Attitudes and Commitment of Healthcare Workers toward Methicillin-resistant Staphylococcus Aureus (MRSA) Infections in Hospitals of Thi-Qar Governorate

The nosocomial infection Methicillin-resistant Staphylococcus aureus (MRSA) can infect both healthcare workers and patients and have an impact on the standard of treatment offered in hospitals.  The study aims to Identify the relations between the attitudes, and commitment of healthcare workers to prevent methicillin-resistant S. aureus (MRSA) and sociodemographic characteristics. A descriptive cross-sectional study was carried out for 362 healthcare workers randomly chosen from four hospitals and distributed as follows: 125 from Nasiriyah Teaching Hospital, 80 from Al-Hussein Teaching Hospital, 80 from Al-Haboubi Teaching Hospital and 77 from Souk Al-Shuyoukh General Hospital Between October 1, 2022, to  May 1, 2023, and data was collected using a self-report paper-based questionnaire. Our findings indicated that 75.1% of the participants have neutral attitudes concerning MRSA infection. The relationships between attitudes and age, education, marital status, job title, and years of service were statistically significant (P <0.05). Healthcare workers' commitment were generally moderated. The participant's commitment to MRSA infection prevention was significantly correlated (P <0.05) with their age, education level, job title, and shift time. So we can conclude that Healthcare workers' attitudes toward the prevention of MRSA infection were neutral while Healthcare workers' commitment to preventing MRSA infection was poor. The study recommended Providing appropriate health facilities and personal protective equipment, Searching for the reasons behind non-compliance of HCWs, and Continual surveillance by medical institution authorities to protect healthcare workers against MRSA infection

Knowledge of healthcare workers to prevent methicillin‑resistant Staphylococcus aureus infection in hospitals of Thi‑Qar Governorate, Iraq

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is considered one of the nosocomial infections that can infect patients and healthcare workers (HCWs) and negatively affect the quality of care provided in the hospital. Objective: Evaluate the knowledge of HCWs regarding the prevention of MRSA infection in Thi-Qar Governorate. Methods: A descriptive cross-sectional study was conducted for 362 HCWs randomly selected from four hospitals and distributed as follows: 125 from Nasiriyah Teaching Hospital, 80 from Al-Hussein Teaching Hospital, 80 from Al-Haboubi Teaching Hospital and 77 from Souk Al-Shuyoukh General Hospital during the period from October 1 (2022) to May 1 (2023) and data was collected by using self-reported paper-based questionnaires. Results: Our study showed 68.8% of HCWs enjoyed a moderate level of knowledge, and there was a strong correlation (P value <0.05), between knowledge and some sociodemographic and occupational characteristics of the participants, which include age, educational level, job title, years of service and workplace in the hospital. Additionally, a relationship between knowledge and the source of the MRAS information was demonstrated which is a highly significant association between the total knowledge score and the sources of information. Conclusions: The knowledge of MRSA infection prevention among HCWs was moderate

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Awareness level of parents toward antibiotics those are prescribed to their children in al-dammam city

Background: Misuse of antibiotics is worldwide problem and annoying pediatricians. This misuses result in the increase the prevalence of one of global health problem which is antibiotic Resistance. Many studies mentioned that misusing of antibiotics is related to antibiotic resistance. The main reason of antibiotics misuse is low public awareness towards antibiotics indications. Also, patient's knowledge and practice with the antibiotic like self-prescription is common in developing countries. The antibiotics prescribed from private pharmacies are given to parents and parents are responsible to give medications to their children. So, we need to increase parents' awareness toward antibiotics usage to decrease the incidence of antibiotic resistance. Objective: To evaluate the parents' level of awareness towards antibiotics those prescribed to their children in At Dammam city Saudi Arabia. Methods: Questionnaire based on cross-sectional study. Questionnaires filled by parents whom have children less than 12 years old in public places randomly in the period from October to November 2018. The questionnaires has two parts: the first part is containing social-demographic data. While the second part: LIP of parents towards antibiotics. Data entering and analysis by SPSS. Results: Questionnaires have been distributed to 450 parents, most in participants were aged 20-29 . years old, the vast majority of participants have misconception regarding the antibiotics indications and (40%) of participants chose that antibiotics use for fever, (22%) for cough and (21%) do not know. Regarding parents' attitude toward antibiotics, (71.3%) have used antibiotics for their children but fortunately, Majority of the participants believe that their children don't need to antibiotics every time when they are sick (70%). in addition, Most of the. participants believe that antibiotics may harm the children (60%) Conclusion: Level of awaraness of parents in Dammam city is moderately acceptable. We can expect antibiotics resistance to happen among new generation in Al-Dammam city if there is no enough campaigns to increase the awareness and to fill the gap

Management and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Study

Background: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. Methods: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted. Outcomes were measured at 30 days and included mortality, surgical site infection, organ space infection and reintervention rate. Multilevel logistic regression models were used to adjust for clinically plausible explanatory variables. Effect estimates are expressed as odds ratios (ORs) alongside their corresponding 95% confidence intervals. Results: A total of 88 patients across the GlobalSurg 1 and GlobalSurg 2 studies were included, from 11 countries. Children comprised 38.6% (34/88) of included patients. Most patients (87/88) had intestinal perforation. The 30-day mortality rate was 9.1% (8/88), which was higher in children (14.7 vs. 5.6%). Surgical site infection was common, at 67.0% (59/88). Organ site infection was common, with 10.2% of patients affected. An ASA grade of III and above was a strong predictor of 30-day post-operative mortality, at the univariable level and following adjustment for explanatory variables (OR 15.82, 95% CI 1.53–163.57, p = 0.021). Conclusions: With high mortality and complication rates, outcomes from surgery for intestinal typhoid remain poor. Future studies in this area should focus on sustainable interventions which can reduce perioperative morbidity. At a policy level, improving these outcomes will require both surgical and public health system advances

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Letter to the editor

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially