Background Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac ICU. Methods We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts and tables. Results Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and 14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%), and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Resistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.

Background: Preoperative information about pain has been shown to improve postoperative pain perception and reduce postoperative analgesia requirements. However, there is limited data regarding the effect of preoperative counselling in low resource settings. This study aimed at assessing the effect of preoperative information about pain on postoperative pain experience measured as postoperative pain using a verbal numerical rating scale (VNRS) and patient satisfaction with pain management. Methods: A randomised, double blind, controlled trial was done in Mulago National Referral Hospital (MNRH), Kampala. We prospectively enrolled 400 participants aged 18years and above scheduled for elective orthopaedic surgery. The consented patients were randomised to either receive the specific preoperative information about pain or not. The primary end points were postoperative pain score and patient satisfaction. A total of 340 were analysed with 170 in either arm. Secondary analyses where done to determine the factors that were associated with postoperative pain and patient satisfaction.Results: In both arms, the lowest pain score was 0/10 at 0 hours and the highest was 7/10 at 12 hours. A statistically significant difference between the intervention and control arms for the median pain score at 48hours (4/10 vs. 5/10) P-value= 0.029 was seen but none at 0, 12, 24hours. There was no difference in satisfaction with pain management (P value=0.059). Conclusion: Preoperative information about pain improves postoperative pain experience and may negatively impact patients’ satisfaction with pain management due to unmet expectations.Trial registration: Clinicaltrials.gov, NCT03056521. Registered 17 February 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03056521