Search results for: blood stream infections
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3680

Search results for: blood stream infections

3680 Trends in the Incidence of Bloodstream Infections in Patients with Hematological Malignancies in the Period 1991–2012

Authors: V. N. Chebotkevich, E. E. Schetinkina, V. V. Burylev, E. I. Kaytandzhan, N. P. Stizhak

Abstract:

Objective: Blood stream infections (BSI) are severe, life-threatening illness for immuno compromised patients with hematological malignancies. We report the trend in blood-stream infections in this group of patients in the period 1991-2013. Methods: A total of 4742 blood samples investigated. All blood cultures were incubated in a continuous monitoring system for 7 days before discarding negative. On signaled positive, organism was identified by conventional methods. The Real-time polymerase chain reaction (PCR) was used for the indication of human herpes virus 6 (HHV-6), Cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Results: Between 1991 and 2001 the incidence of Gram-positive bacteria (Staphylococcus epidermidis, Staphylococcus aureus) being the most common germs isolated (70,9%) were as Gram-negative rods (Escherichia coli, Klebsiella spp., Pseudomonas spp.) – 29,1%. In next decade 2002-2012 the number of Gram-negative bacteria was increased up to 40.2%. It is shown that the incidence of bacteremia was significantly more frequent at the background of detectable Cytomegalovirus and Epstein-Barr virus-specific DNA in blood. Over recent years, an increased frequency of micro mycetes was registered in blood of the patients with hematological malignancies (Candida spp. was predominant). Conclusion: Accurate and timely detection of BSI is important in determining appropriate treatment of infectious complications in patients with hematological malignancies. The isolation of Staphylococcus epidermidis from blood cultures remains a clinical dilemma for physicians and microbiologists. But in many cases this agent is of the clinical significance in immunocompromised patients with hematological malignancies. The role of CMV and EBV in development of bacteremia was demonstrated.

Keywords: infectious complications, blood stream infections, bacteremia, hemoblastosis

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3679 Frequency of Nosocomial Infections in a Tertiary Hospital in Isfahan, Iran

Authors: Zahra Tolou-Ghamari

Abstract:

Objective: Health care associated with multiresistant pathogens is rising globally. It is well known that nosocomial infections increase hospital stay, morbidity, mortality, and disability. Therefore, the aim of this study was to define the occurrence of nosocomial infections in a tertiary hospital in Isfahan/Iran. Materials and Methods: The data were extracted from the official database of hospital nosocomial infections records that included 9152 vertical rows. For each patient, the reported infections were coded by number as UTI-SUTI; Code 55, VAE-PVAP; Code 56, BSI-LCBI Code 19, SSI-DIP; Code 14, and so on. For continuous variables, mean ± standard deviation and for categorical variables, the frequency was used. Results: The study population was 5542 patients, comprised of males (n=3282) and females (n=2260). With a minimum of 15 and a maximum of 99, the mean age in 5313 patients was 58.5 ± 19.1 years old. The highest reported nosocomial infections (n= 77%) were associated with the ages 30-80 years old. Sites of nosocomial infections in 87% were as: VAE-PVAP; 27.3%, VAE-IVAC; 7.7, UTI-SUTI; 29.5%, BSI-LCBI; 12.9%, SSI-DIP; 9.5% and other individual infection (13%) with the main pathogens klebsiella pneumonia, acinetobacter baumannii and staphylococcus. Conclusions: For an efficient surveillance system, adopting pharmacotherapy used antibiotics in terms of monotherapy or polypharmacy control policy, in addition to advanced infection control programs at regional and national levels in Iran recommended.

Keywords: infection, nosocomial, ventilator, blood stream, Isfahan, Iran

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3678 Association of Transmission Risk Factors Among HCV-infected Bangladeshi Patients With Different Genotypes

Authors: Nahida Sultana

Abstract:

Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. The hepatitis C virus is a blood-borne virus, and most infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusion, injection drug use, and sexual practices that lead to exposure to blood. Hepatitis C virus (HCV) causes chronic infections that mainly affect the liver leading to liver diseases. This study aimed to determine whether there is any significant association between HCV transmission risk factors in relation to genotypes in HCV-infected Bangladeshi patients. After quantification of HCV viral load, 36 samples were randomly selected for HCV genotyping and risk factor measurement. A greater proportion of genotype 1 (p > 0.05) patients (40%) underwent blood transfusion compared to patients (22.6%) with genotype 3 infections. More genotype 1 patient underwent surgery and invasive procedures (20%), and rather than those with genotype 3 patients (16.1%). The history of IDUs (25.8%) and sexual exposure (3.2%) are only prevalent in genotype 3 patients and absent in patients with genotype 1 (p >0.05). There was no significant statistical difference found in HCV transmission risk factors (blood transfusion, IDUs, Surgery& interventions, sexual transmission) between patients infected with genotypes 1 and 3. In HCV infection, genotype may have no relation to transmission risk factors among Bangladeshi patients.

Keywords: HCV genotype, alanine aminotransferase (ALT), HCV viral load, IDUs

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3677 Distinguishing between Bacterial and Viral Infections Based on Peripheral Human Blood Tests Using Infrared Microscopy and Multivariate Analysis

Authors: H. Agbaria, A. Salman, M. Huleihel, G. Beck, D. H. Rich, S. Mordechai, J. Kapelushnik

Abstract:

Viral and bacterial infections are responsible for variety of diseases. These infections have similar symptoms like fever, sneezing, inflammation, vomiting, diarrhea and fatigue. Thus, physicians may encounter difficulties in distinguishing between viral and bacterial infections based on these symptoms. Bacterial infections differ from viral infections in many other important respects regarding the response to various medications and the structure of the organisms. In many cases, it is difficult to know the origin of the infection. The physician orders a blood, urine test, or 'culture test' of tissue to diagnose the infection type when it is necessary. Using these methods, the time that elapses between the receipt of patient material and the presentation of the test results to the clinician is typically too long ( > 24 hours). This time is crucial in many cases for saving the life of the patient and for planning the right medical treatment. Thus, rapid identification of bacterial and viral infections in the lab is of great importance for effective treatment especially in cases of emergency. Blood was collected from 50 patients with confirmed viral infection and 50 with confirmed bacterial infection. White blood cells (WBCs) and plasma were isolated and deposited on a zinc selenide slide, dried and measured under a Fourier transform infrared (FTIR) microscope to obtain their infrared absorption spectra. The acquired spectra of WBCs and plasma were analyzed in order to differentiate between the two types of infections. In this study, the potential of FTIR microscopy in tandem with multivariate analysis was evaluated for the identification of the agent that causes the human infection. The method was used to identify the infectious agent type as either bacterial or viral, based on an analysis of the blood components [i.e., white blood cells (WBC) and plasma] using their infrared vibrational spectra. The time required for the analysis and evaluation after obtaining the blood sample was less than one hour. In the analysis, minute spectral differences in several bands of the FTIR spectra of WBCs were observed between groups of samples with viral and bacterial infections. By employing the techniques of feature extraction with linear discriminant analysis (LDA), a sensitivity of ~92 % and a specificity of ~86 % for an infection type diagnosis was achieved. The present preliminary study suggests that FTIR spectroscopy of WBCs is a potentially feasible and efficient tool for the diagnosis of the infection type.

Keywords: viral infection, bacterial infection, linear discriminant analysis, plasma, white blood cells, infrared spectroscopy

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3676 The Value of Serum Procalcitonin in Patients with Acute Musculoskeletal Infections

Authors: Mustafa Al-Yaseen, Haider Mohammed Mahdi, Haider Ali Al–Zahid, Nazar S. Haddad

Abstract:

Background: Early diagnosis of musculoskeletal infections is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. White blood cell count, erythrocyte sedimentation rate, and C-reactive protein are not specific as they can also be elevated in conditions other than bacterial infections. Materials Culture and sensitivity is not a true gold standard due to its varied positivity rates. Serum Procalcitonin is one of the new laboratory markers for pyogenic infections. The objective of this study is to assess the value of PCT in the diagnosis of soft tissue, bone, and joint infections. Patients and Methods: Patients of all age groups (seventy-four patients) with a diagnosis of musculoskeletal infection are prospectively included in this study. All patients were subjected to White blood cell count, erythrocyte sedimentation rate, C-reactive protein, and serum Procalcitonin measurements. A healthy non infected outpatient group (twenty-two patients) taken as a control group and underwent the same evaluation steps as the study group. Results: The study group showed mean Procalcitonin levels of 1.3 ng/ml. Procalcitonin, at 0.5 ng/ml, was (42.6%) sensitive and (95.5%) specific in diagnosing of musculoskeletal infections with (positive predictive value of 87.5% and negative predictive value of 48.3%) and (positive likelihood ratio of 9.3 and negative likelihood ratio of 0.6). Conclusion: Serum Procalcitonin, at a cut – off of 0.5 ng/ml, is a specific but not sensitive marker in the diagnosis of musculoskeletal infections, and it can be used effectively to rule in the diagnosis of infection but not to rule out it.

Keywords: procalcitonin, infection, labratory markers, musculoskeletal

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3675 Determination of Flow Arrangement for Optimum Performance in Heat Exchangers

Authors: Ahmed Salisu Atiku

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This task involves the determination of the flow arrangement for optimum performance and the calculation of total heat transfer of two identical double pipe heat exchangers in series. The inner pipe contains the cold water stream at 27°C, whilst the outer pipe contains the two hot stream of water at 50°C and 90 °C which can be mixed in any way desired. The analysis was carried out using counter flow arrangement due to its good heat transfer ability. The best way of heating this cold stream was found out to be passing the 90°C hot stream through the two heat exchangers. The outlet temperature of the cold stream was found to be 39.6°C and overall heat transfer of 131.3 kW. Though starting with 50°C hot stream in the first heat exchanger followed by 90°C hot stream in the second heat exchanger gives an outlet temperature almost the same as 90°C hot stream alone, but the heat transfer is low. The reason for the low heat transfer was that only the heat transfer in the second heat exchanger is considered. Whilst the reason behind high outlet temperature was that the cold stream was already preheated by the first stream.

Keywords: cold stream, flow arrangement, heat exchanger, hot stream

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3674 Impact of Environmental Changes on Blood Parameters in the Pelophylax ridibundus

Authors: Murat Tosunoglu, Cigdem Gul, Nurcihan Hacioglu, Nurdan Tepeova

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Amphibian and Reptilian species are influenced by pollution and habitat destruction. Blood parameters of Amphibia species were particularly affected by the negative environmental conditions. Studied frog samples 36 clinically normal Pelophylax ridibundus individuals were captured along the Biga Stream between April–June 2014. When comparing our findings with the Turkish legislation (Water pollution control regulation), the 1. Locality of the Biga stream in terms of total coliform classified as "high quality water" (Coliform: 866.66 MPN/100 mL), while the 2. locality was a "contaminated water" (Coliform: 53266.66 MPN/100 mL). Blood samples of the live specimens were obtained in the laboratory within one day of their capture. The blood samples were taken from the etherized frogs by means of ventriculus punctures, via heparinized hematocrit capillaries. Hematological and biochemical analyses based on high quality water and contaminated water, respectively, are as follows: Red blood cell count (444210.52-426846.15 per cubic millimeter of blood), white blood cell count (4215.78-4684.61 per cubic millimeter of blood), hematocrit value (29.25-29.43 %), hemoglobin concentration (7.76-7.22 g/dl), mean corpuscular volume (637.64-719.99 fl), mean corpuscular hemoglobin (184.78-174.75 pg), mean corpuscular hemoglobin concentration (29.44-24.82 %), glucose (103.74-124.13 mg/dl), urea (87.68-81.72 mg/L), cholesterol (148.20-197.39 mg/dl), creatinine (0.29-0.28 mg/dl), uric acid (10.26-7.55 mg/L), albumin (1.13-1.39 g/dl), calcium (11.45-9.70 mg/dl), triglyceride (135.23-155.85 mg/dl), total protein (4.26-3.73 g/dl), phosphorus (6.83-17.86 mg/dl), and magnesium (0.95-1.06 mg/dl). The some hematological parameters in P. ridibundus specimens are given for the first time in this study. No water quality dependent variation was observed in clinic hematology parameters measured.

Keywords: Pelophylax ridibundus, hematological parameters, biochemistry, freshwater quality

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3673 Geometrical Fluid Model for Blood Rheology and Pulsatile Flow in Stenosed Arteries

Authors: Karan Kamboj, Vikramjeet Singh, Vinod Kumar

Abstract:

Considering blood to be a non-Newtonian Carreau liquid, this indirect numerical model investigates the pulsatile blood flow in a constricted restricted conduit that has numerous gentle stenosis inside the view of an increasing body speed. Asymptotic answers are obtained for the flow rate, pressure inclination, speed profile, sheer divider pressure, and longitudinal impedance to stream after the use of the twofold irritation approach to the problem of the succeeding non-straight limit esteem. It has been observed that the speed of the blood increases when there is an increase in the point of tightening of the conduit, the body speed increase, and the power regulation file. However, this rheological manner of behaving changes to one of longitudinal impedance to stream and divider sheer pressure when each of the previously mentioned boundaries increases. It has also been seen that the sheer divider pressure in the bloodstream greatly increases when there is an increase in the maximum depth of the stenosis but that it significantly decreases when there is an increase in the pulsatile Reynolds number. This is an interesting phenomenon. The assessments of the amount of growth in the longitudinal resistance to flow increase overall with the increment of the maximum depth of the stenosis and the Weissenberg number. Additionally, it is noted that the average speed of blood increases noticeably with the growth of the point of tightening of the corridor, and body speed increases border. This is something that can be observed.

Keywords: geometry of artery, pulsatile blood flow, numerous stenosis

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3672 Some Hematological Parameters of the Mauremys rivulata in Two Different Water Quality in the Biga Stream (Çanakkale, Turkey)

Authors: Cigdem Gul, Murat Tosunoglu, Nurcihan Hacioglu

Abstract:

The contamination or desiccation of fresh waters also has a negative effect on freshwater turtles like other fresh water-dependent species. In order to conserve those species, which are confronted with such negative conditions, it is necessary to know beforehand the biology and the physiology of species. In this study, a comprehensive health assessment was conducted on a total of 20 clinically normal individuals free living Western Caspian Turtle (Mauremys rivulata) captured from two different freshwater localities in the Biga stream (Çanakkale-Turkey). When comparing our findings with the Turkish legislation (Water pollution control regulation), the 1. Locality of the Biga stream in terms of total coliform classified as "high quality water" (Coliform: 866.66 MPN/100 mL), while the 2. Locality was a “contaminated water" (Coliform: 53266.66 MPN/100 mL). Blood samples for hematological and biochemical analyses were obtained from the dorsal coccygeal vein. A total of 1-2 mL of blood was collected from each of the specimens via needle. After the required procedures had been performed, the turtles were put back in the same localities. Hematological and biochemical analyses based on high quality water and contaminated water, respectively, are as follows: Red blood cell count (512600-582666.66 per cubic millimeter of blood), white blood cell count (5920-5980 per cubic millimeter of blood), hematocrit value (24-24.66 %), hemoglobin concentration (6.52-6.35 g/dl), mean corpuscular volume (466.20-468.98 fl), mean corpuscular hemoglobin (125.77-113.84 pg), mean corpuscular hemoglobin concentration (28.25-26.49 %), glucose (94.43-87.43 mg/dl), creatinine (0.23-0.3241 mg/dl), uric acid (12.59-10.48 mg/L), albumin (1.46-1.25 g/dl), calcium (8.67-9.59 mg/dl), triglyceride (95.55-75.21 mg/dl), and total protein (4.85-3.45 g/dl). When an examination was made depending on the water quality of freshwater, variations were detected in hematology and biochemistry values, but not found significant difference.

Keywords: biochemistry, freshwater quality, hematological parameters, Mauremys rivulata.

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3671 Rapid Detection of the Etiology of Infection as Bacterial or Viral Using Infrared Spectroscopy of White Blood Cells

Authors: Uraib Sharaha, Guy Beck, Joseph Kapelushnik, Adam H. Agbaria, Itshak Lapidot, Shaul Mordechai, Ahmad Salman, Mahmoud Huleihel

Abstract:

Infectious diseases cause a significant burden on the public health and the economic stability of societies all over the world for several centuries. A reliable detection of the causative agent of infection is not possible based on clinical features, since some of these infections have similar symptoms, including fever, sneezing, inflammation, vomiting, diarrhea, and fatigue. Moreover, physicians usually encounter difficulties in distinguishing between viral and bacterial infections based on symptoms. Therefore, there is an ongoing need for sensitive, specific, and rapid methods for identification of the etiology of the infection. This intricate issue perplex doctors and researchers since it has serious repercussions. In this study, we evaluated the potential of the mid-infrared spectroscopic method for rapid and reliable identification of bacterial and viral infections based on simple peripheral blood samples. Fourier transform infrared (FTIR) spectroscopy is considered a successful diagnostic method in the biological and medical fields. Many studies confirmed the great potential of the combination of FTIR spectroscopy and machine learning as a powerful diagnostic tool in medicine since it is a very sensitive method, which can detect and monitor the molecular and biochemical changes in biological samples. We believed that this method would play a major role in improving the health situation, raising the level of health in the community, and reducing the economic burdens in the health sector resulting from the indiscriminate use of antibiotics. We collected peripheral blood samples from young 364 patients, of which 93 were controls, 126 had bacterial infections, and 145 had viral infections, with ages lower than18 years old, limited to those who were diagnosed with fever-producing illness. Our preliminary results showed that it is possible to determine the infectious agent with high success rates of 82% for sensitivity and 80% for specificity, based on the WBC data.

Keywords: infectious diseases, (FTIR) spectroscopy, viral infections, bacterial infections.

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3670 The Administration of Infection Diseases During the Pandemic COVID-19 and the Role of the Differential Diagnosis with Biomarkers VB10

Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

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3669 Prevalence and Factors Associated with Multiple Parasitic Infections among Rural Community in Kano State Nigeria

Authors: Salwa S. Dawaki, Init Ithoi, Sa’adatu I. Yelwa

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Introduction: Parasitic infections are major public health problems worldwide, particularly in developing countries. Two third of the world population is infected while about 3 billion are at risk of parasitic infections. It is demonstrated that most parasitic infections occur as multiple infections especially among poor and rural communities of most countries in the tropical regions. Parasitic infections are endemic in Nigeria, yet multiple infections are rarely reported. The study aimed to estimate the prevalence and identify factors associating with multiple parasitic infections among rural population in Kano State Nigeria. Methodology: A cross-sectional survey was conducted from June to August 2013 in rural Kano State, Nigeria. Three samples stool, urine, and blood were collected from each of the 551 volunteers aged between one and ninety years old recruited for the survey. A pre-tested questionnaire was used to obtain epidemiological data. Data were analysed using appropriate descriptive, univariate and multivariate logistic regression methods. Major findings: The participants were 61.7% male, 38.3% female, and 69.0% were adults of 15 years and above. Overall, 463 (84%) were infected with parasitic infections among which 60.9% had multiple infections. A total of 15 parasitic species were recovered, and up to 8 different parasitic species were found concurrently in a single host. Plasmodium was the most common parasite followed by Blastocystis, Entamoeba species, and hookworms. It was found that presence of an infected family member (P = 0.017; OR = 1.52; 95% CI = 1.08, 2.13) and not wearing shoes outside home (P = 0.043; OR = 1.50; 95% CI = 1.01, 2.18) significantly associated with higher risk of having multiple parasitic infections among the studied population. Conclusion: Parasitic infections pose a public health challenge in the rural community of Kano. Multiple parasitic infections are highly prevalent and presence of an infected family member as well as not wearing proper foot wear outside home increases the risk of infection. Poor hygiene, unfavourable socioeconomic conditions, and culture promote survival and transmission of parasites. There is a need for implementation of integrated approach aimed at controlling or eliminating the infections with emphasis on public awareness.

Keywords: multiple infections, parasitic infections, poor hygiene, risk of infection

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3668 Numerical Study of an Impinging Jet in a Coflow Stream

Authors: Rim Ben Kalifa, Sabra Habli, Nejla Mahjoub Saïd, Hervé Bournot, Georges Le Palec

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The present study treats different phenomena taking place in a configuration of air jet impinging on a flat surface in a coflow stream. A Computational Fluid Dynamics study is performed using the Reynolds-averaged Navier–Stokes equations by means of the Reynolds Stress Model (RSM) second order turbulent closure model. The results include mean and turbulent velocities and quantify the large effects of the coflow stream on an impinging air jet. The study of the jet in a no-directed coflow stream shows the presence of a phenomenon of recirculation near the flat plate. The influence of the coflow velocity ratio on the behavior of an impinging plane jet was also numerically investigated. The coflow stream imposed noticeable restrictions on the spreading of the impinging jet. The results show that the coflow stream decreases considerably the entrainment of air jet.

Keywords: turbulent jet, turbulence models, coflow stream, velocity ratio

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3667 Streptococcus anginosus Infections; Clinical and Bacteriologic Characteristics: A 6-Year Retrospective Study of Adult Patients in Qatar

Authors: Adila Shaukat, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal

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Background: The aim of this study was to assess clinical presentation and antimicrobial susceptibility of Streptococcus (S.) anginosus group infections in Hamad General Hospital, a tertiary care hospital in the state of Qatar, which is a multinational community. The S. anginosus group is a subgroup of viridans streptococci that consist of 3 different species: S. anginosus, S. constellatus, and S. intermedius. Although a part of the human bacteria flora, they have potential to cause suppurative infections. Method: We studied a total of 101 patients with S. anginosus group infections from January 2006 until March 2012 by reviewing medical records and identification of organisms by VITEK 2 and MALDI-TOF. Results: The most common sites of infection were skin and soft tissue, intra-abdominal, and bacteremia (28.7%, 24.8%, and 22.7%, respectively). Abscess formation was seen in approximately 30% of patients. Streptococcus constellatus was the most common isolated species (40%) followed by S. anginosus(30%) and S. intermedius(7%). In 23% of specimens, the species was unidentified. The most common type of specimen for organism isolation was blood followed by pus and tissue (50%, 22%, and 8%, respectively). Streptococcus constellatus was more frequently associated with abdominal and skin and soft tissue infections than the other 2 species, whereas S. anginosus was isolated more frequently from blood. All isolates were susceptible to penicillin, ceftriaxone, and vancomycin. Susceptibility to erythromycin and clindamycin was also good, reaching 91% and 95%, respectively. Forty percent of patients needed surgical drainage along with antibiotic therapy. Conclusions: Identification of S. anginosus group to species level is helpful in clinical practice because different species exhibit different pathogenic potentials.

Keywords: abscess, bacterial infection, bacteremia, Streptococcus anginosus

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3666 Blood Glucose Level Measurement from Breath Analysis

Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: blood glucose level, breath acetone concentration, diabetes, linear regression

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3665 EhfadHaya (SaveLife) / AateHayah (GiveLife) Blood Donor Website

Authors: Sameer Muhammad Aslam, Nura Said Mohsin Al-Saifi

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This research shows the process of creating a blood donation website for Oman. Blood donation is a widespread, crucial, ongoing process, so it is important that this website is easy to use. Several automated blood management systems are available, but none provides an effective algorithm that takes into account variables such as frequency of donation, donation date, and gender. In Oman, the Ministry of Health maintains a blood bank and keeps donors informed about the need for blood through a website. They also inform donors and the wider public where and when is their next blood donation event. The website's main goals are to educate the community about the benefits of blood donation. It also manages donor and receiver documentation and encourages voluntary blood donation by providing easy access to information about blood types and blood distribution in various hospitals in Oman, based on hospital needs.

Keywords: Oman, blood bank, blood donors, donor website

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3664 Numerical Simulation of Magnetohydrodynamic (MHD) Blood Flow in a Stenosed Artery

Authors: Sreeparna Majee, G. C. Shit

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Unsteady blood flow has been numerically investigated through stenosed arteries to achieve an idea about the physiological blood flow pattern in diseased arteries. The blood is treated as Newtonian fluid and the arterial wall is considered to be rigid having deposition of plaque in its lumen. For direct numerical simulation, vorticity-stream function formulation has been adopted to solve the problem using implicit finite difference method by developing well known Peaceman-Rachford Alternating Direction Implicit (ADI) scheme. The effects of magnetic parameter and Reynolds number on velocity and wall shear stress are being studied and presented quantitatively over the entire arterial segment. The streamlines have been plotted to understand the flow pattern in the stenosed artery, which has significant alterations in the downstream of the stenosis in the presence of magnetic field. The results show that there are nominal changes in the flow pattern when magnetic field strength is enhanced upto 8T which can have remarkable usage to MRI machines.

Keywords: magnetohydrodynamics, blood flow, stenosis, energy dissipation

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3663 Signal Processing of the Blood Pressure and Characterization

Authors: Hadj Abd El Kader Benghenia, Fethi Bereksi Reguig

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In clinical medicine, blood pressure, raised blood hemodynamic monitoring is rich pathophysiological information of cardiovascular system, of course described through factors such as: blood volume, arterial compliance and peripheral resistance. In this work, we are interested in analyzing these signals to propose a detection algorithm to delineate the different sequences and especially systolic blood pressure (SBP), diastolic blood pressure (DBP), and the wave and dicrotic to do their analysis in order to extract the cardiovascular parameters.

Keywords: blood pressure, SBP, DBP, detection algorithm

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3662 Retrospective Evaluation of Vector-borne Infections in Cats Living in Germany (2012-2019)

Authors: I. Schäfer, B. Kohn, M. Volkmann, E. Müller

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Introduction: Blood-feeding arthropods transmit parasitic, bacterial, or viral pathogens to domestic animals and wildlife. Vector-borne infections are gaining significance due to the increase of travel, import of domestic animals from abroad, and the changing climate in Europe. Aims of the study: The main objective of this retrospective study was to assess the prevalence of vector-borne infections in cats in which a ‘Feline Travel Profile’ had been conducted. Material and Methods: This retrospective study included test results from cats for which a ‘Feline Travel Profile’ established by LABOKLIN had been requested by veterinarians between April 2012 and December 2019. This profile contains direct detection methods via polymerase chain reaction (PCR) for Hepatozoon spp. and Dirofilaria spp. as well as indirect detection methods via immunofluorescence antibody test (IFAT) for Ehrlichia spp. and Leishmania spp. This profile was expanded to include an IFAT for Rickettsia spp. from July 2015 onwards. The prevalence of the different vector-borne infectious agents was calculated. Results: A total of 602 cats were tested using the ‘Feline Travel Profile’. Positive test results were as follows: Rickettsia spp. IFAT 54/442 (12.2%), Ehrlichia spp. IFAT 68/602 (11.3%), Leishmania spp. IFAT 21/602 (3.5%), Hepatozoon spp. PCR 51/595 (8.6%), and Dirofilaria spp. PCR 1/595 cats (0.2%). Co-infections with more than one pathogen could be detected in 22/602 cats. Conclusions: 170/602 cats (28.2%) were tested positive for at least one vector-borne pathogen. Infections with multiple pathogens could be detected in 3.7% of the cats. The data emphasizes the importance of considering vector-borne infections as potential differential diagnoses in cats.

Keywords: arthopod-transmitted infections, feline vector-borne infections, Germany, laboratory diagnostics

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3661 Chemical and Biomolecular Detection at a Polarizable Electrical Interface

Authors: Nicholas Mavrogiannis, Francesca Crivellari, Zachary Gagnon

Abstract:

Development of low-cost, rapid, sensitive and portable biosensing systems are important for the detection and prevention of disease in developing countries, biowarfare/antiterrorism applications, environmental monitoring, point-of-care diagnostic testing and for basic biological research. Currently, the most established commercially available and widespread assays for portable point of care detection and disease testing are paper-based dipstick and lateral flow test strips. These paper-based devices are often small, cheap and simple to operate. The last three decades in particular have seen an emergence in these assays in diagnostic settings for detection of pregnancy, HIV/AIDS, blood glucose, Influenza, urinary protein, cardiovascular disease, respiratory infections and blood chemistries. Such assays are widely available largely because they are inexpensive, lightweight, and portable, are simple to operate, and a few platforms are capable of multiplexed detection for a small number of sample targets. However, there is a critical need for sensitive, quantitative and multiplexed detection capabilities for point-of-care diagnostics and for the detection and prevention of disease in the developing world that cannot be satisfied by current state-of-the-art paper-based assays. For example, applications including the detection of cardiac and cancer biomarkers and biothreat applications require sensitive multiplexed detection of analytes in the nM and pM range, and cannot currently be satisfied with current inexpensive portable platforms due to their lack of sensitivity, quantitative capabilities and often unreliable performance. In this talk, inexpensive label-free biomolecular detection at liquid interfaces using a newly discovered electrokinetic phenomenon known as fluidic dielectrophoresis (fDEP) is demonstrated. The electrokinetic approach involves exploiting the electrical mismatches between two aqueous liquid streams forced to flow side-by-side in a microfluidic T-channel. In this system, one fluid stream is engineered to have a higher conductivity relative to its neighbor which has a higher permittivity. When a “low” frequency (< 1 MHz) alternating current (AC) electrical field is applied normal to this fluidic electrical interface the fluid stream with high conductivity displaces into the low conductive stream. Conversely, when a “high” frequency (20MHz) AC electric field is applied, the high permittivity stream deflects across the microfluidic channel. There is, however, a critical frequency sensitive to the electrical differences between each fluid phase – the fDEP crossover frequency – between these two events where no fluid deflection is observed, and the interface remains fixed when exposed to an external field. To perform biomolecular detection, two streams flow side-by-side in a microfluidic T-channel: one fluid stream with an analyte of choice and an adjacent stream with a specific receptor to the chosen target. The two fluid streams merge and the fDEP crossover frequency is measured at different axial positions down the resulting liquid

Keywords: biodetection, fluidic dielectrophoresis, interfacial polarization, liquid interface

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3660 Mongolian Water Quality Problem and Health of Free-Grazing Sheep

Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai

Abstract:

Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.

Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water

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3659 Hepatitis B, Hepatitis C and HIV Infections and Associated Risk Factors among Substance Abusers in Mekelle Substance Users Treatment and Rehabilitation Centers, Tigrai, Northern Ethiopia

Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

Abstract:

Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

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3658 DCT and Stream Ciphers for Improved Image Encryption Mechanism

Authors: T. R. Sharika, Ashwini Kumar, Kamal Bijlani

Abstract:

Encryption is the process of converting crucial information’s unreadable to unauthorized persons. Image security is an important type of encryption that secures all type of images from cryptanalysis. A stream cipher is a fast symmetric key algorithm which is used to convert plaintext to cipher text. In this paper we are proposing an image encryption algorithm with Discrete Cosine Transform and Stream Ciphers that can improve compression of images and enhanced security. The paper also explains the use of a shuffling algorithm for enhancing securing.

Keywords: decryption, DCT, encryption, RC4 cipher, stream cipher

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3657 Epidemiological Profile of Healthcare Associated Infections in Intensive Care Unit

Authors: Abdessamad Dali-Ali, Houaria Beldjillali, Fouzia Agag, Asmaa Oukebdane, Ramzi Tidjani, Arslane Bettayeb, Khadidja Meddeber, Radia Dali-Yahia, Nori Midoun

Abstract:

Healthcare-associated infections are a real public health problem, especially in intensive care units. The aim of our study was to describe the epidemiological profile and to estimate the incidence of these infections at the intensive care unit of our teaching hospital. A prospective study was conducted, from June 2012 to December 2013. During this period, 305 patients having a duration of hospitalization equal or more than 48 hours were included in the study. In terms of the incidence of healthcare associated infections, nosocomial pneumonia occupied the first position with a cumulative incidence rate of 20.0%, followed by bacteremia (5.6%), central venous catheter infections (4%), and urinary tract infections (3%). In the case of isolated microorganisms, Gram-negative bacilli not enterobacteriaceae occupied the first place with 48.5%, followed by enterobacteria (32.1%). Acinetobacter baumannii was the most common germ (27.6%). Our study showed that the rate of health-care-associated infections was relatively high in the intensive care unit. A control program to reduce all infections is a priority for the Infection Control Associated Committee.

Keywords: epidemiological profile, healthcare associated infections, intensive care units, teaching hospital of Oran, Algeria

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3656 Simulation of Remove the Fouling on the in vivo By Using MHD

Authors: Farhad Aalizadeh, Ali Moosavi

Abstract:

When a blood vessel is injured, the cells of your blood bond together to form a blood clot. The blood clot helps you stop bleeding. Blood clots are made of a combination of blood cells, platelets(small sticky cells that speed up the clot-making process), and fibrin (protein that forms a thread-like mesh to trap cells). Doctors call this kind of blood clot a “thrombus.”We study the effects of different parameters on the deposition of Nanoparticles on the surface of a bump in the blood vessels by the magnetic field. The Maxwell and the flow equations are solved for this purpose. It is assumed that the blood is non-Newtonian and the number of particles has been considered enough to rely on the results statistically. Using MHD and its property it is possible to control the flow velocity, remove the fouling on the walls and return the system to its original form.

Keywords: MHD, fouling, in-vivo, blood clots, simulation

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3655 Modular Data and Calculation Framework for a Technology-based Mapping of the Manufacturing Process According to the Value Stream Management Approach

Authors: Tim Wollert, Fabian Behrendt

Abstract:

Value Stream Management (VSM) is a widely used methodology in the context of Lean Management for improving end-to-end material and information flows from a supplier to a customer from a company’s perspective. Whereas the design principles, e.g. Pull, value-adding, customer-orientation and further ones are still valid against the background of an increasing digitalized and dynamic environment, the methodology itself for mapping a value stream is characterized as time- and resource-intensive due to the high degree of manual activities. The digitalization of processes in the context of Industry 4.0 enables new opportunities to reduce these manual efforts and make the VSM approach more agile. The paper at hand aims at providing a modular data and calculation framework, utilizing the available business data, provided by information and communication technologies for automizing the value stream mapping process with focus on the manufacturing process.

Keywords: lean management 4.0, value stream management (VSM) 4.0, dynamic value stream mapping, enterprise resource planning (ERP)

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3654 Stream Channel Changes in Balingara River, Sulawesi Tengah

Authors: Muhardiyan Erawan, Zaenal Mutaqin

Abstract:

Balingara River is one of the rivers with the type Gravel-Bed in Indonesia. Gravel-Bed Rivers easily deformed in a relatively short time due to several variables, that are climate (rainfall), river discharge, topography, rock types, and land cover. To determine stream channel changes in Balingara River used Landsat 7 and 8 and analyzed planimetric or two dimensions. Parameters to determine changes in the stream channel are sinuosity ratio, Brice Index, the extent of erosion and deposition. Changes in stream channel associated with changes in land cover then analyze with a descriptive analysis of spatial and temporal. The location of a stream channel has a low gradient in the upstream, and middle watershed with the type of rock in the form of gravel is more easily changed than other locations. Changes in the area of erosion and deposition influence the land cover changes.

Keywords: Brice Index, erosion, deposition, gravel-bed, land cover change, sinuosity ratio, stream channel change

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3653 The Prevalence of Blood-Borne Viral Infections among Autopsy Cases in Jordan

Authors: Emad Al-Abdallat, Faris G. Bakri, Azmi Mahafza, Rayyan Al Ali, Nidaa Ababneh, Ahmed Idhair

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Background: Morgues are high-risk areas for the spread of infection from the cadavers to the staff during the postmortem examination. Infection can spread from corpses to workers by the airborne route, by direct contact, or from needle and sharp object injuries. Objective: Knowledge about the prevalence of these infections among autopsies is prudent to appreciate any risk of transmission and to further enforce safety measures. Method: A total of 242 autopsies were tested. Age ranged from 3 days to 94 years (median 75.5 years, mean 45.3 (21.9 ± SD)). There were 172 (71%) males. Results: The cause of death was considered natural in 137 (56.6%) cases, accidental in 89 (36.8%), homicidal in 9 (3.7%), suicidal in 4 (1.7%), and unknown in 3 (1.2%). Hepatitis B surface antigen was positive in 5 (2.1%) cases. Hepatitis C virus antibody was detected in 5 (2.1%) cases and the hepatitis C virus polymerase chain reaction was positive in 2 of them (0.8%). HIV antibody was not detected in any of the cases. Conclusions: Autopsies can be associated with exposure to blood borne viruses. Autopsies performed during the study period were tested for hepatitis B surface antigen, hepatitis C virus antibody, and human immunodeficiency virus antibody. Positive tests were subsequently confirmed by polymerase chain reaction. There is low prevalence of infections with these viruses in our autopsy cases. However, the risk of transmission remains a threat. Healthcare workers in the forensic departments should adhere to standard precautions.

Keywords: autopsy, hepatitis B virus, hepatitis C virus, human immunodeficiency virus, Jordan

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3652 Spectrum of Bacteria Causing Oral and Maxillofacial Infections and Their Antibiotic Susceptibility among Patients Attending Muhimbili National Hospital

Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon

Abstract:

Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.

Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania

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3651 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis

Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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