus Valley, Portugal

Cryptosporidium is a protozoan parasite with worldwide distribution, infecting a wide range of hosts with some zoonotic species. Calves have been identified as one of the most common reservoirs of this parasite. However, little is known about the genetics of Cryptosporidium in calves in Portugal. This study aimed to molecularly characterize infections of Cryptosporidium in pre-weaned calves from the Lisbon and Tagus Valley (LTV) in Portugal. Fifty-two samples were collected from calves from eight dairy and two beef farms in LTV, Portugal. Cryptosporidium oocysts were detected by Modified Ziehl-Neelsen staining (MZN) and direct immunofluorescent assay (DFA). MZN and DFA revealed the presence of Cryptosporidium oocysts in 40.4% (21/52) and 67.3% (35/52) samples, respectively. Positive samples were analyzed by PCR-RFLP of the 18 s rRNA gene for species identification. DNA amplification of the 18S rRNA gene was successful for 88.6% (31/35) of samples. Cryptosporidium parvum was identified in 96.8% (30/31) of the samples, and from one sample Cryptosporidium bovis was identified. Cryptosporidium parvum positive samples were subtyped by sequencing the PCR product of a partial fragment of the 60 kDa glycoprotein (gp60) gene. Subtype analysis of the C. parvum isolates revealed that all isolates belonged to subtype family IIa. Four subtypes were recognized within this subtype family, including the hyper-transmissible IIaA15G2R1 subtype that is the most frequently reported worldwide (27/30), IIaA14G2R1 (1/30), IIaA16G2R1 (1/30) and IIaA19G2R1 (1/30). To our knowledge, this is the first report of C. bovis, and C. parvum subtypes IIaA14G2R1 and IIaA19G2R1 in cattle in LTV, Portugal. The presence of the zoonotic C. parvum subtype in this study suggests that pre-weaned calves are likely to be a significant reservoir of zoonotic C. parvum, highlighting the importance of animal-to-human infection transmission risk. Further molecular studies are required to better understand the epidemiology of cryptosporidiosis in Portugal.

ANALISIS KONSEP HOSPITAL WITHOUT WALLS PADA PELAYANAN KELAINAN REFRAKSI DI UPTD RUMAH SAKIT MATA PROVINSI SULAWESI UTARA

A hospital without walls or known as a hospital without walls is very useful for patients who come to the hospital for treatment with referrals from the public health center as the entry point for referral diagnosis, this is to minimize the risk of infection transmission and other disease problems. The purpose of this study is to analyze the concept of a hospital without walls and the obstacles and challenges in providing refractive errors. The research was conducted at the UPTD Eye Hospital in North Sulawesi Province, from January to December 2022 using in-depth interviews with five research informants, namely the director, head of medical services, ophthalmologist, family doctor and patient. Instruments in the form of in-depth interview guidelines and a list of questions that have been provided. The stages of data processing are narrating, inferring, reducing, recording, sampling, unitizing. Data analysis is content analysis. The validity of the research results using triangulation of data sources and methods. The results of this study were obtained from the summary of the answers of the research informants that the concept of a hospital without walls all understand and know this concept to mitigate the accumulation of services in hospitals, but this concept has not been implemented because there are several factors such as standard operating procedures, human resources and infrastructure which is not yet possible for some FKTPs to be able to complete services at the community health center or family doctor, the obstacle presented by the informant is that there are still many patients who want to carry out direct services to the hospital without going to the health center or family doctor, another obstacle is the lack of tools for examining refractive errors and competence general practitioners to be able to make referrals in the diagnosis of disease. Hospital income will also increase if implementing this concept, if there is collaboration with related stakeholders such as BPJS Health, the Health Service, and other private parties, so that this will also have a good impact on the quality of service when hospital accreditation is carried out. The sophistication of information technology needs to be implemented as much as possible from the hospital so that it is easier so that patients do not pile up during services by registering online. The conclusion of this study is that the concept of a hospital without walls has not been implemented in the Eye Hospital of North Sulawesi Province because it has not followed standard operating procedures, quality competent resources and adequate infrastructure. FKTP Puskesmas in providing refractive error services have not provided complete supporting tools and the skills of FKTP doctors are still lacking, this will have an impact on assessing hospital accreditation in the quality of health services.
 Keywords: hospitals without walls, eye refractive error, family doctors

Increasing Passenger Efficiency and Minimizing Infection Transmission in Chinese Metro Stations during COVID-19: A Simulation-Based Strategy Analysis

This study addresses the challenging problem of increasing passengers’ travel efficiency while lowering the infection transmission risk at metro stations during COVID-19 pandemic. To achieve this objective, we deploy Anylogic software and formulate an infection risk model. As a case study, this study focuses on a transfer metro station in Xi’an, China. Firstly, by utilizing Anylogic software, three distinct strategies are simulated: flow-control fences, travel reservation, and the collaborative use of travel reservations and flow-control fences. Secondly, the passenger density and average dwell time under these strategies are assessed while constructing an infection risk model to quantify the risk faced by passengers. Thirdly, when compared to the absence of any strategy, the results are as follows: (1) The flow-control fences strategy: implementing flow-control fences can effectively reduce the risk of passenger infection when the length of the flow-control fences is fixed at 47.5 m, but comes at the cost of a 20.15% decrease in passenger travel efficiency; however, excessively long flow-control fences will neither alleviate congestion nor reduce the infection risk. (2) The travel reservation strategy: the adoption of travel reservations, along with a fast track for reserved users, when the reservation proportion is 40%, leads to a remarkable 29.05% improvement in travel efficiency and reduces the risk of passenger infection by 67.12%. (3) The combined strategy: the combined utilization of travel reservations and flow-control fences enhances travel efficiency by 15.80% and reduces the risk of passenger infection by 56.77% when the reservation proportion is set at 30%. When the reservation proportion is between 10 and 30%, its infection risk reduction effect is better than that of the travel reservation strategy, but this is not necessarily true for their effects on travel efficiency. Finally, this study was compared to an existing study that proposed a new strategy by combining travel reservations with departure intervals, analyzing the effect of the implementation of the strategy with different departure intervals. The findings from this study have implications for developing appropriate strategies to optimize passenger flow without significantly compromising the transmission of infection risk during the pandemic.

Five core areas to focus infection prevention and transmission risk breaches training based on quarantine staff orientation sessions: A qualitative study

Background & Aim: Breach awareness in relation to types, mitigation, and reporting should be a routine part of infection prevention training. Understanding breaches can reduce risk of disease transmission to staff and communities when contextualized to the infectious disease, environment, and situation. At a large-scale Australian COVID-19 quarantine facility, this study examined the core personal protective equipment and infection prevention breaches new quarantine workers identified during their site orientation to inform future breach training.
 Methods & Materials: Through the application of a qualitative approach, the project implemented a descriptive thematic analysis to identify the different types of breaches staff presented. An additional summative content analysis method was applied to determine if the breaches staff identified were breaching and if the risk level staff allocated to the breach was mapped to the risk of disease transmission. Data were collected from 30 orientation sessions and included 603 breach risk responses for analysis.
 Results: There were five core breach areas identified: donning and doffing of personal protective equipment, failure of personal protective equipment or lack of equipment, environmental factors, staff behaviors, and resident behaviors. The breach allocations by staff demonstrated knowledge deficits across health and non-health staff in disease transmission, particularly in the actual level of the risk for transmission.
 Conclusion: Breaches awareness in relation to types, mitigation and reporting should be a routine part of infection prevention training. The five areas of breaches present an adaptable foundation to base infection prevention breach training for any health facility. When contextualised to the communicable disease, environment and situation, understanding breaches can reduce the risk of disease transmission to staff and communities.

Potential of physical barriers integrated with personal exhaust ventilation in decreasing airborne infection risk for people

A new approach was presented in this study that combines partition screens and personal exhaust ventilation to reduce the risk of infection transmission among individuals seated closely together at short distances. The effectiveness of this approach was experimentally studied in a test room using N2O as a tracer gas to simulate pollutant dispersion from an infected person. The concentration of N2O was measured at three different points near the source location. The results showed that using partitions alone might increase the probability of virus transmission compared to the case without partitions. However, combining personal exhaust with partitions significantly reduces the infection risk.

Psychosocial determinants associated with healthcare workers’ self-reported compliance with infection prevention and control during the COVID-19 pandemic: a cross-sectional study in Dutch residential care facilities for people with intellectual and developmental disabilities

BackgroundHealthcare workers’ (HCWs) compliance with infection prevention and control (IPC) is crucial to reduce the infection transmission risk. However, HCWs’ compliance with IPC in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is known to be suboptimal. Therefore, this study examined sociodemographic and psychosocial determinants associated with IPC non-compliance in this setting, to inform IPC policy and promotion programmes for adequate IPC behaviour.MethodsAn online questionnaire was administered to 285 HCWs from 16 RCFs between March 2021 and March 2022. Determinants associated with IPC non-compliance were assessed using logistic regression analyses.ResultsBeing a woman (OR: 3.57; 1.73–7.37), and being a non-medical professional were associated with increased odds of non-compliance (social workers, OR: 2.83; 1.65–4.85; behavioural specialists, OR: 6.09; 1.98–18.72). Perceived inadequate education/training (aOR: 1.62; 1.15–2.27) and perceived time constraints/competing priorities (aOR: 1.43; 1.03–1.98) were also associated with increased odds of non-compliance, independent of sociodemographic variables. In contrast, the belief that the supervisor complies with IPC (descriptive norm supervisor) was associated with decreased odds of non-compliance (aOR: 0.60; 0.41–0.88).ConclusionsTo improve IPC in disability care settings, the implementation of tailored and structural IPC education and training programmes (e.g., on-the-job training) is recommended to increase HCWs’ capabilities and bridge the IPC compliance gap between medical and non-medical professionals. In addition, role models, particularly supervisors, are crucial for promoting IPC behaviour. Facilities should create a culture of IPC compliance by norm setting, acting on, and modelling IPC behaviours at all levels of the organisation (management, medical, and non-medical staff).

Sexually Transmitted Infection Risks and Symptoms Heightened Among Female Sex Workers who Started Selling Sex Before the Age of 18 in Five Cities in Cameroon

Many adolescents under 18 years old who sell sex are at elevated risk for sexually transmitted infection (STI) acquisition, which may persist into adulthood. There has been limited study of the burden of the risks and vulnerabilities among women who started selling sex as adolescents across Sub-Saharan Africa. In this study, a Adult female sex workers (FSW) recruited through respondent-driven sampling in five cities in Cameroon from December 2015 to October 2016 completed a questionnaire and human immunodeficiency virus (HIV) and syphilis testing. Multivariable logistic regression analysis controlling for age was used to identify factors associated with reporting selling sex before age 18. Selling sex before age 18 was reported by 11.5% (256/2,220) of FSW. Initiation of selling sex as an adolescent was positively associated with experiencing dysuria (adjusted odds ratio [aOR]:1.50, 95% confidence interval [CI]:1.08–2.10) or genital warts (aOR:1.78, 95% CI:1.08–2.94) and negatively associated with prior recent testing for HIV (aOR:0.71, 95% CI:0.53–0.96) or STIs (aOR:0.65, 95% CI:0.44–0.96). Consistent condom use with clients was negatively associated with early initiation of selling sex (aOR:0.58, 95% CI:0.42–0.80), while experience of recent sexual violence was positively associated with early initiation (aOR:1.74, 95% CI:1.15–2.63). There were no independent significant differences in HIV (24.5%) or syphilis (8.3%) prevalence. Given the limited use of HIV and STI testing services by women who sold sex as adolescents, the prevalence of forced sex, condomless sex, and STI symptoms were high. Programs serving FSW should more vigorously aim to serve adolescents and adults who began selling sex early.

Self-reported compliance with infection prevention and control of healthcare workers in Dutch residential care facilities for people with intellectual and developmental disabilities during the COVID-19 pandemic: A cross-sectional study

BackgroundCompliance of healthcare workers (HCWs) with infection prevention and control (IPC) is crucial to resident safety. Nevertheless, HCWs’ compliance with IPC has not been previously studied in a disability care setting. ObjectiveTo assess levels of self-reported compliance with IPC among HCWs in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs), and to assess whether IPC compliance varies among different professional groups. MethodsA total of 285 HCWs from 16 Dutch RCFs completed an online questionnaire assessing 16 IPC procedures, following national guidelines. Data were analysed using descriptive statistics and chi-square tests to assess potential differences in compliance between professional groups. ResultsOverall, HCWs complied on average with 68.7% of IPC. Only 30.1% of HCWs had sufficient compliance (defined as compliance with ≥80% of IPC practices). Compliance varied considerably between individual IPC procedures, in which compliance with wearing short-sleeved clothes (30.9%) and using disposable protective clothing (32.7%) were the lowest. Compliance with jewellery and hair regulations was suboptimal (45.6% and 55.4%, respectively). Non-medical professionals complied with IPC less frequently (social workers, 24.2%; behavioural specialists, 12.9%) than medical professionals (47.4%) (p < 0.001). ConclusionsThe majority of HCWs had suboptimal compliance with IPC. As IPC compliance differs between professionals, recommendations are to 1) implement tailored education and training programmes, and 2) pursue a facility-wide minimum required IPC compliance. Implementing and communicating a minimum set of IPC procedures – including hand hygiene, personal hygiene, and clothing requirements − applying to all professionals is important to minimise the infection transmission risk in RCFs for people with IDDs.

Approach to suspected donor-derived infections.

Prevention of donor-derived disease among pediatric solid organ transplant recipients requires judicious risk-benefit assessment. Comprehensive guidelines outline specific donor risk factors and post-transplant monitoring strategies to prevent and mitigate transmission of HIV, hepatitis B, and hepatitis C. However, elimination of unanticipated donor-derived infections remains challenging. The objectives of this review are to (1) define risk of anticipated vs. unanticipated disease transmission events in pediatric solid organ transplant recipients; (2) discuss donor presentations that confer greater risk of unanticipated disease transmission; (3) develop a matrix for consideration of donor acceptance; and (4) discuss limitations and future directions for donor screening. Although solid organ transplant confers inherent risk of infection transmission, the risk of significant disease transmission events may be mitigated by a comprehensive approach including donor assessment, consideration of recipient need, post-transplant monitoring, and early intervention.

Hand hygiene knowledge and practices of family caregivers in inpatient pediatrics.

Family caregivers are essential inpatient pediatric care partners, yet their handwashing knowledge and compliance are rarely studied. Through hand hygiene audits and self-administered questionnaires, we observed 9% compliance, significantly lower than self-reported practice. We suggest interventions to improve caregiver handwashing behaviors to decrease infection transmission risk to hospitalized children.

Bacterial contamination on the white coats of medical laboratory students at a tertiary care hospital

Background: White coats might be a potential source of infection and play a huge role in transmitting pathogenic bacteria in hospital setup as well as in the community. Objective: This cross-sectional study was conducted to evaluate the bacterial contamination on white coats of students working in diagnostic laboratories and determine their antibacterial susceptibility. Methods: Swabs were collected from the sleeves and pockets of the white coat of 96 students working in various diagnostic labs in a tertiary care hospital and processed for bacteriological analysis based on standard procedures. Results: Among 96 white coats, bacterial contamination was observed in 63 white coats. Pockets of the white coats were highly contaminated with pathogenic bacteria than sleeves. Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus were isolated only from 13 white coats. The majority were Staphylococcus epidermidis, followed by Micrococcus luteus. All isolates of S. aureus were susceptible to antibiotics used. Few isolates of A. baumannii were resistant to ampicillin and amoxicillin. One isolate of P. aeruginosa exhibited resistance to Cefoperazone. Conclusion: White coats of students working in diagnostic labs were contaminated with both pathogenic and nonpathogenic bacteria, which can cause cross contamination and increase the spread of nosocomial infection. Bacteria resistant to antibiotics can lead to treatment complications. Thus, policies should be prepared and followed to reduce the risk of infectious disease transmission by following routine laboratory practices such as hand washing, frequent cleaning of white coats and disinfecting other fomites.

A single-arm, prospective study comparing translaryngeal ultrasonography with direct visualisation by flexible laryngoscopy for vocal cord assessment in patients undergoing oesophagectomy or mediastinoscopy.

Translaryngeal ultrasonography (TLUSG) for diagnosis of vocal cord palsy, a relatively new, safe and noninvasive bedside technique with minimal risk of respiratory infection transmission, has been effective in patients with thyroid disease. We studied its use as an alternative method to visual inspection by flexible laryngoscopy (FL) for vocal cord assessment in patients undergoing thoracic surgeries. After Institutional Ethics Committee approval and trial registration, in this single-arm, prospective study, the vocal cord function of 110 patients who underwent either total oesophagectomy or mediastinoscopy was assessed immediately after extubation by both FL and TLUSG. A follow-up assessment was done by laryngoscopy using Hopkin's endoscope (HL) and a repeat TLUSG. The primary outcome was the concordance between direct visualisation (FL or HL) and TLUSG. Vocal cords were successfully visualised by TLUSG in 90% of male and all female patients. Findings of FL and TLUSG done at the first assessment matched in 89 (86.4%) out of 103 patients, and the degree of concordance was 0.69 (95% confidence interval [CI] =0.52-0.83). At the second assessment, HL and TLUSG findings matched in 83 (94.3%) out of 88 patients, and the degree of concordance was 0.89 (95% CI = 0.77-0.98). TLUSG is an effective noninvasive alternative to direct visualisation for vocal cord assessment in both male and female patients undergoing thoracic surgery.