scholarly journals Bio contamination of surfaces and medical devices in controlled environment areas at a hospital in Morocco

2021 ◽  
Vol 319 ◽  
pp. 01080
Author(s):  
Samira Jaouhar ◽  
Abdelhakim El Ouali Lalami ◽  
Khadija Ouarrak ◽  
Jawad Bouzid ◽  
Mohammed Maoulouaa ◽  
...  

The hospital environment, especially medical devices and surfaces, represents a secondary reservoir for pathogens. This work aims to evaluate the microbiological quality of surfaces and medical equipment of controlled environment services (burn unit, operating room, and sterilization service) at a hospital in Meknes (center of Morocco). This study was carried out for three months (September-December of 2017). A total of 63 samples were taken by swabbing technique from different surfaces and medical equipment after bio-cleaning. Identification was performed according to conventional bacteriological methods and by microscopic observation for fungi. The study showed that 68% of the surface was contaminated. The operating room recorded a rate of 93% of contamination (p-value <0.01), 83% for sterilization service, and 47% for burn unit. A percentage of 67% of the isolates were identified as Gram-positive bacteria against 32% Gram-negative bacteria (p-value <0.05). Bacterial identification showed Coagulase-negative Staphylococci (45%), Enterobacter cloacae (14%), Micrococcus sp (10%), Klebsiella pneumoniae, peptostreptococcus sp and Pseudomonas fluorescens (7% for each one), Escherichia coli, and Methicillin-resistant Staphylococcus aureus (5% for each one). These results require corrective action represented by rigorous cleaning and disinfection procedures.

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Samira Jaouhar ◽  
Abdelhakim El Ouali Lalami ◽  
Khadija Ouarrak ◽  
Jawad Bouzid ◽  
Mohammed Maoulouaa ◽  
...  

Background. Equipment and hospital surfaces constitute a microbial reservoir that can contaminate hospital users and thus create an infectious risk. The aim of this work, which was carried out for the first time at a hospital in Meknes (regional hospital in the center of Morocco), is to evaluate the microbiological quality of surfaces and equipment in three potential risk areas (burn unit, operating room, and sterilization service). Methods. This study was carried out over a period of 4 months (February–May 2017). A total of 60 samples were taken by swabbing according to the standard (ISO/DIS 14698-1 (2004)) in an environment of dry area and equipment after biocleaning. Isolation and identification were performed according to conventional bacteriological methods and by microscopic observation for fungi. Results. The study showed that 40% of surface samples were contaminated after biocleaning. The burn unit recorded a percentage of 70% contamination (p value <0.001), 13% for the sterilization service, and 7% for the operating room. 89% of the isolates were identified as Gram-positive bacteria against 11% for fungi (p value <0.001). Bacterial identification showed coagulase-negative staphylococci (32%), Bacillus spp. (16%), Corynebacterium (8%), and oxidase-negative Gram-positive bacillus (40%) while fungal identification showed Aspergillus niger (n = 2) and Aspergillus nidulans (n = 1). Conclusion. To control the infectious risk related to equipment and hospital surfaces, it would be necessary to evaluate the disinfection protocol applied in these units.


2021 ◽  
Vol 319 ◽  
pp. 02023
Author(s):  
Nabila Saouide El Ayne ◽  
Hinde Hami ◽  
Samir Hamama ◽  
Sanou Khô Coulibaly ◽  
Abdelrhani Mokhtari ◽  
...  

Introduction: The fight against nosocomial infections, particularly those linked to environmental germs, is one of the priorities of health establishments. Microbiological control of the hospital environment is an essential element of the strategy for the fight against these infections. The aim of this study is to determine the microbial ecology of hospital surfaces and medical devices. Methods: This is a study, which was carried out in the El Idrissi hospital in Kénitra. For the microbiological control of surfaces, we opted for the swab technique: the search for specific germs on flat surfaces and in areas that are difficult to access and not flat. Results: Among the bacteria most frequently responsible for isolated nosocomial infections: Bacillus (28%) and coagulase-negative staphylococci (27%) were predominant, followed by Staphylococcus aureus (19%), Klebsiella pneumoniae (17%), Pseudomonas aeruginosa (5%), Enterobacter cloacae (3%) and Proteus vulgaris (1%).The overall distribution of germs by department showed their predominance in intensive care units (30%), traumatology (11%), emergencies (11%) and in operating rooms (9%). Conclusion: Periodic microbiological controls must be put in place in order to identify any contamination, to carry out preventive actions, procedures and a fundamental approach for the control of infectious risks in the hospital.


2021 ◽  
pp. 70-75
Author(s):  
Viktor Yurievich Kozlov ◽  
Larisa Arkadyevna Karaseva

A safe hospital environment should fully provide the patient and healthcare professional with the comfort and safety conditions that effectively address vital health needs. To this end, medical devices are manufactured for the healthcare industry to ensure the safety of the hospital environment for patients and medical workers [2, 3].


2021 ◽  
Vol 3 ◽  
Author(s):  
Francesca Berti ◽  
Luca Antonini ◽  
Gianluca Poletti ◽  
Constantino Fiuza ◽  
Ted J. Vaughan ◽  
...  

This study aims at proposing and discussing useful indications to all those who need to validate a numerical model of coronary stent deployment. The proof of the reliability of a numerical model is becoming of paramount importance in the era of in silico trials. Recently, the ASME V&amp;V Standard Committee for medical devices prepared the V&amp;V 40 standard document that provides a framework that guides users in establishing and assessing the relevance and adequacy of verification and validation activities performed for proving the credibility of models. To the knowledge of the authors, only a few examples of the application of the V&amp;V 40 framework to medical devices are available in the literature, but none about stents. Specifically, in this study, the authors wish to emphasize the choice of a relevant set of experimental activities to provide data for the validation of computational models aiming to predict coronary stent deployment. Attention is focused on the use of ad hoc 3D-printed mock vessels in the validation plan, which could allow evaluating aspects of clinical relevance in a representative but controlled environment.


2011 ◽  
Vol 60 (2) ◽  
pp. 155-161 ◽  
Author(s):  
GRAŻYNA SZYMAŃSKA ◽  
MAGDALENA SZEMRAJ ◽  
ELIGIA M. SZEWCZYK

The activity of beta-lactam antibiotics (oxacillin, cloxacillin, cephalotin), vancomycin, gentamicin and rifampicin applied in vitro individually and in combination against 37 nosocomial methicillin-resistant strains of coagulase-negative staphylococci (CNS) was assessed to demonstrate the heterogeneity of this group of bacteria and estimate the chance of the efficacy of such therapy. The strains belonged to four species: Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus cohnii, Staphylococcus hominis. They originated from a hospital environment and from the skin of medical staff of the intensive care unit of a paediatric ward at a university hospital. All strains were methicillin-resistant, according to CLSI standards, but individual strains differed in MIC(ox) values. Susceptibility to other tested antibiotics was also characteristic for the species. The increased susceptibility to antibiotics in combinations, tested by calculating the fractional inhibitory concentration (FIC) index, concerned 26 out of 37 investigated strains and it was a feature of a particular species. Combinations of vancomycin and cephalotin against S. epidermidis and oxacillin with vancomycin were significant, as well as cephalotin and rifampicin in growth inhibition of multiresistant S. haemolyticus strains.


1999 ◽  
Vol 37 (9) ◽  
pp. 2781-2788 ◽  
Author(s):  
Tomasz A. Łe˛ski ◽  
Marek Gniadkowski ◽  
Anna Skoczyńska ◽  
Elz˙bieta Stefaniuk ◽  
Krzysztof Trzciński ◽  
...  

An outbreak of mupirocin-resistant (MuR) staphylococci was investigated in two wards of a large hospital in Warsaw, Poland. Fifty-three MuR isolates of Staphylococcus aureus, S. epidermidis, S. haemolyticus, S. xylosus, and S. capitis were identified over a 17-month survey which was carried out after introduction of the drug for the treatment of skin infections. The isolates were collected from patients with infections, environmental samples, and carriers; they constituted 19.5% of all staphylococcal isolates identified in the two wards during that time. Almost all the MuR isolates were also resistant to methicillin (methicillin-resistant S. aureus and methicillin-resistant coagulase-negative staphylococci). Seven of the outbreak isolates expressed a low-level-resistance phenotype (MuL), whereas the remaining majority of isolates were found to be highly resistant to mupirocin (MuH). The mupA gene, responsible for the MuH phenotype, has been assigned to three different polymorphic loci among the strains in the collection analyzed. The predominant polymorph, polymorph I (characterized by a mupA-containingEcoRI DNA fragment of about 16 kb), was located on a specific plasmid which was widely distributed among the entire staphylococcal population. All MuR S. aureus isolates were found to represent a single epidemic strain, which was clonally disseminated in both wards. The S. epidermidis population was much more diverse; however, at least four clusters of closely related isolates were identified, which suggested that some strains of this species were also clonally spread in the hospital environment. Six isolates of S. epidermidis were demonstrated to express the MuL and MuH resistance mechanisms simultaneously, and this is the first identification of such dual MuR phenotype-bearing strains. The outbreak was attributed to a high level and inappropriate use of mupirocin, and as a result the dermatological formulation of the drug has been removed from the hospital formulary.


Author(s):  
A Tavakoli Golpaygani

Nowadays, more than 10,000 different types of medical devices can be found in hospitals.These devices used in medical centers and hospitals for monitoring and treatment of patients require periodic safety and performance checking in order to have confidence in their functioning and operation. Physicians need better accurate medical measurements in order to better diagnose diseases, monitor patients and deliver treatments, in this way failure to ensure appropriate measurements will certainly have diverse effects. Safety and performance testing of medical devices in the medical sector is a one of the key factor in improving public health. Acquiring results of some investigations indicate a need for new and severe regulations on periodic performance verifications and medical equipment quality control program especially in highrisks instruments.The metrological reliability of four high risk medical devices, Electrosurgical unit, Defibrillator, Syringe pump and Infant incubator in use some hospitals (privates and publics) in one of the province of Iran according to international and national standards was evaluated. Quantitative analysis of Some parameters that impact the safety and performance showed the amount of the obtained results in some equipment are in critical range and have higher values than standard limitations. General electrical safety evaluations for measuring the patient leakage currents and patient auxiliary currents carried out for all of groups,in some cases the amount of leakage currents were over the standard limitations.Acquiring results indicate a need for new and severe regulations on periodic performance verifications and medical equipment quality control program especially in high risk instruments. It is also necessary provide training courses for operating staff in the field of meterology in medicine and what’s the critical parameters and how they can get good accuracy results equipment.


2020 ◽  
Vol 3 (2) ◽  
pp. 01-06
Author(s):  
Fathy Abdolmejed ◽  
Khalid Almajri ◽  
Ghamela Ali

Retrospective statistical study a collection of all patients with post intra vitreal injection (IVI) endophthalmitis in last 10 year period between 2010–2019 in eye department of Tobruk medical center -Tobruk and eye department of Alwahda hospital - Derna. We aim in this study to review the microbiology, clinical characteristics, diagnosis, and management strategies of post-intra vitreal injection endophthalmitis, by comparing our results with the different studies designs and treatment protocols. There were 9 patients of the after intra vitreal injections endophthalmitis cases. The age average is 70 years, 6 cases are females and 3 casees are male, all of them were practice post intravitreal Avastin injection endophthalmitis. There were 8 patients had Diabetes mellitus (DM), 2 patients had cardiovascular disease and 1 patient had hepatitis C as a systemic disease. The most common causative organism after intra vitreous injection endophthalmitis is Coagulase-negative staphylococci (CNS) 100% from the 56% positive causative organisms and 44% are no detected microorganisms, the outcome of cases which managed with pars-plana-vitrectomy (PPV) improved significantly about 60 Letters (> 3 Lines) and cases managed without PPV > 15 Letters (> 3 Lines). The cases of post intraocular endophthalmitis which diagnosed and treated early with PPV give a good result and can save the vision. The cases of acute POE in the first 3 day had significant better function (P value = 0.02).


Author(s):  
Putu Ayu Mega Agnihortry ◽  
I Made Dwie Pradnya Susila ◽  
A.A. Ngurah Nara Kusuma

Patient safety has now become a global issue and a critical component of hospital quality management. One of the components in patient safety that must be carried out in the operating room is the application of the surgical safety checklist. Adherence in implementing the surgical safety checklist is influenced by several factors such as the knowledge of patient safety that nurses have. This study aims to determine the relationship between the level of patient safety knowledge and the compliance of nurses in implementing the surgical safety checklist in the Pre-Operation Room, the Operation Room, RSD Mangusada Badung. This study used a quantitative observational method with a cross sectional design. The sample was all nurses in the operating room installation room RSD Mangusada Badung who were selected by a total sampling of 41 people. The research was conducted from 01-31 October 2020. The results of data analysis using the rho Spearman nonparametric statistical test at a significance level of ? 0.05, the p value was 0.000 <0.05. This shows that there is a significant relationship between the level of patient safety knowledge on nurses' compliance in implementing the surgical safety checklist in the Pre-Operation Room for the Operation Room, RSD Mangusada Badung. It is hoped that health workers, especially nurses in the operating room, can increase knowledge about patient safety and be more obedient in implementing the surgical safety checklist.


2021 ◽  
Author(s):  
Yi Ye ◽  
Guanghui Zheng ◽  
Yueyue Kong ◽  
Jiawei Ma ◽  
Guojun Zhang ◽  
...  

Abstract Background: Previous studies discuss the positive predictive value through whether the bacteria are coagulase-negative staphylococci. The view may need to be updated. The aim was to evaluate the positive predictive value of different bacteria species isolated from cerebrospinal fluid cultures and discuss the rationality to view coagulase-negative staphylococci as a group.Methods: This retrospective cohort study recruit all adults with positive cerebrospinal fluid cultures sampled by lumbar puncture 2012-2020 in the Department of Neurosurgery. The exposure was bacteria species, and the outcome was positive predictive value. An episode was defined as a patient with one bacteria. When episodes with a bacteria species reached five, the bacteria species was analyzed specifically. The positive predictive value was defined as the incidence of isolated-bacteria-related infected episodes. The isolated-bacteria-related infected episode was defined as the patient was with clinical features of bacterial meningitis, and the improvement was related to sensitive antibacterial agents. Then the differences of the positive predictive value of different bacteria in all specific bacteria species, coagulase-negative staphylococci, and non-coagulase-negative staphylococci bacteria were calculated, respectively. The results were statistically significant when P-value <.05.Results: 1180 episodes from 1133 patients with 79 bacteria were studied; the positive predictive value was 54.3%. The bacteria included 67 bacteria species, ten bacteria genus, viridans streptococci, and unclassified coagulase-negative staphylococci. Twenty-four specific bacteria species were analyzed. The range of positive predictive values of them was 29.4%-100.0% (P<.0001). The positive predictive value for Enterobacter aerogenes, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca was the highest, while the positive predictive value for Staphylococcus cohnii was the lowest. Moreover, 767 (65.0%) were with coagulase-negative staphylococci, the positive predictive value was 46.4%, and the range was 29.4%-85.7% (P=.0020); 413 (35.0%) were with non-coagulase-negative staphylococci bacteria, the positive predictive value was 69.0%, and the range was 40.0%-100.0% (P<.0001).Conclusions: This study suggests that the positive predictive value of different bacteria species is different. It is more reasonable to discuss the positive predictive value of bacteria isolated from cerebrospinal fluid cultures through the bacteria species rather than whether they are coagulase-negative staphylococci.Trial registration: This is a retrospective study without interventions on participants.


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