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

Multidrug-resistant bacteria among patients with ventilator-associated pneumonia in an emergency intensive care unit, Egypt

Ventilator-associated pneumonia [VAP] is the most common hospital-acquired infection among mechanically ventilated patients. Our objectives were to determine the incidence of VAP, isolate multidrug-resistant bacteria, identify the most prevalent resistant strains and identify their antibiotic susceptibility pattern. The VAP rate was calculated. The isolated microbes were identified and tested for antibiotic susceptibilities. The minimum inhibitory concentrations were determined of imipenem, meropenem and ertapenem for Klebsiella isolates. Klebsiella isolates resistant to carbapenems were tested for the presence of the blaKPC gene. The VAP incidence density rate was 48.8 incidences/1 000 ventilator days. The most common Gram-positive organism was Staphylococcus aureus, of which 86.6% of isolates were resistant to cefoxitin, but 100% were sensitive to teicoplanin, linezolid and tigecycline. The most common Gram-negative bacillus was Klebsiella, of which 94.6% of isolates were resistant to cefotaxime, 70.2% to imipenem, and 64.9% to ertapenem, but 100% were sensitive to colistin and 94.6% were sensitive to tigecycline. Of the carbapenem-resistant Klebsiella strains, 23.1% had the blaKPC gene. The high rates of VAP and the high rates of resistance among isolated organisms point to improper implementation of infection control programmes