International Journal of Endorsing Health Science Research (IJEHSR)

Candidemia in Pediatric Patients: Changing Pattern of Isolated Candida Species and Risk Factors in Eastern India.

2023-03-29T04:44:01+00:00

Background: Candidemia is a life-threatening bloodstream infection caused by Candida species and is a major concern in pediatric patients, particularly in developing countries like India. Therefore, the goals of the current study are to isolate and identify several Candida species from blood samples, link various risk factors with candidemia, and ascertain the antifungal sensitivity pattern of each species.

Methodology: This study is an observational, cross-sectional study conducted to determine the prevalence, distribution, and antifungal susceptibility of Candida species among pediatric patients with candidemia. The current study collected blood samples in BACT/ALERT 3D Pediatric bottles for fungal blood culture. After positive growth was obtained from Blood agar and Sabouraud's dextrose agar (SDA), a range of biochemical reactions, including Gram staining, Germ tube test, CHROM agar Candida Medium, and Sugar fermentation, were carried out. The Kirby-Bauer disc diffusion method was used for conducting the antifungal susceptibility test.

Results: Among the total of 156 different species of Candida, the maximum isolates were Candida albicans (CA) (42.9%), followed by Candida tropicalis (23.1%) and Candida parapsilosis (14.7%). The Pediatric Intensive Care Unit (PICU) had the most Candida isolates, and catheterization was a leading risk factor. Susceptibility to Amphotericin B, Caspofungin, and Voriconazole was 84.6%, 81.4%, and 76.9%, respectively. Our study observed that the azole group of antifungals revealed pretty high resistance to Non-Candida albicans (NCA).

Conclusion: The prevalence of candidemia was higher in the pediatric ICU and neonatal ICU, and the incidence rate was highest among neonates and infants. The study concludes that NCA species are gradually replacing C. albicans as an important pathogen, and clinicians need to be aware of the antifungal resistance patterns of the different Candida species.

A cross-sectional survey on hand hygiene among nursing students working in an eastern Indian hospital.

2023-03-29T04:44:01+00:00

Background: Proper hand hygiene practices by healthcare providers are critical to prevent healthcare-associated infections (HCAIs). This study aimed to assess the hand hygiene knowledge and practices of nursing students in various departments and operation theatres of a tertiary care hospital in Eastern India.

Methodology: A cross-sectional survey based on WHO questions was conducted in March-April 2022 to evaluate the hand hygiene knowledge and practices of 105 nursing students. The study included nursing students from different departments, including medicine, surgery, pediatrics, obstetrics and gynecology, eye, different ICUs (adult, NICU, and PICU), and different OTs. The collected data were analyzed according to the STROBE guidelines.

Results: Of the 105 nursing students, 42.86% had no training in hand hygiene practices, highlighting the need for additional training. However, due to the COVID-19 pandemic, most students (86%) were familiar with using alcohol-based hand rubs. Most students preferred hand rubbing before giving an injection (65.74%), while hand washing was preferred after vacating a bedpan (91.42%) or being exposed to blood (89.52%). Comparing the pre-and post-workshop questionnaires showed a significant improvement in hand hygiene knowledge. However, more training is required to understand the importance of infection spread from the infected hands of HCWs. Additionally, gloves are not a substitute for hand hygiene practices, and wearing jewelry and artificial nails should be avoided. Regular training and workshops can increase awareness among nursing students.

Conclusion: The findings indicate a need for ongoing training to improve hand hygiene practices among nursing students. Regular training and workshops can increase awareness and knowledge, leading to decreased incidence of HCAIs.

Uterocutaneous fistula managed medically: A case report.

2023-03-29T04:44:00+00:00

Background: The uterocutaneous fistula is an abnormal connection or passageway between the uterus and the skin. The most common causes include infections, trauma, or surgery, a severe medical condition requiring prompt medical attention and treatment.

Case Presentation: Here, we describe the case of a 36-year-old female who developed a uterocutaneous fistula after cesarean delivery. Her post-cesarean recovery was complicated by wound infection, and after healing the wound, she presented with cyclical bloody discharge from a pinpoint opening in the healed wound scar.

Management: On ultrasound and MRI, she was diagnosed as having a uterocutaneous fistula. She opted for non-surgical management and underwent successful medical management with GnRH agonists. She remained symptom-free after the resumption of her menstrual cycle.

Conclusion: In younger populations hoping to avoid surgery, pharmacological care with GnRH agonist therapy can be a reasonable alternative to surgical resection of the fistulous tract. Healthcare professionals should have a high index of suspicion to diagnose this condition.