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Table of Contents
September-December 2021
Volume 9 | Issue 3
Page Nos. 69-108
Online since Friday, July 22, 2022
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PAPERS PRESENTED AT THE XVII ANNUAL CONFERENCE OF HOSPITAL INFECTION
Surveillance of device-associated infections at a tertiary care hospital of Punjab
p. 69
Veenu Gupta, Sarit Sharma, Ashwani Chaudhary, Jyoti Chaudhary, PL Gautam
DOI
:10.4103/jpsic.jpsic_18_22
Background:
Surveillance of health-care-associated infections (HAIs) plays a key role in the hospital infection control programme and reduction of HAIs. Device-associated infections (DAIs) are an important cause of excessive stay and mortality. The prevalence of HAIs is underreported from developing nations due to a lack of systematic surveillance.
Aims and Objectives:
The aim of the study was to know the rate and microbiological profile of DAIs.
Materials and Methods:
This surveillance study was conducted over a period of 2 years. Patients with indwelling devices were included. The data were collected and analysed by infection control team and labelled DAIs as per the CDC guidelines. The rates of HAIs and the profile of pathogens isolated were analysed.
Results:
A total of 294 patients developed DAIs, of which 181 were male and 113 were female. A total of 239 device-associated infections were reported in 2019 and 55 in 2020 and overall rate of DAIs was 1.81 and 0.58/1000 device days, respectively. Among DAIs, 50 were ventilator-associated pneumonia (VAP), 71 central line-associated bloodstream infections (CLABSI) and 173 catheter-associated urinary tract infection (CAUTI) cases. Overall, the rate was 2.02,1.21,1.21/1000 device days for VAP, CLABSI and CAUTI, respectively. In DAI's, majority were males and maximum cases developed after 6–10 days, 15 days and 11–15 days of device use in VAP/CAUTI and CLABSI, respectively. Gram-negative isolates (85.1%) were predominant, and among these, most common were Klebsiella
spp, Acinetobacter spp and Escherichia coli
. A high rate of multidrug resistance was observed.
Conclusions:
The present surveillance shows high resistance pattern of Gram-negative organisms causing DAIs. To reduce the risk of infection in hospitalised patients, DA-HAI surveillance is of primary importance as it helps in implementing preventive measures.
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Outbreak investigation of
Elizabethkingia meningoseptica
at a tertiary care hospital
p. 77
Pragathi Kottapalli, Chintha Deepika, S Jyothi, Rincy Mol, YV Sadhana, P Naveen Chander Reddy
DOI
:10.4103/jpsic.jpsic_20_22
Aim and Objective of the Study:
The aim and objective of this study were to do a prospective study on patients with
Elizabethkingia meningoseptica
infection at AIG Hospitals and to identify the possible source of
E. meningoseptica
in our hospital.
Materials and Methods:
Outbreak of infection with
E. meningoseptica
was identified in intensive care units (ICUs) in February 2021. A prospective study was taken up and environmental surveillance swab cultures were collected along with clinical data from case sheets using a pro forma to identify the possible risk factors associated with
E. meningoseptica
infection. Interventional strategies were planned by infection control team along with hospital administration.
Results:
A total of 10
E. meningoseptica
bacteraemia and pneumonia cases were documented between March 2021 and May 2021. It was more common among patients with COVID-19, with prolonged ICU stay, and on multiple antibiotics and was associated with poor outcomes. Surveillance swab cultures collected from various sources showed growth of
E. meningoseptica
in the tap water of some ICUs.
Conclusion:
Considering that
E. meningoseptica
are usually resistant to multiple antibiotics and that inappropriate antimicrobial therapy is an independent risk factor for mortality, early diagnosis and adequate antibiotic treatment are vital for patients with
E. meningoseptica
infection.
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Prevalence of Hepatitis A in and around the Aligarh region
p. 83
Arti Kumari, Adil Raza, Haris Manzoor Khan, Hiba Sami
DOI
:10.4103/jpsic.jpsic_21_22
Background:
Hepatitis A virus (HAV) most commonly affects children, is transmitted by faecal–oral route and is prevalent worldwide. It is usually present in the highest concentration in the stool of the infected individuals, with the greatest viral load occurring near the end of the incubation period.
Aim:
The aim of the present study was to study the prevalence of hepatitis A in and around the Aligarh region.
Methodology:
A total of 524 samples were collected from all age groups, who were suspected of having viral hepatitis. The serum was separated and processed for performing the enzyme-linked immunosorbent assay (DIA. PRO, Italy).
Results:
Out of 524 samples tested, 229 (43.7%) were positive for anti-HAV immunoglobulin M, most of which (82.53%) were from the 10 years' age group.
Conclusions:
The predominance of hepatitis A was found in under 10-year-old children, with mast case occurrences between June and September.
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A study on the prevalence of needle stick injuries among health-care workers of a tertiary care hospital in Aligarh
p. 87
Manal Khursheed, Fatima Khan, Zeeshan A Hashmi, Haris M Khan, Asfia Sultan
DOI
:10.4103/jpsic.jpsic_14_22
Context:
Globally, the reporting on the incidents of needle stick injuries (NSI) is far below the actual, and in hospitals which depend on their normal reporting systems, this figure may be up to ten times lower. NSIs can serve as a source of life-threatening infections; therefore, an insight into various factors that lead to it, along with the knowledge regarding prophylactic measures is important.
Aim:
The study aimed to develop an understanding of the causes and probability of NSI and knowledge of prophylactic measures among health-care workers (HCWs).
Settings and Design:
An institutional-based cross-sectional study was conducted.
Subjects and Methods:
A structured questionnaire was developed for the study.
Statistical Analysis Used:
IBM Statistical Package for Social Science (SPSS), v22.0 was used.
Results:
A total of 255 HCW were recruited, which consisted of 129 doctors, 110 nurses, and 16 laboratory assistants. The results of the study found that 36.1% of the HCW suffered from NSI. Of the total reported needlestick injuries, the maximum was among the doctors and in the age group of 22–30 years. Only 35.9% had reported the incident. Injuries were mostly sustained to the fingers occurred during use in the morning shift. Majority of the HCW were aware of HBV transmissibility and were vaccinated against it. Although a substantial number (162) of HCW were aware to take post-exposure prophylaxis against HBV and HIV within 72 h, only 12% took prophylactic treatment against HIV.
Conclusions:
NSI prevention strategies should be strictly implemented at the workplace and followed during procedures.
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Knowledge and practices of health-care workers regarding face mask in hospital
p. 91
Mitali Maradia, Rupali Patil, Shivani Gajjar
DOI
:10.4103/jpsic.jpsic_12_22
Aim and Objective:
The aim of the study is to know the knowledge and practices of health-care workers regarding surgical face mask.
Materials and Methods:
This is a cross-sectional study. Mask plays a pivot role in the protection of health-care workers (HCWs) from acquiring respiratory infections, special during coronavirus-2019 outbreak. A self-constructed questionnaire that contains 10 question and answer (Q/A) regarding surgical face mask. These Q/A are for knowledge assessment of staff. We also conduct an observational survey which includes 6 points about practices of HCWs regarding face mask. The strata of personnel were included doctors, nurses, paramedical and others staff. Questions related to knowledge were in the form of multiple-choice questions with one correct answer. The knowledge–practices score was turn converted into percentage before the analysis of results – >80% score for good, 60%–80% moderate and <60% poor level knowledge.
Results:
Completed questionnaires were sent for statistical analysis. In our study, totally 109 HCWs were participated. In which (12) 11% doctors, (76) 70% nursing staff, (21) 19% paramedical staff covered. Out of which 95 (87%) were female and 14 (13%) were male. Most staff had work experience of 2–5 years. 74% staff were younger less than 30 years. Around 63% of participants knew about correct way of wearing a surgical face mask, 90% knew that there were 3 layers, 62% knew middle layer act as barrier, 64% knew the maximum duration of wearing it, 75% knew that cloth mask was not as effective as surgical mask. 88% knew that surgical mask can be reused. 87% knew surgical face mask discarded in yellow bag. 97% knew metal strip to fit nose. Majority 95% believe that mask is required in this situation. In practices, we observed 71% staff worn surgical mask, out of which 84% staff worn it correct way blue front. 9% staff worn filtering face piece type of mask, 20% staff worn cloth mask. 15% staff nose was not covered, 2.8% staff mouth was not covered, 28% staff metal strip was not pressed/fitted and 25% staff not tied their mask properly. During observation, three staff touched the front surface of mask.
Conclusion:
Knowledge and practices of HCWs regarding the use of surgical face mask were found to be good-to-moderate level.
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Knowledge, attitude and practices of medical students regarding biomedical waste management
p. 95
Fatima Khan, Jowairiya Tehreem Khan, Manal Khursheed, Asfia Sultan, Haris M Khan
DOI
:10.4103/jpsic.jpsic_17_22
Context:
India generates around 3 million tonnes of medical wastes every year, an amount that is expected to grow at 8% annually. Improper handling of biomedical waste (BMW) can result in the spread of infections such as HIV-acquired immunodeficiency syndrome, hepatitis B virus and hepatitis C virus in addition to being a burden on the environment. Segregation being the most important step in BMW management (BMWM) necessitates that people working in the health-care system are aware of its rules and regulations. Therefore, it is important to understand and explore any lacunae in knowledge, attitudes and practices regarding BMWM.
Aim:
The aim of this study is to develop an insight into the knowledge, attitude and practices of medical students regarding BMWM.
Settings and Design:
An institutional-based cross-sectional study with a quantitative approach was conducted.
Subjects and Methods:
A structured questionnaire prepared according to the knowledge, attitude and practices (KAP) model.
Statistical Analysis Used:
Data were analysed by the IBM SPSS (Statistical Package for the Social Sciences), v20.0 software.
Results:
The participants' knowledge on BMWM was scored on a scale of 0–50. Thirty-six per cent of them scored in the range of 20–30, while 30.9% scored between 30 and 40. Three-fourths of them believed that it was important to be aware of BMW generation, hazards and legislation. About 87.09% opined that soft skills regarding BMWM should be a part of the curriculum for health-care students. About 76% of the respondents claimed to follow colour coding while discarding BMW. About 41.3% of the participants responded that they would report anyone found breaking the rules of BMWM.
Conclusions:
The study revealed that there is still a significant lack in the KAP of health-care students regarding BMWM.
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A microbiologist managing COVID-19 patients: Optimism amidst pessimism
p. 100
Neha Gupta, Renu Gur, Shrishti Makhijani
DOI
:10.4103/jpsic.jpsic_13_22
In April 2021, amidst rising COVID-19 cases in Delhi with negativity all around, we all faced challenges. However, a microbiologist working on the forefront as a clinician with COVID-19 patients was scary as well, more so for patients. Starting a banquet hall as COVID care facility was full of hurdles which were gradually overcome with each other's cooperation and support. Variety of experiences during that duty made me a better version of myself both as a person and as a doctor.
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Microbiologists playing a significant role in the fight against COVID-19: Learning amidst disparity
p. 102
Shrishti Makhijani, Renu Gur, Neha Gupta
DOI
:10.4103/jpsic.jpsic_19_22
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Complexity of carbapenem resistance reporting in a critically ill cancer patient: A noteworthy practice point
p. 104
Sujata Lall, Vivek Bhat, Sanjay Biswas
DOI
:10.4103/jpsic.jpsic_16_22
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A case series of clinically suspected cases of tetanus
p. 106
Y Kathyayani
DOI
:10.4103/jpsic.jpsic_15_22
Tetanus is a serious illness contracted through exposure to the spores of the bacterium,
Clostridium tetani,
which live in soil, saliva, dust and manure. The bacteria can enter the body through a deep cuts, wounds or burns affecting the nervous system. The infection leads to painful muscle contractions, particularly of the jaw and neck muscle, and is commonly known as “lockjaw. The disease remains an important public health problem in many parts of the world, but especially in low-income countries or districts, where immunization coverage is low and unclean birth practices are common. WHO estimates that in 2018 for which estimates are available), 25 000 newborns died from neonatal tetanus, 88% reduction from the situation in 2000. Global tetanus vaccination programs contributed to a 95% reduction in neonatal tetanus deaths in the last 30 years and continue to decrease tetanus burden.
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