Revista de Enfermedades Infecciosas y Medicina

Typhoid and Dengue both are so different diseases but they have some similar routine manifestations like fever. Our 6 months performed study was to determined contemporaneous infection of both diseases having same routine manifestations in patients at the same period of time. We were collected the blood samples from suspected patients. The serum were separated out through centrifugation from the desired blood samples and tested for typhoid by Rapid Immuno-chromatographic (typhidot) technique and for the dengue we performed NS1 Rapid technique. The performed results showed that 64.4% typhoid positive from dengue negative patients and 4% dengue positive from typhoid negative patients but we were not found any suspected patient who infected with both diseases at the same time. From our performed results we can conclude that the contemporaneous infections should be confirmed by diagnostic laboratory properly because it may leads to misdiagnosis and creates difficulties to the physician for their respective treatments. To restraint the contagious infections we should prevent the route of infections because prevention is better than cure.

Background: Patients being treated in ICUs are at high risk of developing infection due to invasive procedures, frequent underlying health problems and immunosuppression resulting from their critical illness and co-morbidities. This project aimed to assess the incidence of HAI in A1 Adults Surgical ICU at Tygerberg Hospital and to improve infection prevention and control practices. Methods: This was a prospective observational study conducted during a period of 5 weeks, starting from 08 September to 15 October 2014. During the first four weeks, all new bacterial positive isolates from A1 Surgical ICU were collected daily, and then patient clinical data collected from patient files and from clinician’s interactive (doctors and nurses). The diagnosis of HAI was made based on the NHSN definitions. Wound contamination class used is the one described by Altemeier. Direct observation on hand hygiene practice was done to check whether any correlation between hand hygiene compliance and HAI rate. Data was analysed using Ms Excel. Results: There was a very high LRTI with 81.8 infections per 1000 IP-Days per month, followed by SSI with 31.7 infections per 1000 IP-Days and BSI with 26.4 infections per 1000 IP-Days per month. Acinetobacter baumannii was the most common organism representing 31% of all infections. VAP incidence density was 12.3 infections per 1000 ventilator-days per month, while CAUTI incidence density was 7.9 infections per 1000 catheter-days per month. There was no case of CLABSI during the surveillance period. Multidrug resistant organisms represented 65.4% of all isolated organisms causing HAI. Conclusion: HAI rates were very high for LRTI (81.8/1000 IP-Days), SSI (31.7/1000 IP-Days) and BSI (26.4/1000 IP-Days). MDR is very high (65.4%). HH compliance was very scared (29.3%). Only CLABSI bundle was implemented in A1 Surgical ICU. Bundles of care other than CLABSI such as VAP, CAUTI should be implemented to reduce HAIs. The clinical staff should comply with IPC precautions, especially standard precautions to reduce the risk of patients from getting HAIs.

Background: Risk management is a process consisting of well-defined steps which, when taken in sequence, support better decision making by contributing to a greater insight into risks and their impacts. It is as much about identifying opportunity as is about avoiding losses. Effective prevention and control of infection must be part of everyday practice and be applied consistently by everyone. Methods: The study was conducted at Tygerberg Hospital in 8 clinical areas/wards during a period of 3 weeks from 23 November 2013 to 9 October 2013. Risk Assessment IPC Inspection Checklist for healthcare institutions provided by the Unit for Infection Prevention and Control (UIPC) at Stellenbosch University was used for data collection. A feedback report was shared with the unit managers and ward in-charges, and the improvement plan was developed in collaboration with them. The follow-up was done to evaluate the implementation of the improvement plan. Data was analysed using Ms Excel. Results: 6 out of 8 (75%) wards complied with ward design, hand hygiene facilities available in all wards, 5 out of 8 wards (62.5%) had inadequate and insufficient protective clothing, 7 out of 8 (87.5%) wards did not have suitable patient toilet facilities. 7 out of 8 wards (87.5%) had suitable sluice area, while 7 out of 8 wards (87.5%) had appropriate treatment area. Quality of maintenance of aseptic procedures improved from 64% (18/28) to 85% (22/26) in patients with indwelling urinary catheter. The similar improvement was noted in patients with peripheral IV lines, from 81% (57/70) to 86% (48/56) as well as in the patients with wound, from 92% (22/24) to 100% (21/21). Conclusion: 6 out of 8 (75%) assessed wards complied against IPC standards. Conducting regular IPC assessment in clinical areas in collaboration with clinical staff (unit managers and in-charges) is essential to improve the quality and safety of healthcare service delivery. Significant improvement was noted in 7 wards during follow up assessment conducted one week after the initial risk assessment, whereby urinary catheter care improved from 64% to 85% (a 21% improvement) and peripheral IV line care improved from 81% to 86% (a 5% improvement). IPC and clinical teams (nurses, doctors, etc) should work hand in hand to improve the quality and safety of healthcare service delivery.

Background: The Expanded Program on Immunization (EPI) aims at delivering primary immunization services to at least 90% of infants. This study seeks to evaluate routine vaccination coverage using estimated and survey generated populations and also investigates the reasons for inadequate levels of routine vaccination coverage. Method: A cross-sectional survey was conducted in all 11,101 households spread across 111 communities in the 12 administrative wards of Orhionmwon LGA of Edo state in October 2016. Results: A total of 1209 children under the 0-11 month’s age bracket had been fully immunized. From this figure, 72.9% of the children had been fully immunized based on the actual population (1657) of children as discovered from this survey while 12.5% of the children in the same aforementioned age bracket had been fully immunized based on the projected target population (9625). Obstacles (40%), ‘lack of information (33%)’ and ‘lack of motivation (27%)’were the major reason why survey respondents didn’t participate in routine immunizations. Conclusion: Discrepancies in actual population of children for RI and poor access to RI services continue to negatively affect RI delivery mechanisms. We recommend the regular use of coverage surveys such as this for the estimation of actual target.

Fever is one of the most common symptoms among children, which worries parents and makes them go to physicians or emergency centers. One way to control the fever is to administer acetaminophen. Limited studies have been done on the dosage and route of administration of acetaminophen in children. This paper is a review of the correct use of acetaminophen in children based on existing randomized clinical trial studies and with emphasis on dosage and route of administration

Objective: We aimed to evaluate the status of knowledge and attitudes of medical students about HIV/ AIDS. Material and methods: In this descriptive, cross-sectional survey study, the status of knowledge and attitudes of medical students of Grigore T. Popa University of Medicine and Pharmacy about HIV/AIDS in June 2017 were evaluated. Results: A total of 85 medical students answered all of our 19 survey questions. The mean age was 21.80 ± 1.37 years (Range: 19-24 years). In the second question, six out of the 15 choices were correct and the mean of correct answers was 4.41 ± 1.49. There was a significant relationship between the grade of the students and the level of knowledge in the responses to the seventh question (p: 0.024). Conclusion: It is obvious that there are needed more health- informative organizations targeting the young population especially at schools and universities about sexually transmitted diseases, especially HIV/AIDS – transmission routes, misconceptions about HIV, prevention measures and life expectancy after HIV acquirement. Those programs may raise the HIV awareness and be useful to change the behaviour against HIV patients eliminating stigma.

Dengue Fever (DF), Dengue hemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS) are topmost public health concerns today, especially in tropical and subtropical countries, mainly involving urban and semi-urban areas. It is estimated that two fifth of the population in tropical countries, around 2.5 billion people are vulnerable. Approximately, 50 million dengue infections occur worldwide of which 500,000 people are hospitalized with DHF annually. Nearly 90 percent of them are children less than five years old, and about 2.5 percent die. Dengue epidemics are occurring at an increased frequency and one or more types of serotypes circulate. During these epidemics, infection rate among virus naïve patients ranges from 40-90 percent. In India, Dengue is hyperendemic (Category A) and is a notifiable infectious disease. Our hospital has been identified as a Sentinel Surveillance centre for diagnosis and treatment of Dengue in North West district of Delhi. Though gaps exist in terms of public health measures and health education among public, microbiological laboratory plays a crucial role in confirmation of dengue infection and estimation of burden of disease.

Infection of the amniotic cavity remains a major cause of preterm birth, stillbirth, fetal injury and early onset, fulminant infections in newborns. Currently, there are no effective therapies to prevent in utero infection and consequent co-morbidities. This is in part due to the lack of feasible and appropriate animal models to understand mechanisms that lead to in utero infections. Use of mouse and rat models do not fully recapitulate human pregnancy, while pregnant nonhuman primate models are limited by ethical considerations, technical constraints, and cost. Given these limitations, the guinea pig is an attractive animal model for studying pregnancy infections, particularly as the placental structure is quite similar to the human placenta. Here, we describe our studies that explored the pregnant guinea pig as a model to study in utero Group B Streptococci (GBS) infections. We observed that intrauterine inoculation of wild type GBS in pregnant guinea pigs resulted in bacterial invasion and dissemination to the placenta, amniotic fluid and fetal organs. Also, hyperhemolytic GBS such as those lacking the hemolysin repressor CovR/S showed increased dissemination into the amniotic fluid and fetal organs such as the fetal lung and brain. These results are similar to those observed in mouse and non-human primate models of in utero infection, and support use of the guinea pig as a model for studying GBS infections in pregnancy.