Unrevealing the therapeutic potential of artesunate against emerging zoonotic Babesia microti infection in the murine model.

Babesiosis, a zoonotic blood protozoal disease, threatens humans and animals and is difficult to treat due to growing antimicrobial resistance. The study aimed to investigate the therapeutic efficacy of artesunate (AS), a well-known derivative of artemisinin, against Babesia microti (B. microti) using a murine infection model. Male BALB/c mice (6 weeks old; 15 per group) were chosen and randomly divided into 1) the control group, 2) the B. microti group, and 3) the B. microti + artesunate treatment groups. AS treatment at 2 mg/kg, 4 mg/kg, and 8 mg/kg of body weight significantly (p < 0.05) reduced the B. microti load in blood smears in a dose-dependent manner. Additionally, AS treatment mitigated the decrease in body weight and restored the normal state of the liver and spleen viscera index compared to the B. microti-infected group after 28 days. Hematological analysis revealed significant increases in RBC, WBC, and PLT counts post-AS treatment compared to the B. microti-infected group. Furthermore, AS administration resulted in significant reductions in total protein, bilirubin, ALT, AST, and ALP levels, along with reduced liver and spleen inflammation and lesions as observed through histopathological analysis. AS also elicited dose-dependent changes in mRNA and protein expression levels of apoptotic, proinflammatory, and anti-inflammatory cytokines in the liver compared to the control and B. microti-infected groups. Immunolabeling revealed decreased expression of apoptotic and inflammation-related proteins in AS-treated hepatic cytoplasm compared to the B. microti-infected group. AS also in dose-dependent manner decreased apoptotic protein and increased Bcl-2. Overall, these findings underscore the potential of AS as an anti-parasitic candidate in combating B. microti pathogenesis in an in vivo infection model, suggesting its promise for clinical trials as a treatment for babesiosis.

Infection status and molecular detection of pathogens carried by ectoparasites of Miniopterus fuliginosus bats in Yunnan, China.

Bats serve as natural hosts for various infectious agents that can affect both humans and animals, and they are geographically widespread. In recent years, the prevalence of bat-associated pathogens has surged on a global scale, consequently generating significant interest in bats and their ectoparasites. In this study, we specifically selected the Miniopterus fuliginosus as the host and conducted bat captures in Nanjian Yi Autonomous County, Dali Bai Autonomous Prefecture, and the other in Mouding Township, Chuxiong Yi Autonomous Prefecture, located in Yunnan Province, China. Ectoparasites were meticulously collected from the bat body surface, alongside blood samples for subsequent analyses. Following collection, the ectoparasites were methodically identified and subjected to comprehensive ecological analysis. Additionally, DNA was extracted from both the bat blood and bat flies, with conventional PCR techniques utilized for molecular screening of four pathogens: Anaplasma sp., Babesia sp., Hepatozoon sp., and Bartonella sp. The capture efforts yielded a total of 37 M. fuliginosus, from which 388 ectoparasites were recovered, including 197 gamasid mites (Cr = 50.77%, PM = 94.59%, MA = 5.32, MI = 5.63) and 191 bat flies (Cr = 49.23%, PM = 75.68%, MA = 5.16, MI = 6.82). Notably, Steatonyssus nyctali (Y = 0.28, m*/m = 2.44) and Nycteribia allotopa (Y = 0.23,m*/m = 1.54) predominated among different individuals of M. fuliginosus, exhibiting an aggregated distribution pattern. The infection rates of Bartonella sp. were identified to be 18.92% (7/37) among bats and 37.17% (71/191) among bat flies, based on the testing of 37 bats and 191 bat flies. Phylogenetic analysis demonstrated that the Bartonella sequences exhibited similarity to those found in bats and bat flies within China and South Korea. This study not only contributes to our comprehension of ectoparasite infection in M. fuliginosus but also establishes a foundation for potential exploration of their role as vectors.

Needlestick injuries in dentistry: Time to revisit.

BACKGROUND: Blood-borne pathogens (BBPs) are infectious microorganisms that are found in human blood and can cause diseases in humans. Health care workers such as physicians, surgeons, nurses, dentists, dental students, dental assistants, laboratory technicians, personnel handling infectious waste, and other health care employees are at increased risk of exposure to these pathogens. Percutaneous injuries from needles or other sharp objects are the major sources of BBPs in the workplace. Needlestick injuries (NSIs) have the most potential to transmit and have the easiest mode of transmission of BBPs. TYPES OF STUDIES REVIEWED: The authors searched electronic databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, MEDLINE-Ovid) for studies and articles focused on the various aspects of NSIs, their possible causes, prevention, and management protocols. RESULTS: There is a lack of literature on the global prevalence of NSIs among dental practitioners and underreporting of NSIs by clinicians. The authors also found that dental students and inexperienced practitioners were the most vulnerable. They found apparent inconsistencies in guidelines and recommendations from various regulatory and statutory agencies in charge of limiting and managing NSIs. CONCLUSION: The most significant occupational risks for health care workers globally are NSIs. Dentists are recognized as one of the high-risk groups for exposure to NSIs. Although the reporting rate was noticeably low, the frequency of NSIs among dental students was alarmingly high. PRACTICAL IMPLICATIONS: Appropriate and succinct training of dental health care workers is crucial for prevention and management of NSIs. It is recommended that dentists familiarize themselves with recommendations from such agencies and organizations as the Center for Disease Control and Prevention, Occupational Safety and Health Administration, and American Dental Association.

Are multiple blood cultures advantageous for canine patients?

Successful treatment of bacteremic patients depends largely on timely detection of blood-borne pathogens. Failure to detect an infection and/or contamination of blood samples can substantially delay the proper treatment. To increase the detection rate of blood-borne pathogens, well-established guidelines on blood collection and processing have been practiced in human medicine. Investigations involving human blood cultures have shown that the multiple blood sample approach significantly improves the detection rate of bacterial pathogens in the blood. Unfortunately, veterinary-specific blood culture guidelines have not been defined. Therefore, we compared detection rates of blood-borne pathogens between single and multiple blood culture approaches in a retrospective study of the clinical data from canine blood culture cases. We analyzed the data that had been collected over ~6 y and 8 mo from 177 dogs admitted to a veterinary medical teaching hospital. The triple blood culture approach increased the detection rate of blood-borne pathogens by 19.5% compared to single sampling. The optimal timing between multiple sample collections remains to be determined.

Surveillance of occupational exposure to blood-borne pathogens among medical workers in a tertiary general hospital from 2010 to 2022 / 预防医学

Objective @#To investigate the occupational exposure to blood-borne pathogens among medical workers in a tertiary general hospital in Hangzhou City from 2010 to 2022, so as to provide the evidence for improving occupational protective measures among medical workers.@*Methods@#The registration and follow-up data of occupational exposure to blood-borne pathogens among medical workers from 2010 to 2022 were collected from the blood-borne occupational exposure monitoring system in a tertiary general hospital in Hangzhou City. The population distribution, occurrence, protection and disposal of occupational exposure to blood-borne pathogens were analyzed using a descriptive epidemiological method.@*Results@#A total of 1 230 cases were reported with occupational exposure to blood-borne pathogens among medical workers in the study hospital from 2010 to 2022, with the highest incidence in 2021 (4.67%) and the lowest incidence in 2010 (0.99%). The incidence of occupational exposure to blood-borne pathogens appeared a tendency forwards a rise from 2010 to 2022 (P<0.05). Of all cases with occupational exposure to blood-borne pathogens, there were 934 women (75.93%), 656 nurses (53.33%), and 514 cases with working experiences of one year and shorter (41.79%). Hand was the predominant site of occupational exposure to blood-borne pathogens (92.03%) and ward was the predominant place of exposure (35.37%), while scalp needle was the predominant mode of exposure (32.68%), and removal of needle was the predominant procedure of exposure (32.36%). A total of 1 106 cases were tested for the blood-borne pathogens in the exposure sources, and 448 cases were tested positive for blood-borne pathogens, with a detection rate of 40.51%. Hepatitis B virus, treponema pallidum and human immunodeficiency virus were the three most common blood-borne pathogens, and there were 739 cases (60.08%) with personal protective equipment during exposure. Following the follow-up surveillance for more than 6 months post-exposure, no infections occurred. @*Conclusions@#Junior nurses and hand exposure were predominant among medical workers with occupational exposure to blood-borne pathogens in the study hospital from 2010 to 2022, and hepatitis B virus was the predominant blood-borne pathogen. No post-exposure infections occurred.

Needlestick and sharps' injury in healthcare students: Prevalence, knowledge, attitude and practice.

Purpose: Needlestick and sharps injury is an occupational hazard, and it presents with a constant risk of exposure to blood-borne pathogens. Students are particularly at risk due to a lack of experience and handling skills. The present study was designed to assess the prevalence of needle stick injury and evaluate the knowledge, attitude, and practice regarding its prevention and management among students of a medical campus. Methods: A cross-sectional, questionnaire-based study was conducted among healthcare students of the medical campus in Sangli, Maharashtra. Overall, the study included 942 participants belonging to medical, dental, and nursing faculties. Results: Overall, the prevalence rate of needlestick and sharps injury was found to be 25.2%. The prevalence was highest amongst nursing students. The students had adequate knowledge about blood-borne virus (BBV) transmission and prevention of needlestick injury. However, there was a substantial shortfall in post-exposure prophylaxis knowledge amongst the students. A deficit in translation between knowledge to practice was noted, particularly in the case of needlestick injury prevention and management. Conclusion: The present study found that one in four students experience needlestick injury; overall knowledge regarding prevention and management of needlestick injury was lesser than desired, and gaps in knowledge and practice were identified in the present study. This can be rectified by curricular reforms, periodic educational programs and stern reinforcement of guidelines. Instilling reporting centers and devising a standing operating procedure in the event of needlestick injury are the needs of the hour.

An Ebola, Neisseria and Trypanosoma human protein interaction census reveals a conserved human protein cluster targeted by various human pathogens.

Filovirus ebolavirus (ZE; Zaire ebolavirus, Bundibugyo ebolavirus), Neisseria meningitidis (NM), and Trypanosoma brucei (Tb) are serious infectious pathogens, spanning viruses, bacteria and protists and all may target the blood and central nervous system during their life cycle. NM and Tb are extracellular pathogens while ZE is obligatory intracellular, targetting immune privileged sites. By using interactomics and comparative evolutionary analysis we studied whether conserved human proteins are targeted by these pathogens. We examined 2797 unique pathogen-targeted human proteins. The information derived from orthology searches of experimentally validated protein-protein interactions (PPIs) resulted both in unique and shared PPIs for each pathogen. Comparing and analyzing conserved and pathogen-specific infection pathways for NM, TB and ZE, we identified human proteins predicted to be targeted in at least two of the compared host-pathogen networks. However, four proteins were common to all three host-pathogen interactomes: the elongation factor 1-alpha 1 (EEF1A1), the SWI/SNF complex subunit SMARCC2 (matrix-associated actin-dependent regulator of chromatin subfamily C), the dolichyl-diphosphooligosaccharide--protein glycosyltransferase subunit 1 (RPN1), and the tubulin beta-5 chain (TUBB). These four human proteins all are also involved in cytoskeleton and its regulation and are often addressed by various human pathogens. Specifically, we found (i) 56 human pathogenic bacteria and viruses that target these four proteins, (ii) the well researched new pandemic pathogen SARS-CoV-2 targets two of these four human proteins and (iii) nine human pathogenic fungi (yet another evolutionary distant organism group) target three of the conserved proteins by 130 high confidence interactions.

Relationship among bats, parasitic bat flies, and associated pathogens in Korea.

BACKGROUND: Bats are hosts for many ectoparasites and act as reservoirs for several infectious agents, some of which exhibit zoonotic potential. Here, species of bats and bat flies were identified and screened for microorganisms that could be mediated by bat flies. METHODS: Bat species were identified on the basis of their morphological characteristics. Bat flies associated with bat species were initially morphologically identified and further identified at the genus level by analyzing the cytochrome c oxidase subunit I gene. Different vector-borne pathogens and endosymbionts were screened using PCR to assess all possible relationships among bats, parasitic bat flies, and their associated organisms. RESULTS: Seventy-four bat flies were collected from 198 bats; 66 of these belonged to Nycteribiidae and eight to Streblidae families. All Streblidae bat flies were hosted by Rhinolophus ferrumequinum, known as the most common Korean bat. Among the 74 tested bat flies, PCR and nucleotide sequencing data showed that 35 (47.3%) and 20 (27.0%) carried Wolbachia and Bartonella bacteria, respectively, whereas tests for Anaplasma, Borrelia, Hepatozoon, Babesia, Theileria, and Coxiella were negative. Phylogenetic analysis revealed that Wolbachia endosymbionts belonged to two different supergroups, A and F. One sequence of Bartonella was identical to that of Bartonella isolated from Taiwanese bats. CONCLUSIONS: The vectorial role of bat flies should be checked by testing the same pathogen and bacterial organisms by collecting blood from host bats. This study is of great interest in the fields of disease ecology and public health owing to the bats' potential to transmit pathogens to humans and/or livestock.

Zoonotic Blood-Borne Pathogens in Non-Human Primates in the Neotropical Region: A Systematic Review.

Background: Understanding which non-human primates (NHPs) act as a wild reservoir for blood-borne pathogens will allow us to better understand the ecology of diseases and the role of NHPs in the emergence of human diseases in Ecuador, a small country in South America that lacks information on most of these pathogens. Methods and principal findings: A systematic review was carried out using PRISMA guidelines from 1927 until 2019 about blood-borne pathogens present in NHPs of the Neotropical region (i.e., South America and Middle America). Results: A total of 127 publications were found in several databases. We found in 25 genera (132 species) of NHPs a total of 56 blood-borne pathogens in 197 records where Protozoa has the highest number of records in neotropical NHPs (n = 128) compared to bacteria (n = 12) and viruses (n = 57). Plasmodium brasilianum and Trypanosoma cruzi are the most recorded protozoa in NHP. The neotropical primate genus with the highest number of blood-borne pathogens recorded is Alouatta sp. (n = 32). The use of non-invasive samples for neotropical NHPs remains poor in a group where several species are endangered or threatened. A combination of serological and molecular techniques is common when detecting blood-borne pathogens. Socioecological and ecological risk factors facilitate the transmission of these parasites. Finally, a large number of countries remain unsurveyed, such as Ecuador, which can be of public health importance. Conclusions and significance: NHPs are potential reservoirs of a large number of blood-borne pathogens. In Ecuador, research activities should be focused on bacteria and viruses, where there is a gap of information for neotropical NHPs, in order to implement surveillance programs with regular and effective monitoring protocols adapted to NHPs.

Needlestick Injury in Otolaryngology-Head and Neck Surgery Resident Programs.

OBJECTIVES/HYPOTHESIS: Up to 800,000 percutaneous injuries involving healthcare workers occur each year. The morbidity of needlestick injuries (NSIs) ranges from nothing to death. The incidence of NSI in otolaryngology residency is deemed to be high based on prior studies. This study aimed at defining the trends in otolaryngology residents regarding sharps exposure. STUDY DESIGN: Cross-sectional study using survey/questionnaire. METHODS: Otolaryngology accredited residency programs in North America were surveyed in 2013 and 2017 regarding their experience with NSI and perceived risk of acquiring a blood-borne infection. RESULTS: Surveys were received from 314 residents (31 programs). There was a total of 509 needlesticks, primarily occurring during junior years (post-graduate year 1-3, 81%). Sixty-eight percent of residents had experienced an NSI. Of the residents that had an injury, the mean number of sticks was 2.37 sticks/resident. Junior residents were less likely to report their injury compared to senior residents (50% vs. 30%). The primary reason for not reporting was the time commitment. Residents underestimated their risk of acquiring human immunodeficiency virus (51% of residents) and overestimated their risk of acquiring hepatitis C virus (90% of residents). CONCLUSIONS: Occupational exposure is high in healthcare and particularly high in surgical trainees. The majority of otolaryngology trainees undergo a needlestick injury in their junior years. There continues to be underreporting of these injuries by residents, who report that the process is too time-consuming. Most residents do not have an accurate understanding of their actual risk of acquiring a blood-borne disease. These findings emphasize the need for education regarding risks and development of strategies to encourage reporting of injuries. LEVEL OF EVIDENCE: VI Laryngoscope, 131:E1076-E1080, 2021.

The human spleen as the center of the blood defense system.

Blood-borne infections can develop into sepsis and are therefore a major human health risk. The responsible pathogens thus need to be eliminated rapidly. Intravascular macrophages in the liver and bone marrow (BM) sinuses, and in the red pulp and marginal zone of the spleen, remove the majority of these microorganisms via innate immunity. However, specific antibodies are essential for their complete elimination. Splenic marginal zone B cells simultaneously produce many of the IgM and IgG2 antibodies that target blood-borne pathogens within a few days of infection. Subsequently, follicular B cells of the white pulp of the spleen produce specific IgG antibodies against the invading pathogens, known as adaptive immunity. Although the liver, BM, and spleen work together to activate the defense response to blood-borne pathogens through innate and adaptive immunity, the spleen acts as the center of the blood defense system (BDS). The structure of the spleen is introduced in this review in relation to its function in the BDS as part of the response of the immune system and of functioning organs to blood-borne pathogens. The concept of a BDS is also important for hematological disorders, such as lymphomas and; therefore, may be useful to hematologists and pathologists.

Multimodal Magneto-Fluorescent Nanosensor for Rapid and Specific Detection of Blood-Borne Pathogens.

Detection of bacterial contaminants in blood and platelet concentrates (PCs) continues to be challenging in clinical settings despite available current testing methods. At the same time, it is important to detect the low bacterial contaminants present at the time of transfusion. Herein, we report the design and synthesis of a dual-modal magneto-fluorescent nanosensor (MFnS) by integrating magnetic relaxation and fluorescence modalities for the wide-range detection of blood-borne pathogens. In this study, functional MFnS are designed to specifically detect Staphylococcus epidermidis and Escherichia coli, two of the predominant bacterial contaminants of PCs. Specific interaction between the target pathogen and functional MFnS resulted in the change of water proton's magnetic relaxation time (T2 MR), indicative of sensitive detection of the target bacteria from low to high colony forming unit (CFU). In addition, the acquired MR signal of MFnS further facilitated the quantitative assessment of the slow and fast growth kinetics of target pathogens. Moreover, the presence of fluorescence modality in MFnS allowed for the detection of multi-contaminants. The bacterial detection was also performed in complex media including whole blood and platelet concentrates, which further demonstrated for it's robust detection sensitivity. Overall, our study indicated that the designer MFnS will have potential for the wide-range detection of blood-borne pathogens, and features desirable qualities including timeliness, sensitivity and, specificity.

Babesia microti Infection Changes Host Spleen Architecture and Is Cleared by a Th1 Immune Response.

Babesia microti is a malaria-like parasite, which infects ∼2000 people annually, such that babesiosis is now a notifiable disease in the United States. Immunocompetent individuals often remain asymptomatic and are tested only after they feel ill. Susceptible C3H/HeJ mice show several human-like disease manifestations and are ideal to study pathogenesis of Babesia species. In this study, we examined parasitemia of B. microti at different time points and assessed its impact on hemoglobin levels in blood, on spleen pathology and overall immune response in C3H/HeJ mice. Peak parasitemia of 42.5% was immediately followed by diminished hemoglobin level. Parasitemia at 21 days of infection was barely detectable by microscopy presented 5.7 × 108 to 5.9 × 109B. microti DNA copies confirming the sensitivity of our qPCR. We hypothesize that qPCR detects DNA released from recently lysed parasites or from extracellular B. microti in blood, which are not easily detected in blood smears and might result in under-diagnosis of babesiosis in patients. Splenectomized patients have been reported to show increased babesiosis severity and result in high morbidity and mortality. These results emphasize the importance of splenic immunity in resolution of B. microti infection. Splenomegaly in infected mice associated with destruction of marginal zone with lysed erythrocytes and released B. microti life forms in our experiments support this premise. At conclusion of the experiment at 21 days post-infection, significant splenic B and T cells depletion and increase in macrophages levels were observed in B. microti infected mice suggesting a role of macrophage in disease resolution. Infected mice also showed significantly higher plasmatic concentration of CD4 Th1 cells secreted cytokines such as IL-2 and IFN-γ while cytokines such as IL-4, IL-5, and IL-13 secreted by Th2 cells increase was not always significant. Thus, Th1 cells-mediated immunity appears to be important in clearance of this intracellular pathogen. Significant increase in IL-6 that promotes differentiation of Th17 cells was observed but it resulted in only moderate change in IL-17A, IL-17F, IL-21, and IL-22, all secreted by Th17 cells. A similar immune response to Trypanosoma infection has been reported to influence the clearance of this protozoan, and co-infecting pathogen(s).

Detection and identification of blood-borne infections in dogs in Nigeria using light microscopy and the polymerase chain reaction.

Many sick dogs brought to the University of Ibadan Veterinary Teaching Hospital (UIVTH) are infested with ticks and are anemic. Up until recently, light microscopy (LM) has been the only available means used for detection of blood-borne infections. In other parts of the world, PCR-based assays been used as a gold standard for accurate diagnosis of blood-borne infections. In this study, we used LM and broad-spectrum rRNA gene PCR-based assays on 116 blood samples from dogs brought to the UIVTH for detection of the 18S rRNA gene of Babesia and the 16S rRNA genes of Ehrlichia and hemotropic mycoplasmas. The relationship between clinicopathological findings and PCR results was evaluated. Age, sex, presence of ticks, anemia, co-infection status, and fever were also assessed in relation to PCR positivity to determine the risk factors using stepwise logistic regression analyses. Light microscopic examination revealed an overall prevalence of infection of 14.7% (17/116). Organisms detected were Babesia canis (3.5%), Ehrlichia canis (10.3%) and Trypanosoma congolense (0.9%) and a single co-infection with Babesia canis and Ehrlichia canis (0.9%). PCR analysis revealed 89/116 (76.7%) positive samples. Infections with 1, 2 and 3 infectious agents occurred in 49 (55.1%), 36 (40.4%) and 4 (4.5%) samples, respectively. Specifically, among the 89 PCR positive samples, Babesia spp. (85.4%) was the most abundant infection followed by Ehrlichia spp. (46.1%) and hemoplasmas (13.5%). Sequencing of PCR products identified two samples (1.7%) that contained Hepatozoon canis DNA. Sequencing of hemoplasma positive samples identified 'Candidatus Mycoplasma haemobos' in 0.8% of dogs. Using PCR, a 5-fold higher prevalence of blood-borne infections was found in the dogs (76.7%, 89/116) than with LM (14.7%, 17/116) alone" Dogs between 1 and 12months were the most frequently infected with multiple agents (47.2% double and 50.0% triple infections). Male dogs had the highest prevalence of infection (80.4%) and more triple infections (75.0%). A total of 57.3% of infected dogs were anemic. Anemic dogs were 2.77 times more likely to test positive for Ehrlichia spp. (OR: 2.77 95% CI: 1.25-6.16) and dogs with ticks were 3.6 times more likely to test positive for hemoplasmas (OR=3.60 95% CI: 1.05-12.38). This study underscores the abundance of blood-borne infections in dogs in Ibadan, Nigeria, which is underestimated using light microscopy. This is also the first evidence of existence of 'Candidatus Mycoplasma haemobos' in a dog in Nigeria and in Africa. Consequently there is a need for molecular diagnostic facilities for routine screening of sick animals, as multiple infections were not found by light microscopy.

Awareness of risk of cross-infection and infection-control measures among patients attending University Dental Hospital, Peradeniya, Sri Lanka.

AIM: The aim of the present study was to assess awareness of the risk of cross-infection and infection-control measures practiced in dental clinics for patients attending the outpatient dental department (OPD) at University Dental Hospital, Peradeniya, Sri Lanka. METHODS: A descriptive cross-sectional study was carried out among 427 patients who attended the OPD clinics at University Dental Hospital. An interviewer-administered questionnaire was used to collect data, and chi-squared-test of association was applied where appropriate. RESULTS: Most patients (75.2%) were aware that there was a chance of infection transmission during dental treatments, and nearly 72% stated that wearing gloves and masks by their dentists was important during dental treatment. Awareness was higher among patients with a higher educational level. Participants revealed their fear of potential transmission of blood-borne pathogens in the dental setting. Awareness of sterilization of dental instruments was poor. CONCLUSIONS: The public should be made aware of the possible risks of cross-infection and the importance of infection-control practices in dental clinics. Dental professionals should fill the information gap.

Characteristics as well as prevention and control costs of occupational ex-posure to blood-borne pathogens / 中国感染控制杂志

Objective To study the characteristics of occupational exposure to blood-borne pathogens and the cost of prevention and control,and provide evidence for policy making in medical institutions.Methods A prospective study was conducted to collect the data and follow-up data about occupational exposure of health care workers(HC-Ws)from the occupational exposure reporting system of a hospital between June 1,2016 and May 30,2017.Results There were 95 cases of occupational exposure to blood-borne pathogens.Occupational exposure occurred mainly in June,July,and November,peak time for occurrence was 12∶00 at noon.The main occupations of HCWs who sustained occupational exposure were nurses (41.05%),doctors (28.42%),and practice nurses (15.79%).The main departments of occupational exposure were central operating room (21.05%), emergency department (1 1.58%),and interventional radiology department (6.32%).The total cost of prevention and control for 95 times of occupational exposures were 33 235.20 Yuan,with an average of 349.84 Yuan per case.The average cost per case after human immunodeficiency virus (HIV)exposure was the highest (2 787.50 Yuan);and cost of syphilis exposure was the lowest (58.88 Yuan).Conclusion It is necessary to strengthen the training and education of high-risk time,high-risk population,and high-risk departments of occupational exposure to blood-borne pathogens,pre-vention of occupational exposure with high cost of prevention and control such as HIV should be especially paid attention.

Determining the factors associated with blood-borne virus testing of substance misusers presenting to hospital.

BACKGROUND: Diagnosing blood-borne virus (BBV) infection is an essential first step in eliminating transmission and securing access to treatment amongst substance misusers. AIMS: To determine the proportion of substance misusers presenting to hospital who undergo BBV testing and the factors influencing testing. METHODS: A retrospective cross-sectional study was performed of patients presenting to two Sydney teaching hospitals with substance misuse diagnoses between January and April 2015. Proportions tested for human immunodeficiency virus, hepatitis C and hepatitis B previously and during the index hospitalisation presentation were examined. Multivariable analysis was performed to determine factors associated with testing. RESULTS: Of 239 patients, 47 (19.7%) had a documented BBV at baseline. Of those with unknown BBV status, 29 (12.8%) had undergone some attempt at testing during presentation; 3.1% had their hepatitis B immunity assessed. Factors associated with an increased likelihood of testing during presentation included documented injecting drug use (odds ratio (OR) 15.14; 95% confidence interval (CI) 4.21-54.50; P < 0.001), admission under a physician (OR 11.79; 95% CI 2.82-49.40; P = 0.001) and admission on a Friday (OR 4.46; 95% CI 1.28-15.48; P = 0.02). Patients who had had more than one previous admission in the preceding 6 months (OR 0.24; 95% CI 0.078-0.73; P = 0.01) or a length of stay of 1 day or less (OR 0.17; 95% CI 0.032-0.87; P = 0.033) were less likely to be tested. CONCLUSION: Despite the high baseline prevalence of BBV infections in the population, there were many missed opportunities for BBV testing. We found patient-, admission- and clinician-level barriers that could be addressed to enhance BBV testing uptake.

Psychological stress reactions of occupational exposure to blood-borne infectious pathogens among medical staff: A longitudinal study / 中国心理卫生杂志

Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.

In-vitro evaluation of surgical helmet systems for protecting surgeons from droplets generated during orthopaedic procedures.

BACKGROUND: Operating theatres and surgical clothing are designed to protect the patient from surgical site infections. However, there is still a risk of infection of the surgical team with blood-borne pathogens via ocular or mucocutaneous exposure. Whereas conventional surgical clothing provides some protection against contamination, surgical helmet systems (SHS) are intended to provide a high level of protection by forming a barrier for particles, aerosols and fluids between surgeon and surgical field of work. AIM: The aim of this study was to quantify the contamination of the surgeon by droplets during orthopaedic procedures by an in-vitro simulation of hip and knee arthroplasty while wearing SHS versus conventional surgical clothing. METHODS: Hip and knee arthroplasty procedures were performed on artificial foam bone, which was continuously kept wet with a marker fluid. Each of the procedures was carried out by ten subjects wearing conventional surgical clothing or wearing SHS with integrated toga. After the simulated operation, pictures of the subjects were taken under ultraviolet illumination. Images wearing the full gown, and after removal of the gown, were evaluated for stained areas. FINDINGS: The contamination risk was 30% while wearing conventional clothing. In none of the 20 subjects using the SHS stains could staining be detected after removal of the protective clothing. CONCLUSION: This study has demonstrated that the protective properties of the SHS are superior to conventional surgical clothing. Using SHS in high-risk procedures could reduce occupational exposure to blood-borne infections in surgeons.