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Objective: To analyze the risk factors of blood-borne occupational exposure among medical staff and explore the relevant intervention measures. Methods: In June 2020, the data of blood-borne occupational exposure and related factors reported by medical staff in a grade Ⅲ, Grade A general hospital from 2011 to 2019 were analyzed by retrospective investigation. Results: Among 431 cases of blood-borne occupational exposure, 69.37% were nurses. It mainly occurred in medical staff with 0-4 years of service, accounting for 63.57%; The main place of occupational exposure was in the ward 47.56%; Sharp instrument injury was the main occupational exposure route 91.65%. Occupational exposure department was mainly surgery department 17.87%; The main source of exposure was hepatitis B virus (HBV) 37.12%, followed by treponema pallidum 20.19%. Statistical analysis results show that: Exposure sites (χ(2)=43.585, P<0.01) , exposure sources (χ(2)=22.693, P<0.01) , treatment methods after exposure (χ(2)=18.866, P<0.01) , Flushing (χ(2)=31.963, P<0.01) and disinfection (χ(2)=14.216, P<0.01) were significantly different. Conclusion: The effective measures to reduce blood-borne occupational exposure are to strengthen occupational protection training of medical staff, standardize operation procedures, strengthen supervision of key groups and departments, improve reporting, monitoring and follow-up systems to realize informatization, and do a good job in risk control.
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Humans , Blood-Borne Pathogens , Medical Staff , Needlestick Injuries , Occupational Exposure/prevention & control , Retrospective Studies , Risk FactorsABSTRACT
【Objective】 To understand the occupational exposure of blood center staff during blood collection and supply, analyze the influencing factors, explore preventive measures and improve the self-protection awareness of staff, so as to further improve the prevention of such occupational exposure in blood centers. 【Methods】 Seventy-two occupational exposure cases, which occurred and registered in Beijing Red Cross Blood Center from January 2010 to December 2021, were reviewed by retrospective survery methods, and such cases were classified and analyzed statistically. The incidence of blood-borne occupational exposure was compared by genders, departments, occurrence locations, education level, occupation type, work link, causes of exposure and body parts, so as to analyze the influencing factors, and then propose corresponding prevention strategies. 【Results】 From 2010 to 2021, a total of 72 blood-borne occupational exposure cases occurred. When classified by gender, the exposure rate of women was more than twice that of men; by age, the exposure rate of 18~25 years old was the highest, reaching 7.84%, but 26~40 years old group contributed the most cases, accounting for 70.83% (51/72); by working years, the exposure rate of staff with working years less than 3 years was relatively high, but the staff with 4~10 working years contributed the most cases, accounting for 54.17% (39/72); by the education level, the the exposure rate of stall with bachelor degree and below was the highest(90.28%, 65/72); by the professional title level, the exposure rate of staff with primary and intermediate professional titles was relatively high (94.44% , 68/72); by departments, the exposure rate of Blood Donation Service was the highest (81.94%, 59/72), which was twice or even three times than that of other departments; by occupational type, nurses had the highest exposure rate, accounting for 87.5% (63/72); by body parts, hands were the most vulnerable body parts to occupational exposure; by location, the exposure rate on mobile vehicles is four times than that in indoor places; by the number of exposure times, the incidence of one exposure cases accounted for 72.22%(52/72)while multiple exposure was rare by work link, the exposure rate of the sampling link was significantly higher than that of the other links. 【Conclusion】 Blood-borne occupational exposure of staff in blood centers is closely related to gender, age, working years, professional title level, department, occupational type, occurrence place, and body part, and has nothing to do with the education level. More attention should be paid to middle-aged female nurses on the front line of blood donation service, staff with primary or intermediate titles and undergraduate degrees. Otherwise, training and protection should be enhanced, operation methods be standardized, the blood collection environment be improved, and the management, automation and intelligent level of blood collection be promoted.
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Objective@#To understand the status of blood-borne occupational exposure and protection among health care workers (HCWs) in dental practice, and provide evidence for making effective prevention.@*Methods@#From April 1 to 15, 2019, a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018, and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals, such as nurses, doctors and trainees, and among different-grade hospitals.@*Results@#A total of 166 HCWs were exposed to occupational exposure 269 times, with the annual incidence of 75.11% (166/221) , and 37.55% (101/269) of exposures were reported. However, all source patients of exposures had failed to be traced. 89.59% (241/269) of exposures were sharp injuries. The top three instruments caused injuries were syringe/bilan needles, suture needles and vehicle needles, accounting for 35.68% (86/241) 、16.60% (40/241) and 16.18% (39/241) , respectively; and the top three exposure operations were removal/disposal of needles or instruments, suture/assisting suture and injection of anesthetic, accounting for 37.17% (100/269) 、22.30% (60/269) and 17.84% (48/269) , respectively. There were statistically significant differences among different professionals in occupational exposure frequency, reporting rate, the types of instruments caused injuries, exposure operations and hepatitis B vaccinated time (P<0.01) . The compliance rate of standard precautions, safe operation, post-exposure reporting and prevention, and training on occupational protection were generally poor among HCWs, with significant differences in different-grade hospitals (P<0.01) .@*Conclusion@#There is a high incidence, low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs. Strongly suggesting that standard precautions, safe use and disposal of oral instruments, active post-exposure report and prevention must be improved for everyone.
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Background: Needle stick injury among health workers is regarded as an occupational hazard. Health care workers are at risk of having blood-borne diseases in case they are exposed to blood and other biological samples of the patients. Moreover, staff including doctors working in tertiary care hospitals has high work load which results in increased chances of getting these injuries. The aim and objectives of this study were to find out the prevalence of needle stick injury among different categories of health care workers. Authors also aimed to assess the knowledge, attitude and practices associated with it.Methods: A hospital based cross sectional study design to know the prevalence of needle stick injury among various health care workers of Karpagam Faculty of Medical Sciences and Research, a tertiary level care hospital in Coimbatore, Tamilnadu, India. A total of 250 health care workers were selected for the study purpose. A self-designed, semi-structured, pre-tested questionnaire was used to assess the prevalence of needle stick injuries and the factors associated with it.Results: A majority of health care workers (94%) knew about needle stick injury and 92% were aware that HIV can be transmitted through needle stick injury, 78.4% and 69.65% were aware of Hepatitis-B and Hepatitis-C transmission respectively. About 28.4% of subjects had encountered needle stick injury in their past. Furthermore, it was found that type of exposure and place of exposure was significantly associated with different categories of health care workers (p <0.001).Conclusions: Prevention of health workers against needle stick injury is the best possible way to prevent several bloods borne diseases. There should be a prevention programme which special focus on training of health care workers. Further strategies aiming at preventive measures and reporting of the Needle stick injuries accidents should be made compulsory among health care workers.
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Purpose: The aim of this study is to know practice pattern of cataract surgeons when operating on patients, positive for blood-borne viral infections (BBVIs), namely, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. We also studied their awareness, knowledge, and attitude toward universal precautions and guidelines. Methods: The telephonic survey enrolled practicing cataract surgeons, who were interviewed to record responses pertaining to their practice using an open-ended questionnaire. We studied statistical significance of difference of frequency of prick injuries in topical versus peribulbar anesthesia, and phacoemulsification versus manual small incision cataract surgery by employing Chi-square test. Significance of proportion was calculated using z-test. For all statistical calculations, significance level was set at 0.05%. Results: Of 623 ophthalmologists contacted, responses of 479 (79%) ophthalmologists were analyzed. Maximum participants were in private practice (48%). During whole practicing carrier, 313 (65%; 95% confidence interval [CI]: 61–70) participants admitted having suffered injury with needle or sharp instruments; of these, 204 (65%; 95% CI: 60–70) participants did not report their injury. Wearing “double gloves” during cataract surgery was the most common barrier adopted by participants. Conclusion: We found high prevalence of occupational-related sharp injuries among ophthalmologists in this survey. Majority of them were aware of universal precautions, but adherence to postexposure prophylaxis was lacking.
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Objective@#To understand the current situation of blood-borne occupational exposure among health care workers and evaluate the intervention effect of PDCA.@*Methods@#Retrospective survey was adopted to investigate and analyze the blood-borne occupational exposure incidents in a hospital from January 2015 to December 2018, and to compare the intervention effects after PDCA management.@*Results@#A total of 82 cases of occupational exposure occurred from 2015 to 2017, and only 9 cases happened after the implementation of PDCA intervention. The exposed population was mainly consisted of nurses (59 cases, 64.83%) , and mainly with low-working age (1-5 years) (56 cases, 61.54%) , and the main source of exposure was hepatitis B (34 cases, 37.36%) . In addition, after the implementation of PDCA, the vaccination rate of personnel was 77.78%, the standardized field treatment rate was 100%, the preventive drug use rate was 88.89%; The qualified rate of occupational protection assessment was higher than that before intervention, which all shows the difference was statistically significant (P<0.05) .@*Conclusion@#With the guide of PDCA management, Strengthen the training of new employees or ones with low working years as well as their awareness of protection, and standardize the relevant operational procedures, which can significantly improve the prevention of blood-borne occupational exposure and stress management of medical staff.
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PURPOSE: Exposure to blood and body fluids represents a significant occupational risk for nurses. This study was done to identify the level of knowledge of and compliance with blood-borne pathogen prevention of hospital nurses according to clinical experience, and to identify factors affecting compliance with blood-borne pathogen prevention. METHODS: A descriptive correlational study was conducted in which self-reported knowledge of and compliance with blood-borne pathogen prevention was assessed. The relationships between variables were examined. Registered nurses who were employed (n=345) were surveyed. Data were analyzed using, t-test, ANOVA, Pearson correlation, and multiple linear regression. RESULTS: Nurses with more than 5 years experience had greater knowledge of blood-borne pathogen prevention than nurses with less than 5 years experience. However, there was no significant difference in compliance with blood-borne pathogen prevention between the two groups. No significant correlation was found between knowledge and compliance with blood-borne pathogen prevention according to experience standards. In nurses with less than 5 years experience, gender, age, reported exposure to a blood-borne pathogen, and compliance with principles of prevention had a significant impact on compliance with blood-borne pathogen prevention. For nurses with more than 5 years experience, reporting after exposure to blood-borne pathogen was a contributing factor to compliance with blood-borne pathogen prevention. CONCLUSION: The study results show that to improve the implementation of preventive measures against blood-borne pathogens different strategies are needed, depending on clinical experience of the nurses.
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Humans , Blood-Borne Pathogens , Body Fluids , Career Mobility , Compliance , Linear Models , NursesABSTRACT
@#Needlestick injury (NSI) is a serious occupational hazard against healthcare workers (HCWs) in a hospital setting with multiple implications, thus adherence to post-NSI management including follow-up protocol is crucial.This research was conducted to describe the distribution of NSI cases among HCWs working in Ministry of Health Malaysia (MOH)’s hospital in Selangor and adherence to a follow-up protocol, as well as the factors related to it.This was a cross-sectional quantitative study reviewing retrospectively all notified NSI cases in January-September 2016. Data were taken from Sharps Injury Surveillance (SIS) system and analyzed into descriptive and analytical statistics.There were 143 notified NSI cases. The majority of the cases were female(76.2%), Malay(60.1%), medical doctors(56.6%) and in a medical-based department (44.8%). The median age of NSI cases was 27 years old (IQR:5) and median years of employment was 1.5 (IQR:4.5). Most cases happened in a ward setting (58.7%) involving contaminated (95.8%) hypodermic needle (43.4%), occurred mostly during the procedure of drawing blood (23.1%). Only 86.7% of NSI cases were source-known and some were tested positive with blood borne pathogens. However, no occurrence of seroconversion among the injured HCWs detected. The overall adherence rate to the follow-up protocol was 72.3%. Multiple logistic regression yielded significant association between age, gender, department, device contamination, procedure conducted and source HBV status with adherence to follow-up of post-NSI protocol. Further comprehensive studies involving more determinants such as therapy-related factors and potential interventions are needed to optimize adherence rate to the follow-up protocol post-NSI.
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Guideline Adherence , Needlestick Injuries , Health Personnel , Post-Exposure Prophylaxis , Blood-Borne PathogensABSTRACT
BACKGROUND@#The objectives of this study are to investigate the incidence and reporting behavior of sharp injuries among healthcare workers (HCWs) and identify the risk factors associated with these injuries.@*METHODS@#A cross-sectional survey was conducted in February 2017 in a provincial teaching hospital in China. Data were collected from 901 HCWs using a self-administered questionnaire which included demographic information, experience, and reporting behavior of sharp injuries. Stepwise logistical regression was used to analyze the risk factors.@*RESULTS@#HCWs (248 [27.5%]) had sustained a sharp injury in the previous year. Factors including seniority, job category, title, education, department, and training programs were associated with the occurrence of sharp injuries. According to the stepwise logistical regression, seniority, and training programs were the risk factors associated with the occurrence of sharp injuries. Of 248 sharp injuries, 130 HCWs were exposed to blood. Only 44 (33.9%) HCWs reported their injuries to the concerned body. The main reasons for not reporting the sharp injuries were as follows: perception that the extent of the injury was light (30.2%), having antibodies (27.9%), and unaware of injury (16.3%).@*CONCLUSIONS@#Sharp injuries in the studied hospital were common and were likely to be underreported. Therefore, an effective reporting system and sufficient education on occupational safety should be implemented by the relevant institutions. Moreover, it is important to take effective measures to manage sharp injuries in HCWs and provide guidance for their prevention.
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Adult , Female , Humans , Male , China , Epidemiology , Cross-Sectional Studies , Health Personnel , Hospitals, Teaching , Incidence , Needlestick Injuries , Epidemiology , Psychology , Occupational Exposure , Risk FactorsABSTRACT
Objective To study the characteristics of occupational exposure to blood-borne pathogens and the cost of prevention and control,and provide evidence for policy making in medical institutions.Methods A prospective study was conducted to collect the data and follow-up data about occupational exposure of health care workers(HC-Ws)from the occupational exposure reporting system of a hospital between June 1,2016 and May 30,2017.Results There were 95 cases of occupational exposure to blood-borne pathogens.Occupational exposure occurred mainly in June,July,and November,peak time for occurrence was 12∶00 at noon.The main occupations of HCWs who sustained occupational exposure were nurses (41.05%),doctors (28.42%),and practice nurses (15.79%).The main departments of occupational exposure were central operating room (21.05%), emergency department (1 1.58%),and interventional radiology department (6.32%).The total cost of prevention and control for 95 times of occupational exposures were 33 235.20 Yuan,with an average of 349.84 Yuan per case.The average cost per case after human immunodeficiency virus (HIV)exposure was the highest (2 787.50 Yuan);and cost of syphilis exposure was the lowest (58.88 Yuan).Conclusion It is necessary to strengthen the training and education of high-risk time,high-risk population,and high-risk departments of occupational exposure to blood-borne pathogens,pre-vention of occupational exposure with high cost of prevention and control such as HIV should be especially paid attention.
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Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.
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Objective@#To improve the awareness of bloodborne pathogen exposure protection knowledge, reduce the contact incidence (including sharp injuries, contacting with the broken skin and mucous mem-brane contact) , and increase the self-report incidence of bloodborne pathogen exposure in the healthcare work-ers of the investigated hospital after the intervention. To summarize effective prevention and intervention mea-sures of occupational exposure to bloodborne pathogen.@*Methods@#The project was on the basis of previous inves-tigations in a general hospital, after comparing the personnel structure and departments distribution of 727 HC-Ws before the intervention and 614 HCWs after the intervention, we selected several departments in which the healthcare workers with a higher risk of occupational exposure to bloodborne pathogens. We promoted the hospi-tal to set up occupational health prevention and control system, improved related files, supplemented by knowl-edge training, discussion and field guidance, such a comprehensive intervention in the hospital. After the inter-vention, we conducted an cross-sectional investigation, and compared the rate of protection knowledge aware-ness, self-reporting rate after exposure, occupational exposure to bloodborne pathogens (including sharp inju-ries, contacting with the broken skin and mucous membrane contact) incidence before and after the intervention.@*Results@#Before and after the intervention, the total score of the investigated population of 14 knowledge points that we focused on in training showed a significant difference (P<0.05) , total contact incidence of bloodborne pathogen exposure reduced from 81.57 persons/100 persons per year to 43.81 persons/100 persons per year, the RR of bloodborne pathogen exposure in the former investigation was 1.86 times of that in the latter investigation, the self-reported incidence increased form 2.06 persons/100persons per year to 9.45 persons/100 persons per year, self-reporting rate after exposure increased form 0.47% to 9.65%.@*Conclusion@#The interventions signifi-cantly improved the awareness of bloodborne pathogen exposure protection knowledge, effectively reduced the contact incidence of bloodborne pathogen exposure, and increased the self-reported incidence in the healthcare workers of the investigated hospital.
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Context: HCWs all over the world carry occupational risk of getting infected with major blood borne infections through needle stick injuries (NSIs). As health care industry has been expanding, risk of nosocomial infections is increasing proportionately. Measures to prevent it and put in place a mechanism to control these injuries are needed urgently, especially in India where there is not only increase in domestic demand but impetus in health tourism. Aim: To determine HBs Ag, HBc IgM level and to assess anti-HBs level prevalence in HCWs, in a tertiary care hospital and to study the influence of factors like age and sex in the vaccinated HCWs and formulate mechanism to increase awareness to create a safe working environment in the hospitals. Settings and Design: 437 HCWs, working in Laboratories, Surgical, Medical or Dental departments in 11 Civil Hospitals and Sub-district Hospitals covering 8 circles of the State. Methods and Material: Qualitative and Quantitative estimation of HBs Ag and Anti-HBs by sandwich ELISA technique and qualitative HBc IgM level by antibody-capture, non-competitive test. Liver profile (SGPT, SGOT and Alkaline Phosphatase) by IFCC method done. Statistical Analysis Used: Tabulation and Pie Circle Result: 193 of the total 229 vaccinated HCWs tested positive for core antibody, meaning that they were infected prior to HBs Ag vaccination, leaving a total of 36 ‘truly’ vaccinated HCWs. 11 HBs Ag positive HCWs were tested for Liver Profile and all had ALAT, ASAT and ALP within normal range. Out of total number of 141 HCWs having 10 and below IU/L anti HBs, 5 HCWs were positive for HBS Ag, showing a positivity of 3.5%. Conclusion: Need of vaccination and for post-vaccination serological testing of all HCWs considering the high rates of non-responders and low responders (anti-HBs-34.2%). Importance of educating the HCWs of safety precautions while handling body fluids, and the management of ‘ sharps ‘ injuries.
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Objective:To understand general hospital medical staff status quo and characteristics of blood -borne occupational exposure , analysis its ethics factor , to make the prevention countermeasures of blood -borne oc-cupational exposure to provide scientific basis .Methods:From January 2013 to December floor all the medical staff of blood -borne occupational exposure cases were retrospectively analyzed .Results:A total of 101 medical staff blood-borne occupational exposure , which is given priority to with the nurse , accounted for 60 .40%;More con-centrated in under 30 employees, accounted for 70.29%;Occupational exposure personnel distribution in the ma-jority with surgical department (42.57%), followed by the physician (36.63%);Wards (60.40%), the operat-ing room (15.84%) and therapy (11.88%) are the sites of occupational exposure often happen;Sharp injury in the composition of the ratio of 87.12%, in the first place, in which a proportion (23.76%), pull out the needle (18.81%) and blood (15.84%), surgical suture (14.85%) and transfusion injection (13.86%) as the sharp injury of frequent occurrence of occupational exposure;Exposure is given priority to with hepatitis b ( 61 .38%) . Conclusion:Medical staff blood-borne occupational exposure risk is high , the hospital infection control personnel must pay attention to occupational exposure of the whole education , strengthen the administration of the occupation-al exposure of ethics , reduce the risk of occupational exposure and injury .
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Extraction of an impacted third molar is one of the most frequently performed techniques in oral and maxillofacial surgery. Surgeons can suffer numerous external injuries while extracting a tooth, with percutaneous injuries to the hand being the most commonly reported. In this article, we present a case involving a percutaneous injury of the surgeon's femoral region caused by breakage of the fissure bur connected to the handpiece during extraction of the third molar. We also propose precautions to prevent such injuries and steps to be undertaken when they occur.
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Accidents, Occupational , Blood-Borne Pathogens , Hand , Infection Control , Molar, Third , Surgery, Oral , Tooth , Tooth Extraction , Wounds, PenetratingABSTRACT
Objective To investigate occupational exposure among health care workers (HCWs)in a tertiary comprehen-sive hospital,and analyze the causes and preventive measures of occupational exposure.Methods 134 cases of occupational exposure among HCWs in a hospital from January 2010 to December 2013 were analyzed.Results Of HCWs sustained oc-cupational exposure,doctors,nurses,and technicians accounted for 59.70%,19.40%,and 9.70% respectively.The main cause for occupational exposure was non-standardized management of the sharps (46.27%,n=62),followed by unex-pected operation(42.54%,n=57)and inadequate protective measures (11.19%,n=15);The main exposure mode was sharp injury(94.78%,n=127),mucosal exposure accounted for 5.22% (n= 7);42.54% of exposure sources were not clear,57.46% of exposure sources were clear,35.82%,12.69%,3.73%,and 2.24% of which were hepatitis B virus (HBV),hepatitis C virus(HCV),Treponema pallidum(TP),and human immunodeficiency virus(HIV);2.24%(n=3)of exposure sources were co-infection of HBV and HCV;0.74% (n = 1 )was co-infection of HIV,HBV,HCV,and TP. 95.52%of occupational exposures were treated correctly.Conclusion The high-risk population for occupational exposure are nurses,standard occupational precautions and management of the sharps can reduce the occurrence of occupational expo-sure among HCWs.
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The Retrovirus Epidemiology Donor Study (REDS) program was established in the United States in 1989 with the purpose of increasing blood transfusion safety in the context of the HIV/AIDS and human T-lymphotropic virus epidemics. REDS and its successor, REDS-II were at first conducted in the US, then expanded in 2006 to include international partnerships with Brazil and China. In 2011, a third wave of REDS renamed the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) was launched. This seven-year research program focuses on both blood banking and transfusion medicine research in the United States of America, Brazil, China, and South Africa. The main goal of the international programs is to reduce and prevent the transmission of HIV/AIDS and other known and emerging infectious agents through transfusion, and to address research questions aimed at understanding global issues related to the availability of safe blood. This article describes the contribution of REDS-II to transfusion safety in Brazil. Articles published from 2010 to 2013 are summarized, including database analyses to characterize blood donors, deferral rates, and prevalence, incidence and residual risk of the main blood-borne infections. Specific studies were developed to understand donor motivation, the impact of the deferral questions, risk factors and molecular surveillance among HIV-positive donors, and the natural history of Chagas disease. The purpose of this review is to disseminate the acquired knowledge and briefly summarize the findings of the REDS-II studies conducted in Brazil as well as to introduce the scope of the REDS-III program that is now in progress and will continue through 2018.
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Humans , Blood Safety , Hematologic Diseases , Retroviridae Infections/epidemiology , Retroviridae , Blood Transfusion/standardsABSTRACT
Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was done with the 42 cases of fungemia in our hospital.Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia.95.2％ of the fungemia pathogen agent was monilia.8 cases combined with bacterial septicemia,accounting for 19.0％.Drug sensitivity test showed that 2 cases were intermediary to Fluconazole,1 patient was resisdence to Amphotericin B but sensitive to Voriconazole,Itraconazole and fluorocytosine.The main risk factors of fungimia included using wide-spectrum antibiotic,neutophil less than 0.5 × 109/L,central venous indwelling catheter,age and the time of in hospital more than 15 days.Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors.Timely and effectively antifungal therapy is also needed.
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Objective To analyze the patients with infection before transfusion in onder to avoid misdiagnosis and blood transfusion caused by cross-infection and remind medical staff attention to operation and self-protection.Methods HBsAg,Anti-HCV,Anti-TP,Anti-HIV1/2 were detecced by 2 576 cases of pre-operative,prenatal,blood transfusions before the patient's blood ELISA assay.Results 2 576 cases of infectious markers in patients with serum positive rate was 12.15％.The positive rates of was HBsAg,Anti-HCV,Anti-TP,Anti-HIV1/2:11.06％,2.13％,1.67％,0.00％,HBsAg and Anti-HCV were positive for both the percentage of 0.54％.Conclusion The transfusion of pre-infection detection is necessary for patients with early diagnosis and treatment of infectious diseases to avoid and prevent hospital infections,medical personnel,as well as occupational infection to reduce or avoid blood transfusion caused by medical disputes.
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BACKGROUND: The aim of this study was to investigate the clinical features and epidemiology of bloodstream infections (BSIs) in 2 distinctive hematological wards of the Catholic Blood and Marrow Transplantation (BMT) center. MATERIALS AND METHODS: We retrospectively reviewed the medical data of patients who developed BSIs from June 2009 to May 2010 in 2 hematologic wards at the Catholic BMT center. Ward A is a 44-bed unit mainly conducting conventional high dose chemotherapy and ward B is a 23-bed unit exclusively conducting BMT. RESULTS: Overall, 222 BSI episodes were developed from 159 patients. Acute myeloid leukemia in ward A and multiple myeloma in ward B were more frequent than in ward B and A, respectively. Sex, age, presence of neutropenia, shock, Pitt bacteremia score, type of central catheter, level of C-reactive protein, duration of admission days, type of BSI, overall mortality and distribution of organisms were not different between the 2 wards. There were 202 monomicrobial and 20 polymicrobial BSI episodes, including 2 fungemia episodes. The incidence rate of overall BSIs per 1,000 patient-days was higher in ward A than in ward B (incidence rate ratio 2.88, 95% confidence interval 1.97-4.22, P<0.001). Among 243 organisms isolated, the number of gram positives, gram negatives and fungi were 122, 119 and 2, respectively. Escherichia coli was the most common organism in both ward A and B (27.6% and 42.4%), followed by viridians streptococci (18.6% and 15.2%) and Klebsiella pneumoniae (13.3% and 9.0%). Extended spectrum beta-lactamase (ESBL) producers accounted for 31.9% (23/72) of E. coli and 71.0% (22/31) of K. pneumoniae. Out of 19 Enterococcus faecium, 7 isolates (36.8%) were resistant to vancomycin. The crude mortality rates at 7 and 30 days after each BSI episode were 4.5% (10/222) and 13.1% (29/222), and were significantly higher in the patients with shock compared with those without shock (20.5% vs. 1.1%, P<0.001 and 38.5% vs. 7.7%, P<0.001, respectively). CONCLUSIONS: The incidence rate of BSIs was higher in patients receiving chemotherapy than those receiving BMT, but the distribution of organisms was not different between the 2 wards. E. coli was the most common causative BSI organism in hematologic wards followed by viridians streptococci and K. pneumoniae.