Leading Types Of Healthcare-Associated Infections (HAIS) By Hospital Wards In The University Hospital Of Ruse For The Period 2014-2016

Introduction: Improving the quality and safety of healthcare through decrease of healthcare-associated infections (HAIs) and limitation of antibiotic resistance is an essential aim of every healthcare facility.Aim: The aim of this article is to study the most frequent sites of HAIs in the different types of wards in the University Hospital of Ruse for the period 2014-2016.Materials and Methods: We have used protocols, investigations, reports, public access information from the Regional Health Inspectorate (RHI) of Ruse, data from the microbiological laboratory of the RHI of Ruse. The methods implemented were documental, epidemiological analysis, graphics, and statistics.Results: Surgical site infections were the leading type of HAI in the wards of surgery, urology, orthopedics and traumatology, and anesthesiology and reanimation in 2015.Conclusion: 1. Surgical site infections are the leading type of HAI - 33% in 2015, 18.35% in 2016, and 49.38% in 2014. 2. Infections of the eye, ear, nose, throat and oral cavity range between 13.92% and 17.04% and were registered in 4 departments: neonatology, physiotherapy and rehabilitation, neurosurgery and neurology. 3. The percentage of nosocomial sepsis was 3.01% of the HAIs in 2014, reported in 4 wards: intensive care unit for surgical diseases, intensive care unit for non-surgical diseases, neurosurgery, neonatology. 4. Intubation related pneumonia was found in 8.15% of all HAIs in 2015 and 14.23% in 2016 in 3 departments. Of them, the intensive care unit for non-surgical diseases registered 75.49% of all intubation related pneumonias for both years

Preventive Measures Including Disinfection, Disinsection And Deratization As A Supportive Element Of The Surveillance Of Healthcare-Associated Infections

Introduction: Sanitary and hygienic care and disinfection are actions that support the epidemiologic surveillance, exercised by infection control sections in healthcare facilities. These include also prevention of rodent and insect infestations (as reservoirs and vectors of infectious and parasitic diseases).Aim: The aim of this article is to investigate the buildings of St. Marina University Hospital of Varna and share our experience in terms of organization, management and control of the disinfection, disinsection and deratization (DDD) activities, accomplished in the period 2011 – 2015.Materials and Methods: We have used factsheets, reports, analyses of the Regional Health Inspectorate of Varna and of St.Marina University Hospital of Varna; epidemiological studies, healthcare educational materials regarding DDD. The methods we used were descriptive, statistical, and inquiries.Results: In hospital settings DDD activities are regularly performed and checked periodically according to a schedule by an internal control section. Microbiological sample collection is directed to the main factor responsible for pathogen exchange between patients and medical staff – hands and hospital environment. In 2014, 887 double microbiological samples from hands and environment were taken, 103 of them were positive. The ready-to-use disinfection solutions were always investigated in parallel as well. Fifty-eight of them were microbiologically investigated with 6 positive results. In the same year, 350 disinsections were performed – focal and barrier. Three general disinsections of the building by stage took place, as well as 3 general barrier processings of the yard area against ticks and fleas. Two hundred and fifteen deratizations were performed, 3 of them complex covering the canals.Conclusion: 1. The necessity of development of a hospital program regarding organization of the DDD activities as an element of the surveillance of healthcare-associated infections (HAIs) was practically proven. 2. Indispensable efficacy of the DDD of the building and adjacent open areas was achieved resulting in a decrease of rodent and arthropod numbers to a biologically safe minimum. 3. Efficient coordination was found between the different control sections. An emphasis is put upon prophylaxis that is much more effective and cheap

SYNERGY EFFECT: HOW TO CAPTURE VALUE IN THE BUSINESS STRATEGY? A CASE OF IT BUSINESSES IN NORTH MACEDONIA

Nowadays, businesses are required to create added value and difference. In recent years, the synergy perspective grew into one of the main concerns of corporate and strategic management. It creates a new path for change in the way of designing the business strategy, characterized by the collaboration mindset embedded in the overall strategic thinking context. This paper investigates the perceptions and practices of the IT managers with regards to the potential of synergy strategies. It aims to explore the growing importance of synergies between all elements, stakeholders, and processes in the organization, with a particular emphasis on the connections which include cooperation, interaction and working together to realize accepted purposes and strategic goals. The primary data were obtained through a survey carried out in the IT businesses in North Macedonia and evaluated by using the descriptive statistics. The key findings indicate that synergy strategies can create added value on the company’s sustained competitive advantage. The results showed that the synergy strategy appears to be a good managerial practice to be fostered on the organizational level to produce greater results. As the synergy effects seem to be a widespread practice, but rarely discussed topic within the IT sector in North Macedonia, the research will attempt to provide a theoretical contribution to the academic community, but also to help local managers to identify and coordinate opportunities for integrating the sinergy in their business strategy. Apart from the main research focus, our aim expands further to making a broader contribution to the theories of strategy and organization. JEL codes: L19, M1

Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-beta-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results. Interpretation The main risk factors for CRE infections in hospitals with high incidence included previous coloni-zation, urinary catheter and exposure to broad spectrum antibiotics

Aqueous solutions of random poly(methyl methacrylate-co-acrylic acid): effect of the acrylic acid content

Aqueous solutions from two types of PMMA–AA polymers (PMMA–25AA and PMMA–50AA) are investigated. The aim is to outline the effect of AA content on the bulk solution and air/solution interface properties. The experiments include dynamic light scattering, surface tension and interfacial rheology measurements. The drainage kinetics and stability of microscopic foam films are also investigated. It is established that at similar conditions (pH = 10, temperature 20 °C) the polymer molecules have almost the same mean molecular weight and size distribution of the bulk globules. Dynamic and equilibrium surface tension measurements reveal systematically higher values for PMMA–50AA as compared to PMMA–25AA. These outcomes are related to higher bulk electrophoretic mobility in the PMMA–50AA case and the overall more stretched configuration of the polymer at the air/solution interface. Surface dilational rheology characteristics are particularly sensitive to the polymer structural peculiarities: while no significant changes are registered in the case of PMMA–25AA, the solutions of PMMA–50AA exhibit a pronounced maximum in surface dilational elasticity for the concentration ∼1 × 10−4 mol L−1. This observation is a clear sign of specific bulk and/or interfacial (structure) transition which has to be investigated in further studies. Microscopic foam films provide additional evidence for the effect of fine-tuning the AA content of the copolymer. All microscopic films are stable which is due predominantly to the overwhelming electrostatic repulsion effects. The obtained results add new knowledge to the structure–property relationships of the PMMA–AA based aqueous formulations. They give valuable hints for further fine-tuning opportunities of these systems, that have high innovative potential for various applications

Maintenance of oral hygiene of dental implants

Introduction: Proper medical approach to loss of teeth is by placing dental implants. They allow transmission of chewing pressure in bone tissue and thus stimulate the regeneration of bone after the loss of teeth. Bad oral hygiene is the most common cause of complications after implantation Aim: Maintaining oral hygiene after the installation of dental implants is of great importance for the success of the implantation. Materials and methods: In the period from year to year and a half after the burden on the implants as the most common complication of poor oral hygiene is periimplantitis. Therefore the training of the patient for maintaining oral hygiene is crucial. Check-ups are scheduled for 3 to 6 months and later on, when the patient will develop the technique of maintaining oral hygiene these check-ups can be performed once a year. Regular brushing of the teeth i.e. of the prosthetic construction, flossing and antiseptic solvents for teeth at home is necessary as an imperative. We recommended that patients use tough antiseptics such as chlorhexidine, Listerine, Septodont and others. Smoking as a risk factor is excluded before placing the implants. The removal of soft deposits, rinsing with antiseptic was done by the therapist at every checkup and the state of the soft tissues around the implants was monitored as well as the osteointegration. The way to maintain oral hygiene is controlled and further instructions are provided. Results: After the regular check-ups on 3 months, 6 months and a year at these patients with already placed implants we noticed oral hygiene on a very high level according to our instructions and that is one of the main things that the procedure of imaplanting depends on. Conclusion: The good side is that the implant cannot be spoiled as natural tooth, but if proper oral hygiene is not maintained there is a risk of developing an infection and loss of the implant

Synergy in Aqueous Systems Containing Bioactive Ingredients of Natural Origin: Saponin/Pectin Mixtures

Biocompatible and biodegradable ingredients of natural origin are widely used in the design of foam and emulsion systems with various technological applications in the food, cosmetics and pharmaceutical industries. The determination of the precise composition of aqueous solution formulations is a key issue for the achievement of environmentally-friendly disperse systems with controllable properties and reasonable stability. The present work is focused on the investigation of synergistic interactions in aqueous systems containing Quillaja saponins and Apple pectins. Profile analysis tensiometer (PAT-1) is applied to study the surface tension and surface dilational rheology of the adsorption layers at the air/solution interface. The properties and the foam films (drainage kinetics, film thickness, disjoining pressure isotherm, critical pressure of rupture) are investigated using the thin-liquid-film (TLF) microinterferometric method of Scheludko&ndash;Exerowa and the TLF-pressure-balance technique (TLF-PBT). The results demonstrate that the structure and stability performance of the complex aqueous solutions can be finely tuned by changing the ratio of the bioactive ingredients. The attained experimental data evidence that the most pronounced synergy effect is registered at a specific saponin:pectin ratio. The obtained information is essential for the further development of aqueous solution formulations intended to achieve stable foams based on mixtures of Quillaja saponins and Apple pectins in view of future industrial, pharmaceutical and biomedical applications