Day 2 :
- Disinfection
Session Introduction
Michael Mark Dalauidao
King’s College Hospital, UK
Title: Establishing a new standard method to assess the effectiveness and improve the environmental cleaning and disinfection in an acute district general hospital
Biography:
Mark is currently working as a Band 8a Modern Matron in Infection Prevention and Control at King’s College hospital NHS Foundation Trust. He is a member of the Scientific programme Committee of the Infection Prevention Society UK. He is also one of the current Regional Board of Director for London Region for the Filipino Nurses Association -UK (FNAUK). The Association was founded on the 2nd July 2020 in the midst of the COVID-19 pandemic to provide a forum for Filipino nurses in the UK to network and discuss issues of collective interest that have an effect on all of us, including signposting individual members to the right place if they have specific issues that need to be addressed. As an IPC Nurse Specialist he was given a once in a lifetime opportunity to contribute in a national level during the COVID 19 pandemic. Together with the other IPC specialists they managed the London Nightingale Hospital during the 1st and 2nd wave of the pandemic.
Abstract:
Introduction:
Environmental cleaning and disinfection is paramount in minimising and preventing hospital acquired infections. One of the most important responsibilities of healthcare facilities is to ensure high standards of the environmental cleaning and disinfection. However, there is a lack of standard process to check and assess cleaning effectiveness.
Methods: A quality improvement model based on Plan Do Study Act (PDSA) Cycle approach was utilised for this project. Process mapping, stakeholder analysis and a driver diagram were undertaken to understand the current practice. A questionnaire was developed for cleaning staff in the hospital in order to understand and establish their current knowledge and practice. This survey helped to identify gaps and establish the focus of the intervention. An invisible fluorescent marker gel was used as the method of assessment in conjunction with the traditional visual inspection, feedback and education. Ten high touch areas around the patient’s bed space were identified where the fluorescent gel was applied and these were checked using a portable ultraviolet light by the author and later on the project he was joined by the zonal managers from the cleaning team at a weekly to twice weekly intervals. The expectation is that the gel must be either partially (at least three quarters of the gel) or completely removed for the surface to be considered clean.
Results: The survey showed that there is a need for further training among the cleaning staff and they feel that their role is not valued in the clinical area, hence morale is quite low. At the initiation of the new assessment method in February 2021, compliance with the cleaning and disinfection standard was 27%. Weekly to twice weekly assessment, education and feedback was commenced. At the end of the implementation phase, the compliance had increased to 91%. In addition, the cleaning staff morale had increased and they now feel more valued and appreciated. This is demonstrated by the improvement in quality of cleaning they have consistently delivered throughout the duration of the project.
Conclusion: The introduction of the fluorescent marker gel and the portable UV light, in conjunction with visual inspection, training and feedback has improved and sustained the quality of environmental cleaning and disinfection.
- HIV Prevention, Treatment and Cure
Session Introduction
Chatuphon Phuwongsa
Bankruat Hospital, Thailand
Title: The Impact of the COVID-19 pandemic and the real-world on Pre-Exposure Prophylaxis (PrEP) in Men Who Have Sex with Men (MSM) in High-Risk HIV groups in Thailand
Biography:
Dr Chatuphon Phuwongsa graduated with a Doctor of Medicine degree with 2nd class honours, currently aged 30, working as a general practitioner at Ban Kruat Hospital, Buriram Province, Thailand, performing duties taking charge of the patient care system both for prevention, surveillance, and treatment of disease, especially during the Covid-19 pandemic. He has worked to help patients receive safe medical services. Previous research, he participated in the AMEE 2014 research paper in Milan Italy on the research topic “Stress, Depression and Psychological factors among Medical Students”. A cross-sectional study at Buriram Medical Education Centre, Institute of Medicine, Suranaree University of Technology.
Abstract:
The Impact of the COVID-19 Pandemic and the Real-World on Pre-Exposure Prophylaxis (PrEP) in Men Who Have Sex with Men (MSM) in High-Risk HIV Groups in Thailand: It performs each type during three evolutionary stages: (1) before the COVID-19 evolution stage (1 January–30 April 2021),
(2) the COVID-19 evolution stage (1 May–30 August 2021), and (3) the plateau phase (1 September– 31 December 2021). Most scrutinized literature was collected from different sources including PubMed. Mixed methods were used in a total of 245 who responded to online questionnaires (Google Form) (100%) and 30 in-depth interviews (In-depth Interview) (100%). The results showed that PrEP was known before the survey 62.04%. The most cited sources of information about PrEP were Internet/Social Media (33.47%). At 42.04% admitted that they had multiple sexual partners during the past year. An average 17.14% had sex without a condom in the last half year, 62.04% had mental health problems in the past, and an average of 51.43% of them had partially disclosed their sexual orientation to the public. The results of the in-depth interviews were 1) gaining knowledge or perceived negatively receiving PrEP services. 2) Understand that HIV prevention is more convenient and cost-effective than PrEP. 3) Use of PrEP is limited by relatively low access to services. 4) Inconvenience of accessing services during each Covid epidemic period VID-19 and 5) restrictions on access to medical services for MSM only. It should be made in order to meet the needs of each time period.
- Infection Control Treatment & Diagnosis
Session Introduction
Luis Martin Moltrasio
Instituto Cordis, Argentina
Title: CIED (Cardiac implantable Electronic Device)-related endocarditis. Diagnostic/treatment algorithm proposal in a limited resources setting
Biography:
Luis Martin Moltrasio has formal training in Intensive Medicine (Residence and head of residents, Hospital Julio C. Perrando, Resistencia, Argentina), Infectious Diseases (fellowship, Hospital Italiano de Buenos Aires). He was head of the Emergency Service and head of the Stroke Unit at Hospital Julio C. Perrando. From 2018 to January 2022 He worked as Head of the Intensive Medicine, Infectious Diseases services and also coordinator of the cardiovascular recovery area of the Cordis Institute, a health facility specialized in cardiac pathology. Since February 2022, He has been in charge of the Cordis Institute's Medical Directorate.
Abstract:
CIED-related endocarditis refers to infection involving the transvenous portion of the lead (with involvement of the contiguous endocardium or tricuspid valve). CIED systemic infection can occur with or without involvement of the generator pocket. Patients with systemic infection generally have positive blood cultures and/or vegetation on TEE. This infection primarily involve the intracardiac portion of the lead and essentially represent a right-sided endocarditis. The approach to evaluation of suspected CIED-related endocarditis is summarized in various algorithms and includes, clinical presentations, blood cultures and echocardiography.
The limitations of TEE for discriminating between infectious lead vegetations and thrombus were demonstrated, infectious and noninfectious echodensities did not differ in their echocardiographic characteristics.
In general, successful management of CIED-related endocarditis requires an antibiotic therapy and explantation of the entire CIED (leads, including residual leads that are non-functional, and pulse generator). For patients with echocardiography demonstrating a valve or lead vegetation, without definitive diagnostic of endocarditis, in general physicians favor presumptive treatment for endocarditis, but antimicrobial treatment up to four weeks without device removal has a very low chance of success and raise antimicrobial resistance. Otherwise device removal without a define endocarditis, in a low resources setting is associated, due our experience, with increased morbimortality.
In many cases with suspected infection, fluorine-18 fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) scanning may be helpful to define, however such diagnostic test, involves transfers of more than one thousand kilometers in our region. Our team have developed an evidence and experience based algorithm to try to resolve these problems in a low resource setting.
Fuxiang Wang
Shenzhen Third People Hospital, China
Title: Young MSM changed HIV-1 epidemic pattern in Northeast China
Biography:
Fuxiang Wang has completed his PhD at the age of 32 years from The Fourth Military Medical University. He is the director of Department of Infectious Diseases,Shenzhen Third People's Hospital, Shenzhen, China. He has published more than 90 papers in journals.
Abstract:
Background: Human immunodeficiency virus type 1 (HIV-1) epidemic in China is featured by geographical diversity of epidemic patterns. Understanding the characteristics of regional HIV epidemic allows carrying out targeted prevention and control measures. However, in some regions of Northeast China, current HIV-1 epidemic feature is largely unknown.
Methods: Information of 1006 newly diagnosed HIV-1 infected participants were collected before antiretroviral therapy during 2010-2016 in Heilongjiang province of Northeast China. HIV-1 genotype was identified based on the viral gag and env gene sequences. Recent infection was determined by Limiting-Antigen Avidity assays and the coreceptor usage of HIV-1 strains was predicted by Geno2Pheno software. Comparison analyses were made among different participant groups and sampling time periods to understand HIV-1 epidemic situation in this region.
Results: Homosexual contact among men who have sex with men (MSM) was the main transmission route and CRF01_AE was the most dominant HIV-1 genotype. Newly diagnosed cases showed a younger trend, which was mainly due to the continuous increase in young cases (aged < 30 years) among MSM population, especially the young MSM infected by CRF01_AE virus. CRF01_AE had surpassesd subtype B and become the dominant HIV-1 genotype among young MSM cases. The young MSM infected by CRF01_AE exhibited higher CD4 cell counts and a higher recent infection rate, and contained viruses with lower frequency of predicted CXCR4/CRR5CXCR4 usage. The MSM participants who were recently infected by CRF01_AE virus had a lower CD4 cell count than those by non_CRF01_AE virus.
Conclusions: Young MSM have become a new vulnerable group for HIV-1 transmission in Northeast China. This group is changing local HIV-1 epidemic pattern. Measures for preventing and controlling HIV-1 infection among this population are urgently needed in the future.
- Nosocomial Infections & Control
Session Introduction
Ogra Marufu
Sidra Medicine, Qatar
Title: Implementing a robust and successful multidrug resistant organisms screening program in a new tertiary pediatric and women’s hospital
Biography:
Ogra Marufu is a holder of MSc Health and Environment from Cranfield University, UK. She is the Manager – Infection Prevention and Control at Sidra Medicine, Qatar. She has published one paper in a peer reviewed journal on C.difficile which has been cited in international guidelines and other artciles. She has co-authored numerous abstracts and presented at international conferences. She is a Forbes Ignite Impact Fellowship Fellow (2021) and worked as part of a team of women from across the globe using artificial intelligence (AI) to develop solutions for healthcare challenges. She has a keen interest in AI and how this can impact infection control.
Abstract:
Multidrug resistant organisms (MDROs) are spreading across the globe in healthcare facilities leading to protracted hospital stays, increased healthcare costs and mortality. Sidra Medicine. a women’s and children hospital, opened in 2018 in Doha, Qatar. It was important to establish a robust MDRO screening programme in order to determine the epidemiology of the MDROs in the population served by the hospital. The goals of the programme are to ensure the early detection of colonised and infected patients on admission to ensure their appropriate managment and prevent outbreaks. The MDRO surveillance programme and risk based screening protocol were developed based on international guidelines. The targeted MDROs are Methicilin resistant Staphylococcus aureus (MRSA), Carbapenemase producing organisms (CPO), Vancomycin resistant Enterococci (VRE) and Candida auris. The decision to target these four was based on the global MDRO epidemiology and on Qatar’s population profile. The Infection Prevention and Control (IPAC) team met with all key stakeholders and agreed on the screening worklows for each clinical division, the practicalities of impelementing the programme and the management of positive patients. This allowed for clear designation of responsibilities. In addition to the admission screening and swabbing of patients, the long stay patients (i.e. those who are inpatient for ≥14 days) are swabbed. The compliance with screening and swabbing is audited every month by the IPAC team and results are shared with the clinical units. The compliance with MDRO admission screening across the clinical units has been sustained ≥90% for the past 12 months.
- Infection Control Bacteriology
Session Introduction
Jibi Thankachan
Tertiary Care Hospital, UK
Title: “Neonatal Sepsisâ€- Gram Positive & Negative Bacteria’s and their Antibiotic Susceptibility in NICU
Biography:
Jibi T has completed his Bachelor Degree in Nursing from Rajiv Gandhi University, India. After completing the studies he has joined one of the prestigious Hospitals based in USA, Columbia Asia from where he completed his basic Training in Infection Control. he had also completed his advanced training in Infection Control From Columbia Asia Bangalore India. Later he took Specialty training in Surgical Site Infection Prevention from ANCC. Since 2011 he works with King Saud Medical City, Riyadh Saudi Arabia as a Specialist/Senior Preventionist of Infection Control.
In 2021 he has completed his Advanced Training in Covid19 Tracing Methodogy from John Hopkins University and also Covid 19 advanced Practices Training from Stanford University Online. He also works a Covid-19 Rapid Response at Central First Health Cluster, MOH, and Riyadh.
Abstract:
Back Ground:
Neonatal sepsis is one of the most common causes of Neonatal Mortality and Morbidity in developing countries. Its causative bacteria’s and their sensitive patterns are different in each hospitals and regions. The objective of the study was to determine the causation bacteria’s and their pattern of susceptibility to antibiotic s in NICU of a tertiary care center.
Material and Methods:
The prospective study was carried out at a tertiary care hospital during the period from January 2020 to January 2021. A total of 1712 blood cultures sent from different sites of the patients in NICU during this period. Out of which 1011 cultures came with positive bacterial growth (Includes gram +ve & -ve, Cons and other Recognized pathogens). All cultures were screened by using a micro ESR & Culture and Sensitivity methods.
Results:
A total of 1011 cultures were found to be positive out of 1712 cultures sent. Out of 1011 positive cultures 450+ are of gram positive organisms and remaining are of positive results with growth. The most common organisms isolated was Staph Epidermidis (68%), followed by Staph Heamolyticus (10%), Staph Hominis(7%), Enterococcus Fecalis(5%). Other Organisms where much less in number which includes Pathogenic Streptococcus, Enterococcus Feacium, Staph Capitis, Bacillus Species etc. There was Incidence of Gram Negative Organisms like E - Coli, Proteus Mirabilis, Serratia Marcescens were also got isolated from Cultures. The Gram Positive Organisms except Streptococcus displayed a high degree of resistance to most Penicillin and Ciprofloxacin and were most time sensitive to Vancomycin, Amikacin and Cefepime. In some cases high incidence of resistance noted with Ampicillin, Gentamicin amongst most Gram Negative Organisms, where in Cefepime, Amikacin and Meropenem were effective in most cases
Conclusion:
There is an increasing trend of antibiotic resistance to the commonly used front line drugs. Continuo’s surveillance for antibiotic susceptibility is needed to ensure proper empirical therapy.
- Disinfection and Sterilization
Session Introduction
Radhika Krishnan Radhakrishnan
Primary Health Care Corporation, Qatar
Title: Implementation of web based mobile application to report hand hygiene compliance among health care workers.
Biography:
Radhika Krishnan Radhakrishnan has completed her master in business administartion – Hospital management , RN , Certified in Infection control . She e is the Infection control cocordinator in Primary health care coorporation under the umbrella of ministry of public health . She initiated many projects in PHCC to standardise and to have secure system in infection control it included digitalisation of hand hygine monitoing systyem as mentioned in abtract , digitalisation of CSSD documents and quality assurance test in 31 HCs.
Abstract:
Yogesh Kumar Gupta
Rukmani Birla Hospital, India
Title: Multidrug Resistant Stenotrophomonas maltophilia - Changing Sensitivity Pattern with Resistance to Trimethoprim-Sulfamethoxazole
Biography:
Dr. Yogesh Kumar Gupta, Microbiology professional with a “MBBS, MD (Microbiology), IDCC”. Over 15 years of professional experience – Lab head, Senior Consultant - Microbiology, Head - Infection Control, Organizing Secretary Antimicrobial Stewardship Committee, Organizing Secretary Biomedical Waste Committee at Rukmani Birla Hospital, Jaipur; Conducted several CME’s on Antimicrobial Stewardship to improve the compliance related to surgical prophylaxis; Conducting lectures in Microbiologist forum specifically for doctors managing ICU’s; Independently conducted 3 consecutive CME cum Certificate Course on Infection Control for doctors and infections control nurses for which he received the credit from Rajasthan State Medical Council; Created Rajasthan State Chapter of Indian Association of Medical Microbiologist and currently holding the Founder Secretary position.
Abstract:
Bckground: Stenotrophomonas maltophilia is a gram-negative bacillus, multidrug resistant opportunistic pathogen, which is normally present in hospital surroundings. It has been one of the leading causes of nosocomial infections due to risk factors such as extended intensive care unit stays and multiple invasive procedures. In this study we wanted to assess the antibiotic sensitivity pattern with various antimicrobial agents i.e. levofloxacin, minocycline, ceftazidime, chloramphenicol, & ticarcillin-clavulanic acid with special focus on trimethoprim-sulfamethoxazole.
Methods: In vitro analysis was conducted on 164 Stenotrophomonas maltophilia strains isolated from blood and respiratory tract from January 2016 to November 2020. Antibiotic susceptibility and minimum inhibitory concentration testing for trimethoprim-sulfamethoxazole, levofloxacin, ticarcillin - clavulanic acid, and minocycline were performed using Vitek 2, as per clinical and laboratory standards institute guideline.
Results: A total of 164 S. maltophilia were isolated. Out of the 164 S. maltophilia isolates, 26 (16 %) were isolated from blood, 114 (70 %) were isolated from respiratory samples, 20 (12 %) from pus & tissue, and 4 (2 %) from urine. Out of the 164 patients, 130 (80 %) were males and 32 (20 %) were females. Maximum patients were above 50 years of age 93 (56 %) followed by 20 - 50 years 55 (34 %). Out of the 164 patients, 67 (40 %) were admitted to wards, 92 (56 %) were in ICU and 5 (3 %) were seen in OPD. A total of 90 % strains were sensitive to trimethoprim-sulfamethoxazole . Total 91 % strains were sensitive to levofloxacin.
Conclusions: S. maltophilia is emerging as a significant nosocomial pathogen, with a growing rate of isolation. Trimethoprim- sulfamethoxazole is still the drug of choice, but resistance to it has been reported.
- Infection Control Bacteriology
Session Introduction
Amani Hashim Yousif
Kau Midical Servec Center, Saudi Arabia
Title: Efficiency of Adherence to Safety practices and protocols in protection during handling ofcovid_19 samples in the laboratories 2020 Higher Diploma of Quality and Medical Laboratory Management
Biography:
Amani Hashim Yousif, Kau Midical Servec Center, Saudi Arabia
Abstract:
Background: Coronaviruses are large group of viruses that can cause disease in animals and humans. This virus emerged in the Chinese city of Wuhan in 2019. Corona virus can cause mild respiratory infection, like common cold, but can lead to serious illnesses, like pneumonia. Due to the severity of this disease most of people applied the safety precautions, particularly health care workers.
Aim: According to CDC and OSHA standard the study aimed to detect if the safety practices applied in side laboratories according to OSHA and CDC standard, can provide a good protection for laboratory workers from covid_1
Material and Method: To find out, the researcher prepared a close- ended questionnaire depending on Likert scale and containing various questions about safety practices should be applied in side laboratories to avoid incidence of infection with corona. After that the questionnaire was distributed to twenty laboratory technologists from different laboratories, eleven of them from Makkah region (Kingdom of Saudi Arabia) and nine from AL- Doha (Qatar).
Result: The most important result was 85% of laboratory workers protected themselves form infection with covid_19 after applying most of appropriate safety practice when manipulating of corona virus samples and there was 14.3% infected with corona virus, suggesting that the adherence to safety practice in side laboratories is very importance to give good protection against covid_19 infection.
Conclusion: The study showed obviously, there is a strong relationship between the adherence of laboratory employee to safety precautions and the incidence of infection.
Key word s: Covid-19, sars_cov_2, PPE, N95 respirator, BSC, CDC, OSHA, safety practices.
- Pediatric Infectious Diseases
Session Introduction
Fahad AL Jarboa
King Abdulaziz Medical City, Saudi Arabia
Title: Brucellosis in a 12-Year-Old Boy in Saudi Arabia: A Case Report for Literature Review
Biography:
Fahad Al Jarboa has completed his MBBS at 1997 at King Fasial College, Medical Scool, Al Khobar, Saudi Arabia. Then he finished his Arab Board and Saudi Board for Pediatric at 2003.Now he is working as Consultant Pediatrician Ambulatory Care.
Abstract:
Brucellosis is a type of an infection caused by bacteria that affects humans and animals and usually affects the former by drinking unpasteurized milk. This study deals with a clinical case of human Brucellosis. Sudden onset of left hip pain with no history of past trauma, recent URTI, or any other abnormal symptom was examined, and left joint effusion was found. On further investigation, ESR was determined to be 41, and high levels of antibody against Brucella were revealed after the serum agglutination test. Methods to prevent the prevalence of this disease by implementing various measures and creating awareness have also been made.
- Infection Control Business
Session Introduction
Jessica Dangles
Executive Director, Certification Board of Infection Control and Epidemiology, USA
Title: Certification options for the infection prevention and control professional
Biography:
Jessica Dangles, MBA, MS, PMP is the Executive Director of the Certification Board of Infection Control and Epidemiology (CBIC). Ms. Dangles holds a Master of Business Administration from the University of Illinois and a Master of Science in Human Resources from Loyola University Chicago.
Abstract:
The Certification Board of Infection Control and Epidemiology (CBIC) is a voluntary, autonomous, multidisciplinary board that provides direction for and administers the certification process for professionals in infection control and applied epidemiology. CBIC was founded in 1981 and is the largest certifying body for infection prevention and control professionals in the world. CBIC has certified over 9,000 infection prevention and control professionals worldwide. CBIC offers the Certification in Infection Prevention and Control (CIC) credential. The CIC credential is internationally recognized as the standard for infection prevention and control certification and has certified individuals in over 45 countries. Additionally, CBIC offers the associate-infection prevention and control certification, an entry-level certification in infection prevention and control. This certification is designed for the novice IPC professional and for those interested in pursuing careers in infection prevention and control. In 2023, CBIC developed the long-term care certification in infection prevention and control (LTC-CIP). Certification opens new job opportunities, as many healthcare employers require certification for certain positions or prefer certified individuals. Obtaining certification in infection prevention and control yields numerous benefits, including expanded knowledge and skills, increased job opportunities, heightened patient safety, facilitated professional development, and enhanced credibility and recognition.
- Emerging Infectious Diseases
Session Introduction
Sarafraz Ahmad Kasana
Govt Medical College , India
Title: Clinical profile, cardiac involvement and immediate outcome of children admitted with multisystem inflammatory syndrome (mis-c) in picu at gb pant children hospital Srinagar, India
Biography:
Sarafraz Ahmad Kasana, Govt Medical College , India
Abstract:
Introduction:-Multisystem inflammatory syndrome in children (MIS-C) is a severe hyper inflammatory post infectious complication of acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, which typically occurs 2–6 weeks after exposure to SARS-CoV-2. Although the exact pathophysiology of MIS-C is uncertain, it is thought to be due to immune dysregulation occurring after recovery from acute infection.
Aims:-To determine the clinical profile, cardiac involvement and outcome of children admitted with multisystem inflammatory syndrome in pediatric intensive care unit.
Materials and Methods:-This Prospective observational study was conducted in pediatric intensive care unit over a period of two years. After informed consent from parents, all those patients meeting inclusion criteria were subjected to complete history, General and Systemic Physical Examination. Routine baseline investigations included CBC, LFT, KFT, ABG, Serum calcium and phosphorous, and other investigations like echocardiography, troponin-t, COVID-19 RAT and RTPCR and various inflammatory markers like serum ferritin, pro-calcitonin, CRP and ESR ,whenever required ,were done.
Results:- A total of 77 MIS-C patients, who met inclusion criteria were included in this study. It included 40 males and 37 females with an average age of 7.4 years and a male female ratio of 1.1:1.Out of them 47 (61%) patients had a history of covid-19 infection / contact with positive covid-19 cases 3 to 4 weeks before presentation. On echocardiography out of 77 MIS-C patients, 15 (19.5%) had pericardial effusion ranging from mild to massive , 25 (32.5%) had coronary artery dilatations and 32 patients (41.5%) had left ventricular systolic dysfunction with LVEF <55%. 12 (15.5%) patients had mild LV dysfunction (EF= 41 -55%), 16 [20.8%] patients had moderate LV dysfunction (EF=31-40) and 4 [5.2%] patients had severe LV dysfunction (EF ≤30). Coronary arteries were normal in 52 [67.5%] patients and LVEF function was normal in 45 [58.5%] patients. 7 ( 9.1%) patients expired during hospitalization.
Conclusion:-Pediatric multisystem inflammatory syndrome associated with SARS-COV-9 led to serious and life threatening illnesses which had a significant impact on morbidity and mortality in children .
Key Words:- Multisystem inflammatory syndrome, COVID-19, Cardiac abnormalities, Shock.