Prevalence of COVID19 infection in health care workers in first wave of pandemic and role of hospital infection control committee in subsequent waves of pandemic

: Corona virus disease 2019 (COVID-19) is a new emerging infectious disease, first identified in China in December 2019, caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). : To study and analyze the prevalence, demographic characteristics of healthcare workers (HCWs) who tested positive for COVID-19 in a dedicated Covid hospital in Mumbai.This was a retrospective observational study of HCWs with COVID-19 in a dedicated Covid Hospital, Mumbai from April to October 2020.HCW tested positive for COVID-19 was 55 from April to October 2020.The percentage of infected hospital staff was 9.8%. Most of the infected HCWs were in the age group of 51 to 60. Mean age was 42 years. Mortality was 0.1%. Majority HCWs (70.9%) acquired infection from community; 20% acquired from the hospital and 9.1% acquired infection from infected coworkers. Majority of the affected HCWs were nurses followed by doctors. Comorbidities were reported in 23.6% of infected HCWs. 5.4% of infected HCWs received infection because of aerosol generated procedures. 58.1% of HCWs got infection despite receiving prophylaxis like HCQ, Arsenicumalbicum.HCWs are at an increased risk of COVID-19 in the workplace. Preparedness of HICC (Hospital Infection Control Committee), frequent training sessions and mock drills are of paramount importance in preventing spread of infectious disease. Coordination between Hospital Administrators, Public Health Officials of national and international organizations, Engineering Department, Occupational Health and Safety staff is essential in combating pandemic.

Clonal Relationship and Resistance Profiles Among ESBL-Producing Escherichia coli

AmpC β-lactamases hydrolyze all β-lactams except cefepime and carbapenems. The study of AmpC-producing E. coli has high priority for the infection control committee. This research is aimed to investigate the resistant urinary AmpC-generating E. coli isolates and identify their genetic variety. Some 230 E. coli isolates from patients suffering urinary tract infection symptoms were studied in 2017–2018 to assess their susceptibility toward antimicrobial agents. AmpC gene was evaluated by PCR and molecular typing using the 10-loci MLVA method. MLVA images were examined by BioNumerics 6.6 software through the use of the UPGMA algorithms. Thirty-eight AmpC-generating E. coli isolates were detected. The most abundant determinant was blaCIT and blaEBC, blaFOX, and blaDHA had the next ranks, respectively. Six major clusters and a singleton were identified by MLVA. AmpC beta-lactamases in urinary isolates of E. coli in the hospital under study and high rate of additional resistance to gentamicin, cotrimoxazole and ciprofloxacin. The most frequent gene determinant of AmpC beta-lactamase was blaCIT and vary depending on time and geographical location.

Multiresistant microorganism infection in newborns at an intermediate neonatal care unit and intensive care unit of reference: cross-sectional study

The objective was to describe the infection profile of multidrug-resistant organisms of newborns (NB), admitted to the neonatal intermediate care unit and the intensive care unit. It was a descriptive cross-sectional study of epidemiological nature, composed of 931 medical records and/or Hospital Infection Control Committee notification records, during the period of June to September 2012. Eight hundred and seventy newborns (NB) were admitted to the neonatal intensive care units and to intermediate care, with a final sample of 45 NB presenting bloodstream infections (BSI) caused by multiresistant microorganisms. From the analyses, the following results were highlighted: gestational age < 37 weeks in 42 (93.3%); low weight at birth between < 750g to 1.499g. The profile for resistance to enterobacteriaceae was 100% for cefepime and ceftazidime concerning non-fermenting gram-negative bacteria, it was found that (100%) of P.aeruginosa was resistant to aztreonam, (100%) of S. maltophilia resistant to ceftazidime and to gentamycin, however, (1.1%) of S. aureus isolates were resistant to oxacillin and (12.5%) of S. haemolyticus demonstrated a confirmed resistance to vancomycin. These results are worrying and express the importance of correct monitoring, and the need for producing a propaedeutic protocol in consensus with the multiprofessional team through the Hospital Infection Control Committee and managers, which is then implemented and regularly assessed by the service.

Improvement of hand hygiene compliance in a private hospital using the Plan-Do-Check-Act (PDCA) method

Objective: Improving the compliance to hand hygiene in healthcare providers is important to reduce healthcare-associated infections. This study aimed to compare the compliance rate before and after the improvement of compliance to hand hygiene. Methods: In this study 270 of the 348 medical staff working in a 61-bed private hospital was observed. The informed observation was performed by the infection control committee in the entire hospital using “Five Moments for Hand Hygiene” for a period of one year. After the first six months, an improvement study was conducted together with the hospital’s quality department using the plan-do-check-act cycle. The study was conducted in a private hospital in Istanbul/Turkey; Kadıkoy Florence Nightingale Hospital in 2014. Results: In the first six months of the year, 153 actions were observed at 316 proper situations. The compliance rate was 35%, 54% and 64% for the physicians, nurses and, other healthcare staff, respectively. The overall compliance rate was 48%. One hundred eighty-three actions were observed for 306 situations after the improvement and education studies. The compliance rate was 29%, 72% and 86%. The overall mean compliance rate was 60%. Conclusion: The promotion of hand hygiene requires the cooperation of the hospital administrators, infection control committee, and quality departments for better hand hygiene practices among the healthcare providers. doi: https://doi.org/10.12669/pjms.35.3.6 How to cite this:Demirel A. Improvement of hand hygiene compliance in a private hospital using the Plan-Do-Check-Act (PDCA) method. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.6 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Are We Ready for Bioterrorism? Health Personnel were Affected by Contaminated Meat Cooked at a Daily Routine Hospital Kitchen

Introduction:Salmonellae are gram-negative motile bacilli. The transmission of salmonellae to a susceptible host usually occurs from the consumption of contaminated foods. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, but can be severe enough to require hospitalization.Aim:Describe a hospital kitchen based mass foodborne infection.Methods:Descriptive analysis of the foodborne infection event.Results:310 health personnel were contaminated from lunch that was cooked at our hospital kitchen. On that day 70 patients came to the emergency department for complaints of vomiting, fever, and diarrhea. During the next two days, we canceled all planned surgical operations. At the second day, we followed 80 patients and third day 150 patients came to our emergency services. Our emergency services and ıntensive care units were blocked because of personnel illness. We examined all patients, got blood tests and stool stains and cultures. Because of this mass casualty contamination, our infection control committee gave formal information that suspicious of Salmonellosis. 13 of 310 infected health personnel were hospitalized. They got intravenous saline and electrolytes support like calcium and potassium. After two days we got Results of stool cultures, there was inoculation of Salmonella types. None of them died.Discussion:We realized that we are not ready for mass casualty incidents like this contamination. Because our patient flow was really blocked. We had to call in new doctors and nurses from different hospital staffs. The event was similar to bioterrorism conditions and we suddenly have to put in place hospital disaster plans at the beginning of decontamination. This situation made us to recognize bioterrorism agents like Salmonella types. We have to raise awareness of the community about chemical, biological, radiological and nuclear agents attacks.

Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study

Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics. A cross-sectional survey of 2514 randomly sampled US NHs was conducted to assess IP training, staff turnover, and infection control program characteristics (ie, frequency of infection control committee meetings and the presence of 7 antibiotic stewardship policies). Responses were linked to concurrent Certification and Survey Provider Enhanced Reporting data, which contain information about NH facility characteristics and citations. Descriptive statistics and multivariable regression analyses were conducted to account for NH characteristics. Surveys were received from 990 NHs; 922 had complete data. One-third of NHs in this sample received an infection control deficiency citation. The NHs that received deficiency citations were more likely to have committees that met weekly/monthly versus quarterly ( P < .01). The IPs in 39% of facilities had received specialized training. Less than 3% of trained IPs were certified in infection control. The NHs with trained IPs were more likely to have 5 of the 7 components of antibiotic stewardship in place (all P < .05). The IP training, although infrequent, was associated with the presence of antibiotic stewardship policies. Receiving an infection control citation was associated with more frequent infection control committee meetings. Training and support of IPs is needed to ensure infection control and antibiotic stewardship in NHs. As the CMS rule becomes implemented, more research is warranted. There is a need for increase in trained IPs in US NHs. These data can be used to evaluate the effectiveness of the CMS final rule on infection management processes in US NHs.

PERCEPÇÃO DOS ENFERMEIROS ASSISTENCIAIS SOBRE A COMISSÃO DE CONTROLE DE INFECÇÃO HOSPITALAR

Objetivo: analisar a percepção dos enfermeiros assistenciais sobre a função da Comissão de Controle de Infecção Hospitalar. Metodologia: pesquisa descritiva, com abordagem qualitativa, desenvolvida em um hospital universitário, com oito enfermeiros. Para a análise dos dados, utilizou-se a análise de conteúdo. Resultados: emergiram três categorias temáticas: conhecimento acerca da função da CCIH; reconhecimento da importância do enfermeiro na CCIH e contribuição do enfermeiro assistencial para com a CCIH. Conclusão: destaca-se o não reconhecimento da Comissão como órgão preventivo, mas muitas vezes atrelado somente à pós-exposição a acidentes de trabalho, evidenciando a cultura curativa no ambiente hospitalar.Descritores: Infecção Hospitalar, Controle de Infecções, Enfermagem.UNDERSTANDING OF ASSISTANT NURSES ABOUT THE HOSPITAL INFECTION CONTROL COMMITTEEObjective: To analyze the understanding of assistant nurses on the role of the Hospital Infection Control Committee. Methodology: Descriptive research, with a qualitative approach, developed in a university hospital, with eight nurses. For the analysis of the data, the content analysis was used. Results: Three subject areas emerged: Awareness about the role of HICC; Recognition of the importance of nurses in the HICC and their contribution to it. Conclusion: Failure to recognize the Commission as a preventive body stands out, but often only linked to post-exposure to work accidents, revealing the curative care culture in the hospital environment.Descriptors: Hospital Infection, Infection Control, Nursing.PERCEPCIÓN DE LOS ENFERMEROS ASISTENCIALES SOBRE LA COMISIÓN DE CONTROL DE INFECCIONES HOSPITALARIASObjetivo: Analizar la percepción de los enfermeros asistenciales sobre el papel de la Comisión de Control de Infecciones Hospitalarias. Metodología: estudio descriptivo con un enfoque cualitativo, desarrollado en un hospital universitario, con ocho enfermeros. Para la análisis de los datos, se utilizó la análisis de contenido. Resultados: tres categorías temáticas surgieron: El conocimiento de la función de CCIH; El reconocimiento de la importancia de los enfermeros en CCIH y la contribuición del enfermero asistencial por el CCIH. Conclusión: Es digno de mención o no reconocimiento de la Comisión como órgano preventiva, a menudo torpe justo después de la exposición a los accidentes de trabajo, mostrando una cultura curativa en el ámbito hospitalario.Descriptores: Infección Hospitalaria, Control de infecciones, Enfermería.