Risk factors analysis and intervention of blood-borne occupational exposure in medical staff / 中华劳动卫生职业病杂志

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.

Conhecimento e adesão como fatores associados a acidentes com agulhas contaminadas com material biológico: Brasil e Colômbia / Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia / Conocimiento y adhesión como factores asociados a los accidentes con agujas contaminadas con material biológico: Brasil y Colombia

Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.

Abstract This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.

Resumen Hicimos estudio transversal como punto de partida de estudio de cohorte en dos Hospitales Universitarios en dos países - Brasil y Colombia - para evaluar la prevalencia de accidentes con material biológico (AT-MB), el nivel de adhesión a las Precauciones Estándares (PUs) y el conocimiento sobre patógenos transmisibles y factores asociados entre trabajadores y estudiantes de la Salud en el marco de la implementación de la norma NR-32. Creamos escalas para evaluar el conocimiento y la adhesión con base en 12 e 11 preguntas respectivamente. Utilizamos Regresión de Poisson-Tweedie para evaluar asociación entre el conocimiento y la adhesión a las PUs con sufrir AT-MB. Evaluamos 965 individuos (348 estudiantes e 617 profesionales). El puntaje medio de conocimiento fue 10,98 con mediana de 11 (10, 12) y α-Cr de 0,625. La media de adhesión fue de 30,74 con mediana de 31 (28, 34) e α-Cr de 0,745, asociándose a país, grupo (estudiantes) e percepción de riesgo. Entre los factores asociados al relato de AT-MB encontramos conocimiento, adhesión a las PUs, país de origen y tener el esquema completo de vacunación contra Virus da Hepatitis B. Concluimos que el nivel de conocimiento y adhesión fueron adecuados, aunque mejores entre los participantes del Brasil y se asociaron a los AT-MB.

Requirements and Evaluation of Sharps Injury Prevention Devices / 中国医疗器械杂志

Accidental sharps injuries are a serious problem in healthcare, many healthcare workers acquire infectious diseases from bloodborne pathogens by sharps injuries during their work. The cost of injury and exposure takes an emotional and financial toll, which has attracted worldwide attention. This paper analyzed the regulatory requirements on sharps injury prevention devices in the United States and the European Union, described the classification and basic requirements of sharps injury prevention devices, evaluation of protective functions, risk identification and control to provide references for regulation and development of such products in our country.

Post-exposure prophylaxis protocol for exposure to blood-borne pathogens: an intervention to improve knowledge and practice among medical students in a South African hospital

Background:Globally, approximately three million healthcare workers experience a percutaneous injury each year. Medical students are at a particularly high risk of exposure to blood-borne pathogens. Despite this, the rate of non-reporting is still high. Objectives: The objectives of this study were to describe and improve the knowledge and practice of the post-exposure prophylaxis (PEP) protocol among medical students, through the implementation of quality-improvement interventions, with a view to improving the protocol. Methods: This was an intervention study conducted among third- to fifth-year students, in 2015 and 2016. The quality-improvement interventions took place over 11 months and included the issuing of laminated protocols, posters and lectures. Data from survey questionnaires were used to quantify the impact of these interventions. Student practice was measured by the number of correct steps of the protocol completed. McNemar and Wilcoxon signed-rank tests were used to test differences in the paired categorical data. Results: Of approximately 750 students who participated in the study intervention, 407 returned the initial questionnaire and 148 returned the post-intervention survey questionnaire. Eighty-six students (21.1%) completed both questionnaires. The blood-borne pathogen exposure rate prior to the intervention period was 28.0%. In the paired group, reporting of exposures increased from 12.2% in 2015 to 31.3% in 2016. Knowledge of the PEP protocol increased significantly in the paired group, from 17.4% to 40.2% (p < 0.001). Prior to the intervention, 91.7% completed fewer than half of the steps of the PEP protocol. This decreased significantly to 69.4% in the paired group, post-intervention (p = 0.03). Conclusion: Practice of the PEP protocol significantly improved after the intervention was implemented. In addition, there was a significant improvement in the knowledge of students about postexposure management. However, many exposures were still unreported post-intervention, indicating that more work is needed to improve reporting behaviour

Presencia de Patógenos transmisibles en las unidades de paquete sanguíneo de donantes del Banco de Sangre del Hospital General Santa Teresa, Comayagua, Honduras. 2013-2017 / Presence of transmissible pathogens in the donor blood pack units of the Blood Bank of the General Santa Teresa Hospital, Comayagua, Honduras. 2013-2017

OBJETIVO: Determinar la presencia de patógenos transmisibles en los componentes sanguíneos donantes del banco de sangre del Hospital General Santa Teresa Comayagua, Honduras 2013-2017. DISEÑO: el universo estuvo constituido por todos los 8254 donantes de sangre del 2013 al 2017. La muestra consistió en 607 todos los donantes positivos serológicamente para alguno de los patógenos estudiados, que cumplieron los criterios de inclusión. En esta investigación se estudió la prevalencia de patógenos trasmisible en las unidades de sangre, se recolectaron los datos de los libros y bases de datos del banco de sangre, esta recolección, y tabulación fue realizada por el investigador principal de agosto a noviembre del 2018. RESULTADOS: se encontró que el 83.7 de los donantes con serología positiva fueron del sexo masculino, con una edad media de 32 años. El antígeno que se detectó con mayor frecuencia fue el VHB core en el 61% de los casos, el 91% de las pruebas realizadas para la detección de antígenos fue la prueba ELISA. El año donde se detectaron más casos fue el 2017 con 8% de prevalencia general de patógenos trasmisibles detectados en unidades de sangre. CONCLUSIONES: La mayoría de los donantes de sangre con serología positiva pertenecen al género masculino, con edades que oscilaban de los 17 hasta los 58 años, el antígeno que se identificó con mayor frecuencia en los paquetes sanguíneos fue el VHB core, similar a lo encontrado en la literatura revisada. Todos los agentes se identificaron utilizando prueba de ELISA, para la detección de Sífilis se realzo RPR y conformación por ELISA

Knowledge and Compliance with Blood-Borne Pathogen Prevention of Hospital Nurses: Based on Clinical Experience / 임상간호연구

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.

Needlestick Injury Cases And Adherence To The Follow-Up Protocol Among Healthcare Workers In Selangor

@#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.

Trends of blood-borne infectious diseases in a rural blood donation center of southeast Gabon (Koula-Moutou)

Introduction: blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) viruses and Treponema pallidum remain a major public health problem in sub-Saharan Africa. The purpose of this study was to assess the frequency and clinical implications of HIV, HBV, HCV and Treponema pallidum markers in blood donors in a rural area of Southeast Gabon (Koula-Moutou) from 2012 to 2017.Methods: hepatitis B surface antigen (HBsAg), anti-HIV, anti-HCV and anti-Treponema pallidum antibodies were screened using rapid diagnostic tests. Results: of a total of 5,706 blood donors, 1,054 (18.5%) were seropositive for at least one infectious marker and 59 (5.6%) had serologic evidence of multiple infections. The overall seroprevalence of HIV, HBsAg, HCV, and syphilis was 3.1%; 5.9%; 6.2% and 3.3%, respectively. HIV, syphilis and HCV distributions were associated with neither the sex nor the age of the donors. Only HBsAg seroprevalence was significantly higher in donors of the age group 26-35 years old compared to donors of the age group 36-45 years (OR = 1.43 (95% CI: 1.01-2.04), P = 0.045). There was a significant increase in the frequencies of HIV and syphilis and a regression of HBsAg and HCV among blood donors.Conclusion: this study presents the epidemiology of the main pathogens detected in blood donors in a rural area in Gabon. We found that the overall distribution of transfusion transmitted infectious diseases were lower than those observed in the general population but could be underestimated due to the use of rapid diagnostic tests (RDTs) in the screening process of the blood donations

Danger in the streets: exposures to bloodborne pathogens after community sharp injuries in Rio de Janeiro, Brazil

ABSTRACT Objective: Exposures to sharps injuries occurring in the community are relatively frequent. We describe characteristics of community sharp exposures reported in the city of Rio de Janeiro from 1997 to 2010. Methods: A cross-sectional analysis of exposure reports to sharps in the community reported to a surveillance system, designed for health care workers, of the Municipal Health Department of Rio de Janeiro. The characteristics of exposed individuals analyzed included types of exposure, the circumstances of the accident, and the prophylaxis offered. Results: 582 exposures were studied. Median age was 30 years and 83 (14%) involved children with less than 10 years of age. Two hundred and seventeen (37%) occurred with sharps found in the streets. The exposure was percutaneous in 515 (89%) and needles where involved in 406 (70%) of them. The sharps were present in the trash in 227 (39%) or in the environment in 167 (29%) of the reports. Professionals who work with frequent contact with domestic or urban waste were 196 (38%). The source was known in 112 (19%) of the exposures and blood was involved in 269 (46%). Only 101 (19%) of the injured subjects reported a complete course of vaccination for hepatitis B. Antiretroviral prophylaxis was prescribed for 392 (68%) of the exposed subjects. Conclusions: Sharps injuries occurring in the community are an important health problem. A great proportion would be avoided if practices on how to dispose needles and sharps used outside health units were implemented.

Whole blood pathogen reduction technology and blood safety in sub-saharan Africa: a systematic review with regional discussion

Background: Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. Objective: This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. Method: The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization's Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. Results: Existing literature suggests that combining PRT with current blood safety measures(such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. Conclusion: Following a detailed appraisal of two leading PRT systems, the Mirasol® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa

Clinical treatment adherence of health care workers and students exposed to potentially infectious biological material / Seguimiento Clínico De Profesionales Y Estudiantes Del Área De La Salud Expuestos A Material Biológico Potencialmente Contaminado / Seguimento clínico de profissionais e estudantes da área da saúde expostos a material biológico potencialmente contaminado

OBJECTIVE To assess adherence to clinical appointments by health care workers (HCW) and students who suffered accidents with potentially infectious biological material. METHOD A retrospective cross-sectional study that assessed clinical records of accidents involving biological material between 2005 and 2010 in a specialized unit. RESULTS A total of 461 individuals exposed to biological material were treated, of which 389 (84.4%) were HCWs and 72 (15.6%) students. Of the 461 exposed individuals, 307 (66.6%) attended a follow-up appointment. Individuals who had suffered an accident with a known source patient were 29 times more likely to show up to their scheduled follow-up appointments (OR: 29.98; CI95%: 16.09-55.83). CONCLUSION The predictor in both univariate and multivariate analyses for adherence to clinical follow-up appointment was having a known source patient with nonreactive serology for the human immunodeficiency virus and/or hepatitis B and C. .

OBJETIVO Evaluar la asistencia a las consultas clínicas de profesionales y estudiantes del área de salud que sufrieron accidente con material biológico potencialmente contaminado. MÉTODO Estudio de corte transversal, de carácter retrospectivo, que evaluó las fichas de atenciones referentes a los accidentes con material biológico ocurridos de 2005 a 2010, en una unidad especializada. RESULTADO Fueron atendidas 461 personas, siendo 389 (84,4%) profesionales y 72 (15,6%) estudiantes del área de la salud que sufrieron exposición a material biológico. La asistencia al seguimiento clínico fue realizada por 307 (66,6%) de los accidentados. Los sujetos víctimas de accidente con paciente fuente identificado tuvieron 29 veces más probabilidad de acudir a los retornos citados (OR: 29,98; IC95%: 16,09-55,83). CONCLUSIÓN Tanto en el análisis univariado como en el multivariado el pronosticador para la asistencia al seguimiento clínico fue ser el paciente fuente conocido y con serología no reactiva para los virus de la inmunodeficiencia humana y/o las hepatitis B y C. .

OBJETIVO Avaliar o comparecimento aos agendamentos clínicos de profissionais e estudantes da área de saúde que sofreram acidente com material biológico potencialmente contaminado. MÉTODO Estudo de corte transversal, de caráter retrospectivo, que avaliou as fichas de atendimentos, referentes aos acidentes com material biológico ocorridos de 2005 a 2010, em uma unidade especializada. RESULTADO Foram atendidas 461 pessoas, sendo 389 (84,4%) profissionais e 72 (15,6%) estudantes da área da saúde que sofreram exposição a material biológico. O comparecimento ao seguimento clínico foi realizado por 307 (66,6%) acidentados. Os sujeitos vítimas de acidente com paciente-fonte identificado tiveram 29 vezes mais chance de comparecer aos retornos agendados (OR: 29,98; IC95%: 16,09-55,83). CONCLUSÃO Tanto na análise univariada quanto na multivariada, o preditor para o comparecimento ao seguimento clínico foi ter o paciente-fonte conhecido e com sorologia não reagente para os vírus da imunodeficiência humana e ou das hepatites B e C. .

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...

Occupational injuries prone to infectious risks amongst healthcare personnel in Kuwait: a retrospective study

The study aimed at determining the prevalence of incident occupational exposure to blood and other potentially infectious materials [OPIM] among healthcare personnel [HCP] during 2010 and at evaluating the factors associated with these incidents. Subjects and an epidemiological, retrospective, record-based study was conducted. All self-reported incidents of occupational exposure to blood and OPIM among HCP from all healthcare settings of the Kuwait Ministry of Health during 2010 were included. The total number of the exposed HCP was 249. The prevalence of incident exposure was 0.7% of the HCP at risk. Their mean age was 32.31 +/- 6.98 years. The majority were nurses: 166 [66.7%], followed by doctors: 35 [14.1%], technicians: 26 [10.4%] and housekeeping personnel: 22 [8.8%]. Needle stick injury was the most common type of exposure, in 189 [75.9%], followed by sharp-object injury, mucous-membrane exposure and contact with nonintact skin. The majority of needle stick exposures, i.e. 177 [93.7%], were caused by hollow-bore needles. Exposure to blood represented 96.8%, mostly during drawing blood and the insertion or removal of needles from patients [88 [35.4%]] and when performing surgical interventions [56 [22.6%]]. Easily preventable exposures such as injuries related to 2-handed recapping of needles [24 [9.6%]] and garbage collection [21 [8.4%]] were reported. Exposures mainly occurred in the inpatient wards [75 [30.1%]] and operating theaters [56 [22.6%]]. Among the exposed HCP, 130 [52.2%] had been fully vaccinated against hepatitis B virus [HBV]. Needle stick injuries are the most common exposure among HCP in Kuwait, and nurses are the most frequently involved HCP category. A good proportion of exposures could be easily prevented. HBV vaccination coverage is incomplete

Percutaneous self-injury to the femoral region caused by bur breakage during surgical extraction of a patient's impacted third molar

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.

Knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin, China.</p><p><b>METHODS</b>By random, stratified, and clustered sampling, 507 reproductive health-related medical workers in Tianjin were selected. A Self-Administered KAP Questionnaire on blood-borne occupational exposure was employed to gauge the general characteristics, awareness of knowledge, attitudes to occupational exposure, implementation of pre-exposure protection, incidence of occupational exposure, and demands for continuing education.</p><p><b>RESULTS</b>Among all respondents, 63.15% (305/483) were aware of the reporting procedures and related departments after the incidence of occupational exposure. The awareness rate of classification of HIV occupational exposure was 48.45% (234/483). About preventive medication time after HIV and hepatitis B virus exposure, the awareness rates were 37.89% (183/483) and 31.47% (152/483), respectively. The average score of occupational exposure knowledge among respondents was 74.45±14.00. The multivariate analysis indicated that medical staff of obstetrics and gynecology, females, doctors and high-level medical institutions showed significantly higher awareness than urology professionals, males, nurses, and medical staff of primary health care institutions, respectively (t = 12.140, t = 5.428, t = 2.582, F = 4.218, P<0.05). Of the respondents, 93.17% (450/483) and 94.41% (456/483) thought that washing hands properly and wearing protective glasses were effective methods for the prevention of occupational exposure, but only 15.94% (89/483) and 3.93% (19/483) adhered to proper hand washing and wearing protective glasses within nearly one year in practical work. Of the respondents, 60.46% (292/483) had experienced the occupational exposure during their vocation, and 95.65% (462/483) needed respective trainings.</p><p><b>CONCLUSION</b>The awareness of occupational exposure among reproductive health-related medical staff is lacking, especially in preventative medication and reporting procedures after the incidence of occupational exposure. The implementation of protective measures is inadequate and incidence of occupational exposure is higher. Therefore, continuing education is necessary to improve the knowledge and attitudes towards occupational exposure in medical staff. At the same time, strict and effective supervision and management system should be established.</p>

Clinical features of inhaled and blood-borne Staphylococcus aureus pneumonia and analysis of antibiotic resistance of the pathogen in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the clinical manifestations between inhaled and blood-borne Staphylococcus aureus pneumonia (SAP) and the antibiotic resistance between the isolates of inhaled and blood-borne Staphylococcus aureus.</p><p><b>METHODS</b>The clinical data of 44 pediatric SAP cases in the Children′s Hospital, Chongqing Medical University from January 2008 to December 2013 were retrospectively analyzed. Twenty-four cases were identified as inhaled SAP, and 20 cases as blood-borne SAP.</p><p><b>RESULTS</b>Inhaled SAP was more common in children younger than 3 years of age, while blood-borne SAP was more prevalent in children older than 6 years of age. Patients with inhaled SAP had significantly higher incidence rates of cough, wheeze, moist rales, dyspnea and empyema than those with blood-borne SAP (P<0.05). The patients with blood-borne SAP were more vulnerable to severe fever, unconsciousness, dysfunction of liver and kidney, pyogenic osteomyelitis, septic arthritis, sepsis, and abscess of skin and soft tissues (P<0.05). Inhaled SAP isolates had significantly higher rates of resistance to amoxicillin/clavulanic acid, oxacillin, and cefoxitin than blood-borne SAP isolates (P<0.05), while the latter had a higher rate of resistance to cotrimoxazole (P<0.05).</p><p><b>CONCLUSIONS</b>Inhaled SAP often occurs in children younger than 3 years of age, and the respiratory manifestations are commonly seen. Blood-borne SAP often occurs in children older than 6 years of age, with the infectious-toxic symptoms that result in multiple organ infection and dysfunction. The isolates of inhaled and blood-borne SAP have different antibiograms.</p>

Forensic luminol blood test for preventing cross-contamination in dentistry: an evaluation of a dental school clinic

More than 200 different diseases may be transmitted from exposure to blood in the dental setting. The aim of this study is to identify possible faults in the cross-contamination chain control in a dental school clinic searching for traces of blood in the clinical contact surfaces [CCS] through forensic luminol blood test. Traces of invisible blood where randomly searched in CCS of one dental school clinic. Forty eight surfaces areas in the CCS were tested and the presence of invisible and remnant blood was identified in 28 [58.3%] items. We suggest that the luminol method is suitable for identifying contamination with invisible blood traces and this method may be a useful tool to prevent cross-contamination in the dental care setting

Prevalence and determinants of occupational exposures to blood and body fluids among health workers in two tertiary hospitals in Nigeria

Background: Healthcare associated infections among health workers commonly follow occupational exposures to pathogens infecting blood or body fluids of patients. We evaluated the prevalence and determinants of occupational exposures to blood/body fluids among health workers in two tertiary hospitals in Nigeria. Methods: In a cross section study undertaken in two tertiary hospitals in North-central and South-south Nigeria in 2011; a structured self-administered questionnaire was used to obtain demographic data and occupational exposures to blood/body fluids in the previous year from doctors; nurses and laboratory scientists. Independent predictors of occupational exposures were determined in an unconditional logistic regression model. Results: Out of 290 health workers studied; 75.8; 44.7; 32.9; 33.9 and 84.4 had skin contact with patient's blood; needle stick injuries; cut by sharps; blood/body fluid splashes to mucous membranes and one or more type of exposures respectively. Ninety one percent; 86; 71.1; 87.6; 81.3; and 84.4 of house officers; resident doctors; consultant doctors; staff nurses; principal/chief nursing officers and laboratory scientists; respectively had one or more type of exposures in the previous year (P0.05). Professional group was found to be the only independent predictor of cut by sharps. House officers and nurses had higher and more frequent occupational exposures than other professional groups. Conclusion: Our results suggest high rates of occupational exposures to blood/body fluid among health workers in Nigeria; especially among newly qualified medical doctors and nurses. Health facilities in Nigeria ought to strengthen infection prevention and control practices while targeting high risk health workers such as house officers and nurses

An Integrative Model of Workplace Self-protective Behavior for Korean Nurses

PURPOSE: This study was conducted to develop and test a hypothetical stage model of workplace self-protective behaviors with respect to blood transmitted infections and musculoskeletal injuries for Korean nurses. METHODS: A nonexperimental, cross-sectional study designwas adopted. The study participants were 320 nurses at two Korean university hospitals. Perceived sensitivity, severity, barriers, benefits, self-efficacy, social support, and safety climate were assessed. RESULTS: Overall, fit indicators showed a good fit for the hypothetical model of self-protective behaviors against blood transmitted infections and musculoskeletal injuries. The significant factors of self-protective behaviors against blood transmitted infections were perceived barriers and social support. The significant factors of self-protective behaviors against musculoskeletal injuries were perceived benefits, barriers, and self-efficacy. CONCLUSION: Our findings suggest that the significant psychosocial constructs of stages of self-protective behavior are dependent on health problem type. Accordingly, we advise that characteristics of behavior and types of disease and health problem should be given priority when developing intervention programs for particular self-protective health behaviors.