Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevent...Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.展开更多
Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated wit...Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.展开更多
Introduction: Infections are significant causes of mortality in sickle cell children in resource-limited countries. This study aimed to determine the clinical profile and bacterial ecology of infections in children wi...Introduction: Infections are significant causes of mortality in sickle cell children in resource-limited countries. This study aimed to determine the clinical profile and bacterial ecology of infections in children with sickle-cell disease in two referral hospitals in Niamey. Patients and methods: A retrospective descriptive study was conducted from January 2018 to July 2020 in two referral hospitals in Niamey. All children aged one (1) to 15 years with sickle cell disease admitted for suspected infection, including at least one bacterial culture, were studied. Bacteriological analysis was performed using the appropriate culture media, using BactAlert (Reference 4700003 BTA3D60 BioMérieux). Results: Over 36-months, 350 children with a mean age of 10.9 months were admitted. The sex ratio was 1.2. The SS electrophoretic profile was the most common (93.4%). Immunization status was up to date in 66% of patients. Fever was the common reason for consultation (55.1%). Infection was confirmed in 62 patients (17.7%). The primary diagnoses were bacterial gastroenteritis (24.2%) and urinary tract infection (19.4%). Blood cultures were isolated from Salmonella typhi (13.0%) and Escherichia coli (8.7%). Klebsiella spp (7.1%) and Escherichia coli (5.0%) were detected in cytobacteriological examination of urine. Salmonella typhi (23.5%) and Escherichia coli (5.9%) were isolated on coproculture. Conclusion: Bacterial ecology appears not different from that usually observed in sickle-cell children. Salmonella and Escherichia coli were predominant.展开更多
Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital i...Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.展开更多
Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University Hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to ...Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University Hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 women.The sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara University Hospital, with a high mortality rate due to delayed consultations.展开更多
Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may i...Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may influence the behavioral pattern and adoption of preventive measures against the virus and can affect the uptake of the Hepatitis B vaccine. This study assesses the perception of medical students towards Hepatitis B virus infection and Hepatitis B Vaccination in a Private Tertiary Hospital in Jos North Local Government, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in August 2021 among 236 clinical medical students using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: Two-thirds of respondents were of the opinion that they are at risk of contracting HBV. Half were of the opinion that the risk is very much while a third believed the risk is moderate. Among those who think they are not at risk of contracting HBV, the majority felt so because they are vaccinated while 10.3% believe that they are safe. 43.2% of respondents think that HBV Vaccine is very effective in preventing HBV infection while 39.8% think it is slightly effective, and 7.6% think it is not effective. Almost all respondents, 99.2% are of the opinion that HBV Vaccination is important for students while 0.8% think it is not important. The majority of the respondents at 95.8% were willing to be screened for HBV. The majority (85.6%) of respondents are willing to pay for HBV Vaccine as against 14.4% of respondents who are not willing to pay. Conclusion: Summarily, 21 (8.9%) of the students had a negative perception of Hepatitis B Vaccination, and 215 (91.1%) had a positive perception of Hepatitis B Vaccination. Perception-sustaining events like seminars, workshops, road shows, and campaigns should be organized among students and health workers.展开更多
BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction ...BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction of patients with high risk of death.METHODS:The Emergency Bloodstream Infection Score(EBS)for CABSIs was developed to visualize the output of a logistic regression model and was validated by the area under the curve(AUC).The Mortality in Emergency Department Sepsis(MEDS),Pitt Bacteremia Score(PBS),Sequential Organ Failure Assessment(SOFA),quick Sequential Organ Failure Assessment(qSOFA),Charlson Comorbidity Index(CCI),and McCabe–Jackson Comorbid Classification(MJCC)for patients with CABSIs were computed to compare them with EBS in terms of the AUC and decision curve analysis(DCA).The net reclassification improvement(NRI)index and integrated discrimination improvement(IDI)index were compared between the SOFA and EBS.RESULTS:A total of 547 patients with CABSIs were included.The AUC(0.853)of the EBS was larger than those of the MEDS,PBS,SOFA,and qSOFA(all P<0.001).The NRI index of EBS in predicting the in-hospital mortality of CABSIs patients was 0.368(P=0.04),and the IDI index was 0.079(P=0.03).DCA showed that when the threshold probability was<0.1,the net benefit of the EBS model was higher than those of the other models.CONCLUSION:The EBS prognostic models were better than the SOFA,qSOFA,MEDS,and PBS models in predicting the in-hospital mortality of patients with CABSIs.展开更多
A retrospective analysis of the diagnostic laboratory submissions from 2016 to 2020 was performed to assess the antibiotic resistance of Staphylococcus pseudintermedius and determine locations in the hospital which mi...A retrospective analysis of the diagnostic laboratory submissions from 2016 to 2020 was performed to assess the antibiotic resistance of Staphylococcus pseudintermedius and determine locations in the hospital which might be acting as environmental source(s). Previous studies have identified a significant increase in infections with S. pseudintermedius. Samples were taken from the hospital environment by swabbing areas in the intensive care unit and anesthesia preparation room and bacterial species identified. Isolates obtained from patients were then examined regarding the ability to form biofilm, an important phenotype on hospital-related infection. In addition, veterinary hospital associated strains of S. pseudintermedius were used to determine the bactericidal effect of the used disinfectant, applying the hospital current protocol, by comparing the efficacy against S. pseudintermediius and a strain of Staphylococcus aureus from a dog. The isolates identified were resistant to commonly used antibiotics such as enrofloxacin and cephalosporins, and 45% percent of those were methicillin resistant. The environmental survey in the hospital identified S. pseudintermedius in the pre-anesthesia area, although the isolate was killed by the current used disinfection protocol. A few disease associated bacteria were evaluated for biofilm formation in comparison to a dog isolate of Staphylococcus aureus, demonstrating strong ability to form biofilms.展开更多
Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract...Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.展开更多
Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in C...Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.展开更多
Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respirato...Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mali.展开更多
Background: Operative site infections (ISO) are typically nosocomial. According to the WHO the incidence of ISO varies from 0.5% to 15% and exceeds 25% in developing countries. They result from the combined action of ...Background: Operative site infections (ISO) are typically nosocomial. According to the WHO the incidence of ISO varies from 0.5% to 15% and exceeds 25% in developing countries. They result from the combined action of several factors and represent a concern for public health. To study the contributing factors of surgical site infections in patients operated at the University Clinic of Orthopedic Traumatology of CNHU-HKM of Cotonou. Method: This was an analytical cross-sectional study that involved 35 operated patients and ten nurses. Were included in our study: 1) All patients, without distinction of sex or age, having been operated on in the university clinic of orthopedic traumatology, during the survey period;2) Patients hospitalized for post-operative care during the survey period;3) The nursing staff on duty during our study period. The usual statistical measures were used according to the type of variables: means, standard deviations, percentages. Data analysis first involved calculating percentages for the qualitative variables and means followed by their standard deviations for the quantitative variables. Next, the Pearson Chi-square test was used to test the association between the dependent variable and the independent variables of interest. The significance level is set at p Results: The prevalence of surgical site infections was 28.58%. The main factors contributing to the occurrence of SSIs that were found were the patient’s level of education (p = 0.003) and the reuse of bandages used for dressing (p = 0.004). Other potential factors such as the economic status of the patient, the poor quality of technical dressings, and the preoperative stay were also highlighted. Conclusion: Surgical site infections remain a global concern. Risk factors were found on both the patient and nurse sides. It is urgent to address these various factors to minimize the occurrence of surgical site infections.展开更多
Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ bir...Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ birth weights. This study sought to determine the relationship(s) between pregnancy trimesters, UTIs and changes in progesterone levels among pregnant women. Materials and Methods: The study was conducted in 2016 at Moi Teaching and Referral Hospital (MTRH) antenatal clinic which is a referral facility that attends to patients from most Counties in western region of Kenya. A cross-sectional study design was used to collect blood and urine specimens from 78 participants. Blood was used to determine progesterone levels using ELISA technique and urine cultures with bacterial colony counts ≥ 10<sup>5</sup> were appropriately identified to species level. Trimester periods and participants’ demographic information were obtained using a structured questionnaire. Results: Culture results showed that the most abundant bacterial species isolated in urine from the pregnant women was Escherechia coli (63.7%). The more affected age-group was women between 30 - 39 years during trimester three, suggesting that bacterial colonization of genital track occurred more frequently in older compared to the younger women. There was an exponential increase in progesterone levels among the pregnant women during trimester three compared to other trimesters, although these increases occurred independent of age. However, high levels of progesterone among pregnant women in third trimester corresponded with increased number of E. coli causing UTI. Conclusion: The results showed that progesterone levels increase with trimester and the most prevalent bacteria associated with this was E. coli even though age and increase in progesterone levels had no significant impact on E. coli infection.展开更多
Introduction: Healthcare-associated infections (HAIs) are a worldwide concern because of their magnitude and their human and financial cost. While nurses’ non-compliance of hygiene and asepsis measures is questioned,...Introduction: Healthcare-associated infections (HAIs) are a worldwide concern because of their magnitude and their human and financial cost. While nurses’ non-compliance of hygiene and asepsis measures is questioned, the rationale behind it is not fully understood. We hypothesized that nurses’ experiences and perceptions are one of the reasons for their non-compliance with prevention recommendations. Also, nurses’ caring approach would play an important role in patient safety. The objective of this study was to describe nurses’ experiences and perceptions of HAIs in a district hospital in Burkina Faso with the aim of developing a culture of safety in health care practices. Methods: Qualitative data were collected through unstructured interviews with twenty nurses from the Ziniaré district hospital. Data analysis followed the qualitative phenomenological method according to Giorgi. Results: Phenomenological analysis yielded the following themes: “an ignored reality”;“a denied responsibility”;and “a vulnerable problem”. These results show that nurses’ perception of the extent and seriousness of HAIs is low, and that they deny responsibility for their occurrence. As a result, HAIs are not always perceived as a concern. However, nurses deplore the situation, but remain optimistic about resolving the problem. Conclusion: These nurses’ perceptions of HAIs could explain their non-compliance with prevention recommendations. Corrective action could be redirected by raising awareness, continuing training, improving working conditions and involving all players, including patients and their families, in the fight against HAIs. .展开更多
Background: Surgical site infections (SSIs) are considered as result of the healthcare quality in hospitals. Objective: to study SSI at Saint Jean de Dieu Hospital Tanguieta (SJDHT), prior to the implementation of a p...Background: Surgical site infections (SSIs) are considered as result of the healthcare quality in hospitals. Objective: to study SSI at Saint Jean de Dieu Hospital Tanguieta (SJDHT), prior to the implementation of a permanent monitoring system. Method: transversal, and descriptive study with prospective data collection was performed from 1 July to 31 janvier 2017 in the department of general surgery of SJDHT. The hospital lacks in a microbiology unit. All patients who underwent surgery during this period were included and the monitoring lasted one month. SSIs diagnostic was carried out according to WHO criteria as described in the Practical Guide for the Prevention of Nosocomial Infections published in 2002. Statistical tests (χ-square and Student’s t-test) were applied and p 0.05 were statistically significant. Results: Of 343 patients recorded, 105 (30.6%) had SSI. Their age averaged 40.3 years and the sex-ratio (men/women) was 2.8. The emergency surgery resulted in a 50.0% rate of SSI (p = 0.00). The SSI rate for clean and clean-contaminated surgery was 6.3% against 94.6% for infected surgery (p = 0.00). The SSI rates were 100% and 66.7% for NNISS = 2 and NNISS = 1 (p = 0.00), respectively. Superficial SSI rate was 13.3%, while deep SSI and organ/space SSI were 46.7% and 40%, respectively. The hospital stay of patients with SSI was three times longer than the length of patients without SSI (p = 0.00). Conclusion: SSIs are real burden at SJDHT. Appropriate measures must be adopted to reduce its prevalence.展开更多
Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, po...Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, posing a significant health challenge. This study aims to determine the characteristics of ESBL-producing bacteria causing UTIs in expectant women. Methodology: A self-administered survey was carried out;300 expectant women were recruited using a random sampling method. A questionnaire was used to collect socio-demographic information. Urine samples were collected in sterile universal bottles and processed at the JKUAT Zoology laboratory. Urine samples were analyzed using urinalysis, microscopy, culture, and sensitivity testing. ESBL-producing bacteria were identified phenotypically using the double-disc synergy test (DDST) and genotyped for specific resistant genes using PCR. Results: UTI prevalence was 32.7% (98/300). UTI was significantly associated with the history of previous UTI (OR = 0.84, p = 0.02) and multigravida (OR = 0.14 p = 0.01). UTI was common in women aged between 28-37 years in their second trimester. Bacteria isolated were E. coli 57.1% (56/98), S. aureus 21.4% (21/98) K. pneumonia 11.2% (11/98) and Proteus spp 10.4% (10/98). Bacteria antibiotic resistance patterns were E. coli-tetracycline (91.1%), sulfamethoxazole (55.4%), cefotaxime (53.4%) and augmentin (53.4%). S. aureus-sulfamethozaxole (100%) and augmentin (71.4%), K. pneumoniae-sulfame-thoxazole (72.2%) cefotaxime (63.6%), chloramphenicol and tetracycline (54.5%). Proteus spp: tetracycline (100%), nitrofurantoin (90%), cefotaxime and chloramphenicol (50%). The proportion of ESBLs bacterial producers was 37.6% (29/77) and 44.8% (13/29) possessed ESBLs resistant genes;Bla CTX-M 53.8% (7/13), Bla SHV and Bla TEM 23.1% (3/13) each, Bla OXA (0%) was not detected. Conclusion: The study revealed a high proportion of ESBLs producing bacteria responsible for UTI in expectant women. ESBLs screening, routine culture and sensitivity testing will guide on proper management and empirical treatment of UTI patients thus reducing multi-drug resistance.展开更多
Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge...Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge and compliance with standard precautions at the maternity hospital.Materials and Methods:A quasi‑experimental one‑group pretest‑posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital,Kasr El Ainy,who received“designed infection control educational program”for 6 months.The data were collected through the questionnaire comprising demographics,knowledge,and compliance with standard precautions questionnaire.The nurses’knowledge and compliance score were compared before and after intervention.Results:The studied nurses had higher level of knowledge(85.3%)and compliance(92.8%)regarding infection control standard precautions after the educational program compared to before the program.The results revealed statistically significant difference between before and after the program regarding nurses’knowledge score(15.5±2.9 vs.17.1±1.6,P<0.001)and compliance score(58.5±13.2 vs.74.3±5.1,P<0.001).In addition,there was insignificant relation between nurses’knowledge and compliance with standard precautions both before(r=0.952,P=0.474)and after educational program(r=0.164,P=0.223).Conclusion:The nurses’level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program.Therefore,it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.展开更多
Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive a...Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.展开更多
Multiple waves of coronavirus disease 2019(COVID-19) outbreaks have affected numerous countries worldwide. The first case of SARS-CoV-2 reinfection was reported in Hong Kong in August 2020^([1]), leading to increased ...Multiple waves of coronavirus disease 2019(COVID-19) outbreaks have affected numerous countries worldwide. The first case of SARS-CoV-2 reinfection was reported in Hong Kong in August 2020^([1]), leading to increased interest in the effectiveness of natural immunity acquired from primary infection. While data reports vary across countries, all findings indicate that prior SARS-CoV-2 infection provides substantial protection against reinfection^([2]). However, natural immunity from infection with previous non-Omicron or early Omicron sub-lineages offers lower levels of protection against Omicron reinfection, with rates below 60%^([3]) and approximately 75%[4], respectively.展开更多
Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Sy...Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.展开更多
文摘Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.
文摘Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.
文摘Introduction: Infections are significant causes of mortality in sickle cell children in resource-limited countries. This study aimed to determine the clinical profile and bacterial ecology of infections in children with sickle-cell disease in two referral hospitals in Niamey. Patients and methods: A retrospective descriptive study was conducted from January 2018 to July 2020 in two referral hospitals in Niamey. All children aged one (1) to 15 years with sickle cell disease admitted for suspected infection, including at least one bacterial culture, were studied. Bacteriological analysis was performed using the appropriate culture media, using BactAlert (Reference 4700003 BTA3D60 BioMérieux). Results: Over 36-months, 350 children with a mean age of 10.9 months were admitted. The sex ratio was 1.2. The SS electrophoretic profile was the most common (93.4%). Immunization status was up to date in 66% of patients. Fever was the common reason for consultation (55.1%). Infection was confirmed in 62 patients (17.7%). The primary diagnoses were bacterial gastroenteritis (24.2%) and urinary tract infection (19.4%). Blood cultures were isolated from Salmonella typhi (13.0%) and Escherichia coli (8.7%). Klebsiella spp (7.1%) and Escherichia coli (5.0%) were detected in cytobacteriological examination of urine. Salmonella typhi (23.5%) and Escherichia coli (5.9%) were isolated on coproculture. Conclusion: Bacterial ecology appears not different from that usually observed in sickle-cell children. Salmonella and Escherichia coli were predominant.
文摘Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.
文摘Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University Hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 women.The sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara University Hospital, with a high mortality rate due to delayed consultations.
文摘Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may influence the behavioral pattern and adoption of preventive measures against the virus and can affect the uptake of the Hepatitis B vaccine. This study assesses the perception of medical students towards Hepatitis B virus infection and Hepatitis B Vaccination in a Private Tertiary Hospital in Jos North Local Government, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in August 2021 among 236 clinical medical students using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: Two-thirds of respondents were of the opinion that they are at risk of contracting HBV. Half were of the opinion that the risk is very much while a third believed the risk is moderate. Among those who think they are not at risk of contracting HBV, the majority felt so because they are vaccinated while 10.3% believe that they are safe. 43.2% of respondents think that HBV Vaccine is very effective in preventing HBV infection while 39.8% think it is slightly effective, and 7.6% think it is not effective. Almost all respondents, 99.2% are of the opinion that HBV Vaccination is important for students while 0.8% think it is not important. The majority of the respondents at 95.8% were willing to be screened for HBV. The majority (85.6%) of respondents are willing to pay for HBV Vaccine as against 14.4% of respondents who are not willing to pay. Conclusion: Summarily, 21 (8.9%) of the students had a negative perception of Hepatitis B Vaccination, and 215 (91.1%) had a positive perception of Hepatitis B Vaccination. Perception-sustaining events like seminars, workshops, road shows, and campaigns should be organized among students and health workers.
基金supported by the National Key Research and Development Program of China(2021YFC2501800)。
文摘BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction of patients with high risk of death.METHODS:The Emergency Bloodstream Infection Score(EBS)for CABSIs was developed to visualize the output of a logistic regression model and was validated by the area under the curve(AUC).The Mortality in Emergency Department Sepsis(MEDS),Pitt Bacteremia Score(PBS),Sequential Organ Failure Assessment(SOFA),quick Sequential Organ Failure Assessment(qSOFA),Charlson Comorbidity Index(CCI),and McCabe–Jackson Comorbid Classification(MJCC)for patients with CABSIs were computed to compare them with EBS in terms of the AUC and decision curve analysis(DCA).The net reclassification improvement(NRI)index and integrated discrimination improvement(IDI)index were compared between the SOFA and EBS.RESULTS:A total of 547 patients with CABSIs were included.The AUC(0.853)of the EBS was larger than those of the MEDS,PBS,SOFA,and qSOFA(all P<0.001).The NRI index of EBS in predicting the in-hospital mortality of CABSIs patients was 0.368(P=0.04),and the IDI index was 0.079(P=0.03).DCA showed that when the threshold probability was<0.1,the net benefit of the EBS model was higher than those of the other models.CONCLUSION:The EBS prognostic models were better than the SOFA,qSOFA,MEDS,and PBS models in predicting the in-hospital mortality of patients with CABSIs.
文摘A retrospective analysis of the diagnostic laboratory submissions from 2016 to 2020 was performed to assess the antibiotic resistance of Staphylococcus pseudintermedius and determine locations in the hospital which might be acting as environmental source(s). Previous studies have identified a significant increase in infections with S. pseudintermedius. Samples were taken from the hospital environment by swabbing areas in the intensive care unit and anesthesia preparation room and bacterial species identified. Isolates obtained from patients were then examined regarding the ability to form biofilm, an important phenotype on hospital-related infection. In addition, veterinary hospital associated strains of S. pseudintermedius were used to determine the bactericidal effect of the used disinfectant, applying the hospital current protocol, by comparing the efficacy against S. pseudintermediius and a strain of Staphylococcus aureus from a dog. The isolates identified were resistant to commonly used antibiotics such as enrofloxacin and cephalosporins, and 45% percent of those were methicillin resistant. The environmental survey in the hospital identified S. pseudintermedius in the pre-anesthesia area, although the isolate was killed by the current used disinfection protocol. A few disease associated bacteria were evaluated for biofilm formation in comparison to a dog isolate of Staphylococcus aureus, demonstrating strong ability to form biofilms.
文摘Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.
文摘Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.
文摘Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mali.
文摘Background: Operative site infections (ISO) are typically nosocomial. According to the WHO the incidence of ISO varies from 0.5% to 15% and exceeds 25% in developing countries. They result from the combined action of several factors and represent a concern for public health. To study the contributing factors of surgical site infections in patients operated at the University Clinic of Orthopedic Traumatology of CNHU-HKM of Cotonou. Method: This was an analytical cross-sectional study that involved 35 operated patients and ten nurses. Were included in our study: 1) All patients, without distinction of sex or age, having been operated on in the university clinic of orthopedic traumatology, during the survey period;2) Patients hospitalized for post-operative care during the survey period;3) The nursing staff on duty during our study period. The usual statistical measures were used according to the type of variables: means, standard deviations, percentages. Data analysis first involved calculating percentages for the qualitative variables and means followed by their standard deviations for the quantitative variables. Next, the Pearson Chi-square test was used to test the association between the dependent variable and the independent variables of interest. The significance level is set at p Results: The prevalence of surgical site infections was 28.58%. The main factors contributing to the occurrence of SSIs that were found were the patient’s level of education (p = 0.003) and the reuse of bandages used for dressing (p = 0.004). Other potential factors such as the economic status of the patient, the poor quality of technical dressings, and the preoperative stay were also highlighted. Conclusion: Surgical site infections remain a global concern. Risk factors were found on both the patient and nurse sides. It is urgent to address these various factors to minimize the occurrence of surgical site infections.
文摘Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ birth weights. This study sought to determine the relationship(s) between pregnancy trimesters, UTIs and changes in progesterone levels among pregnant women. Materials and Methods: The study was conducted in 2016 at Moi Teaching and Referral Hospital (MTRH) antenatal clinic which is a referral facility that attends to patients from most Counties in western region of Kenya. A cross-sectional study design was used to collect blood and urine specimens from 78 participants. Blood was used to determine progesterone levels using ELISA technique and urine cultures with bacterial colony counts ≥ 10<sup>5</sup> were appropriately identified to species level. Trimester periods and participants’ demographic information were obtained using a structured questionnaire. Results: Culture results showed that the most abundant bacterial species isolated in urine from the pregnant women was Escherechia coli (63.7%). The more affected age-group was women between 30 - 39 years during trimester three, suggesting that bacterial colonization of genital track occurred more frequently in older compared to the younger women. There was an exponential increase in progesterone levels among the pregnant women during trimester three compared to other trimesters, although these increases occurred independent of age. However, high levels of progesterone among pregnant women in third trimester corresponded with increased number of E. coli causing UTI. Conclusion: The results showed that progesterone levels increase with trimester and the most prevalent bacteria associated with this was E. coli even though age and increase in progesterone levels had no significant impact on E. coli infection.
文摘Introduction: Healthcare-associated infections (HAIs) are a worldwide concern because of their magnitude and their human and financial cost. While nurses’ non-compliance of hygiene and asepsis measures is questioned, the rationale behind it is not fully understood. We hypothesized that nurses’ experiences and perceptions are one of the reasons for their non-compliance with prevention recommendations. Also, nurses’ caring approach would play an important role in patient safety. The objective of this study was to describe nurses’ experiences and perceptions of HAIs in a district hospital in Burkina Faso with the aim of developing a culture of safety in health care practices. Methods: Qualitative data were collected through unstructured interviews with twenty nurses from the Ziniaré district hospital. Data analysis followed the qualitative phenomenological method according to Giorgi. Results: Phenomenological analysis yielded the following themes: “an ignored reality”;“a denied responsibility”;and “a vulnerable problem”. These results show that nurses’ perception of the extent and seriousness of HAIs is low, and that they deny responsibility for their occurrence. As a result, HAIs are not always perceived as a concern. However, nurses deplore the situation, but remain optimistic about resolving the problem. Conclusion: These nurses’ perceptions of HAIs could explain their non-compliance with prevention recommendations. Corrective action could be redirected by raising awareness, continuing training, improving working conditions and involving all players, including patients and their families, in the fight against HAIs. .
文摘Background: Surgical site infections (SSIs) are considered as result of the healthcare quality in hospitals. Objective: to study SSI at Saint Jean de Dieu Hospital Tanguieta (SJDHT), prior to the implementation of a permanent monitoring system. Method: transversal, and descriptive study with prospective data collection was performed from 1 July to 31 janvier 2017 in the department of general surgery of SJDHT. The hospital lacks in a microbiology unit. All patients who underwent surgery during this period were included and the monitoring lasted one month. SSIs diagnostic was carried out according to WHO criteria as described in the Practical Guide for the Prevention of Nosocomial Infections published in 2002. Statistical tests (χ-square and Student’s t-test) were applied and p 0.05 were statistically significant. Results: Of 343 patients recorded, 105 (30.6%) had SSI. Their age averaged 40.3 years and the sex-ratio (men/women) was 2.8. The emergency surgery resulted in a 50.0% rate of SSI (p = 0.00). The SSI rate for clean and clean-contaminated surgery was 6.3% against 94.6% for infected surgery (p = 0.00). The SSI rates were 100% and 66.7% for NNISS = 2 and NNISS = 1 (p = 0.00), respectively. Superficial SSI rate was 13.3%, while deep SSI and organ/space SSI were 46.7% and 40%, respectively. The hospital stay of patients with SSI was three times longer than the length of patients without SSI (p = 0.00). Conclusion: SSIs are real burden at SJDHT. Appropriate measures must be adopted to reduce its prevalence.
文摘Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, posing a significant health challenge. This study aims to determine the characteristics of ESBL-producing bacteria causing UTIs in expectant women. Methodology: A self-administered survey was carried out;300 expectant women were recruited using a random sampling method. A questionnaire was used to collect socio-demographic information. Urine samples were collected in sterile universal bottles and processed at the JKUAT Zoology laboratory. Urine samples were analyzed using urinalysis, microscopy, culture, and sensitivity testing. ESBL-producing bacteria were identified phenotypically using the double-disc synergy test (DDST) and genotyped for specific resistant genes using PCR. Results: UTI prevalence was 32.7% (98/300). UTI was significantly associated with the history of previous UTI (OR = 0.84, p = 0.02) and multigravida (OR = 0.14 p = 0.01). UTI was common in women aged between 28-37 years in their second trimester. Bacteria isolated were E. coli 57.1% (56/98), S. aureus 21.4% (21/98) K. pneumonia 11.2% (11/98) and Proteus spp 10.4% (10/98). Bacteria antibiotic resistance patterns were E. coli-tetracycline (91.1%), sulfamethoxazole (55.4%), cefotaxime (53.4%) and augmentin (53.4%). S. aureus-sulfamethozaxole (100%) and augmentin (71.4%), K. pneumoniae-sulfame-thoxazole (72.2%) cefotaxime (63.6%), chloramphenicol and tetracycline (54.5%). Proteus spp: tetracycline (100%), nitrofurantoin (90%), cefotaxime and chloramphenicol (50%). The proportion of ESBLs bacterial producers was 37.6% (29/77) and 44.8% (13/29) possessed ESBLs resistant genes;Bla CTX-M 53.8% (7/13), Bla SHV and Bla TEM 23.1% (3/13) each, Bla OXA (0%) was not detected. Conclusion: The study revealed a high proportion of ESBLs producing bacteria responsible for UTI in expectant women. ESBLs screening, routine culture and sensitivity testing will guide on proper management and empirical treatment of UTI patients thus reducing multi-drug resistance.
文摘Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge and compliance with standard precautions at the maternity hospital.Materials and Methods:A quasi‑experimental one‑group pretest‑posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital,Kasr El Ainy,who received“designed infection control educational program”for 6 months.The data were collected through the questionnaire comprising demographics,knowledge,and compliance with standard precautions questionnaire.The nurses’knowledge and compliance score were compared before and after intervention.Results:The studied nurses had higher level of knowledge(85.3%)and compliance(92.8%)regarding infection control standard precautions after the educational program compared to before the program.The results revealed statistically significant difference between before and after the program regarding nurses’knowledge score(15.5±2.9 vs.17.1±1.6,P<0.001)and compliance score(58.5±13.2 vs.74.3±5.1,P<0.001).In addition,there was insignificant relation between nurses’knowledge and compliance with standard precautions both before(r=0.952,P=0.474)and after educational program(r=0.164,P=0.223).Conclusion:The nurses’level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program.Therefore,it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.
文摘Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.
文摘Multiple waves of coronavirus disease 2019(COVID-19) outbreaks have affected numerous countries worldwide. The first case of SARS-CoV-2 reinfection was reported in Hong Kong in August 2020^([1]), leading to increased interest in the effectiveness of natural immunity acquired from primary infection. While data reports vary across countries, all findings indicate that prior SARS-CoV-2 infection provides substantial protection against reinfection^([2]). However, natural immunity from infection with previous non-Omicron or early Omicron sub-lineages offers lower levels of protection against Omicron reinfection, with rates below 60%^([3]) and approximately 75%[4], respectively.
文摘Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.
