Nosocomial RSV-related in-hospital mortality in children <5 years: a global case series

Background According to the World Health Organization the global burden of nosocomial infections is poorly characterized as surveillance systems for nosocomial infection are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on community-acquired disease. We aimed to characterize children with nosocomial RSV-related mortality and to understand the potential impact of RSV immunization strategies. Methods RSV GOLD is a global registry of children younger than 5 years who died with laboratory-confirmed RSV infection. We compared clinical and demographic characteristics of children with nosocomial and community-acquired RSV in-hospital mortality. Results We included 231 nosocomial and 931 community-acquired RSV-related in-hospital deaths from 65 countries. Median age at death was similar for both groups (5.4 vs 6 months). As expected, a higher proportion of children with nosocomial infection had comorbidities (87% vs 57%; p<0.001) or was born preterm (46% vs 24%; p<0.001) than children with community-acquired infection. The proportion of nosocomial deaths among all RSV deaths was lower in LMICs than in upper-middle-income countries (UMICs) and HICs (12% vs 18% and 26%, respectively). Conclusions This is the first global case series of children dying with nosocomial RSV infection. Future infant-targeted immunization strategies can prevent the majority of nosocomial RSV-related deaths. Although nosocomial RSV deaths are expected to occur at highest rates in LMICs, the number of reported nosocomial RSV deaths was low in these countries. Hospital-based surveillance is needed to capture the full burden of nosocomial RSV mortality in LMICs.

Assessing Knowledge, Attitude, and Practices of Hand Hygiene among Health Care Workers in Eradah Complex in Jeddah

Background: Most of the persons thought that nosocomial infection is spread from the hands of health care workers. The main aim of hand washing is to be aware for all to know that this is a myth that nosocomial infection is spread from hand. Methods: This cross-sectional study was conducted in Eradah Complex in Jeddah. The Saudi Commission for Health Specialties (SCFHS) has accredited Eradah Complex for Mental Health- Jeddah, as a training center for addiction medicine fellowship program. An observation is done by providing a Google form to the health care workers of the Eradah complex in Jeddah. This is to observe the views of the health care workers on the issue of practices of hand hygiene. Results: There were a total of 178 study participants (111 male and 67 participants). Age groups demonstrate that 34.27% of participants belong to the age group of 36 to 45 years. 32.02% of the participants belong to the age group of 26 to 35 years of age group. Moreover, the graph has shown that 14.04% of participants belong to the age group of 18 to 25 years. It has been seen that the number of female workers bearing the position of Nurse is less than those of males. It is important to have more respondents being nurses as the nurses usually communicate directly with the patients. There is a doctor too, but they are less interaction directly with the patient. Therefore, overall graph shows that only 6.18% participants prefer other professions whereas among other percentages, 7.30% participants are pharmacists, 25.28% people are nurses, and 18.54% participants are doctors. Conclusion: The present study has discussed that maintenance of hand hygiene in the hospitals and clinics are of sheer importance. The research methodology that is incorporated in the present study has been helpful for the researchers in understanding the perception of the healthcare workers what they think about the aspect of washing hands primarily after the pandemic. Therefore, it has been seen that most of the participative healthcare workers primarily males do not find the aspect hand hygiene much important and so they rarely use soap for hand wash. On the contrary, the female workers understand the importance of hand wash more and thus, they support the thought of hand hygiene at the workplace.

Relationship of Nurse's Knowledge with Measures Nosocomial Infection Prevention in the Room Internal Care of a Regional General Hospital, Majene Regency

Nosocomial infection is an infection that is acquired by the patient when the patient is in the nursing care process at the hospital that occurs at least after 3 x 24 hours since the patient started treatment in the hospital. The risk of nosocomial infection in addition to occurring in patients who are hospitalized, can also occur in hospital staff. This study aims to determine the relationship between nurses' knowledge and prevention of nosocomial infections in the internal care room of the Majene Regency General Hospital. This research is an analytical survey research with a cross sectional study approach. The sample in this study were all nurses in the internal treatment room of the Majene Regency General Hospital as many as 30 people. Collecting data by using a questionnaire. The results showed that the level of knowledge of the majority of respondents about nosocomial infections was good, namely 27 people (90%) and the level of knowledge of respondents about prevention of nosocomial infections was good, namely 18 people (60%). Based on the results of the Fisher's exact test, the value of p = 0.054 which means it is greater than the value of = 0.05, which means that there is no relationship between the level of knowledge and the behavior of nurses on prevention of nosocomial infections. Keywords: Knowledge, Nosocomial Infections, Preventive Measures.

Applicability of contemporary quality indicators in vestibular surgery—do they accurately measure tumor inherent postoperative complications of vestibular schwannomas?

Background Due to rising costs in health care delivery, reimbursement decisions have progressively been based on quality measures. Such quality indicators have been developed for neurosurgical procedures, collectively. We aimed to evaluate their applicability in patients that underwent surgery for vestibular schwannoma and to identify potential new disease-specific quality indicators. Methods One hundred and three patients operated due to vestibular schwannoma were subject to analysis. The primary outcomes of interest were 30-day and 90-day reoperation, readmission, mortality, nosocomial infection and surgical site infection (SSI) rates, postoperative cerebral spinal fluid (CSF) leak, facial, and hearing function. The secondary aim was the identification of prognostic factors for the mentioned primary outcomes. Results Thirty-day (90-days) outcomes in terms of reoperation were 10.7% (14.6%), readmission 9.7% (13.6%), mortality 1% (1%), nosocomial infection 5.8%, and SSI 1% (1%). A 30- versus 90-day outcome in terms of CSF leak were 6.8% vs. 10.7%, new facial nerve palsy 16.5% vs. 6.1%. Hearing impairment from serviceable to non-serviceable hearing was 6.8% at both 30- and 90-day outcome. The degree of tumor extension has a significant impact on reoperation (p < 0.001), infection (p = 0.015), postoperative hemorrhage (p < 0.001), and postoperative hearing loss (p = 0.026). Conclusions Our data demonstrate the importance of entity-specific quality measurements being applied even after 30 days. We identified the occurrence of a CSF leak within 90 days postoperatively, new persistent facial nerve palsy still present 90 days postoperatively, and persisting postoperative hearing impairment to non-serviceable hearing as potential new quality measurement variables for patients undergoing surgery for vestibular schwannoma.

Nosocomial infections in an Iranian educational hospital: an evaluation study of the Iranian nosocomial infection surveillance system

Background Nosocomial infection (NI) or cross-infection is a major health problem in hospitals worldwide. Aim This study aimed to report the status of NIs and to evaluate the Iranian nosocomial infection surveillance system (INISS) in a teaching hospital in the south of Iran. Methods This is a comparative historical study on the records of hospital admitted patients from 2018 to 2019. Data on patients who were diagnosed with NI was extracted from the INISS database. The database includes data on the incidence of different types of NIs in each hospital ward, the patient’s infection outcome, the agents involved, and the site of infection. Results The results indicated that the rate of NI (cases of NI/ 100 admissions) in the hospital was %2.95. The highest rate of NIs was reported from ICUs. Of the infected patients, 45.61% were female, 98.95% had underlying diseases, and 30.88% died due to nosocomial infections. The median (IQR) of the duration of hospital stay among infected patients was 13 (7–18). The most common site of infection was VAE (ventilator-associated events) (39.40%) and the most common isolated agent, irrespective of the organ involved, was Acinetobacter (spp.) (22.75%). Conclusions We reported ICU and Acinetobacter (spp.) as the most affected ward and most common agent involved in recorded NIs respectively. The rate of NI in the study hospital was exceptionally low when compared to its counterparts in a few other developed countries. The INISS needs to be further evaluated with regard to the completeness and representativeness of the surveillance system. Also, we need to evaluate the adherence to the INISS guidelines among staff and physicians in reporting the NIs.