ABSTRACT
Context : During COVID-19 Pandemic, frontline Health Care Worker (HCW) in hospitals were mandated to Personal Protective Equipment (PPE), while caring for suspected or confirmed COVID-19 patients, which involved the donning of close-fitting N95 Face Masks, Protective Eyewear, Gowns, Surgical Gloves and the use of Powered AirPurifying Respirators (PAPR). Aims : This study is to know the challenges faced during use of PPE among frontline HCW. Methods and Material : This is a cross-sectional study among HCW at our Tertiary Institution who were working in high-risk hospital areas during COVID-19. All respondents completed a self-administered questionnaire Statistical analysis used : Data were entered in Microsoft Excel and analyzed using SPSS version 23. Baseline characteristics were described using frequency and percentages. Association between predictors of PPE associated symptoms were assessed using Chi-square test with p-value of <0.05 considered as significant. Results : Total of 190 Health Care Workers participated in the study. Doctors- contributed most [143/189 (75.2%)]. Majority of the respondents reported usage of Masks, Eyewear, Shield and Gown [126/189 (66.7%)], in which most of them donned N-95 mask [152/189(80.5%)], and Goggles [110/189 (58.2%)] average for 6.32 (2.40) hours a day and 18.15(8.65) days in a month. 83 respondents reported a new onset headache associated with usage of PPE. Majority of the respondents localized Headaches as frontal (69.9%) which was statistically significant. Other symptoms were Tiredness (73.5%), Excess Sweating (45.4%) and Giddiness (20.6%). Conclusions : Prevalence and characteristics of PPE- associated symptoms in HCW working in high-risk areas in Tertiary Care Centers necessitates better measures and strategies for designing PPE and reducing the exposure time in HCW and also the impact on their work performance
ABSTRACT
Background: There is an increased incidence of hospital acquired infection, especially in ICU setting, the most common being ICU acquired pneumonia which increases the morbidity, mortality, prolongs hospital stay and consuming more resources. Microbial etiology of intensive care unit (ICU)-acquired pneumonia (ICUAP) determines antibiotic treatment and outcomes which vary from centre to centre. Hence, a study of risk factors, clinical profile of patient, microorganisms and their resistance patterns to antibiotics are important for the diagnosis, prognosis of patient with ICU acquired pneumonia and also in the prevention of the same.Methods: Patients with ICUAP confirmed microbiologically were prospectively compared according to identification of 1 (monomicrobial) or more (polymicrobial) potentially pathogenic microorganism. Patients without microbiological confirmation were excluded from the study. We assessed clinical characteristics, microbiology and outcome variables.Results: In the present study 60 patients with ICU Pneumonia were included out of which 50 (83%) had mono-microbial infection. Most common organism isolated in mono microbial infection was Klebsiella species (26%), followed by Acinetobacter species (25%), out of which 20 percent was multidrug resistant. Multi-drug resistance was similarly frequent in both groups. Outcome variables like initial response to the empiric treatment, length of stay and mortality were similar in both monomicrobial and polymicrobial pneumonia. Mortality rates were higher with higher pneumonia scores (p value <0.002) and with multi organ dysfunction (p <0.008) irrespective of mono microbial or poly microbial infection.Conclusions: In this study mono microbial infection was more than polymicrobial, the most common organism being Kliebsiella species followed by Acinetobacter species. When empiric treatment is frequently appropriate, mortality rates were higher with higher pneumonia scores and MODS. In our study polymicrobial aetiology did not influence the outcome of ICUAP.