Primer caso de transmisión de mpox mediante toma de muestra por desteche en Chile

Mpox es una zoonosis vírica que causa síntomas similares a la viruela, aunque menos graves. La infección fue descrita inicialmente en África central y occidental. Luego del brote multinacional ocurrido el año 2022, ya no es considerada una emergencia de salud pública de importancia internacional. El mecanismo de transmisión es por contacto físico estrecho o directo con lesiones cutáneas de individuos infectados. Presentamos el caso clínico de una enfermera que se infectó por mpox tras un accidente cortopunzante durante la toma de muestra de una lesión por desteche con bisturí en un paciente con VIH. La transmisión percutánea tuvo un período de incubación corto, seguido de una lesión cutánea y síntomas sistémicos. Aunque infrecuente, se destaca el riesgo de transmisión ocupacional de mpox en la atención clínica. Es importante que el personal sanitario adhiera estrictamente a las medidas de prevención, como el uso de equipo de protección personal y la práctica segura en la toma de muestra.

Monkeypox is a viral zoonosis that causes symptoms similar to smallpox, but less severe. The infection was initially described primarily in central and western Africa. After multi-country outbreak in 2022; it is currently no longer a public health emergency of international concern. The main mode of transmission is through close or direct contact with the skin lesions of an infected individual. We report a case of a nurse was infected with mpox after a needlestick injury during a skin sample collection from an HIV-positive patient. Percutaneous transmission resulted in a short incubation period, followed by a skin lesion and systemic symptoms. This case highlights the risk of occupational transmission of mpox in healthcare settings. It is important for healthcare workers to take rigorous prevention measures, such as the use of appropriate personal protective equipment and safe sample collection practices.

Prevalence of needlestick injury among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND@#Health facilities can provide diagnostic, curative, and prognostic services for the community. While providing services, healthcare workers can be exposed to needlestick injuries that can transmit pathogenic organisms through body fluids.@*OBJECTIVE@#The aim was to establish the pooled prevalence of needlestick injuries among healthcare workers in Ethiopia.@*METHODS@#This systematic review and meta-analysis was conducted according to PRISMA guidelines. Articles were searched from Google Scholar, PubMed, Science Direct, and Scopus databases using a combination of keywords and Boolean functions. All the searched articles were imported into the EndNote X9 software, and then, duplicate data files were removed. Article screening and data extraction were done independently by two authors. Data manipulation and analyses were done using STATA version 15.1 software.@*RESULTS@#The analysis of 23 full-text articles showed that the prevalence of the 12-month and lifetime needlestick injuries among the primary studies ranged from 13.2 to 55.1% and 18.6 to 63.6%, respectively. The pooled prevalence of needlestick injuries among the Ethiopian healthcare workers was 28.8% (95% CI 23.0-34.5) and 43.6% (95% CI 35.3-52.0) for the 12 months and lifetime, respectively.@*CONCLUSIONS@#The pooled prevalence of needlestick injuries among Ethiopian healthcare workers was high. Therefore, efforts should be implemented to reduce the occurrence of injuries. Adequate protective equipment and safety-engineered devices should be supplied for the healthcare workers. It could be more effective to reduce the factors contributing to increased exposures through the allocation of adequate numbers of the healthcare workforce and implementing in-service training.

Association of Sleep Disturbance, Fatigue, Job Stress and Exposure to Blood and Body Fluid in Shift-work Nurses

PURPOSE: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. METHODS: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. RESULTS: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance (ISI≥15), fatigue (FSS score≥4), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS score≥4). CONCLUSION: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

Elimination of Lancet-Related Needlestick Injuries Using a Safety-Engineered Lancet: Experience in a Hospital

BACKGROUND: Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. MATERIALS AND METHODS: We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. RESULTS: There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. CONCLUSION: The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.

Elimination of Lancet-Related Needlestick Injuries Using a Safety-Engineered Lancet: Experience in a Hospital

BACKGROUND: Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. MATERIALS AND METHODS: We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. RESULTS: There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. CONCLUSION: The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.

Risk factors affecting occupational exposure to blood and body fluids among dental students: a cross-sectional study in a Brazilian Federal University

Introduction: Dental students are often exposed to bloodborne pathogens during dental training. Several factors are involved in increased risk of human deficiency, hepatitis B and hepatitis C virus (HIV, HBV, and HCV) infection. However, there are few studies that address the risks and forms of prevention among dental students in Brazil. Methods: A cross-sectional study of occupational exposure to blood or body fluids among dental students of Universidade Federal do Rio Grande do Sul, Brazil, was performed. These students were referred to the Occupational Medicine Department of Hospital de Clínicas de Porto Alegre from January 2007 to April 2015. Analyzed data included type of exposure (needlestick injury, mucosal exposure, and exposure to non-intact skin); source patient status for HBV, HIV and HCV infection, accident during dental training, procedure performed, biological material involved, type of accident, and hepatitis B vaccination and serological protection status. The objective was to know the incidence rate and others characteristics of accidents in order to prevent them. Results: There were 312 accidents during the study period of 8 years and 4 months. Incidence rate was 87,42 exposures per 1000 students year. Source patient was known in 297 of the cases (95.2%), of which 3 were HBsAg reagent, 12 were HIV reagent, and 17 were HCV reagent. The majority of accidents occurred during procedure, but nearly as high as 40% occurred after procedure, of which 63% occurred during instrument cleaning, disinfecting or sterilizing. Most involved sharp instruments were anesthetic syringe needle and curette. Only 48% of dental students knew their antiHBs was > 10 mIU/mL. Conclusions: Dental students should be tested for hepatitis B immune status at the beginning of training, and vaccination should be available to all dental students before they start clinical practice. Work practice controls on sharp devices should be addressed at the beginning and strengthened during dental training. Dental training institutions should review instrumental cleaning process to minimize handling of loose contaminated instruments (AU)

Status of needlestick injuries among nurses in China during venous blood sampling / 中国感染控制杂志

Objective To investigate the current status of nurses'' needlestick injuries during venous blood sampling, evaluate effective prevention strategies.Methods A stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on.Results A total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered.93.17％ of the investigated nurses had participated in the training of venous blood sampling regularly;87.15％ received regular check of venous blood sampling;before venous blood sampling, only 72.74％ knew whether the patient had bloodborne infectious disease;only 61.01％ wore gloves during blood sampling.Incidence of needlestick injuries during venous blood sampling was 20.78％ in the past year.There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson x2=1.649, P=0.438).48.21％ of needlestick injuries occurred during disposing medical waste.Conclusion The training and management on nurses'' venous blood sampling is better in China, but incidence of needlestick injuries is still high.It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses'' unsafe behavior during venous blood sampling.

Needlestick accident resulting in occupational transmission of HCV: report of two cases

Occupational transmission of hepatitis C virus (HCV) through needlestick injury is a serious problem worldwide. Occupational transmission of HCV is estimated at an average rate between 0.5% and 0.75%. There are factors associated with increased risk of transmission, such as deep injuries, procedures involving hollow-bore needle placement in the source patient’s vein or artery, and high HCV RNA titer in the source patient. We describe two cases of HCV seroconversion in nursing assistants after different risk needlestick injuries...

Incidence of needlestick injury in Chinese nursing interns: a Meta-analysis / 中国实用护理杂志

Objective To systematically assess the incidence of needlestick injury in Chinese nursing interns.Methods Research articles published on China Academic Journal Electronic Retrieval Database (CNKI),Chinese Scientific Journals Full-text Database (VIP),Wanfang DATA,ISI Web of Knowledge,PUBMED,OVID,Springer and other databases before 2013 were searched,which were relevant to needlestick injury in Chinese nursing interns.Using STATA 12.0 software,pooled estimates were summarized by Meta-analysis.Results 61 articles were included in this study,which covered a total of 15 451 nursing interns.Meta-analysis showed that the pooled incidence of needlestick injury in nursing interns was 65％,95％CI=60％～71％.Although the incidence declined year by year in recent decade,it was still higher than 55％.However,the injury reporting rate was 22％,95％ CI=16％～29％.Conclusions Needlestick injury showed a high incidence in Chinese nursing interns,but declined slightly year by year.However,the injury reporting rate was still very low.

Status of knowledge, attitude and practice for needlestick injury prevention among clinical nurses and analysis of its influencing factors / 中国实用护理杂志

Objective To understand the status quo of knowledge,attitude and practice of clinical nurses’ needlesrick injury (NSI) prevention and its influencing factors.Methods In our cross-sectional study,1020 clinical nurses in different levels of hospitals in Suzhou were recruited to participate the questionnaire survey by stratified cluster sampling.Results The average scores of knowledge,attitude,and practice about NSI prevention were (78.60+15.30),(78.88+8.31) and (70.60+13.86),individually.There was significant correlation among knowledge,attitude and practice.Stepwise regression analysis indicated that knowledge,occupational safety training,section,attitude,rifle,work environment and the level of hospital were the main influencing factors of NSI prevention practice.Condusions NSI prevention knowledge,attitude and practice among clinical nurses are unsatisfactory.Nursing administrators should pay close attention to the nursing staffs’ need of NSI prevention knowledge and provide targeted education to promote the formation of positive attitude,correct bad behaviors and promote healthy behaviors of NSI prevention.

Needle stick injuries among health care workers in a tertiary care hospital of India.

Background & objectives: Percutaneous injuries caused by needlesticks, pose a significant risk of occupational transmission of bloodborne pathogens. Their incidence is considerably higher than current estimates, and hence a low injury rate should not be interpreted as a non existent problem. The present study was carried out to determine the occurrence of NSI among various categories of health care workers (HCWs), and the causal factors, the circumstances under which these occur and to, explore the possibilities of measures to prevent these through improvements in knowledge, attitude and practice. Methods: The study group consisted of 428 HCWs of various categories of a tertiary care hospital in New Delhi, and was carried out with the help of an anonymous, self-reporting questionnaire structured specifically to identify predictive factors associated with NSIs. Results: The commonest clinical activity to cause the NSI was blood withdrawal (55%), followed by suturing (20.3%) and vaccination (11.7%). The practice of recapping needles after use was still prevalent among HCWs (66.3%). Some HCWs also revealed that they bent the needles before discarding (11.4%). It was alarming to note that only 40 per cent of the HCWs knew about the availability of PEP services in the hospital and 75 per cent of exposed nursing students did not seek PEP. Interpretation & conclusions: The present study showed a high occurrence of NSI in HCWs with a high rate of ignorance and apathy. These issues need to be addressed, through appropriate education and other interventional strategies by the hospital infection control committee.

Implication of the prevalence of needlestick injuries in a general hospital in Malaysia and its risk in clinical practice

<p><b>OBJECTIVES</b>To determine the prevalence of cases and episodes of needlestick injury among three groups of health care workers in the past one-year, the level of knowledge on blood-borne diseases and universal precautions and the practice of universal precautions. Other factors associated with the occurrence of needlestick injuries and the reporting of needlestick injuries were also analysed.</p><p><b>METHODS</b>A cross-sectional study was conducted in May 2003 to study the needlestick injuries among 285 health care workers (doctors, nurses, medical students) in a public teaching hospital in Negeri Sembilan, Malaysia.</p><p><b>RESULTS</b>The prevalence of needlestick injuries among the respondents was 24.6% involving 71 cases i.e. 48.0% among doctors, 22.4% among medical students, and 18.7% among nurses and the difference was statistically significant (p<0.001). There were a total of 174 episodes of needlestick injury. Prevalence of episode of needlestick injuries was highest among doctors (146%), followed by nurses (50.7%) and medical students (29.4%). Cases of needlestick injuries attained lower scores on practice of universal precautions compared to non-cases (p<0.001). About 59% of cases of needlestick injury did not report their injuries.</p><p><b>CONCLUSIONS</b>The study showed that needlestick injuries pose a high risk to health care workers and it is underreported most of the time. Many needlestick injuries can be prevented by strictly following the practice of universal precautions.</p>

The Relationship between Job Stress and Needlestick Injury among Nurses at a University Hospital / 대한산업의학회지

OBJECTIVES: This cross-sectional study investigated the relationship between job stress and needlestick injury the nurses at a University hospital in Incheon, Korea. METHODS: A questionnaire survey was conducted targeting 476 nurses, of which 320 (67.2%) questionnaires were returned and 256 (53.8%) were regarded as being reliable data for analyses. We estimated the relation of job stress to needlestick injury using univariate and multiple logistic regression analyses. RESULTS: One hundred sixty-five nurses (64.5%) had suffered at least one needlestick injury (included sharp injuries) during the previous year. After adjusting for potential confounders, we found that the high job control group was less likely than the other group to experience needlestick injury (OR=0.51, 95% CI=0.27-0.97). Job demand and social support, however, were unrelated to needlestick injury. The high job strain group was more likely to experience needlestick injury (OR=2.57, CI=1.13-5.83) than the low job strain group. CONCLUSIONS: Our results tend to suggest that nurses who were in the low job control or high job strain status were more likely to suffer a high rate of needlestick injury.

The occupational hazards of interns & residents during training / 대한산업의학회지

OBJECTS: Residents are exposed to various hazards and harassed by sleep deficiency due to overwork. This study was performed to outline the health condition of residents and develop the ways of improving it. METHODS: A questionnaire was distributed to 881 army doctors who enrolled at the Korea Third Military Academy and The Armed Force Health Service School in 2000 with the exception of medical doctors who joined the armed service without going through intern and resident periods , dental and oriental medical doctors. 784 (89.0%) of the 881 questionnaires were returned of which 704 cases (79.9%). This should actually be 89.0% were regarded for analyses as being reliable data. RESULTS: More than 20% of residents were exposed to radiation, laser, disinfectants, anesthetic gas, and anticancer drugs during their training periods with preventive measures for each of these hazards taken in about 10% of the cases of the lesser hazards but in about 35% for the hazards from radiation and laser. 91.1% of residents had experience of needlestick injuries during their training periods with over 36.3% being exposed to patients with infection during that time. The cases contracting HBV and HCV diseases due to pricking are 2.3 and 0.6% respectively. The average number of night duties per month during a one-year resident's period was about 19. The average sleeping time on duty during a one-year residents was less than 4 hours .28.4% of respondents were not satisfied with their occupation, 96.5% felt tired from overwork and 69.5% wanted to change their occupation to another that would pay the same salary. CONCLUSION: Residents are exposed to harmful physical , chemical and biological factors, but the preventive care seldom undertaken. In addition, their overwork brings about lack of sleep which causes them problems when giving medical treatment to patients during their training periods. Despite the resident's interest in an occupation as a doctor, many intend to select other occupations if they can receive the same salary. According to the above results, preventative systems and measures should be prepared with environmental improvements for residents, and proper rewards for their overwork should be accomplished.