International Congress on Nosocomial and Healthcare Associated Infections October 02-04, 2017 Las Vegas,Nevada,USA

Chair

Hua-Wei Chen

Naval Medical Research Center, USA

Co-Chair

Sami Rtimi

Swiss Federal Institute of Technology, Switzerland

Session Introduction

Hua-Wei Chen

Naval Medical Research Center, USA

Title: The development of lyophilized loop-mediated isothermal amplification reagents for the detection of Coxiella burnetii

Biography:

Hua-Wei Chen has received his PhD from the University of Maryland at College Park and completed his Post-doctoral studies from National Cancer Institute. He

is a Member of the American Society for Rickettsiology. He has been working in the Viral and Rickettsial Diseases Department since 2004 on Rickettsioses, and

other closely related diseases. He has published more than 25 papers in reputed scientific journals.

Abstract:

Coxiella burnetii, the bacterium causing Q fever, is an obligate intracellular biosafety level 3 agent. PCR based diagnostic assays have

been developed for detecting C. burnetii DNA in cell cultures and clinical samples. Because PCR method requires specialized

equipment and extensive end user training, it is not suitable for routine work especially in the resource-constrained areas. We have

developed a loop-mediated isothermal amplification (LAMP) assay with lyophilized reagents to detect the presence of C. burnetii

in patient samples. This method can be performed at a single temperature around 60°C with a heating block. The sensitivity of this

LAMP assay is very similar to PCR method with a detection limit at about 25 copies. The amplified DNA products were visualized

with a naked eyes using hydroxynaphthol blue or addition of SYBR green dye in the reaction with a UV lamp. The stability of the

lyophilized reagents were tested and followed for 24 months, 18 months, and 42 days when the reagents were stored at 4°C, 25°C, and

37°C, respectively. The results showed the lyophlized reagents retain the same reactivity as freshly prepared reagents when stored at

4°C for 24 months, 25°C for 28 days, and 2 days at 37°C. The lyophilized LAMP reagents are perfect to be used in resource-limited

settings where Q fever is endemic

Sami Rtimi

Ecole Polytechnique Fédérale de Lausanne, Switzerland

Title: Antibacterial surfaces with presenting redox properties for indoor hospital surfaces

Biography:

Sami Rtimi is a Scientist presently working at Swiss Federal Institute of Technology.

Abstract:

Surfaces coating is drawing attention as effective method to kill bacteria by contact in hospital facilities. Many coating methods

were studied and showed antibacterial capability. Many of them have the drawback of leaching out heavy metals, metal oxides,

antibiotics/antiseptics leading to the degradation of the environment and the ecosystem. Physical vapor deposition was used to

prepare metal oxides uniform, adhesive and ultra-thin coatings. In this direction, we provide insight into two different uniform

atomic-scale microstructures of Cu and Ti-oxides sputtered on polyethylene-based serum bags leading to fast bacterial inactivation

without losing the visibility of the liquid inside the bag. Co-sputtered (CuOx-TiO2-PE) consists mainly of CuO led to bacterial

inactivation kinetics within 20 min under very low intensity actinic/indoor light. This light is similar to the ones used in hospital

facilities and public places in Europe. The sequential sputtered (CuOx/TiO2-PE) consist mainly of Cu2O led to bacterial inactivation

within 90 minutes. By X-ray photoelectron microscopy (XPS), redox catalysis was observed to proceed during bacterial inactivation

for both coatings. The energetics and mechanism for the bacterial inactivation of E. coli on the co-sputtered and the sequential

sputtered catalysts are suggested. The Cu and Ti uniform distribution on the catalyst surface was mapped along the coating thickness

by wavelength dispersive spectrometry (WDS). By fluorescence stereomicroscopy the inactivation time of E. coli was found to be

in agreement with the times found by agar plating. The short-lived transients on the co-sputtered catalyst surface were followed by

femtosecond spectroscopy in the fs-ps region. By atomic force microscopy (AFM) the roughness of the co-sputtered (CuO) and

sequentially sputtered samples (Cu2O) were found respectively to present values 1.63 nm and 22.92 nm and the magnitude of the

roughness was correlated with the bacterial inactivation times. A deep understanding of the quantitative parameters controlling both

coatings leading to bacterial inactivation will be discussed.

Dhruv Kamlesh Mamtora

S L Raheja Hospital, India

Title: Interventions for prevention of device associated infections in superspeciality tertiary care center in Mumbai

Biography:

Dhruv Kamlesh Mamtora has completed his MBBS in 2010 from Lokmanya Tilak Municipal Medical College, Mumbai. He also did MD in Medical Microbiology from

Government Medical College, Miraj, Maharashtra in year 2013. He is Head of Microbiology and Infection control at S L Raheja Hospital, a 150 bedded multispecialty

hospital and center of excellence for diabetes and oncology. He has published papers in journals and has been serving as Editor for pubmed indexed journal. He

is also media subject expert on infection control, microbiology, antimicrobials and outbreaks.

Abstract:

Device associated infections and morbidity associated with hospital acquired infections have tremendous impact on patient

outcomes including prolonged stay, use of higher antibiotic therapy, use of invasive devices and overall financial loss and loss of

productivity. Hospital is a 150 bedded superspeicality tertiary care center hospital with center of excellence for diabetes and oncology

in the city of mumbai. The infection control department carries out surveillance of all infections including hospital acquired infections.

The infections for which routine surveillance is done are Ventilatory associated pneumonia (VAP) and Ventilatory associated events

(VAE), Catheter associated blood stream infections (CLABSI), Catheter associated urinary tract infections (CAUTI) and Surgical

site infections(SSI). The standard definitions are followed as per NHSN definitions and as per NABH accreditation guidelines.

Culture related microbiology surveillance is done for all central lines, urine, respiratory samples (ET secretions, Mini BAL, BAL) and

surveillance sysem to track SSIs. Prevention aspect of HAIs is taken cared by bundled care approach and round the clock audits done

by 10 infection control assistants and Infection control nurses which are 2 in number. The audits include insertion audits for central

line catheters and urinary catheters which is something unique and acheived with 100% compliance for all patients. The training

is extensive and include induction and on going trainings. One to one training is given to ICU nurses by infection control nurses

and infection control officer. Rounds are taken on daily basis by infection control team and all adverse events related to infection

control are documented and root cause analysis for all events are done during validation meeting conducted by management and key

stakeholders on monthly basis. The HAIs are also one of common agenda for Hospital infection control comittee. Key success factor

include low incidence of hospital acquired infections in spite of being primarily diabetic and oncology hospital. The reason being

round the clock surveillance activity, bundled care approach compliance, continuous and on going trainings and good hand hygiene

compliance.

Chair

Hua-Wei Chen

Naval Medical Research Center, USA

Co-Chair

Shabanov A.K

N.V. Sklifosovsky Institute of Emergency Medicine, Russia

Session Introduction

Alberti Amador E,

International Center for Neurological Restoration

Title: Epidemiologic, clinical and microbiological characteristics of nosocomial urinary infection the spinal cord lesioned patient

Biography:

Alberti Amador E is a Researcher at Cuba International Center for Neurological Restoration, Cuba.

Abstract:

Urinary infections constitute one of the main causes of intrahospitalary infections. At the clinic for the attention of spinal cord

injured (SCI) patients, we observed that these can be the causes of high incidence rates as a consequence of multiple risk factors

associated with the neurogenic bladder as: vesicle urethral reflux, vesicle lithiasis, diverticula and pseudo diverticula, urethral stenosis

and permanent or intermittent catheterization objective lesioned patients with neurogenic bladder as well as their microbiological

behavior.

Patients & Method: We performed a descriptive, retrospective-type study on 68 patients in order to schedule a neuro restorative

treatment for the affectation of the SCI for six months. They all received clinical, imaging test and bacteriologic assessment, that is,

urocultures, uretheral and vaginal exudates to determine risk factors, forms of presentation of the infection, as well as associated

complications and microbiological behavior.

Results: The most frequent forms of presentation of infections are: recurrent symptomatic bacteriuria, asymptomatic bacteriuria,

bacterial urethritis, bacterial vaginosis and acute pyelonephrites. Most acute germs are: Ecerichia coli (for a 46% of isolation), followed

by Klepsiella pneumoniae (l6%), Proteus mirabilis 8.1% and other Enterobacteria 10%. Sensitiveness to aminoglycosides was kept high,

where we observed a growing resistance to sulphas (100%) and fluoroquinolones (>60%), cefalosporine (Cefepime 34%) amikacine

7% and very sensitivenes a carbapenemics 100%.

Conclusions: Clinical peculiarities of urinary infections in the patient with neurogenic bladder, allow performing more adequate

strategies for treatment as to the clinical, microbiological and epidemiologic criteria.

Dhruv Kamlesh Mamtora

S.L. Raheja Hospital

Title: Challanges and Implementation of Antimicrobial Stewardship program in diabetic superspeciality tertiary care center in Mumbai

Biography:

Dhruv Kamlesh Mamtora has completed his MBBS in 2010, from Lokmanya Tilak Municipal Medical College, Mumbai. He also did MD in Medical Microbiology from

Government Medical College, Miraj, Maharashtra in year 2013. He is Head of Microbiology and Infection control at S L Raheja Hospital, a 150 bedded multispecialty

hospital and center of excellence for diabetes and oncology. He has published papers in journals and has been serving as Editor for pubmed indexed journal. He

is also media subject expert on infection control, microbiology, antimicrobials and outbreaks.

Abstract:

Antimicrobial stewardship program implementation is a challenge for private healthcare settings especially it is a multispeciality

hospital catering exclusively to diabetic and oncology patients and in city like Mumbai where antibiotics are sold as over the

counter medicines. Looking at the antimicrobial resistance pattern of institution, we have implemented extensive and elaborated

antimicrobial stewardship program starting from critical care settings and operation theatres with respect to surgical prophylaxis

extending to wards. The challenges faced are multifaced and solution to each and every step needs team work and integration of

multiple specialities. First and foremost was to form SOP as per international guidelines, next step was to prepare antibiograms

and antibiotic policy which was reviewed by clinicians. The team was formed with AMS workgroup and roles were assigned to each

of the key members. Then program was rolled out with CME program highlighting issue of antimicrobial resistance in India and

importance of antimicrobial stewardship progrm and launching program of antibiotic policy. The daily follow up is continuous

and ongoing process. Justification of each restricted antibiotics needs to be implemented by every clinicians prescribing restricted

antibiotic and relevant cultures are sent before empiric antibiotic therapy is started. Compliance is fluctuating but process has >90%

compliance in critical care area where maximum consumption of restricted antibiotics is done. Being a diabetic hospital, no direct

restrictions were done for issuing restricted antibiotics however every issue needs to be justified by issuing consultants supported by

culure evidence. The help from IT department was taken on streamlining process at multiple level and hence the program could be

successful program.

Barrantes K

University of Costa Rica, Costa Rica

Title: Detection of integrases clases 1 and 2 (inti-1 and inti-2) in multidrug resistant enterobacterias isolated from clinical samples

Biography:

Barrantes K is a Microbiologist and Researcher at the Health Research Institute (INISA) from University of Costa Rica (UCR). She has completed her Master

degree on Microbiology and a specialist degree on immunology from UCR. She has published more than 10 papers in the field of infectious diseases transmited

by food and water and antibiotic resistant pathogens.

Abstract:

The disease burden of bacterial infections is found to coexist with the rapid spread of resistance to commonly used antibiotics. The

molecular basis of antibiotic resistance lies within genetic elements such as plasmids, transposons, integrons, genomic islands,

etc., which are found in the bacterial genome. Integrons are known to acquire,exchange, and express genes within gene cassettes and

it is hypothesized that they play asignificant role in the transmission of multidrug resistance genes in several Gram-negative bacteria

including enterobacterias. Here we are reporting the presence of class 1 and class 2 integrases (intI-1 and intI-2) and antibiotic

resistance genetic cassettes (blaOXA, blaTEM, sul1 and sul2) among multidrug resistant enterobacteria isolates in Costa Rica. The

antibiotic resistance pattern and presence of antibiotic resistance genes were analyzed in 58 bacterial isolates, including Shigella,

Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, among others. All isolates were resistant to at least, one antibiotic.

Multidrug resistance was observed in 54 out of 58 isolates (93%), and 100% of isolates carried integrase class 1 (intI-1). Integrase class

2 (intI-2), blaOXA, blaTEM, sul1 and sul2 were observed in Shigella isolates. In 19 out of 24 Shigella isolates, transfer of intI-1 blaOXA

and blaTEM, cassettes were detected by conjugative plasmids to a competent and antibiotic-sensitive strain of E. coli. These results

confirm that information about epidemiology and molecular mechanisms of multidrug resistance determinants in enterobacterias

is important to develop intervention strategies. Regional and local antimicrobial resistance pattern in bacterial pathogens should be

considered as a part of control strategies.

Shabanov A.K

N.V. Sklifosovsky Institute of Emergency Medicine, Russia

Title: Early immunosubstitution therapy for severe multiple injury

Biography:

Aslan Shabanov, MD, with the higher qualification. Senior researcher in the intensive care unit. General seniority in this field is 22 years. He has been working: as

a reanimatologist since 1997. Also he have been into emergency medical helicopter group since 2002.

Achievements: Development of diagnostic methods and treatment of patients with severe polytrauma, which provides proper improvement of the treatment.

Abstract:

Introduction: Severe multiple traumas are the main non-specific factor that causes early immune imbalance, which in turn

acutely increases the risks of development of infectious complications in the affected areas. In a comparative individual analysis

of deviations in the values of immunogram parameters, more than a third of victims with severe multiple trauma, an imbalance in

hypoergic or hyperergic type is observed already on the first day. Currently there are nearly no data justifying the conduction of early

immunosuppressive therapy at early stage of multiple trauma and to assess its impact on the development of nosocomial infection

and the parameters of immune system.

Aim of the Study: Evaluation of the effectiveness of early immunosubstitution therapy (IST) in patients with severe multiple trauma

(SMT).

Materials & Methods: 225 patients with severe co-occurring trauma (ISS>30 points) were examined. The mean age was 35.5±14.1

years. Depending on the use of early IST therapy with donor IgG (daily for the first three days) patients were split into two groups:

the first- 126 patients with standard intensive treatment supplemented with IST; the second-99 victims, who did not receive IST.

Immunological examination was performed on days 1, 3, 6 and 9 after trauma. The relative and absolute number of lymphocytes

of the main populations were determined: (CD3+)-T lymphocytes and (CD19+)-B lymphocytes; T cell subpopulations: (CD4+)

T helper and (CD8+) T cytotoxic lymphocytes, concentration of immunoglobulins class A, G, M (IgA, IgG, IgM); absorbing and

bactericidal activity of neutrophils; serum content of circulating immune complexes: large, medium and small, as well as concentration

of C-reactive protein (CRP) and procalcitonin (PCT). In both groups the severity of the condition was assessed according to the

APACE-II scale (in dynamics), duration of mechanical ventilation, incidence of nosocomial pneumonia, CPIS score (in dynamics)

and outcome.

Results: The study showed that in the group of victims who received IST the need for prolonged mechanical ventilation was 1.7 times less

infectious complications developed 1.4 times less, the signs of nosocomial pneumonia decreased on the CPIS scale and the mortality

decreased by 1.6 times. The favorable course of the posttraumatic period was expressed in the improvement of the APACE-II scale

and the reduction of the ICU stay for more than 7.5 days.

Conclusion: The use of early immunosuppressive therapy in the treatment of patients with severe multiple trauma reduced the

duration of mechanical ventilation and the incidence of nosocomial pneumonia, which in turn reduced mortality in the investigation

group.

 

Ivana Haluskova

French society of immunology, France

Title: Tackling resistance in infectious diseases

Biography:

Ivanka Haluskova Balter is a Medical and cosmopolitan professional specialised in infectious diseases, internal medicine covering various therapeutic axes,

certified in Immunology and Pediatric, MBA vaccinology and years of clinical practise contributing to bring innovative science and diplomacy for global health.

Abstract:

Antibiotic resistance is regarded as a major threat to global public health, to the extent that medicine could be on its way “back to

the future” of a pre-antibiotic era. The issue is receiving high-level political attention, with resolutions passed at events such as the

G7 Health Ministries summit and the European Parliament, the endorsement by the WHO of the AMR Global Action Plan, and

culminating at the United Nations High-Level Meeting on AMR and the adoption of its declaration by the UN General Assembly.

The list was drawn up in a bid to guide and promote research and development (R&D) of new antibiotics, as part of WHO’s efforts

to address growing global resistance to antimicrobial medicines. The list highlights in particular the threat of gram-negative bacteria

that are resistant to multiple antibiotics. These bacteria have built-in abilities to find new ways to resist treatment and can pass along

genetic material that allows other bacteria to become drug-resistant as well.(27th February 2017, WHO) meantime Tuberculosis

(omitted from the list ) and resistant tuberculosis in particular (MDR/XDR) merits interest for rapid, affordable, easy diagnostic,

innovative immunology approach for vaccine research. HIV/AIDS has known link with tuberculosis but other risk factors have also

emerged in recent years as important determinants of the TB epidemic, one of which is diabetes mellitus. Bacille Calmette – Guérin

(BCG )vaccine successfully helped to interrupt transmission cycle and along with antibiotic discovery to decrease mortality. BCG

has been used for more than 90 years with astonishing safety records. However, its efficacy remains controversial. No universal

BCG vaccination policy exists, with some countries merely recommending its use and others that have implemented immunization

programs. XDR tuberculosis has evolved in several tuberculosis-endemic countries to drug-incurable or programmatically incurable

tuberculosis (totally drug-resistant tuberculosis). Of note that HIV/AIDS has known link with tuberculosis but other risk factors

have also emerged in recent years as important determinants of the TB epidemic, one of which is diabetes mellitus.This poses several

challenges similar to those encountered in the pre-chemotherapy era, including the inability to cure tuberculosis, high mortality, and

the need for alternative methods to prevent disease transmission. Another issue is reappearing of “old diseases” like pertussis, measles

but meantime existence of viral or parasitic diseases resistant to current treatment (HIV, Malaria, Hepatitis C) underline important

role of adapted immunization as one of strong tool with large impact along with role of effective diagnostic and surveillance and

better understanding of genetic and immunologic background of host specific response and pathogen evolution. Additionally, risk

or new emerging and re-emerging pathogens originated from animals after having crossed the species barrier underline importance

to implement preventive and intervention strategies including boosted vaccine research and development. Immunology and deep

understanding (along with genetics) and lesson learned from oncology research helps to orientate vaccine research for improved

delivery (use of sIgA as mucosal vaccine vehicle for example applicable for live attenuated vaccines), vectors (live attenuated,

recombinant virus vectored vaccines and to look at host improved innate and adaptive immune response (APC – DC, CD4/CD8) to

combined major pathogens and development of “universal vaccines”. Know limitations for use of anti-infectives and antivirals antiparasitic

treatments such us comorbidities, potential drug toxicity, disease related organ dysfunctions, drug–drug interactions and

overlapping toxicities, pill burden, particularities of children population and immune reconstitution inflammatory syndrome support

role of vaccines as highly potent tool to tackle resistance and valuable alternative from long term perspective and clearly recognized

being major tool for public health.

Chair

Jorg Imberger

University of Miami, USA

Session Introduction

Prof. Jyotsna Agarwal

King George’s Medical University, India

Title: Genotyping of E. coli associated with community acquired vs. hospital acquired urinary tract infection

Biography:

Jyotsna Agarwal has joined at King George’s Medical University, Lucknow as faculty in April 2002, and is currently working as Professor of Microbiology, In-Charge

Bacteriology Laboratory. She received her MBBS degree from CMC, Vellore and MD in Microbiology from BHU, Varanasi. She is Nodal Officer In-Charge for

regional centre of WHO sponsored diphtheria surveillance project and regional RTI/STI Centre for state of Uttarpradesh. She is working in the field of pathogenesis

of urinary tract infections in women from last eight years. Her other research interests include antimicrobial resistance, molecular diagnostics; focus areas are

infections of children including pneumonia, septicemia and meningitis along with sexually transmitted/reproductive tract infection. She has more than 50 publications

in reputed journals.

Abstract:

Uropathogenic E. coli (UPEC) are responsible for ~90% of community aquired and ~65% of and Hospital acquired Urinary tract

infections (UTIs). We compared genotypic profiles of E. coli strains associated with community acquired cystitis (CA; n=40)

and hospital acquired UTI (HA; n=20) in the present study by analyzing them for phylogroups & 15 putative virulence genes (VGs).

Virulence score was calculated for each isolate as number of virulence genes detected. The bacterial culture and identification were

done using standard conventional methods. 63.2% E.coli isolates associated with HA E. coli isolates belongs to commensal phylogroup

A & B1 in comparision to CA E. coli isolates where 57.5% were from pathotypic phylogroups i.e. B2 & D. Average virulence score was

higher for CA E. coli isolates (4.95) than HA E. coli isolates (4.09). VGs like fimH, papA, kpsMII, fyuA, traT and afa/draBC were more

frequently present in CA E. coli isolates. It may be that other factors like general condition of patients and ease of bacterial entry in to

the body and infection prevention practices play more important role in HA UTI than virulence potential of pathogen itself.

Meiriele S Neves

Londrina State University, Brazil

Title: Antibacterial activity of biogenic silver nanoparticles against Salmonella enterica

Biography:

Meiriele S Neves is a PhD student from Londrina State University, Brazil. She has studied about natural antimicrobials against Salmonella enterica. She works with

biological silver nanoparticle obtained from Fusarium oxysporum and oregano oil. This study can help to develop alternatives to control food contamination. Her

interest includes application of AgNPbio in food products and the interaction of this compound with the food.

Abstract:

The increase of resistant strains is a major problem in these days. Researchers are testing new antimicrobials, inclusive compounds

produced by nanotechnology. Salmonella is a genus of bacteria that are a major cause of foodborne illness in the world and

are transmitted through contaminated food. In this study, we tested biologically synthesized silver nanoparticles (AgNPbio) against

Salmonella enterica. AgNPbio were prepared according to a method by Durán et al., 2005. The AgNPbio diameter and zeta potential were

determined by photon correlation spectroscopy. Minimal inhibitory concentrations (MICs) were determined by broth microdilution

assays in 96-well plates, as suggested by CLSI. The in vitro antibacterial activity of AgNPbio was examined against four reference

bacterial strains (ATCC), Staphylococcus aureus 25923, Escherichia coli 25922, Salmonella typhimuirum UK1 and Salmonella

enteritidis 13076, and 19 bacteria isolated from chicken. Minimal bactericidal concentration (MBC) was determined by sub-culturing

10 μL from the broth dilution MIC. The AgNPbio presented the size range 81.25 nm, zeta potential –36.4 mV and PI= 0.296. E. coli

and S. aureus with MIC of 39.4 μM while S. typhimuirum and S. enteritidis showed MIC value of 78.7 μM. Isolates from chicken also

showed sensitivity for AgNPbio with MIC ranged from 78.7 μM to 157.5 μM, and all bacterial strains showed the MBC≤157.5 μM. The

AgNPbio is a great alternative because it was not related to any bacterial strain naturally resistant to silver nanoparticles. Our study

suggests that the use of AgNPbio can be effective against Salmonella enterica strains, an important food pathogen.

Ramos Guillermo Enrique

Buenos Aires University, Argentina

Title: Systemic antimicrobial prophylaxis in burn patients: Systematic review

Biography:

Ramos Guillermo Enrique has completed his MD in 1989 from Buenos Aires University. He is specialist in Internal Medicine, Intensive Care and Burn Care

Medicine. He is ICU staff of Argerich Hospital and ICU Chief of Dupuytren Clinic. He was Organizing Committee President of the Argentine Burn Association

Meeting in 2013. He is Professor and Professional Member of Argentine Intensive Care Medicine Society and Argentine Burn Association.

Abstract:

As nosocomial infections in burn patients are prevalent and dangerous, systemic antibiotic prophylaxis has been considered,

beside other interventions. However, this kind of therapy has been questioned due to controversy related to their effectiveness

and complications, such as drug toxicity and development of multidrug-resistance. We reviewed systemic antibiotic prophylaxis

in burn patients considering therapeutic target in different types of populations or procedures. The searching was conducted in

electronic databases during the period 1966-2016. The quality of evidence and strength of recommendation of these guidelines are

based on the GRADE system. Nineteen trials met the selection criteria. Early post-burn period prophylaxis was assessed in non

severe burn patients (6 trials), and in severe burn patients (7 trials). Antimicrobial prophylaxis showed no effectiveness for toxic

shock syndrome or burn wound infection prevention (Grade 1C) but could be useful in patients with severe burns and mechanical

ventilation requirement (Grade 2B). Moreover, perioperative prophylaxis was assessed in six trials. Beside, prophylaxis during

resection of devitalized tissue would not have indications in most burn patients (Grade 2B), but there is not enough evidence to

make a recommendation on extensive burns. Finally, it could be used for the prevention of split-thickness skin graft infections in

selected procedures (Grade 2B). We concluded that available evidence does not support the role of systemic antibiotic prophylaxis in

the management of the majority of burn patients. Nevertheless, it could be useful in patients with severe burns with requirement for

mechanical ventilation and in selected split-thickness skin grafting.

Cesar Henriquez-Camacho

University Hopsital Foundation Alcorcon, Spain

Title: POCUS: Approach to the patient using point-of-care ultrasound

Biography:

Cesar Henriquez-Camacho is an infectious diseases specialist within the Division of Internal Medicine Unit at Alcorcon Hospital, Madrid-Spain. He completed his

PhD at Universidad Complutense de Madrid and developed a post-doctoral at Uniformed Services University. He has particular interest in the areas of point of care

ultrasound, hospital-acquired infections, HIV, mHealth, and tropical/travel medicine.

Abstract:

Bedside ultrasound evaluation is a simple diagnostic method for infections and can be performed by clinicians promptly at the

bedside, using simple equipment and without irradiation. The discovery of the foci using ultrasound often enables prompt

antimicrobial therapy and even early ultrasound-guided procedure, facilitating earlier microbiology confirmation. These procedures

are made safer using ultrasound by the clinician. Future challenges for an infectious diseases specialist include training and gaining

experience about the appropriate use of point-of-care ultrasound (POCUS).

Anna Letícia Miranda

Universitary Hospital Maria Aparecida Pedrossian, Brazil

Title: Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit

Biography:

Anna Leticia Miranda Nurse, Student of the Doctoral Program in Applied Sciences for Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Master in Infectious

and Parasitic Diseases(UFMS). Specialist in Cardiology and Hemodynamics(UNIFEV). Specialist for the Training Program in Advanced Heart Failure by the School of Cardiac

Transplantation Hospital Sírio Libanês.

Daiana Terra Nacer, Nurse, Student of the Doctoral Program in Nursing in Adult Health, University of São Paulo(USP), specialist in Adult Intensive Therapy, Emergency and

Emergency and Master in Nursing(UFMS).

Abstract:

Introduction: Healthcare-associated infections (HAIs) are considered infections which occur after the admission of the patient to

the hospital. Of the HAIs, urinary tract infections (UTI) are one of the most prevalent, and have the greatest potential for prevention,

due to their relationship with urethral catheterization. Although cases of patients with urinary infection present a lower mortality rate

(0.28%), a notification of an infection rate of 25% to 60%.

Aim & Objective: To compare the results of urinary tract infection incidence, by means of the rate of indwelling urethral catheter

use, and to identify microorganisms in urine cultures before and after the implementation of a clinical protocol for intensive care

unit patients.

Method: UTI is defined as a positive urine culture >105 CFU/mL, notified by the hospital infection control service, six months before

and after the implementation of the protocol. The sample consisted of 47 patients, 28 reported before and 19 after implementation.

The protocol established in the institution is based on the Ministry of Health manual to prevent healthcare related infections.

Results: A negative linear correlation was observed between the later months of implementation and the reduction of reported

cases of UTI, using the Spearman rank order coefficient (p=0.045), and a reduction in the number of urine culture microorganisms

(p=0.026) using the Fisher exact test.

Conclusion: Educational interventions with implementation protocols in health institutions favor the standardization of maintenance

of the invasive devices, which may reduce colonization and subsequent infections

Daiana Terra Nacer

Federal University of Minas Gerais, Br

Title: Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit

Biography:

 Daiana Terra Nacer Nurse, Student of the Doctoral Program in Applied Sciences for Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Master in Infectious

and Parasitic Diseases(UFMS). Specialist in Cardiology and Hemodynamics(UNIFEV). Specialist for the Training Program in Advanced Heart Failure by the School of Cardiac

Transplantation Hospital Sírio Libanês.

Daiana Terra Nacer, Nurse, Student of the Doctoral Program in Nursing in Adult Health, University of São Paulo(USP), specialist in Adult Intensive Therapy, Emergency and

Emergency and Master in Nursing(UFMS).

Abstract:

Introduction: Healthcare-associated infections (HAIs) are considered infections which occur after the admission of the patient to

the hospital. Of the HAIs, urinary tract infections (UTI) are one of the most prevalent, and have the greatest potential for prevention,

due to their relationship with urethral catheterization. Although cases of patients with urinary infection present a lower mortality rate

(0.28%), a notification of an infection rate of 25% to 60%.

Aim & Objective: To compare the results of urinary tract infection incidence, by means of the rate of indwelling urethral catheter

use, and to identify microorganisms in urine cultures before and after the implementation of a clinical protocol for intensive care

unit patients.

Method: UTI is defined as a positive urine culture >105 CFU/mL, notified by the hospital infection control service, six months before

and after the implementation of the protocol. The sample consisted of 47 patients, 28 reported before and 19 after implementation.

The protocol established in the institution is based on the Ministry of Health manual to prevent healthcare related infections.

Results: A negative linear correlation was observed between the later months of implementation and the reduction of reported

cases of UTI, using the Spearman rank order coefficient (p=0.045), and a reduction in the number of urine culture microorganisms

(p=0.026) using the Fisher exact test.

Conclusion: Educational interventions with implementation protocols in health institutions favor the standardization of maintenance

of the invasive devices, which may reduce colonization and subsequent infections