Scholarly article on topic 'Assessment of infection control knowledge and compliance among health workers in government and primary health care facilities in Esan North East LGA, Edo State, Nigeria'

Assessment of infection control knowledge and compliance among health workers in government and primary health care facilities in Esan North East LGA, Edo State, Nigeria Academic research paper on "Health sciences"

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Academic research paper on topic "Assessment of infection control knowledge and compliance among health workers in government and primary health care facilities in Esan North East LGA, Edo State, Nigeria"


16th ¡CID Abstracts/International Journal of Infectious Diseases 2IS (2014) 1-460

Methods & Materials: For the duration of one year, all patients who had been hospitalised abroad in the two months prior to visiting our hospital were screened for carriage with MDRO according to national guidelines. We determined associations between MDRO carriage and demographic characteristics, region and country of hospitalisation abroad, and type of intervention abroad.

Results: Between July 2012 and July 2013, 194 patients had been hospitalised abroad; screening results were available for 148 patients. Nineteen patients carried a MDRO (12.8%; 95% CI 8.119.0%): 3 MRSA and 16 multidrug resistant gram negative bacteria, including Acinetobacter baumannii XMR, Klebsiella pneumoniae Oxa 48, and ESBL positive bacteria. Risk factor analysis showed MDRO carriage was highest in patients who were hospitalized in Asia or the Middle East (7/35; 20.0%) and Southern or Eastern Europe (4/24; 16,4%) and lowest in patients hospitalised in western European countries. Twenty-four percent of the outpatients were hospitalized within three months of outpatient visit; among them were 6 MDRO carriers. Risk factor analysis of type of intervention abroad is awaiting.

Conclusion: This study shows that the risk of MDRO carriage depends on the country of hospitalisation, which probably reflects geographical differences in MDRO prevalence. Determining the risk associated with type of intervention abroad (e.g. invasive vs. non-invasive, or admission to an intensive care unit) will be of additional value. To prevent hospital transmission of MDRO in low- and middle-income countries, targeted MDRO screening maybe a feasible and cost-effective strategy if patients transferred from countries or settings with higher endemic MDRO levels are admitted. In high resource settings patients visiting the outpatient department should also be considered as target population for MDRO screening. Type: Poster Presentation

Final Abstract Number: 61.021

Session: Infection Control, Nosocomial Infections and Critical Care Date: Saturday, April 5,2014 Time: 12:45-14:15 Room: Ballroom


A Risk assessment and safe practices study at Tygerberg Hospital, November 2013

J.M.V. Namahoro

Stellenbosch University, Cape Town, South Africa

Background: The outbreak and increasing of healthcare associated infection were reported since last year and up to now at Tygerberg Hospital. However, the healthcare workers hands are the most common vehicle for the transmission of healthcare-associated pathogens from patients and within the healthcare environment.

A risk assessment approach was used to understand a risk of infection transmission in six wards.

Methods & Materials: A Descriptive study design and structured audit form were used to collect the data from six wards. The wards were randomly selected and study start from 9 September to 8 November 2013.

Results: Infection Prevention and Control (IPC) best practice measured according the IPC standard the overall marks were 86% of good IPC practices from six wards. The highest score of good IPC practices was found in A5 Intensive Care Unit and lowest score in C2A gynecology ward. The most common risk of infection trans-

mission were: patient toilets, linen management, sluice area and intravenous-care.

Conclusion: The risk factors of infection transmission were identified and the results revealed compliant of good IPC practice. However, some improvement should be made for intravenous-care, at sluice area, patient toilet and linen management in purpose to reduce risk infection transmission at lowest level. Type: Poster Presentation

Final Abstract Number: 61.022

Session: Infection Control, Nosocomial Infections and Critical Care Date: Saturday, April 5, 2014 Time: 12:45-14:15 Room: Ballroom

Assessment of infection control knowledge and compliance among health workers in government and primary health care facilities in Esan North East LGA, Edo State, Nigeria

E.A. Tobin1-*, D. Asogun2, M. Ekomoezor3, S. Gunther4

1 Irrua Specialist Teaching Hospital, Irrua, Nigeria

2 Irrua Specialist Teaching Hospital, Irrua, Edo, Nigeria


4 Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany

Background: Nosocomial transmission of emerging diseases, such as Lassa fever, can be prevented even in resource poor settings by strict adherence to infection control standards. The study sought to assess the knowledge, attitude and compliance with infection control among health workers in Primary and Secondary health care facilities in Esan North East Local Government Area of Edo State, Nigeria.

Methods & Materials: The descriptive cross sectional study was carried out in 2013, in fourteen Primary health centres and one Government hospital in the LGA. One Hundred and fifty three consenting health workers comprising Doctors, Nurses, Laboratories Scientist, Community health workers and Health Assistance were interviewed using structured pre-tested questionnaires. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) version 16. Knowledge, attitude and practice were graded as good, fair and poor. Results were presented as tables and charts; and associations tested with Chi-square test, with p set as<0.05. Ethical clearance was obtained from the Ethical review board of the Teaching hospital.

Results: Ninety one (59.6%) respondents had good knowledge of infection control. Knowledge was significantly associated with profession as doctor (p = 0.00), being of female gender (p = 0.03), and duration of work >10 years (p = 0.00). Fifty four (25.3%) respondents were assessed to have good practice, and 26 (17.0%) poor practice. Practice was significantly associated with age > 50 years (p = 0.00), being of male gender (p = 0.03), duration of service >10 years (p = 0.00) and being a doctor (p = 0.00). Good compliance with infection control was significantly associated with good knowledge (p = 0.00).

Conclusion: There is need to develop a system of continuing medical education on infection control in government owned health facilities, that will target all categories of health providers,

16th ICID Abstracts/International Journal of Infectious Diseases 2IS (2014) 1-460

focus on identified gaps in knowledge, and laying emphasis on compliance. Type: Poster Presentation

Final Abstract Number: 61.023

Session: Infection Control, Nosocomial Infections and Critical Care Date: Saturday, April 5,2014 Time: 12:45-14:15 Room: Ballroom


Clonal lineages of resistant (HLAR) & virulent Enterococcus faecalis isolates from diverse sources in Nigeria

B. Ghebremedhin1-*, A. Ibukun2, T. Odugbemi3, W. König2

1 University Witten, Med. Microbiology & Lab.Medicine, Wuppertal, Germany

2 Medical Microbiology, Magdeburg, Germany

3 Medical Microbiology and Parasitology, Lagos, Nigeria

Background: Enterococci are the leading cause of nosocomial infections, and therefore a persisting clinical problem globally. This study was undertaken to compare the virulence and the high-level resistance towards aminoglycosides (HLAR) in E. faecalis of different sources: human, animals and environmental specimens

Methods & Materials: We investigated from in 1-yr-period in 2009 106 isolates of Enterococcus faecalis various human clinical specimens (45), stool samples of healthy animals: pigs (23), chicken (21), cattle (10) and a major recreation water body in Lagos (7 isolates). Identification and susceptibility testing was carried out using the automated V1TEK-2 system. Multiplex PCR was used to investigate the presence of 6 high level aminoglycoside resistance genes (aac(6')-Ie-aph(2")-la, aph (2")-Ib, aph(2")-Ic, aph(2")-Id, aph(3")-IlIa, ant(4')-Ia) and seven putative virulence genes (esp, cyl, gelE, hyl, ace, efaA, asal). Multilocus sequence typing (MLST) scheme was used to analyse the clonality of the isolates.

Results: Only 3 isolates (pig, cattle and water isolate), had intermediate resistance to vancomycin and no acquired vancomycin resistance gene was detected. HLAR to gentamicin was observed in 46.7% of clinical isolates and 13.7% of animal isolates (chicken) and was accompanied by high level resistance to kanamycin, encoding of the aac(6' )-Ie-aph(2")-1a gene and resistance to ciprofloxacin with mutation in the gyrA (Gly105-Asp). Isolates with HLAR to Streptomycin harboured the aph(3")-IIIa gene. Mobile genetic elements Tn916 was observed to be highly associated with the HLAR. MLST analysis revealed that 33.3% of HLAR isolates were ST6 belonging to clonal lineage CC2 and 25% were ST116. Other STs determined included ST40, ST28 and ST16. The virulence genes esp and hyl occurred only in clinical isolates (6.4% and 2.1%) while cyl was found in both clinical (8.5%) and animals (2%) isolates.

Conclusion: The spread of the aac(6' )-Ie-aph(2")-Ia and aph(3")-IIIa gene is responsible for high-level resistance to aminoglycosides among E. faecalis isolated from South-western region of Nigeria. Animal isolates belonged to ST116 whereas human isolates were mostly typed as ST6. Early detection of HLAR along with their virulence trait will help in preventing the establishment and spread of multidrug resistant E. faecalis in hospital setting and in the community.

Type: Poster Presentation

Final Abstract Number: 61.024

Session: Infection Control, Nosocomial Infections and Critical Care Date: Saturday, April 5,2014 Time: 12:45-14:15 Room: Ballroom


Diphtheria immunity and serologic response after Td booster vaccination in Thai health care workers

S. Wiboonchutikul1-*, W. Manosuthi1, C. Sangsajja1, V. Thientong1, S. Likanonsakul1, S. Srisopha1, P. Termvises1, J. Rujitip1, S. Loiusirirotchanakul2, P. Puthavathana2

1 Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand

2 Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Background: Diphtheria remains circulate in many countries including Thailand. Health care workers (HCWs) are at risk to diphtheria exposure. No routine diphtheria-tetanus toxoid (Td) booster vaccination program for adults in Thailand. We aimed to assess baseline immunity against diphtheria among Thai HCWs and define factors associated with immune protection to diphtheria. Immuno-logic response as well as safety to Td booster vaccination was also evaluated.

Methods & Materials: A prospective study was conducted among HCWs during March-September 2013 at Bamrasnaradura Infectious Diseases Institute, Thailand. The prevalence and factors associated of seroprotection to diphtheria (diphtheria antibody levels >0.1 lU/ml) as measured by a toxoid enzyme-linked immunosorbent assay were determined. Seroprotection rate and diphtheria antibody level at pre- and post- vaccination were also compared.

Results: There were 250 HCWs with mean (±SD) age of 35.4 (±11.7) years and 76.4% of participants were females. By staff position categories, 62.0% were clinical staffs, 34.8% were non-clinical ancillary staffs and 3.2% were laboratory staffs. 72.4% had a history of adult diphtheria and/or tetanus booster vaccination before enrollment but only 30.4% were Td. A protective antibody was found in 89.2% of HCWs prior receiving Td booster vaccination, comparing to 98.4% after receiving first dose booster (p <0.001). 100% of seroprotection was achieved after the second Td booster administration. The mean antibody level to diphtheria (95% Cl) before and after first dose Td booster vaccination were 0.39 (0.350.44) and 1.20 (1.12-1.29), respectively (p <0.001). Multivariate analysis showed only history of receiving adult Td booster vaccination was significantly associated with immune protection to diphtheria at baseline (odds ratio 5.39; 95% confidence interval 1.08-26.80; p= 0.040). No serious adverse event or hospitalization was observed after vaccination.

Conclusion: Thai HCWs may be at risk to acquire diphtheria infection. Td vaccine is safe and booster vaccination for Thai HCWs should be recommended. Routine Td booster vaccination program in Thai HCWs should be considered by local or public health administration.