RESUMEN
Central line-associated bloodstream infection [CLABSIs] is an importanthealthcare-associated infection in the critical care units. It causes substantial mor-bidity, mortality and incurs high costs. The use of central venous line [CVL] insertionbundle has been shown to decrease the incidence of CLABSIs.Our aim was to study the impact of CVL insertion bundle on incidence of CLABSIand study the causative microbial agents in an intensive care unit in Kuwait.Surveillance for CLABSI was conducted by trained infection control team usingNational Health Safety Network [NHSN] case definitions and device days measure-ment methods. During the intervention period, nursing staff used central line carebundle consisting of [1] hand hygiene by inserter [2] maximal barrier precautionsupon insertion by the physician inserting the catheter and sterile drape from headto toe to the patient [3] use of a 2% chlorohexidine gluconate [CHG] in 70% ethanolscrub for the insertion site [4] optimum catheter site selection. [5] Examination ofthe daily necessity of the central line.During the pre-intervention period, there were 5367 documented catheter-daysand 80 CLABSIs, for an incidence density of 14.9 CLABSIs per 1000 catheter-days. After implementation of the interventions, there were 5052 catheter-days and 56CLABSIs, for an incidence density of 11.08 per 1000 catheter-days. The reduction inthe CLABSI/1000 catheter days was not statistically significant [P = 0.0859].This study demonstrates that implementation of a central venous catheter post-insertion care bundle was associated with a reduction in CLABSI in an intensive carearea setting
RESUMEN
This study investigated the vaginal colonization rate of Streptococcus agalactiae [group B streptococci, GBS] in an antenatal population in a maternity hospital. Subjects and Anal, vaginal and combined anal and vaginal specimens were obtained from 110 pregnant women [mean age 30.7 ' 5.5 years] at 35-37 weeks of gestation, using a commercially prepared culturette, and transported in 0.5 ml of Stuart's transport medium. The specimens were then cultured in standard selective Todd-Hewitt broth medium, supplemented with gentamicin and nalidixic acid. After 36 h of incubation, the broth culture was subcultured onto sheep blood agar and incubated in 5% carbon dioxide for 18-24 h. Representative colonies morphologically resembling GBS were tested with latex agglutination kit. Each culture-positive woman was given ampicillin or piperacillin prophylactically and followed up through labour and postpartum. Detailed records of biodata, antecedent antenatal events and pregnancy outcome were reviewed. The combined vaginal and anal specimens were positive for GBS in 18 [16.4%] women. Gestational age at delivery was 39.01 ' 1.79 weeks. The deliveries were uneventful and no neonate developed sepsis. Diabetes mellitus and pregnancy-induced hypertension/hypertension were detected antenatally in 16.6 and 11.5%, respectively. GBS carriage was not associated with adverse outcome of pregnancy. The colonization rate of GBS in pregnant women in Kuwait is high, and on the basis of the documented benefits of antenatal screening in Western countries, we recommend routine screening especially for our at-risk patients