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   Table of Contents - Current issue
January-April 2022
Volume 10 | Issue 1
Page Nos. 1-32

Online since Saturday, November 12, 2022

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The future of COVID-19: The game of variants p. 1
Namita Jaggi
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Role of analysis of threshold cycle (Ct) values in cartridge-based nucleic acid amplification test (CBNAAT) result: Impact on public health in relation to tuberculosis control and drug resistance p. 3
Indranath Roy
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Bacterial counts of hospital linen and effectiveness of laundry process: A need for consensus on microbial sterility of hospital linen p. 6
Raman Sharma, Sivanantham Krishnamoorthi, Ashok Kumar, Manisha Biswal, Vipin Koushal
Background: Health care linen is a source of healthcare-associated infections. Hospital laundry services play a vital role in linen decontamination. Effective laundry is essential in preventing hospital-acquired infections, especially in multidrug-resistant organisms. Aims and Objectives: The study aimed to check the microbial load in linen after the laundry process and the during the supply chain in the hospital. We investigated the bacterial load in linen before and after the laundering process and the linen from stored linen banks. Materials and Methods: Linens (n=125) from the hospital were collected in different stages of the laundry process [31 linen before decontamination; 94 linen after decontamination (Post washing = 30; Linen Bank = 34; Ward 30)]. A square inch of linen from each linen was vortexed in normal saline, and colony forming units (CFU)/inch of linen were calculated using appropriate media. The identification and susceptibility of organisms were performed using MALDI-TOF MS and CLSI disk diffusion methods, respectively. The difference in the load of the organism was analysed between different stages of the laundry and storage process. Results: We found that100% of pre-decontamination linen harbour viable organisms (22.59% including multidrug-resistant pathogenic organisms: MDROs), which decreased to 40% (no MDROs) post-decontamination. The overall load was reduced by a factor of 103.77. Conclusion: The microbial contamination of linen is common, and there is an urgent need to develop consensus on the microbial examination frequency and acceptable range of organisms on hospital linen worldwide.
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Hand hygiene: An effective key HIC parameter for reducing healthcare-associated infections in a haemodialysis unit – Identification and analysis of work system factors p. 10
Rajesh Harsvardhan, Richa Mishra, Ruchi Kushwaha, Narayan Prasad
Introduction: Infection is the most common cause of hospitalisation and the second most common cause of mortality amongst haemodialysis (HD) patients, after cardiovascular disease. Hand hygiene (HH) reduces infections and enhances patient safety across all settings. However, the lack of compliance with HH amongst health-care providers is problematic worldwide. With the above background, a study was conceptualised to ascertain the current status of the HH practices during a complete HD procedure among nursing staff of an HD unit at a tertiary healthcare teaching institute in India. Methodology: A prospective cross-sectional study was conducted from 10 October, 2018, to 10 December, 2018. A structured checklist for HH during a complete HD procedure was developed as per the WHO's five moments of HH. One hundred and fifty HD procedures were observed for compliance appropriate number of HH. Data analysis was done using the SPSS version 22. Results: Despite being a very simple step, the compliance rates of health-care workers (HCWs) in HH were found extremely poor, ranging from 23% to 35% only. Reasons for non-compliance by HCWs told by them were: poor nurse-to-patient ratio, frequent turnover of nursing staff, lack or inadequate training and lower level of competency among HD staff. Conclusion: The high number of times an HD staff is required to perform HH could be a reason for lack of compliance. However, compliance can be improved by continuous education and supervision and by providing, in convenient locations, sufficient number of sink with soap dispensers, paper towels, hand lotions and Anti-Bacterial Hand Rubs (ABHRs) placed at each patient station.
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A cross-sectional surveillance on healthcare-associated infections in a trauma centre in Eastern Uttar Pradesh: Experience of a student researcher p. 14
Amartya Seth, Arghya Das, Ravindra Singh, Tuhina Banerjee
Objectives: Surveillance of healthcare-associated infection (HAI) is extremely important for the implementation and monitoring of infection prevention and control (IPC) policies and practices in health-care organisations. This study led by a Phase 2 medical student researcher was performed to assess the burden of different HAIs in a type 1 trauma centre. Materials and Methods: A cross-sectional study was conducted on patients with a provisional diagnosis of HAI. Pretested and predesigned pro forma fulfilling the criteria for surveillance of HAIs from the Centers for Disease Control and Prevention-National Healthcare Safety Network was used to collect data. The microbiological culture reports were reviewed. The rates of different HAIs were calculated in Microsoft Excel 2010 based on standard definitions. Results: The rates of catheter-associated urinary tract infection and ventilator-associated event (VAE) were 1.19/1000 catheter days and 36.99/1000 ventilator days, respectively. The surgical site infection rate was 4.97/100 surgeries with the majority of infections noted after orthopaedic interventions. Conclusions: Among all HAIs, VAE rate, mostly due to Acinetobacter baumannii, was higher than the existing Indian estimate, requiring immediate attention on prevailing IPC practices. The involvement of medical student researchers could help in the generation of baseline data in resource-limited settings.
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Microbiological profile of oxygen humidifiers at a tertiary care centre in the Himalayas: An exploratory study p. 18
Oshin Puri, Sasi Rekha Udayakumar, Mohit Bhatia, Monika Pathania, Meenakshi Dhar
Background: Reusable humidifiers are often colonised by microbes, the aerosols generated from which are hypothesised to transmit respiratory infections-jeopardising patient safety. Materials and Methods: In this time-bound cross-sectional study, 10 ml of water was collected in sterile containers from humidifiers installed in selected wards/critical care units/intensive care units and from the source used to refill these humidifiers. These samples were subjected to KOH and gram staining followed by inoculation on blood, MacConkey and Sabouraud dextrose agar and brain heart infusion broth in the aerobic environment at 37°C. Observations were recorded as per standard guidelines and compared against blood and respiratory cultures of patients. Results: Despite an average of 8.23 days of exposure to oxygen humidified by contaminated water, n = 28 (of n = 39) blood samples reported no growth (NG) and n = 12 reported nonpathogenic organisms (NPO). Among n = 18 available respiratory samples, n = 1 reported Escherichia coli, which was not cultured from the same humidifier indicative of some other source. n = 1 reported NG, n = 6 reported NPO and n = 10 reported normal throat flora. No fungal elements were reported from any humidifier, source, or patient samples. The source-humidifier pathogen pair did not match for any humidifier. Conclusions: Sterile patient cultures, despite prolonged exposure to oxygen humidified with contaminated water, indicate that humidifier contaminants did not infect patients. The disparity between the source or patient cultures and humidifier contaminants may be attributed to compromised universal precautions due to the exhaustion of health-care professionals during COVID-19. Furthermore, the type of water used to refill (Distilled/RO/Tap water) had no effect on the microbial contamination of humidifiers.
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I wear a mask because I care about you p. 27
Harish Gupta
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Antimicrobial resistance in COVID-19: Pandemic within pandemic p. 29
Areena Hoda Siddiqui
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Cusco's speculum-induced iatrogenic deep vaginal wall laceration in a peri-menopausal woman – An unusual case report p. 31
Vijayan Sharmila, Garikapati Kavitha
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