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INTRODUCTION: In India, due to manpower constraints, patients' family members are often actively involved in healthcare activities of their near and dear ones. They have significant contact with the patient at all World Health Organization (WHO) 'five moments for hand hygiene'. This study analysed the impact of decade-long awareness campaigns on the hand hygiene compliance (HHC) by our patients' carers. METHODS: Trained infection control nurses observed the HHC at each of the five moments for patients' attendants in different hospital settings from January 2014 to December 2018. Compliance was calculated as percentage of events divided by total opportunities. FINDINGS: A total of 7302 opportunities were observed with an overall compliance of 46.1% (35.5% in 2014 to 48.2% in 2018, P < 0.0001). Compliance at WHO moments 1, 2, 3, 4, and 5 was 51.0%, 47.4%, 67.6%, 48.8%, and 24.3% respectively. Among family members, mothers of newborns had a much higher HHC (77%) than others (44.5%) (P < 0.0001). Also, the compliance was higher in medical versus surgical wards and in paediatric wards versus adult wards (P < 0.0001 in both). CONCLUSION: This is the first study on family members' HHC in a hospital setting in a low- and middle-income country. The study shows that family members, once trained, exhibit fairly good HHC while caring for their patients, especially mothers of newborns. It is worthwhile empowering and educating patient attendants about the importance and process of hand hygiene as it is likely to result in immense benefit for patients.
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Adhesión a Directriz/estadística & datos numéricos , Higiene de las Manos/estadística & datos numéricos , Visitas a Pacientes/estadística & datos numéricos , Infección Hospitalaria/prevención & control , Familia , Educación en Salud , Personal de Salud , Hospitales , Humanos , IndiaRESUMEN
Bevacizumab, a recombinant humanized monoclonal antibody to inhibit tumour angiogenesis, is available for off-label use for treating choroidal neovascularization. Outbreaks have been reported after use of this drug, either because of contamination during manufacturing or the practice of multiple doses being administered from a single vial to different patients. In our institute we investigated one endophthalmitis outbreak following intravitreal injection of bevacizumab, rapidly identified the Stenotrophomonas maltophilia as the causative agent, and established the contaminated bevacizumab vial as the source using matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS) typing. The study emphasizes the need for early diagnosis of the source and pathogen for appropriate control measures.
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Brotes de Enfermedades , Contaminación de Medicamentos , Endoftalmitis/epidemiología , Infecciones por Bacterias Gramnegativas/epidemiología , Inyecciones Intravítreas/efectos adversos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Stenotrophomonas maltophilia/aislamiento & purificación , Técnicas Bacteriológicas/métodos , Bevacizumab/administración & dosificación , Estudios de Cohortes , Endoftalmitis/microbiología , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Factores Inmunológicos/metabolismo , Stenotrophomonas maltophilia/químicaRESUMEN
Oculomycosis is a major cause of visual impairment. Eye pain, redness, discharge, diminution and photophobia are presenting features. We collected corneal scraping, vitreous, aqueous fluids and conjunctival swabs after the slit-lamp examination. Ophthalmological findings were hypopyon, stromal congestion, conjunctival congestion and epithelial defect. Direct microscopy of 10% potassium hydroxide (KOH) wet mounts, gram staining, fungal and bacterial cultures were performed. Fungal isolates were obtained in 24% patients with equal number of both sexes and average age 49 years. KOH revealed fungi in 73% samples and 43.33% were positive on Gram staining. Fusarium spp. (36.66%), Aspergillus spp. (23.33%) and melanised fungi (20%) were common etiological agents. Fusarium spp. was more often associated with complications. Trauma was a predisposing factor in 65% cases and occurred mainly with vegetable matter. The majority responded to the conservative management with 5% natamycin and four patients required surgery.
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Infecciones Fúngicas del Ojo/epidemiología , Infecciones Fúngicas del Ojo/microbiología , Hongos/clasificación , Hongos/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antifúngicos/uso terapéutico , Niño , Infecciones Fúngicas del Ojo/patología , Infecciones Fúngicas del Ojo/terapia , Femenino , Humanos , India/epidemiología , Masculino , Técnicas Microbiológicas , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Procedimientos Quirúrgicos Operativos , Adulto JovenRESUMEN
Enteric fever due to Salmonella Paratyphi A (SPA) is a global problem occurring as outbreaks at times. An unusual SPA (2,12:a:-) variety durazzo has been reported rarely. We report an outbreak of enteric fever due to this variety affecting 43 individuals. The blood samples grew unusual mucoid, lactose non-fermenting colonies with atypical biochemical reactions in sugar fermentation and amino acid decarboxylation. Isolates had sensitivity to ceftriaxone, chloramphenical, cotrimoxazole, intermediate susceptibility to ciprofloxacin and resistance to ampicillin and nalidixic acid. Identification was confirmed as SPA (2,12:a:-) at the National Salmonella Centre.
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Brotes de Enfermedades , Fiebre Paratifoidea/epidemiología , Salmonella paratyphi A/aislamiento & purificación , Adolescente , Adulto , Anciano , Antibacterianos/farmacología , Técnicas de Tipificación Bacteriana , Cultivo de Sangre , Niño , Preescolar , Femenino , Humanos , India/epidemiología , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Fiebre Paratifoidea/microbiología , Salmonella paratyphi A/clasificación , Salmonella paratyphi A/efectos de los fármacos , Adulto JovenRESUMEN
Legionella pneumophila is one of the important pathogen responsible for community -acquired pneumonia attributing for 1-5% of cases. Since early and accurate therapy reduces mortality, rapid and reliable diagnostic methods are needed. A total of 134 samples of blood, urine and respiratory tract fluids were collected. Blood was tested for IgG, IgM and IgA antibodies using commercially available kits. A total of 8 (6%) samples were found to be positive for L. pneumophila by quantitative reverse transcription polymerase chain reaction (qRT-PCR), compared to conventional PCR where 6 (4.4%) samples were positive. Serology was positive in a total of 32 (23%) cases though only 3 (2.2%) of the PCR-positive cases were positive by serology as well. These results suggest that real-time PCR can detect Legionella infection early in the course of the disease before serological response develops.
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Infecciones Comunitarias Adquiridas/diagnóstico , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Legionella pneumophila/genética , Masculino , Persona de Mediana Edad , Centros de Atención Terciaria , Factores de Tiempo , Adulto JovenRESUMEN
Paecilomyces lilacinus is a filamentous fungus found in soil and air, which is a rare cause of ocular infection. The majority of case reports involving P. lilacinus among healthy hosts are of endophthalmitis and keratitis. We report a rare case of keratomycosis by P. lilacinus, in an immunocompetent, which responded well to treatment with ketoconazole. Some species belonging to the genus Paecilomyces such as P. lilacinus generally shows a poor response to conventional antifungal drugs. Therefore, correct identification of clinical isolates to the species level is mandatory for the appropriate treatment of the disease.