Background: Needle stick and sharp injuries (NSSIs) amongst healthcare workers (HCWs) are among the most common occupational accidents in hospitals. Approximately half of the responsible instruments are contaminated with blood, putting users at risk infection from blood-borne pathogens such as HIV. Although post-exposure prophylaxis has been shown to reduce the risk of HIV transmission, adherence to therapy is a well-documented challenge. Aim: To assess healthcare workers adherence to HIV post-exposure prophylaxis following Needle stick and sharp injuries. Method: A retrospective chart review was conducted on HCWs who were started on HIV PEP following a reported occupational exposure due to NSSIs between February 2017 and June 2022 to assess adherence. Result: A total of 136 HCWs had occupational exposure to NSSIs. The majority of the exposures (82.3%) were high risk for HIV transmission. Overall adherence to the 28-day HIV PEP course was 26%. HCWs were more likely to complete HIV PEP when the source's HIV status was positive compared to when it was negative [ 42.4% vs 11.8%; p = 0.001]. The drug regimen (TDF/3TC/DTG) was significantly associated with defaulting treatment (aOR; 5.5 (95% CI 2.16 - 14.02) (p= 0.001), compared with patients using the TDF/3TC/ATVr regimen. Conclusion: 74% of HCWs who started PEP defaulted the recommended 28-day course. Possible strategies for improving adherence and occupational health are required. Contributions: Few studies in Kenya have assessed the completion rate for PEP among HCWs; these findings will contribute to the body of knowledge in this area.

Data on antimicrobial resistance (AMR) and association with outcomes in resource-variable intensive care units (ICU) are lacking. Data currently available are limited to large, urban centers. We attempted to understand this locally through a dual-purpose, retrospective study. Cohort A consisted of adult and pediatric patients who had blood, urine, or cerebrospinal fluid cultures obtained from 2016 to 2020. A total of 3,013 isolates were used to create the Kijabe Hospital’s first antibiogram. Gram-negative organisms were found to be less than 50% susceptible to third- and fourth-generation cephalosporins, 67% susceptible to piperacillin–tazobactam, 87% susceptible to amikacin, and 93% susceptible to meropenem. We then evaluated the association between AMR and clinical characteristics, management, and outcomes among ICU patients (Cohort B). Demographics, vital signs, laboratory results, management data, and outcomes were obtained. Antimicrobial resistance was defined as resistance to one or more antimicrobials. Seventy-six patients were admitted to the ICU with bacteremia during this time. Forty complete paper charts were found for review. Median age was 34 years (interquartile range, 9–51), 26 patients were male (65%), and 28 patients were older than 18 years (70%). Septic shock was the most common diagnosis (n = 22, 55%). Six patients had AMR bacteremia; Escherichia coli was most common (n = 3, 50%). There was not a difference in mortality between patients with AMR versus non-AMR infections (P = 0.54). This study found a prevalence of AMR. There was no association between AMR and outcomes among ICU patients. More studies are needed to understand the impact of AMR in resource-variable settings.