Journal of North Khorasan

Abstract Background and Objective: Premature neonates, low birth weigth neonates weighing less than 2 kg or neonates with severe health problems kept at N.I.C.U are highly at risk of contracting nosocomial infections, in particular septicemia. Therefore, we decided to investigate the prevalence of bacteria in this ward. Materials and Method: In this descriptive cross-sectional study, 100 hospitalized neonate in-patients in NICU were studied. Samples were taken from five parts of the neonates' body (rectum, skin, nose, pharynx and umbilicus) in three turns for microbiological analysis in the laboratory. Blood samples were also taken from neonates hospitalized with blood infection for microbiological analysis. Results: Results of this study showed the bacteria identified in different parts of the neonate΄s body were Staphylococcus epidermidis, Klebsiella pneumonia and Escherichia coli in the amount of 484, 243 and 191 respectively. Also, 7 cases of septicemia caused by Staphylococcus epidermidis, Klebsiella pneumonia and Escherichia coli were observed, the number of cases being 4, 2 and 1 respectively. Conclusion: As the results of this research shows Staphylococcus epidermidis, Klebsiella pneumonia, Escherichia coli and Staphylococcus saprophyticus are the main cause of microbial colonization and septicemia in the neonates.

Abstract Background & Objectives: As one of the most vital sections in every hospital, the Neonatal Intensive Care Unit (NICU) is where controlling nosocomial infections play an important role in recovery and health improvement of patients. In the present study, effort has been made to find out the Sources of bacteria causing nosocomial infections in order to prevent nosocomial infections in NICU. Material & Methods: In this cross-sectional research, the involving bacteria were identified by collecting samples from hands and nipples of 50 mothers who regularly came in NICU to visit and breastfeed their babies. In addition, samples were collected from hands of 50 hospital staff, breast milk from 50 mothers, airstream in HVAC system, and 50 of the medical equipments available at NICU. Results: This study indicated that in respect of frequency, coagulase-negative staphylococci, Klebsiella pneumonia, and Escherichia coli were the main bacteria isolated from mothers’ hands and nipples, hands of the staff, feeding bottles and breast milk samples. As for the airstream in HVAC system, however, no types of bacteria were observed. Conclusion: Coagulase-negative Staphylococci and Klebsiella pneumonia are the most widespread colonized bacteria causing nosocomial infections such as neonatal sepsis in NICU. Having isolated the highest amount of Coagulase-negative staphylococci and Klebsiella pneumonia, the present study revealed that hands and nipples of the mothers, hands of the staff, feeding milk bottles and the containing breast milk are among the major Sources of bacteria causing nosocomial infections at NICU. With regard to the cultured samples of the airstream in HVAC system, there existed no types of bacteria therefore, it could not have been a Sources of bacteria at NICU.

Abstract Background & Objectives:One of the members of the health care team whose role is critical in control of nosocomial infection is nurse. For this reason, proper scientific information from a variety of nosocomial infections and their prevention methods are necessary. So we evaluated the knowledge, attitude and practice of intensive care units nurses in North Khorasan province. Methods:The study was a descriptive – analytic which included all the nurses in intensive care units in North Khorasan Province. 60 nurses working in ICU units were selected as samples. The data collection tool was a self-made questionnaire to assess knowledge and attitude and also included a behavioral check list. Results:Findings showed that 87.7% of nurses had low knowledge and the average attitude towards nosocomial infections control was 24.4%. 78% of nurses had low practice to control nosocomial infections. There was not a statistically significant relationship between knowledge, attitude, and practice and demographic characteristics of samples (P>0.05). Conclusion:Considering the low level of knowledge, attitude and practice of most nurses, paying more attention by authorities to this specific topic is essential in order to apply the necessary actions for training of nurses.

Abstract Background & Objectives: Nosocomial infections have increasingly resulted in death and the patients should bear high treating costs. Members of the medical team could play an important role in prevention and control of nosocomial infections. This research has been done to determine the knowledge, attitude, and practice personnel about Nosocomial Infections Control and ways to protect against them in Teaching Hospitals of Bojnurd year 1391 Material and method: In this descriptive research, 140 Members of the medical team working in three hospitals in bojnurd were selected as samples. The data collection tool was a self-made questionnaire to assess knowledge and attitude and also included a behavioral check list. Content validity was established. Reliability was examined by test-retest (for knowledge and attitude section) and split-half technique (for practice section). Results: Findings showed that 63.6% of Members of the medical team had average knowledge and 65 % had positive attitude towards nosocomial infections control. About half of Members of the medical team (55.7%) had moderate practice to control nosocomial infections. There was not a statistically significant relationship between knowledge, attitude, and practice of samples (P>0.05). Conclusions: Considering the average level of knowledge and practice of most Members of the medical team, paying more attention by authorities to this specific topic is essential in order to apply the necessary actions for training of the medical team.

Abstract Background & Objectives: In this study we attempted to search important sources of Aspergillus spores and Candida elements in hospitals indoor spaces using two identification methods of morphology and molecular. Material & Methods: From February 2008 to September 2009, total of 198 clinical and environmental specimens were collected from two Iranian training educational hospitals of Urmia. Clinical specimens included bronchoalveolar lavage, sputum, sinus discharge and urine. Also 111 environmental specimens including air samples and surface swabs were obtained from the rooms where our cases were hospitalized. All specimens were tested for Aspergillus and Candida species. The Identification of isolated fungi was confirmed using PCR-RFLP method. Results: Totally 93 (47%) clinical specimens were positive for fungal or bacterial infections. 54 (58%) fungi isolated from clinical specimens included 36 (66.6%) Candida spp., 17(31.4%) Aspergillus spp and also only other one fungal saprophytic agent. Environmental isolates were included Candida spp., 35 (31.5%), Aspergillus spp., 48 (43.2%) and other saprophytic fungi, 28 (25.3%). Conclusions: Our findings of PCR-RFLP on rDNA gene of Candida and Aspergillus isolates showed a similarity between some environmental isolates and the relevant clinical isolates but use of method RAPD–PCR confirmed only 20-40% similarity with two of 5 random primers for some clinical isolates and related environments. We conclude that fungal contamination of the hospital indoor environments maybe important factor for the hospital acquired fungal infections.

Abstract Background & Objectives: One of the ways to control nosocomial infection is to identify the disease transmission tool, and to determine the infection transmitted through the tool. The aim of this study was to determine the prevalence, type and severity laryngoscope pollution blades for 4 months in treatment wards of Musabne Jafar (AS) hospital Quchan in 2000. Material & Methods: This was a descriptive study in which 104 laryngoscope blades were randomly selected from all the blades disinfected during the four months. Sampling was done with sterile swab samples. In case of bacterial growth and production of colonies, slide preparation and the type of bacteria and bacterial growth was studied. Statistical data were analyzed by SPSS 17 software and used descriptive statistical tests. Results: The results show that the 52.9% (n=55) was infected. Most types of microbial contamination associated with coagulase negative staphylococcus strains with 36.4% (n=20) and the least polluting type associated with enterococci 9.1% (n=5). Comparing the intensity of the treatment units showed the most is relevant to the operating room and the lowest in pediatrics and surgery in men. Conclusion: General principles and methods are common in washing and disinfecting the laryngoscope blades that are acceptable. But the observance of detail and fastidious cleaning and disinfection procedures by the people in different sectors are not approved and not verifiable, that requires more training and the committee of infection control must strict.