Moral responsibilities of care, prevention and control of infections

Transcription

Moral responsibilities of care, prevention and control of infections
Authors:* Zahra Ayazi1- sayed Jalil Hosseini Irani2- Homeira Mohamadi3-Nasrin Khosravi4
1.Iran. shahrekorduniversity of medical sciences -MSc medical Seines & BSc Nursing- Tel: 13313349561 – 19131345619- Email: Ayazi_z56@yahoo.com.
2. shahrekord university of medical sciences .MSc Nursing-Tel: 1331-3349561 – 19134133635Email: jalil_irani_s@yahoo.com.
3.shahrekord university of medical sciences ,BSc Nursing-Mobile:19131343630-Email:
mohamadih0003@yahoo.com.
4-Mashhad university of medical sciences , BSc Nursing-19133332613
Introduction: care is not limited to Nursing But, Nursing is unique. Nursing practice is where
experience, emotions and relationships that make up the main body of the work day. Care should be
Of humans by humans, for humans and human dignity are done This last aspect of care that makes it
so unique. With this approach safely and with minimal care, avoidable risk in terms of infection
control and prevention, including professional and ethical responsibilities of nursing.
Methods: This article cross - library that will be reviewed in 2115 has been adjusted by the use of
paper Scientific-Research Information Search Engine google scholar and magiran the database of
books in this field of study, analyze, summarize and editing is.
Results: Protect patients against nosocomial infections through professional standards, Improve the
health of patients and clients, Public health, Worthy of trust and confidence in patient care, With the
approval and support of professional behavior, Responsibility for care, Providing high quality care to
patients, Professional rules and guidelines have been notified in all aspects of care, including carebased prevention and control of infection in particular, Involving patients in care, Maintain the
dignity of patients, regardless of economic status, race, culture, religion, etc., Observe patient care
priorities, Collaboration with the health care team in the control and prevention of nosocomial
infections, Share abilities and capabilities in the control and prevention of infection, Comprehensive
patient safety, Anticipated and appropriate action regarding the events that may occur during
treatment, Identify individuals who are directly involved in complications of care, Identify key people
to deal with the consequences of nosocomial infections, Identify the basic needs of patients,
Identification of individual moral aspects that need attention are ... One of the most important
ethical care of patients for the prevention and control of infection.
Conclusion: Professional nurses in close contact with the patient or the patient who takes care of
them Since receiving the care and safety of patients' rights is essential to the professional care is
combined with professional ethics.
Keywords: moral responsibility, care, prevention, infection control
‫مسئًلیتُبی اخالقی مراقبت‪،‬پیشگیری يکىترل عفًوت‬
‫وًیسىدگبن‪ :‬زَرا ایبزی‪-*1‬سید جلیل حسیىی ایراوی‪ - 2‬حمیرا محمدی‪– 3‬وسریه خسريی‪4‬‬
‫‪ * -1‬ایران‪-‬داوشگبٌ علًم پسشکی شُرکرد‪-‬معبيوت درمبن‪--‬بلًارشُیدآیت‪-‬ادارٌ پرستبری‪-‬کبرشىبس‬
‫ارشدپرستبری‪،‬آمًزش پسشکی‪Email:ayazi_z56@yahoo.com-99131845699-‬‬
‫‪ -2‬ایران‪-‬داوشگبٌ‬
‫علًم‬
‫پسشکی‬
‫شُرکرد‪-‬معبيوت‬
‫درمبن‪--‬بلًارشُیدآیت‪-‬ادارٌ‬
‫پرستبری‬
‫‪-‬کبرشىبس‬
‫ارشدپرستبری‪-‬تلفه‪Email:Jalil_irani_s@yahoo.com-93813349569-99134133685:‬‬
‫‪ -3‬ایران‪-‬داوشگبٌ علًم پسشکی شُرکرد‪-‬معبيوت درمبن‪--‬بلًارشُیدآیت‪-‬ادارٌ پرستبری ‪-‬کبرشىبس پرستبری‪-‬تلفه‬
‫َمراٌ‪Email: mohamadih7778@yahoo.com -99131848637:‬‬
‫‪ -4‬ایران‪-‬داوشگبٌ علًم پسشکی مشُد‪-‬بیمبرستبن امبم رضب(ع)‪-‬سًپريایسر کىترل عفًوتُبی بیمبرستبوی‪-‬تلفه‬
‫َمراٌ‪99133832618:‬‬
‫مقدمٍ‪:‬هزالجت هٌحصز ثِ پزستبری ًیست ‪ ،‬اهب پزستبری اهزی هٌحصز ثِ فزد ثِ شوبر هی رٍد‪.‬پزستبری فؼبلیتی ػولی است وِ در آى‬
‫تجزثِ‪،‬ػَاطف ٍارتجبطبت ‪،‬ثذًِ اصلی وبر رٍساًِ را تشىیل هی دٌّذ‪.‬هزالجت اهزی است هزثَط ثِ اًسبًْب وِ تَسط اًسبى‪،‬ثزای اًسبى ٍدر‬
‫همبم اًسبى صَرت هی پذیزد‪.‬ایي آخزیي جٌجِ هزالجت است وِ اس آى اهزی هٌحصز ثِ فزد هی سبسد‪.‬ثب ایي رٍیىزد هزالجت ایوي ٍثب‬
‫ووتزیي خطز لبثل اجتٌبة اس حیث وٌتزل ػفًَت ٍپیشگیزی آى اس جولِ هسئَلیتْبی اخاللی ٍحزفِ ای پزستبری است‪.‬‬
‫ريش بررسی‪ :‬ایي همبلِ اس ًَع همبلِ ّبی تَصیفی –وتبثخبًِ ای است وِ ثصَرت هزٍری در سبل‪ 3131‬تٌظین شذُ است ‪.‬در آى ثب‬
‫استفبدُ اس همبلِ ّبی ػلوی‪-‬پژٍّشی اطالػبت هَتَر جستجَی ‪ّmagiran ٍgoogle.scholar‬وچٌیي پبیگبُ اطالػبتی ٍ وتبثْبی‬
‫هَجَد در ایي سهیٌِ هَرد تجشیِ ٍ تحلیل لزار گزفتِ ٍ ثِ جوغ ثٌذی آى پزداختِ شذُ است‪.‬‬
‫یبفتٍ َب‪ :‬حفبظت اس ثیوبراى در ثزاثز ػفًَتْبی ثیوبرستبًی اس طزیك استبًذاردّبی حزفِ ای‪،‬حفظ سالهت ثیوبراى ٍهذدجَیبى‪،‬حفظ‬
‫سالهت جبهؼِ‪،‬اًجبم هزالجت در خَر اػتوبد ٍاطویٌبى ثِ ثیوبراى‪،‬تأییذ ٍحوبیت اس حزفِ ثب رفتبر هٌبست‪،‬هسئَلیت پذیزی در اًجبم‬
‫هزالجت‪،‬ارائِ هزالجت ثب ویفیت ثبال ثِ ثیوبراى‪،‬رػبیت لَاًیي ٍدستَرالؼولْبی حزفِ ای اثالؽ شذُ در ولیِ سهیٌِ ّبی هزالجت ثِ طَر اػن‬
‫ٍهزالجت هجتٌی ثز پیشگیزی ٍوٌتزل ػفًَت ثِ طَر اخص‪،‬هشبروت دادى ثیوبراى در اًجبم هزالجت ‪،‬حفظ شأى ٍهٌشلت ثیوبراى ثذٍى‬
‫تَجِ ثِ ٍضؼیت التصبدی‪ً،‬ژادی‪،‬فزٌّگ‪،‬هذّت ٍ‪،...‬رػبیت اٍلَیتْبی هزالجت اس ثیوبراى‪ّ،‬وىبری ثب تین هزالجتی در وٌتزل ٍپیشگیزی اس‬
‫ػفًَتْبی ثیوبرستبًی‪،‬ثِ اشتزان گذاشتي تَاًبیی ّب ٍتَاًوٌذیْبی ػولی در وٌتزل ٍپیشگیزی اس ػفًَت ‪،‬حفظ ایوٌی ّوِ جبًجِ‬
‫ثیوبر‪،‬پیش ثیٌی ٍالذا م هٌبست در هَرد رخذادّبیی وِ در حیي هزالجت هوىي است رخ دّذ‪،‬شٌبسبیی افزادی وِ هستمیوبً درگیز ػَارض‬
‫ًبشی اس هزالجت هی شًَذ‪،‬شٌبسبیی افزاد ولیذی ثزای همبثلِ ثب ػَارض ٍػفًَتْبی ثیوبرستبًی‪،‬شٌبسبیی ًیبسّبی اسبسی ثیوبراى‪،‬شٌبسبیی‬
‫جٌجِ ّبی اخاللی فزدی وِ ًیبسهٌذ تَجِ هی ثبشٌذ ٍ‪ ...‬اسجولِ هْتزیي هَاردهزالجت اخاللی اس ثیوبراى ثزای پیشگیزی ٍوٌتزل ػفًَت‬
‫هی ثبشذ‪.‬‬
‫وتیجٍ گیری‪ :‬پزستبراى در توبس حزفِ ای ًشدیه ثب ثیوبراى یب هذدجَیبًی ّستٌذ وِ اس آًبى هزالجت هی ًوبیٌذ ٍاس آًجب وِ دریبفت‬
‫خذهبت هزالجت ایوي اس حمَق اسبسی ثیوبراى هی ثبشذ‪.‬السم است وِ ایي هزالجتْبی حزفِ ای آهیختِ ثب اخالق حزفِ ای ثبشذ‪.‬‬
‫ياشٌ َبی کلیدی‪ :‬هسئَلیتْبی اخاللی‪،‬هزالجت‪،‬پیشگیزی‪،‬وٌتزل ػفًَت‬
Infection control in intensive care units (ICU)
Authors: Amir Mohammad Ghani 1*, Seyed Jalil Hosseini Irani 2, Humaira Mohammadi 3, Z. Ayyazi 4
1*. Iran-Shahre-kord university of Medical Sciences - Assistant Therapy – Str. Ayat – MSc in medical Eng.
Tel:62131836326- Email:amir.ghani@gmail.com
2. Shahre-kord university of medical science.MSc Nursing-Tel: 6381-3342566 – 62134133685- Email:
jalil_irani_s@yahoo.com
3.Shahre-kord university of medical science ,BSc Nursing-Mobile:62131848630-Email:
mohamadih0008@yahoo.com
4. Shahre-kord university of medical science -MSc medical Seines & BSc Nursing- Tel: 6381-3342566 –
62131845662- Email: ayazi_z65@yahoo.com
Background and Objectives: The ICU is one of the riskiest places to Rvd.myzan's hospital infection
prevalence in this section 01-3 the rest of the hospital. Patients at risk of invasive infections caused by the care
and use of equipment Vvsayl including bacteremia, pneumonia, urinary tract infections are the 10 percent risk of
respiratory tract infection, urinary tract, blood current 42 percent, 04 percent.
Methods: This article is an overview of the digital and manual inspection of the books, articles and websites
have been developed in 0131.
Results: The main objective of hospital infection control programs, reducing the risk of infection acquired by
patients, hospital staff, especially nurses and prevent the transmission of infectious diseases using the basic
steps for designing educational programs Note aspects of human resources service provider in the intensive care
unit dimensions educational practice and update their knowledge on how to standard care of patients admitted
to the ICU regular their performance with standard care of patients who can be a focus of infection practice care
of their rooms, isolated and in compliance with standard precautions and care in the ICU Engineering intensive
care unit, including fitness area with the number of beds, number of restroom locations and dramatically
reducing pollution prevention and control of nosocomial infections can improve infection control.
Conclusion: Today, infection control precautions are based on the use of personal protective equipment.
Although many of these infections are preventable infection control tests. But none of these measures without
applying the precautionary principle consistently Vbkargyry staff trained health service providers in this sector
with the physical space will not affect the ICU.
Keywords: infection control,ICU ward
‫روشهای کنترل عفىنت در بخش های مراقبت ویژه(‪)ICU‬‬
‫نىیسنذگان‪ :‬امیرمحمذ قانی*‪-1‬سیذ جلیل حسینی ایرانی‪ - 2‬حمیرا محمذی‪ - 3‬زهرا ایازی‬
‫‪-1‬‬
‫* ایران‪-‬داوشگاٌ علًم پسشکی شهرکرد‪-‬معايوت درمان‪--‬بلًارشهیدآیت‪-‬ادارٌ تجهیسات پسشکی‪-‬کارشىاس ارشد مهىدسی پسشکی‪-‬‬
‫تلفه‪62111810190‬‬
‫‪-9‬‬
‫داوشگاٌ علًم پسشکی شهرکرد‪-‬معايوت درمان‪--‬بلًارشهیدآیت‪-‬ادارٌ پرستاری ‪-‬کارشىاس ارشدپرستاری‪-‬تلفه‪-62113111080:‬‬
‫‪Email:Jalil_irani_s@yahoo.com-61811132006‬‬
‫‪ -1‬ایران‪-‬داوشگاٌ علًم پسشکی شهرکرد‪-‬معايوت درمان‪--‬بلًارشهیدآیت‪-‬ادارٌ پرستاری ‪-‬کارشىاس پرستاری‪-‬تلفه همراٌ‪-62111838010:‬‬
‫‪Email: mohamadih0008@yahoo.com‬‬
‫‪ -3‬ایران‪-‬داوشگاٌ علًم پسشکی شهرکرد‪-‬معايوت درمان‪--‬بلًارشهیدآیت‪-‬ادارٌ پرستاری‪-‬کارشىاس ارشدپرستاری‪،‬آمًزش پسشکی‪-‬‬
‫‪Email:ayazi_z65@yahoo.com-62111830062‬‬
‫مقدمه‪ :‬تخش ‪ ICU‬یکی از پرخغرتریي هکاًْا ترای اتتال تِ عفًَتْای تیوارستاًی تِ شوار هی رٍد‪.‬هیساى شیَع عفًَت در ایي‬
‫تخش ‪ 3-01‬تراتر سایر تخشْای تیوارستاى است‪.‬تیواراى تستری در ایي تخش هستعذ عفًَتْای ًاشی از هراقثت ٍتِ کارگیری‬
‫تجْیسات ٍٍسایل تْاجوی از جولِ تاکتریوی‪،‬پٌَهًَی ٍعفًَتْای هجرای ادراری هی تاشٌذ کِ خغر عفًَت سیستن‬
‫تٌفسی‪10‬درصذ‪،‬سیستن ادراری‪42‬درصذ ٍجریاى خَى‪04‬درصذ است‪.‬‬
‫روش بررسی‪ :‬ایي هقالِ یک پژٍّش هرٍری هی تاشذ کِ عی تررسی دستی ٍ دیجیتال از کتة‪،‬هقاالت ٍ سایت ّای ایٌترًتی در‬
‫سال ‪ 0111‬تذٍیي گردیذُ است‪.‬‬
‫یافته ها‪ّ :‬ذف اصلی ترًاهِ کٌترل عفًَتْای تیوارستاًی‪،‬کاّش خغر اکتساب عفًَت تَسظ تیواراى‪،‬کارکٌاى تیوارستاى تاالخص‬
‫پرستاراى ٍجلَگیری از اًتقال عفًَت تا تکارگیری اقذاهات اساسی ٍتذٍیي ترًاهِ ّای آهَزشی است‪.‬تَجِ ٍیژُ تِ جٌثِ ًیرٍی‬
‫اًساًی ارائِ دٌّذُ خذهت در تخشْای هراقثت ٍیژُ در اتعاد آهَزشی ٍعولکردی ٍتِ رٍز ًوَدى داًش آًاى در هَرد ًحَُ هراقثت‬
‫استاًذارد از تیواراى تستری در تخش ‪ٍICU‬پایش هٌظن ٍهذاٍم عولکرد آًاى تِ ّوراُ هراقثت استاًذارد از تیواراًی کِ هی تَاًٌذ‬
‫تِ عٌَاى کاًَى عفًَت عول ًوایٌذ ٍهراقثت از آًاى در اتاقْای ایسٍلِ ٍّوچٌیي رعایت احتیاعْای استاًذارد هراقثتی در‬
‫تخش‪ٍ ICU‬هٌْذسی تخش هراقثتْای ٍیژُ از جولِ تٌاسة هساحت تخش تا تعذاد تخت‪،‬تعذاد ٍهَقعیت دستشَیی ّا ٍ‪ ...‬تِ ًحَ‬
‫چشوگیری در کاّش ٍکٌترل عفًَتْای تیوارستاًی هی تَاًذ کٌترل عفًَت ٍجلَگیری از آلَدگی را تْثَد تخشذ‪.‬‬
‫نتیجه گیری‪ :‬امروز کٌترل عفًَت تر هثٌای قاًَى احتیاط استَار است‪.‬اگرچِ تسیاری از هَارد عفًَت تا تکارگیری ٍسایل‬
‫حفاظت فردی ٍتکٌیکْای کٌترل عفًَت قاتل پیشگیری است‪.‬اها ّیچیک از ایي اقذاهات تذٍى تکارگیری اصل احتیاط هذاٍم‬
‫ٍتکارگیری کارکٌاى ارائِ دٌّذُ خذهات سالهت ٍرزیذُ در ایي تخش تِ ّوراُ ساختار فضای فیسیکی تخش ‪ICU‬هؤثر ًخَاّذ‬
‫تَد‪.‬‬
‫واژه های کلیدی‪ :‬کٌترل عفًَت‪ ،‬تخش ‪ICU‬‬
International standards for the prevention and control of infections
Authors:* sayed Jalil Hosseini Irani1- Dr.Alireza Asgharzade2- Homeira Mohamadi3- Zahra Ayazi4
1. Iran.shahrekord university of medical sciences.MSc Nursing-Tel: 1331-3349561 – 19134133635Email: jalil_irani_s@yahoo.com
2.shahrekord university of medical sciences – GP- specialty and subspecialty Polyclinic Imam Ali (AS)
-Tel:1331-2241231-19132312116- Email: Alireza.asgharzade@yahoo.com
3.shahrekord university of medical sciences ,BSc Nursing-Mobile:19131343630-Email:
4. shahrekord university of medical sciences.Godal cheshme- corresponding Author: MSc-Medical
Education and BSc Nursing-1331-3349561 – 19131345619- Email: Ayazi_z56@yahoo.com
Introduction: The purpose of the prevention and control of hospital infection, Identify and reduce
the risk of transmission of infection between patients, staff, health care professionals, students and
visitors are. Infectious risks in the plan of a hospital to another hospital, according to hospital clinical
services, geographic location, number of patients and medical staff varies. However, standards for
infection prevention and control can be expanded to include all hospitals.
Methods: This article is a Review article during the review of handheld digital books and Internet
sites have been developed in 2115.
Results: Infection prevention and control standards in aspects:
A) Leader ship program includes monitoring activities, control and prevention of infection,
Monitor the activities of infection control staff, Presentation and dissemination of guidelines
and regulations to control the infection and to provide adequate resources to support the
infection control program.
B) Standards focus of the program include: Develop a comprehensive plan to reduce the risks
of infection, creating a safe environment for care, focusing on the reduction and prevention
of infection, determining methods and processes to reduce the risk of infection, appropriate
decontamination and monitoring of textile and laundry equipment, proper disposal of
infectious waste and sharp objects and dangerous, food service
C) Improve the quality of patient safety standards, including: Use of the information concerning
risks, the amount and procedures for designing or modifying processes, the results of
hospital infection surveillance authorities.
D) Staff training standards for infection control program including measures necessary and
important that hospitals should be deciding.
Conclusion: The application of professional standards of care, control and prevention of nosocomial
infections, hospital, clear vision to develop goals and strategies for coping with hospital infection
prevention and removal of human and financial resources to be drawn.
Keywords: standard, prevention, infection control
‫استاًذاسدُای تیي الوللی پیطگیشی ّکٌتشل عفًْت‬
‫ًْیسٌذگاى‪:‬سیذ جلیل حسیٌی ایشاًی‪ - *1‬دکتشعلیشضا اصغشصادٍ ‪-2‬حویشا هحوذی‪ - 3‬صُشا ایاصی‪4‬‬
‫‪-1‬‬
‫*‬
‫ایران‪-‬داوشگاٌ‬
‫علًم‬
‫پسشکی‬
‫شهرکرد‪-‬معايوت‬
‫درمان‪--‬بلًارشهیذآیت‪-‬ادارٌ‬
‫پرستاری‬
‫‪-‬کارشىاس‬
‫ارشذپرستاری‪-‬‬
‫تلفه‪Email:Jalil_irani_s@yahoo.com-53813349565-59134133685:‬‬
‫‪-2‬‬
‫ایران داوشگاٌ علًم پسشکی شهرکرد‪ -‬پسشک عمًمی‪ ،‬پلی کلیىیک تخصصی يفًق تخصصی امام علی(ع) ‪-59132852116-‬‬
‫‪Email:Alireza.asgharzade@yahoo.com‬‬
‫‪ -3‬ایران‪-‬داوشگاٌ علًم پسشکی شهرکرد‪-‬معايوت درمان‪--‬بلًارشهیذآیت‪-‬ادارٌ پرستاری ‪-‬کارشىاس پرستاری‪-‬تلفه همراٌ‪-59131848637:‬‬
‫‪Email: mohamadih7778@yahoo.com‬‬
‫‪ -4‬ایران‪-‬داوشگاٌ علًم پسشکی شهرکرد‪-‬معايوت درمان‪--‬بلًارشهیذآیت‪-‬ادارٌ پرستاری‪-‬کارشىاس ارشذپرستاری‪،‬آمًزش پسشکی‪-‬‬
‫مقدمه‪ُ:‬ذف تیواسستاى اص تشًاهَ پیطگیشی ّکٌتشل عفًْت‪،‬ضٌاسایی ّکاُص هخاطشات ًاضی اص اًتقال عفًْت ُا هیاى‬
‫تیواساى‪،‬کاسکٌاى‪،‬هتخصصاى هشاقثت سالهت‪،‬داًطجْیاى ّعیادت کٌٌذگاى است‪.‬هخاطشات عفًْی دس تشًاهَ هقاتلَ اص یک‬
‫تیواسستاى تَ تیواسستاى دیگش تا تْجَ تَ خذهات تالیٌی تیواسستاى ‪،‬هحل جغشافیایی‪،‬تعذاد تیواساى ّکادس دسهاًی هتفاّت است‪.‬تا‬
‫ایي حال استاًذاسدُای پیطگیشی ّکٌتشل عفًْت هی تْاًذ دس تشگیشًذٍ تواهی تیواسستاًِا تاضذ‪.‬‬
‫روش بررسی‪ :‬این مقاله یک ‪ Review article‬می باشد که طی بررسی دستی و دیجیتال از کتب و سایت های اینترنتی در سال‬
‫‪ 9313‬تدوین گردیده است‪.‬‬
‫یافته ها‪:‬تذّیي استاًذاسدُای پیطگیشی ّکٌتشل عفًْت دس اتعاد ‪:‬الف)سُثشی تشًاهَ ضاهل ًظاست تش فعالیتِای کٌتشل‬
‫ّپیطگیشی اص عفًْت‪ً،‬ظاست تش فعالیت ُای کادس دسهاًی اص ًظش کٌتشل عفًْت‪،‬اسائَ ّاضاعَ دستْسالعول ُای هْسد قثْل‬
‫ّآییي ًاهَ ُای هشتْط تَ کٌتشل غفًْت ّفشاُن ًوْدى هٌاتع هٌاسة تشای حوایت اص تشًاهَ کٌتشل عفًْت ب)استاًذاسدُای‬
‫توشکض تشًاهَ ضاهل‪ :‬تذّیي یک تشًاهَ جاهع تشای کاُص خطشات عفًْت‪،‬ایجاد هحیط ایوي تشای هشاقثت‪،‬توشکض تش کاُص‬
‫ّپیطگیشی عفًْت‪،‬تعییي سّضِا ّفشآیٌذُای کاُص خطش عفًْت‪،‬آلْدگی صدایی هٌاسة تجِیضات ًّظاست تش الثسَ‬
‫ّسختطْیخاًَ‪،‬اًِذام هٌاسة صتالَ ُای عفًْی ّاجسام ًْک تیض ّخطشًاک ‪،‬سشّیس دُی هٌاسة غزا ّ‪...‬پ)استاًذاسدُای تِثْد‬
‫کیفیت ّایوٌی تیواس ضاهل‪:‬استفادٍ اص اطالعات هْجْد دس خصْظ هخاطشات‪،‬هیضاًِا ّسًّذُا تشای طشاحی یا تعذیل‬
‫فشآیٌذُا‪،‬اسائَ ًتایج پایص عفًْت تیواسستاى تَ هشاجع ری طالح ّ‪)...‬استاًذاسدُای آهْصش کاسکٌاى دس هْسد تشًاهَ کٌتشل‬
‫عفًْت اص جولَ اقذاهات ضشّسی ّهِوی است کَ تیواسستاًِا تایستی تذاى ُوت گواسًذ‪.‬‬
‫نتیجه گیری‪:‬تَ کاسگیشی استاًذاسدُای حشفَ ای دس تشًاهَ هشاقثت‪،‬کٌتشل ّپیطگیشی اصعفًْتِای تیواسستاًی‪،‬چطن اًذاص سّضٌی‬
‫تشای تذّیي اُذاف ّاستشاتژیِای تیواسستاى تشای هقاتلَ تا عفًْتِای تیواسستاًی ّپیطگیشی اص ُذسسفت هٌاتع اًساًی ّهالی‬
‫تشسین هی ًوایذ‪.‬‬
‫واژه های کلیدی‪:‬استاًذاسد‪،‬پیطگیشی‪،‬کٌتشل عفًْت‬
The role of hand hygiene in the clinical laboratory
Authors: Mojtaba Heidari 1* - Zahra Ayazi 2- sayed jalil Hosseini irani 3- Homeira Mohammadi4
1.*Iran.shahrekord university of medical sciences - specialty and subspecialty Polyclinic Imam Ali (AS) – BSc laboratory
science, Tel:1331-2241231-15131333651- Email: Mheidari111@yahoo.com
2. shahrekord university of medical sciences -MSc medical Seines & BSc Nursing- Tel: 1331-3345561 – 15131345615Email: Ayazi_z56@yahoo.com
3. shahrekord university
jalil_irani_s@yahoo.com
of
medical
sciences.
MSc
Nursing-Tel:
1331-3345561
–
15134133635-
Email:
4.shahrekord university of medical sciences ,BSc Nursing-Mobile:15131343630-Email: mohamadih0003@yahoo.com
Introduction: patient care during sampling and doing experiments with contaminated hands, causing the transmission of
nosocomial infections are laboratories, staffs may be at risk of contagious diseases and infectious diseases transmitted
through blood due to needlestick and or discharge and other opportunistic infections are alive. So use personal
protective( mask, glasses &…)standard precaution and hand washing is necessary to prevent these infections. Hands
washing as the most effective, cheapest way to prevent these infections, especially in clinical laboratories. no addition of
training costs are highly dependent on the behavior of health care providers at the hospital.
Methods: This study was a retrospective study, looking through books, articles library was developed in 2115.
Findings: Despite adequate knowledge and attitude about the role of hands in the transmission of infection in hospitals,
behavioral changes they recommended Ast.lza little hands be washed in the following: immediately after accidental skin
contact with blood, body fluids or tissues. If the call The contamination occurs through tearing gloves should
immediately discard the gloves and hands thoroughly before and after contact.- Baby ward. labor. samples after
completion of the work and before leaving laboratory. After removing gloves or wearing new gloves before.-before all
the activities in which the eye skin contact occurs.
Conclusion: A laboratory environment with various risky, conducted laboratory experiments to staff its hard and Hand
washing is the most important principle pollution prevention and education is no substitute to change the behavior of the
partners is inevitable.
Keywords: hand washing, clinical laboratories, infection control
‫وقص بهذاضت دست در آزمایطگاٌ بالیىی‬
‫وًیسىذگان‪ :‬مجتبی حیذری*‪-1‬زهرا ایازی‪-2‬سیذ جلیل حسیىی ایراوی‪ - 3‬حمیرا محمذی‪4‬‬
‫‪ *-1‬ایران‪-‬داوطگاٌ علًم پسضکی ضهرکرد‪ -‬کارضىاس علًم آزمایطگاهی‪-‬مذیر پلی کلیىیک تخصصی يفًق تخصصی امام علی(ع)‬
‫‪Email:mheidari111@yahoo.com-19131833651‬‬‫‪-2‬داوطگاٌ علًم پسضکی ضهرکرد‪-‬معايوت درمان‪--‬بلًارضهیذآیت‪-‬ادارٌ پرستاری‪-‬کارضىاس ارضذپرستاری‪،‬آمًزش پسضکی‪-‬‬
‫‪-3‬داوطگاٌ‬
‫علًم‬
‫پسضکی‬
‫ضهرکرد‪-‬معايوت‬
‫درمان‪--‬بلًارضهیذآیت‪-‬ادارٌ‬
‫‪-‬کارضىاس‬
‫ارضذپرستاری‪-‬‬
‫‪-4‬داوطگاٌ‬
‫علًم‬
‫پسضکی‬
‫ضهرکرد‪-‬معايوت‬
‫درمان‪--‬بلًارضهیذآیت‪-‬ادارٌ‬
‫‪-‬کارضىاس‬
‫پرستاری‪-‬تلفه‬
‫همراٌ‪Email: mohamadih7778@yahoo.com -19131848637:‬‬
‫همذهِ‪ :‬ارائِ خذهات تِ تیوار حیي اًجام ًوًَِ گیزی ٍاًجام آسهایطات‪،‬تا دستْای آلَدُ‪،‬سثة تزٍس ٍاًتمال عفًَتْای تیوارستاًی هی گزدد‪.‬واروٌاى‬
‫آسهایطگاُ هوىي است در هعزض اتتالء تِ تیواریْای هسزی ٍ تیواریْای عفًَی هٌتملِ اس طزیك خَى ) تِ جْت ًیذل استیه ضذى ( ٍ یا تزضحات‬
‫سًذُ ٍ سایز عفًَت ّای فزصت طلة تاضٌذ ‪.‬تٌاتزایي استفادُ اسٍسایل حفاظت فزدی)هاسه‪ ،‬عیٌه ٍدستىص ( ‪،‬رعایت اصَل احتیاطات استاًذارد ٍ‬
‫ضستي هزتة دست ّا تزای پیطگیزی اس ایي عفًَت ّا تسیار ضزٍری هی تاضذ‪ .‬ضستطَی دستْا تعٌَاى هؤثزتزیي‪،‬ارساى تزیي ٍراحت تزیي رٍش‬
‫پیطگیزی اس ایي عفًَتْا تَیضُ در آسهایطگاّْای تالیٌی هی تاضذ‪.‬وِ ّشیٌِ ای ًذاضتِ ٍعالٍُ تز آهَسش تِ ضذت ٍاتستِ تِ رفتار ارائِ دٌّذگاى‬
‫خذهات سالهت در تیوارستاى است‪.‬‬
‫رٍش تزرسی‪ :‬ایي هطالعِ یه پضٍّص هزٍری تَدُ وِ اسطزیك جستجَی وتاتخاًِ ای تاتزرسی وتة ٍهماالت درسال ‪3131‬تذٍیي ضذُ است‪.‬‬
‫یافتِ ّا‪ :‬تحمیمات ًطاى دادُ اًذ وِ رفتار ضستطَی دستْا اس طزف ارائِ دٌّذگاى خذهات سالهت همثَلیت وافی ًذاضتِ ٍدرهَارد اًجام‬
‫ّن‪،‬ویفیت هٌاسثی ًذارد‪.‬هطالعات اًجام ضذُ در ایزاى تیاًگز آى است وِ رفتار ایطاى در ضستي دستْا در حذ ضعیف تا هتَسط تَدُ است ٍ علی‬
‫رغن ٍجَد آگاّی ًٍگزش وافی درخصَظ ًمص دستْا در اًتمال عفًَت در تیوارستاى‪،‬تغییزات رفتاری آًْا اًذن است‪.‬لذا تَصیِ هی گزدد در ایي‬
‫هَارد دستْا ضستِ ضًَذ‪ :‬ـ فَراً تعذ اس تواط اتفالی پَست تا خَى‪ ،‬هایعات تذى یا تافت ّا‪-‬اگز تواسی تا هَاد آلَدُ اس طزیك پارُ ضذى دستىص‬
‫ّا اتفاق تیفتذ تایذ تالفاصلِ دستىص ّا را درآٍردُ ٍ دست ّا را واهالً ضست‪-.‬ـ لثل ٍ تعذ اس تواط تاتیواراى ٍیاتواط تا ًوًَِ ّای آسهایطگاّی‪.‬ـ‬
‫تعذ اس اتوام وار ٍ لثل اس تزن آسهایطگاُ‪.‬ـ تعذ اس درآٍردى دستىص ّا ٍ یا لثل اس آًىِ دستىص جذیذی پَضیذُ ضَد‪-.‬لثل اس ّوِ فعالیت ّایی‬
‫وِ در آًْا تواط واهل دست تاهخاط چطن ّایاخزاش ّای پَست اتفاق هی افتذ‪.‬‬
‫ًتیجِ گیزی‪ :‬آسهایطگاُ تعٌَاى هحیطی پزهخاطزُ تا ًوًَِ ّای هختلف‪،‬اًجام آسهایطات را تزای واروٌاى علَم آسهایطگاّی سخت هی ًوایذٍرعایت‬
‫هْوتزیي اصل پیطگیزی اس آلَدگیْا یعٌی ضستطَی دست ّیچ جایگشیٌی ًذارد ٍآهَسش هؤثز تا تغییز رفتار در ایي ّوىاراى‪،‬اهزی اجتٌاب ًاپذیز‬
‫است‪.‬‬
‫ٍاصُ ّای ولیذی‪ :‬ضستطَی دست ‪،‬آسهایطگاُ تالیٌی‪،‬وٌتزل عفًَت‬
Prevalence of blaTEM, blaIMP, BlaVIM and blaADC genes in Extended-Spectrum βLactamase–producing Acinetobacter Baumannii in burn unit of Imam Reza hospital,
Mashhad
SaeidAmel Jamehdar1, Nazanin Sahaddi2, Samaneh Dolatabadi2
1
Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of
Medical Sciences, Mashhad, Iran
2
Department of biology, Neyshabur branch, Islamic Azad University, Neyshabur, Khorasan
Razavi, Iran
Introduction:
Escherichia coliexpressing extended-spectrum β-lactamase (ESBL) are among the most
multidrug-resistant pathogens in hospitals and are spreading worldwide. These phenotypes
cause infections that produced in poor outcomes, reducedrates of clinical and microbiological
responses, longer hospitalization, and high hospital expenses.In addition to the CDC
guidelines, the medical staff and patientswere asked to frequently gargle and wash their
hands, and a private room was assigned to thepatients infected with ESBL-producing
bacteria.In this study, weevaluate prevalence of ESBL-producing Escherichia coli in
pediatric ward.
Materials and Methods:
Escherichia coliisolates were collected from pediatric ward of Imam Reza hospital and then
were approved based on morphological characteristics and biochemical tests. Antimicrobial
resistance test was conduct by disc diffusion method according to CLSI guideline
recommendations. For detection of ESBL isolates thedifference between susceptibility zone
of ceftazidim and ceftazidim+clavulanic acid was measured. Data Analysis was conducted by
using SPSS version 1111.
Results:
In this study ninety-nine E. coli isolate was evaluated. This study indicated that 31 isolates
(31133) was ESBL.
Discussion:
It is necessary to screen patients because the number of those infected with ESBL-producing
E. coli has seen an increase recently in the community.Our results indicate that it is necessary
to carefully monitor patients to determine whetheror not they are infected with ESBLproducing E. coli.
Key Words: E. coli, ESBL, Pediatric
Nurses and standard precautions in hospitals
Authors: * Homeira Mohamadi1–Mohammad shahin2-sayed Jalil Hosseini Irani3Zahra Ayazi4
1-Iran.shahrekord university of medical sciences , BSc Nursing-Mobile:73131343630-Email:
2.shahrekorduniversity –Tel:73133367736- Email: mohammad.shahin@gmail.com
3. shahrekord university of medical sciences. MSc Nursing-Tel: 7331-3343567 – 73134133635Email: jalil_irani_s@yahoo.com
4. shahrekord university of medical sciences.Godal cheshme- corresponding Author: MSc-Medical
Education and BSc Nursing-7331-3343567 – 73131345673- Email: Ayazi_z56@yahoo.com
Introduction: With the expansion of hospitals Nosocomial infections are a major health problem in
With increased morbidity and mortality and length of stay in hospital, which is resulting in increased
hospital costs. So simple compliance strategies for the prevention of damage to the priorities of
senior executives, especially hospitals, nursing managers, supervisors and supervisors should be.
Methods: This article cross - library that will be reviewed in 2115 has been adjusted by the use of
paper Scientific-Research Information Search Engine google. scholar and magiran the database of
books in this field of study, analyze, summarize and editing is.
Results : Many infections of hospital staff, patients, visitors and equipment can be transmitted to
patients To reduce the risk of transmission of microorganisms in hospitals, standard precautions are
used Precautions for all personnel with blood, liquid waste and damaged skin contact is mandatory.
Because nurses are known as the main providers of patient services plays an important role in
promoting these precautions are implemented. Wash hands immediately after exposure to blood
and body fluids Regardless of gloves When exposed to liquid blood to the body, Mask, eye
protection during mouth face care, Useganat the time of patient care. Collection and transfer sheets
stained with blood and mucus in the standard way Precautions in dealing with contaminated sharp
objects Seating for patient care standards and disinfecting the room and equipment after patient
use, Isolation of infectious patients and ... In addition to simply perform substantially in reducing the
incidence of nosocomial infections can be effective.
Conclusion: Because the nurses providing direct care to patients in hospitals are, Also worthy of
attention to their pivotal role in the control of nosocomial infections from their ability to develop
strategies and policies related to hospital infection control must be used properly.
Keywords: Nurse, precautions, hospital
‫پرستاران ي احتیاطُای استاودارد در بیمارستان‬
‫وًیسىدگان‪ :‬حمیرا محمدی ‪ -*1‬محمدشاَیه‪ -2‬سید جلیل حسیىی ایراوی‪ – 3‬زَرا ایازی‪4‬‬
‫‪ *-1‬ایران‪-‬داوشگاٌ علًم پسشکی شُرکرد‪-‬معايوت درمان‪--‬بلًارشُیدآیت‪-‬ادارٌ پرستاری ‪-‬کارشىاس پرستاری‪-‬تلفه‬
‫َمراٌ‪Email: mohamadih7778@yahoo.com-79131848637:‬‬
‫‪-2‬ایران‪-‬داوشگاٌ شُرکرد—داوشجًی مقطع کارشىاسی رشتٍ زیست شىاسی عمًمی‪-79138867736-‬‬
‫‪Email:mohammad.shahin@gmail.com‬‬
‫‪-3‬ایران‪-‬داوشگاٌ علًم پسشکی شُرکرد‪-‬معايوت درمان‪--‬بلًارشُیدآیت‪-‬ادارٌ پرستاری ‪-‬کارشىاس ارشدپرستاری‪-‬‬
‫‪-4‬ایران‪-‬داوشگاٌ علًم پسشکی شُرکرد‪-‬معايوت درمان‪--‬بلًارشُیدآیت‪-‬ادارٌ پرستاری‪-‬کارشىاس ارشدپرستاری‪،‬آمًزش‬
‫پسشکی‪Email:ayazi_z56@yahoo.com-79131845679-‬‬
‫مقدمٍ‪ّ :‬وسهاى تا گسترش تیوارستاًْا ‪،‬عفًَتْای تیوارستاًی ّوَارُ از هطکالت عوذُ تْذاضتی تَدُ ٍتا افسایص هذت اقاهت تیوار در‬
‫تیوارستاى هَجة اتتالء ٍهرگ ٍهیر ٍدر ًتیجِ افسایص ّسیٌِ ّای تیوارستاًی ضذُ است‪.‬تٌاترایي تذٍیي ٍرعایت استراتژیْای سادُ ترای‬
‫پیطگیری از ایي خسارتْا تایستی در اٍلَیت ترًاهِ ّای هذیراى ارضذ تیوارستاى ٍخصَصاٌ هذیراى پرستاری‪،‬سَپرٍایسرّا ٍسرپرستاراى قرار‬
‫گیرد‪.‬‬
‫ريش بررسی‪ :‬ایي هطالعِ ‪ ،‬هقالِ ای تَصیفی –کتاتخاًِ ای تَدُ کِ تصَرت هرٍری در سال‪ 3131‬تٌظین ضذُ است ٍتا استفادُ از هقالِ‬
‫ّای علوی‪-‬پژٍّطی اطالعات هَتَر جستجَی ‪ّmagiran ٍgoogle.scholar‬وچٌیي پایگاُ اطالعاتی ٍ کتاتْای هَجَد در ایي زهیٌِ‬
‫تررسی‪،‬آًالیس ‪،‬جوع تٌذی ٍتذٍیي ضذُ است‪.‬‬
‫یافتٍ َا‪ :‬تسیاری از عفًَتْا از کارکٌاى تیوارستاى ‪،‬تیواراى‪،‬عیادت کٌٌذگاى ٍتجْیسات تِ تیوار سرایت هی کٌذ‪.‬توٌظَر کاّص خطر‬
‫اًتقال هیکرٍ ارگاًیسن ّا در تیوارستاى‪،‬احتیاطْا ی استاًذارد تِ کار هی رًٍذ‪.‬رعایت احتیاطات استاًذارد ترای ّوِ پرسٌل کِ تا‬
‫خَى‪،‬هایعات دفعی ٍپَست آسیة دیذُ در تواس ّستٌذ‪،‬الساهی است ٍاز آًجا کِ پرستاراى تِ عٌَاى ارائِ دٌّذگاى اصلی خذهات تالیٌی‬
‫تیوار ضٌاختِ هی ضًَذ‪ً،‬قص هْوی در اجرا ٍترٍیج ایي احتیاطْا دارًذ‪.‬ضستي دستْا تالفاصلِ پس از هَاجِْ تا خَى ٍهایعات تذى ‪،‬تذٍى‬
‫در ًظر گرفتي استفادُ از دستکص تِ ٌّگام هَاجِْ تا خَى ٍهایعات تذى تیوار‪،‬استفادُ از هاسک‪،‬هحافظ چطن ٍصَرت ٍدّاى در حیي‬
‫اًجام هراقثت ‪ ،‬استفادُ از گاى در ٌّگام هراقثت از تیوار ‪،‬جوع آٍری ٍاًتقال هلحفِ آلَدُ تِ خَى ٍترضحات تِ رٍش استاًذارد‪،‬رعایت‬
‫احتیاط در هَاجِْ تا اضیاء آلَدُ ًَک تیس‪،‬رعایت استاًذاردّای هخصَظ هحل استقرار ٍهراقثت از تیوار ٍضذعفًَی کردى اتاق ٍٍسایل‬
‫پس از استفادُ تیوار‪،‬ایسٍلِ ًوَدى تیواراى عفًَی ٍ‪ ...‬عالٍُ تر سادگی در اجرا تِ ًحَ چطوگیری هی تَاًذ در کاّص هَارد عفًَتْای‬
‫تیوارستاًی هؤثر تاضذ‪.‬‬
‫وتیجٍ گیری‪:‬از آًجا کِ پرستاراى هحَر ارائِ هراقثتْای هستقین ترای تیواراى تستری در تیوارستاى هی تاضٌذ‪،‬ضایستِ است ضوي تَجِ‬
‫تِ ًقص هحَری آًاى در کٌترل عفًَتْای تیوارستاًی از تَاًوٌذی آًاى در جْت تذٍیي استراتژیْا ٍخط هطی ّای هرتثط تا کٌترل‬
‫عفًَتْای تیوارستاًی تِ ًحَ هطلَب استفادُ گردد‪.‬‬
‫ياشٌ َای کلیدی‪ :‬پرستار‪،‬احتیاط استاًذارد‪ ،‬تیوارستاى‬
Review study in the role of mycoplasma infections in infertility of men and women
Dr Ali khorsand, assistant professor of acupuncture, Imam Reza Hospital, University of Medical Sciences , Mashhad
Nasrin Esfahani, BS of Nursing , Imam Reza Hospital, University of Medical Science,Mashhad
Azam sadat Amini, MS in cell development, Imam Reza Hospital, University of Medical Sciences, Mashhad*
Abstract:
Mycoplasma family are bacteria without cell walls in different hosts, including humans, animals, plants
and insects can be found.
Mycoplasma bacteria are the smallest and simplest. They have a free life. Most men and women are
urogenital tract flora and species are potential pathologies.
infections due to Mycoplasma and Ureaplasma genital can lead to infertility and infertility. Ability of
attachment of microorganism to epithelial cells urinary tract-urogenital, sperm cell, enabling them to
develop a urinary tract infection has urogenital.
These infections are often asymptomatic and have negative effects on the reproductive effects.
The effect of infection on PH, motility, morphology and sperm count in men and women pass through the
birth canal of factors are associated with infertility.
Nowadays different estimates of the various parts of the world about the role of infections in infertility is
present in %93 in developed countries, to %53 in African countries are variable.
The prevalence of Urea plasma in infertile couples (24% to 953) higher than in fertile couples (4%% to
453) have been reported.
Late and inadequate treatment of bacterial infections of the urogenital tract leading to reduced male
fertility and in severe cases can lead to infertility. Pelvic inflammatory disease and infertility in women
are caused.
The identification of these bacteria in infertile men and women with no clinical symptoms have very high
importance and microbial screening for infertile couples, especially at a young age is essential.
Keywords : Bacterial infection, infertility, urogenital infections
Necessary precautions in dealing of patients with positive HBS & HCV.
( Study of patients referred to Burning operating room of mashhad imam reza hospital
in2931 )
Mahdiani A 1 , Khorsand vakilzadeh A 2, Bonakdaran Z3 , rashchi M 4
1 Infection Control research center , Hormozgan university of medical science.bandar abbas , iran
2-3-4 complementary medicine research center , Mashhad university of medical science.
Introduction: The number of transferable because HBS- HCV infected patients is very high & Groups of
health care workers are at risk of infection . So some Instructions under "standard precautions" has been
developed that all healthcare workers should apply them to minimize the risk of transmission .
this study was conducted To better understand the required precautions in hospitals.
Methodology:
This descriptive cross-sectional study was conducted on all patients admitted to Burning operating room of
mashhad imam reza hospital in1332. Information about the HBS and HCV positive patients analyzed and
evaluated by SPSS ver. 16.
Results:
1. The total number of patients with positive HBS & HCV admitted to Burning operating room of mashhad
imam reza hospital in1332, were 23.
2. range of age in these patients were between 22-53 .
2. 21 of them with positive HCV (%2.47 ) & 8 of them with positive HBS (2%.67)
3. 24 of them were men(82.%) & 5 of them were women(1%.3)
Conclusions:
Primary prevention is very important & so the Observance of these primary prevention is necessary.
1- Community education about transmission routes and sanitation
2- Trained manpower in the medical sector
3- Identify carriers and training
Keywords: positive HBS - positive HCV- standard precautions- Operating room staff
Acinetobacter infection of burn wounds and drug sensitivity in referring to burn center of
Imam Reza Hospital in Mashhad
Dr Ali khorsand, assistant professor of acupuncture, Imam Reza Hospital, Mashhad University of Medical Sciences
Nasrin Esfahani, BS of Nursing, Imam Reza Hospital, Mashhad University of Medical Sciences
A. S. Amini, MS cell development, Imam Reza , Mashhad University of Medical Sciences*
Background:
Burn infections, as nosocomial infections are significant contributor to mortality and morbidity
after the burn. Since the notice of infection-causing bacteria and their susceptibility to antibiotics
have significant role in preventing and early treatment of burns and infections , This study aimed
to assess Acinetobacter infection in burn wounds in hospital burn unit of Imam Reza in Mashhad
and determine the sensitivity of the bacteria to some antibiotics were designed and implemented.
Materials and methods:
During a one-year period, 333 patients admitted to burn unit of Imam Reza hospital were
studied. Isolation and identification of microorganisms were performed using standard methods.
Antibiotic susceptibility was determined by disk diffusion method.
Results:
The mean age of patients was 02 years (range 1 to 02 years). Most number of patients under 12
years of age. The number of positive cultures of Acinetobacter in the study was 022 people from
333 people. The highest drug sensitivity was to Cefepim (n = 182) and After that, respectively
Ciprofloxacin (101), Cotrimoxazole (n = 131), Cefixime (130), Meropne (133), Amikacin
(101), Amipene (103 persons ), Piperacillin (111), Ceftriaxone (120) and Gentamicin (123) was
reported.
Conclusion:
Acinetobacter infections in burn patients and drug sensitivity of the bacteria, Need to make a
decision for the treatment of infection in these patients, as well as the control of antibiotic
resistance.
Keywords: burn wound infections, bacteria, antibiotics Sensitivity
Prevalence of Extended-Spectrum β-Lactamase–producing Escherichia coli in pediatric
ward of Imam Reza hospital, Mashhad
Mehdi kouhi1, HosseinKhoshkharam Roodmajani1, Mahboubeh Mohammadzadeh1, Leila
Ataei1, Ali Sardari1,SaeidAmel Jamehdar1,1*
1
Department of Microbiology, Imam Reza Hospital, School of medicine, Mashhad University of
1
Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of
Introduction and Objective: Escherichia coli expressing extended-spectrum β-lactamase
(ESBL) are among the most multidrug-resistant pathogens in hospitals and are spreading
worldwide.These phenotypes cause infections that produced in poor outcomes, reducedrates
of clinical and microbiological responses, longer hospitalization, and high hospital
expenses.In addition to the CDC guidelines, the medical staff and patientswere asked to
frequently gargle and wash their hands, and a private room was assigned to thepatients
infected with ESBL-producing bacteria.In this study, weevaluate prevalence of ESBLproducing Escherichia coli in pediatric ward.
Materials and Methods: Escherichia coli isolates were collected from pediatric ward of
Imam Reza hospital and then were approved based on morphological characteristics and
biochemical tests. Antimicrobial resistance test was conduct by disc diffusion method
according to CLSI guideline recommendations. For detection of ESBL isolates thedifference
between susceptibility zone of ceftazidim and ceftazidim+clavulanic acid was measured.
Data Analysis was conducted by using SPSS version 1111.
Results: In this study ninety-nine E. coli isolate was evaluated. This study indicated that 11
isolates (11113) was ESBL.
Discussion: It is necessary to screen patients because the number of those infected with
ESBL-producing E. coli has seen an increase recently in the community.Our results indicate
that it is necessary to carefully monitor patients to determine whetheror not they are infected
with ESBL-producing E. coli.
Key Words: E. coli, ESBL, Pediatric ward
Title
Considering The Pattern of antibiotic resistance in microorganisms in the urine of patients
hospitalized care unit, university hospital of Uremia
Authors names:1 Zahra mollabashi, Hanie Sharifian
Affiliation: 1Skin Diseases and leishmaniasis Research center, Isfahan university of Medical
sciences, Isfahan, Iran
2
Skin Diseases and leishmaniasis Research center, Isfahan university of Medical sciences, Isfahan,
Iran
Abstract
Introduction
The presence of resistant bacteria in different parts of hospitals and difficulties resulted from them in
treatment of patients, make identification of the properties of these bacteria and their susceptibility pattern
and antibiotic resistance necessary.
Objective
The aim of this study is to consider antibiotic resistance pattern of microorganisms in culture of patients'
Urine hospitalized in ICU of uremia teaching hospital.
Materials and Methods
In this retrospective study, positive urine culture sheets were collected from patients in ICU part of
Uremia Amam Khomani hospital and their data was extracted such as isolated organism and its
antibiogram and this data was transferred to spss-20 software and then it analysed.
The results
The finding of this study show that the most frequency of microorganisms in urine culture are as
following: Ecoli, spp klebsiella, Acinetobacter, pseudomonas, Entrococci.
The most resistance of E.coli is toward to antibiotics such nalidixic acid %86/4 , cotrimvksazvl %83 and
ceftriaxone %78 and the most resistance of %80/1 and nalidixic acid %72/3.
Discussion and conclusion
The results suggest that an important change did not occur during the time in view of the prevalence of
causative agents of urinary tract infections and then urocepsis in ICU and these organisms will be the
agent of difficult in most cases. Unfortunately (it was specified that organism being sensitive to variety of
antibiotics before were changed to organisms resistant to several antibiotics that even new antibiotics are
not influential on them such as carbapenem.
For determining exactly antibiotic sensitivity pattern, it is recommended to study more widely with more
samples in different medical center.
Keywords:
resistance, antibiotic , microorganism , urine culture
Title:A survey on human Cryptosporidiosis in Urmia city
Authors:Dr . Sohrab Rasouli1 , Dr. Mohammad Sadaghian , Reza Salmanzadeh , Farshad
Mazaheri
Islamic Azad University of Urmia
Abstract
Introduction & Objectives:
Cryptosporidium micro organisms are small Coccidial parasites that attack to microvilli of
epithelial cells of digestive and breathing organs of vertebrate.There is no specific host for this
parasite and it is seen in different animals , also cross transferring is observed among
species.The importance of this disease is very high and it is obviously important in term of
economics and general hygiene.
It causes calves diarrhea syndrome and lead to gastroenteritis.Also may cause to pneumonia in
infants and people with low immune system , so In this study examines ways to detect, prevent
and treat this disease
Because Urmia has high population it puts emphasize on epidemiologyic studies for evaluation
of this zoonotic disease , so this city was chosen for study.
Durinig this study 130 stool samples of children wich were send to children ward of urmia
motahhary hospital were collected and colored by changed – method of zilnilson.
Result:
6 stool samples of children under 36 month of age were reported positive to Oocyte infection.
Conclusion:
The results were compared with studies of other entities , concluded that the outbreak of
cryptosporidiosis among children is more than adults,in most parts of the world , thought to be
due to cell-mediated immunodeficiency in children and the contamination of the surface
potential health and safety contact with contaminated items directly related to.
keywords:Imperfect immune system , diarrhea,Cryptosporidium parasite.
1
sohrab_rasouli86@yahoo.com
Evaluation of antibiotic resistance in patients with urinary tract infection,
khorramabad Madani hospital
Tarhani F1 ; Dalvand sh
Lorestan university of medical science ,khorramabad , Iran
Abstract: urinary tract infection is a common bacterial infection in childhood. approximately 3-55 of
girls and 15 of boys acquire a urinary tract infection(UTI) .
The management of UTI is complicated by the increasing prevalence of antibiotic –resistance strains
and over the – counter antibiotics empiric therapy with antibiotic such as ampicillin ,amoxicillin and
cotrimoxazole world cost more and lead to widespread antibiotic resistance.
Material and Methods: In this study we aimed at assessment of prevalence of antibiotic resistance
in 121 patient with positive urine culture based on antibiogram results.
This cross – sectional study was performed in khorramabad madani hospital ?
62.25 of the patients were female and 31.75 were male.
Finding: Culture results were: Ecoli (13.35) ,Proteus(12.65) ,Klebsiela (%.45) .Entrobacter (3.15)
,Citerobacter (%.75) ,Yersinia(%.75) .
Overall antibiotic resistance was %6.%5 and resistance to antibiotics ,were: Ampicillin (77.25)
,Amoxicillin (76.65) ,Cotrimoxazole (15.65) , Nitrofurantion (17.%5),Nalidixic acid (1%.25)
,Cefixim(4.15) Ceftriaxon(3.15),Gentamicin (11.75) ,Amikacin (3.15).
Conclusion: Results showed that antibiotic resistance is more significant to antibiotics which have
been used for respiratory tract infection and available even without prescription ,such as Ampicillin
and Amoxicillin . we suggest close observation and more control on medicine availability .
Key words: urinary tract infection, children, Antibiotic resistance
Title: Determination of the role of special care in decreasing the risk of ventilatorassociated pneumonia after open heart surgery in CSICU unit in Razavi hospital
Authors names: fatame abbasi, sara kamali, DR khalighi
Site of research: CSICU unit in Razavi hospital
Introduction and Objectives: Ventilator-associated pneumonia (VAP) is the second most
common cause of nosocomial infection for patients undergoing major open heart surgery that
can affect significant increase in mortality, morbidity. Ventilator-associated pneumonia is a
second main infections in hospitals, the risk of developing nosocomial infections remains a
real threat as more patients of greater age and with more co-morbidity are to be operated on
Materials and Methods: This study was performed in CSICU unit in Razavi hospital.
Nursing interventions are trained to nurses due to control and prevention of VAP. Sampling
is performed in period of 6 months from August 1393 until the end of December 1393. The
questionnaire is used for data collection. For comparison, the questionnaires were filled for
the same issue according to patient s archives for six months before.
Result, Conclusion: We found the incidence of VAP of 3.5% that is significant and maybe
refers to early-onset ventilator-associated pneumonia. There issn't a significant difference
between risk of the VAP and the age (EF<40) (P.value =0.665),, There is link between risk of
the VAP and the kidney (EF<40).
Keyword: ICU open heart surgery - pneumonia, ventilator - a risk factor
Evaluation the Effect of Oral Administer PUFAs on Apoptosis in
Gastric Mucosa in Patients Infected with Helicobacter Pylori
Rasoul Sharifi 1, Mohammad Nouri2, Akram Eidi3, Ebrahim Fattahi4, Zahra Noormohammadi5,
Homayun Dolatkhah6
1.
2.
3.
4.
5.
6.
Corresponding Author, PhD Student in Biochemistry, MSc, Department of Biology, School of Basic
Sciences, Science and Research Branch, Islamic Azad University, Tehran, I. R. IRAN. Email:
rasoulsharifi.sci@gmail.com, Mobile: 90105543264.
Professor in Clinical Biochemistry, PhD, Department of Clinical Biochemistry and Laboratories Medicine,
Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, East Azarbaijan, I. R. IRAN.
Association Professor in Animal Sciences, PhD, Department of Biology, School of Basic Sciences, Science
and Research Branch, Islamic Azad University, Tehran, I. R. IRAN.
Professor in Liver and Gastrointestinal Disease, MD, Liver and Gastrointestinal Disease Research Center,
Tabriz University of Medical Sciences, Tabriz, East-Azarbaijan, I. R. IRAN.
Assistant Professor in Molecular Genetics, PhD, Department of Biology, School of Basic Sciences, Science
and Research Branch, Islamic Azad University, Tehran, I. R. IRAN.
PhD Student in Clinical Biochemistry, MSc, Department of Clinical Biochemistry, School of Pharmacy and
Pharmaceutics Sciences, Isfahan University of Medical Sciences, Isfahan, I. R. IRAN.
Abstract
Introduction and Objective: Helicobacter Pylori infection makes a high percentage of
stomach tissue infection, and is one of the major causes of oxidative stress, peptic ulcers and
other gastrointestinal disorders. Some studies have investigated the effects of dietary regimes
such as fatty acids on preventing cancers , and unsaturated necessary fatty acids and
Arachidonic acid influence many physiological processes such as immune response and
apoptosis. In this study, the effect of oral administration of omega-3 fatty acids, Omega-6 and
Omega-0 on the process of apoptosis have been investigated in H. Pylori infected patients.
Materials and Method: This study was a clinical trial, and selected patients underwent
endoscopy and with the help of Rapid Urease Test and pathological checking’s H. Pylori was
detected. Then, 34 patients were divided into 2 groups of 11. All patients were homogenized for
age, sex and nutritional requirements. In the first group, treatment was performed by routine
antibiotics without supplementation and the second group treatment was performed with the
same antibiotics with omega 3, 6 and 0 fatty acids pills for 2 consecutive weeks. After this
period, again endoscopy was done on these patients with biopsies taken from the fasting
stomach, and H. Pylori eradication and elimination of chronic active gastritis was followed. The
amount of semi-quantitative Bcl2 proteins and caspase-3 enzyme by Frozen Section method and
immunohistochemistry before and after the treatment were measured and their genetic
expressions were analyzed using Real-Time PCR.
Results: Caspase-3 protein enzyme in mucosal gastric tissue after 2 weeks of drug therapy in
both groups increased , but this increasing was much higher in the second group , and
statistically it was significant (p= 9.9941). Bcl-2 protein in gastric tissue after 2 weeks of drug
therapy decreased in both groups , and this decreasing was significant in the second group
(p=9.915). To confirm this increasing and decreasing in the next stage, the extraction and
quantification of the enzyme caspase-3 gene and Bcl-2 protein was performed. The results
confirmed this increasing.
Conclusion: According to the results of this study and various previous studies, it seems that the
effect of oral administration of omega 3, 6 and 0 fatty acids with commonly used antibiotics can
be useful for the eradication of Helicobacter pylori and apoptosis stimulation of gastric epithelial
cells.
Key words: Helicobacter Pylori Infection, drug resistance, PUFAs, Apoptosis, Bcl-2 protein,
Caspase-3
Determin corollation of H.pylori infection with incidence and relapse of nephrotic
syndrome in children
Dr farokh farokhnia1,Dr abdolkarim ghadimi moghadam1,Dr mohammad hosain
falahzadeh2,Dr ali darakhshan 2,Dr mohesen dehghani2
yasuj university of medical sciences.department of pediatric1
shiraz university of medical sciences.department of pediatric2
Introduction and background: Nephrotic syndrome in children is one of the most common
kidney disease. the detection of disease’s etiology,can help us for better treatment of this
patients,the main objective of this project was to demonstrate the relationship between H.pylori
infection with nephrosis in children.this infection is one of the most common human infections
and its role has been proved in numerous diseases.
Material and methods:All children with 1 to 12 years with new cases and relapse of idiopathic
nephrotic syndrome were evaluated.They divided to two groups ,forty cases were in control
group and forty cases were patients. Both groups were tested for H.pylori infection by stool
antigen.In patients who test was seen positive, endoscopy was done for them and positive rapid
urease test and histological examination was considered for diagnosis of H.pylori infection.
Results :the total number of groups participating in this study were 08 cases.11 of them were
positive for H.pylori infection (13.%.) In control group 7cases were positive for H.pylori
infection (17.%) and in patients 4 were positive(181). two groups in the statistics of patients
infected H.pylori,were not significantly different .(Pvalue=.063) (Pvalue=.063)
conclousion:this study showed that there is no any significant difference between control and
patients groups for incidence of H.pylori infection.
Keyword:H.pylori infection-nephrotic syndrome-incidence-relapse
Hand hygiene practices
Abbas Bahreini1, Masumeh Saeidi2
1
Resident of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Abstract
Antiseptic handwashing. Washing hands with soap and water,or other detergents containing an
antiseptic agent.
Antiseptic handrubbing (or handrubbing). Applying an antiseptic handrub to reduce or inhibit the
growth of microorganisms without the need for an exogenous source of water and requiring no rinsing or
drying with towels or other devices.
Hand antisepsis/decontamination/degerming. Reducing or inhibiting the growth of microorganisms by
the application of an antiseptic handrub or by performing an antiseptic handwash.
Hand care. Actions to reduce the risk of skin damage or irritation.
Handwashing. Washing hands with plain or antimicrobial soap and water.
Hand cleansing. Action of performing hand hygiene for the purpose of physically or mechanically
removing dirt, organic material, and/or microorganisms.
Hand disinfection is extensively used as a term in some parts of the world and can refer to antiseptic
handwash, antiseptic handrubbing, hand antisepsis/decontamination/degerming,handwashing with an
antimicrobial soap and water, hygienic hand antisepsis, or hygienic handrub. Since disinfection refers
normally to the decontamination of inanimate surfaces and objects, this term is not used in these
Hygienic hand antisepsis. Treatment of hands with either an antiseptic handrub or antiseptic handwash
to reduce the transient microbial flora without necessarily affecting the resident skin flora.
Hygienic handrub. Treatment of hands with an antiseptic handrub to reduce the transient flora without
necessarily affecting the resident skin flora. These preparations are broad spectrum and fast-acting, and
persistent activity is not necessary.
Hygienic handwash. Treatment of hands with an antiseptic handwash and water to reduce the transient
flora without necessarily affecting the resident skin flora. It is broad spectrum, but is usually less
efficacious and acts more slowly than the hygienic handrub.
Surgical hand antisepsis/surgical hand preparation/
presurgical hand preparation. Antiseptic handwash or antiseptic handrub performed preoperatively by
the surgical team to eliminate transient flora and reduce resident skin flora. Such antiseptics often have
persistent antimicrobial activity.
Surgical handscrub(bing)/presurgical scrub refer to surgical hand preparation with antimicrobial soap
and water.
Surgical handrub(bing) refers to surgical hand preparation with a waterless, alcohol-based handrub.
Key Words: Hygiene, Hand, Practice.
Overview of assessment strategies to promote hand hygiene in health care
providers
Atefeh Behboudifar*- Zeynab Kazem zadeh*Simin Sharafi*
*Student of Nursing MS, Mashhad university of Medical Science
Introduction:
Hospital-acquired infections (HAIs) burden patients, complicate treatment, prolong hospital
stay, increase costs and can be life threatening. Adequate hand hygiene (HH) among hospital
health care providers could prevent an estimated 15% to 30% of the HAIs. Many strategies
have been designed and evaluated to address the problem of low compliance, but most of the
effects are small to moderate
and often short term. So this study was conducted to assess the hand hygiene strategies to
evaluate and promote it in health care providers.
Methods:
Regarding hand hygiene strategies, databases and library resources published from 2008 to
2015were studied. Results are extracted from 15 relevant articles.
Results:
The results of the literature shows that variant strategies are used to evaluate and promote the
hand hygiene, such as Electronic evaluation ways, training sessions for health care providers,
students and faculty members, lecturing, using leadership and team based strategies, selfassessment by personnel. direct observation, clinical audit, periodic visits and using
checklists to assess the hand hygiene are more used in our country.Moreover the most
frequently of studies, addressed determinants were knowledge, awareness, action control, and
facilitation of behaviour and Fewer addressed social influence, attitude, self-efficacy, and
intention.
Conclusion:
Due to the poor hand hygiene in health care centers, despite the use of different strategies, the
result of articles shows that in order to promote the hand hygiene in personnel, applying only
one way is not effective. But to achieve the desired results, it will be required to incorporate
evidence-based and innovative ways to change health behaviors.
Key words:
Hand hygiene promotion, evaluation strategies, health care
The Effectiveness of Occupational Health in Reduction of Healthcare Associated infections in
Hospital Healthcare Workers
Seyedeh Negar Assadi
Associate Professor, Health Sciences Research Center, Department of Occupational Health
Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
Email:assadin@mums.ac.ir
Introduction and objective: Occupational risk factors are different and one of the important risks is
biological. Healthcare workers are at risk of many risks such as physicals, chemicals, ergonomics, shift
work and biological. Occupational Health can prevent them. The objective of study was the introduction
of effectiveness of occupational health in reduction of healthcare associated infections in hospital
healthcare workers.
Materials and Methods: By research in occupational health and medicine texts and literature, scientific
journals, and evidence based medical and health websites specially national institute for occupational
safety and health from the centers for disease control and prevention, world health organization, haz-map,
international labor organization this study was done.
Results: In these studies were emphasized on checking the immunity at the first time. Vaccinations in pre
placement examination were a necessity for this reason. Follow ups in periodic examination were helpful.
Engineering controls were absolutely necessary for correction of ventilations in the hospitals and other
related centers. Administrative controls were related to managerial systems and programs of shifts and
personal protective devices such as respirators were useful specially respirators for protection from
biological hazards. Other devices were necessary for example protective gloves, eye protectors and
special cloths.
Conclusion: Attention to immunity situation at the beginning of the jobs and doing the preventive
methods can be useful and practical.
Keywords: Healthcare, Occupational infection, Occupational health, Occupational Medicine
‫تاثیر حفظ سالمت شغلی بر کاهش عفونت ناشی از مراقبت بیمار در پرسنل بیمارستانی‬
‫سیده نگار اسعدی‬
‫متخصص طب کار ‪ ،‬دانشیار مرکز تحقیقات علوم بهداشتی‪ ،‬گروه مهندسی بهداشت حرفه ای ‪ ،‬دانشکده بهداشت ‪ ،‬دانشگاه‬
‫علوم پزشکی مشهد ‪ ،‬مشهد ‪ ،‬ایران‬
‫پست الکترونیک‪assadin@mums.ac.ir :‬‬
‫مقدمه وهدف‪ :‬عوامل خطر شغلی گوناگون هستند یکی از آنها عوامل بیولوژیک است‪ .‬عوامل خطری که پرسنل‬
‫بهداشتی‪ -‬درمانی را تهدید می کند شامل عوامل فیزیکی ‪ ،‬شیمیایی ‪ ،‬ارگونومیک ‪ ،‬نویت کاری و بیولوژیک هستند‪.‬‬
‫بهداشت حرفه ای به کاهش این خطرات کمک می کند‪ .‬هدف این مطالعه تعیین تاثیر سالمت شغلی در کاهش عفونت ناشی‬
‫از مراقبت بیمار در پرسنل بیمارستانی است‪.‬‬
‫روش کار‪ :‬با مطالعه متون و کتابهای علمی در زمینه بهداشت حرفه ای و طب کار و همچنین با مطالعه ژورنال عای علمی‬
‫مرتبط و مراجعه به مدارک معتبر به روز یعنی سایتهای علمی مانند انستیتو ایمنی وبهداشت حرفه ای وابسته به مراکز کنترل و‬
‫پیش گیری از بیماری ها ‪ ،‬سازمان بهداشت جهانی ‪ ،‬سازمان بین المللی کار و سایر سایتهای معتبر این مطالعه انجام شد‪.‬‬
‫نتایج‪ :‬مطالعات نشان داده اند ایمن سازی پرسنل در بدو استخدام وپیگیری وضعیت ایمنی در معاینات دوره ای و استفاده از‬
‫روش های کنترلی مهندسی مانند تهویه ها ‪ ،‬استفاده از تهویه های استاندارد وقابل قبول ‪ ،‬روش های کنترل مدیریتی و تنظیم‬
‫برنامه کاری و نهایتاً استفاده از وسایل حفاظت فردی مانند انواع رسپیراتورها که برای حفاظت از عوامل بیولوژیک تهیه شده‬
‫اند همچنین سایر وسایل مانند دستکش ها ‪ ،‬عینک محافظ و لباس می توانند در کاهش عفونت شغلی موثر باشند‪.‬‬
‫نتیجه گیری کلی‪ :‬حفظ سالمت شغلی با توجه به ایمن بودن پرسنل نسبت به عفونت ها و رعایت نکات بهداشت حرفه ای‬
‫می تواند در کاهش عفونت موثر باشد‪.‬‬
‫کلمات کلیدی‪:‬پرسنل بهداشتی‪ -‬درمانی ‪ ،‬عفونت شغلی ‪ ،‬سالمت شغلی ‪ ،‬طب کار‬
Historical perspective on hand hygiene in health care
Maryam Ajilian Abbasi1, Masumeh Saeidi2
1
Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Abstract
In the mid-1800s, studies by Ignaz Semmelweis in Vienna, Austria, and Oliver Wendell Holmes
in Boston, USA, established that hospital-acquired diseases were transmitted via the hands
of HCWs. In 1847, Semmelweiss was appointed as a house officer in one of the two obstetric
clinics at the University of Vienna Allgemeine Krankenhaus (General Hospital). He observed
that maternal mortality rates, mostly attributable to puerperal fever, were substantially higher in
one clinic compared with the other (16% versus 7%).50 He also noted that doctors and medical
students often went directly to the delivery suite after performing autopsies and had a isagreeable
odour on their hands despite handwashing with soap and water before entering the clinic. He
hypothesized therefore that “cadaverous particles” were transmitted via the hands of doctors and
students from the autopsy room to the delivery theatre and caused the puerperal fever. As a
consequence, Semmelweis recommended that hands be scrubbed in a chlorinated lime solution
before every patient contact and particularly after leaving the autopsy room. Following the
implementation of this measure, the mortality rate fell dramatically to 3% in the clinic most
affected and remained low thereafter.
Key Words: perspective, hand hygiene, health care.
Oral manifestations of HIV/AIDS
Zohreh Dalirsani *1, Atessa Pakfetrat 2, Maryam Amirchaghmaghi3
1
Associate Professor of Oral Medicine, Oral and Maxillofacial Diseases Research Center ,
Department of Oral Medicine, Faculty of Dentistry, Mashhad University of Medical Sciences,
Mashhad, Iran.
2
Associate Professor of Oral Medicine, Addiction Research Center , Department of Oral
Medicine , Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
3
Associate Professor of Oral Medicine, Dental Research Center , Department of Oral Medicine,
Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Presenter: Zohreh Dalirsani
Address: Dental School, Vakil Abad BLVD, Mashhad, Iran
Postal code: 91735
Email: dalirsaniz@mums.ac.ir
Tel: 09155002857
Introduction and Objectives:
HIV/AIDS is currently the fourth leading cause of death worldwide.Some studies have been done
on effects of HIV infection on oral mucosa.In some cases,oral manifestations are the first
findings of HIV/AIDS.
In this article,we discuss about oral manifestations of HIV/AIDS and how one dentist or
physician could relate these changes to this infection.
After searching in articles published in Pubmed/Medline, oral manifestations of HIV/AIDS were
concluded in this paper.
Results:
In the oral cavity,a variety of alterations are common in HIV/AIDS that often are related to
consequence of immune system deficiency.
According to the results of various studies,oral lesions are observed in 70–90% of HIV+ patients
during the different stages of the disease. These lesions include oral candidiasis, hairy leukoplakia,
Kaposi sarcoma, necrotizing ulcerative periodontitis, aphthous ulcer. Other lesions reported in some
articles are human papillomavirus infection, hyperpigmentation, xerostomia, leukoplakia, herpes
zoster, non-Hodgkin’s lymphoma, histoplasmosis, exfoliative cheilitis, salivary gland disease.
Oral findings play an important role in the detection of infection, prediction of viral infection
progress and progression to AIDS.
Some studies showed that CD4+ count plays a crucial role in some oral findings such as oral
candidiasis,hairy leukoplakia,Kaposi sarcoma.
It appears that race,sex, route of transmission and stage of disease progression affect the
development of oral lesions.
Conclusion:
Sometimes, oral findings of HIV/AIDS are the first manifestations of the infection.These changes
predict the prognosis of disease.The dentists should pay attention to these changes for correct
diagnosis and appropriate treatment.
Key words:HIV/AIDS,oral manifestations.
‫عٌَاى‪:‬‬
‫ًقص سَسزی آهزیکبیی ٍ سَسزی آلوبًی (سَسزیْبی اّلی) در اًتقبل ػفًَت ّبی ببکتزیبیی در بیوبرستبًْب‬
‫ًَیسٌدگبى‪:‬‬
‫عببس بْراهی*‪ ،1‬فراًک فیرٍزفر‪ ،2‬شْیي سیبُ تیری‪ ،3‬هرین زهبًی فرد‬
‫‪3‬‬
‫*‪ - 1‬دکتری حشرُ شٌبسی پسشکی ٍ هببرزُ بب ًبقلیي ‪،‬گرٍُ اًگل شٌبسی ٍ قبرچ شٌبسی داًشکدُ پسشکی‪،‬‬
‫داًشگبُ علَم پسشکی البرز‪ ،‬کرج‪ ،‬ایراى‬
‫‪ – 2‬کبرشٌبس ارشد حشرُ شٌبسی پسشکی ٍ هببرزُ بب ًبقلیي‪ ،‬عضَّیئت علوی داًشکدُ بْداشت داًشگبُ علَم‬
‫پسشکی خراسبى شوبلی‪ ،‬بجٌَرد‪ ،‬ایراى‬
‫‪ - 3‬هربی آهَزشگبُ بَْرزی هرکس بْداشت شْرستبى سبٍجبالغ‪ ،‬داًشگبُ علَم پسشکی البرز‪ ،‬کرج‪ ،‬ایراى‬
‫هقدهِ‪:‬‬
‫در سبل ّبی اخیز ػفًَت ّبی بیوبرستبًی اس هؼضالت هْن بْذاضتی در بیوبرستبًْب ٍ هزاکش درهبًی ّستٌذ‪ .‬در هحیط‬
‫بیوبرستبًْب بؼضی اس حطزات اس جولِ سَسزی ّب آفبت بْذاضتی ّستٌذ کِ در قسوت ّبی هختلف بیوبرستبى ّب ببػث اًتقبل‬
‫ػَاهل ػفًَت سا بِ بیوبراى ٍ افزاد دیگز هی ضَ ًذ‪ .‬سَسزی آهزیکبیی ٍ آلوبًی اس جولِ آفبت هْن بْذاضتی ّستٌذ کِ در‬
‫راستِ دیکتیَپتزا ٍ خبًَادُ بالتیذُ قزار دارًذ ٍ دارای اًتطبر جْبًی هی ببضٌذ‪ .‬بیص اس یکصذ گًَِ اس ػَاهل بیوبریشایی‬
‫ببکتزیبیی اس ایي سَسزی ّبی اّلی جذا ضذُ است‪ .‬سَسزی ّب ًبقلیي هْن گًَِ ّبی هختلف ببکتزی ّب اس جولِ اضزضیب کلی‪،‬‬
‫اًتزببکتزیبسِ‪ ،‬کلبسیال‪ ،‬سَدٍهًَبسْب‪ ،‬سزاتیب‪ ،‬استبفیلَکَکْب‪ ،‬ضیگال‪ ،‬اًتزٍکَکَسْب ٍ ببسیلَسْب ّستٌذ‪.‬‬
‫هَاد ٍ رٍشْب‪:‬‬
‫در هطبلؼبتی کِ بز رٍی سَسزی ّب اًجبم گزفتِ است سَسزی ّب را بب استفبدُ اس تلِ ّبی چسببى اس قسوت ّبی هختلف‬
‫بیوب رستبى جوغ آٍری هی کٌٌذ ٍ آًْب را اس ًظز جٌس ٍگًَِ تطخیص هی دٌّذ‪ .‬سَسزی ّبی صیذ ضذُ ّزکذام جذاگبًِ در‬
‫داخل لَلِ ّبی استزیل گذاضتِ ضذُ ٍ بِ آسهبیطگبُ هٌتقل هی کٌٌذ‪ .‬در آسهبیطگبُ ّز سَسزی بؼذ اس تطخیص اس ًظز جٌس‬
‫ٍگًَِ ‪ ،‬اس سطح خبرجی ٍ ّن اس سطح داخلی(دستگبُ گَارش) آى ًوًَِ سَاپ تْیِ هی ضَد ٍ کطت ّبی هختلف ببکتزیبیی‬
‫بز رٍی آًْب اًجبم هی ضَد‪ .‬بزای اًجبم ًوًَِ بزداری اس دستگبُ گَارش سَسزی‪ّ ،‬ز سَسزی اس ًبحیِ ضکن ببس ضذُ ٍ اس هَاد‬
‫هَجَد در قسوت هؼذُ ٍ رٍدُ بب استفبدُ اس سَاپ استزیل ًوًَِ بزداری اًجبم هی ضَد‪.‬‬
‫ًتبیج‪:‬‬
‫طبق هطبلؼبت اًجبم ضذُ در اًستیتَ تحقیقبت بْذاضتی بزسیل بز رٍی سَسزی آهزیکبیی‪ %74/6 ،‬اس سَسزی ّب بِ ببکتزیْبی‬
‫گزم هٌفی ٍ ‪ % 25/4‬اس آًْب بِ ببکتزیْبی کَکسی گزم هثبت آلَدُ بَدًذ‪ .‬در کطَر لْستبى در هطبلؼِ ای بز رٍی سَسزی ّب‬
‫اًَاع ببکتزی ّبی اًتزٍببکتز‪ ،‬کلبیسال‪ ،‬سیتزٍببکتز‪ ،‬سزاتیب‪ ،‬سَدٍهًَب‪ ،،‬استبفیلَکَکَ‪ ٍ ،‬اًتزٍکَکَ‪ ،‬اس آًْب جذا ضذُ ٍ‬
‫تطخیص دادُ ضذًذ‪ .‬در هٌطقِ تبًجیز کطَر هزاکص در یک بزرسی بز رٍی آلَدگی سَسزی ّب بِ ػَاهل بیوبریشایی ببکتزیبیی‬
‫چٌذیي گًَِ اس جولِ استبفیلَکَکَ‪ ،‬اپیذرهیذیس‪ ،‬اضزضیب کلی‪ ،‬استزپتَکَکَ‪ ،،‬کلبسیال ٍ گًَِ ّبی آًتزٍببکتز ٍ سزاتیب‬
‫ضٌبسبیی ضذًذ‪ .‬در هطبلؼِ دیگزی در ًیجزیِ ببکتزیْبی کلبسیال پٌَهًَیب‪ ،‬اًتزٍببکتز کلَآکب‪ ،‬ضیگال سًَئی‪ٍ ،‬یبزیَ کلزا ٍ‬
‫سیتزٍببکتز فزئًَذی اس سَسزی ّبی آهزیکبیی ٍ آلوبًی جذا ضذُ است‪ .‬در کطَرهبى هطبلؼبت سیبدی بز رٍی آلَدگی‬
‫ببکتزیبیی سَسزی ّب در بیوبرستبًْب اًجبم ضذُ است‪ .‬هطبلؼِ ای در ضْز سٌٌذج بز رٍی سَسزی ّبی صیذ ضذُ اس‬
‫بیوبرستبًْبی ایي ضْز ًطبى هی دّذ کِ ‪ %74‬اس سَسزی ّبی صیذ ضذُ الاقل بِ یکی اس ػَاهل ببکتزیبیی ضطگبًِ‬
‫سَدٍهًَب‪ ،،‬اًتزٍببکتز‪ ،‬اضزضیب‪ ،‬کلبسیال‪ ،‬پزٍتئَ‪ ٍ ،‬سزاتیب آلَدُ بَدُ اًذ‪ .‬در ایي تحقیق اضزضیب کلی بب ‪ %61/5‬آلَدگی‬
‫دارای بیطتزیي فزاٍاًی ٍ سزاتیب بب ‪ % 6/1‬آلَدگی‪ ،‬کوتزیي فزاٍاًی را در بیي ػَاهل ببکتزیبیی داضتٌذ‪ .‬در بیوبرستبًْبی ضْز‬
‫اَّاس بزرسی ّب ًطبى هی دّذ کِ ‪ % 66/7‬اس سَسزیْبی آهزیکبیی صیذ ضذُ بِ ببکتزی اضزضیب کلی ٍ ‪ %73/3‬اس آًْب بِ ببکتزی‬
‫پزٍتئَ‪ٍ ،‬لگبریس آلَدُ بَدًذ‪ .‬در یک هطبلؼِ اًجبم ضذُ بز رٍی سَسزی ّبی بیوبرستبًْبی خزهطْز ‪ %100‬اس ًوًَِ ّبی‬
‫صیذ ضذُ بِ ػَاهل هختلف ببکتزیبیی آلَدُ بَدًذ بطَریکِ گًَِ ّبی کلبسیال‪ ،‬سَدٍهًَب‪ ٍ ،‬اضزضیب کلی بیطتزیي آلَدگی را‬
‫ًسبت بِ ببکتزی ّبی دیگز داضتٌذ‪ .‬در بیوبرستبًْبی ضْز ّوذاى ًیش سَسزیْب بِ گًَِ ّبی هختلف ببکتزیْبی بیوبریشا آلَدُ‬
‫بَدًذ کِ در بیي آًْب اًتزٍببکتزّب (‪ ،)%22/6‬کلبسیال(‪ ٍ )%21‬اًتزٍکَکَ‪ )%17/3( ،‬آلَدگی در بیي سَسزی ّب داضتٌذ‪.‬‬
‫بحث‪:‬‬
‫در هٌبطق ضْزی هخصَصب در هحیط ب یوبرستبًْب‪ ،‬سَسزیْب ًقص هْوی در اًتقبل ػَاهل بیوبریشایی ببکتزیبیی دارًذ ٍ یکی اس‬
‫ػلل ایجبد ػفًَتْبی بیوبرستبًی ًبضی اس حضَر ایي حطزات در بخص ّبی هختلف بیوبرستبًی است‪ .‬آلَدگی بسیبر ببالی‬
‫سَسزی ّبی صیذ ضذُ در هحیط بیوبرستبًْب در هقبیسِ بب سَسزی ّبی هٌبطق دیگز ًطبى هی دّذ کِ سَسزی ّب در‬
‫بیوبرستبًْب ًقص هْوی در تببدل ػَاهل ػفًَی در بیي بخص ّبی هختلف بیوبرستبى ٍ اًتقبل آى بِ بیوبراى ٍ حتی افزاد‬
‫سبلن دارًذ‪ .‬بٌببزایي کٌتزل سَسزی ّب در هحیط بیوبرستبى ّب ٍ کبّص جوؼیت آًْب ببػث کبّص اًتقبل ػَاهل بیوبریشا ٍ‬
‫کبّص هیشاى ػفًَتْبی بیوبرستبًی در بیي بیوبراى ٍ افزاد سبلن هی ضَد‪.‬‬
‫لغبت کلیدی‪ :‬سَسزی‪ ،‬سَسزی آهزیکبیی‪ ،‬سَسزی آلوبًی‪ ،‬ػفًَتْبی ببکتزیبیی‪ ،‬بیوبرستبى‬
Microbial Colonization of Endotracheal Tube in intensive care unit Patients
Shahla Samieeifard1, Neda Kiasat2, Elham Baghdadi3, Farzaneh Nateghi3, Fatemeh Noorbakhsh3, Sadegh
Khodavaisy4,5*
1
Department of Microbiology, Jondishapour University of Medical Sciences, Ahwaz, Iran.
Department of Medical Mycology, Jondishapour University of Medical Sciences, Ahwaz, Iran.
3
Department of Microbiology, Islamic Azad University of Varamin-Pishva Branch, Iran.
4
Department of Medical Parasitology and Mycology, Kurdistan University of Medical Sciences,
Sanandaj, Iran.
5
Department of Medical Mycology, Kurdistan University of Medical Sciences, Sanandaj, Iran.
2
Introduction and Objectives: Microbial biofilms has remained a major complication of tracheal
intubation in patients requiring ventilator equipments. The aim of this study was to characterise bacterial
and fungal biofilms in extubated endotracheal tubes from ICU patients in Emam Khomaini and Golestan
hospitals, Ahwaz, Iran.
Materials & methods: In this cross-sectional descriptive study, patients admitted to ICU that required
mechanical ventilation for at least 24 hours were evaluated. Specimens were collected from tracheal tubes
of patients with endotracheal aspiration, when they had clinical manifestation of pneumonia. The
specimens were microbiologically investigated and the fungal and bacterial isolates were identified by
using standard cultural and biochemical tests.
Results: In total, 353 cases had tracheal tube aspirate positive cultures were studied. The positive
specimens were belonged to 242 male and 131 female (with the mean age of 36.2±1.35) hospitalized
patients. Most of isolates are known to cause colonization of endotracheal tube included: Coagulase
negative staphylococci (12.21), Escherichia coli (121), Enterobacter spp. (16.21), Pseudomonas spp.
(14.61), Acinetobacter spp. (2..1), Staphylococcus aurous (2.11), Klebsiella spp. (6..1), and Serratia
spp. (3.41). ..41 were colonized with candida spp. that the most common species was C. albicans (42.31)
followed by C. glabrata (251), C. tropicalis (21..1), and C. krusei (13.21). There was significant
association between duration of being intubated and S. aurous, Enterobacter spp. (P=3.332).
Conclusion: The presence of bacterial and fungal biofilms of endotracheal tube suggests may be
important in biofilm development and may provide a therapeutic target for the prevention of ventilatorassociated pneumonia.
Keywords: Nosocomial, Endotracheal Tubes, Biofilm
HN11111111101
New teaching methods in Nosocomial infection prevention and control for nursing students
Introduction and Objectives: Nosocomial infections are prevalent nationally and internationally; and
occur in patients of all age group It has been identified that education should be a part of any overall
strategy for Nosocomial infection prevention and control in health care settings. nursing students have an
important role to play for Nosocomial infection prevention and control and therefore need to be taught
good practice both in their clinical placements and by their educational institutions. purpose of this study
is review efficient teaching methods for Nosocomial infection control and prevention for nursing students.
Method: published article between 0222 to 0202 searched and reviewed in Persian electronic resource
in SID, Magiran and iranmedex. and Latin electronic resource in pubmed, sciencedirect, proquest and
googlescholar. and at last 01 articles used in this review study.
Result: students have lower motivation towards learning if taught by lecture in comparison with more
attractive approaches in Nosocomial infection prevention and control teaching. the e-learning programs
was rated as good as on design, academic content were motivating for their learning. more than 125 of
nurse student find that computer assisted learning software program is easy and enjoyable for it's learning.
using interpersonal simulation-based learning and teaching by doing- scenario based simulation teaching
make students more aware of how complex each scenario. implication of self-learning models is one of
useful methods in its teaching. but more than %25 of nurse educators do not use this methods in this
matter for nursing students.
Conclusion: Nursing students must consider how they address Nosocomial infection prevention and
control in health care setting. teaching and learning in Nosocomial infection prevention and control for
nurse students is a joint responsibility between the university and practice placement by using efficient
teaching methods.
key words: education, nurse students, Nosocomial infection ,prevention and control
‫روش ٌای وویه آموزشی کىرتل و پیشگیری عفووت ٌای بیمارستاوی برای‬
‫داوشجویان پرستاری‬
‫‪2‬‬
‫وُيسىذگبن‪ :‬امري رضب صبحل مقذم‪ ،1‬سُملبس ٌالکُ‬
‫‪ – 1‬عضُ ٌيئت علمي داوطگبي علُم پشضکي مطٍذ‬
‫‪ – 2‬داوطجُي کبرضىبسي ارضذ پزستبري داوطکذي پزستبري َ مبمبيي مطٍذ‬
‫وُيسىذي مسئُل‪ :‬سُملبس ٌالکُ امييل‬
‫‪-Holakous121@mums.ac.ir‬‬
‫مقدمً و ٌدف‪ :‬عفُوت ٌبی بيمبرستبوی در مهً کطُرٌب َ در مهً گزَي ٌبی‬
‫سىی ضيُع داروذ‪ .‬آمُسش بً عىُان خبص ضزَری بزای پيطگيزی َ کىرتل‬
‫عفُوت ٌبی بيمبرستبوی می ببضذ‪ .‬بب تُجً بً وقص پزستبران بً عىُان‬
‫خبص ضزَری آمُسش داوطجُيبن پزستبری حمسُة می ضُد‪ .‬ايه مطبلعً بب ٌذف‬
‫مزَری بز مطبلعبت رَش ٌبی وُيه آمُسضی کىرتل َ پيطگيزی عفُوت ٌبی‬
‫بيمبرستبوی بزای داوطجُيبن پزستبری اجنبم ضذي است‪.‬‬
‫روش کار‪ :‬در پبيگبي ٌبي اطالعبتي التني ‪ ، science direct، pubmed،proquest‬در‬
‫ببسي ‪ َ 2214-2222‬در پبيگبي ٌبي فبرسي ‪ iranmedex ,SID ,Magiran‬در ببسي‬
‫سمبوي ‪ 1313 -1331‬جستجُ اجنبم ضذ کً يبفتً ٌبی ‪ 15‬مقبلً مزتبط َارد‬
‫مطبلعً گزديذ ‪.‬‬
‫یافتً ٌا‪ :‬يبفتً ٌبی ايه مطبلعً وطبن می دٌذ کً داوطجُيبن در‬
‫يبدگيزی پيطگيزی َ کىرتل عفُوت ٌبی بيمبرستبوی اس طزيق آمُسش‬
‫سخىزاوی اوگيشي پبييىی داروذ‪ .‬بزوبمً ٌبي آمُسش الکرتَويکی بستگی بً‬
‫طزاحی آن‪ ،‬حمتُای آمُسضی يبدگيزی در سطُح خمتلفی را ارائً می دادوذ‪.‬‬
‫بيص اس پىجبي درصذ اس داوطجُيبن يبدگيزی رايبوً ای را سبدي َ لذت‬
‫خبص عىُان کزدوذ‪ .‬آمُسش بب استفبدي اس ضبيً سبسی بيه حزفً ای َ‬
‫سىبريٌُبی َابستً بً ضبيً سبسی ويش يبدگيزی بب اجنبم دادن کبر در‬
‫وظز گزفتً ضذي است َ ويش رَش ٌبی آمُسضی يبدگيزی مستقل بً عىُان‬
‫رَضی مفيذ َ اثز خبص در آمُسش پيطگيزی َ کىرتل عفُوت ٌبی بيمبرستبوی‬
‫می ببضذ؛ کً بيص اس سی درصذ مزبيبن آمُسش پزستبری اس ايه رَش ٌبی‬
‫آمُسضی وبآگبي مي ببضىذ‪.‬‬
‫وتیجً گیری‪ .:‬داوطجُيبن پزستبری درببري ی چگُوگی ضىبسبيی پيطگيزی َ‬
‫کىرتل عفُوت ٌبی بيمبرستبوی ببيذ آگبٌی السم َ کبفی را داضتً ببضىذکً‬
‫بً کبرگيزی رَش ٌبی‬
‫مسئُليت خطيزی بزای حميط ٌبی آمُسضی می ببضذ‪.‬‬
‫وُيه آمُسضی در راستبی ايه ٌذف می ببضذ‪.‬‬
‫کلید واژي ٌا‪ :‬آمُسش‪ ،‬عفُوت بيمبرستبوی ‪،‬کىرتل‪ ،‬پيطگيزی‪،‬‬
‫پزستبری‬
‫داوطجُ‬
HN11111111111
Patient centered hand hygiene and nurse role
Introduction and Objectives: Hand hygiene is fundamental action for control infection . patient often
rely on health care workers of course nurses to encourage and assist them with their hand hygiene.
purpose of this study is review studies about Patient centered hand hygiene and nurse role in this matter.
Method: published article between 0222 to 0202 searched and reviewed in Persian electronic resource
in SID, Magiran and iranmedex. and Latin electronic resource in pubmed, sciencedirect, proquest and
googlescholar. and at last ... articles used in this review study
Result: Result of review studies is divided to patients and nurse perceptions, attitudes and behaviors
about hand hygiene and interventions to improve hand hygiene in patient hand hygiene. more than 02
percent of patients have not feel comfortable asking a nurse to perform hand hygiene and but finding of
some studies present opposite of this result. nurse have positive attitude towards patient hand hygiene but
its weak correlated with self reported behaviors. there is variation in actual number of patient that practice
empowerment for hand hygiene is ranging 5% to 582. A single intervention is not sufficient to sustain
changes in hand hygiene behavior and education must be augment by reminders that are reluctant and
easily understand by patients. overall studies remain small scale, poorly controlled and follow up to date
collection is abounded to establish impact longer time.
Conclusion: technique, education, promotion and potential barriers of hand hygiene is unique to each
patient's condition and the actual performance of patient empowerment can be increased when a patient is
supported by nurses. there is need to develop programs.
key words: Hand hygiene, Nurse, Patient
‫نقش پرستار در هبداشت دست متمرکز بر بیمار‬
‫‪2‬‬
‫ًْيسٌدگبى‪ :‬اهري رضب صبحل هقدم‪ ،1‬سْملبز ُالکْ‬
‫‪ – 1‬عضْ ُيئت علوي داًطگبٍ علْم پسضکي هطِد‬
‫‪ – 2‬داًطجْي کبرضٌبسي ارضد پرستبري داًطکدٍ پرستبري ّ هبهبيي هطِد‬
‫ًْيسٌدٍ هسئْل‪ :‬سْملبز ُالکْ امييل‬
‫‪-Holakous121@mums.ac.ir‬‬
‫هی‬
‫مقدمه و هدف‪ :‬هبداضت دست فعبليتی پبيَ ای برای کٌرتل عفًْت‬
‫ببضد ّ رعبيت اصْل آى تْسظ بيوبراى در بسيبری از هْارد ّابستَ بَ‬
‫راٌُوبيی ّ تطْيق کبرکٌبى خبص سالهت ّ بَ ّيژٍ پرستبراى هی ببضد‪ .‬ايي‬
‫هغبلعَ بب ُدف بررسی ّ هرّر هغبلعبت هبداضت دست بيوبر ّ ًقص پرستبر‬
‫اجنبم ضدٍ است‪.‬‬
‫روش کار‪ :‬در پبيگبٍ ُبي اعالعبتي التني ‪science ، pubmed،proquest‬‬
‫‪ ،direct‬در ببزٍ ‪ ّ 2214-2222‬در پبيگبٍ ُبي فبرسي ‪,SID‬‬
‫‪ iranmedex ,Magiran‬در ببزٍ زهبًي ‪ 1313 -1331‬جستجْ اجنبم ضد کَ‬
‫‪13‬هقبلَ هرتبظ ّارد هغبلعَ گرديد‬
‫یافته ها‪ :‬يبفتَ ُب بَ دّ دستَ ًگرش ّ عولکرد بيوبر ّ پرستبر در‬
‫اثرخبطی هداخالت بَ کبرگرفتَ ضدٍ تقسين‬
‫هبداضت دست بيوبر ّ‬
‫هْرد‬
‫ُفتبد درصد بيوبراى در‬
‫در برخی هغبلعبت بيص از‬
‫بٌدی ضدٍ است‪.‬‬
‫هْرد درخْاست از پرستبراى برای رعبيت هبداضت دست احسبش خْبی‬
‫اسبش ًتبيج هظبلعبت ديگر ببص از ُفتبد‬
‫ًداضتٌد‪ .‬در حبلی کَ بر‬
‫درصد در ايي هْرد ًگرش هثبتی داضتٌد‪ .‬بب ايي ّجْد اکثر پرستبراى‬
‫ًگرش هثبتی بَ هبداضت دست بيوبر داضتٌد؛ ّلی ًتبيج ارتببط ضعيفی بب‬
‫عولکرد آى ُب را ًطبى هی داد‪ .‬هيساى هْفقيت تْامنٌدسبزی هبداضت دست‬
‫بيوبراى بيي پٌج تب ُطتبد درصد گسارش ضدٍ است‪ .‬بَ عْری کَ يک‬
‫برًبهَ هداخلَ ای بَ تٌِبيی برای تداّم هبداضت دست بيوبراى کفبيت منی‬
‫ّ پيگيری‬
‫کٌد‪ .‬بَ عْر کلی در دسرتش ًبْدى هقيبش سٌجص هعترب‪ ،‬کٌرتل‬
‫ضعيف هْاًعی برای اجرای اثرخبطی برًبهَ ُبی آهْزضی در دراز هدت هی‬
‫ببضد‪.‬‬
‫نتیجه گیری‪ :‬برًبهَ ُب ّ تکٌيک ُبی آهْزضی ّ ًيس هْاًع اجرايی‬
‫هبداضت دست برای ُر بيوبری هٌحصر بَ فرد هی ببضد‪ .‬تْامنٌد سبزی بيوبر‬
‫در ايي هْرد ّابستَ بَ برًبهَ ُبی محبيتی پرستبر هی ببضد‪ .‬کَ در ايي‬
‫هْرد ًيبز بَ تْسعَ برًبهَ ُبی آهْزضی هطبُدٍ هی گردد‪.‬‬
‫کلید واژ ها‪ :‬هبداضت دست‪ ،‬پرستبر‪ ،‬بيوبر‬
‫داوشت اه ملتو‬، ، ‫ بیمارستاان اتا‬، ‫ داوشیار گروه زوان‬،‫دکترمليحه حسن زاده مفررد فلوشیپ اوکولوشی زوان‬
)‫ (مج‬، ‫دفارگروه زوان بیمارساان اا‬،‫پسشکي مشهد‬
1144-31140485 ‫ فاكس‬1144 – 3147148 5 ‫تلفه‬
Email:Hasanzademofradm@mums.ac.ir
Post-operative infection
Infection complicating surgical procedures has been the consternation of gynecologists
since the first operations were performed. Even when medical and surgical care are
beyond reproach, infectious morbidity can complicate the postoperative course.
Unfortunately, using antibiotics prophylactically at the time of surgery does not eliminate
this risk of infection.
It is imperative that the gynecologic surgeon understand basic infectious disease concepts
to treat infected patients appropriately. Diagnosis and treatment are not guess work but
depend on understanding basic principles.
An understanding of bacteria that are a part of the normal vaginal flora enables the
gynecologist to recognize the pathogenic bacteria that contribute to postoperative
infection.
Steps to prevent infection must become routine with every surgeon on every case. These
steps are necessary not only for the operator, but also for all personnel participating in the
surgical and medical treatment of the patient.
Key word: infection, bacteria, surgery
‫عفونت پس از عمل جراحی‬
‫عفًْت ُای پص از عول جراحی از اّلیي عول جراحی کَ یک هتخصص زًاى شرّع هی کٌذ ّی را درگیر‬
.‫حتی با ّجْد هراقبت ُا ی طبی ّ جراحی هْربیذتَ ُای عفًْی پص از عول جراحی رخ هی دُذ‬.‫هی کٌذ‬
.‫هتاضفاًَ بااضتفادٍ از اًتی بیْتیک پرّفیالکطی در زهاى جراحی خطر عفًْت از بیي ًوی رّد‬
‫ایي ًکتَ هِن اضت کَ یک هتخصص زًاى با هطایل پایَ ای بیواریِای عفًْی برای درهاى عفًْت ُا اشٌا‬
‫با درک ایٌکَ باکتری قطوتی از فلْر‬.‫تشخیص ّ درهاى بر اضاش درک هطایل پایَ ای صْرت هی گیرد‬.‫باشذ‬
‫ًرهال ّاژى هی باشذ هتخصص زًاى هی تْاًذ باکتری دخیل در عفًْت ُای پص از عول جراحی را تشخیص‬
‫دُذ‪.‬‬
‫ًتیجَ گیری ‪:‬هراحل برای جلْگیری از عفًْت بایذ تْضط ُر جراح ّ در ُر بیوار اًجام شْد‪ .‬ایي هراحل ًَ تٌِا‬
‫تْضط جراح بلکَ برای ضایر اشخاصی کَ در درهاى طبی ّ جراحی دخیل ُطتٌذ ًیسبایذ رعایت شْد‪.‬‬
‫کلوات کلیذی‪ :‬عفًْت‪ ،‬باکتری‪ ،‬جراحی‬
‫پذیزش بهذاشت دست در ایزان‪ :‬چالشی بزای کنتزل و پیشگیزی اس عفونتهای بیمارستانی در‬
‫بخشهای ویژه‬
‫اسمعیل محمدنژاد(‪ ،*)1‬یاسر طالبیان(‪ ،)2‬فاطمه نعمتی(‪)3‬‬
‫‪ -1‬داَطجٕی دکتزای پزستبری‪ ،‬کًیتّ تحقیقبت داَطجٕیی‪ ،‬داَطگبِ ػهٕو پشضکی ضٓیذ بٓطتی تٓزاٌ(َٕیسُذِ يسئٕل)‬
‫‪-2‬کبرضُبص ارضذ پزستبری‪ ،‬داَطگبِ ػهٕو پشضکی تٓزاٌ‬
‫‪-3‬کبرضُبص ارضذ پزستبری‪ ،‬گزِٔ ايٕس بیًبرستبٌ صُؼتی يبْطٓز‬
‫چكيده‬
‫زمينو ً ىدف ‪ :‬اَتقبل يیکزٔارگبَیسى ْب بّ ٔسیهّ دست کبرکُبٌ يزاکش بٓذاضتی یکی اس راِ ْبی اصهی اَتقبل ػفَٕت ْبی بیًبرستبَی در َظز گزفتّ‬
‫يی ضٕد ‪.‬ػفَٕت در يحیط ْبی بٓذاضتی دريبَی خطزی يٓى بّ ضًبر يی رٔد ٔ حفبظت اس کبرکُبٌ ٔ يذدجٕیبٌ در بزابز آٌ اس أنٕیت ْبی‬
‫پیطگیزی در يزاکش دريبَی يی ببضذ‪ .‬بذنیم َیبس بّ ضُبسبیي رَٔذ يطبنؼبت يزبٕط بّ بٓذاضت دست ٔ بزَبيّ ریشی در سيیُّ ارتقبي بٓذاضت دست‪،‬‬
‫يزٔري بز يطبنؼبت يٕجٕد در ایٍ سيیُّ در ایزاٌ ضزٔري است‪ْ.‬ذف اس ایٍ يطبنؼّ" يزٔري بز يتٌٕ ٔ يطبنؼبت قبهي يزبٕط بّ بٓذاضت دست‬
‫در ایزاٌا ست "‬
‫رًش بررسي ‪:‬يقبالت پژْٔطي يُتطز ضذِ بیٍ سبل ْبي ‪ 1331‬تب ‪، 1331‬بب جستجٕ در پبیگبِ ْبي اطالػبتي ٔ يُببغ كتببخبَّ اي‪ ،‬در سيیُّ‬
‫بٓذاضت دست در ایزاٌ‪ ،‬يٕرد بزرسي قزار گزفتُذ‪.‬‬
‫يافتو ىا‪:‬در يجًٕع ‪ 11‬يقبنّ يٕرد بزرسي قزار گزفت‪ .‬بب ٔجٕد اًْیت بٓذاضت دست‪ ،‬يطبنؼبت يحذٔدي در ایٍ سيیُّ صٕرت گزفتّ است ‪.‬‬
‫يطبنؼبت يٕرد بزرسي‪ ،‬آگبْي‪ ،‬پذیزش‪ٔ ،‬ػًهكزد كبركُبٌ بٓذاضتي بّ ٔیژِ در بخص ْبي يزاقبت ٔیژِ را ضؼیف گشارش ًَٕدِ است‪.‬‬
‫نتيجو گيري كلي ‪ :‬يًٓتزیٍ ػهت ضیٕع ػفَٕت در يزاکش بٓذاضتی ‪ ،‬اَتقبل ػفَٕت اس طزیق دست کبدر بٓذاضتی است بب ٔجٕد اًْیت دست ضستٍ‬
‫در پیطگیزی اس ػفَٕت ْبی بیًبرستبَی تحقیقبت َطبٌ يی دُْذ کّ پذیزش پزسُم بٓذاضتی بزای ضستطٕی دست‪ ،‬پبییٍ بٕدِ است‪.‬‬
‫كليد ًاژه ىا‪::‬بيداشت دست‪ ،‬عفٌنت ىاي بيمارستاني‪ ،‬ايران‪ ،‬بررسي مرًري‬
‫ٍضعیت عفًَت ادراری هزتثط تا کاتتز ادراری در تیواراى تستزی‬
‫سیدُ اکزم حسیٌی‬
‫کارضٌاط ارضد آهَسش پزستاری‪ ،‬داًطکدُ پزستاری قَچاى‬
‫‪Hossainia19@yahoo.com‬‬
‫هقدهٍِّدف‪:‬‬
‫عفًَت سیستنادراری تیص اس ‪ 04‬درصد توام عفًَتّای تیوارستاًی را تطکیلهیدّد‪ .‬تِکارگیزی کاتتزّای ادراری تِ‬
‫ٍیضُ در طَالًی هدت‪ ،‬اصلیتزیي عاهل در ایي تارُ هحسَب هیضَد کِ گاّا خطزات ٍخیوی ّواًٌد عفًَتخًَی را تِ‬
‫دًثال خَاّدداضت‪ .‬هطالعِی حاضز تا ّدف تطزیح علل ایجاد ٍ گستزش عفًَتادراری ٍ ًیش راّکارّای هزتفع ساختي‬
‫آى در تیواراى تا کاتتز ادراری هیتاضد‪.‬‬
‫رٍشکار‪:‬‬
‫ایي پضٍّص یک هطالعِ ی هزٍری است کِ در آى هقاالت ٍ هتَى هزتثط تا هَضَع تا استفادُ اس فْزستی اس ٍاصگاى‬
‫کلیدی در پایگاُّای اطالعاتی ‪ elsiver ،sid ،pubmed‬هَرد تزرسی قزار گزفت‪.‬‬
‫یافتِّا‪:‬‬
‫اهزٍسُ کاتتزّای ادراری تِ صَرت گستزدُ استعوال هیضًَد‪ .‬در حدٍد ‪ 12-75‬درصد هَارد اًدیکاسیَى هٌاسة ٍ‬
‫ٍاضحی ًدارًد‪ .‬تعثیِ کاتتز ادراری در تیواراى تا ساتقِی دیاتت‪ ،‬هصزف دارٍّای کَرتَى ٍ سزکَب کٌٌدُ ایوٌی ٍ اس‬
‫ّوِ هْنتز آًتی تیَتیکّای ٍسیعالطیف در قثل اس پذیزش در تیوارستاى سهیٌِ را تزای عفًَت فزاّن هیکٌد‪ .‬هحدٍد‪-‬‬
‫کزدى استفادُ اس کاتتز ٍ ًیش حذف سٍدٌّگام آى در پیطگیزی اس ضزٍع عفًَت تسیار هؤثز است‪ ،‬عالٍُ تز آى ًقص‬
‫پزستار تِ عٌَاى هؤثزتزیي فزد در اهز درهاى تا آهَسش تِ تیوار در سهیٌِی هزاقثت عوَهی اس کاتتز ًیش قاتل تَجِ است‪.‬‬
‫ًتیجِ گیزیکلی‪:‬‬
‫تأکید هتَى تز هحدٍد کزدى استفادُ اس کاتتز ادراری در تیواراى پزخطز تِ لحاظ عفًَت‪ً ،‬قص پزستار را تِ عٌَاى کلیدی‬
‫در کاّص عفًَت تا تِکارگیزی تحزیکات حسی در هَرد هثاًِ ًطاى هیدّد‪ .‬اها تا ٍجَد هَرد غفلت قزارگزفتي ایي‬
‫هزاقثتّا ٍ توایل تِ تعثیِ کاتتز رعایت ضزایط استزیل ٍ هزاقثت اس آى حائش اّویت است‪.‬‬
‫کلواتکلیدی‪:‬‬
‫عفًَتتیوارستاًی‪ ،‬عفًَتادراری‪ ،‬کاتتزادراری‬
Urinary Tract Infections associated with urinary catheters in hospitalized patients
Seyedeh Akram Hosseini
MSc in nursing/ Faculty of Nursing, Quchan, Iran
‎Hossainia19@yahoo.com
Background and Objectives:
Urinary Tract Infections make up Over %04 of all nosocomial infections. Use of urinary catheters,
especially in the long period is the main factor in this regard, that sometimes will be followed by
serious risks such as Septicemia. This study was done to describe the causes start and development
of urinary infection about patients with urinary catheters.
Method:
This is a review research in which articles associated with the topic were investigated by list of
keywords in various databases such as pubmed, elsiver in the last 90 years.
Results
Nowadays Urinary catheters used are extensively. About 19-%74 do not have appropriate and clear
indications. Use of Urinary catheter in patients with a history of diabetes, consumption corticosteroids
and immunosuppressive drugs and most important of all antibiotics before admission to hospital,
provide grounds for infection. In addition, the role of the nurse as most effective person in treatment
and care of patient with education in the field of general care of catheters are also important.
Conclusion:
The literature emphasis on restricting use of urinary catheters in patients with high risk of infection
then indicate the nurse's role as the key to reducing infection by using the sensory stimulation of
bladder. But despite tend to the use the catheter under sterile conditions and care is important.
Keywords: nosocomial infections, Urinary Tract Infections, urinary catheter
‫هروری بر وضعیت بهداشت دست ارائه دهندگاى هراقبت در بیوارستاى های کشور‪ :‬لسوم توجه به بهداشت دست‬
‫هوراهیاى بیوار‬
‫عاطفه بهبودی فر*‪ ،‬زینب کاظن زاده*‬
‫*دانشجوی کارشناسی ارشد پرستاری‪ ،‬دانشگاه علوم پسشکی هشهد‬
‫‪Behboudifara1@mums.ac.ir‬‬
‫مقدمه‪:‬‬
‫آلَدگی دست اسائِ دٌّذگبى هشاقجت ثِ ثیوبساى ٍسغَح ثیوبسستابى دساجدتبد ػنًَاْتبی ثیوبسستابًی تبئض اّویتت استت ثتِ‬
‫هٌظَسکبّص ٍقَع اجي ػنًَت ّب‪ ،‬هَثشتشجي ٍکن ّضجٌِ تشجي ساُ‪ ،‬سػبجت ثْذاضت دست تَسظ افشاداسائِ دٌّذُ هشاقجتت هتی‬
‫ثبضذ لزا ثب تَخِ ثِ اّویت هَضَع اجي هغبلؼِ ثبّذف ثشسسی ٍضؼیت ثْذاضت دست اسائتِ دٌّتذگبى هشاقجتت دس ثیوبسستابى‬
‫ّبی کطَساًدبم ضذُ است‬
‫روش کار‪:‬‬
‫هقبالت هٌاطش ضذُ ثیي سبلْبی ‪ 5831‬تب‪ 5838‬ثب خسادَ دسپبجگبُ ّبی اعالػبتی ٍهٌبثغ کابثخبًتِ ای دسصهیٌتِ ثْذاضتت دستت‬
‫دساجشاى هَسد ثشسسی قشاسگشفت ًابجح اصهیبى ‪ 51‬هقبلِ هشتجظ ثِ دست آهذُ اساخشاج ضذُ است‬
‫یافته ها‪:‬‬
‫ًابجح هقبالت ًطبى هی دّذ کِ ثب ٍخَدآگبّی پشسٌل اصاسابًذاسدّب‪ ،‬سفابس ثْذاضت دست کواش اص تذاًاظبس استت ٍ ثْستبصی‬
‫هحیظ ٍثشگضاسی کالع ّبی آهَصضی ًیضتبثیشچٌذاًی دساستقبء ٍضؼیت ثْذاضت دستت ًذاضتاِ استت ضتوي اجٌعتِ سػبجتت‬
‫ثْذاضت دست خصَصب قجل اصتوبع ثب ثیوبس ٍ ًیض ثؼذ اصتوبع ثب هحیظ اعشاف ثیوبسکواش اصسبجش هَقؼیت ّبست ثتب تَختِ ثتِ‬
‫ًابجح هغبلؼبت‪ ،‬سغَح هحیغی اعشاف ثیوبس خضءآلَدُ تشجي سغَح هی ثبضذ کِ توبع دست ثباجي هحیظ ّب دساًاقبل ػنًَتت‬
‫ًقص ثسیبس هْوی سااجنب هی کٌذ ثِ دلیل ضَس ّوشاّیبى دسثخص ّبی ثستاشی ٍتوتبع دستت آى ّتب ثتب هحتیظ ّتبی آلتَدُ‬
‫ا اوبل اًاقبل آلَدگی تَسظ آًْب ًیضٍخَد داسد‬
‫نتیجه گیری‪:‬‬
‫ثب تَخِ ثِ ًابجح ثِ دست آهذُ ٍ ٍضؼیت ًبهغلَة ثْذاضتت دستت دساسائتِ کٌٌتذگبى هشاقجتت‪ ،‬پیطتٌْبد هتی ضتَد هغبلؼتبت‬
‫ثیطاشی ثِ هٌظَس ثشسسی ٍاسائِ ساّعبسّبی هٌبست اسصجبثی ٍپ بجص دسخْتت افتضاجص اًگیتضُ کبسکٌتبى ثتشای ثْذاضتت دستت‬
‫اًدبم ضَد ٍ ثْذاضت دست ّوشاّیبى ثِ ػٌَاى جک ػبهل ثبلقَُ دساجدبد ػنًَاْبی ثیوبسسابًی هَسدتَخِ قشاس ثگیشد‬
‫کلید واژه ها‪:‬‬
‫ػنًَت ثیوبسسابًی‪ ،‬ثْذاضت دست‪ّ ،‬وشاّی ثیوبس‬
‫مقدمه‪:‬‬
‫هشاقجت ّبی سالهت ثِ عَس غیش قبثل اخاٌبثی ثب افضاجص ثشٍص خغش ثشای اجوٌی ثیوبس ٍ تْذجذ سالهت ٍی ّوشاُ است ثیوبساى‬
‫ق داسًذ کِ اًاظبس داضاِ ثبضٌذ هشاقجت اص اى ّب ػالٍُ ثش تغبثق ثب ثْاشجي ضشاجظ ٍ اسابًذاسد ّب ٍ آخشجي ضَاّذ ػلوی ٍ‬
‫ثبلیٌی‪ ،‬سالهای اجطبى سا دچبس هخبعشُ ًسبصد جعی اص هخبعشات اجدبد ضذُ ثشای ثیوبساى دس عَل هذت ثساشی اثاال ثِ‬
‫ػنًَاْبی ثیوبسسابًی است ػنًَت ثیوبسسابًی ثِ ػنًَای اعالق هی گشددکِ دسعَل صهبى ثساشی ثَدى دسثیوبسسابى اجدبد‬
‫ضذُ‪ٌّ ،‬گبم پزجشش ثیوبس ٍخَد ًذاضاِ ٍدسدٍسُ کوَى ًیضًجَدُ است (‪ )5‬ػنًَاْبی ثیوبسسابًی اص‪8‬خٌجِ اثاال‪ ،‬هیشاجی ٍ ّضجٌِ‬
‫اّویت داسًذ هیضاى ثشٍصػنًَاْبی ثیوبسسابًی ذٍد‪ 1‬تب‪% 51‬تخویي صدُ هی ضَد جؼٌی ‪1‬تب‪ %51‬توبهی ثیوبساى ثساشی‬
‫دسثیوبسسابًْب دچبساجي گًَِ ػنًَاْب هی ضًَذ هیضاى ّبی اثاال اص‪%5‬دسثخص ّبی ًَسٍلَطی تب ‪ %55 1‬دسثخص ّبی سَخاگی‬
‫قبثل تغییش است ػنًَاْبی ثیوبسسابًی ّن ثِ ػلت ٍجظگیْبی ػبهل ػنًَاضا (هقبٍهت‪ ،‬قذست تْبخن ٍثیوبسجضاجی) ٍ ّن ًَع‬
‫ثیوبساًی کِ دچبس آى هی ضًَذ داسای کطٌذگی ثبالجی است اگشاجي ػنًَاْب ساثِ ػٌَاى ػلت هساقین هشگ دسًظش ثگیشجن‬
‫ثغَسهیبًگیي ‪%8‬هجاالجبى سا اص ثیي هی ثشد ٍاگشػلت غیش هساقین دسًظشثگیشجن تبثیشآى ثشهیشاجی ثسیبس ثیطاشخَاّذثَد دسجک‬
‫هغبلؼِ دسکطَسآلوبى ًطبى دادُ ضذکِ ػنًَاْبی ثیوبسسابًی هشگ ٍهیشثیوبسسابًی ساثِ ‪8‬ثشاثشافضاجص هی دّذ گناِ هی ضَد‬
‫ّش ػنًَت ثیوبسسابًی ثغَسهاَسظ ‪ %5 1‬سٍص ثِ سٍصّبی ثساشی هی افضاجذ ٍلی هی تَاًذاص ‪5‬تب‪2 5‬سٍصهاغیشثبضذ دسًایدِ‬
‫ّضجٌِ قبثل تَخْی ساثشثیوبسسابى تحویل ًوبجذ (‪)2‬‬
‫هغبلؼبت ًطبى هی دّذ کِ ػنًَت ّبی هشتجظ ثب ثْذاضت هشاقجیي جک ػلت هْن دس هیضاى هشگ ٍ هیش دس ثیي ثیوبساى ثساشی‬
‫دس ثیوبسسابى دس سشاسش دًیب هی ثبضذ ثب تَخِ ثب آهبس هَخَد ذٍد ‪ 31111‬هشگ سبالًِ دس آهشجعب ثِ ػلت ػنًَت ّبی‬
‫ًبضی اص ثیوبسسابى است هٌبثغ اًاقبل ػَاهل ثیوبسی صا خَد ثیوبس‪ ،‬ثیوبساى دجگش‪ ،‬سغَح ٍ هحیظ اعشاف ثیوبس ٍ خَد کبسکٌبى‬
‫ّساٌذ ٍ اًاقبل پبتَطى ّبی هسئَل‪ ،‬ثیطاش اص عشجق دست ّبی آلَدُ اتنبق هی افاذ ثش اسبع آهبسّبی ‪ %31 WHO‬ػنًَاْبی‬
‫ثیوبسسابًی اص عشجق دست ّبی آلَدُ هٌاقل هی ضَد (‪ )8‬ثشّویي اسبع سػبجت ثْذاضت دست ّب‪ ،‬ضساطَی دست ّب جعی اص‬
‫هْن تشجي ػَاهل قبثل کٌاشل دس کبّص هیضاى ػنًَت ّبی ّوشاُ ثب ثْذاضت هشاقجیي رکش ضذُ است دس ٍاقغ ثْذاضت دست‬
‫جعی اص هْواشجي ‪ ،‬سبدُ تشجي‪ ،‬هَثشتشجي ٍ کن ّضجٌِ تشجي سٍش ّب ثشای پیطگیشی اص اًاطبس هقبٍهت ضذ هیعشٍثی است(‪ )5‬ثش‬
‫اسبع دساَسالؼول ّبی سبصهبى ثْذاضت خْبًی کِ هَقؼیت ّبی ثْذاضت دست سا قجل اص توبع ثب ثیوبس‪ ،‬ثؼذ اص توبع ثب‬
‫تشضحبت ثیوبس‪ ،‬قجل اص اقذاهبت آسپایک ٍ ثؼذ اص توبع ثب هحیظ ثیوبس رکش کشدُ است‪ ،‬ضساطَی دست هشاقجت کٌٌذگبى اص‬
‫ثیوبس ثؼذ اص توبع ثب هحیظ ثیوبس جعی اص ػَاهل هَثش دس قغغ صًدیشُ اًاقبل ػنًَت رکش ضذُ است لزا ثب تَخِ ثِ اّویت‬
‫هسبلِ کٌاشل ػنًَاْبی ثیوبسسابًی ٍ ثْذاضت دست اجي هغبلؼِ ثب ّذف ثشسسی ٍضؼیت ثْذاضت دست هشاقجیي هساقین‬
‫ثیوبساى دس ثیوبسسابى اًدبم گشدجذ‬
‫روش کار‪:‬‬
‫خسادَی اعالػبت اص عشجق پبجگبّْبی اعالػبتی ‪ SID, Magiran, Pubmed,Sience Direct, Ovid‬دس هحذٍدُ‬
‫سبل ّبی ‪ 5838-5831‬دس هَسد هَضَع ّبی هَسد ًظش ثب کلیذ ٍاطُ ّبی ثْذاضت دست ‪ّ ،‬وشاّی ثیوبس‪ ،‬ػنًَت ّبی‬
‫ثیوبسسابًی ٍ هؼبدل ّبی اًگلیسی آى اًدبم گشدجذ ٍ ًابجح اص هیبى ‪ 21‬هغبلؼِ هشتجظ اساخشاج ضذُ است هقبالت تحقیقی ثِ‬
‫صثبى فبسسی ٍ اًگلیسی کِ ثیي سبلْبی ‪ 5831‬تب ‪ 5838‬دس اجشاى صَست گشفاِ اًذ ٍ ثشهسئلِ ثْذاضت دست دس ثخص ّبی‬
‫ثیوبسسابى توشکضداضاِ اًذ ثشای ثشسسی اًاخبة ضذًذ دس اًاخبة هقبالت‪،‬هحذٍدجای اص ًظش کبسکٌبى ٍ هشاکض ثْذاضای‬
‫دسهبًی ًٍَع هغبلؼِ ٍخَد ًذاضت دس اجي هغبلؼِ هٌظَس اص ثْذاضت دست‪ ،‬ضساي دست ّب ثب صبثَى ٍ جب اسانبدُ اص هحلَل‬
‫العلی است دس هوَع تؼذاد ‪ 21‬هقبلِ ثِ دست آهذ ٍاص اجي تؼذاد هقبالت کِ ثِ کل هاي آى دساشسی ًجَد اص هَاسد ثشسسی‬
‫کٌبس گزاضاِ ضذ ٍ دس ًْبجت ‪ 51‬هقبلِ هَسد ثشسسی قشاس گشفاٌذ‬
‫یافته ها‪:‬‬
‫هغبلؼبت هخالنی دس اجشاى دس ساسابی ثشسسی هیضاى ثْذاضت دست کبسکٌبى اًدبم ضذُ است کِ دس اجٌدب ثِ ًابجح ثشخی اص آى‬
‫ّب اضبسُ هی کٌین هغبلؼِ هحوذی ٍ ّوعبساى(‪ ) 5831‬کِ ثِ ثشسسی آگبّی ٍ ًگشش پشسٌل ثخص هشاقجت ّبی ٍجظُ ًَصاداى‬
‫پشداخاِ اًذ ًطبى هیذّذ کِ هیضاى آگبّی ٍ ًگشش پشسابساى ٍ پضضعبى دس ساثغِ ثب ػنًَاْبی ثیوبسسابًی ٍ اّویت سفابسّبی‬
‫ثْذاضای کشدى دست ّب دس سغح خَة ٍ دس هَسد کوک ثْیبساى دس سغح ضؼیف هی ثبضذ (‪)1‬هغبلؼِ هصذق ٍ ّوعبساى‬
‫(‪ً )5835‬یض ًطبى هی دّذ کِ ّش چٌذ ثب ٍخَد ثْسبصی اهعبًبت ٍ ثشگضاسی کالع ّبی آهَصضی هیضاى سػبجت ثْذاضت‬
‫دست افضاجص صجبدی ًذاضاِ است اهب دس ثیي کبسکٌبى دسهبًی‪ ،‬ثیطاشجي هیضاى ثْذاضت دست هشثَط ثِ پشسابساى ثَدُ است‬
‫(‪ )8‬هغبلؼِ ػضتی ٍ هخابسی(‪ً )5835‬یض ًابجح هطبثْی سا ًطبى هی دّذ (‪)58‬‬
‫هحوذی(‪ ) 5838‬کِ دس هغبلؼِ خَد ثِ ثشسسی فشآجٌذ ضساطَی دست ثِ سٍش هویضی ثبلیٌی پشداخاِ است ًیض ًطبى هی دّذ‬
‫کِ ثب ٍخَد اجي کِ ‪ % 51‬اص پشسٌل آگبّی خَثی دس ساثغِ ثب اسابًذاسدّبی ضساطَی دست داضاِ اًذ اهب اجي اسابًذاسدّب دس‬
‫‪ %11‬هَاسد سػبجت ًوی ضَد ضوي اجٌعِ اجي هغبلؼِ ًطبى هی دّذ کِ ‪ %31‬پشسابساى دس ساثغِ ثب ثْذاضت دست قجل اص توبع‬
‫ثب ثیوبس دس ٍضؼیت ًبهغلَثی قشاس داضاِ اًذ دس بلیعِ اجي هَضَع دس ساثغِ ثب ثْذاضت دست ثؼذ اص توبع ثب ثیوبس کبهال‬
‫هؼعَع ثَدُ ثِ عَسجعِ ثیص اص ‪ %31‬پشسابساى اجي اسابًذاسدّب سا سػبجت هی کشدًذ لزا ًابجح اجي هغبلؼِ ًطبى هی دّذ کِ ثب‬
‫ٍخَد آگبّی پشسٌل دسهبًی اص تَصیِ ّبی ضساطَی دست‪ ،‬اجي آگبّی هَخت اجدبد اًگیضُ دس ساثغِ ثب ثْذاضت دست قجل‬
‫اص توبع ثب ثیوبس ًطذُ است (‪)5‬‬
‫دس هغبلؼِ ًَسی ٍ ّوعبساى(‪ً )5835‬یض کِ دس آى ثِ ثشسسی ٍضؼیت ثْذاضت دست دس ثخص ّبی هخالف ثیوبسسابى ثِ سٍش‬
‫هویضی ثبلیٌی پشداخاِ اًذ‪ ،‬ثیبى ضذُ کِ ثیطاش ثخص ّب دس سغح اثاذاجی ٍ هاَسظ قشاس داضاِ اًذ‪ ،‬ضوي اجٌعِ ػذم اسصجبثی‬
‫هٌبست ٍ ثبصخَسد اص عشف هسئَلیي ثِ ػٌَاى هْواشجي ػبهل دس ػذم سػبجت هٌبست اسابًذاسدّبی ضساطَی دست رکش ضذُ‬
‫است (‪ّ )7‬وچٌیي هغبلؼِ صًذجِ ٍ ثشصٍ (‪ً ) 5831‬یض کِ ساثغِ ثب ضساطَی دست دس اتبق ػول اًدبم ضذُ است‪ً ،‬طبى هی دّذ‬
‫کِ ثب ٍخَد اجٌعِ هیضاى ثْذاضت دست دس توبهی هحیظ ّبی پظٍّص ثیص اص هاَسظ(‪ )%55 8‬ثَدُ است‪ ،‬اهب کواشجي هَسد‬
‫ثْذاضت دست ػذم ضساطَی دساْب ثب آة ٍ صبثَى ثؼذ اص توبع ثب ثیوبس ٍ خشٍج دساعص ٍ ّوچٌیي اسانبدُ اص دساعص‬
‫ثشای هشاقجت اص ثیوبس ثَدُ است (‪)3‬‬
‫دس هغبلؼِ ًظشی ٍ ّوعبساى(‪ ) 5831‬کِ ٍضؼیت ثْذاضت دست کبسکٌبى ثخص ّبی هشاقجت ٍجظُ سا هَسد ثشسسی قشاس دادُ‬
‫است ًیض ثیبى ضذُ است کِ کبسکٌبى دس ‪ %35 8‬هَقؼیت ّب دساعص پَضیذُ ٍ دس ‪ %55 3‬اص هَقؼیت ّب اقذام ثِ ثْذاضت دست‬
‫ًوَدُ اًذ ٍ اص اجي هیضاى ًیض ‪ % 75‬هَاسد اص هحلَل العلی ٍ دس سبجش هَاسد اص آة ٍ صبثَى اسانبدُ ضذُ است کِ اجي هیضاى‬
‫ثسیبس کواش اص ذ اًاظبس گضاسش ضذُ است (‪)3‬‬
‫خالل پَس ٍ ّوعبساى (‪ )5831‬دس هغبلؼِ خَد ٍ ثب ثشسسی هقبالت پظٍّطی اًدبم ضذُ‪ ،‬اضبسُ کشدُ اًذ کِ سغَح ثیوبسسابى‬
‫هٌبثغ ثبلقَُ ای ثشای نظ ٍ ًگْذاسی ثبکاشی ّبی ثیوبسجضا هحسَة هی ضًَذ ٍ ًقص هَثشی دس چشخِ ػنًَت ثش ػْذُ‬
‫داسًذ ثبکاشی ّبی هَخَد دس سغح اص تَاى اًاطبس هحذٍدی ثشخَسداس ّساٌذ ٍ دس صَست ٍخَد جک ػبهل اًاقبل دٌّذُ دس‬
‫ثیوبسسابى هٌاطش هیگشدًذ دست پشسٌل ثیوبسسابى ثیطاشجي توبع سا ثبسغَح ثَجظُ سغَح پش توبع داسد ٍ هْواشجي ػبهل‬
‫اًاقبل ٍ اًاطبس ثبکاشجْب دس ثیوبسسابى هحسَة هیگشدًذ لزا استقبء ثْذاضت دست پشسٌل ٍ سغَح ثیوبسسابى‪ ،‬هْواشجي اثضاس‬
‫کٌاشل ػنًَاْبی ثیوبسسابًی ثطوبس هی سٍد (‪ً )51‬ابجح هغبلؼِ کبظوی ٍ ّوعبساى(‪ً )5835‬یض ًطبى دادُ است کِ ثیطاشجي‬
‫هیضاى سػبجت ضساطَی دست هشثَط ثِ هش لِ ثؼذ اصآلَدگی ثب تشضحبت ثیوبس )‪ٍ ( 51 %‬کواشجي هیضاى )‪ ( 88 %‬هشثَط ثِ‬
‫ضساطَی دست ثؼذ اص توبع ثبهحیظ هدبٍس ثیوبس ثَد‪)55( .‬‬
‫هغبلؼِ کشهی ٍ ّوعبساى(‪ ) 5835‬کِ ثب ّذف ثشسسی خغش اًاقبل ػنًَت دس ثخص ّبی ٍجظُ اًدبم ضذُ است ًطبى هی دّذ‬
‫کِ ثیطاشجي آلَدگی سغَح ثِ تشتیت هشثَط ثِ دساگیشُ دس‪ ،‬کف اتبق‪ ،‬تخت ثیوبس‪ ،‬صٌذلی ٍ هیض کٌبستخت ثَدُ است (‪)52‬‬
‫ثب تَخِ ثِ ضشاجظ فؼلی ثیوبسسابى ّبی کطَس‪ ،‬لضٍم ضَس هذاٍم ّوشاّی ثش ثبلیي ثیوبساى خصَصب دس ثخص ّبی اعنبل ٍ جب‬
‫توبجل خبًَادُ ثشای ضَس دس کٌبس ثیوبس دس سبجش ثخص ّبی ثساشی هَخت توبع دست ّوشاّیبى ثب ثسیبسی اص سغَح کِ‬
‫عجق هغبلؼبت اًدبم ضذُ ثِ ػٌَاى هٌجغ تدوغ ثبکاشی ّبی ثیوبسجضا ثِ ضوبس هی سًٍذ ضذُ است ًابجح هغبلؼبت اًدبم ضذُ ًیض‬
‫ًطبى دادُ اًذ کِ کواشجي هیضاى ضساطَی دست دس هشاقجیي(کبسکٌبى) قجل اص توبع ثب ثیوبس ثَدُ است ثٌبثشاجي ثِ ًظش هی سسذ‬
‫کِ توبع هعشس دست ّوشاّی ثیوبس ثب سغَح آلَدُ هبًٌذ دساگیشُ دس‪ ،‬تخت ٍ صٌذلی‪ ،‬ػذم سػبجت ثْذاضت دست قجل اص‬
‫توبع ثب ثیوبس‪ ،‬توبع ثب سبجش ثیوبساى ٍ ػذم سػبجت ثْذاضت فشدی تَسظ ّوشاّی ًیض هی تَاًذ دس اًاقبل ػنًَت ثِ ثیوبساى ٍ‬
‫ثشٍص ػنًَاْبی ثیوبسسابًی هَثش ثبضذ ثب اجي بل دس ثشسسی ّبی اًدبم ضذُ ٍ خسادَ دس پبجگبّبی هخالف هغبلؼِ ای کِ ثِ‬
‫ثشسسی ثْذاضت دست دس ّوشاّیبى ٍ تؼییي ًقص ا اوبلی آى دس ثشٍص ػنًَاْب دس کطَس هب ٍ سبجش کطَسّب پشداخاِ ثبضذ‪،‬‬
‫جبفت ًطذ‬
‫نتیجه گیری‪:‬‬
‫ًابجح هغبلؼبت ثشسسی ضذُ ًطبى هی دّذ کِ ٍضؼیت ثْذاضت دست دس ثیوبسسابى ٍ دس هیبى هشاقجیي ثیوبساى دس ضشاجظ‬
‫هغلَثی قشاس ًذاسد (‪)55‬اسابًذاسدّبی ضساطَی دست دس هَقؼیت ّبی ‪ 1‬گبًِ اػالم ضذُ تَسظ سبصهبى ثْذاضت خْبًی دس‬
‫اکثش هَاسد ٍ خصَصب قجل اص توبع ثب ثیوبس سػبجت ًوی ضَد ٍ سٍش ّبی هخالف ثِ کبس گشفاِ ضذُ خْت افضاجص آگبّی‬
‫کبسکٌبى ٍ ّوچٌیي پبجص ٍضؼیت ثْذاضت دست ٍ توْیذات ثعبس سفاِ ثِ هٌظَسکٌاشل ٍ اسصجبثی اجي اهش هبًٌذ اسانبدُ اص‬
‫چک لیست ّبی کٌاشل ٍ ثبصسسی ّبی دٍسُ ای تب کٌَى کوک چٌذاًی ثِ افضاجص اًگیضُ کبسکٌبى‪ ،‬ثْجَد ٍضؼیت ثْذاضت‬
‫دست ٍ سػبجت اسابًذاسدّبی هَخَد ًعشدُ است ّش چٌذ هسبلِ ثْذاضت دست دس کطَسّبی دس بل تَسؼِ ثب هطعالت‬
‫صجبدی سٍثشٍست اهب ثب تَخِ ثِ اّویت صجبد آى دس سبجش کطَسّب ًیض ثِ ػٌَاى جک هؼضل ضٌبخاِ ضذُ ٍ اجي کطَسّب ًیض ثِ‬
‫دًجبل ساّعبسّبجی خْت استقب ٍضؼیت ثْذاضت دست دس ثیوبسسابًْب ٍ هشاکض دسهبًی خَد ّساٌذ لزا ثِ ًظش هی سسذ اًدبم‬
‫هغبلؼبت ثیطاش دس اجي صهیٌِ ٍ اسانبدُ اص ساّعبسّبی ثِ کبس سفاِ دس سبجش کطَسّب هبًٌذ ثِ کبسگیشی تعٌَلَطی ّبجی هبًٌذ‬
‫هبًیاَسجٌگ ٍ جب اًدبم کطت اص دست کبسکٌبى ثِ صَست تصبدفی ٍ دٍسُ ای‪ ،‬اسانبدُ اص هذل ّبی آهَصضی هانبٍت ٍ جب‬
‫تطَجقبت هٌبست ثشای اجدبد اًگیضُ دس کبسکٌبى کوک کٌٌذ ُ ثبضذ ّوچٌیي ثب تَخِ ثِ ضَس ّوشاّی دس ثیطاش ثخص ّبی‬
‫ثیوبسسابًْب ٍ توبع دست ّوشاّیبى ثب سغَح هخالف ثبلقَُ آلَدُ کٌٌذُ هبًٌذ هحیظ ثیوبس ٍ ػذم سػبجت ثْذاضت دست‬
‫تَسظ آى ّب خصَصب قجل اص توبع ثب ثیوبس ٍ هغبلؼبت ثسیبس هحذٍد اًدبم ضذُ دس اجي صهیٌِ‪ ،‬پیطٌْبد هی ضَد هغبلؼبت ثیطاش‬
‫ًقص ّوشاّیبى سا دس اًاقبل ػنًَت ثِ ثیوبساى ٍ اجدبد ػنًَاْبی ثیوبسسابًی ثشسسی ًوبجذ ضوي اجٌعِ ّوگبم ثب آهَصش ّبی‬
‫اسائِ ضذُ ثشای کبسکٌبى دس خصَظ سػبجت اسابًذاسدّبی ثْذاضت دست‪ ،‬آهَصش ّبی الصم ثِ ّوشاّیبى ثیوبساى ًیض ثِ‬
‫هٌظَس افضاجص آگبّی آى ّب دس هَسد لضٍم سػبجت ثْذاضت دست ًیض ضشٍسی ثِ ًظش هی سسذ‬
‫اهیذ است ثب ثْشُ گیشی اص کلیِ ساّعبس ّبی هوعي ثاَاى گبهی دس خْت استقب ٍضؼیت ثْذاضت دست دس ثیوبسسابًْب ٍ هشاکض‬
‫دسهبًی ٍ دس ًایدِ کبّص ػنًَاْبی ثیوبسسابًی ٍ کبّص هقبٍهت ّبی داسٍجی ًبضی اص هصشف آًای ثیَتیک ّبی ٍسیغ‬
‫الغیف ثشداضت ٍ ثذجي عشجق خذهبت ثب کینیت هٌبست دس ساسابی ا قبق قَق ثیوبساى اسائِ گشدد‬
References:
1- Suddarths B. Text book of Medical Surgical nursing- nfectious Disease, 11 editor. Tehran:
Boshra; 2112.
2- Mian Abadi M. Nosocomial infectious.2115.availeble from http://www.shomal.sbmu.ac.ir
3- Mosadegh M, Rabbani A, Bromand H.Classes impact on the rate of hand hygiene in medical
personnel of Dr Sheikh. Journal of National congress of quality promotion.211301(1)
4- Rooeen T. Assess of bacterial prevalence and evaluation of personal’s hand hygiene in emam
reza hospital. Journal of National congress of quality promotion.21131:(1)
5- -Mohamadi F and et al. Knowledge and attitude of personals in NICUs toward hygiene
behaviors. Health and care journals.2113;14(3)
6- Mohamaddi G. Assess of hand hygiene in nurses in Gonbad hospital. Journal of National
congress of quality promotion.211301(1)
7- Nori M et all.Rate of doing hand hygiene CDC standards in clinical ward- Tabriz Hospital-1393.
Journal of National congress of quality promotion.211301(1)
8- Zandiyeh M, Borzo R.The level of hand hygiene compliance by operating room personnel of
Edu cational Hospitals in Hamadan University of Medical Science.Holistic Nursing and
Midwifery Journals.2113;22(67)
9- Nazari R, Ahmadi MH, Dadashzade M, Asgari P. Study of hand hygiene behavior among nurses
in Critical Care Units. Iranian Journal of Critical Care Nursing.2111;4(2):93-96
11- Jallalpoor SH, Kermanshahi r, Noohi A, Zarkesh H.The importance of staff hand ,low levels and
high levels of hospital exposure in formation and control of nosocomial infections.Iranian Journal
of Medical Microbiology.2112;5(7):14-22
11- - Kazemi L et al. Assesse of medical personals hand hygiene in Mdani hospital of Tabriz.
Journal of National congress of quality promotion.211301(1)
12- Karami GH et al.Evaluation risk of transmission nosocomial infection in ICU Ward of Kashan
Behashti hospital in 2112. Scientific Journal of Hamadan Nursing & Midwifery
faculty.2114;22(2)
13- Ezati M, Mokhtari A. Assess of personals hand contamination in khatam alanbia hospitalSalmas-1393. Journal of National congress of quality promotion.211301(1)
14- Najafi Ghezeljeh T, Abbas Nejhad Z, Rafii F. A Literature Review of Hand Hygiene in Iran. Iran
Journal of Nursing (IJN).2113;25(81):1-13
Effects of medicinal plants on microorganisms involved in ventilator-associated
pneumonia
Zeinab Bahrami-eyvanaki , Somaieh Borji
Abhar school of nursing
Introduction and Objectives: ventilator-associated pneumonia (VAP) is defined as
pneumonia that occurs 84-27 hours after endothracheal intubation.VAP increase healthcare
coast and it is important cause of death in critical care unit. Bacteria's causing VAP includes
streptococcus pneumonia, heamophilus influenza, staphylococcus aureus and pseudomonas
aeruginosa. Multiple drug resistance microorganisms have been developed due to
indiscriminate use of commercial antibiotic drugs. Aim of this study is evaluation of effects
of medicinal plants on microorganisms involved in ventilator-associated pneumonia.
Materials and Methods: information of this review article have been gathered from journals
accessible in databases such as science direct, Iran medex and pubmed. The search terms
were ventilator-associated pneumonia and medicinal plants.
Result: studies showed that medicinal plants have antifungal, antibacterial, antiviral and
antioxidant effects and they have therapeutic potential to replace with chemical drugs. Plants
for example Mespilus germanica, tanacetum parthenium L, Zataria Moltiflora Boiss have
activity against staphylococcus aureus, pseudomonas aeruginosa and heamophilus influenza.
Conclusion: medicinal plants have antibacterial activity against bacteria's causing VAP and
so these plants can be considered in the control of VAP.
Key word: ventilator-associated pneumonia, medicinal plants
HN10103130201
The hands, as the major cause of infection in hospitals, charitable, military in Mashhad
Masoumeh Mokaram Rad, Amir Hojabr Kalali, Javad Panahandeh, Saed Lotfi
Abstract :
Introduction: The Challenge of infections due care treatment centers. To reduce the incidence of
these infections are most effective, easiest and least expensive way to hand hygiene by staff
including nurses, midwives, technicians, is known.
Objective: This study of hand hygiene by staff, especially the military and charitable hospitals in
Mashhad.
Methods: The study included all the staff the intensive care unit especially the Charity and military
Hospital, Mashhad took place.
Results: Mean score of general hand hygiene was %3.16 of total score.In most samples (651)
the quality of general hand hygiene perform once was averag and mean score of
general hand hygiene in Besat, Maternity and the military and charitable hospitals respectively were
%1.36
%5.56 and %3.16 of total score .There was no si gnificant difference between m ean score and
different hospitals, type of surgery and personel level of education.
The least comp liance
with hand hygiene was regarding hand wash with soap before(5.56) and after(33.56
patient care and after rem oving gloves(31.06) Also most of samples (%9.76) wear gloves for patient
care.
Conclusion: In this study average score of gene ral hand hygiene were greater than
516(%3.16) of total score but what is of im portanc is the non com plianc with hand washing before
and after patient care (alt hough it is among most im portant and effective means of prevention of mi
cro organism transm ission).
Keywords: hand hygiene , Infection Control, Nursing Staff, HealthStatus, Cross Infection, Surgical
Procedures
How nurses think about problems with hand hygiene?
Authors name: Ahmadreza Yazdan nik, Elham Izadi
The importance of hand sanitation and its role to control the hospital infections has documented in
different researches. We can say that infection will decrease to a great extent with hand sanitation.
repeated hand washing isn’t done in an acceptable level due to some causes and not to care about
infection criteria’s show that how weak is the structure , operation ,knowledge and outlook in this field.
Variety of researches has verified this fact. This research aims to determine the causes of lack of
sanitation in the point of view of infection controllers of Isfahan clinics and prioritize these causes.
This research is a combined one that its first part is done to the target of determining causes in quality
and with content analyzing and its second part is done for prioritizing the causes and in quantity. First
part’s samples include 23 nurses of infection control centers’ nurses and second parts are 100 nurses of
emergency ward of one huge educational center of Isfahan city that were chosen in an easy way.
Gathering information of first part of research was formed by answering to 5open answered written
questions. Regarding answers, the codes extracted and categorized in 20 sub levels and 3 general levels
consisting structured, operational causes and knowledge outlook. In the second part the above 20
causes were gathered in a question form and prioritized by nurses and the average point of priority
grade determined for each criteria.
Results:
As of the nurses’ views causes that are related to structural problems such as critical decrease in human
forces and high workload, caring the patients with vital needs, improper equipment and facilities has the
most importance in lack of hand sanitation. About operational causes not using disinfectors due to nails
beauty and about outlook causes not being satisfied by salary are told by nurses.
Discussion:
In despite of importance of hand sanitation in controlling the hospital infections this topic is challenging
and due to some reasons isn’t accomplished to normal extent. The results in two points of quantity and
quality show that nurses believe that lack of hand sanitation are more due to lack of necessary facilities
rather than personal reasons.
Key words: hand sanitation, nurses, infection control
Inducible clindamycin-resistant Staphylococcus aureus in Iran: a meta-analysis
Ahmadreza Zarifian1, Yasin Setayesh1, Emran Askari1, Aminreza Amini2, Mohammad Rahbar3, 4,
Mahboubeh Naderinasab5
1- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences,
Mashhad, Iran
3- Department of Microbiology, Reference Health Laboratories Research Center, Deputy of
Health, Ministry of Health and Medical Education, Tehran, Iran
4- Antimicrobial Resistance Research Center, Tehran University of Medical sciences, Tehran,
Iran
5- Microbiology Laboratory, Central Laboratory, Imam Reza Hospital, Mashhad, Iran
Introduction and Objectives: Staphylococcus aureus is a prominent human pathogen.
Clindamycin is among the drugs used in the treatment of staphylococcal infections. Resistance to
clindamycin includes two types: inducible and constitutive. Routine laboratory methods of
antibiotic susceptibility testing cannot detect the inducible type and D-test is required for its
detection. This meta-analysis determines the relative prevalence of this type of resistance in Iran.
Methods: Search terms "inducible clindamycin resistant", "D-test", "Staphylococcus aureus" and
"Iran" were used to find relevant articles in PubMed, Google Scholar and two Persian search
engines. In addition, the abstracts of the recent national microbiology congresses were checked.
All studies used D-test to find iMLSB (inducible macrolide, lincosamide and streptograminB
resistance) phenotype among clinical isolates (not nasal swabs) of S. aureus, were included. In
order to perform meta-analysis, we used “comprehensive meta-analysis” software (ver. 2).
Results: Totally, 9 articles and 8 abstracts related to the topic of the study were found. Random
effects meta-analyses showed a pooled estimate for percentage of iMLSB phenotype among 2683
samples of S. aureus was about 10% (95% confidence interval: 0.07-0.12). Using the fixed effect
model, the odds of positive iMLSB in methicillin-resistant S. aureus was about 5 times more likely
to occur in comparison with methicillin-susceptible S. aureus(95% CI: 3.49 to 7.76).
Conclusion: Frequency of clindamycin inducible resistance in Iran is relatively low. However, Dtest should be performed for all erythromicin-resistant isolates in order to identify inducible
resistance to clindamycin. Moreover, reevaluation of inducible resistance to clindamycin is highly
recommended.
Keywords: Staphylococcus aureus, inducible resistance, clindamycin, Iran, systematic review
Infection in children with granulomatosis polyangitis
Fatemeh Tahghighi Shorbian, Vahid Ziaee
Introduction
Granulomatosis polyangitis(GPA)is an uncommon chronic systemic vasculitis in children that
mainly affecting the upper and lower respiratory tracts and kidneys that usually involve small to
medium-sized arteries. The aim of this study was to discribe infection in pediatric patients with
GPA.
Material and Methods
We studied all patients with GPA diagnosis who were referred to Pediatric Rheumatology
Division of children’s medicine center from 2002 to 2022.we used the EULAR/PRES criteria to
confirm the diagnosis.Data included age,gender,age of onset,delay in diagnosis, clinical features
,laboratory and histopathological findings,treatment and complications.
Results
A total of 22 patient (5 females and 6 males)enrolled in this study.Infection was observed in 4
children (66.63) and one of them was died due to fungal infection. Three patients had otitis and
one of them had a retroorbital granulomatous mass due to fungal infection. Mortality rate was
21.23 due to pulmonary vasculitis and infection.
Conclusion
Althought GPA is a rare rheumatology disorder in children ,infection can be with significant
mortality rate in the disease,so a high index of suspicion must be preserved for the diagnosis of
infection in such patients.
Title: Infection transmission by health care uniforms : its reduction approach
Marzieh Jahani 1, Ezzat Paryad2
1-Jahani M.Supervisor.MSn.Nursing,Guilan University of Medical Sciences ,Rasht,Iran
2- Paryad ezzat faculty member social determinants of health research center(SDHRC) Guilan University of
Medical Sciences ,Rasht,Iran
Introduction and Objectives: Human skin has microorganism.These organisms can cause diseases
by transmission of health care skins’ to their uniform and from their uniform to patients.The
nasocomial infections may start by the way difference of uniforms' materials,difference washing
styles,detergents for uniforms washing ,duration time between uniform washing and arriving out of
hospitals in uniform can be the source of the most current nosocomial infection.Assessing the
approaches to modify this problem in others studies, was this objective of this paper.
Materials and methods: In this review article eighteen articles was printed through 1998 to 2013
were assessed. The key words were health care uniform and nasocomial infections. The research was
done in Medline and Google scholar data bases.
Results: The predominant result of these original articles was showed the uniform of the majority of
physician and nurses were infected by staphylococcus especially around packets, sleeves. in front of
uniform around abdomen and the ties. High duration between two steps uniform washing and current
using of one uniform more than one health center were other major findings.
Conclusion: If the health managers decide to wash all of health care providers' uniforms regularly by
health care center supervision, infection reduction will be occurred.
Key word: infection, nasocomial infections, health care uniform
‫ارزیابی برخی از عوامل اپیذمیولوژیک در بیماران مبتال بً سل خارج ریوی مراجعً کىىذي بً مراکس بٍذاشتی‬
0931-0931 ‫درماوی مشٍذ در سال ٌای‬
‫ حسیه مختاری‬-‫مریم شریعت جعفری‬
Introduction: Tuberculosis is a global public health emergency and infects one third of the world’s
population Extra pulmonary tuberculosis affects other organs of body expect of lung. The
prevalence of extra pulmonary tuberculosis is different between %5 to %%5 in developing countries
and 4%5 of infection are located in this countries. Because importance of tuberculosis and high
prevalence of extra pulmonary tuberculosis in iran, this study done by purpose of investigation
some epidemiologic factors in patients referred to health care centers of Mashhad in 5%3% to
5%41 in order to help in faster diagnosis of this disease.
Materials and Method:
Type of study is case- series which is based on collected data from questionnaire and data was
analyzed.
Results:From 732 patients with extra pulmonary tuberculosis:
541 patients (43.35) were male and 542 patients (%5.75) were female.
The average age of patients was 4.54±2951 years old.172 of patients (49454) were Iranian. Most
disease outbreaks were occurred winter season (41851).Occupation groups that have the highest
share among patients were housewife. Most patients were who did not finished their high school
courses. More common kinds of involvement were lymphadenitis(4.659) then plural(42858) then
osteoarticular (4954) tuberculosis.
Conclusions: According to this study, it seems that despite the relative decrease in number of
patients in recent years, we see outbreak of diseases again in 0931 that it is a very important issue.
Also the most extra pulmonary involvement are the 5 and 6 decades of life. and the most involved
organs
are
lymphatic
system
and
then
pleura
Key Words: extra pulmonary Tuberculosis, Epidemiology, health care.
Investigation of deaths due to nosocomial infections in hospitals host INIS Covered Mashhad
University of Medical Sciences in 1392
Mojtaba Taghvaei Ahmadi1, Dr. Zahra. Nehbndani2, Mashallah Sayahnejad3
1. Expert Health Center of Disease- Mashhad University of Medical
2. The Director of the Department of disaeses, Mashhad University of Medical
Introduction and Objectives
Nosocomial infections have shown that the direct and indirect causes of death 19000 leading man.
Mortality from circulatory diseases, followed by 25 to 50%, followed by pneumonia is 7 to 27%. The
aim of this study was to investigate the deaths of hospital infection host INIS Covered Mashhad
University of Medical Sciences in 1392, respectively.
Methods:
This descriptive - retrospective where all deaths due to infection in the host 8 hospitals in the study
have been analyzed on the basis of software INIS.
Results:
From 5187 to 1392, the 258 registered deaths in hospitals due to nosocomial infections was 0.59 /
4% of deaths in women and 40/6% of male deaths in the age group 15-65 years Ast.byshtryn with
45/3 percent Bashd.fvnthay BSI with 33/7% of deaths accounted Dah Ast.mhmtryn disease in
patients with hypertension, 5/03% Bashd.byshtryn invasive interventions performed in patients
died, with 248 being the venous catheter.
Conclusion:
hospital infection control committee and staff supervision and ongoing work on the use of personal
protective equipment, wash hands and observe standard Ahtatat reduce infections and deaths are
very effective.
Keywords: death, INIS, Mashhad
Investigation of nosocomial infections in hospitals host INIS Covered Mashhad University of
Medical Sciences in 1392
Mojtaba Taghvaei Ahmadi1, Dr. Zahra. Nehbndani2, Mashallah Sayahnejad3
2. The Director of the Department of disaeses, Mashhad University of Medical
Nosocomial Infection Infection is said that after admission to hospital (48 or 72 hours) or
over a given time (10 to 30 days) after patient discharge occurs at the time of admission does
not exist in the its latency should be. The aim of this study was to evaluate hospital infection
host INIS Mashhad University of Medical Sciences in 1392 is covered.
Methods:
This descriptive - retrospective in which patients with nosocomial infections in hospitals 8
host, has been studied and analyzed are based on software INIS.
Results:
In 1392 a total of 219,567 patients admitted to hospitals with a total of 2375 cases of
nosocomial infection incidence is 1/08. 66/35% of positive cultures and 33/65% of clinically
diagnosed. The incidence of infection was 53% in men and 47% women. Age group 64-15
years had the highest incidence rate of 56/63%. The incidence of infection in burn units with
28/65%, followed by the PICU with 25/57% of all the 14/78% have been reported. The most
important risk factor, Kattrvrydy by 25/57% Vmhmtryn diabetes disease by 45/45%,
respectively. UTI with 25/1% highest and lowest infection rate was 13%.
Conclusion:
According to the studies of the most important ways to reduce hospital infections, continuing
education about hand washing and use of personal protective equipment by personnel.
Keywords: nosocomial infection, INIS, Mashhad
‫عنوان ‪ :‬مصرف منطقی آنتی بیوتیک ها‬
‫نویسنذگان ‪ :‬مرضیه ملکی‪ ،1‬پریسامیرزاونذیان‪ ،2‬فرانک میرزاونذیانی‪،2‬احمذ جعفرزاده‬
‫‪2‬‬
‫‪ .1‬کارشناس پرستاری‪،‬مرکسآموزشی درمانی شهذای عشایر‪،‬دانشگاه علوم پسشکی لرستان‬
‫نویسنذه پاسخگو ‪malekimarzie@yahoo.com‬‬
‫‪ .2‬کارشناس پرستاری‪،‬مرکسآموزشی درمانی شهذای عشایر‪،‬دانشگاه علوم پسشکی لرستان‬
‫مقذمه‪:‬تالش تزای هٌطمی کزدى هصزف دارٍتِ ػٌَاى یکی اسهَارد هْن سیاست گذاری ّای دارٍیی ّوَارُ هَرد‬
‫تَجِ تَدُ است‪.‬طثك ًظز ساسهاى جْاًی تْذاضت‪،‬جْت دستیاتی تِ هصزف هٌطمی دارٍ ًیاستِ استفادُ اسدارٍّایی هٌاسة‬
‫هی تاضذ کِ تتَاًٌذ ًیاسّای تالیٌی تیواراى را در هحذٍدُ جغزافیایی خاظ تا کن تزیي ػَارض ٍ کن تزیي ّشیٌِ تزطزف‬
‫ًوایٌذ‪.‬‬
‫روش بررسی‪:‬هطالؼِ حاضزاسًَع هزٍری تااستفادُ اسجستجَ در کتة‪،‬هٌاتغ هؼتثز ػلوی _ پشضکی در سایت ّای‬
‫هؼتثز ٍ جْاد داًطگاّی (‪ ) Sid‬تا کلیذ ٍاصُ هٌاسة اطالػات جوغ آٍری ضذُ است‪.‬‬
‫یاقته ها‪:‬هزکش پیطگیزی ٍکٌتزل تیواری ّاتخویي هی سًذ کِ ساالًِ درآهزیکا حذٍد ‪ 055،555‬ػفًَت سخن جزاحی‬
‫اتفاق هی افتذ‪.‬ػفًَت سخن تاػث افشایص هزگ ٍهیز‪ّ،‬شیٌِ ّاٍطَل هذت تستزی تیواراى در تیوارستاى هی گزدد ‪.‬اسسَی‬
‫دیگزهماٍهت هیکزٍتی تِ آًتی تیَتیک ّاتِ طَر رٍسافشٍى اّویت ٍیضُ پیذ کزدُ است ٍتاٍجَد دُ ّا ًَع آًتی تیَتیک‬
‫هَجَد‪،‬تیواراى سیادی تِ ػلت هماٍم تَدى تاکتزی در تزاتز آًتی تیَتیک رٍساًِ اس دست هی رًٍذ‪.‬‬
‫نتیجه گیری‪:‬درجْت کاّص ّشیٌِ ّای درهاًی‪،‬ضٌاسایی ػَاهل هْن ٍضایغ تیواریشاّای تیوارستاًی ٍتؼییي الگَی‬
‫دلیك هماٍهت آًتی تیَتیکی درجْت کٌتزل ضیَع ایٌگًَِ ػَاهل هزتَط تِ ًظز هی رسذ‪ّ.‬وچٌیي اًجام ایي اهَرهی تَاًذ‬
‫هَثز تاضذ‪:‬رػایت تْذاضت دست ّا ٍ سایز اسثاب آلَدُ ٍ ٍسایلی کِ احتوال آلَدگی درآى ّا ٍجَد دارد‪،‬تؼییي ًَع‬
‫آًتی تیَتیک هَثزتاکطت ٍضٌاسایی هیکزٍارگاًیسن لثل اسدرهاى‪،‬ضزٍع آًتی تیَتیک هَثزٍتاحذ اهکاى دردٍرُ ی‬
‫کَتاُ‪،‬تَجِ تِ دستَرالؼول ّای هصزف آًتی تیَتیک ّا کِ اسطزف کویتِ کٌتزل ػفًَت تیوارستاى یاهٌطمِ ای‬
‫ٍفزاهٌطمِ ای صادر هی ضَد‪.‬‬
‫ٍاصگاى کلیذی‪:‬آًتی تیَتیک‪،‬هفاٍهت دارٍیی‪،‬پزٍفیالکسی‬
‫‪HN71717111111‬‬
‫بررسی الگوی حساسیت و مقاومت آنتی بیوتیکی در میکروارگانیسم های ایسوله شده از بیماران بستری‬
‫نویسندگان‪:‬دکتز ػلیزضا ًیکًَضاد ‪،‬دکتز ًادر آقاخاًی‪،‬دکتز هحوذ داٍری‬
‫نشانی ‪ :‬داًطگاُ ػلَم پشضکی ارٍهیِ‬
‫مقدمه و هدف‪ٍ:‬خَد تاکتزی ّای هقاٍم در تخص ّای هختلف تیوارستاى ّا ٍ هطکالتی کِ در درهاى تیواراى تِ ٍخَدهی‬
‫آٍرًذ‪ ،‬ضزٍرت ضٌاخت ٍ اطالع دقیق اس ایي تاکتزی ّا ٍ الگَی حساسیت ٍ هقاٍهت آًتی تیَتیکی آى ّا را ضزٍری هی‬
‫کٌذ‪ .‬ایي پضٍّص تا ّذف تؼییي الگَی حساسیت ٍ هقاٍهت آًتی تیَتیکی در هیکزٍارگاًیسن ّای ایشٍلِ ضذُ اس تیواراى‬
‫تستزی در تیوارستاى صَرت گزفتِ است‪.‬‬
‫روش کار‪ :‬در ایي پضٍّص ‪ً،‬وًَِ ّای کطت تیواراى تستزی ارسال ضذُ اس تخص ّای هختلف تیوارستاى ضاهل‪ :‬ادرار‪ ،‬خَى‪،‬‬
‫خلط‪ ،‬سخن‪ ،‬تزضح تِ آسهایطگاُ هَرد تزرسی قزار گزفتٌذ‪ .‬خْت تؼییي آًتی تیَگزام اس رٍش دیسک آگار دیفیَصى استفادُ‬
‫ضذ‪ ،‬کطت ّای هثثت استخزاج ضذُ ٍ ًتیدِ آى ّا اس ًظز ًَع تاکتزی ٍ ًتایح آًتی تیَگزام در تزگِ آسهایص هطاّذُ ٍ ثثت‬
‫گزدیذ‪ .‬دادُ ّای خوغ آٍری ضذُ تَسیلِ ًزم افشار ‪ Spss‬هَرد تدشیِ ٍ تحلیل قزار گزفتٌذ‪.‬‬
‫نتایج‪:‬اس ّوِ ًوًَِ ّای کطت اًدام ضذُ در هذت ‪ 2‬سال ‪ 964‬هَرد هثثت گشارش ضذ کِ ‪ً 640‬وًَِ هزتَط تِ تیواراى‬
‫تستزی در تخص ّای هختلف تیوارستاى ٍ‪ً ٪48/4‬وًَِ ّای هزتَط تِ تیواراى هزد ٍ ‪ ٪51/6‬تیواراى سى ٍ هیاًگیي سٌی تیواراى‬
‫‪ 60‬سال ٍ سي تیواراى اس ‪ 12‬تا ‪ 99‬هتغیز تَد‪ .‬ضایؼتزیي تاکتزی گزم هٌفی‪ ،‬ای کالی تَد کِ حساستزیي دارٍ تزای آى‬
‫ًیتزٍفَرا ًتَئیي خَراکی ٍ هقاٍم تزیي سفالکسیي ٍ ًالیذیکسیک اسیذ تَدًذ‪ّ .‬وچٌیي ضایؼتزیي تاکتزی گزم هثثت استاف‬
‫کَآگَالس هٌفی تَد کِ حساط تزیي دارٍّا تِ آى ٍاًکَهایسیي ٍ ایوی پٌن ٍ هقاٍم تزیي اریتزٍهایسیي ٍ سفالکسیي ٍ‬
‫سفیکسین تَدًذ‪ .‬ضایؼتزیي تاکتزی ٍ ح ساط تزیي آًتی تیَتیک در اًَاع ًوًَِ ّا تِ تزتیة؛ ادرار‪ ،‬ای کالی ‪،٪57/9‬‬
‫ًیتزٍفَراًتَئیي‪ -‬خَى؛ استاف کَآگَالس هٌفی ‪ٍ ،٪33/5‬اًکَهایسیي‪ً -‬وًَِ ّای سخن ٍ تزضحات ؛ استاف اٍرئَط‪،‬‬
‫ٍاًکَهایسیي ٍ خلط؛ آسیٌتَتاکتز‪ ،‬ایوی پٌن تَد ٍ هقاٍم تزیي دارٍّا در ّوِ ًوًَِ ّای هذکَر‪ ،‬سفالکسیي‪ ،‬اریتزٍهایسیي ٍ‬
‫سفیکسین ( تیطتز اس ‪ ) ٪70‬تؼییي ضذ‪.‬‬
‫نتیجه گیری کلی‪ً :‬تایح ایي هطالؼِ ًطاى اس افشایص هقاٍهت تاکتزی ّا ًسثت تِ آًتی تیَتیک ّای رایح هاًٌذ‬
‫فلَرٍکیٌَلَى ّا ٍ سفالَسپَریي ّا ٍ غیزُ هی تاضذکِ ضایذ ػلت آى تدَیش ٍ هصزف تی رٍیِ آًتی تیَتیک ّا تاضذ کِ‬
‫تَصیِ هی ضَد در اًتخاب آًتی تیَتیک خْت درهاى تدزتی ٍ تدَیش آى دقت تیطتزی تِ ػول آیذ ‪.‬تزای تؼییي دقیق الگَی‬
‫حساسیت آًتی تیَتیکی هطالؼات گستزدُ تز تا ًوًَِ ّای تیطتز در هزاکش درهاًی هختلف تَصیِ هی ضَد‪.‬‬
‫کلمات کلیدی‪:‬الگَی حساسیت ‪،‬هقاٍهت آًتی تیَتیکی‪،‬هیکزٍارگاًیسن ‪ ،‬ایشٍلِ‬
Sensitivity pattern and resistance against antibiotics in isolated microorganisms of hospitalized
patients
Authors: Alireza Nikoonejad*, Dr. Nader Aghakhani, Dr. Mohammad Davari
Address: Urmia University of Medical Sciences
Abstract
Introduction and Objectives: Presence of resistant bacteria in different parts of hospitals and the
problems these persistent bacteria cause in treating the patients, urge the necessity of identification and
precise knowledge about these bacteria and their sensitivity pattern and resistance against antibiotics. This
investigation was conducted in order to determine the sensitivity pattern and resistance against antibiotics
in isolated microorganisms from hospitalized patients in hospitals took place.
Methods & Materials: This is a descriptive sectional investigation which was conducted from January
9002 to January 9022 in Taleghani Hospital of Urmia City and the cultured samples of patients from
different parts of hospital including urine, blood, phlegm, ulcer, discharge, etc. which were sent to the
laboratory were investigated. In order to determine antibiogram disk agar diffusion (DAD).Method was
used, positive cultures were extracted and their results with regard to type of bacteria and antibiogram
results were recorded in the experiment paper. The gathered data were analyzed using SPSS-90 software.
Results: From all cultured samples in 9 years, 269 samples were reported and 690 samples were from
hospitalized patients from different parts of the hospital which 94.94 of the samples were from male
patients and %2.64 from female patients and age average of the patients was 60 years and the age range of
the patients was from 29 to 22. The highest sensitivity among all samples belonged to vancomycin (more
than 204). and the highest resistance belonged to cephalexin, erythromycin and cefixime (more than
%04).The most common bacterium and the most sensitive antibiotic (with ignoring vancomycin) were: in
urine samples: E.Coli %%.24, nitrofurantoine – blood: negative staph coagulase 55.%4, rifampin –
discharge: staph. aureus 54.64,imipenem– ulcer: staph. aureus 54.64, nitrofurantoin and co-trimoxazole –
sputum : acintobacter 9%.%4, rifampin.
Conclusion: The results of this research shows extensive increase in the resistance of the bacteria
compared to common antibiotics the reason of which may be irregular consumption and prescription of
antibiotics, so it is advised that more care be used in choosing antibiotics for the treatment and its
prescription. Also, precise determination of antibiotic sensitivity pattern need more extensive
investigation with more samples in different treatment centers.
Key words: Sensitivity pattern, resistance, antibiotics, microorganisms, hospitalized patients
Improvement to Automated Plasmodium vivax Detection System toward
Accurate diagnosis and prompt Treatment of Malaria cases Using
Classifier Fusion
1
Leila Malihi,Karim Ansari-Asl1,Abdolamir Behbahani2
Electrical Department,Engineering Faculty,Shahid Chamram University,Ahvaz,Iran
2
School of Health,Ahvaz Jundishapur University of Medical Sciences,Ahvaz,Iran.
Introduction and Objectives: Visual recognition is Common way to diagnose malaria that is
very time consuming, difficult and low accuracy so the automatic detection of the disease
increases the accuracy and speed of treatment. With automatic detection of the malaria
parasite life stage, stage and severity of the disease can be identified. In this research, first
parasite and then stages of plasmodium vivax are detected.
Materials and Methods: 400 images of malaria parasites have been used in this section.
MATLAB software are used. At first, red blood cells and other stained elements of
blood such as parasites, white blood cells, and platelets were extracted; then, red blood cell
mask was located and features were extracted and used as classifier inputs. Using
Adaboost classifier based on Decision tree with 150 repeat increased accuracy. In the next
section 120 images of p.vivax used to detect stages of that.
Number of vacuoles, gradient and flat-texture features are combined and used as QD and
Fisher classifier fusion input.
Result: The accuracy of detecting malaria parasite using Adaboost method was 95.5% and
the accuracy of detecting p.vivax stages was 98.33%.
Conclusion: The priority of designing a fast acting system to detect and prompt treatment of
discovered malaria cases in the community is obvious to protect the whole community from
occurring indigenous Malaria transmission.
Keywords: classifier, Adaboost, Plasmodium, vivax, Fisher, QD, Decision-tree, fusion
classifier, Malaria
Fees paid by poisoned patients with aspiration pneumonia
HaghNejad . F1, Eizadi Moud. N 2
1. Toxicology graduate student at Azad University of Shahreza, Isfahan, Iran
1. Nursing staff of social security organization
2-Toxicologist, professor and member of the faculty of Isfahan medical sciences
Author E-mail: Yaali440@yahoo.com
Introduction and objectives: Poisoned patients present different clinical situations. A decreased
level of consciousness is one of the most common major complications, which can lead to
aspiration pneumonia, respiratory distress syndrome, and cardiovascular death is sudden.
Increased hospital stay and ICU stay and imposes a heavy burden on the patient and society.
Material and methods: 4750 patients admitted to the Hospital Noor (Isfahan) within one year of
study and the selection of patients with aspiration pneumonia and 79 patients were sampled.
After extracting information from the check lists, the data were analyzed using SPSS version 19.
Results: 1671990000 rials and fees equal samples of at least 540,000 rials up to 12.38 million
rials .Variables, including specialized consulting fees, Hoteling and services, intensive care, and
laboratory tests, medications, especially antibiotics.
Conclusion: Continuous education of the medical community in dealing with traumatized
patients and providing accurate and timely pre-hospital phase can be complications such as load
increases costs and prevent infections was effective.
Keywords: Toxicological, costs, pneumonia, aspiration
Study of the quality of vascular access: Hemodialysis patients
2
1
2*
3
Hamid Reza Chamanzari , Ali Bazzi , Maryam Bagheri , Toktam masoumian hoseini
1. Patient Safety Research Center, Faculty of Nursing and Midwifery, Mashhad University of
2. Patient Safety Research Center , Faculty of Nursing and Midwifery, Mashhad University of
3. Patient Safety Research Center, Faculty of Nursing and Midwifery, Mashhad University of
*
Corresponding author: Ali Bazzi: , Faculty of Nursing and Midwifery, Mashhad University of
Email: bazzia911@mums.ac.ir
Abstract
Introduction
Care for vascular access of patients undergoing hemodialysis is a critical issue. Inflammation and
subsequent infection are the major factors that threaten patients' health and reduce the effectiveness of
hemodialysis.
Objective: To evaluate the severity and incidence of inflammation of vascular access in hemodialysis
patients.
Method: This cross-sectional study was conducted on 90 patients undergoing hemodialysis in Emam
Reza Hospital and Montaserie Hospital during the month of Tir 1393. Evaluation of inflammation
severity over the course of one month (12 hemodialysis sessions) took place by means of an
inflammation tool by the Board of Nursing. Data were analyzed using SPSS software version 16 and
descriptive and chi-square tests.
Results: The mean and standard deviation of incidence of inflammation in the first session of
hemodialysis patients was 3.2± 1.3. The mean and standard deviation of the intensity of inflammation
was 12.5 ± 4.7.
Conclusions: Because the inflammation of vascular access in hemodialysis patients impairs their
safety and health improvement, necessary measures to reduce this complication must be considered.
Keywords: Vascular access, inflammation during hemodialysis, health promotion of hemodialysis
patients
Post-exposure care during dental treatments
Zohreh Dalirsani *1, Atessa Pakfetrat 2 Pegah Mosannen Mozaffari3
1
Associate Professor of Oral Medicine, Oral and Maxillofacial Diseases Research
Center , Department of Oral Medicine, Faculty of Dentistry, Mashhad University of
Medical Sciences, Mashhad, Iran.
2
Associate Professor of Oral Medicine, Addiction Research Center , Department of
Oral Medicine , Faculty of Dentistry, Mashhad University of Medical Sciences,
Mashhad, Iran.
3
Assistant Professor of Oral Medicine, Oral and Maxillofacial Diseases Research
Center , Department of Oral Medicine, Faculty of Dentistry, Mashhad University of
Presenter: Zohreh Dalirsani
Address: Dental School, Vakil Abad BLVD, Mashhad, Iran
Postal code: 91735
Email: dalirsaniz@mums.ac.ir
Tel: 09155002857
Needle prick during dental treatment is not uncommon. For occupational safety some
processes are advised during dental treatments includes vaccination (HBV), using
protective barriers. Despite protective procedures sometimes dentists become injured
with sharp devices need to emergency procedures for reduction of possibility of
infection.
After searching in articles published in Pubmed/Medline,post-exposure steps were
summarized in this paper.
Results:
Emergency steps after exposure to contaminated sharp instruments are washing
contaminated skin using large amounts of soap and water or betadine for 10 minutes.
Contaminated eyes and mucous membranes should be irrigated for 15 minutes using
normal saline or water.
For assessment of infection risk, source of exposure should be evaluated regarding
presence of HBs-Ag,HBe-Ag,HBc-Ab ,HCV-Ab,HIV-Ab and HTLV-Ab. If source is
unknown,we assess epidemiologic evidences.
Furthermore, it should be clarified whether exposed person has immunity to HBV
infection or not. If the dentist is not vaccinated, post-exposure prophylaxis for HBV
with hepatitis B immune globulin(HBIG) within 7 days is about 70% effective in
preventing HBV infection.
If dentist is exposed to a hepatitis C positive patient, blood test should be done
during 4- 6 weeks. After taking antiviral drugs, follow-up test until 4 -6 months is
advised.
If the patient is HIV+ it is better to start antiretroviral drugs within 24- 72 hours after
exposure and continue for 28 days.
Conclusion: post-exposure steps is recommended during the first days after exposure,
however, prevention is superior to treatment.
Key words: Post-Exposure, Needle prick, Hepatitis, HIV
Optimum performance Guidelines for intensive care unit design
Behzad Maghsoudi
Designing the ICU for infection control can lower infection rates and therefore morbidity
and mortality, cost per case, and length of stay .The goal of the design process is to
create a healing environment for the physical or psychological states of patients, staff,
physicians, and visitors .
THE PATIENT CARE ZONE
Design begins with analysis of patient care and support functions, workflow, and hospital
policies . Single rooms are superior to multibed rooms.
The doors should be sized to permit rapid movement . Patients exposed to natural
sunlight have been shown to experience less perceived stress, use fewer analgesics, and
have improved sleep quality and quantity . Room design should afford privacy in the use of
mobile commode chairs, or bedpans .
Isolation: Negative pressure, relative to adjacent spaces, can be used to prevent the spread
of airborne pathogens from an infected patient.
CLINICAL SUPPORT ZONE
The design of the unit must consider the pharmaceutical delivery functional process , 42hr clinical laboratory services , Imaging services and respiratory therapist and equipments .
Provisions should be made for storage and rapid retrieval of one or more “crash carts”
with emergency life-support equipment and supplies. Multiple areas should be allocated
for storing nonemergency equipment. ICU design must consider both vertical and
horizontal transport paths.
UNIT SUPPORT ZONE
A variety of offices and conference spaces ,supplies, Workrooms,and space for On-call ,
Staff Lounge, Restrooms and Lockers are needed.
FAMILY SUPPORT ZONE
Spaces and functions outside of the patient room to serve family and visitors. Family
support has been recognized as a significant factor in patient recovery and reduced
morbidity .
HAND HYGIENE
Hand washing stations, both soap and water and alcohol gel systems should be readily
accessible throughout the unit.
Without such design the best personnel ,equipments and drugs may be inefficient for a
minor insult.
A Comparative Study of the Effects of Teucrium Polium and Silver Sulfadiazine
Ointment %1 on Burn Wounds in Male Rats of Wistar Race
Ebrahim Momeni, Jamshid Mohamadi, Mohammad Behnammoghadam, Zahra Sadat
Ismailinejad
Central Institute for Medicinal Plants, Yasuj University of Medical Sciences, Yasuj , Iran.
Abstract
Introduction: Burns and their related injuries are the leading causes of mortality and
disabilities around the world. Traditional medicine has benefitted from miraculous effects of
herbs in ameliorating the pains of burn wounds. Among these herbal medicines, Teucrium
Polium possesses antioxidant, antimicrobial, and antiseptic effects and due to
its miraculous power of healing, it has got the place among the top ranked herbal medicines.
So, the present paper seeks to study the healing effect of Teucrium Polium extract on seconddegree burns in male rats.
Materials and Methods: In this clinical study, 04 male rats of Wistar race were randomly
collected and divided into 0 equal groups of 04 animals. The first group was considered as
control group, so it did not receive any burn or treatment. Second group were washed with
physiology serum. Third and fourth groups were respectively treated with Teucrium Polium
extract and Silver Sulfadiazine ointment 01. The rats were anesthetized with Thiopental
Sodium (04 ml/Kg/IP). Then, each rat from group second, third, and fourth was
accommodated in a plastic container with an aperture of 2cm square that enabled exposure of
animal’s dorsum to boiling water (°69C) for 04 s. After 53 days of treatment, the rats were
anesthetized again with Thiopental Sodium and blood samples were also taken from their
hearts to determine the serum level of malondialdehyde. It should be mentioned that the
specimen of the skin tissue of the injured area were taken and transferred to Formalin 041
solution. After tissue processing, the specimen were molded, sections of 3 micron were
prepared and staining was done with hematoxylin - eosin. After all these, the histological
changes were examined by light microscope and the obtained data were analyzed using SPSS
software and ANOVA test.
Results: The Obtained results showed that the antibiotic effects of Teucrium Polium in
healing the burn wounds have significant differences in comparison to control group (P<
4043). The antibiotic effects of Teucrium Polium in healing burn wounds have significant
differences in comparison to the group which was treated with Silver Sulfadiazine ointment 0
%( P< 4043) .
Key Words: Skin, Burn, Teucrium Polium, Rat, Silver Sulfadiazine Ointment.
Prevalence of respiratory infections (PNEU) in hospitals host INIS Covered Mashhad
Medical University in 1392
Mojtaba Ahmadi Taghvaei1
1. Expert Health Center of Disease- Mashhad Medical University
Hospital-acquired infections are common in patients with mechanical ventilation (VAP),
elderly patients with underlying diseases, extensive surgery and ICU patients is more
common. The aim of this study was to evaluate respiratory infections in hospitals host INIS
Covered Mashhad University of Medical Sciences in 1392, respectively.
Method:
This descriptive study - retrospective in which patients with respiratory infection in 8 host
hospitals in the study have been analyzed on the basis of software INIS.
Result:
In 1392 a total of 2375 patients with nosocomial infections in hospitals, 517 patients
developed respiratory infection 21/7 percent. 43 is the number of deaths due to respiratory
infections. 87% of positive cultures, 13% of clinically diagnosed. The incidence of infection
in 60% of men and 40% women. Age group 65-15 years had the highest incidence rate of
53/5%. The incidence of infection in the ICU with a 77/3% have been reported and the most
common cause of death in ICU with 72 percent. The pathogen infection, Acinetobacter
incidenceof47/5percent.
Conclusion:
The most important way to reduce respiratory infections, wash hands, observing the correct
and
appropriate
use
of
personal
protection
is
Vyntlatvrv.
Keywords: respiratory infections, INIS, Mashhad
Pneumococcal Sepsis, Peritonitis, and Cellulitis at the First Episode of Nephrotic Syndrome
Mitra Naseri
Introduction: Bacterial infections are common in patients with nephrotic syndrome, including
peritonitis, sepsis, meningitis, urinary tract infection, and cellulitis
Case presentation: An 8-year-old boy presented with colicky abdominal pain, vomiting,
swollen and painful erythematous lesions around the umbilicus and in anterior surface of left
thigh (cellulitis), mild generalized edema, and ascites. He had been admitted 1 week earlier with
generalized edema, proteinuria, hypoalbuminemia (serum albumin level < 5.2 g/dL) and
nephrotic-range proteinuria (urinary protein excretion rate > 1g/m5/d). The final diagnosis was
nephrotic syndrome and the patient had been discharged with prednisolone, 06 mg/d, in divided
doses. The microorganism isolated from peritoneal fluid and blood cultures was Pneumococcus.
Association of pneumococcal sepsis, peritonitis, and cellulitis has been rarely reported in
nephrotic syndrome.
Keywords. nephrotic syndrome, Streptococcus pneumoniae, sepsis, peritonitis, cellulitis
Prevalence of microorganisms from infection burning in Qom hospitals
*Mohammad Khodadad Motlagh
*Bacteriology PhD student, Department of Pathobiology, School of Veterinary Medicine,
Shiraz university of Shiraz.
Corresponding: Mohammad Khodadad Motlagh
Tel: 09126512440
Email: m.khodadadmotlagh@gmail.com
Introduction and Objectives: Burn wounds are suitable environments for the growth of
various opportunistic infections. The knowledge of the common microorganisms in these
infections and their antibiotic resistance are fundamental. We studied common
microorganisms and their antibiotic resistance in burn ward of Nekuei Hospital, Qom, Iran.
Materials and method: In this study, during 5 months, 70 patients admitted to the burn ward
of Nekuei hospital were examined. After Sampling and isolation of bacteria, biochemical
standard tests for determination of microorganisms were done.
Results: Totally, the cultures of 54 cases (77.14%) of a total of 70 samples were positive.
The most common isolated bacteria were Pseudomonas aeruginosa (38.9%), Staphylococcus
aureus, and staphylococcus epidermidis (11.42%), and Enterococcus faecalis (9.59%).
Conclusion: The most common bacteria in infection of burn wound was pseudomonas
aeruginosa, which was mostly susceptible to amikacin and gentamicin. Either beside our
choice drug treatment we must try to evaluate the mechanisms of resistant in bacterial
infections to be able conquer the limitation of clinical treatments.
Keywords: infection, burn wound, bacteria, antibiotic resistance
‫ﺑﺮرﺳﯽ ﻣﯿﮑﺮوارﮔﺎﻧﯿﺴﻢ ﻫﺎي ﻣﻮﺛﺮ در ﻋﻔﻮﻧﺖ زﺧﻢ ﻫﺎي ﺳﻮﺧﺘﮕﯽ در ﺑﯿﻤﺎرﺳﺘﺎن ﺳﻮﺧﺘﮕﯽ ﻗﻢ‬
‫ﻣﺤﻤﺪ ﺧﺪاداد ﻣﻄﻠﻖ‬
‫داﻧﺸﺠﻮی دﮐﺘﺮی ﺑﺎﮐﺘﺮی ﺷﻨﺎﺳﯽ‪ ،‬ﮔﺮوه ﭘﺎﺗﻮﻟﻮژی‪ ،‬داﻧﺸﮑﺪه داﻣﭙﺰﺷﮑﯽ‪،‬‬
‫داﻧﺸﮕﺎه ﺷﯿﺮاز‪.‬‬
‫ﭼﮑﯿﺪه ‪:‬‬
‫ﻣﻘﺪﻣﮫ ‪ :‬زﺧﻢ ھﺎی ﺳﻮﺧﺘﮕﯽ ﻣﺤﯿﻂ ﻣﻨﺎﺳﺒﯽ ﺟﮭﺖ رﺷﺪ اﻧﻮاع ﻣﯿﮑﺮوارﮔﺎﻧﯿﺴﻢ‬
‫ھﺎی ﻓﺮﺻﺖ ﻃﻠﺐ ﻋﻔﻮﻧﺖ زا ﻣﯽ ﺑﺎﺷﻨﺪ‪.‬آﮔﺎھﯽ از ﻣﯿﮑﺮوارﮔﺎﻧﯿﺴﻢ ھﺎی ﻣﻮﺛﺮ‬
‫در ﺑﺮوز ﻋﻔﻮﻧﺖ و ﺣﺴﺎﺳﯿﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ آﻧﮭﺎ در ﭘﯿﺸﮕﯿﺮی و درﻣﺎن‬
‫ﺻﺤﯿﺢ و ﺑﮫ ﻣﻮﻗﻊ ﻋﻔﻮﻧﺖ ﻧﻘﺶ اﺳﺎﺳﯽ دارد‪ .‬در اﯾﻦ ﻣﻄﺎﻟﻌﮫ ‪،‬ﻋﻮاﻣﻞ‬
‫ﺑﺎﮐﺘﺮﯾﺎﯾﯽ ﻣﻮﺛﺮ در ﻋﻔﻮﻧﺖ ھﺎی ﭘﺲ از ﺳﻮﺧﺘﮕﯽ و اﻟﮕﻮی ﻣﻘﺎوﻣﺖ آﻧﺘﯽ‬
‫ﺑﯿﻮﺗﯿﮑﯽ آﻧﮭﺎ در ﺑﺨﺶ ﺳﻮﺧﺘﮕﯽ ﺑﯿﻤﺎرﺳﺘﺎن ﻧﮑﻮﯾﯽ ﻗﻢ ﺗﻌﯿﯿﻦ ﮔﺮدﯾﺪ‪.‬‬
‫ﻣﻮاد و روش ھﺎ ‪:‬‬
‫در اﯾﻦ ﻣﻄﺎﻟﻌﮫ از‪ 70‬ﺑﯿﻤﺎر ﺑﺴﺘﺮی در ﺑﺨﺶ ﺳﻮﺧﺘﮕﯽ ﺑﯿﻤﺎرﺳﺘﺎن ﻧﮑﻮﯾﯽ‬
‫در ﯾﮏ ﺑﺎزه زﻣﺎﻧﯽ ‪ 5‬ﻣﺎھﮫ ﻧﻤﻮﻧﮫ ﮔﯿﺮی اﻧﺠﺎم ﮔﺮﻓﺖ ‪ .‬ﭘﺲ از ﻧﻤﻮﻧﮫ‬
‫ﮔﯿﺮی و ﺟﺪاﺳﺎزی ﺑﺎﮐﺘﺮی ھﺎ ﺗﺴﺖ ھﺎی ﺑﯿﻮﺷﯿﻤﯿﺎﯾﯽ ﻃﺒﻖ اﺳﺘﺎﻧﺪاردھﺎی‬
‫ﻣﻮﺟﻮد ﺟﮭﺖ ﺷﻨﺎﺳﺎﯾﯽ ﻣﯿﮑﺮوارﮔﺎﻧﯿﺴﻢ ھﺎ اﻧﺠﺎم ﺷﺪ‪.‬‬
‫ﯾﺎﻓﺘﮫھﺎ‪ :‬در اﯾﻦ ﻣﻄﺎﻟﻌﮫ‪ ،‬از ‪ 70‬ﻧﻤﻮﻧﮫ ﮔﺮﻓﺘﮫﺷﺪه از ﺑﯿﻤﺎران ﺑﺴﺘﺮی‬
‫در ﺑﺨﺶ ﺳﻮﺧﺘﮕﯽ‪ 54 ،‬ﻧﻤﻮﻧﮫ )‪ (%77/15‬از زﺧﻢھﺎ دارای ﮐﺸﺖ ﻣﺜﺒﺖ ﺑﻮدﻧﺪ‪.‬‬
‫ھﻤﭽﻨﯿﻦ ﺑﺎﻛﺘﺮي ﺳﻮدوﻣﻮﻧﺎس آﺋﺮوﺟﯿﻨﻮزا ﺑﺎ ‪ 40‬ﻧﻤﻮﻧﮫ )‪،(%38/09‬‬
‫ﺑﮫﻋﻨﻮان ﺷﺎﯾﻊﺗﺮﯾﻦ ﻋﺎﻣﻞ ﻋﻔﻮﻧﺖ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ‪ ،‬ﭘﺲ از آن اﺳﺘﺎﻓﯿﻠﻮﮐﻮﮐﻮس‬
‫اورﺋﻮس و اﺳﺘﺎﻓﯿﻠﻮﮐﻮﮐﻮس اﭘﯿﺪرﻣﺎﯾﺪﯾﺲ ﺑﺎ ‪ 12‬ﻧﻤﻮﻧﮫ )‪ (%11/42‬و‬
‫اﻧﺘﺮوﮐﻮﮐﻮس ﻓﮑﺎﻟﯿﺲ ﺑﺎ ‪ 10‬ﻧﻤﻮﻧﮫ )‪ (%9/59‬ﮔﺰارش ﮔﺮدﯾﺪ‪.‬‬
‫ﻧﺘﯿﺠﮫ ﮔﯿﺮی‪:‬‬
‫ﻧﺘﺎﯾﺞ اﯾﻦ ﻣﻄﺎﻟﻌﮫ ﻧﻤﺎﯾﺎﻧﮕﺮ اﯾﻦ اﺳﺖ ﮐﮫ ﺳﻮدوﻣﻮﻧﺎس آﺋﺮوﺟﯿﻨﻮزا از‬
‫ﺷﺎﯾﻊ ﺗﺮﯾﻦ ﺑﺎﮐﺘﺮی ھﺎی ﻣﻮﺛﺮ در ﻋﻔﻮﻧﺖ ھﺎی ﺳﻮﺧﺘﮕﯽ اﺳﺖ ﮐﮫ ﺑﯿﺸﺘﺮﯾﻦ‬
‫ﺣﺴﺎﺳﯿﺖ را ﻧﺴﺒﺖ ﺑﮫ آﻣﯿﮑﺎﺳﯿﻦ و ﺟﻨﺘﺎﻣﺎﯾﺴﯿﻦ ﻧﺸﺎن ﻣﯽ دھﺪ‪.‬‬
‫واژﮔﺎن ﮐﻠﯿﺪی ‪ :‬ﻋﻔﻮﻧﺖ ‪ ،‬زﺧﻢ ﺳﻮﺧﺘﮕﯽ ‪ ،‬اﻧﺘﺮوﮐﻮﮐﻮس ﻓﮑﺎﻟﯿﺲ ‪ ،‬ﻣﻘﺎوﻣﺖ‬
‫آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ‬
report a rare case of VCJD in Al-Zahra university hospital in 2012
Tahere Momeni-Ghaleghasemi1, Amir Musarezaie2
U
U
Variant Creutzfeldt-Jakob disease (vCJD) is a rare and fatal human neurodegenerative
condition. The consumption of food of bovine origin contaminated with the agent of
Bovine Spongiform Encephalopathy (BSE), a disease of cattle, has been strongly linked
to the occurrence of vCJD in humans. 175 cases of vCJD were reported in the United
Kingdom of Great Britain and Northern Ireland (United Kingdom), and 49 cases in other
countries from October 1996 to March 2011. Early in the illness, patients usually
experience psychiatric or sensory symptoms, which most commonly take the form of
depression, apathy or anxiety, and occasionally (in a third of the cases) unusual persistent
and painful sensory symptoms. Neurological signs, including unsteadiness, difficulty
walking and involuntary movements, develop as the illness progresses and, by the time of
death, patients become completely immobile and mute.
The patient presented with depression, irritability, personality change and allodynia,
followed by gait ataxia and cognitive impairment. The patient developed akinetic mutism
at 12 months and died at 18 months after onset. The clinical presentation and
neuroimaging findings were compatible with the vCJD cases reported since 1996, and
met the World Health Organization Case Definition for probable vCJD.
1. MSc, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan,
Iran (Corresponding Author) Email: t_momeni@nm.mui.ac.ir
2. MSc, Behavioral Sciences Research Center, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan
University of Medical Sciences, Isfahan, Iran.

Moral responsibilities of care, prevention and control of infections

Transcription

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