Evaluation and monitoring of infection control practices

This work was done to evaluate the impact of infection control practices implementation on intravenous fluid [IVF], medication contamination and neonatal sepsis at NICUs. The study was designed to conduct an infection control practice training course at six private neonatal intensive care units at three governorates with evaluation of the results before and after the study. Samples of all available in-use intravenous fluid bottles and previously used bottles, opened medication ampoules and blood samples from the clinically suspected infants were collected and cultured to detectthe organisms and their sensitivity to antimicrobial agents before and one month later after the training course. Also, infection control practice observation tool was designed and used for evaluation of the infection control practice at each NICU before the study and one month later. The results showed that K. pneumonia, K. terrigena and Enterobacter spp. were the commonest types of organisms at the pre-training visit; while, at the post-training visit, K. pneumonia and coagulase negative Staph. were the commonest types of organisms. At the pre-training visit, the IVF contamination rates was 62%, the medication contamination rate was 16.1% and the blood infection rate was 64.8%. At the post-training visit, IVF contamination rate dropped to 32%, medication contamination rate dropped to 0% and the blood infection rate to 50%. There was a significant reduction in both IVF and medication contamination frequency. The mean score of infection control practices concerning the training aspects was significantly increased at the post-training visit at the six NICUs. A significant positive correlation was found between infection control practice score in the six NICUs and the negative IV fluid [free samples]. In conclusion, surveillance of nosocomial infections in NICUs and successful strategies to decrease infections, such as infection control practice and optimal antibiotic use, are warranted. The significant decrease in contamination rate of IV fluids and medications and positive blood culture results after the training practice point to the importance of microbiological culture of in-use IV fluids, which could be a helpful adjunct to epidemiologic studies to directly assess the effectiveness of infection control practices related to IV fluid preparation and use, also, point to the significance of proper health hygiene in nosocomial infection control

role of interleukin 16 in the immunopathogenesis of rheumatoid arthritis

Rheumatoid Arthritis [RA] is a chronic inflammatory disease characterized by hyperplasia of the synovium and excessive cellular infiltration, which leads to progressive joint destruction. We analyzed, interleukin 16 [IL16], in relation to disease activity to characterize its biologic function in RA. Secreted IL-16 was measured by enzyme immunoassay in sera from 30 RA patients and 30 healthy controls [HC], and also in synovial fluid [SF] from 16 RA patients and 15 patients with non-RA synovitis as controls. IL-16 expression in peripheral blood mononuclear cells [PBMC] was characterized by flow cytometric analysis after intracellular cytokine staining for IL-16. In synovial tissue specimens, both were done: Immunohistochemistry for localization of IL-16, and histopathology, in which the tissue scored semiquantitatively for synovial hyperplasia and cellular infiltration. IL-16 was detected at significantly higher levels in sera and SF of RA patients in comparison to HC and non-RA synovitis [p<0.001 and p<0.0001 respectively]. Also, IL-16 was detected significantly higher in SF in comparison to sera in RA patients [p<0.001]. Flow cytometry of PBMC showed that a great proportion of both CD4+ and CD8+ cells expressed IL-16 protein. Also, immunohistochemistry revealed more CD4+ and less frequency of CD8+ cells in synovial infiltration. A significant correlation between IL-16 expression and local inflammatory activity could not be established [p>0.21] by microscopic analysis of the synovial cells infiltrate. In addition, no significant association was observed between serum, SF, and synovial tissue expression of IL-16 and clinical disease activity in RA [p>0.61, p>0.5 and p>0.42 respectively]. This indicated that, IL-16 played a regulatory rather than a proin-flammatory role in the immunopathogenesis of RA