2^nd International congress on Nosocomial and Healthcare Associated Infections October 15-16, 2018 Las Vegas, USA

Biography:

Salman Abdulaziz graduated from King Saud University, Saudi Arabia. He had his clinical training of Internal Medicine in King Fahad National Guard Hospital in Riyadh from (2002-2006). He had Arab board, Saudi board, MRCP(UK) of Internal Medicine in 2006. He got the Saudi Board of Critical Care from King Faisal Specialist Hospital and Research Center in year 2012. He is an active member of Quality Improvement Committee in Global Sepsis Alliance. He is the chairperson of Sepsis clinical guidelines protocol and pathway Taskforce in Rashid Hospital in Dubai, where he works currently as a consultant of Internal Medicine and Critical Care.

Abstract:

Clostridium difficile infections (CDIs) had become of major burden on healthcare system. These infections are the result of collateral damage to the normal bacterial flora of the human body, which is an inevitable complication of antibiotics use. CDIs pose immediate threat to the health of patients received antibiotics, more so than antimicrobial resistance. 

Considering CDIs are nearly always complications of antibiotics use, the development of program to ensure appropriate antibiotics use is considered an important prevention intervention. Multidisciplinary managed program such as antimicrobial stewardship has been initiated in health care facilities to control the misuse of antimicrobial therapies and reduce their complications. Clinical pharmacist involved antimicrobial ward-round is designed to help limit CDIs and other hospital-associated organisms by optimizing antimicrobial selection, dosing, de-escalation, and duration of antimicrobial therapy. Other activates such as audit with feedback and antibiotic restriction also have been established to impact on the antimicrobial utilization. These programs also incorporate implementation of hospital-wide guidelines, staff education, enforcement of infection-control policies, and the use of electronic medical records when possible to help control antimicrobial use. 

The literature strongly emphasize on how antimicrobial stewardship programs impact on CDIs rates discusses experiences in designing, implementing, monitoring, and follow-through of such programs. Literature shows significant decrease in the use of parenteral broad-spectrum antibiotic and in incidence of CDIs.

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Mohammad Aadam has completed his Masters in Medical Microbiology at the age of 25 years from KLE University, Belagavi, Karnataka and working as Microbiologist/Tutor at All India Institute of Medical Sciences, Bhopal. He has attended serveral CME, workshops and National International conference, he has went through many training during his studings period. He has published  5 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

These guidelines, written for clinicians, contains evidence-based recommendations for the prevention of hospital acquired infections Hospital acquired infections are a major cause of mortality and morbidity and provide challenge to clinicians. Measures of infection control include identifying patients at risk of nosocomial infections, observing hand hygiene, following standard precautions to reduce transmission and strategies to reduce VAP, CR-BSI, CAUTI. Environmental factors and architectural lay out also need to be emphasized upon. Infection prevention in special subsets of patients - burns patients, include identifying sources of organism, identification of organisms, isolation if required, antibiotic prophylaxis to be used selectively, early removal of necrotic tissue, prevention of tetanus, early nutrition and surveillance. Immunodeficient and Transplant recipients are at a higher risk of opportunistic infections. The post tranplant timetable is divided into three time periods for determining risk of infections. Room ventilation, cleaning and decontamination, protective clothing with care regarding food requires special consideration. Monitoring and Surveillance are prioritized depending upon the needs. Designated infection control teams should supervise the process and help in collection and compilation of data. Antibiotic Stewardship Recommendations include constituting a team, close coordination between teams, audit, formulary restriction, de-escalation, optimizing dosing, active use of information technology among other measure. The recommendations in these guidelines are intended to support, and not replace, good clinical judgment. The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of evidence supporting the recommendation, so that readers can ascertain how best to apply the recommendations in their practice environments.

Biography:

Nina Gatcheva has completed her PhD in 1982 from the National Center of Infectious and Parasitic Diseases and has been working as Head of the Department of epidemiology in the same institution until her retirement in 2007. She is the founder and president of the Bulgarian Association for Prevention of Nosocomial Infections – BulNoso, 2003-2013 and at present serves as honorary president and board member of the Association. She has published more than 95 papers (more than 10 in international journals) and is Chief - editor of the national journal “Nosocomial infections” available on the website of  BulNoso association : www.bulnoso.org.

Abstract:

In Bulgaria, the protection of medical staff through hepatitis B vaccination is arranged based on the Ministry of Health Regulation â„–4/2002 and is a responsibility of the employer. In 2008-2010 three surveys were carried out to assess the level of staff protection against hepatitis B. We present an overview of the results of these studies discussed in parallel. Hepatitis B vaccination coverage of healthcare personnel (HCP) varied substantially between different hospitals (23% to 85%) according to the prevalence study in 2010 and between different services/units (63% to 91%) based on the self-report questionnaire survey in 2008. In parallel, significant differences between hospitals exist in post-hepatitis B vaccination seroprotection rate (28% to 60%) as it was shown in seroprevalence study, 2007. As a potential impact of vaccination, a substantial reduction of newly acquired HBV infections in HCP was found with up to 3-fold lower anti-HBc prevalence when compared with the general population of the same age groups tested in the 1980s. A high antibody response rate (≥95%) in the first months after the hepatitis B vaccination and a decline of protective antibody to undetectable level in one-third of the staff tested 10-15 years post vaccination was demonstrated, in line with other similar studies. Our results showed that among hospital-based medical staff an average of 47% had not received hepatitis B vaccination and 36% were still susceptible to HBV. Further efforts should be focused on ongoing education to improve HCP knowledge of and to overcome their concerns about the vaccine.

Biography:

Anjeela Koirala, a registered nurse with 9 years of experience, works as an infection control coordinator at Grande International Hospital Nepal. She received her Bachelor's degree from  Purbanchal University. Her expertise lies in, but not limited to, Infection Prevention & Control(IPC)  as well as in the area of critical care. She has established IPC Nepal group with a goal to train doctors & nurses in the field of IPC. Furthermore, she organized awareness sessions for doctors and nurses, developed and presented hand hygiene awareness video. She has attended various national & international conferences as a speaker.

Abstract:

Healthcare- associated Infection (HCAI) is amongst the most common complications of hospital care, leading to high morbidity & mortality. HCAI includes Ventilator Associated Pneumonia (VAP), Central Line Associated Bloodstream Infection (CLABSI), Catheter Acquired Urinary Tract Infection (CAUTI), and Surgical Site Infection (SSI). Purpose of the study was to review the profile of HCAIs in our hospital, a multi-specialty tertiary care center, where we are implementing effective infection prevention and control measures including hand hygiene, isolation and antimicrobial stewardship since the last two years. This is a retrospective observational study conducted  in the ICU of Grande International Hospital. All the data were entered under INICC (International Nosocomial Infection Control Consortium) guidelines from 13^th April, 2016 to 13^th April, 2017. Out of 664 patients, the majority of infections (21.08%) were seen among the age group of 65- 78 years.  Pneumonia was diagnosed in 27 patients out of total 664 patients and the incidence of VAP was 14.84 per 1000 MV days. The most common pathogen encountered was Acinetobacter Baumanii, in 28.79% of samples. The incidence of CLABSI was 3.6 per 1000 CL days. CAUTI was diagnosed in 1.8 per 1000 CL days & the most common pathogen isolated was Klebsiella Pneumonia. Most of the HCAIs in our ICU were caused by MDR Gram Negative Organism. The overall mortality attributed to HCAIs was 12.61%. This study shows incidence of HCAIs with MDRO are very high in comparison to other countries resulting in prolonged stay in the ICU and increased risk of mortality.

Biography:

Muhammad Hakim has completed his Master Field Epidemiology and Biostatistics at the age of 35 years from FELTP-Pakistan and is a Postgraduate Resident of College of Phsician and Surgeons Pakistan,in Department of Community Mediciene and Public Health Sciences.He worked as N-STOP Officer in PEI/EPI program Pakistan.He led the Outbreak investigations in FATA-Pakistan and also presented his work in 5th EMPHNET Conference.

Abstract:

Introduction: FATA has set up of AFP surveillance system for immediate case investigation and specimen collection for detecting wild polio virus. The goal is polio eradication. Khyber Agency shares borders with Afghanistan and Peshawar due to which remains a major reservoir of polio virus and has contributed 76 cases in 2014. The purpose of this evaluation is to identify the weaknesses and strengths of this system to formulate recommendations.

Methodology: CDC’s updated guide lines for evaluation of public health surveillance system were followed and a descriptive study was carried out in May 2015 to evaluate the system’s functioning in 2014. Literature was studied, records were reviewed in Khyber Agency health department, stakeholders were identified and information was obtained through a designed questionnaire based on system attributes by conducting in depth interviews with the stakeholders.

Results: System was found simple; stable and flexible. Representativeness was average. Sensitivity was 100% while predictive value positive was 48.10%.Cases with adequate stools were 128 (81%). Completeness and timeliness of report files were 26 (86.66%).Case investigations within 48 hours of report 156(98.73%). Stool specimens collected within 14 days of paralysis onset 128(81.01%). Percentage of AFP cases with 60 days follow-up by 90 days after onset 58(36.70%).

Conclusion: AFP surveillance system in reality is not achieving as envisioned objectives due to the security compromised situation. The system needs improvement in logistics planning, data management, data quality including completeness and analysis. High sensitivity was due to the broad case definition to avoid missing any case. Regular field /desk reviews of system are required. Refresher training for health practitioner and community involvement were recommended.

Biography:

Phyllis Hazel Twala Qualified Professional Nurse

RN, RM , RC, BA in Infection Control , PGD in HIV/AIDS Management, PGD in Nur Educ )

Presented national and international presentations on infection control. Facilitating PCI Mandatory Infection control Course in AFHSR

Abstract:

Although healthcare associated infections (HAIs) are a recognized public health problem worldwide, they are presently a great concern for each and every healthcare setting. CLABSI is the most common infection especially in critical ill patients despite of international interventions to prevent CLABSI by adhering to the best practices. Thus further studies of good quality are essential. Hospital acquired infections (HAIs); definitions are adapted from the CDC’s National Healthcare Safety Network. Nonspecific (fever-associated) HAI, was defined as patient who has been on the surveillance ward >48hrs and has new onset (i.e. not present on admission) of fever or hypothermia (>38°C or <35°C). Relatively high prevalence of CLABSI is in NICU & ICUs which suggests that infection prevention practices (e.g., hand hygiene, cohorting practices, insertion of central lines) should be assessed and improved in these settings. Monitoring of CLABSI care bundle compliance by all healthcare workers and recording. Quality Improvement Project,  route cause analysis  FOCUS PDCA. Staff education and training on prevention of CLABSI.

Biography:

I am Golam Sorowar Porag. I am a final year student, Dept. of Microbiology in Noakhali Science and Technology University. I was a participant of International Young Microbiologist Competition 2014. Now I am working to publish a survey based paper on antibiotic resistance in different regions in Bangladesh.

Abstract:

Nosocomial infections are common phenomenon for causing serious diseases for healthy patients. It is essential to prevent the spread of nosocomial infections. In this study, we have found out the risk factors and preventive measures for control of infection. The Different types of food habitats, practice of proper personnel hygienic activities, drug administration play a significant role for defeating MRSA. Herbal drug administration is one of the effective and easier ways for the treatment of MRSA. The direct and indirect contamination by MRSA can spread the MRSA through behavior of hospital staffs, patients and visitors. Proper selection of drug and proper dosage can stop the spread the MRSA infection. Different types of effective sanitizers and chemical agents.     

Biography:

Mbutshu Lukuke Hendrick completed his doctorate at the age of 42 years at Lubumbashi University, where he is Associate Professor of hospital hygiene at the Public Health School of the same university. He has published more than 10 articles in journals Pan African, Asian, European and American.

Abstract:

Introduction: We conducted study that had the objective to determine the risk factors of nosocomial infections of surgical wounds in the maternity wards of public hospitals in Lubumbashi.

method: We conducted an analytical cross-sectional study whosea study population consisted of women whose delivery was associated with surgery, including cesarean section or episiotomy. Data collection was carried out in a comprehensive manner and a case of nosocomial infection in surgical wounds was defined according to WHO definition.

The factors were assessed by the value of prevalence ratio in percent significance level 0.05 Ë‚ by binary logistic regression.

Results: We obtained 443 cases of surgical procedures including 253 cases or 57.1% of caesarean sections and 190 or 42.9% episiotomies and prevalence of nosocomial infections of surgical wounds was 9.9%.The risk of nosocomial surgical site infection was 7 times higher at the hospital of the National Society of the Congo railway and 5.0 times at General Hospital Jason Sendwe reference that the General Referral Hospital Kenya (p =  0.0022). Unmarried had twice the risk of developing theNosocomial infections of surgical wounds that married (p =  0.0022). The long hospital stay lasting more than 10 days (p =0.0010), Cesarean delivery (p =0.0481), The parturient carrying the indwelling catheter (p =0.0162) and the use of antibiotics were associated with the occurrence of nosocomial infection in surgical wounds.

Conclusion: We must improve the hygienic conditions of maternity and apply a good political use of antibacterial agents.

Biography:

Muhammad Hakim has completed his Master Field Epidemiology and Biostatistics at the age of 35 years from FELTP-Pakistan and is currently a Postgraduate Resident of College of Phsician and Surgeons Pakistan,in Department of Community Medicine and Public Health Sciences.He worked as N-STOP Officer in PEI/EPI program Pakistan.He led the Outbreak investigations in FATA-Pakistan and also presented his Public health work in 5th EMPHNET Conference 2016.

Abstract:

Background:Measles is readily spread to susceptible individuals,a leading cause of morbidity and mortality in the developing countries including Pakistan.During week,20 of May-2017 total 17 measles patients reported, eight cases from UC Anjani and seven cases from UC Kadda Orakzai Agency.The objective of a field investigation to identify gaps and provide recommendations for measles outbreak response and immunization program improvement.

Methods:The study conducted from 25^th  May to 8^th June 2017.A case of measles defined “A person of any age resident of UC Anjani and UC Kadda, with rash, fever and at least one of the following cough,coryza and conjunctivitis presenting between 1^st May to 8^thJune-2107.Epidemiological,clinical and risk factors were recorded and analyzed by using Epi Info.

Results:There were 51 cases and Zero deaths identified of measles during outbreak investigation.The symptoms were fever,rash,coryza and conjunctivitis among 51(100%) and pneumonia 41(80%) of 51 cases.About 22 (45%) of 51 cases were male and 28(55 %) of 51 cases were female.The mean age of cases was 56 months,while most of the cases 26 (51%) of 51cases were in the age group of 6-10 years.All of the 51(100%) respondent parents were illiterate. The vaccination status of all 51 (100%) cases were zero doses.The index case were on 1^st May 2017 and cases increased from 5^th May 2017.The EPI survey in UC Anjani were 40% RI coverage.The EPI survey in UC Kadda were 80% RI coverage.Majority 41(80.39 %) of 51respondents were unaware about RI, whereas 29 (56.36%) of 51 respondent stated that the vaccinator did not visit their areas. The Vaccine Efficacy were 28%.

Conclusions:This outbreak was a result of  vaccination coverage gap.Functionalization of EPI centre,vaccinations of all children and mass education was strongly recommended.Outreach activity must be carried out regularly to reach scattered population.Surveillance for vaccine preventable diseases should be strengthened to prevent outbreaks.