جستجوی مقالات مرتبط با کلیدواژه « عفونت بیمارستانی » در نشریات گروه « پزشکی »

Acinetobacter baumannii, a non-fermenting Gram-negative coccobacillus, exhibits high resistance to antimicrobial compounds. Biofilm formation is a crucial feature in many Acinetobacter species, contributing to their antibiotic resistance. The present study aimed to investigate the prevalence of ompA, csuA, bap and pgaB genes in clinical isolates of Acinetobacter baumannii with biofilm formation ability.

In this cross-sectional study, 49 isolates of Acinetobacter baumannii were collected from patients hospitalized in the health centers of Borujerd City. Acinetobacter baumannii isolates were confirmed by biochemical tests. In these isolates, the biofilm production ability was investigated by microtitreplate method. Then, using PCR method and specific primers, ompA, csuA, bap and pgaB genes were identified.The collected data were analyzed descriptively and analytically using SPSS version 16 software. Data analysis was done with Chi-square test, Fisher's exact test, and P<0.05 was considered as the basis of significance.

The presence of ompA, csuA, bap, and pgaB genes was detected in 87%, 92%, 98%, and 100% of the isolates, respectively. Additionally, the microtitreplate method revealed that biofilm formation was strong in 3 isolates (6%), moderate in 17 isolates (35%), and weak in 29 isolates (59%).

The prevalence of genes associated with biofilm formation in Acinetobacter baumannii isolates was high. This suggests that the studied isolates possess a significant ability to form biofilm structures.

Nosocomial infections are considered as the important parts of the treatment challenges in hospitals. The genus Artemisia is widely distributed in Iran. Their species produce antibacterial, antiviral, and antifungal compounds belonging to different groups including phenols, terpenoids, sterols and polyacetylenes. The purpose of the present study is to investigate the in vitro effects of different hydroethanolic extracts of Artemisia species against bacterial strains in nosocomial infection.

12 different extracts, including 50% and 70% hydroethanolic extracts were prepared from the aerial parts of Artemisia ciniformis, A. turanica, A. kopetdaghensis, A. khorasanica, A. vulgaris, and A. sieberi. The winterization of the extracts produced corresponding defatted extracts. The minimum inhibitory concentration (MIC) values of the extracts against the bacterial strains Staphylococcus aureus, Streptococcus pyogenes, Acinetobacter sp., Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococus epidermidis, Micrococcus luteus, Klebsiella  pneumoniae and Escherichia coli were measured using the microdilution broth method. Total phenolic contents were determined by the Folin-Ciocalteu method.

Among the extracts analyzed in this experiment, the lowest MIC value was observed for the 50% hydroethanolic extract of A. turanica (0.25 mg/ml) against S. epidermidis. The largest range of bacterial sensitivity (6 strains) was related to the 50% hydroethanolic extracts of A. turanica (defatted and non-defatted) and A. kopetdaghensis (defatted). The growth of S. epidermidis was inhibited by all of the extracts. The highest total phenolic content and yield of extraction were recorded for 70% hydroethanolic extract of A. sieberi and 50% hydroethanolic extract of A. ciniformis, respectively.

The 50% hydroethanolic extract of A. turanica was superior to the other extracts in terms of the in vitro antibacterial spectrum and selective potency. A. turanica and A. kopetdaghensis are probably suitable choices for further phytochemical and antibacterial investigations.

Hospital infections are one of the modern medical problems. The present study was conducted with the aim of determining the effect of educational intervention based on the health belief model regarding the preventive behaviors of hospital infections in midwifery trainees of Shahrekord Azad University in 2023.

The present study is a semi-experimental intervention study, with an intervention and a control group, conducted on midwifery trainees of Shahrekord Azad University,. The sample size included 36 people in each group and simple random sampling method was used by randomly assigning the individuals to each group. The data collection tool was a questionnaire of preventive behaviors against hospital infection based on the health belief model. After completing the pre-test questionnaires, the educational content was provided to the intervention group and then a post-test was conducted one month later. The collected data were analyzed using SPSS20 and conducting paired and independent t-tests.

The mean age of the participants in the study was 21.68± 0.90. The results of the paired t-test showed that in the intervention group, the mean score of knowledge increased (0.5±0.38) (p<0.05), guidance for action (2.83±1.08) (p<0.05) and preventive behavior (2±1.59) (p<0.05) was significant after the training and the reduction of perceived barriers (2.64±0.83) (p<0.05) was also significant. Independent t-test showed that the mean score of guidance for action (p<0.05) and preventive behavior (p<0.05) after training in the intervention group was higher than the control group.

Training about hospital infection prevention was associated with increasing awareness, reducing perceived barriers, increasing guidance for preventive action and behavior. Therefore, appropriate  training of people at risk, especially medical science trainees, can be effective in prevention.

Nursing care is an essential part of health care services and should be fully provided. Missed nursing care is a major threat to patient safety and health care quality. The purpose of this study was to determine the amount and reasons for missed nursing care in infection control and prevention from the point of view of care providers working in the medical, educational, and therapeutic center of Besat Sanandaj during 2023.

This cross-sectional study was conducteed in Besat Hospital, one of the teaching hospitals of Kurdistan University of Medical Sciences. The research samples in this cross-sectional study included 389 nurses and midwives working in Besat Hospital who were included in the study by census. To collect data, three tools were used: a demographic information registration form, a questionnaire on the missed nursing care in infection prevention and control, and a questionnaire on factors related to missed care.

The findings of the present study showed that the average score of missed nursing care in infection prevention and control was 75.83 ± 23.28 and below the average. The most important missed nursing care from the point of view of the nurses and midwives of Besat Hospital was the use of personal protective equipment by the service personnel of the department (4.88 %), the report of the patient's infection status when transferred to another department or paraclinical unit such as radiology (3.86 %), and teaching patients about bathing before surgery (3.86 %). The most important factor of forgotten nursing care was unexpected increase in workload and number of patients in the ward (79.69 %) along with insufficient number of nursing and midwifery personnel in the ward (32.75 percent). A statistically significant relationship was observed between forgotten nursing care in infection prevention and control with the related factors (P = 0.0001), (R = - 0.1940).

The missed nursing care in the prevention and control of infection from the point of view of nurses and midwives of Besat Hospital was average. The most important factor was the unexpected increase in the workload the number of patients and the lack of personnel. The people participating in the research emphasized the role of systemic, organizational, and management factors in preventing effective infection control. Therefore, it seems necessary to reduce the factors that cause missed care with proper planning and management by reducing nurses' workload and providing budget and manpower.

Fungal infections are increasingly common in the hospital environment and the risk factors for these infections continue to increase and can become a serious threat to the life and health of employees and patients. The aim of this study was to explain the principles of prevention of fungal infections in hospitals at different stages of construction activities. This study is of the type of narrative review study, which is based on a comprehensive search of the key words "hospital fungal infections", "construction activities", "preventive requirements", "schools", their combination in the database. Valid citations available on national and international lines such as Scopus, Google Scholar, PubMed, Medline, Science direct, and Persian SID, Irandoc and Magiran databases were done from 1391 to 1401. Preventive health requirements were then formulated prior to, during and following the implementation of hospital construction projects. According to several reports, more than 5000 deaths occur annually due to fungal infections related to construction and reconstruction activities in hospitals and health care centers, and transplant patients who are infected with Aspergillus. They face mortality between 74 and 92%. As a result, it is very necessary to prevent the spread of fungal spores through activities such as construction and renovation and to prevent the spread of fungal infections in hospitals. Because these activities predispose conditions for the spread of fungal infections and increase in mortality. It is necessary to design, implement, control and monitor preventive measures as a main strategy in three stages, including before the start of the project and simultaneously with the design of construction activities, during implementation and after the completion of construction operations by the infection control team of the hospital.

The least expensive way to prevent hospital infections is hand hygiene. This study investigated the causes of non-observance of hand hygiene in the intensive care unit (ICU) department of the studied hospitals and effective strategies to reduce it.

This interventional study was conducted in the ICU wards of six hospitals (A-F) affiliated with Tehran University of Medical Sciences, 2018-2020. In order to improve the process of hand hygiene, the - nine step FOCUS-PDCA method was used. In each hospital, hand hygiene compliance was measured in five different situations (before contact with the patient, before aseptic procedures, after contact with the patient fluids, after contact with the patient, and after contact with the environment), in three professional career subgroups before and after the implementation of the intervention, using the World Health Organization checklist by the trained people. The data were analyzed in SPSS software version 24.

In all the hospitals under study, the level of hand hygiene compliance in all five situations had a significantly increasing trend, so that at the end of the study in the six medical centers, the level of hand hygiene compliance reached above 41%. In all medical centers, nurses had the highest amount of hand washing. After the intervention, the average level of hand hygiene in all hospitals increased significantly (p<0.01) and reached41.6%. Also, the level of hand hygiene in all job professional subgroups showed a significantly increasing trend (p<0.01) in which the nurses had the highest scores. An increasing trend was observed in all five different situations of hand hygiene in all hospitals (p<0.01).

The findings of the present study showed that the implementation of the FOCUS-PDCA model in the hospital can increase the level of hand hygiene compliance among healthcare workers, especially nurses.

Background &

Burns are one of the most common problems worldwide. Burn wound in cases of hospital infection is one of the main causes of death of these patients. This study was conducted with the aim of determining the prevalence and type of wound infection in burn patients admitted to 5 Azar Hospital in Gorgan.
Materials &

In this retrospective descriptive study, out of a total of 99 cases of patients with 2nd degree burns and above who were hospitalized, 62 cases were included in the study and 37 cases were excluded due to the death of the patients or incomplete information. Demographic information, underlying disease history, duration of hospitalization, percentage of burn, type of burn and type of infection were monitored with the help of HIS system and recorded in the checklist. Data were analyzed with SPSS22 software and mean, frequency, chi-score, Fisher's exact and U-Man-Whitney tests at a significance level of 0.05.

Out of 62 patients, 55 (88.7%) patients had an infection and 7 (11.3%) patients did not have an infection. The most common cause of infection were Gram-negative bacteria (32.3%). Infection had a statistically significant relationship with the total length of hospitalization (p=0.009), burn percentage (p=0.004) and burn site in the upper limbs (p=0.022). Infection had no significant relationship with demographic characteristics including gender, previous history, age and body mass index.

The percentage of burns and the place of burns in the upper limbs and the duration of the patient's stay in the hospital are effective in causing and the rate of infection. As a result, reducing the time of the patient's stay in the hospital prevents the infection to some extent.

 Surgical Site Infection (SSI) occurs within 30 days after surgery and involves the skin and subcutaneous tissue of the surgical incision. In addition to harming the patient, surgical site infection imposes a high cost on the health system. This research aimed to estimate the cost of surgical site infection in a hospital Iran.

 This descriptive study was conducted in a university hospital in Kashan in 2016. The cost of diagnosis, treatment and care of SSI was identified and calculated by an experienced medical doctor and two experienced nurses by studying the patient's medical record. Data were analyzed with SPSS software (version 16) and using descriptive statistics and inferential statistics.

 The prevalence of SSI was 1.04% in the hospital. The median additional cost attributable to SSI per patient was 33,089,572 Rials (997 US$), which includes the cost of medication (7,838,412 Rials), tests (1,294,244 Rials), and imaging (1,462,692 Rials). ), re-surgery (7,938,158 Rials) and other services (14,556,066 Rials). The cost of SSI has a significant association with patient age, diabetes, type of surgery, duration of surgery, placement of device in the patient body, patient length of stay in the hospital before infection and patient hospitalization department (p<0.05).

 Surgical site infection imposes a high cost on the patient, the health insurance organization and the hospital. Health system policy makers and hospital managers should use appropriate interventions to prevent and control surgical site infections

In hospitals, the emergency department is a complex healthcare environment, and it is necessary to attention to nosocomial infections. This study aimed to evaluate the implementation of nosocomial infection program in the emergency department.

This descriptive study was conducted in hospitals of Gorgan, Iran, in 2022, using the WHO checklist with 96 questions in 9 section staff; patients, environment, equipment, drug, prevention of infections wound, urinary, respiratory, and blood. Data were collected via observation and interviews. A checklist containing 45 questions was used to determine the impact of staff awareness on the infection control program, in 4 sections oftheoretical knowledge, performing procedures, immunization, and environmental hygiene.

The results show that 82.46% of the infection control program was satisfactory. The percentage of scores for different sections of nosocomial infection program including staff, patients, environment, equipment, drug, infection prevention of wound, urinary, respiratory and blood  was 79.31, 77.78,  81.25,  83.34, 100, 44.34, 75.00, 87.88 and 100, respectively. Moreover, the percentage awareness score for emergency medicine specialists, general practitioners, medical interns, and nurses was 100, 95.83, 87.5, and 79.92, respectively.

The implementation quality of the infection control program was acceptable and satisfactory. However, some factors were lower than the desired level, which could be dangerous for medical staff, patients, and visitors. The medical staff believed that the support of the senior managers of the University was essential for the implementation of an infection control program, and also holding training courses, and accelerating data sharing.

Hospital infections are one of the most common health problems which can be controled by education. The purpose of this study was to compare the effect of two e-learning methods (problem solving and examination of question) on awareness; Attitude and performance of Islamic Azad University–Maybod branch nursing and midwifery students regarding hospital infection control in 2022.

The current study was a semi experimental in which 36 Islamic Azad University–Maybod branch nursing and midwifery students were randomly Probability Proportional to Size assigned to intervention(problem solving, examination question) and control groups (N=12) based on the entry and exit criteria using probability proportional to size method.  Education based on hospital infections booklet was assigned. Before and after the intervention, students’ knowledge, attitude and performance scores were evaluated using a standared questionnaire (alpha=0/82). The distribution of quantitative variables was done using the Kolmograph Smirnov test and parametric statistical tests (t_test/pair t_test/one way anova t test) considering the significance level of 0.05.

Comparing the scores of awareness (p=0.993), attitude (p=0.997) and performance (p=0.998) in the intervention groups; there is no significant difference and it means the same effect of two educational methods. Teaching two methods of problem solving – question and answer has no effect on improving students’ short-term attitude (p=0.172) and improving long-term performance scores (p=0.075). The effect of education in the two ways mentioned on improving awareness; Long-term attitude and short-term performance were significant (p<0.05).

e-learning in two ways of problem solving-examination question in increasing the average scores of knowledge; Attitude and performance have been equally effective.

Surgical site infection (SSI) is an infection that occurs within 30 days after surgery and involves the skin and subcutaneous tissue of the surgical incision. It is one of the most common nosocomial infections which, in addition to endangering lives of the patients, increases the heath care expenditures in the health system. The objective of this study was to estimate the cost of surgical site infections in hospitals.

This was a case-control study conducted in a teaching hospital in Kashan, Iran in 2017 to find information about direct hospitalization costs of surgical site infections. Detailed information about the hospiutalization costs of case and control patients was extracted using patient records and the hospital information system software.

Out of all the patients 115 (1.04%) experienced an SSI. The median additional direct medical cost was US$ 2577 and US$ 1034 for the case and control in-patients, respectively (p <0.001). The cost of treating SSI was US$ 1543 per patient. The direct hospitalization costs were 2.5 times greater for patients with an SSI than for those without an SSI.  Further analysis of the data showed that the cost of SSI was related to the patient's age, duration of surgery and length of hospital stay before infection.

Surgical site infection treatment costs imposes high costs  on the patients, health insurance companies and the hospitals. Therefore, hospitals managers should design and implement interventions to reduce surgical site infections.

Acinetobacter baumannii is a gram negative and it is one of the most important and drugresistance infections in hospitals.After Staphylococcus aureus and Pseudomonas aeruginosa, Acinetobacter baumannii is one of the included multidrug resistance infectious bacteria. The aim of this study is to review of pathogenesis and drug-resistance mechanisms in Acinetobacter baumannii.

Methods and Materials:

 International scientific databases including PubMed, Scopus and google scholar were used to review the articles. Out of the 150 articles obtained, only 105 of them with full text have been used in the study. Moreover, articles with abstracts and those received money were excluded from the study.

The rate of drug resistance is growing by examining the scientific papers in most countries of the world. This bacterium gained a specific mechanism of resistance which is a cause of global concern for this organism. Beta-lactamase enzyme producing genes such as OXA, TEM and others are widespread.

In less developed countries, with the indiscriminate use of antibiotics in the society and, in most cases, without the cultivation of pathogenic agents, it causes the emergence and acquisition of resistance genes by the organism. It is recommended that doctors in the hospital request microbial culture from infected samples before treating hospitalized patients in order to prevent resistance as much as possible.

 Increasing antibiotic resistance in most bacteria has led to the development of natural antimicrobial compounds. The purpose of this study was to investigate the disinfection effect of Ajowan essential oil (EO) on the standard strain of Pseudomonas aeruginosa

In this study, the essential oil was prepared by distillation of Ajowan. The components of the essential oil were separated and identified by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS). Then the antibacterial effects of two combinations including Ajowan EO +dimethyl sulfoxide (DMSO) and glutaraldehyde 2% on standard strain of Pseudomonas aeruginosa were evaluated and determined using dilution broth and disk diffusion methods.

The results of the study showed that the most component of the essential oil consist of: Thymol (50%), P-cymene (23.6%), and Terpinen (20.3%). The mean values of MIC in the antibacterial substances (Ajowan EO+DMSO,   Glutaraldehyde 2%) were 83 and 125µg/mL respectively. The mean values of MBC for abovementioned substances were 125 and 166 µg/mL respectively. The mean diameter of the inhibition zone in the MIC concentration was 11and 12.66 mm respectively.

According to the obtained results, Essential oils Ajowan has similar effect of glutaraldehyde 2% on Pseudomonas aeruginosa. It may be a possible substitute to glutaraldehyde in hospital disinfection purposes.

Considering the frequency of MRSA strains in hospitals and medical centers as well as in different communities, it seems necessary and important to observe the use of appropriate drugs in order to reduce antibiotic resistance and reduce the economic costs of treatment. This study aimed to investigate the antibiotic resistance pattern of MRSA isolated from blood and wound samples of patients. The study patients were hospitalized in different departments in a number of Tehran University of Medical Sciences hospitals.

In this descriptive cross-sectional study from September 2021 to February 2022, the blood and wound samples of the patients were collected and referred to laboratory. Staphylococcus aureus had identified by phenotypic and biotypic tests. MRSA isolates were screened by showing resistance to Cefoxitin by disc diffusion method and finally confirmed by examining the mecA gene by PCR. The microbial resistance pattern of MRSA was also measured by disk diffusion method and resistance to Vancomycin was confirmed by E.test.

41 isolates from 87 Staphylococcus aureus samples were confirmed as MRSA by present the mecA gene. The mecA gene was detected in all MRSA by PCR method. The antibiotic resistance pattern showed the highest sensitivity to Vancomycin and Linezolid with 100% sensitivity and the highest resistance to three antibiotics Erythromycin, Ceftriaxone and Cloxacillin with 97.57%by disk diffusion method. The most MRSA strains were isolated from the ICU department with 13 cases and the least MRSA strains were isolated from the two NICU and pediatric departments with one case.The majority of the population infected with MRSA belonged to the age group of 40-65 years.

The prevalence of microbial resistance with high dispersion was obtained among MRSA strains isolated from clinical samples; which indicates a significant increase in resistant strains and requires a quick and timely diagnosis to prescribe the appropriate antibiotic.

Nosocomial infection is a health problem in all countries. Considering the role of midwives in controlling nosocomial infection, the aim of this study was to determine the effect of an educational intervention based on model on preventive behaviors of nosocomial infection by Babol hospitals midwives was done.

The present study was a quasi-experimental study with intervention and control group. The interventions were performed in three 40-minute sessions in the Shahid Yahya Nejad Hospital in April and May 2017. The data collection tool was a structure Health Belief Model based(Awareness, structure Health Belief Model and behavior) on a questionnaire completed Its validity and reliability were assessed two months before and one month after Midwives who met the inclusion criteria education. Data were collected and analyzed by SPSS software v. 24 by Anova , T-test and ANCO one-way Covariance tests.

This research paper has been approved by the ethics committee IR.IAU.TMU.REC.1398.068 and informed consent will be taken from the participants in the study the information will remain confidential.

Before the intervention, the two groups did not differ significantly in terms of, mean scores of different model structures. After intervention, there was a significant difference in the mean and standard deviation of the effect of education on knowledge score (1.0±0.3), perceived sensitivity (2.8±1.5), perceived severity (3.6±1.7) Perceived barriers (-6.4±1.3), perceived benefits (5.1±4), self-efficacy (4.6 ± 2.6) and behavior( 3.1±1.1) was seen in the intervention group (P>0.05).

By increasing the scores obtained from the structures Especially self-efficacy and reduction of perceived barriers, designing and implementing an educational program based on model in midwives can increase their performance regarding the prevention of nosocomial infections.

Nosocomial infections (NIs) during ICU admission may cause morbidity, mortality and hospital readmissions. The aim of this study was to determine risk factors of nosocomial infections in ICUs with an emphasis on preoperative antibiotic prophylaxis.

A retrospective study of NIs was conducted in ICUs of a public hospital in Iran between October 2019 and May 2020. The overall rate of NI, distribution of the infection sites and responsible pathogen and the length of ICU stay as well as the risk factors of NIs were investigated.

The rate of NIs in patients receiving one preoperative antibiotic was much lower than that in patients receiving more than one antibiotics (p<0.001). Long-term pre-operative antibiotic prophylaxis or use of broad spectrum surgical prophylaxis increased the risk of NIs in ICUs.

The results indicated that using of more than one antibiotic as preoperative prophylaxis is associated with higher risk of NIs. Moreover, administration of broad spectrum antibiotics as preoperative prophylaxis increase the risk of NIs in critically ill patients.

Antibiotic resistance of pathogens responsible for nosocomial infections, has been a growing concern for healthcare system in recent decades. The aim of the current study was to identify the strains responsible for nosocomial infections and determine their frequency rates and antimicrobial resistance profiles in the patients admitted to intensive care units of Hazrat-e Rasool General Hospital in Tehran.

In this cross-sectional study we collected 936 blood, urine and sputum samples from the patients who had been admitted to the intensive care units of Hazrat-e Rasool General Hospital in Tehran between March 2020 and March 2021. Determination of strains and frequency rates of pathogens were carried out using multiple specific differential cultures. Then, we detected antibiotic resistance profile of each pathogen by using disc diffusion method.

Acinetobacter (22.5%), Klebsiella pneumoniae (18.7%), Pseudomonas aeruginosa (13.6%), Candida albicans (11.2%) and Escherichia coli (7.2%) were the most common pathogens involved in nosocomial infections in this study. Acinetobacter isolates showed the highest sensitivity to clostin (100%) and cefotaxime (97.2%), respectively, and the highest resistant rate to ampicillin sulbactam (38.9%).

The results of the present study showed that in addition to the diversity of different pathogens in causing nosocomial infections in intensive care units, antibiotic resistance of these pathogens which is on the rise should be regarded important. Results of the current study and other similar periodic studies can provide valuable information for monitoring and management of emerging drug resistant infections.

Surgical site infection (SSI) is one of the most important nosocomial infections that increases costs and mortality. The aim of this study was to evaluate the frequency of infection after surgery in gynecology.

In a cross-sectional descriptive-analytic study, the data of 329 patients who underwent gynecological surgeries at Al-Zahra Hospital in Isfahan in 2019 were included in the study. Data related to age, body mass index (BMI), underlying diseases, urgency of surgery, history of surgery at the same site and number of days of hospitalization before surgery were extracted. Patients were examined for 30 days after surgery. Cases of infection after surgery were diagnosed by a specialist. Data analysis was performed by Chi-square and Independent t-tests.

Among the 329 patients who underwent hysterectomy, salpingo-oophorectomy, tubal ligation and tumor resection in the gynecology ward, a total of 21 patients (6.38%), developed wound infection at the surgical site. The highest and lowest occurrence of infection after surgery occurred in patients undergoing hysterectomy (30%) 99 and tubal ligation 43 (13.06%), respectively. Among patients who underwent hysterectomy, women with a higher mean BMI were significantly more likely to develop postoperative infections.

Emergency operation without administration of prophylaxis antibiotic and obesity increased the frequency of surgical wound infection in gynecological surgeries.