Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

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.

Hospital Acquired Infections in Low and Middle Income Countries: Root Cause Analysis and the Development of Infection Control Practices in Bangladesh

Nosocomial or hospital acquired infections are a major challenge for low and middle income countries (LMICs) which have limited healthcare resources. Risk factors include the lack of appropriate hospital facilities such as isolation units, bed space, and sinks;inadequate waste management, contaminated equipment, inappropriate use of antibiotics and transmission of infection from the hands of healthcare workers and family caretakers due to inadequate hand washing. Nosocomial infections increase the costs of healthcare due to added antimicrobial treatment and prolonged hospitalization. Since the prevalence of nosocomial infections is generally higher in developing countries with limited resources, the socio-economic burden is even more severe in these countries. This review summarizes the current knowledge on the risks of hospital acquired infections and summarizes current recommendations for the development of hospital infrastructure and the institution of protocols to reduce these infections in LMICs such as Bangladesh.

Study of the Effectiveness of Papaver Sp. Alkaloids as Future Therapeutic Alternatives against Enterococcus Sp. Causing Hospital-Acquired Septicemic Infections

Background and Objective: In recent years, control of Enterococcus sp. It has been proven in the local medical environment to be a cause of acquired septicemia in various age groups, and medical instruments are considered an effective means of transmitting enterococcal septicemia, and catheters are at the forefront in terms of danger. Based on this risk, this study aimed to monitor the spread of Enterococcus sp., which causes blood poisoning acquired from catheters, and to compare its response to antibiotics with that of those isolated from clinical samples in children, as a first study locally. The effectiveness of alkaloids of different types of Papaver sp. In Syrian plants, they were tested against infection with this bacteria. Materials and Methods: The study dealt with two parts: The first part included collecting clinical samples from the University Children’s Hospital in Damascus/bacterial diagnostic laboratories/then isolating and diagnosing the bacteria by following a set of tests to identify the most prevalent genera and species and comparing their prevalence rate with Enterococcus. The second part;It included collecting plant samples, confirming the species taxonomically, then extracting alkaloids from plant parts (fruit, stem, Flowers), then comparing the extent of resistance of bacterial strains to antibiotics compared to the Enterococcus sp., and then confirming the antibacterial activity of the Papaver sp. alkaloids against Enterococcus sp. Result:In its first part, the study confirmed the significant contribution of the Enterococcus sp. to infections acquired from various sources, largely in catheter tip infections (9.09%) and to a lesser extent in other sources (3.7%), The second part was to confirm the effective-ness of the alkaloid extract of the Papaver sp., especially the two species Papaver syriacum, and Papaver dubium, against Enterococcus sp. with areole diameters that ranged between (15 - 26 mm) for the fruit extract and at a minimum inhibitory concentration (3.12 - 6.25 mml) and then the stem (5 - 20 mm). And the effectiveness of the Flowers extract is very weak to almost non-existent. Conclusions: The catheter and medical sources surrounding the patient constitute a dangerous source of multi-resistant Enterococcus sp., which poses a real threat to the lives of children, with new mechanisms represented by colonization of the skin and the ability to form biofilms Surfaces of medical instruments, with are resistant to a wide range of antibiotics. As an alternative and effective modern source to limit its spread in the future, the alkaloid extract of the fruits and stems of the wild Papaver sp. has proven a strong antibiotic effect, especially the two types: Papaver syriacum and Papaver dubium.

Nosocomial infections:Epidemiology,prevention,control and surveillance

Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7% in developed and 10% in developing countries.As these infections occur during hospital stay,they cause prolonged stay,disability,and economic burden.Frequently prevalent infections include central line-associated bloodstream infections,catheter-associated urinary tract infections,surgical site infections and ventilator-associated pneumonia.Nosocomial pathogens include bacteria,viruses and fungal parasites.According to WHO estimates,approximately 15% of all hospitalized patients suffer from these infections.During hospitalization,patient is exposed to pathogens through different sources environment,healthcare staff,and other infected patients.Transmission of these infections should be restricted for prevention.Hospital waste serves as potential source of pathogens and about 20%–25% of hospital waste is termed as hazardous.Nosocomial infections can be controlled by practicing infection control programs,keep check on antimicrobial use and its resistance,adopting antibiotic control policy.Efficient surveillance system can play its part at national and international level.Efforts are required by all stakeholders to prevent and control nosocomial infections.

Infection Control Measures among Healthcare Workers: Knowledge, Attitude and Practice

Background: Nosocomial infections are some of public health problems globally and continue to be increased regardless of the hospital’s efforts on infection control measures and are contributing significantly to morbidity, mortality and cost. The absence of infection control policies, guidelines and trained professionals also contributes to the magnitude of the problem. The aim of this study was to assess the Knowledge, attitude and practices towards infection control measures among healthcare workers at Old Mutare Hospital. Methods: A cross-sectional survey design was used to acquire information. A purposive sampling method was used to select 22 nurses, 15 nurse Aids and 2 laboratory technicians (Lab Tech). A self-administered questionnaire with four components addressing demographic data, knowledge, attitudes and practices was used to collect data that was completed by a checklist. Results: The study findings revealed a poor knowledge of infection control measures among the nurse’s aide. The attitude and practices among participants were impartially good in all variables. The participants had scored over 50% towards their attitude and their practices on infection control. A significant statistical difference was found between the professional status of the participants and the ability to explain how one can get Hospital Acquired Infections (HAIs) and awareness of infection control programs in their hospital (rs = 0.640, 0.645) with P < 0.05 (0.01, 0.01) respectively. Conclusion: Despite of having a fair attitude and practice towards infection control, the participants had presented poor knowledge;therefore, it had been recommended that in service training and workshop should be planned by the administration to update their knowledge and attain full compliance towards their practice.

Predictive factors for early clinical response in community-onset Escherichia coli urinary tract infection and effects of initial antibiotic treatment on early clinical response

BACKGROUND Urinary tract infection(UTI)is a common disease.It often requires hospitalization,and severe presentations,including sepsis and other complications,have a mortality rate of 6.7%-8.7%.AIM To evaluate the predictive factors for early clinical response and effects of initial antibiotic therapy on early clinical response in community-onset Escherichia coli(E.coli)urinary tract infections(UTIs).METHODS This retrospective study was conducted at Wonkwang University Hospital in South Korea between January 2011 and December 2017.Hospitalized patients(aged>18 years)who were diagnosed with community-onset E.coli UTI were enrolled in this study.RESULTS A total of 511 hospitalized patients were included.66.1%of the patients had an early clinical response.The mean length of hospital stay in patients with an early clinical response were each 4.3 d shorter than in patients without an early clinical response.In the multiple regression analysis,initial appropriate antibiotic therapy(OR=2.449,P=0.006),extended-spectrum(3-lactamase(ESBL)-producing E.coli(OR=2.112,P=0.044),improper use of broad-spectrum antimicrobials(OR=0.411,P=0.006),and a stay in a healthcare facility before admission(OR=0.562,P=0.033)were the factors associated with an early clinical response.Initial broadspectrum antibiotic therapy was not associated with an early clinical response.CONCLUSION ESBL producing E.coli,and the type of residence before hospital admission were the factors associated with an early clinical response.Appropriateness of initial antibiotic therapy was a predictive factor for an early clinical response,but broadspectrum of initial antibiotic therapy did not impact early clinical response.

Laboratory biosafety for handling emerging viruses

Emerging viruses are viruses whose occurrence has risen within the past twenty years,or whose presence is likely to increase in the near future.Diseases caused by emerging viruses are a major threat to global public health.In spite of greater awareness of safety and containment procedures,the handling of pathogenic viruses remains a likely source of infection,and mortality,among laboratory workers.There is a steady increase in both the number of laboratories and scientist handling emerging viruses for diagnostics and research.The potential for harm associated to work with these infectious agents can be minimized through the application of sound biosafety concepts and practices.The main factors to the prevention of laboratory-acquired infection are well-trained personnel who are knowledgable and biohazard aware,who are perceptive of the various ways of transmission,and who are professional in safe laboratory practice management.In addition,we should emphasize that appropriate facilities,practices and procedures are to be used by the laboratory workers for the handling of emerging viruses in a safe and secure manner.This review is aimed at providing researchers and laboratory personnel with basic biosafety principles to protect themselves from exposure to emerging viruses while working in the laboratory.This paper focuses on what emerging viruses are,why emerging viruses can cause laboratory-acquired infection,how to assess the risk of working with emerging viruses,and how laboratory-acquired infection can be prevented.Control measures used in the laboratory designed as such that they protect workers from emerging viruses and safeguard the public through the safe disposal of infectious wastes are also addressed.

A META-analysis of the association between breastfeeding and risk of infant hepatitis C virus infection

Objective: To investigate the association between breastfeeding and infant acquired infection of Hepatitis C Virus(HCV). Methods: To obtain studies eligible for META-analysis, China biological medicine discs(CBMD) and MEDLINE citations were surveyed. Criteria for enrollment of published studies for META-analysis were based on principle by Abdolmaleky HM[1]. Odd ratio(OR) was calculated and summarized by fixed effect model or random effects using RevMan software. The heterogeneity of ORs was assessed using an χ2 test of goodness of fit. The significance of the pooled OR was determined by the z-test. The strength of association was summarized usingOR. An OR>1.0 indicated a positive association between the risk factor and infants HCV infection. Results:After searching in Medline and CBMD, 120 articles were enrolled for further identification. Thirty-seven were of review on relative fields and were excluded. Abstracts of remaining articles were carefully read, and finally, only 6 articles met, the standards for enrollment criteria. After analysis of the factor concerned, no significant association was found between breastfeeding and infant HCV infection, with a pooled OR equal to 0.60(95%CI = 0.22-1.60), and proved not to be of risk factors on infant acquired infection of HCV. Conclusion: Breastfeeding dose not increase the risk of infant acquired infection of HCV.

Disseminated Penicillium marneffei infection in acquired immunodeficiency syndrome: a case report

P enicillium marneffei ( P. marneffei ) is a facultative intracellular pathogen and the only thermally dimorphic fungus. This fungal infection is commonly found in Southeast Asian, Hong Kong, south China, and especially in acquired immunodeficiency syndrome (AIDS) patients. 1-4 We reported a patient with AIDS in whom infection due to P. marneffei was demonstrated. CASE REPORT A 34-year-old man with human immunodeficiency virus (HIV) infection (diagnosed before 6 months), living in Guangzhou of south China, was admitted to the hospital because of prolonged fever, cough, and weight loss. Initial examination revealed permanent high-grade fever (39-40℃) with chill and cough. Laboratory findings revealed haemoglobin concentration at 80 g/L, CD 4 lymphocyte count at 7×10 6/L, and viral load at 1.3×10 5 copies/ml. Blood and urine culture revealed no bacterial growth. Sputum culture was negative for mycobacterium. Chest X-ray film revealed left upper lobe ill-defined parenchymal opacities and widening of the superior mediastinum with left lung hilum prominence (Fig. 1). Abdominal B ultrasound showed hepatoplenomegaly and coeliac enlarged lymph nodes. On physical examination, the patient was found to have facial papula, cervical and superclavicular multiple lymph nodes.

Laboratory biosafety measures of SARS-CoV-2 at containment level 2 with particular reference to its more infective variants

The novel betacoronavirus(Severe Acute Respiratory Syndrome Coronavirus 2,SARS‐CoV‐2)is a pathogen that causes deadly respiratory disease named coronavirus disease 2019(COVID‐19).The incidence of this disease has increased in the last few months affecting 257,832,881 people in 221 countries and 51,68,069 deaths worldwide according to Worldometer at 04:03 GMT on November 22,2021.Thus,the emergence of this disease creates a challenge for health care providers in handling this pathogen and reducing its risk of transmission.In developing countries,this virus is treated in biosafety level 2 laboratories,where a high concentration of pathogen can easily affect the laboratory staff and cause the spread of this disease.Based on the epidemiology and characteristics of the SARS‐CoV‐2 virus already discussed in recent studies,we will provide biosafety guidelines and suggestions for safe handling and transportation of the SARS‐CoV‐2 virus in dealing with the current pandemic situation with a focus on increased infectivity of emerging new variants.

Tier-based approach to establish a culture of biosafety at a medical microbiology research laboratory in Egypt

Microbiology Research Laboratory(MRL)is a biosafety level-2(BSL-2)research laboratory located at the main campus of Faculty of Medicine,Ain Shams University(ASU)in Cairo.With the objective of strengthening the departmental capacities of biosafety,a series of activities were carried out between October 2019,and January 2020 to raise awareness,along with instilling standard biosafety practices and procedures among laboratory staff including non-health professions.MRL staff were categorized according to their biosafety knowledge into three tiers:tier(1):with zero to minimal knowledge,tier(2):with basic knowledge,tier(3):with satisfactory knowledge.Tier based activities were designed to align with their job responsibilities.Results:44 selected laboratory staff were trained on biosafety practices:12 from tier(1),19 from tier(2)and 13 constituted tier(3).Through regular follow-ups,the impact of the implemnted training plan was reflected on the practices and knowledge of all laboratory staff.Knowledge among health professions has increased by 60%.Furthermore,6 staff members have granted a biosafety certification by International Federation of Biosafety Association(IFBSA).Conclusion:establishing a culture of biosafety within microbiology research laboratories is integral to safe research practices.Together with developing local and national biosafety regulations and policies will ensure research advancement without compromising public health or environmental safety.