Reprocessing practices for gastrointestinal endoscopes: a multicentre study in Egyptian university hospitals

The aim of this study was to assess the practices of health care workers during gasterointestinal endoscope reprocessing, evaluate their knowledge about reprocessing, and verify their compliance with laboratory and microbiological tests in endoscopy units at Zagazig University and Fayoum University hospitals. All nursing staff on duty from 10 endoscopy units, with 16 flexible endoscopes, were included. Knowledge and practice were assessed by a questionnaire and a checklist. The mean knowledge score was 7.5 [SD 1.9], which was poor. Compliance was 90% for disinfection and 74% for endoscope processing after disinfection. Before reuse after cleaning, no organisms were detected in 5 endoscopes, while 8 colony forming units were found in 2. Pseudomonas aeruginosa was the most common organism isolated. Strict implementation of the reprocessing guidelines are needed, especially the pre-cleaning stage and leak testing. Repeating high level disinfection after storage and before use must be followed

Hospital outpatient clinics as a potentialhazard for healthcare associatedinfections

Healthcare acquired infections are no longer confined to the hospitalenvironment. Recently, many reported outbreaks have been linked to outpatientsettings and attributed to non-adherence to recommended infection-preventionprocedures. This study was divided into two parts: The first is a descriptive cross-sectional part, to assess the healthcare personnel's knowledge and compliance withStandard Precautions [SP]. The second is an intervention part to assess the roleof health education on reducing the level of environmental and reusable med-ical equipment bacterial contamination. Assessment of the doctors' and nurses'knowledge and compliance with SP was performed using a self-administeredquestionnaire. Assessment of environmental cleaning [EC] and reusable medicalequipment disinfection has been performed using aseptic swabbing method. Theextent of any growth was recorded according to the suggested standards: [A]Presence of indicator organisms, with the proposed standard being <1 cfu/cm[2].These include Staphylococcus aureus [including methicillin-resistant Staphylococ-cus aureus, MRSA], Enterococci, including vancomycin-resistant Enterococci [VRE]and various multidrug-resistant Gram-negative bacilli. [B] Aerobic colony count,the suggested standard is <5 cfu/cm[2]. The effect of health education interven-tion on cleaning and disinfection had been analyzed by comparing the differencein cleaning level before and after interventional education. Good knowledge andcompliance scores were found in more than 50% of participants. Primary screeningfound poor EC and equipment disinfection as 67% and 83.3% of stethoscopesand ultrasound transducers, respectively, were contaminated with indicator orga-nisms. For all indicator organisms, a significant reduction was detected after intervention [p = 0.00]. Prevalence of MRSA was 38.9% and 16.7%, of the total S. aureusisolates, before and after intervention, respectively. Although 27.8% of the totalEnterococcus isolates were VRE before intervention, no VRE isolates were detectedafter intervention. These differences were significant. Development and monitor-ing of the implementation of infection prevention policies and training of HCP isrecommended

Nosocomial infections in respiratory failure patients in intensive care unit

The subjects of this study were 20 ventilated patients with acute respiratory failure and chronic obstructive disease [COD] admitted to the General Intensive Care Unit of Zagazig University Hospital and needed ventilation. Sputum samples from patients and swabs from different parts of ventilators were cultured on Blood agar and MacConkey's agar. Then these cultures were examined for bacterial growth, colonial morphology and cultural characteristics, Gram stained films were done and examined microscopically to identify the organism. As regards ventilated patients 9 patients out of 20 [45%] were already infected before ventilation. After 24 hours the incidence of infection increased to 11 patients [55%]. While after 48 hours 16 patients out of 20 [80%] were infected and increased to 18 patients [90%] after 72 hours. The most predominate organisms isolated from endotracheal secretion were Gram-negative bacilli. [40%]. The use ventilators limb were found to be the main source of contamintion. Only one ventilator [5%] was found to be contaminated from limbs before use. After 24 hours 8 ventilators [50%] and after 48 hours ventilators [45%] were contaminated 10 ventilators [50%] were contaminated from limb after 72 hours. The most prevalent organisms isolated from ventilators were Gram-negative bacilli. The antibiotic sensitivity of the isolated organisms was done

Colorzyme E.A, a simple and rapid test for detection of rabies antigen in infected cell culture and rabies post-vaccination antibody

A new simple, rapid and highly sensitive method, colorzyme, E.A. [lmmunoconcepts] for rabies antigen detection in infected cell culture and for rabies post-vaccination antibody determination has been developed. Vero cells infected by rabies strain, FRVK from passage level 19 to 3.7 were tested by colorzyme test in comparison with immuno-fIuorescent [IF] test and the results were identical in the two tests. 7 days post-infection using colorzyme test, from 60-90% to cells were found to be infected according to the input multiplicity dose of inoculum used [IMD] and the duration of post-infection. Infected cells showed dark blue-purple staining inclusions in the cytoplasm while negative control non infected cells showed faint red staining using only an ordinary microscope. Testing rabies post-Vaccination antibody by colorzyme and ELISA, the results were identical. Sera with high or low antibody level in I/U by ELISA could easily be distinguished by Colorzyme test. All incubations in colorzyme E.A. test were in room temperature and only an ordinary microscope was used