Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute

Background. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac ICU. Methods. We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts and tables. Results. Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and 14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%), and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Resistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion. Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.

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Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49688 ◽

2020 ◽

Vol 35 (2) ◽

pp. 100-104

Author(s):

Maksudur Rahman ◽

Mohammad Abdullah Al Mamun ◽

MAK Azad Chowdhury ◽

Abu Sayeed Munsi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cardiac Intensive Care Unit ◽

Cross Sectional ◽

Cardiac Intensive Care ◽

Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

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Medication time out as a strategy for patient safety: reducing medication errors

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-0136 ◽

2021 ◽

Vol 74 (1) ◽

Author(s):

Laís Lima Santos ◽

Flávia Giron Camerini ◽

Cíntia Silva Fassarella ◽

Luana Ferreira de Almeida ◽

Daniel Xavier de Brito Setta ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medication Errors ◽

University Hospital ◽

P Value ◽

Cardiac Intensive Care Unit ◽

Cross Sectional ◽

Material Resources ◽

Time Out ◽

Cardiac Intensive Care

ABSTRACT Objectives: to analyze the implementation of the medication time out strategy to reduce medication errors. Methods: this is a quantitative, cross-sectional, inferential study, with direct observation of the implementation of the medication time out strategy, carried out in a cardiac intensive care unit of a university hospital in Rio de Janeiro. Results: 234 prescriptions with 2,799 medications were observed. Of the prescriptions analyzed, 143 (61%) had at least one change with the use of the strategy. In the prescriptions altered, 290 medications had some type of change, and 104 (35.9%) changes were related to potentially harmful medication. During the application of the strategy, prescriptions with polypharmacy had 1.8 times greater chance of presenting an error (p-value = 0.031), which reinforces the importance of the strategy for prescriptions with multiple medications. Conclusions: the implementation of the medication time out strategy contributed to the interception of a high number of medication errors, using few human and material resources.

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Incidence of Hospital-Acquired Bacterial Pneumonia and Its Resistance Profiles in Patients Admitted to Intensive Care Unit

Global Journal of Health Science ◽

10.5539/gjhs.v9n3p73 ◽

2016 ◽

Vol 9 (3) ◽

pp. 73 ◽

Cited By ~ 1

Author(s):

Vahid Boostani ◽

Farzaneh Dehghan ◽

Afsaneh Karmostaji ◽

Nader Zolghadri ◽

Afsaneh Shafii

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Antimicrobial Resistance ◽

Bacterial Pneumonia ◽

Clinical Signs ◽

Resistance Rate ◽

Gram Negative Bacteria ◽

Cross Sectional ◽

Gram Negative ◽

Hospital Acquired

Hospital-acquired bacterial pneumonia (HABP) is one of the most important causes of morbidity, mortality and economic problems especially for patients admitted in the intensive care unit (ICU) ward. The aim of this study was to determine the incidence of nosocomial pneumonia in ICU, identify the causative bacteria and their resistance profiles. This cross sectional study was performed on 214 patients who were admitted in the ICU ward of a general hospital requiring mechanical ventilation for at least 48 h. Identification of HABP was based on the clinical signs manifested 48 h or more after admission, new chest X-ray infiltrates and microbiologic examination of endo tracheal secretion. Data were analyzed using SPSS 21 to perform the descriptive statistics. The isolated gram negative bacteria were Klebsiella pneumoniae (50%), Staphylococcus aureus (18.7%), Acinetobacter baumannii (12.5%), Escherichia coli (12.5%) and Pseudomonas aeroginosa (6.3%). The maximum antimicrobial resistance of gram negative bacteria was to Cefazolin (100%) and Ampicillin (84.6%), while antimicrobial resistance to Clindamycin, Azithromycin, Amoxycillin+clavulanate, Trimethoprim+sulfamethoxazole and Ciprofloxacin was 33.3%. No resistance was seen towards carbapenems.The most frequent gram negative isolated bacterium was K. pneumoniae, and maximum antimicrobial resistance rate was observed for Cefazolin and Ampicillin, which is due to betalactamase production.

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