فهرست مطالب

  • Volume:1 Issue: 1, 2015
  • تاریخ انتشار: 1393/12/22
  • تعداد عناوین: 8
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  • Nasrollah Sohrabi, Keyghobad Ghadiri, Alisha Akya, Heydar Ali Ghashghaee, Ebrahim Jannat Sharifi, Farhad Shahveisizadeh, Lealy Nategh, Mohammad Erfan Zare, Atefeh Nasir Kansestani * Page 1
    Background And Objective
    In hospital facilities the quality of indoor air is a critical factor in the prevention of infections. Poor quality air inside hospitals may lead to hospital-acquired infections, sick building syndrome, and various occupational risks. The aim of this study was to determine the level of airborne fungal contamination in a referral burn center in Western Iran, affiliated to Kermanshah University in Medical Sciences.
    Methods
    This study was performed in the burn ward of Imam Khomeini Hospital of Kermanshah University of Medical Sciences, in July 2013. Samples were collected from four different parts of the ward, including; public rooms (31 samples), corridor (10 samples), toilet (9 samples), and dressing room (8 samples). Open lid petri dishes, containing Sabouraud dextrose agar medium, were held approximately 1.5 meters from the floor for 15 minutes. The airborne fungi were identified using mycological methods. Descriptive analysis of data was performed using SPSS software (version 16).
    Results
    Out of a total of 58 culture samples, 38 were positive for fungi. There were 54 colonies from six fungal genera. The most prevalent fungal species were Penicillium spp. with 18 colonies (33.3%), followed by Aspergillus spp. with 13 (24%) colonies. Public rooms were the most contaminated areas (93.5%), while the dressing room (25%) was the cleanest area. The rate of contamination in the dressing room and other areas of the burn ward were statistically significant (P
    Conclusion
    The results of this study indicated a high frequency of fungal contamination in the burn ward, particularly in the public rooms. Our data suggested that this ward -with its high risk patients- needs to be equipped with disinfectant equipment such as a HEPA filter
    Keywords: Airborne Fungi, Contamination rate, Nosocomial infection, Burn ward
  • Amir Jalali, Mohammad-Reza Dinmohammadi, Saadeieh Ali-Mohammadpor *, Mohsen Mohammadi, Mohammad Mahboubi Page 7
    Background And Objective
    Hospitals’ infection control departments are an important part of the validation process in terms of process indicators, performance and documentation, which will be reviewed in this study. Thus, examining the experiences of hospital infection control experts in this program’s performance can significantly improve certain parts of the program, as well as assisting planners and policy makers in future decision making.
    Methods
    Data for this study was collected from a sample of 15 experts who were related to the implementation and evaluation of hospital infection control programs. They were interested in participating in the study, which consisted of an in depth semi-structured face-to-face interview, and they also participated in two focus groups of eight and seven people. Consent was obtained in all of the interviews, either group or individual, and using a content analysis approach, meaning units from the participant's statements were extracted and compared with codes and categories, and the main themes and sub-themes were explored.
    Results
    The results of this study were obtained in the form of 318 codes, 18 sub-themes and seven main categories. Main classes included; Empowerment, Responsibility, Systematic and Services Quality Improvement, Patient Safety, Overwork and Low time interval; Continuity of Learning and Paperwork, each of which had sub-themes related to them.
    Conclusions
    The results showed that the accreditation process, in addition to the empowerment of personnel, leads to an increased sense of accountability and responsibility.
    Keywords: Accreditation, hospital, infection control specialists, content analysis
  • Abbas Farahani, Parviz Mohajeri * Page 18
    Background And Objective
    Carbapenem-resistant A. baumannii has been isolated highly in recent years. Metallo-b-lactamases (MBLs) have been detected and reported from A. baumannii producing carbapenemases in recent times. The aim of this study was to determine both phenotypic and Genotyping of MBL producing A. baumannii isolates.
    Methods
    A total of 110 Acinetobacter spp. were cultured from clinical specimens of hospitals of Kermanshah in western. To screen for the MBLs, E-test strips (AB Biodisk, Solna, Sweden) were used according as per the manufacturer’s instructions. DNA genomic of A. baumannii isolates were SmaI-digested and analyzed by CHEF Mapper PFGE
    Results
    89 (80.9%) of isolates producing MBL by E-test MBL. Of 89 MBL producing A. baumannii tested were recovered from ICU 68 (76.4%), emergency wards 16 (17.9%), and pediatric wards 5 (5.6%). Among 47 MBL producing A.baumannii that selected for Pulsed-field gel electrophoresis analysis, we obtained 7 pulsotypes that including 4 common types and had 3 single types.
    Discussion
    MBL producing A.baumannii has severely limited therapeutic options. The high MBL producing isolates found in this study may be associated with the high frequency at which these antimicrobial drugs were used for both prophylactic and therapeutic treatment of hospitalized. Our study showed that most of the isolates of A. baumannii were obtained from ICU and most members of clone A are collected from this ward. Present of CloneA in ICU ward is warning.
    Keywords: Acinetobacter baumannii, OXA?type, PFGE
  • Kaeyghobad Ghadiri, Tahereh Ghasemi *, Mohammad Heidari, Farid Najafi, Reza Karamimatin Page 23
    Background And Objective
    Burns and its complications are one of the most common causes of death in the world, as well as in Iran. Based on a report by the World Health Organization, 90% of deaths due to burn injuries occur in developing countries and 50% of these deaths occur at 15-44 years-of-age. The aim of this study was to assess the epidemiological aspects of death due to burns in Kermanshah, Iran, during 2004-2009.
    Methods
    This study was based on a collection of patients’ data. The target population was all deceased patients hospitalized due to burn injuries. Statistical analysis was performed using SPSS software (version 15), and T-test, Fisher’s exact test and chi-square tests.
    Results
    Among the 2 875 hospitalized patients during the six year period, 592 (20.5%) patients died, of whom 80.1% (474 cases) were female, and 19.9% (118 cases) were male. The mean age of the deceased patients was 29.8 years, with a range of 4 months to 100 years. Most of the deaths occurred in the age group 0-30 years (69.7%). The lowest rate of mortality was observed in the age group over 50 years with 12.6% of deaths. Patients with second degree burns constituted 1.7% of cases, combined second and third degree burn accounted for 16.6%, and third degree burns 81.8% of cases. The average duration of hospitalization was 8.13 days. Infections were the most common cause of death in these patients.
    Conclusion
    Our data revealed a high percentage of deaths in hospitalized burn patients due to infection and the severity of their burn. Most of the deaths occurred in the active ages of society.
    Keywords: Epidemiology, burn, prevention, hospital infection
  • Aghil Sharifzadeh*, Aasefeh Abbaszadeh, Alireza Khosravi Page 31
    Background And Objective
    Environments, of which hospitals are of particular concern, contain different types of microorganisms, thus patients may serve as a source of pathogenic microbes to other patients, staff, and visitors. The aim of this study was to investigate environmental surveillance and diversity of airborne fungi in the air from six hospitals.
    Methods
    The samples were collected through a passive sedimentation method on to Sabouraud glucose agar containing chloramphenicol and incubated at 30˚C for 7–10 days.
    Results
    A total of 459 samples were obtained from six different hospital environments. Yeast isolates belonged to four genera: Candida (21.78%), Trichosporon (5.22%), Rhodotorula (4.13%), Saccharomyces (4.35%), and filamentous isolates belonged to eight genera: Aspergillus (20.26%), Penicillium (8.49%), Mucor (10.45%), Rhizopus (8.06%), Fusarium (5.66%), Scopulariopsis (3.48%), Cladosporium (4.13%), and Acremonium (3.92%). Candida and Aspergillus species were the most commonly isolated species, respectively, representing a significant difference with other yeast and fungal species.
    Conclusion
    Considering the presence of pathogenic micro- organisms, environmental monitoring is necessary to prevent possible hospital infections.
    Keywords: Airborn fungi, Hospital environment, Aspergillus Spp., Candida Spp
  • Ali Mojtahedi, Hossein Khoshrang*, Mortteza Rahbar Taromsari, Ehsan Kazemnezhadleili, Ebrahimi Hoorvash Page 36
    Introduction and
    Objective
    Nosocomial infection, especially in the ICU, is a serious health center problem that causes the spread of disease in the community, and contributes to increased medical costs and mortality rates.The aim of this study was to find the relative frequency of microbial contamination on the hands of ICU staffs in educational and remedial centers in Rasht, North of Iran.
    Methods
    This cross-sectional study included all ICU staffs in remedial hospitals in Rasht. The samples were obtained using sterile swabs from the staff's hands in different working shifts and these were sent to a central referral laboratory. Finally, the data were analyzed using SPSS software (version16), Pearson’s chi-square and Fisher's exact test.
    Results
    Out of 106 subjects, 90 (84.91%) were female and 16 (15.09%) were male. Of the 106 cultures, 91 (85.9%) were positive and 15 (14.1%) were negative. Coagulase negative Staphylococci (CNS) were the most common resident flora (52.27%) found in the contaminated samples. Pseudomonas was the most common transient flora (73%) on personnel’s hands. Staphylococcus aureus was the most common infectious flora isolated. There were no significant relations between microbial contamination and gender, different ICUs, job positions or work experience.
    Conclusion
    Regarding high microbial contamination on the hands of ICU staffs in our investigation, hand washing is considered to be one of the easiest and most cost-effective measures to prevent nosocomial infection.
    Keywords: Infection transmission, Intensive care units, Nosocomial infection
  • Kaeyghobad Ghadiri, Alisha Akya*, Mehrdad Khodadoost, Amir-Hossain Ziaee Bidgoli, Maryam Amighi Page 44
    Background And Objective
    Introduction and aims: Staphylococcus aureus has been isolated from 20-45 percent of normal individuals. Studies have also reported various results for the resistance patterns and the rate of methicillin-resistant staphylococcus aureus (MRSA) carrier. This study aimed to assess the antibiotic pattern and the rate of S. aurous carriage in children at the time of hospital admission and discharge in Kermanshah city, Iran.
    Methods
    During a cross-sectional study, 874 patients were included and sampled at two different times. First at the time of their admission into the hospital as community acquired isolates, and second at the time of their discharge as hospital acquired isolates. Two samples were collected from the nasal cavity of each patient and tested for S. aureus and then the isolates were tested for antibiotic susceptibility using an E-test. If the result of the nasal culture was positive at the time of admission, they were excluded from sampling at the time of discharge.
    Results
    Of total 874 cases tested at the time of admission, 44 (5%) had positive culture for S. aureus, of which 3 isolates were MRSA. At the time of discharge, 56 (6.4%), who were negative at the time of admission, became positive for S. aureus, and 6 (10.6%) of them were MRSA.
    Conclusions
    The presence of MRSA carriers among children is an important factor in the increase of hospital acquired infections with this pathogen. Given the high usage of antibiotics in our country and nasal colonization of children with MRSA, antibiotics should be used appropriately to prevent MRSA infections.
    Keywords: Staphylococcus aurous, Children, MRSA, Nasal carriers
  • Aisha Akya*, Jila Moradi, Mansur Rezaei Page 49
    Background And Objective
    The antibiotic resistance of pathogenic strains of P. aeruginosa is increasing and the treatment of Pseudomonas infections has become a medical concern. We aimed to test the antibiotic resistance among pathogenic isolates of P. aeruginosa.
    Materials: In this study 96 pathogenic strains of P. aeruginosa were collected from Imam Khomainy and Imam Reza hospitals in Kermanshah during 2011-2012. After identification, the antibiotic susceptibility of bacteria was carried out using disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations.
    Results
    The average age of patients was 34.7±22.5 year. Among isolates, 28 (29.1%) were resistant to all antibiotics, but only 10(10.4%) were sensitive to all antibiotics. The highest sensitivity was for aminoglycosides in particular gentamicin and the lowest sensitivity was for carbenicillin and aztreonam.
    Conclusion
    The results of this study warn for the increasing of multidrug and extensively drug resistant strains in Kermanshah city. Therefore the continuous surveillance for antibiotic resistance can help to better understand the antibiotic susceptibility of this opportunistic pathogen to the current drugs. The results of this study suggest that from anti-Pseudomonas penicillins, piperacillin/tazobactam and from aminoglycosides, gentamicin and amikacin, are effective drugs and can be used for treatment of Pseudomonas infections.
    Keywords: antibiotic resistance, Pseudomonas aeruginosa, Kermanshah