ABSTRACT
The goal of this study was to attempt to determine the rate of con-tamination of health-care workers' [HCWs] hands and environmental surfaces inintensive care units [ICU] by the main bacteria associated with hospital acquiredinfections [HAIs] in Tehran, Iran. A total of 605 and 762 swab samples wereobtained from six ICU environments and HCWs' hands. Identification of the bac-terial isolates was performed according to standard biochemical methods, andtheir antimicrobial susceptibility was determined based on the guidelines recom-mended by clinical and laboratory standards institute [CLSI]. The homology ofthe resistance patterns was assessed by the NTSYSsp software. The most frequent bacteria on the HCWs' hands and in the environmental samples were Acinetobac-ter baumannii [1.4% and 16.5%, respectively], Staphylococcus aureus [5.9% and 8.1%,respectively], S. epidermidis [20.9% and 18.7%, respectively], and Enterococcus spp.[1% and 1.3%, respectively]. Patients' oxygen masks, ventilators, and bed linens werethe most contaminated sites. Nurses' aides and housekeepers were the most contam-inated staff. Imipenem resistant A. baumannii [94% and 54.5%], methicillin-resistantS. aureus [MRSAs, 59.6% and 67.3%], and vancomycin resistant Enterococci [VREs, 0%and 25%] were detected on the hands of ICU staff and the environmental samples,respectively. Different isolates of S. aureus and Enterococcus spp. showed significanthomology in these samples. These results showed contamination of the ICU environ-ments and HCWs with important bacterial pathogens that are the main risk factorsfor HAIs in the studied hospitals
ABSTRACT
Background: n-Butanol is a four-carbon alcohol used widely in foods, cosmetics industries, biology and chemistry research laboratories, and other fields. Long time-effects of inhalation or consumption of small amounts of Butanol on human health are still unknown. On the other hand, numerous reports about the development of n-Butanol toxicity are available. The main objective of the study was to investigate the effects of inhaled and oral administration of n-Butanol as a long-term in vivo investigation
Materials and Methods: small white laboratory, male mice [20-30 g] were used in 11 groups [n=4] including experimental 1 to 6, 1 to 4 control "A" and positive control groups. Experimental groups 1-3, for 10, 20, and 40 days; 5 hours a day were inside a box with ventilation facilities exposed to air saturated with n-Butanol vapor. Experimental groups 4 to 6, received water containing n-Butanol 0.2%, 1% and 5% for 10 days. Control groups B, 1 to 3 was placed for 10, 20, and 40 days inside a similar box exposed to normal air, respectively. Control group B 4 received water without any particular substance for 10 days. The positive control group received 30[micro]l subcutaneous vinblastine. Bone marrow cells were extracted 24 hours after treatments and stained by May-Grünwald-Giemsa staining and the number of micronucleus was counted. Vinblastine, as a positive control, increased an average of micronucleus numbers significantly compared to control group [P<0.001]
Results: n-Butanol inhalation caused no significant difference in 1-3 experimental groups in the average numbers of micronucleus compared to control group, even in the 40 days treatment group, average numbers of micronucleus was decreased comparing to control group [P<0.05]. Also, oral administration of 0.2% and 1% n-Butanol had no effect on the average micronucleus numbers compared to the control group, while oral administration of 5% n-Butanol caused even decrease in average numbers of micronucleus compared to control group [P<0.05]
Conclusion: n-Butanol inhalation may not cause chromosome damages in rat bone marrow cells that probably is due to its very fast metabolism and decomposition in the body. Therefore, the amount of n-Butanol in the systemic circulation and tissues is very low and, probably, the damaging potential is decreased
ABSTRACT
Device-associated health care-acquired infections [DA-HAIs] pose a threat to patient safety, particularly in the intensive care unit [ICU]. However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections [CLABs] per 1000 central line-days, 7.88 ventilator-associated pneumonias [VAPs] per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections [CAUTIs] per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii,Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae andEnterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates. Resistance to oxacillin and imipenem was higher as well. Comparing device use, DA-HAI rates, and bacterial resistance for the primary isolated bacteria indicated a direct association between urinary catheter use and the rates of CAUTI