ABSTRACT
Introduction: SARS CoV-2, a novel corona virus, has emerged in December 2019. The COVID-19 associated mortality is documented in elderly with co morbidities. To have better insight on this issue, the secondary bacterial infections with multi-drug-resistant bacteria in COVID-19 patients need to be studied to evaluate the impact of these infections on the outcome. Aim and objectives: To determine the proportion of secondary infections in COVID-19 patients. To study the spectrum of pathogens and antibiogram of the bacteria isolated from secondary infections in such patients. To evaluate the co-existing co-morbidities, treatment and outcome in these patients. Methodology: The retrospective study was conducted in Departments of Medicine and Microbiology, KMC hospitals Attavara and Ambedkar circle, Mangaluru, including all the hospitalized microbiologically confirmed cases of SARS CoV-2 infection. Details pertaining to the study population were collected using a structured proforma. Descriptive data were entered in the form of mean, median and proportions. The categorical values were analyzed using Chi square test. Values of p < 0.05 were considered as statistically significant. Results: Two hundred COVID-19 hospitalized patients were included.28 out of 200 patients (14%) studied developed secondary infections. The types of secondary infections were Respiratory infections (50%), blood stream infections (17%), UTI (14%), Rhinocerebral Zygomycosis (17%). The predominant organisms were Klebsiella pneumoniae (44%), Zygomycetes (17%). The rates of antibiotic resistance in Gram negative bacilli were 33% to Cefuroxime,25% to aminoglycosides and fluoroquinolones and 16% to carbapenems. The mortality of 42.8% was observed in patients with secondary infections. Conclusion: Close monitoring and follow up especially in high-risk group of severe COVID 19 patients is crucial for better management and outcome.
ABSTRACT
INTRODUCTION: dental procedures produce bio-aerosols that can carry the highly contagious COVID-19 virus. Hence, the entire dental care team has to follow the current COVID-19 related infection control protocols. The study aims to assess the knowledge, attitude, and practices associated with infection control methods during dental procedures among dental practitioners during the COVID-19 pandemic in India. METHODS: the online questionnaire consisted of four sections namely, demographic details, eight questions on knowledge, four questions on attitude and eight questions on the practice of dentists during COVID-19 pandemic. One point was attributed for a correct response and zero point for an incorrect response. The study used descriptive statistics and binary logistic regression models in Jamovi 1.8.1 to establish relationships between knowledge, attitude, and practices among dental professionals and their demographic characteristics. RESULTS: among 384 dentists, 294 (76.6%) were aware of the hand hygiene methods, 372 dentists (96.9%) were aware of the Personal Protective Equipment (PPE), 343 dentists (89.3%) recorded the body temperature of the patients. One hundred and thirty eight (138) dentists (35.9%) did not use rubber dam and 158 dentists (41.1%) were not aware of the four-handed dentistry. Among the study participants, 57.8% displayed adequate knowledge, 63.8% possessed good attitude and 93.5% followed good practices on COVID-19 appropriate infection control measures during dental procedures. The mean knowledge, attitude, and practice scores were found to be 6.61, 2.04, and 3.38 respectively. Based on multivariable binary logistic regression analysis, it is observed that males (aOR: 0.55, 95% CI 0.35-0.87; p=0.011) have a lower likelihood of having a good knowledge when compared with females after adjusting for the other independent variables in the model. Also, individuals with higher qualifications (aOR: 0.57, 95% CI 0.36-0.92; p=0.022) appear to have lower likelihood of having good knowledge on COVID-19 infection control methods during dental procedure. CONCLUSION: the study concludes that participants possess sound knowledge, attitude and practice on hand hygiene, PPE, patient triage and waiting area modifications at the workplace. However, poor response was noted on the use of rubber dam, remote telephonic screening and four-handed dentistry practice.