Day 2 :
Regional Directorate for Infection Prevention and Control
Directorate of Health Affairs, Taif
Kingdom of Saudi Arabia
Keynote: Application of high resolution melting to methicillin resistant Staphlococcus aureus and Shigella sonnei genotyping for epidemiological purposes
Time : 10:00AM- 10:40 AM
Waleed A. Mazi is a Regional Director for Infection Prevention and Control, Taif – Saudi Arabia, and also worked in Philosophy of Medical Science, Clinical Microbiology in Sweden. He also Became Infection Prevention and Control Director, King Abdul Aziz Specialist Hospital – Taif, Saudi Arabia, and published many International articles on prevention of central line –associated bloodstream infection, WHO- Hand Hygiene implementation program, prevention sharp injuries in healthcare settings and molecular genotyping for epidemiological purposes and also participated in the Poster and oral presentations in many international conferences
High resolution melting (HRM) analysis has been used in laboratory medicine as acurate, rapid and cost effective scheme method. Methicillin resistant Staphylococcus aureus (MRSA) infections impose huge risk to public health in healthcare and community settings worldwide. Shigella sonnei has been predominantly responsible for dysentary worldwide. The organism has only one serotype and is genetically homogeneous.
We evaluated MRSA spa typing and introduced new tools for Shigella sonneil genotyping using HRM analysis for epidemiological purposes.
Fifty clinical MRSA isolates were selected randomly from Scotland, Brazil, Sudan and Saudi Arabia. Methicillin-resistant phenotype was determined in accordance with BSAC standards using the Vitek 2system. Ten Shigella sonnei DNA samples were provided by Institut Pasteur, France. Primers for the polymorphic X region of the spa gene and the six single nucleotide polymorphisms (SNPs) within kduD, deoA, emrA, fdX and menF were amplified by colony PCR using the SensiMix HRM kit, and the melting temperature (Tm) and melting curves of the amplicons were analyzed in close tubes using a Rotor-Gene 6000 instrument.
Fifteen spa types detected each had a distinct melting temperature (Tm) that unambiguously assigned 44 isolates. Both t008 and t2770, as well as t311 and t021 spa types, shared the same Tm .
The first set run separated lineages I, II and III with distinctive melting curves and the Tm of each allele was at least a half degree away from that of other alleles. The second set run distinguished the sublineages IIIa, IIIb and IIIc with distinctive melting curves.
HRM analysis is acurate, rapid and cost effective scheme method for identification of MRSA and Shigella sonnie for epidemiological purposes
- Track 13: Respiratory Tract Infection Therapy
Track 14: Preventing Gastrointestinal Infection
Track 15: Infection Control in Clinical Practice
Track 16: Micro Organisms and Their Control
Track 17: Plant Pathology and Diseases Control
Track 18: Disinfection and Sterilization
Track 19: Infection Control Risk Assessment
Track 20: Infection Control for Veterinary Practices
Track 21: Infection Control Nursing
Track 22: Emerging and Re-Emerging Infections
Track 23: Personal Hygiene Practices
Location: Rome, Italy
Title: Infection control among the health care workers to decrease transmission of acute upper respiratory tract infections in outpatient clinics
Time : 11:00-11:30
Badrelsabah Bendery: ENT specialist MSCH zagizig university, auditor certificate, utilization management, Fellowship in hospital management, work in health insurance Egypt, work now in KSA CLIC doing this study to evaluate importance of infection control guidelines in decrease ACURTI
Acute upper respiratory tract infections (AURTI) can spread rapidly among health care personnel in health care settings, particularly for immune compromised persons. In this study we evaluate infection control measures guidelines. Infection control programs in skilled nursing facilities should address: surveillance for infections and antimicrobial resistance, outbreak investigation and control plan for epidemics, isolation precautions, hand hygiene, staff education, immunizations, tuberculin testing, and infection control policies to prevent specific infections. Methods: Our study conducted on 80 Health care workers in outpatient clinics which divided into two groups’ doctors and paramedical (nurses, workers, employees in clinics) age 20-55years, study method by questionnaire about guidelines of infection control, laboratory and radiology screening. Results: we found 70% insufficient infection control auditors, 50% standard precautions of infection control measures inadequate and 20% of asymptomatic of AURTI among workers and employees in clinic especially hand hygiene technique insufficient among health care workers. Some of the nurses did not follow infection-control procedures fully. Conclusions: Infection control interventions should be implemented in outpatient, as well as inpatient, settings to reduce transmission among health care workers and limit progression of AURT infections outbreaks. The healthcare worker, need to be provided education to support patient safety and minimize risk for infection. Infection prevention and control, care should be taken to provide comprehensive infection control measures including contact control, hand hygiene, personal protective equipment, disinfection, and environmental cleaning.
RN ICC Armed Forces Hospital
Time : 11:30-12:00
Ms. Zarina Bee Nazeer has completed her Diploma in Nursing (General, Psychiatric, Community) and Midwifery from Natal College of Nursing, R K Khan Campus Durban South Africa. She has passed the SAMTRAC Course by NOSA. (Safety Management and Training) (Cum Laude) in 2001.She completed the Infection Prevention & Control Course in 2011 at Netcare Nursing Academy in Durban South Africa. She has more than 28yrs experience in the healthcare setting. She is currently the Infection Control Coordinator at AFHSR in Khamis Mushayt KSA. She has been a speaker on Infection Control Topics locally and internationally. She is a presentator at AFHSR IC Mandatory Training Course for all staff. She has coordinated, co-directed and facilitated IC educational activities and has been extensively involved in major infection control activities, projects and programs for the past 15 years, including commissioning of new facilities, developing surveillance programs and evaluating IC programs.
She is an active team player & has been instrumental in the Infection Control Service element for JCIA at AFHSR. The hospital has successfully passed the Joint Commission International Accreditation (JCIA February 2017).
Patient Safety and Quality Patient Care is the ultimate goal of patient care in any healthcare facility. Infection Prevention and Control is the epicenter of Patient Care Delivery, therefore the Infection Control Programme in Healthcare Settings must include the IC Risk Assessment policy which must be proactively done to prevent infections and outbreaks, by assessing the potential risks which may disrupt the IC efforts.
Infection Control Risk Assessment (ICRA)
Infection Prevention and Control (PCI) Risk Assessment describes the Infection risks which is unique to the institution. This Infection Control Risk Assessment (ICRA) will help the institution to assess the Complexity of the Risk identified and the possible actions to reduce the effects of the risk. The risk scoring will help determine the severity of the risk and the prioritization of each risk identified.
Risk assessment is an ongoing process because infection risk changes overtime and at times rapidly. An infection control risk assessment must consider different elements before establishing IPC policies and procedures, goals and objectives.
A written, hospital wide comprehensive risk assessment plan is essential in any healthcare organization because it is a first step in a systematic process to create and implement PCI Plan.
Infection Control Risk Assessment Plan
The Healthcare Accreditation bodies (viz. JCIA – Standard PCI.7) has included the ICRA as a requirement for written risk assessments documenting how the healthcare facility is prioritizing patient and healthcare worker safety.
The PCI Risk Assessment will be done by the Multidisciplinary Team members which may include representation from Infection Control , Environmental Health & Safety( EH&S) , Facilities & Engineering and Continuous Quality Improvement & Patient Safety (CQI&PS) . The Infection Control Committee members will review and approve the facility wide PCI Risk Assessment and the PCI programme Plan for the set year.
Medical Acupuncture and Pain Management Clinic
Title: Why Patients Still Catch Hospital Infections Despite the Practice of Infection Prevention and Control Programs?
Time : 12:00- 12:45
Huang Wei Ling, born in Taiwan, raised in Brazil since the age of one, graduated in medicine in Brazil, specializing in infectious and parasitic diseases, a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca's General Hospital, she was responsible for the control of all prescribed antimicrobial medication, and received an award for the best paper presented at the Brazilian Hospital infection Control Congress in 1998.
She was coordinator of both the Infection Control and the Nutritional Support Committee in Sao Joaquim Hospital in Franca, and also worked at the infectious Sexually Transmitted Disease Reference Center. She is the owner of the Medical Acupuncture and Pain Management Clinic, and since 1997 has been presenting her work worldwide concerning the treatment of various diseases using techniques based on several medical traditions around the world.
Statement of the problem: Very few publications provide sound scientific data used to determine which components are essential for Infection Prevention and Control (IPC) programs in terms of effectiveness in reducing the risk of infection. In recent years, a range of regional best practice or policy principles have been developed that address what could be considered as core components of IPC programs. However there remains a major gap in relation to the availability of international best practice principles for core components of IPC programs. The purpose of this study was to show why patients still catch hospital infections despite IPC programs. A better understanding of a variety of theories is needed that could explain the physiopathology of diverse diseases described in the medical past history, which are usually disregarded clinically today. A broader view seems to show the necessity of seeing the patient as a whole; not only focusing on the disease in the prevention of these hospital infections. The methodology used was a review of these theories such as those presented by Hippocrates (“Natural forces within us are the true healers of disease.”), as well as others from oriental medicine, which explain that diseases originate from three factors: external (exposure to cold, heat, humidity, wind and dryness), internal (emotional) and dietary. Findings: Having a broader view of the patient as a whole (Yin, Yang, Qi, Blood energy and Heat retention), we can understand better the formation of hospital infection which is a systemic energy reaction of our body undergoing normal hospital treatment. Conclusion: To understand better why a patient is still catching hospital infections, despite these IPC programs, we need to broaden our view observing all emotional, environmental and dietary factors, as well as studying his energy situation at the moment of admittance identifying his risk of hospital infection
Title: Fecal carriage of carbapenem resistance Enterobacteriaceae among inpatients in a university hospital in Iran
Time : 12:45-13:15
Fereshteh Shahcheraghi is the Head of the Bacteriology Department of Pasteur Institute Of Iran. She obtained her PhD in medical microbiology in 1996 and joined the Institute Pasteur in 1997 as assistant Professor.From2002-2003 she went to Japan for studying and researching on antibiotic resistance. Her main field is antibiotic resistance especially on Gram Negative Bacteria; she has several project and papers on CRE (carbapenem Resistance Enterobacteriaceae) in outpatients and in patients in Iran. She is the head of Pertussis National Reference Lab of Pasteur Institute, this Lab have collaboration with CDC of Iran for diagnosis of suspected Patients to Pertussis and research on isolated strains. Also she has international project on Pertussis. She has authored more than 60 articles in international peer-reviewed journals and several national and international projects she is also actively involved in research, directing studies of post-graduate students, post-doctoral research workers and trainees
Objectives: Fecal colonization by carbapenem-resistant Enterobacteriaceae (CRE) could serve as a reservoir for transmission of these pathogens to clinical settings, which subsequently increases clinical infections. The aim of this study was to evaluate the prevalence and risk factors associated with CRE fecal colonization among inpatients.
Material and Methods: Rectal swabs from 50 patients in a university hospital were collected. CRE screening was performed by using selective media. Carbapenemase production was detected by phenotypic tests. PCR assays were used to detect carbapenemases genes. Clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE).
Results: The prevalence of fecal colonization was 56% (28/50). Overall, 41 CRE isolates were identified, of which 38 were carbapenemase-producers. Eleven patients (39.3%) were co-colonized with CRE isolates. ICU hospitalization, prior antibiotic therapy, and mechanical ventilation were significant risk factors. The blaOXA-48 was the most frequent carbapenemases followed by blaNDM-1 andblaNDM-7 enzyme. Nine carpapenemase producing Enterobacteriaceae (CPE) isolates co-harbored blaNDM-1 and blaOXA-48. Also, six CPE isolates co-harboredblaNDM-7 and blaOXA-48.We did not detect blaKPC, blaGES, blaIMP and blaVIM. PFGE analysis showed that E. coli clones were diverse, while K. pneumoniae categorize in 3 clusters. Cluster I was the major clone carrying blaOXA-48and blaCTXM-15 genes.
Conclusions: Our study as the first investigation in Iran showed CRE not only had high prevalence in fecal carriages, but also harbored varied antimicrobial resistance elements.
Dr. BenMohamed is a Professor of Immunology, the founder and the head of the Laboratory of Cellular and Molecular Immunology in the Department of Ophthalmology at the University of California. He also holds a joint appointment with the Center of Immunology at UC Irvine and with Chao Family Comprehensive Cancer Center UCI Medical center. Dr. BenMohamed received his Ph.D. in Immunology from the Pasteur Institute, Paris, France in 1997 where he worked as the key developer and co-inventor of a new promising vaccine strategy that uses mucosal delivery of clinically approved lipopeptide molecules. Dr. BenMohamed has been involved in clinical immunology, humoral and cellular immune responses, epitope mapping, epitope improvement, and the development and optimization of sub-unit vaccines against several infectious diseases including malaria Plasmodium falciparum, human immunodeficiency virus (HIV), human cytomegalovirus (HCMV) and herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2). Dr. BenMohamed is an independent immunologist, with a national and international reputation in vaccine development against both infectious diseases and cancer. Dr. BenMohamed is well integrated into the scientific community within the United States as well as Europe and is actively involved in a number of professional societies including American Association of Immunologists (AAI), American Society for Microbiology (ASM), American Society for Hematology (ASH), Association for Research in Vision and Ophthalmology (ARVO).
Herpes simplex virus type 1 (HSV-1) is a prevalent human pathogen that infects over 3.72 billion individuals worldwide and can cause potentially blinding recurrent corneal herpetic disease. HSV-1 establishes latency within sensory neurons of trigeminal ganglia (TG) and TG-resident CD8+ T cells play a critical role in preventing its reactivation. The repertoire, phenotype and function of protective CD8+ T cells are unknown. Bolstering the apparent feeble numbers of CD8+ T cells in TG remains a challenge for immunotherapeutic strategies. In this study, a comprehensive panel of 467 HLA-A*0201-restricted CD8+ T cell epitopes were predicted from the entire HSV-1 genome. CD8+ T cell responses to these genome-wide epitopes were compared in HSV-1 seropositive symptomatic (SYMP) individuals (with a history of numerous episodes of recurrent herpetic disease) vs. asymptomatic (ASYMP) individuals (who are infected but never experienced any recurrent herpetic disease). Frequent polyfunctional HSV-specific effector memory IFN-+CD107a/b+CD44highCD62LlowCD8+ TEM cells were detected in ASYMP individuals and were mainly directed against three “ASYMP” epitopes. In contrast, SYMP individuals have more mono-functional central memory CD44highCD62LhighCD8+ TCM cells. Furthermore, therapeutic immunization with an innovative prime/pull vaccine, based on priming with multiple “ASYMP” epitopes (prime) and neurotropic TG delivery of the T-cell attracting chemokine CXCL-10 (pull), boosted the number and function of CD44highCD62LlowCD8+ TEM and tissue-resident CD103highCD8+ TRM cells in TG of latently infected HLA-A*0201 Tg mice and reduced recurrent ocular herpes following UV-B induced reactivation. These findings have profound implications in the development of T-cell-based immunotherapeutic strategies to treat blinding recurrent herpes infection and disease.
$Footnotes: This work is supported by Public Health Service Research R01 Grants EY026103, EY019896 and EY024618 from National Eye Institute (NEI) and R21 Grant AI110902 from National Institutes of allergy and Infectious Diseases (NIAID), by The Discovery Center for Eye Research (DCER) and by a Research to Prevent Blindness (RPB) grant.
Technical University of Denmark
Than Linh Quyen has started her scientific research career for 3 years, firstly as research assistant in DIANOVA A/S, Denmark on development of isothermal amplification technologies. She currently is a PhD student in Bio-Lab-Chip group at Department of Micro and Nanotechnology, Technical University of Denmark. She continues her research of interests on isothermal amplification technologies, DNA microarray, microfluidics and Lab on a chip for online rapid detection of the infectious
Loop-mediated isothermal amplification (LAMP) has received great interest and is wildly used for point of care (POC) diagnostics based nucleic acid detection of pathogens. For example, DNA dye is an indispensable component in real-time LAMP reaction. Several DNA dyes work well for real-time PCR, but they have inhibition effect in LAMP reaction. Hence, the selection of dyes is urgent need for development of rapid, accurate, sensitive real-time LAMP based quantification and detection of pathogens. In this study, we have investigated twenty four DNA dyes for rapid real-time LAMP detection of Salmonella enteritidis based on inhibition effects. The real-time LAMP reactions were performed with 24 dyes at various concentrations ranged from 0.5 µM to 10 µM. Among the 24 dyes tested, SYTO dye group (except SYTO 60 and SYTO 62), Miami dye group (except Miami Red), and Boxto were the best since non-inhibition effect on the real-time LAMP reaction was observed. Application of one of the best dyes, the SYTO 9, in the real-time LAMP reaction, a detection limit of 3.86 copies of hilA gene for Salmonella spp. within 30 min at 65 °C was archived. The identification of the best dyes for rapid real-time LAMP detection will contribute important information for development of POC real-time LAMP systems for robust, sensitive and rapid online or at site detection of the pathogens.
University of Buea
Ndabong Michael was born on March 19, 1993 at Fondera of the Republic of Cameroon. I am a 4th year medical student at the University of Buea and currently carrying out research work on HIV/AIDS in West Africa
Some degree of interaction has been demonstrated recently between HIV/AIDS and falciparum malaria co-infection in studies carried out in certain parts of Africa, although with conflicting results. However, not much has been done in Cameroon. In order to investigate the interaction, a clinical and laboratory study was carried out in the urban town of Yaoundé the capital city of Cameroon on 480 subjects (15-49 years of age) from March – September, 2015.
Information on the knowledge of practices and attitudes towards both infections was also obtained. Analysis of the questionnaire indicated that participants generally had poor knowledge on HIV and malaria. The prevalence of malaria, HIV and co-infection was 78.8%, 11.7% and 7.9% respectively. The mean temperature of co-infected patients (37.5± 0.007) was higher compared with that of patients infected with HIV (36.7± 0.13). Co-infected patients were significantly more anaemic (t=2.275, p=0.026) and had low red blood cell counts (t=-2.681, p=0.001) than those with mono-infections. The mean parasite density was higher in co-infected patients (1630.97± 231.02) when compared with patients solely diagnosed with malaria (1217.44±67.07) (x2=7.65, p=0.0251). WBC count was lower in co-infected patients compared with patients infected with malaria or HIV only (x2=2.24, p=0.488). The mean CD4 count in co-infected subjects (317.94± 45.00cells/mm3) was lower than in those having HIV only (321.37±24.63cells/mm3), but this difference was not statistically significant (t=-1.521, p=0.265). The follow-up mean CD4 count (350.11 ±30.34) in co-infected patients increased compared with the initial count (31.6±17.82)(x2=-1.613, =0.069). The mean parasite density (109.09±41.08/µl) for co-infected patients after follow-up was significantly lower than the initial value (1630.79±23.102/µl) (t=6.12, p<0.001). Therefore HIV and malaria co-infection in the study site was generally associated with anaemia, high fever, high parasite density, lower RBC and WBC count and reduced CD4 counts
University of science and Technology Nyanza Province
Redemptah Yeda has her expertise in enteric pathogens, in-vitro malaria culture, sensitivity testing, molecular assays and analysis. She has 5 years of experience in research from centre of disease control (CDC) on enteric work and malaria experience from Walter Reed Project (WRP). Currently am a Master of Science student in Epidemiology and Biostatistics
Statement of the Problem: Diarrhea is preventable and treatable by early recognition of dehydration, increased fluids, breastfeeding and timely treatment. Despite the advances to understand management and pathogenesis, globally it’s estimated that diarrhea accounts for 1.5 million deaths annually. 800,000 children die annually in sub-Saharan Africa. In Kenya, infectious diseases are on the rise due to poverty, illiteracy, inadequate safe drinking water and poor sanitation Flood prone areas have high incidence of diarrhea. However, there is no active surveillance to monitor the incidence and also understand the effect of seasons on the incidence. No study has been carried out on the preparedness of the health facilities for the treatment of Diarrhea. The purpose of this study: To investigate the incidence and preparedness for treatment of diarrhea in epidemic prone floods areas in Kisumu County. Methodology & Theoretical Orientation: This was a retrospective study come across sectional study. A key informative interview tool was used to collect data among community health workers and the hospital leads. A conceptual frame work was used to focus on the interaction between incidence and mortality with relation to environment. Findings: Diarrhea is common among the adults compared to other age categories. Conclusion & Significance: Despite the challenges in controlling diarrhea, adults experience more cases. Over the last 20 years diarrhea studies have mainly on the under five However, there is limited information on the epidemiology of diarrhea among adults in sub-Saharan Africa. Recommendations Research is required to establish scientific models to predict diarrhea outbreaks