Infections in Critically Ill Children

Health care–associated infections (HAI) directly influence the survival of children in pediatric intensive care units (PICU), the most common being central line–associated bloodstream infection (CLABSI) 25–30%, followed by ventilator-associated pneumonia (VAP) 20–25%, and others such as catheter-associated urinary tract infection (CAUTI) 15%, surgical site infection (SSI) 11%. HAIs complicate the course of the disease, especially the critical one, thereby increasing the mortality, morbidity, length of hospital stay, and cost. The incidence of HAI in Western countries is 6.1–15.1% and in India, it is 10.5 to 19.5%. The advances in healthcare practices have reduced the incidence of HAIs in the recent years which is possible due to strict asepsis, hand hygiene practices, surveillance of infections, antibiotic stewardship, and adherence to bundled care. The burden of drug resistance and emerging infections are increasing with limited antibiotics in hand, is still a dreadful threat. The most common manifestation of HAIs is fever in PICU, hence the appropriate targeted search to identify the cause of fever should be done. Proper isolation practices, judicious handling of devices, regular microbiologic audit, local spectrum of organisms, identification of barriers in compliance of hand hygiene practices, appropriate education and training, all put together in an efficient and sustained system improves patient outcome.

The burden of healthcare-associated infection in Moroccan hospitals: systematic review and meta-analysis

Healthcare-associated infections (HAI), also referred to as nosocomial infections, is defined as an infection acquired in a hospital setting. This infection is considered a HAI if it was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility. HAI are a major patient safety measure to be considered in hospitals.

Infecciones asociadas al cuidado de salud en la unidad de quemados durante la pandemia SARS-CoV-2 / Healthcare-associated infections in the burn unit during the SARS-CoV-2 pandemic

Introducción: a partir de la pandemia por Covid19 se reportó variabilidad en la incidencia de las infecciones asociadas al cuidado de la salud (IACS). Con el objetivo de describir y comparar las tasas de IACS en la Unidad de Quemados de un hospital pediátrico de tercer nivel, antes y después del inicio de la pandemia se llevó a cabo este estudio. Material y métodos: estudio de cohorte, retrospectivo, descriptivo, de vigilancia epidemiológica. Se registraron todos los eventos de IACS en la Unidad de Quemados desde el 01/07/2018 hasta el 31/06/2021. Se compararon las tasas de las IACS entre el período I (PI) previo a la pandemia (07/2018-12/2019) y el período II (PII) posterior al inicio de la misma (01/2020- 06/2021). Resultados: se registraron 74 episodios de IACS, en un total de 8232 pacientes-día. Se registró una tasa global de IACS similar en ambos períodos, 10,08 ‰ pacientes-día (PI) vs 7,34 ‰ pacientes-día (PII), sin encontrarse diferencias estadísticamente significativas en las tasas de bacteriemia asociada a catéter venoso central (BSI-CVC) 3,32 ‰ días uso de CVC (PI) vs 3,20 ‰ (PII), neumonía asociada a ARM 1.43 ‰ días de uso de ARM (PI) vs un 2.02 ‰ (PII), ni infección urinaria asociada a sonda vesical (SV) 7,36 ‰ días de uso de SV (PI) vs 3,64 ‰ (PII). Conclusiones: no se observaron diferencias estadísticamente significativas en las tasas de IACS entre ambos períodos, lo cual podría justificarse con el estricto protocolo en control de infecciones implementado previo al inicio de la pandemia (AU)

Introduction: since the start of the Covid19 pandemic, variability in the incidence of healthcare-associated infections (HAIs) has been reported. This study was conducted to describe and compare the rates of HAIs in the burn unit of a tertiary pediatric hospital before and after the onset of the pandemic. Material and methods: a retrospective, descriptive, epidemiological surveillance cohort study was conducted. All HAI events in the burn unit from 01/07/2018 to 31/06/2021 were recorded. HAI rates between the pre-pandemic period I (PI) (07/2018- 12/2019) and post-pandemic period II (PII) (01/2020-06/2021) were compared. Results: 74 episodes of HAI were recorded in a total of 8232 patient-days. There was a similar overall rate of HAIs in both periods, 10.08 ‰ patient-days (PI) vs 7.34 ‰ patient-days (PII), with no statistically significant differences found in the rates of central venous catheter-related bloodstream infections (CVC-BSI) 3.32 ‰ days CVC use (PI) vs 3.20 ‰ (PII), ventilator-associated pneumonia 1. 43 ‰ days MV use (PI) vs a 2.02 ‰ (PII), or catheter-associated urinary tract infection 7.36 ‰ days catheter use (PI) vs 3.64 ‰ (PII). Conclusions: no statistically significant differences were observed in the rates of HAIs between both periods, which may be explained by the strict infection control protocol implemented prior to the onset of the pandemic (AU)

Implicações das infeções associadas aos cuidados de saúde na gestão em saúde: revisão

Resumo: Objetivo: Metodologia: Resultados: Conclusões:

Resumen: Objetivo: Metodología: Resultados: Conclusiones: Las IAAS tienen repercusiones directas e indirectas en la vida de los pacientes, ya que representan una amenaza para la seguridad y la calidad de la atención. Los programas de prevención y las medidas de control de la infección se consideran eficaces para reducir la tasa de incidencia de las IAAS y, en consecuencia, los costes.

Abstract: Objective: Method: Results: Conclusions:

Stethoscopes: a potential source of hospital acquired infection

Background: Nosocomial infection has been recognized for over a century as both a critical problem affecting the quality of health care and a leading cause of morbidity, mortality and increased health care cost. Stethoscopes because of their universal use by medical professional, can be a potential source of nosocomial infections. The study was conducted to determine the bacterial contamination of stethoscopes used by health care staff as well as the practices used for cleaning them.Methods: A structured questionnaire was administered to health workers and the surface of the diaphragm of their stethoscopes swabbed for bacteriological analysis using standard techniques.Results: Of the 65 stethoscopes sampled, 33(50.8%) showed bacterial growth. All the bacterial isolates were found to be gram positive organism. The isolates were Micrococcus spp. (35.8%), Coagulase negative staphylococcus (CONS) (30.8%), Bacillus spp. (15.4%), Staphylococcus aureus (10.3%) and Diphtheroids (7.7%).Conclusions: Further research is needed to solve the question whether stethoscope contamination actually results in infection in the patient. However strict adherence to disinfection practices by health workers can minimize cross-contamination and ensure patient safety in hospital environments.

Microorganisms isolated from mobile phones and hands of health-care workers in a tertiary care hospital of Ahmedabad, Gujarat, India

The mobile phones have become an inevitable part of life for communication everywhere. Hospital-acquired infections are causing increased morbidity and mortality of hospitalized patients. After getting approval from the institutional review board, a total of 300 samples from mobile phones and dominant hands of resident doctors, nurses, and support staff working in neonatal intensive care unit, pediatric intensive care unit, intensive care unit, and emergency ward were tested according to standard guidelines for culture. Of 300 samples tested, 144 (96%) mobile phones and 145 (96.66%) dominant hands showed contamination with one or more types of microorganisms. Monomicrobial organisms were recovered from 247 samples and polymicrobial organisms were isolated from 42 samples. Mobile phones and hands of helath care workers serve as a potential reservoir for hospital acquired infections as multi-drug resistant pathogenic bacteria as well as normal flora of skin were recovered.

Epidemiological Profile of Hospital-acquired Infection in a Tertiary Care Hospital of Eastern India

Introduction: “Hospital-acquired infection (HAI)” can be defined as an infection acquired in hospital by a patient who wasadmitted for a reason other than that infection.Purpose: This study was done to observe the incidence of HAI (with bacteriological profile and their antibiotic susceptibilitypattern) in the Orthopaedics Ward of Bankura Sammilani Medical College.Materials and Methods: A total of 2062 patients admitted for more than 48 h were studied for 1 year for the detection of thedevelopment of any of the HAI during hospitalization. On suspicion of the development of an HAI, representative samples forthe diagnosis of a site-specific HAI were collected, processed, and interpreted. A total of 158 patients admitted for more than48 h showing clinical features of any one of the HAIs were selected for sampling.Results: From the 158 samples collected during the study period, samples from 92 patients were positive in bacteriological culture.Conclusion: The study attempts to understand the epidemiological profile of HAI in this tertiary care hospital in a non-urbanregion of eastern India to take necessary infection control measures.

Study of pattern of nosocomial infections among post-operative patients following obstetrical and gynaecological surgeries in a tertiary care institute of northern India

Background: Hospital acquired infections (HAIs) are the major causes of morbidity and mortality, functional disability and financial burden among the patients admitted in hospitals. The nosocomial infection has thrown a big challenge to the health sector in both the developing and developed countries; therefore, it is important to put in place surveillance system for monitoring its incidence rate and planning early interventions for its prevention. The aim and objective of the study was to study the socio demographic profile of the patients who underwent Obstetrical and Gynecological surgeries and to identify the risk factors and causative organisms associated with the post-operative nosocomial infection and pattern of antibiotics sensitivity.Methods: It was a record based retrospective study carried out in a tertiary care referral institute. The case files of all post-operative patients from January 2015 to July 2015 were retrieved from the Medical Record department and an extensive analysis was carried out.Results: It was found that majority of the patients (75%) with nosocomial infection were in the age group of 20-35 years and all were married. Most of them (72%) were from the rural background. It was observed that around 9% patients reported nosocomial infection after emergency laparotomy procedure as compared to 8% of patients after elective procedure.Conclusions: In this study it was found that surgical site infection (SSI) was most common nosocomial infection followed by Urinary tract infection. The majority of surgical site infections can be prevented by the preoperative, intraoperative and postoperative phases of care.

Microbiological Profile of Air and Surface Contamination in Operation Theatres and Intensive Care Units of a Teaching Hospital in Rural North India

Background: Harbouring of potential pathogens in operationtheatres (OTs) and intensive care units (ICUs) of hospital is amajor cause of patient’s morbidity and mortality. Environmentalmonitoring by the microbiological testing of surfaces andequipments is useful to detect changing trends of types andcounts of microbial flora. High level of microbial contaminationindicates the needs for periodic surveillance aimed at earlydetection of bacterial contamination levels and prevention ofhospital acquired infections.Aim: The aims of the study were to count CFU (colony formingunit) rate of indoor air, to identify bacterial colonization ofsurface and equipments isolated from Operation theatres, ICUsand Labour room of a teaching hospital in district Kangra,Himachal Pradesh.Methods: This retrospective study, analyzing themicrobiological surveillance data from OTs over a period of 2years from January2017 to December2018 was conducted at atertiary care hospital. Air sampling of 8 OT’s, 4 ICU’s and 1 LRwere done by settle plate method. Swabs were taken fromdifferent sites, equipments and bacterial species were isolatedand identified from them as per standard guidelines.Result: A total of 105 air samples were collected for 2 yearfrom 8 OT’s, 4 ICU’s and 1 LR. The bacterial CFU/m3 /mincounts of air from all OTs ranged from Superspeciality OTSshowed less bacterial CFU rate of air (0-5 CFU/m3) followed byOpthalmology OT (5-8 CFU/m3) and highest in Gynae (30-46CFU/m3). CCU showed less bacterial CFU rate (10-15CFU/m3) followed by Surgery ICU (28-35 CFU/m3) and highestin PICU (38-42 CFU/m3), Labour room showed 42-51 CFU/m3.Bacterial species were isolated from 43.85 % out of total 157swab samples taken from all OTs and ICUs. The mostcommon isolate was Bacillus species 46% followed by CONS(22%). Pathogenic organisms isolated were 10% Gramnegative bacilli which included 3% Non-Fermenters, thecommon isolate was Klebsiella spp. amongst gram negatives.

Occurrence And Resistance Profile Of Nonfermentative Gram-Negative Bacilli In A Tertiary Care Hospital - A Therapeutic Concern

Aim: To isolate, identify and characterize the prevalence of non- fermenting gram negative bacteria (NFGNB) along with their antimicrobial resistance pattern among the patients attending a tertiary care Hospital in Meerut. Materials and Methods: The isolates of NFGNB obtained from various samples were identified by standard bacteriological technique and VITEK® 2 system (Biomerieux , France) . Antimicrobial susceptibility test was carried out to assess the resistance profile both by Kirby Baeur disk diffusion method and VITEK® 2 system (Biomerieux , France) . Result: Atotal of 16,296 clinical samples from the indoor and outdoor patients were processed in the bacteriology laboratory. Isolation rate of nonfermenters was 7.82% (1274/16296). Pseudomonas spp. was the predominant isolate (66.56%) followed by Acinetobacter spp. (27.16%). Other isolated non-fermenters were Burkholderia cepacia complex (BCC)(1.57%), Stenotrophomonas maltophila (0.86%), Sphingomona spaucimobilis (0.71%), Achromobacter xylosoxidans (0.16%), Ochrobactrum anthropic (0.16%). Conclusion: NFGNB are emerging as important opportunistic pathogens and are mostly resistant to commonly used antimicrobials. Therefore early diagnosis and initiation of appropriate antibiotic therapy would help in efficient management of patients and result in reduction of morbidity and mortality caused by these multi drug resistant organisms.

Shape-Dependent Antibacterial Activity against Staphylococcus aureus of Zinc Oxide Nanoparticles

@#Introduction: There is a growing concern in using zinc oxide nanoparticles (ZnO NPs) for medical devices as alternative options in reducing hospital-acquired infections (HAIs). The commensal HAIs; Staphylococcus aureus (S.aureus) infect patients and lead to increased rates of morbidity and mortality. This study aims to investigate the antibacterial action of ZnO NPs in three different shapes; nanorod, nanoflakes and nanospheres impregnated in low-density polyethylene (LDPE) against S.aureus ATCC 25923. Methods: The antibacterial efficiency of ZnO NPs was studied through two standard test methods included were based on Clinical Laboratory Standards Institute (CLSI) guidelines MO2-A11 under light conditions of 5.70 w/m2 and American standard test method (ASTM) E-2149. Results: Preliminary screening did show a significant growth inhibition against S.aureus with ZnO NPs nanorod and nanoflakes, approximately in 7 to 8 mm zones of inhibition. Further analysis using ASTM E-2149 in dynamic conditions revealed variable activity depending on incubation treatment periods. It demonstrated the ZnO NPs in nanoflakes and nanosphere shape showed better inhibition against S.aureus with maximum reduction (100%). The FESEM results strongly suggest that the structure of ZnO nanoflakes and nanosphere played an importance role in nanomaterial-bacteria interaction which consequently cause cell membrane damage. Additionally, the irradiation under light treatment also enhance the generation of ROS and free radicals which helps the bactericidal activity against S.aureus. Conclusion: This study provides new insights for the antibacterial action of ZnO NPs/LDPE thin films in future biomedical appliances to reduce HAIs risks.

Increasing rates of Clostridium difficile infection in Mexican hospitals

Abstract Introduction The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world. Methods This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis. CDI was classified according to international guidelines. Demographic and clinical data as well as information regarding total hospital admissions, total length-of-hospital stay, and other variables related to hospitalization were gathered from the epidemiology and administration departments of each hospital. Results A total of 2050 hospital beds were analyzed with 288,171 patients hospitalized accumulating 1,576,446 days of hospitalization during the study period. The average rate of CDI per 1000 hospital-days was lower than the rates reported in the US and Europe, although in 2015 CDI rates were almost persistently above the mean rate for the study period. More than half of PCR positive patients were ribotype 027. Conclusion Hospital rates of CDI are increasing in Mexican hospitals with a predominance of infections caused by ribotype 027.

Online continuing interprofessional education on hospital-acquired infections for Latin America

Abstract Introduction: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. Methods: Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. Results: There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. Discussion: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a "New Challenges" course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions.

Nosocomial infections: Epidemiology, prevention, control and surveillance

Nosocomial infections or healthcare associated infections occur in patients under medical care. These infections occur worldwide both in developed and developing countries. Nosocomial infections accounts for 7% in developed and 10% in developing countries. As these infections occur during hospital stay, they cause prolonged stay, disability, and economic burden. Frequently prevalent infections include central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections and ventilator-associated pneumonia. Nosocomial pathogens include bacteria, viruses and fungal parasites. According to WHO estimates, approximately 15% of all hospitalized patients suffer from these infections. During hospitalization, patient is exposed to pathogens through different sources environment, healthcare staff, and other infected patients. Transmission of these infections should be restricted for prevention. Hospital waste serves as potential source of pathogens and about 20%–25% of hospital waste is termed as hazardous. Nosocomial infections can be controlled by practicing infection control programs, keep check on antimicrobial use and its resistance, adopting antibiotic control policy. Efficient surveillance system can play its part at national and international level. Efforts are required by all stakeholders to prevent and control nosocomial infections.

Nosocomial infections: Epidemiology, prevention, control and surveillance

Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7％ in developed and 10％ in developing countries,As these infections occur during hospital stay,they cause prolonged stay,disability,and economic burden.Frequently prevalent infections include central line-associated bloodstream infections,catheter-associated urinary tract infections,surgical site infections and ventilator-associated pneumonia.Nosocomial pathogens include bacteria,viruses and fungal parasites.According to WHO estimates,approximately 15％ of all hospitalized patients suffer from these infections.During hospitalization,patient is exposed to pathogens through different sources environment,healthcare staff,and other infected patients.Transmission of these infections should be restricted for prevention.Hospital waste serves as potential source of pathogens and about 20％-25％ of hospital waste is termed as hazardous.Nosocomial infections can be controlled by practicing infection control programs,keep check on antimicrobial use and its resistance,adopting antibiotic control policy.Efficient surveillance system can play its part at national and international level.Efforts are required by all stakeholders to prevent and control nosocomial infections.

Clonal Relatedness and Antimicrobial Susceptibility Profiling of Acinetobacter Baumannii Isolates from Senile Patients / 现代检验医学杂志

Objective To investigate the clonal relatedness of A.baumannii isolates from senile patients by conducting cross-sectional and longitudinal studies on antimicrobial susceptibility profiling and genomic diversity.Methods Cross-sectional study was done among the 170 non-repetitive A.baumannii isolates which were collected from senile patients during two years.Longitudinal study was conducted among 77 A.baumannii collected from 8 senile patients within longtime hospitalization.Results 75.3 ％ of the 170 isolates were non-susceptible to carbapenems,and the phenotype were XDR or MDR which spread evenly all over the senile wards.The isolates belonged to 36 pulsotypes determined by PFGE.Groups Ⅰ (contain119 isolates) were major epidemic strains,which were CRAB with XDR phenotype.In longitudinal study,comparison of pulsotypes was performed for each patient and all isolates were clustered into group Ⅰ except one isolate.All the 77 isolates were XDR.Conclusion Extensive drug-resistance of A.baumannii was a serious problem in the gerontal wards.Clone dissemina tion was the most important style of XDR strains spread.Horizontal infection control measures to interrupt person-to-person transmission should be reinforced to reduce the further spread of XDR A.baumannii.

Enterobacterias portadoras de KPC en un hospital universitario / KPC-producing Enterobacteriaceae in a university hospital

La resistencia a carbapenemes en enterobacterias representa una situación de alto impacto clínico debido a las limitadas opciones terapéuticas disponibles para el tratamiento de las infecciones causadas por estos microorganismos multirresistentes que cursan con altas tasas de morbilidad y mortalidad. En nuestro país, en los últimos 5 años, se observó la diseminación de aislamientos de Klebsiella pneumoniae portadores de carbapenemasa de tipo KPC pertenecientes al ST258, clon diseminado mundialmente. En nuestro hospital la incidencia de episodios fue aumentando, especialmente la infección del sitio quirúrgico y las bacteriemias. En el último bienio se observó la diseminación del mecanismo de resistencia a otras enterobacterias y probablemente a otros secuenciotipos de K pneumoniae con mayor sensibilidad a antibióticos no ß-lactámicos. Se hace necesario instaurar las correctas medidas de prevención y control para evitar la diseminación de estos patógenos.

The presence of carbapenem -resistant Enterobacteriaceae in clinical settings represents a concerning issue due to the limited therapeutic options available for the treatment of the infections caused by these multi-drug resistant bacteria which usually have high mortality rates. The spread of Klebsiella pneumoniae isolates belonging to ST258 was observed in the last 5 years in our country. In our hospital the number of episodes has grown with the years and the most prevalent infections were the surgical site and bacteremia. In the last 2 years KPC spread to other Enterobacteriaceae and probably to other STs in K pneumoniae which showed different susceptibility patterns to non ß-lactamic antimicrobials. We believe that it is vital to install the appropriate measures to prevent and control the dissemination of these microorganisms.

Assessing the awareness and practice of Hospital Acquired Infections (HAIs) among nursing staff of Civil Hospital, Rajkot, Gujarat, India.

Background: With advances in health care system, threat to Hospital Acquired Infections (HAIs) still remains. HAIs continue to affect hospitalized patients and results in morbidity, mortality and additional costs. Health care workers, especially nurses can play critical role in prevention and control of HAIs. The purpose was to study their awareness regarding HAIs and practice towards prevention and control measures. Methods: It was a cross sectional study conducted in Civil Hospital, Rajkot from October 2014 to December 2014. Out of total 184 staff nurses, 92 (50% of the total following convenient sampling) were selected. A list of all staff nurse was made alphabetically and every alternate nurse was selected for interview. Of the 92 staff nurses approached, 83 consented and gave complete response. Interview was conducted using a pretested semi structured questionnaire and analysis was done using Excel 2007. Results: 80 (93.02%) participants had heard about HAIs. More than half (60.4%) of the participants acknowledged that urinary and respiratory tract infections were the two most common HAIs. 52 (60.4%) of the participants acknowledged that direct skin to skin contact and improper handling of bio medical waste were the two most common modes of transmission of HAIs. 47 (56.6%) practiced hand washing before and after surgical procedures. 30 (36.1%) participants had ‘good’ knowledge regarding HAIs. Conclusions: The present study showed that level of awareness and practice regarding HAIs among nursing staff was average. Considering the important role of nurses in HAIs, there is a need to develop a system of continuous education to increase nurses’ awareness and hence adopt appropriate health behaviours and increase adherence to precautions.

Hand hygiene practices among health providers working in tertiary care hospitals in and around Hyderabad, Telangana State, South India.

Background: Infection control is ac knowledge universally as a solid and essential basis towards patients‟ safety and support the reduction of health care association infection and their consequences. Simple hand hygiene is cost effective method in preventing cross transmission of microorganism. The compliance of health providers with hand washing guidelines seems to be vital in preventing the disease transmission among patients but unfortunately hand hygiene practices have been found to be faulty in most of the health care facilities including tertiary care hospitals. Methods: A cross-sectional study was conducted to evaluate the awareness and compliance of hand hygiene among different health care providers, that includes 100 doctors, 100 nurses, 100 medical students, 50 ward boys working in different tertiary care Hospitals attached to medical colleges, in and around Hyderabad, in Telangana state (India) from April to July - 2014. Knowledge was assessed using WHO hand hygiene questionnaire. Attitude and practices was evaluated by using self-structure questionnaire. A value less than 0.05 was considered significant. Results: Only 16.5 % of participants had good knowledge regarding hand hygiene. Nurses‟ knowledge is better than doctors, Knowledge, attitude and practices of doctor and nurses were better than medical students and ward boys, trained staff have better knowledge on hand hygiene and effective infection control committees have some impact on hand hygiene practices Conclusion: Hand hygiene practices among health providers irrespective of public sector or private sector hospitals were found to be low. It was concluded that serious efforts are need to improve the hand hygiene practices among all health providers.

A study on the effective factors of hospital acquired infections in chronic hepatitis B virus infection / 中国综合临床

Objective To investigate hospital acquired infections in patients with liver cirrhosis caused by relevant factors.Methods From July 2008 to June 2013,the clinical data of 470 cases of hospital acquired infections patients with chronic hepatitis B virus (HBV) infection were retrospectively analyzed by case-control study for the effective factors.Results Hospital acquired rate was 29.1％ (137/470).By logistic regression analysis,the effective factors were length of stay (OR =27.824,95％ CI 7.187-98.386),invasive operation (OR =17.201,95％ CI 4.245-71.303),a complication (OR =2.138,95％ CI 1.030-4.377),preventive use of antibiotics(OR =2.741,95％CI 1.816-4.010),drinking history(OR=34.248,95％CI 13.045-82.328),serum albumin(OR =17.258,95％ CI 6.242-53.162),quantitative PCR-HBVDNA (OR =4.859,95％ CI 3.214 -7.625),white blood cell (OR =4.271,95 ％ CI 1.520-12.157),c holinesterase (OR =2.761,95 ％ CI 1.523 -3.787) and anti virus medicine(OR=0.128,95％CI 0.041-0.375) (P＜0.05).Conclusion This study shows that length of stay,invasive operation history,complications,low white blood cell,low serum protein,low cholinesterase,the prophylactic use of antibiotics,hormone,high PCR-HBVDNA quantitative and drinking are the important risk of hospital acquired infections infection factors of patients of impact chronic HBV infection.Applications of antiviral drugs are effective in the prevention of chronic HBV infection protection factors of hospital acquired infections infection patients.