impact of cytomegalovirus infection on mechanically ventilated patients in the respiratory and geriatric intensive care units

Reactivation of cytomegalovirus [CMV] has been reported in critically ill patients [especially elderly] lying in the intensive care units. So identifying such patients to treat is important. To detect the frequency of CMV infection in mechanically ventilated patients, and its correlation with patients' risk factors, and outcomes. The present study was carried out on 51 mechanically ventilated patients admitted to the Respiratory [20] and Geriatric ICU [31] of the Ain Shams University hospitals over a 3 month period. Serum CMV load was measured by real-time PCR. The overall rate of active CMV infection by RT-PCR among the studied populations was [68.6%], [77.4%] in patients of geriatric ICU versus [55%] in respiratory ICU patients. Comparison between CMV positive and negative cases showed a significant difference in the duration of mechanical ventilation and mortality rate. A statistically higher CMV load was recorded in respiratory ICU patients admitted due to exacerbation of chronic respiratory disease or stroke and developing ventilator associated pneumonia [VAP] or septic shock. Also there was a significant direct correlation between CMV load and age of the patient, duration of mechanical ventilation and duration of ICU stay CMV infection is frequent in mechanically ventilated critically ill patients especially the elderly. It is associated with poor outcomes, leads to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections

Assessment of needle stick injuries and related knowledge among health care workers participating in an infection control-training program at El Minia University Hospital

Needle stick injuries are an important and continuing cause of exposure to serious and fatal diseases among health care workers [HCWs] who suffer daily accidental occupational exposure to needle stick injuries during the course of their role of caring for patients to determine the burden of needle stick injuries, its causes and knowledge related to it among HCW participating in an infection control training program at Minia University Hospital [MUH]. A well-structured pre- and post-training questionnaires about general infection control knowledge was used and included also 10 basic knowledge questions and inquiries about incidents of needle sticks, its frequency and cause, and history of hepatitis B vaccination. A total of 278 physicians and 56 dentists participated in this study. Dentists were younger than physicians, and had a slightly higher knowledge score than physicians. We found that 63.2% of the participating physicians and dentists experienced at lease one needle stick during their practice. About 61% and 71.4% of the physicians and dentists experienced at lease one needle stick during their practice, respectively, suggesting that dentists were more likely to be exposed to needle stick injuries than physicians. The overall mean of needle stick injuries per year among the participants was 4.42 [ +/- 1.83]. However, the average numbers of sticks were 4.51 [ +/- 1.87] and 4.03 [ +/- 1.77] among the participating physicians and dentists, respectively. Self-inflicting injuries during bending or recapping of a used needle was the most frequent cause of needle sticks [41% for physicians and 59% for dentists]. Nearly 72% of the participants were categorized as excellent in basic knowledge regarding infection control. Also, knowledge of needle stick management significantly improved by 63.3% and 7.8% post-training among dentists and physicians, respectively. Importantly, as the knowledge score increases, the liability to be injured by needles decreased. On the other hand, physicians were three times more likely to be vaccinated against Hepatitis B virus [HBV] than dentists although the overall vaccination rate was very low [15.2% vs. 4.2% among physicians and dentists, respectively]. needle stick injuries are common among HCW of MUH and recapping and bending of needles are prevalent inappropriate practices that increase the likelihood of needle sticks. Ensuring that HCW are properly trained on safe use and disposal of sharps will make this practice safer