Knowledge, Attitude, and Practice of Health Care Workers in Management of Bio-Medical Waste – A Cross-Sectional Study

Background: Management of Bio-Medical Waste involves a great concern. Therefore, awareness of Health-Care Workers (HCWs) becomes very important as improper management leads to injuries and the spread of infection to the staff, patients, and environment. The objective is to assess the Knowledge, Attitude, and Practice (KAP) among Health Care Professionals regarding Bio-Medical Waste Management (BMWM). Method: This cross-sectional survey was conducted among HCWs at GMC Jammu, India. Study participants were divided into III groups (Group I- 32 Doctors, group II- 48 Paramedical staff including nurses & laboratory technicians, and group III- 20 sanitary workers). Data was collected using a pre-designed questionnaire regarding BMWM and scored as good, average, and poor. Results: In our study, knowledge regarding symbols of BMWM and awareness regarding categories and segregation of BMW was good in I and II groups but averaged in group III. None in group III has attended CME regarding BMWM in the past. In contrast, this percentage was 61% in group II and 31% in group I. Regarding the capping and destroying of needles, 88% of Paramedics were doing it correctly. None of the class IV employees received the booster dose of HBV vaccination. Conclusion: Knowledge regarding BMWM was average in Group I and Group II, whereas Group III had the slightest knowledge. Attitude regarding the BMW was good in the case of groups I and II, Whereas Group III scored average. Practices were scored average in Group I, good in Group II, and poor in group III

Biofilm Formation by Uropathogens and Its Impact on Antimicrobial Susceptibility Pattern

Background: Out of all Hospital-Associated Infections (HAIs),Urinary Tract Infection (UTI) is the second most common infection that accounts for approximately 34%, and 80% are associated with indwelling catheters and hence with biofilm formation, which invites multi-drug resistant microorganisms. The present study was designed to study in-vitro biofilm forming uropathogens and their antimicrobial susceptibility in a tertiary care hospital in north India. Method:The present cross-sectional study consisted of 200 urine specimens collected over one year from patients with symptoms of urinary tract infection. Following their isolation and identification, all the isolates were subjected to screening for biofilm formation by Congo Red Agar (CRA) and the Tube Adherence (TA) methods. Subsequently, the Kirby Bauer-disk diffusion method performed the antimicrobial susceptibility test. Results: Out of the total samples (n = 200), a total of 46 (23%) were positive by the CRA method, while 33 (16.5%) were positive by the TA method. Twenty-one (21%) isolates came positive by both methods. Biofilm formation was seen more commonly in females (82%). Biofilm-forming uropathogens develop significantly higher resistance to antimicrobial drugs than non-producers. Conclusion: The correlation was significant between biofilm production and multidrug resistance. Also, it was concluded that the CRA method could be employed to detect biofilm formation in resource-limited countries

A Retrospective study on ICU isolates on Tracheostomy tube and their antimicrobial profile

Introduction: The tracheostomized patients are likely to develop pneumonia causing life threatening consequences due to severe, persistent, resistant infections. Objective: This study was done with the aim to identify the common organisms which cause Respiratory Tract Infections (RTI) and their resistant pattern of ventilated patients in Intensive Care Unit (ICU). Methods: This retrospective study was conducted on the patients who underwent tracheostomy in ICU of Government Medical College, Jammu. The samples were processed according to established departmental protocols. Results: Out of 54 samples, 50(93%) were culture positive. 6samples were found to be polymicrobial. 4 samples showed no growth. Citrobacter sp., Escherichia coli, Pseudomonas sp. being the commonest species isolated. Citrobacter sp. and Klebsiella sp., Proteus sp. and Staphylococcus aureus showed high degree of resistance while Pseudomonas sp. and Escherichia coli showed moderate resistance. The gram negative bacilli were all sensitive to Colistin and Polymixin B. Staphylococcus aureus was 100% sensitive to Vancomycin. Conclusions: Intubated patients are the risk factor for development of RTI and to the increase in morbidity and mortality. Inappropriate and inadequate antibiotic treatment causes emergence of drug resistance in pathogens and poor prognosis in patients. The study reported the alarming condition of MDR in tracheal aspirates. Hence, surveillance for source of Multi Drug Resistant bacteria would be beneficial for intervention of infection related to it

Serosurveillance of Dengue, Chikungunya and Zika in Jammu, a Sub-Himalayan Region of India

Introduction: Dengue and chikungunya are Aedes mosquitoborne viral diseases of major public health concern in India. Recently, there is a gradual rise in number of dengue and chikungunya positive cases in various states of Northern India and a similar emergence and increase of dengue positive cases has been observed in Jammu since 2011. Among the mosquitoborne diseases dengue has become a regular seasonal disease while chikungunya has recently emerged in 2016 and Zika the third aedes borne viral infection is needed to be under surveillance under national guidelines. Aim: To report the emergence of chikungunya and analyse the status and pattern of dengue over a period of one year along with serosurveillance of Zika which was done under Central Government guidelines. Materials and Methods: A total of eight hundred eight (808) samples from patients suspected of dengue infection over a period of one year from January 2016 to December 2016 from all the districts of Jammu Province, were tested serologically at our tertiary care centre for dengue NS1 antigen and IgM anti - dengue antibodies. Besides three clinical suspects of chikungunya, 167 dengue (7 positive and 160 negative) sera were tested by National Institute of Virology (NIV) CHIK IgM Capture ELISA, as there is an overlap of clinical symptoms. For Zika testing, the stored negative samples of dengue and Chikungunya (215) were sent to NIV Pune. Results: Recurring dengue infection with periodic upsurge since last few years and emergence of chikungunya was reported in Jammu region. Of the 808 sera tested for dengue and 170 tested for chikungunya, 17.82% and 18.2% were positive respectively. The results for Zika testing were negative. The association of dengue on the basis of sex was found to be highly significant (p=0.009276). Conclusion: In the absence of specific treatment and vaccine for dengue and chikungunya fever, early diagnosis is important in the management of these infections. This also demands continuous seroepidemiological surveillance of the locally prevalent and emerging arthropod borne infections for timely formulation and implementation of effective arboviral control programme