Introduction: Surveillance and antimicrobial resistance (AMR) monitoring are fundamental to Health care associated infections control. Limited data are available from developing countries for both. This study aimed to evaluate incidence and risk factors of surgical site infections (SSIs), etiological pathogens and AMR patterns identification.
Methodology: A prospective active surveillance study was implemented over a 24- month period at a 110-bed multispecialty non-teaching tertiary hospital. Follow up data were collected for 30-90 days. SSI was diagnosed according to Centers for Disease Control and Prevention and National Healthcare Safety Network (CDC/NHSN) criteria. The SSI isolates were identified by Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDITOF/MS). Antibiotics susceptibility test was performed according to Clinical Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST).
Results: Out of a total of 3,642 patients, 70% had complete follow-up. SSI was detected in 57 cases (2.3%), 61.4% of which were detected post discharge. Factors significantly associated with increased SSI risk included smoking, diabetes, ASA score 5/E, ICU admission, previous admission and increased hospital stay. Sixty-five isolates were obtained; 70.8% were GNB while 24.6% were GPC and 4.6% were Candida albicans. Regarding AMR, 58.7% of isolates were extended spectrum β lactamase (ESBL) producers while 45.7% were Carbapenem resistant. Multi drug resistant (MDR) was detected in 13% of isolates, 54.3% were extended drug resistant (XDR) and 10.9% were pan drug resistant (PDR). Eighty-six percent of Staphylococci isolates were methicillin-resistant.
Conclusion: Despite low SSI rates detected, the high incidence of AMR identified is alarming.
Background: Worldwide, prevalence of anti-HCV positivity in health care workers (HCWs) ranges from 0% to 9.7%. The current study was conducted to calculate prevalence of HCV infection, frequency and characteristics of blood and body fluid (BBF) exposure among HCW at the Alexandria University Hospitals. Methods: Hospital-based cross-sectional approach was adopted. At the Hospitals, 62.2% of available nurses and paramedical personnel voluntarily participated (n = 499), and were interviewed, screened for HCV antibodies. Quantitative estimation of HCV-RNA was done to seropositive cases. Results: Prevalence of anti-HCV antibodies and HCV infection was 8.6%, and 4.4% respectively. The frequency of BBF exposures was 66.7%. Blood/blood products were mainly involved (92.1%). More than half of exposed HCWs reported not wearing personal protective devices. Anatomical site of exposure was mainly right hand palm (36.2%). Regarding needle-stick injuries, two thirds of injured HCWs were the original user of sharp item which was contaminated in 79.7% of injuries. In 70.2% of injuries, disposable syringes were involved and occurred during item disposal. About 61% of injuries were superficial. Conclusion: Prevalence of HCV infection among HCWs is similar to that among general population in the country. Nurses and housekeepers are frequently exposed to BBF. Adherence to infection control measures according to the National Guidelines is crucial to reduce HCV transmission.
MALDI TOF is a promising tool in the field of diagnostic microbiology that has the ability to transfer identification and antimicrobial susceptibility testing time from days to hours.
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