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1. Forum for Injection Technique 2.0 Addendum 1: Insulin use in indoor settings

Author

Sanjay Kalra, Hemraj B Chandalia, Manoj Chawla, Nita Munshi, Aruna Poojary, Ami Varaiya, Prajakta Hindlekar, Mugdha Lad, Valsa Thomas, Neha Karle, and A G Unnikrishnan

Subjects
Hospital, insulin, insulin disposal, intravenous insulin, nursing care, subcutaneous insulin, Diseases of the endocrine glands. Clinical endocrinology, RC648-665, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Insulin is a frequently used drug in the indoor setting. Comprehensive recommendations for best practice in insulin injection technique have been published by the forum for injection technique (FIT), India. This addendum focuses on insulin use in indoor settings, and complements the FIT 2.0 recommendations. It discusses insulin use and disposal in critical care and noncritical care settings. It also highlights the need to ensure continuing nursing and medical education, and frame insulin policies for such use.

Published
2016
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2. Using first-contact serum ferritin to predict severe thrombocytopenia in dengue patients: determination and validation in independent cohorts

Author

Abhijit Lodha, Ashwin Pillai, Pavan Reddy, and Nita Munshi

Subjects
Cohort Studies, Dengue, Microbiology (medical), Infectious Diseases, General Immunology and Microbiology, Ferritins, Humans, General Medicine, Thrombocytopenia, Biomarkers
Abstract

Severe thrombocytopenia and associated haemorrhage are dreaded complications of dengue fever. The identification of a biomarker that can predict, or rule out, its subsequent development can help identify at-risk individuals.200 dengue patients were included - the first 100 in the deterministic cohort and the latter, the validation cohort. Serum ferritin levels were measured at first presentation. Platelets were monitored serially. Data from the first cohort was used to determine the optimal ferritin level to predict significant thrombocytopenia (20,000/µL). This threshold was validated in the second cohort.In the deterministic cohort, a ferritin threshold of 593 ng/mL predicted severe thrombocytopenia with a sensitivity of 93.33%, negative predictive value of 98.18% and negative likelihood ratio (LR-) of 0.10. In the validation cohort, the sensitivity and negative predictive value of this threshold were both 100%. The power of the study (determined post-hoc) for each cohort was 98.4% and 86.4% respectively.First-contact ferritin consistently identified at-risk individuals. Individuals with ferritin levels below 593 ng/mL were unlikely to develop severe thrombocytopenia independent of clinical presentation.

Published
2022

3. In vitro activity of Ceftazidime-Avibactam and its comparators against Carbapenem resistant Enterobacterales collected across India: results from ATLAS surveillance 2018 to 2019

Author

Yamuna Devi Bakthavatchalam, Abhisek Routray, Akshata Mane, Shweta Kamat, Anu Gupta, Anurag Kumar Bari, Anusha Rohit, Aruna Poojary, Dip Narayan Mukherjee, Nandini Sethuraman, Nita Munshi, Sweta Shah, Veeraraghavan Balaji, and Yogesh Gupta

Subjects
Microbiology (medical), Drug Combinations, Klebsiella pneumoniae, Infectious Diseases, Carbapenems, Escherichia coli, Humans, General Medicine, Microbial Sensitivity Tests, Azabicyclo Compounds, Ceftazidime, beta-Lactamases, Anti-Bacterial Agents
Abstract

ATLAS (Antimicrobial Testing Leadership and Surveillance) detects trends in multi-drug resistance longitudinally over time. In the present study, the in vitro activity of ceftazidime-avibactam and comparators was analyzed against Escherichia coli (n = 458) and Klebsiella pneumoniae (n = 455) isolates obtained from 9 centers across India. The overall susceptibility to ceftazidime-avibactam was observed to be 72% among K. pneumoniae isolates and 87% among E. coli isolates. Among the tested carbapenem resistant isolates, 51% of CR-K. pneumoniae and 24% of CR-E. coli were susceptible to ceftazidime- avibactam. OXA-48 like was identified in 52% of the K. pneumoniae isolates followed by co-production of NDM with OXA-48 like in 27%. NDM was predominantly identified in 68% of the E. coli isolates followed by OXA-48 like in 24% isolates. The findings suggest that ceftazidime- avibactam is a reasonable alternative to standard therapy for management of carbapenem resistant Enterobacterales infections particularly with K. pneumoniae and E. coli with the OXA-48 like genotype.

Published
2021

4. Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Preethi Pinto, Iqbal Bagasrawala, Tanu Singhal, Sohini Arora, Reshma Naik, Aliasgar Moiyadi, Sanjay Biswas, Pravin Kumar-Nair, Sulochana Sampat, Neelakshi Kumari, Asmita Kamble, Nita Munshi, Sweta Shah, Shailesh V. Shrikhande, Bishnu Panigrahi, Sheila Nainan Myatra, Bindu Sharma, Rohini Kelkar, Victor D. Rosenthal, Jigeeshu V Divatia, Sheena Binu, B.N. Gokul, Sanjeev Sood, Arpita Dwivedy, Angelina Mendonca, Neeru Verma, D.K. Khanna, Ashish Gulia, Sanjeev Singh, Suvin Shetty, Leema Pushparaj, Murali Chakravarthy, Kavitha Radhakrishnan, Ajay Puri, R. Sukanya, Felcy Chacko, Vatsal Kothari, Sandhya Raut, and C.S. Pramesh

Subjects
medicine.medical_specialty, Health (social science), Urban Population, Breast surgery, medicine.medical_treatment, India, Coronary artery bypass surgery, Internal medicine, Epidemiology, medicine, Humans, Surgical Wound Infection, Prospective Studies, Cross Infection, Infection Control, business.industry, Public Health, Environmental and Occupational Health, General Medicine, Targeted interventions, Nosocomial infection control, Hospitals, Surgery, Cardiac surgery, Female, business, Surgical site infection, Abdominal surgery
Abstract

Surgical site infections are a threat to patient safety. However, in India, data on their rates stratified by surgical procedure are not available.From January 2005 to December 2011, the International Nosocomial Infection Control Consortium (INICC) conducted a cohort prospective surveillance study on surgical site infections in 10 hospitals in 6 Indian cities. CDC National Healthcare Safety Network (CDC-NHSN) methods were applied and surgical procedures were classified into 11 types, according to the ninth edition of the International Classification of Diseases.We documented 1189 surgical site infections, associated with 28 340 surgical procedures (4.2%; 95% CI: 4.0-4.4). Surgical site infections rates were compared with INICC and CDC-NHSN reports, respectively: 4.3% for coronary bypass with chest and donor incision (4.5% vs 2.9%); 8.3% for breast surgery (1.7% vs 2.3%); 6.5% for cardiac surgery (5.6% vs 1.3%); 6.0% for exploratory abdominal surgery (4.1% vs 2.0%), among others.In most types of surgical procedures, surgical site infections rates were higher than those reported by the CDC-NHSN, but similar to INICC. This study is an important advancement towards the knowledge of surgical site infections epidemiology in the participating Indian hospitals that will allow us to introduce targeted interventions.

Published
2014

5. Epidemiology of sharp injuries – Prospective EPINet data from five tertiary care hospitals in India – Data for 144 cumulated months, 1.5 million inpatient days

Author

Daisy Mathew, Sohini Arora, Sanjeev Singh, Sukanya Rangaswamy, Janu Rajagopal, Fini K Joseph, Ravneet Kaur, Anita Arora, Neelakshi Kumari, Nita Munshi, Leema Pushparaj, Murali Chakravarthy, Zipporah Meritta, Asmita Kamble, Sharmila Sengupta, and Anupama Nair

Subjects
Microbiology (medical), medicine.medical_specialty, Pediatrics, Epidemiology, business.industry, Public Health, Environmental and Occupational Health, Prospective data, Tertiary care, Infectious Diseases, Health care, Emergency medicine, medicine, business, Waste disposal
Abstract

Aims Sharp injuries (SIs) jeopardize the safety of healthcare workers and are avoidable. This prospective multi-centric study aimed at understanding the epidemiology of sharp injuries in India. This study comes as a sequel to our earlier study, conducted at the same hospitals. Methods The cumulated prospective data of 144 months collected from five participating hospitals during the years 2008–2013 and analysed using the EPINet format. Results During the study period of 2008–2013, there were more than 1.5 million inpatient (IP) days, and 666 SIs (0.43 SIs/1000 IP days) were observed. The data from June 2008 through May 2009 was named data A and from June 2009 through June 2011 as data B. The data in its entirety and the comparison of data A and B was made. The cumulated data showed that the SIs in the patient's room decreased from 0.9 to 0.2 SIs/1000 IP days (27.8%–14.3%). This observation was made in the data from all the participating hospitals; possibly due to providing sharps disposal cans by patient bedside, in addition to aforementioned awareness and educational activities. The SIs among nurses doubled (from 0.01 to 0.02/1000 IP days) and increased among housekeeping personnel. Conclusion SIs caused during the period commencing from completion of injection to disposal decreased in all the participant hospitals, suggesting that the healthcare workers handled the sharps appropriately; however, probably due to wrong disposal, personnel involved in waste disposal got more injuries. Safety engineered devices are not implemented in Indian hospitals despite data supporting their use decreasing SIs.

Published
2014

6. Management of ventilator associated pneumonia with a new antibiotic adjuvant entity (ceftriaxone+sulbactam+disodium edetate) - A novel approach to spare carbapenems

Author

Prachee Sathe, Shilpa Kulkarni, Nita Munshi, and Sagar Maddani

Subjects
Acinetobacter baumannii, Male, Carbapenem, Critical Care and Intensive Care Medicine, law.invention, 0302 clinical medicine, law, polycyclic compounds, 030212 general & internal medicine, Cross Infection, biology, Ceftriaxone, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Sulbactam, Middle Aged, Intensive care unit, Anti-Bacterial Agents, Intensive Care Units, Chemotherapy, Adjuvant, Drug Therapy, Combination, Female, medicine.drug, Acinetobacter Infections, Adult, medicine.medical_specialty, Microbial Sensitivity Tests, Meropenem, 03 medical and health sciences, Internal medicine, medicine, Humans, Intensive care medicine, Edetic Acid, Aged, Retrospective Studies, business.industry, Colistin, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, medicine.disease, 030228 respiratory system, bacteria, Thienamycins, business
Abstract

Background Ventilator associated pneumonia (VAP) is one of the most serious nosocomial infections in Intensive Care Unit (ICU). The aim of this study was to evaluate a new approach to spare the carbapenems for the management of patients diagnosed with VAP due to Acinetobacter baumannii ( A . baumannii ). Method This retrospective study was conducted on VAP patients presenting for treatment at tertiary care centre between May 2014 and March 2016. The case sheets of patients who have been treated for VAP with meropenem, antibiotic adjuvant entity (AAE) and colistin were analysed. Results Out of 113 patients analysed, 24 (21.3%) patients were having VAP due to MDR A . baumannii . Microbial sensitivity has shown that 87.5% of patients were sensitive to AAE and colistin whereas all of them were resistant to meropenem, imipenem and gentamycin. The mean treatment durations were 12.4 ± 2.1, 13.2 ± 2.4 and 14.3 ± 2.1 days for AAE, meropenem + colistin and AAE + colistin treatment groups. In AAE susceptible patients, the mean treatment duration and cost could be reduced by 23–24% and 43–53% if AAE is used empirically. In AAE-resistant patients, the mean treatment duration and cost could be reduced by 21% and 26% if AAE + colistin regime is used empirically instead of meropenem followed by AAE + colistin. Conclusions Clinical assessment with microbial eradication and pharmaco-economic evaluation clearly shows benefits in using AAE empirically in the management of A . baumannii infected VAP cases.

Published
2016

7. 1781. Assessing the Utility of First-Contact Serum Ferritin as an Augur of Severe Thrombocytopenia in Dengue Fever

Author

Nita Munshi, Ashwin Pillai, Pavan Reddy, and Abhijit R Lodha

Subjects
First contact, biology, Dengue hemorrhagic fever, Anemia, business.industry, medicine.disease, Severe thrombocytopenia, Dengue fever, Ferritin, Abstracts, Infectious Diseases, Oncology, Poster Abstracts, Immunology, biology.protein, medicine, Platelet Count measurement, business, Serum ferritin
Abstract

Background Dengue fever is an arboviral infection with global public health concerns. Much of its impact on society is attributable to the economic ramifications on public health programs, particularly in developing countries. Hospitalization accounts for 4/5th of total direct expenditure on the disease. The identification of an inexpensive biomarker to help guide the decision to hospitalize would have great utility. Serum ferritin was selected as levels reflect both infective viral load and host immune response – factors that purportedly determine the likelihood of thrombocytopenia. Methods The study was conducted at α = 0.05 and β = 0.05. We included patients aged ≥12 years, of both sexes, with a definite serological diagnosis of dengue fever. We excluded patients with severe anemia (hemoglobin serum ferritin levels were measured at first medical contact. Patients were monitored with serial total blood counts, until platelet counts normalized. The primary endpoint was severe thrombocytopenia, defined as platelet count nadir Results We included 64 patients in the study. The receiver-operating-characteristics (ROC) curve for the association between serum ferritin levels and the primary end-point had an area-under-curve (AUC) of 0.846, implying a good test accuracy. The ideal cut-off for “high” serum ferritin was determined to be 876 ng/mL, with levels above that predicting severe thrombocytopenia with a sensitivity of 90% and specificity of 74.07%. The negative predictive value at this threshold was 97.56%. The primary endpoint was attained by 39.13% of patients with raised ferritin vs. 2.44% with lower values (P = 0.0002). The Odd’s ratio for developing severe thrombocytopenia was 25.71. This association was consistent irrespective of sex, the day of presentation, baseline hemoglobin, or primary or secondary dengue. Conclusion In appropriately selected patients, serum ferritin is a reliable indicator of severe dengue fever, helping identify patients likely to require more careful observation. Disclosures All authors: No reported disclosures.

Published
2019

8. Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004-2013: Findings of the International Nosocomial Infection Control Consortium

Author

Asmita Sagar Sakle, Bala Ramachandran, Vaibhavi R Subhedar, Nadimpalli Gita, Saroj Kumar Patnaik, Nita Munshi, Pravin K Nair, Anil Kumar Bilolikar, F.E. Udwadia, Murali Chakravarthy, Subhash Todi, Sanjeev Sood, Suman Singh, Nirav Pandya, Siva Kumar, Arpita Dwivedy, Thara Francis, Kashmira Limaye-Joshi, Sheila Nainan Myatra, Anil Karlekar, Camilla Rodrigues, Vikram Padbidri, Maithili Satish Kavathekar, Nagamani Sen, Narinder Saini, Rekha Dubey, Mohammad Mukhit Abdul Gaffar Kazi, Sweta Shah, Anup Warrier, Afzal Azim, Sanjeev Singh, Preeti Mehta, Suneeta Sahu, Victor D. Rosenthal, Samir Sahu, Ramachadran Gopinath, Karthikeya K. Varma, S Muralidharan, Yatin Mehta, Namita Jaggi, and Purva Mathur

Subjects
0301 basic medicine, Microbiology (medical), Adult, Male, medicine.medical_specialty, Catheters, Epidemiology, Urinary system, 030106 microbiology, Advisory Committees, India, Artificial respiration, 03 medical and health sciences, 0302 clinical medicine, medicine, Infection control, Humans, 030212 general & internal medicine, Prospective Studies, Intensive care medicine, Prospective cohort study, Child, Developing Countries, Aged, Cross Infection, Infection Control, Ventilators, Mechanical, business.industry, Ventilator-associated pneumonia, Infant, Newborn, Pneumonia, Ventilator-Associated, Length of Stay, Middle Aged, medicine.disease, Nosocomial infection control, Pneumonia, Intensive Care Units, Infectious Diseases, Equipment and Supplies, Catheter-Related Infections, Equipment Contamination, Female, business, Sentinel Surveillance
Abstract

OBJECTIVETo report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013.METHODSSurveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology.RESULTSWe collected data from 236,700 ICU patients for 970,713 bed-daysPooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–daysIn neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–daysExtra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAPCrude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUsPooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs.CONCLUSIONSDespite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.Infect. Control Hosp. Epidemiol. 2016;37(2):172–181

Published
2015

9. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

Author

Víctor Daniel Rosenthal, Dennis George Maki, Yatin Mehta, Hakan Leblebicioglu, Ziad Ahmed Memish, Haifaa Hassan Al-Mousa, Hanan Balkhy, Bijie Hu, Carlos Alvarez-Moreno, Eduardo Alexandrino Medeiros, Anucha Apisarnthanarak, Lul Raka, Luis E. Cuellar, Altaf Ahmed, Josephine Anne Navoa-Ng, Amani Ali El-Kholy, Souha Sami Kanj, Ider Bat-Erdene, Wieslawa Duszynska, Nguyen Van Truong, Leonardo N. Pazmino, Lucy Chai See-Lum, Rosalia Fernández-Hidalgo, Gabriela Di-Silvestre, Farid Zand, Sona Hlinkova, Vladislav Belskiy, Hussain Al-Rahma, Marco Tulio Luque-Torres, Nesil Bayraktar, Zan Mitrev, Vaidotas Gurskis, Dale Fisher, Ilham Bulos Abu-Khader, Kamal Berechid, Arnaldo Rodríguez-Sánchez, Florin George Horhat, Osiel Requejo-Pino, Nassya Hadjieva, Nejla Ben-Jaballah, Elías García-Mayorca, Luis Kushner-Dávalos, Srdjan Pasic, Luis E. Pedrozo-Ortiz, Eleni Apostolopoulou, Nepomuceno Mejía, May Osman Gamar-Elanbya, Kushlani Jayatilleke, Miriam de Lourdes-Dueñas, Guadalupe Aguirre-Avalos, Diego Marcelo Maurizi, Adriana Montanini, Maria Laura Spadaro, Lorenzo Santiago Marcos, Priscila Botta, Florencia Maria Jerez, Maria Constanza Chavez, Lucia Ramasco, Maria Isabel Colqui, Maria Silvia Olivieri, Ana Silvia Rearte, Gladys Edith Correa, Paola Deolinda Juarez, Paola Fabiana Gallardo, Miriam Patricia Brito, Gabriel Horacio Mendez, Julia Rosa Valdez, Lorena Paola Cardena, Jose Maria Harystoy, Gustavo Jorge Chaparro, Claudia Gabriela Rodriguez, Rodolfo Toomey, Maria Caridi, Monica Viegas, Marisa Liliana Bernan, Adriana Romani, Claudia Beatriz Dominguez, Luis Kushner Davalos, Rosana Richtmann, Camila Almeida Silva, Tatiane T. Rodrigues, Amaury Mielle Filho, Ernandi Dagoberto Seerig Palme, Aline Besen, Caroline Lazzarini, Caroline Batista Cardoso, Francisco Kennedy Azevedo, Ana Paula Fontes Pinheiro, Aparecida Camacho, Braulio Matias De Carvalho, Maria Jose Monteiro De Assis, Ana Paula Vasconcelos Carneiro, Maria Lilian Maciel Canuto, Keyla Harten Pinto Coelho, Tamiris Moreira, Agamenon Alves Oliveira, Marcela Maria Sousa Colares, Marcia Maria De Paula Bessa, Tereza De Jesus Pinheiro Gomes Bandeira, Renata Amaral De Moraes, Danilo Amâncio Campos, Tânia Mara Lima De Barros Araújo, Maria Tereza Freitas Tenório, Simone Amorim, Manuela Amaral, Julianne Da Luz Lima, Lindalva Pino Da Silva Neta, Caphiane Batista, Fabio Jorge De Lima Silva, Maria C. Ferreira De Souza, Katia Arruda Guimaraes, Julia Marcia Maluf Lopes, Karina M. Nogueira Napoles, Lorena Luiza Silva Neto Avelar, Lilian Aguiar Vieira, Luis Gustavo De Oliveira Cardo, Christianne F.V. Takeda, Glaydson A. Ponte, Fco Eduardo Aguiar Leitão, Ricardo De Souza Kuchenbecker, Rodrigo Pires Dos Santos, Erci Maria Onzi Siliprandi, Luiz Fernando Baqueiro Freitas, Ianick Souto Martins, Daiane Casi, Maria Angela Maretti Da Silva, Sergio Blecher, Margarete Villins, Reinaldo Salomao, Solange Regina Oliveira Castro, Daniela V. Da Silva Escudero, Mariana Andrade Oliveira Reis, Marcelo Mendonca, Valter Furlan, Antonio Claudio do Amaral Baruzzi, Tarquino Eristidesg Sanchez, Marina Moreira, Wania Vasconcelos de Freitas, Leonardo Passos de Souza, Velmira Angelova Velinova, Michael M. Petrov, Dimitar Georgiev Karadimov, Emil D. Kostadinov, Violeta Jivkova Dicheva, Chaohua Wang, Xiuqin Guo, Xihua Geng, Shufang Wang, Jinzhi Zhang, Ling Zhu, Shufang Zhuo, Chunli Guo, Tao Lili, Li Ruisheng, Liu Kun, Xuesong Yang, Li Yimin, Mao Pu, Li Changan, Yiang Shumei, Wu Kangxiong, Lin Meiyi, Guxiang Ye, Xu Ziqin, Suo Yao, Song Liqiang, Luis Marino Cañas Giraldo, Elsa Margarita Trujillo Ramirez, Paola Andrea Rios, Juan Carlos Torres Millan, Edwin Giovanny Chapeta Parada, Andres Eduardo Mindiola Rochel, Andres H. Corchuelo Martinez, Ana Marãa Perez Fernandez, Nayide Barahona Guzman, Alfredo Lagares Guzman, Marena Rodriguez Ferrer, Yazmin Leon Vega, Heidi Johanna Munoz, Germán Camacho Moreno, Sandra Liliana Romero Torres, Herlidia Taboada Hernandez, Ismael A. Valderrama MarquezClaudia Linares, Monica Espinosa Valencia, Lusayda Sanchez Corrales, Sandra Milena Bonilla, Jorge Ivan Marin Uribe, David Yepes Gomez, Javier Ospina Martinez, Luz Dary Burgos Florez, Johanna Osorio, Dagoberto Santofimio, Lorena Matta Cortes, Wilmer Villamil-Gomez, Gabriel Munoz Gutierrez, Adela Arguello Ruiz, Carlos Gonzalez Fuentes, Antonio Solano Chinchilla, Ivar Calvo Hernandez, Olber Chavarria Ugalde, Humberto Guanche Garcell, Clara Morales Perez, Selin Bardak, Sumru Ozkan, Nepomuceno Mejia, Adrian M. Puello Guerrero Glenny Mirabal, Margarita Delgado, Ramona Severino, Eliesel Lacerda, Gilda Tolari, María Marcela Bovera, Diego Barahona Pinto, Pedro Fernández González, Gasdali Santacruz, Nelly Alquinga, Celso Zaruma, Nelson Remache, Diego Morocho, Mario Arboleda, Mario Cadena Zapata, Maria Fernanda Garcia, Fabricio Picoita, Jorge Velez, Marcia Valle, Estuardo Salgado Yepez, Diego Morocho Tutillo, Ricardo Arteaga Mora, Andrea Peña Padilla, Mayra Chango, Karina Cabezas, Shirley Tenorio López, Ana Lucía Bonilla Escudero, Gladys Tatiana Sánchez, Hugo Alberto Gonzalez Flores, Islam Abdullorziz Ghazi, Mohamed Hassan, Ghada A. Ismail, Reham Hamed, Mona Mohiedden Abdel-Halim, May Abd El-Fattah, Doaa Abdel-Aziz, Zeinab Salah Seliem, Rasha Hamed Elsherif, Reham Ali Dewdar, Abeer Ahmed Mohmed, Lamiaa Abdel-Fatteh Ahmed, Lilian De Jesus Machuca, Concepcion Bran De Casares, Prokopis Kithreotis, Maria Daganou, Dimitrios Veldekis, Maria Kartsonaki, Achilleas Gikas, Marco Tulio Luque Torres, Denis Padgett, Doris Maribel Rivera, Namita Jaggi, Camilla Rodrigues, Bhagyesh Shah, Keyur Parikh, Jigar Patel, Riya Thakkar, Murali Chakravarthy, B.N. Gokul, R. Sukanya, Leema Pushparaj, Thejas Vini, Sukanya Rangaswamy, Saroj Kumar Patnaik, Vempati Venkateshwar, Biju John, Shamsher Dalal, Suneeta Sahu, Samir Sahu, Banambar Ray, Sudhiranjan Misra, Nisith Mohanty, Biraj Mohan Mishra, Prafulla Sahoo, Naresh Parmar, Sanghamitra Mishra, Basanta Kumar Pati, Santosh Singh, Bhabani Shankar Pati, Aparajita Panda, Swarna Banergee, Dipankar Padhihari, Soumya Samal, Karthikeya Varma, Velu Pandi Suresh Kumar, Ram Gopalakrishnan, Nagarajan Ramakrishnan, Babu Kuruvilla Abraham, Senthilkumar Rajagopal, Ramesh Venkatraman, Ashwin Kumar Mani, Dedeepiya Devaprasad, Lakshmi Ranganathan, Thara Francis, Kotturathu Mammen Cherain, Bala Ramachandran, Ravikumar Krupanandan, S. Muralidharan, Murali Karpagam, Baby Padmini, S. Saranya, Siva Kumar, Nirav Pandya, Rajesh Kakkar, Tenzin Zompa, Narinder Saini, Srinivas Samavedam, Ganshyam Jagathkar, Suhas Nirkhiwale, G.S. Gehlot, Shefali Bhattacharya, Sanjeev Sood, Suman Singh, Sanjeev Singh, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Susmita Basu, Anuradha Agarwal, Manoj Agarwal, Mohit Kharbanda, Sankar Sengupta, Anirban Karmakar, Debkishore Gupta, Ajoy Krishna Sarkar, Rimita Dey, Chandramouli Bhattacharya, Mammen Chandy, V.R. Ramanan, Aseem Mahajan, Manas Roy, Sanjay Bhattacharya, Saswati Sinha, Indranil Roy, Umesh Gupta, Sujoy Mukherjee, Mrinmoy Bej, Purnima Mukherjee, Sumana Baidya, Afzal Azim, Asmita Sagar Sakle, Jehangir Soli Sorabjee, Mrunalini Subhash Potdar, Vaibhavi R. Subhedar, F.E. Udwadia, Hena Francis, Arpita Dwivedy, Sheena Binu, Suvin Shetty, Pravin Kumar Nair, Devendra K. Khanna, Felcy Chacko, Seelas Blessymole, Preeti Rajeev Mehta, Tanu Singhal, Sweta Shah, Vatsal Kothari, Reshma Naik, Mayur Harshadrai Patel, Deepesh Gokulchand Aggarwal, Burhanuddin Qutbuddin Jawadwala, Niketa Kaul Pawar, Shoeb Nizamuddin Kardekar, Abizer Nuruddin Manked, S.N. Myatra, J.V. Divatia, R. Kelkar, S.K. Biswas, V. Raut, S. Sampat, Alka Thool, Anil Karlekar, Sumi Nandwani, Sudhir Gupta, Sanjay Singhal, Madhu Gupta, Purva Mathur, Subodh Kumar, Kavita Sandhu, Arnab Dasgupta, Abhijeet Raha, Padmalatha Raman, Ashoo Wadhera, Binesh Badyal, Sarika Juneja, Bikas Mishra, Sunil Sharma, Megha Mehrotra, Jayant Shelgaonkar, Vikram Padbidri, Rohini Dhawale, Sheena Mary Sibin, Dileep Mane, Hanamant Kashinath Sale, Mohammad Mukhit Abdul Gaffar Kazi, Supriya Chabukswar, Anju Mathew, Dipti Gaikwad, Amol Harshe, Gita Nadimpalli, Sunil Bhamare, Soniya Thorat, Omnarayan Sarda, Pattabhiramarao Nadimpalli, Angelina Mendonca, Sujata Malik, Asmita Kamble, Nilakshi Kumari, Sohini Arora, Nita Munshi, Deepa Ganesh Divekar, Maithili Satish Kavathekar, Anuja Kedar Kulkarni, Madhupriya Vijay Suryawanshi, Madhavi Latha Bommala, Anil Bilolikar, Kashmira Limaye Joshi, Charulata Pamnani, Harvinder Wasan, Sonali Khamkar, Leena Steephen, Arjun Rajalakshmi, Anzar Thair, Aisha Mubarak, Swathy Sathish, Suresh Kumar, H. Sunil, Sujith Sujith, null Dinesh, Nagamani Sen, Nitin Shinde, Masoud Alebouyeh, Somayeh Jahani-Sherafat, Mohammad Reza Zali, Mohammad Reza Sarbazi, Nahid Mansouri, Elahe Tajeddin, Maryam Razaghi, Simasadat Seyedjavadi, Marjan Rashidan, Mansoor Masjedi, Behzad Maghsudi, Golnar Sabetian, Anahita Sanaei, Atefeh Yousefipour, Abdullah Mufareh Assiri, Elaine Mari Furukawa-Cinquini, Areej Dhafer Alshehri, Alysia Faye Giani, Nadia Lynette Demaisip, Elizabeth Laungayan Cortez, Analen Fabros Cabato, Jerlie Mae Gonzales Celiz, Ibrahim A.M. Al-Zaydani Asiri, Yassir Khidir Mohammed, Mohammed Abdullah Al Raey, Ali Omer Abdul Aziz, Saeed Ali Al Darani, Misbah Rehman Aziz, Roaa Hasan Basri, Duaa Khalil Al-Awadi, Syed Zahid Bukhari, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Apsia Musa Molano, Hessa Abdullah Al Enizy, Celia Flores Baldonado, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Avigail M. Tan, Sonia Joseph, Deepa Sasidharan Nair, Nabeela Abdullah Al-Abdullah, Grace Sindayen, Annalyn Amor Malificio, Diaa Abdullah Mohammed, Hanan Mesfer Al Ghamdi, Ameurfina Curioso Silo, Marianina Brenda V. Valisto, Nektarios Foteinakis, Sameeh Salem Ghazal, Mercy V. Joseph, Ahmed Hakawi, Antigona Hasani, Ismet Jusufi, Gazmend Spahija, Nehat Baftiu, Agreta Gecaj-Gashi, Nasser Yehia Aly, Mohammad El-Dossoky Noweir, Suga Thomas Varghese, Ruby Jose Ramapurath, Amna Mostafa Mohamed, Sneha Mary George, Anu Kurian, Amani Fouad Sayed, Mona Foda Salama, Abeer Aly Omar, Flavie Maria Rebello, Dennis Malungcot Narciso, Nada Kara Zahreddine, Zeina Kanafani, Tala Kardas, Bassel Molaeb, Lamia Jurdi, Anwar Al Souheil, Mohamad Ftouni, Hasan Ayash, Tahsine Mahfouz, Tomas Kondratas, Dovile Grinkeviciute, Rimantas Kevalas, Greta Gailiene, Algirdas Dagys, Milena Petrovska, Katja Popovska, Zaneta Bogoevska-Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Tanja Anguseva, Wan Nurbayah Wan Yusoff, Anis Shiham Zainal Abidin, Chin Seng Gan, Hasimah Zainol, Vineya Rai, Wong Kang Kwong, Mohd Shahnaz Hasan, Sasheela Sri La Sri Ponnampala, Jeyaganesh Veerakumaran, Ojan Assadian, Doan Mai Phuong, Nguyen Gia Binh, Kerinjeet Kaur, Joelene Lim, Lian-Huat Tan, Jegathesan Manikavasagam, Yuet-Meng Cheong, Hilario Coronado Magaña, Julio Cesar Mijangos Méndez, Federico Corona Jiménez, Sergio Esparza-Ahumada, Rayo Morfin-Otero, Eduardo Rodriguez-Noriega, Susana Gutierrez-Martinez, Hector Raul Perez-Gomez, Gerardo León-Garnica, Christian Mendoza-Mujica, Martha Cecilia Culebro Burguet, Jorge Horacio Portillo-Gallo, Fernando Aguilera Almazán, Gaspar Iglesias Miramontes, Maria del Rosario Vázquez Olivas, Lucio Alberto Aguilar Angel, Marisol Sanchez Vargas, Angel Orlando Flores Alvarado, Roberto Carlos Mares Morales, Luis Carlos Fernandez Alvarez, Hector Armando Rincon Leon, Karla Reyna Navarro Fuentes, Yuri Mariela Perez Hernandez, Gabriela Martinez Falcon, Angel Gonzalez Vargas, Marco A. Trujillo Juarez, Antonio Martinez Mulia, Paulina Alma Ulloa Camacho, Martha Y. Martinez-Marroquin, Marco Montell Garcia, Araceli Martinez Martinez, Elena Leon Sanchez, Guadalupe Gomez Flores, Marisela del Rocío González Martínez, Jesús Alfonso Galindo Olmeda, Georgina Olivarez, Enrique Barbachano Rodriguez, María Magdalena Gutierrez Castillo, María Guadalupe Villa González, Isaura Beatriz Sauceda Castañeda, Jaime Martínez Rodriguez, Otgon Baatar, Byambadorj Batkhuu, Kabiri Meryem, Barkat Amina, Rédouane Abouqal, Amine Ali Zeggwagh, Tarek Dendane, Khalid Abidi, Naoufel Madani, Syed Faisal Mahmood, Badaruddin A. Memon, Gul Hassan Bhutto, Nadeem Paul, Azra Parveen, Aun Raza, Amjad Mahboob, Summiya Nizamuddin, Faisal Sultan, Hammad Nazeer, Ashraf Ali Khan, Arifa Hafeez, Lydia Lara, Trudell Mapp, Balkys Alvarez, Magda Ivonne Rojas-Bonilla, Elizabeth Castano, Daisy A. De Moros, Roberto Espinoza Atarama, Maria Elena Calisto Pazos, Alfredo Paucar, Marlene Tasayco Ramos, Jenny Jurado, Dafne Moreno, Marãa E. Cruz Saldarriaga, Eliza Ramirez, Carlos Enrique La Hoz Vergara, Walter Enrique Prudencio Leon, Luis Isidro Castillo Bravo, Katya Fernanda Aibar Yaranga, Janet E. Pichilingue Chagray, Vanessa A. Marquez Mondalgo, Socorro Torres Zegarra, Nazario Silva Astete, Francisco Campos Guevara, Javier Soto Pastrana, Carlos F. Linares Calderon, Manuel Jesus Mayorga Espichan, Luis Martin Santivanez Monge, Maria V. Changano Rodriguez, Zoila Rosa Diaz Tavera, Fernando Martin Ramirez Wong, Selene Manga Chavez, Teodora Atencio-Espinoza, Victoria D. Villanueva, Maria Teresa Blanco-Abuy, Arnefelina S. Tamayo, Lailane D. Bergosa, Cristina Mari Jean P. Llames, Marilou F. Trajano, Suzette A. Bunsay, Jessica C. Amor, Regina Berba, Maria Carmen Sg Buenaflor, Ever Labro, Myrna T. Mendoza, Ofelia P. Javellana, Lilibeth G. Salvio, Rhoda Gay Rayco, Vanessa Bermudez, Andrzej Kubler, Marzena Zielinska, Magdalena Kosmider-Zurawska, Barbara Barteczko-Grajek, Ewa Szewczyk, Barbara Dragan, Malgorzata Anna Mikaszewska-Sokolewicz, Tomasz Lazowski, Elsie Cancel, Monica Sorina Licker, Liliana Alina Dragomirescu, Victor Dumitrascu, Dorel Sandesc, Ovidiu Bedreag, Marius Papurica, Delia Muntean, Igor Kotkov, Vladimir Kretov, Vladimir Shalapuda, Alexander Molkov, Sergey Puzanov, Ivan Utkin, Alexander Tchekulaev, Valentina Tulupova, Ljubica Nikolic, Goran Ristic, Jelena Eremija, Jelena Kojovic, Dragana Lekic, Sladjana Vasiljevic, Anna Lesnakova, Alzbeta Marcekova, Katarina Furova, May Osman Gamar Elanbya, Malik Abdo Ali, Shobhana Kumari Kadankunnel, Suwara Somabutr, Rungratchanee Pimathai, Suthinee Wanitanukool, Montri Luxsuwong, Namphon Supa, Pornpheth Prasan, Visanu Thamlikitkul, Silom Jamulitrat, Nonglak Suwalak, Parichart Phainuphong, Bouziri Asma, Borgi Aida, Bel Hadj Sarra, Khaldi Ammar, Gunay Tuncer Ertem, Cemal Bulut, Cigdem Ataman Hatipoglu, Fatma Sebnem Erdinc, Ali Pekcan Demiroz, Menekse Ozcelik, Basak Ceyda Meco, Mehmet Oral, Necmettin Unal, Cigdem Yildirim Guclu, Tanıl Kendirli, Erdal İnce, Ergin Çiftçi, Ayhan Yaman, Çağlar Ödek, Adem Karbuz, Bilge Aldemir Kocabaş, Nilgün Altın, Salih Cesur, Begum Atasay, Omer Erdeve, Hasan Akduman, Dilek Kahvecioglu, Ufuk Cakir, Duran Yildiz, Atila Kilic, Saadet Arsan, Dilek Arman, Serhat Unal, Yasemin Gelebek, Humeyra Zengin, Suha Sen, Hatice Cabadak, Ayse Erbay, Ata Nevzat Yalcin, Ozge Turhan, Melike Cengiz, Oguz Dursun, Perihan Gunasan, Sehnaz Kaya, Atilla Ramazanoglu, Cemal Ustun, Aliye Yasayacak, Hayrettin Akdeniz, Fatma Sirmatel, Ali Metin Otkun, Suzan Sacar, Alper Sener, Huseyn Turgut, Hulya Sungurtekin, Dogaç Ugurcan, Ceyda Necan, Cansu Yilmaz, Davut Ozdemir, Mehmet Faruk Geyik, Nevin Ince, Ayse Danis, Selvi Yener Erdogan, Nurettin Erben, Gaye Usluer, Ilhan Ozgunes, Cengiz Uzun, Oral Oncul, Levent Gorenek, Hakan Erdem, Orhan Baylan, Asu Ozgultekin, Asuman Inan, Sibel Bolukcu, Gunes Senol, Halil Ozdemir, Zeynel Gokmen, Sonay Incesoy Ozdemir, Ali Kaya, Gulden Ersoz, Necdet Kuyucu, Sevim Karacorlu, Zeynep Kaya, Ertugrul Guclu, Gulsume Kaya, Oguz Karabay, Saban Esen, Canan Aygun, Fatma Ulger, Ahmet Dilek, Hava Yilmaz, Mustafa Sunbul, Aynur Engin, Mehmet Bakir, Nazif Elaldi, Iftihar Koksal, Dincer Yildizdas, Ozden Ozgur Horoz, Ayşe Willke, Meliha Meriç Koç, Emel Azak, Naheed Elahi, Philip Annamma, Ashraf El Houfi, Maria Catalina Pirez Garcia, Hector Vidal, Fernando Perez, Gabriel D. Empaire, Yvis Ruiz, Dulce Hernandez, Dayana Aponte, Evelyn Salinas, Claudia Diaz, María Eugenia Guzmán Siritt, Zenaida Durán Gil De Añez, Luis Montes Bravo, Nelva Orozco, Eugenia Mejías, Nguyen Viet Hung, Nguyen Quoc Anh, Ngo Quy Chau, Truong Anh Thu, Le Thi Diem Tuyet, Dang Thi Van Trang, Vo Thi Hong Thoa, Nguyen Phuc Tien, Le Thi Anh Thu, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Dinh Pham Phuong Anh, Ondokuz Mayıs Üniversitesi, KILIÇ, ATİLA, and MERİÇ KOÇ, MELİHA

Subjects
Imipenem, medicine.medical_specialty, Pediatrics, Low income countries, Asia, Epidemiology, Klebsiella pneumoniae, Health care-associated infection, Antibiotic resistance, Catheter-associated urinary tract infection, Ceftazidime, Network, Bloodstream infection, Developing countries, Nosocomial infection, Intensive care, medicine, Ventilator-associated pneumonia, Humans, Hospital infection, Prospective Studies, Urinary tract infection, Cross Infection, Infection Control, biology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, medicine.disease, Nosocomial infection control, biology.organism_classification, Device-associated infection, United States, Europe, Pneumonia, Intensive Care Units, Infectious Diseases, Latin America, Amikacin, Emergency medicine, Africa, Limited resources countries, Central line-associated bloodstream infections, Centers for Disease Control and Prevention, U.S, business, medicine.drug
Abstract

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2014

10. The epinet data of four Indian hospitals on incidence of exposure of healthcare workers to blood and body fluid: a multicentric prospective analysis

Author

Anita Arora, Sharmila Sengupta, Sanjeev Singh, Murali Chakravarthy, and Nita Munshi

Subjects
medicine.medical_specialty, Pediatrics, Developing country, India, Occupational safety and health, Sharps Injury, Prospective analysis, Occupational Exposure, Health care, medicine, Accidents, Occupational, Humans, Prospective Studies, Needlestick Injuries, Developing Countries, Body fluid, business.industry, Incidence (epidemiology), Incidence, General Medicine, Hospitals, Body Fluids, Personnel, Hospital, Emergency medicine, business, Developed country
Abstract

Background : Sharps injury (SI) and blood and body fluid exposure are occupational hazards to healthcare workers (HCWs). Although data from the developed countries have shown the enormity of the problem, data from developing countries, such as India, arelacking. Purpose : The purpose of this study was to cumulate data from fourmajor hospitals in India and analyze the incidence of SI and blood and body fluid exposure in HCWs. Materials and Methods : Four Indian hospitals (hospital A, B, C and D) from major cities of India participated in this multicentric study. Data ranging from 6 to 26 months were collected from these hospitals using Exposure Prevention Information network (EPINet) which is the database created by International Healthcare Worker Safety Research and Resource Center, University of Virginia. Results : Two hundred and forty-three sharp injuries and 22 incidents of blood or body fluid exposure were encountered in the cumulated 50 months of our study. The incidence of SIswas thehighestamong nurses (55%) of allthe HCWs, akin to the global data. An injury rate of nearly 20% among housekeeping staff seems to be specific to the Indian data. Patient's room followed by operation theater appeared to be common locations of injury in our study. The source of the injury was identified in majority (64%) of the injuries. A major part of the group was not the primary users of the sharp (38%). Disposable needles caused nearly half of the injuries. Suture needles contributed to a reasonable number of injuries in one of the hospitals. Conclusions : The incidence of SI is the highest among nurses and the housekeeping staff (>30% each). A substantial number of injuries are avoidable.

Published
2011

12. Primary Pleural Synovial Sarcoma: A Diagnostic Challenge

Author

Bhushan Khedkar, Amit Singh, Nita Munshi, Swapnil Karnik, and Prachi Kate

Subjects
Pulmonary and Respiratory Medicine, Pathology, medicine.medical_specialty, business.industry, Medicine, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, business, medicine.disease, Pleural Synovial Sarcoma, Synovial sarcoma
Published
2013

13. A clinico-epidemiological study of sickle cell anaemia in Saudi Arabia

Author

Nita Munshi, George Aramouni, Peter Iliff, Roopa Mulik, Facharzt paed, and Anthonia Butikofer

Subjects
Male, medicine.medical_specialty, Pediatrics, Adolescent, education, Attack rate, Population, Saudi Arabia, Anemia, Sickle Cell, Penicillins, Pneumococcal Infections, Epidemiology, medicine, Humans, Child, education.field_of_study, business.industry, Data Collection, Age Factors, Infant, medicine.disease, Sickle cell anemia, Infectious Diseases, El Niño, Child, Preschool, Pediatrics, Perinatology and Child Health, Population study, Female, business, Meningitis, geographic locations, Foot (unit)
Abstract

Ninety-nine Saudi Arabian children aged between 3 months and 15 years attending the sickle cell anaemia (SCA) clinic were studied using a review of case notes and an interview at clinic visits. All the patients come from the southwest and west area of Saudi Arabia. Despite the lack of infant screening for SCA, 73 per cent were diagnosed before the age of 3 years, reflecting severe early symptoms of the disease. The serious complications of SCA were two times higher, the number of admissions were three times higher and the attack rate for pneumococcal meningitis was nine times higher in our study population than previously reported from the Eastern Province of the country. Hand-foot syndrome was the commonest complication affecting 58 per cent of the children. It has been stated previously that there is no need to give penicillin prophylaxis to SCA children in Saudi Arabia, based on the observations in the Eastern Province only. Our study shows that SCA in western and southwestern population of Saudi Arabia is as severe as is described in American blacks. Therefore, we recommend penicillin prophylaxis to be given to the SCA children in the southwest and west regions of the country.

Published
1991

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