Day :
- Infection Prevention and Control | Bacteriology | Covid_19 Infections |Global Trends in Emerging Infections |Causes and symptoms of infections | SARS Coronavirus | Infection Control in Critical Care
Location: Webinar
Session Introduction
Virendra Rawat
Founder of Green Mentors, India
Title: Office hygiene and infection control audit
Biography:
Virendra Rawat is the originator of Global Green Schooling Concept, recognized by United Nations as Global Solution, which is listed on UN Global Innovation Exchange. His Green Schooling concept is creating a community of Nature Champions Worldwide.He has addressed the Harvard University and United Nations on Sustainable Practices in Education. He is also recipient of UNGA Award - 2019 for his contribution towards promoting UN SDG No. 4. He also hosted first national Conference on Hygiene and Infection Control with association of City University of New York. He is the author of Diploma on Hygiene and Infection Control in India. He has trained more than 500 Certified Hygiene and Infection Control Auditors in India.
Abstract:
Daily office cleaning tasks involves a checklist for your reception, bathrooms or restrooms, and kitchen or pantry areas. It includes basic vacuum cleaning, moping, and dusting to maintain a clean office.
- Office and reception area:
- Empty garbage bins and replace garbage bags
- Vacuum covers and tangles.
- Sweep or vacuum hard floor surfaces.
- Dust furniture and office equipment, including work areas, seats, tables and computers.
- Disinfect level surfaces with a soaked cloth.
- Mop the hard floors with disinfectant cleaners.
- Clean light changes and ways to eject fingerprints and different impressions.
- Clean the glass windows and the entrances inside.
- Clean surfaces and dividers.
- Bathrooms or restrooms:
- Refill paper towels, toilet paper and hand soap.
- Disinfect toilets and urinals.
- Clean mirrors, windows and glass.
- Disinfect bathroom surfaces, including entry handles, and towel or hand dryer accessories
- Clean the divisions and eject the watermarks.
- Mop tiles and flooring.
Riffat Shaheen
Lead Auditor, Pakistan
Title: Six sigma project on hospital aquired vantilator associated pneumonia at tertiary care hospital
Biography:
Riffat Shaheen is from Karachi, Pakistan and working since more than in the field of IPC, QA, and Healthcare management. Currently Working as consultant QA and IPC with National Institute of Blood Diseases (NIBD) in Karachi.
Abstract:
Ventilator associated pneumonia (VAP) is the most common hospital acquired infection among patient in intensive care unit and is associated with significant mortality rate and rising the cost of care by increasing a patient’s stay (Babcock, 2004). In the month of August 2017 at Tertiary Care Hospital, HAI surveillance system was modified to see that how many patients received hospital acquired pneumonia from ventilator and was identified that 61.2 cases per 1000 ventilated days got VAP which was a leading cause to increase a patient’s stay with ventilator that was almost 8 days. Several standards of care have been developed in attempt to reduce the occurrence of VAP rate and patient stay with ventilator by developing a VAP committee with inclusion of purchase manager to get a right item with required amount for implementation of IPC practices & biomedical managers for medical equipment maintenance to reduce infection rate.
Purpose
1. The 1st purpose of all exercise, to implement a HAI surveillance system in a right manner with described time frame.
2. The 2nd purpose was that, 50% reduction of hospital acquired VAP rate and patient stay with ventilator by the end of December 2017.
3. The 3rd purpose to observe current practices of nursing staff and doctor on patient with mechanical ventilator in critical care units.
4.The 4th purpose to identify the gape for improvement in IPC related practices to reduce the VAP rate.
5. The 5th purpose of this study to see the benefit of supply chain and biomedical managers’ inclusion in VAP committee to reduce a VAP rate.
6. The 6th purpose was that to train all concern people who participate directly or indirectly with maximum and minimum percentage and can contribute in reduction of hospital acquired infection in a future by putting their right efforts.
Methodology:
Setting: Observation was conducted in all intensive care units including medical, surgical and pediatric, consist of 51 beds, at tertiary care hospital.
Population: All patients who are connected to a ventilator after admission. All register nurses and attending doctor are assigned on patient with ventilator.
Inclusion Criteria: All patients who developed a VAP, connected to ventilator for more than 48hours and within 48hours after disconnection of ventilator. Exclusion Criteria: None.
Selection criteria: High risk, high cost, high volume, problem prone and requirement of standard such as IPC and ISO.
Design: That was retrospective and concurrent study.
Data Collection: Collected by making a daily round in all intensive care units, reviewed patient’s clinical condition, and their medical records and reviewed all investigation reports such as x-ray, sputum C/S, CBC. Status of ventilator’s cleaning, PPM and calibration. Supply related respiratory therapy, hand hygiene and PPE such as suction catheter, HME filter, soap, hand rub were reviewed for the specification and inventory management with coordination of purchase department.
Data Analysis: Patients’ data was compiled on excel sheet & mini-tab. Pre and post swim lane & value stream map were prepared on evaluation of staff practices as six sigma project.
Results
Initially as a base line, just observed the current practices and knowledge of the healthcare workers and surveillance systems conducted by IPC team from July to August 2017. During baseline phase, it was observed no coordination among ICU’s stakeholder, IPC team, purchase and bio-medical department. All healthcare worker involved in care on ventilated patient, were educated on VAP bundle, hand hygiene and appropriate using of PPE. VAP committee was established with including of purchase manager and bio-medical manager to purchase right items for use and appropriate cleaning, PPM and calibration. Hand hygiene compliance monitoring systems were introduced. HAI surveillance system was modified. Initially it was based on positive culture reports only. HAI key performance indicators were introduced. All interventions produced improvement and Hospital acquired VAP were reduced from 61.2 to 24.0 cases per 1000 ventilator days. The compliance of IPC practices such as hand hygiene, changes of gloves, proper technique of suctioning, use of RO water for oxygen therapy, oral hygiene, head elevation and humidifier disinfection were improved from 39.2 to 87.8%. The mean of patient’ stay with ventilator were reduced from 6.38 to 4.01 and standard deviation was reduced by 34.9% (p<0.05).
Conclusion:
Conduction of HAI surveillance system is a first necessary step for IPC team there for it is essential that HAI surveillance system must be perform with a right direction to get a correct rate of hospital acquired infection as it will reflect on IPC’s work competency. These whole exercises concluded that by improving of hand hygiene, changing of PPE from one use to another use, VAP bundle implementation, using of RO water for oxygen therapy, avoiding contamination during suction and cleaning and disinfection of oxygen humidifier can play a major role. Another important factor was identified that people who can have indirect relation with less percentage can play a major role to achieve big percentage of compliance. Preparation on monthly VAP indicator will capture the attention of concern stakeholders for continuity of improvement
Limitations:
Initially, implementation of surveillance system with modification was very tough for IPC team as they were not habitual, nor they had a detail concept so there was a possibility to have under reporting system as it been a new for IPC team.
Monitoring of VAP bundle’s implementation, changing of gloves from one use to another use and hand hygiene practices were challenging for IPC team sometimes they were missing observation.
Purchase department managers were not cooperative on initial phase as they had a concept of no need to discuss with IPC team and VAP committee before purchasing any item
Bio-medical department has a same thought regarding PPM and calibration schedule of ventilator.
Huang Wei Ling
Medical Acupuncture and Pain Management Clinic, Brazil
Title: Energy alterations and chakras energy deficiencies and propensity to Coronavirus Infection
Biography:
Huang Wei Ling, born in Taiwan, raised and graduated in medicine in Brazil, specialist in infectious and parasitic diseases, General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress (1998). Since 1997, she works with the approach and treatment of all chronic diseases in a holistic way, with treatment guided through teachings of Traditional Chinese Medicine and Hippocrates.
Abstract:
Coronavirus is a virus that emerged in Wuhan China (December-2019). On May 18th, there was 4,872,016 confirmed cases and 319,206 deaths. In TCM, coronavirus infection is classified as external pathogenic factor invasion. Purpose: The purpose of this study is to demonstrate that patients with chakras energy deficiencies alteration and Heat retention are more prompt to acquire coronavirus infection. Methods: Through a study of the chakras energy level (1000 patients), from 2015 to 2020, 409 patients were selected to be deeply analysed, where the ages, the diagnosis in Western and in TCM, the value of their level of the energy of the chakras were evaluated. The study was made following a statement of Hippocrates “it is more important to know what sort of person has a disease than what sort of disease a person has”. Results: Ages (2 to 70); Most common diagnosis: anxiety, headaches, low back pain and knee pain, in Western medicine; Most common diagnosis in TCM: Yin deficiency, Yin and Yang deficiency, Heat retention; Almost 90% had no energy on the chakras 1 to 6. From this 90%, 70% had energy on the seventh chakra, and 20% did not. Conclusion: Almost 90% of the studied population had no energy on the chakras energy meridians, or massive organs, responsible for the production of energy and normal functioning of the body. This lack of energy is responsible for several complications associated with this infection that may worse with the type of medication, diet and environment of the patient.
Biography:
Riffat Shaheen is from Karachi, Pakistan and working since more than in the field of IPC, QA, and Healthcare management. Currently Working as consultant QA and IPC with National Institute of Blood Diseases (NIBD) in Karachi.
Abstract:
All staffs who are working in deferent departments of any healthcare facility have a significant value to carry out the effective implementation of healthcare management in a hospital. At the situation of COVID-19 pandemic outbreak, all healthcare workers are at on high risk to acquire the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may increase the result of harm while caring of patients in a hospital however they can get severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from their family and community as well. The first case of COVID-19 was reported in Wuhan, China in December 2019 and in Pakistan, the first case of COVID-19 has been confirmed by the Ministry of Health, Government of Pakistan on February 26, 2020, in Karachi, Sindh province. From 8th March 2020, we had started to work on the management of COVID-19 pandemic in our healthcare setup where we had started our triage room, crowed control mechanisms, designated route, and all other strategies implementation. Besides all upcoming patients, we had started to monitor all healthcare works for their practices and clinical status for preventing further spread of COVID-19 and had taken immediate actions as were needed.
Purpose
1. To establish a system of Contact Tracing of all healthcare workers in the hospital.
2. To early identification of a person with signs and symptoms of COVID-19 among Healthcare Workers.
3. To establish a system for the diagnose of exposed and symptomatic healthcare workers, based on their clinical status and test reports.
4. To create a system for the home isolation, and rerun to work for the contacted and symptomatic healthcare works.
5. To build a system for the monitoring of their clinical status in the duration of home isolation. The overall purpose is to create effective strategies that should be easily implemented and accepted by all in overcoming the COVID-19 pandemic situation.
Methodology:
Setting: Observation was conducted in all units including Inpatient Units, Emergency Room, Triage Room, OPD, Day Care, Housekeeping, Laboratory, X-Ray, Ultra Sound, Passive Immunization, Reception, Security, Food Service Department, Pharmacy, Purchase, IT (Information and Technology) Marketing, Account, Transport and Admin units at a specialized hospital.
Population: All Staffs including clinical and non-clinical who are working in the hospital. Inclusion Criteria: All staff who a history of contact with any has suspected or confirm COVID-19 patient in hospital, family & friend circle, and community.
Selection criteria: high risk, high cost, high volume, problem-prone and requirement of IPC
Design: That was the Prospective Observational Study
Data Collection: Collected by making a daily round in all units, Risk Assessment tool of COVID-19 which was used in triage clinic for scoring based on their clinical status and history of contact, tracing list of contacted healthcare works (HCWs), reviewed HCWs’ clinical condition and discussed with the triage doctor about their clinical status, and daily follow-up their status via phone and SMS and investigation reports such as x-ray and RT-PCR.
Data Analysis: Patients’ data was compiled on an excel sheet.
Results
In the COVID-19 pandemic situation, we started our management with the establishment of triage room on 8th March 2020 including dedicated staff for all 3 shifts, and initially, we started to monitor their health status but later it was extended to other units including clinical and non-clinical. Before Eid-ul-Fiter only one staff was identified with COVID -19 symptoms but after Eid Holidays we got 3 staff with symptoms and on the 2nd day we got more staff with COVID symptoms. We modified our strategies immediately, distributed the formal tracing list of contacted HCWs and official memo to all units with requests to extend their cooperation with IPC team. As per the tracing list, 180 staffs out of 300, were identified with the history of contact with suspected or confirmed case in the hospital, family, friend circle or in community and it was impossible to quarantine 60% staffs, therefore, we implemented the policy that after contact with suspected or confirmed case + symptomatic staffs will be remained in home isolation and those staff also with positive PCR due to any reason. From 27th May till the end of July 2020, 33.3% of staff had developed the symptoms and 75 staffs were in home isolation with the percentage with 24.0% because they met the criteria of the COVID-19 Risk Assessment tool. Out of 75, 26.3% staffs are belonged to the laboratory, on 2nd number is from nursing services which is 22.3%, doctors are on 3rd number with 11.8% and the rest of other departmental staff have less than 10%. All staffs were developed symptoms of fever (F), cough (C), difficulty of breath (SOB), diarrhea (D), sore throat (ST) body ache (BA), weakness, and flu (FL) during their isolation period. 13.3% of staffs were remained asymptomatic till 14 days as their PCR test was positive and 86.7% of staff developed symptoms. On follow-up by Infection Prevention and Control (IPC) team during 14 days isolation period, it was noticed that 20% staffs were developed minor or moderate to severe symptoms, 3.3% staff had a situation from server to minor or moderate symptomatic conditions on initial 5 -10 days, 28.3% of staff always informed about their symptomatic condition on follow-up and but on the day of reassessment by the triage doctors they were clinically fit. The 6.7% staff remained a challenge because they did not inform their clinical status via any mode of communication. Healthcare workers (HCWs) develop different type of symptoms 63.1% with fever, 60% with body ache, 53.8% with cough, 33.8%with shortness of breath, 26.2% with weakness, 15.4% with sore throat, 3.1% diarrhea and 1.5% with flu as alone or with combination of COVID-19 symptoms in home isolation period.
Conclusion:
Proper handling of the COVID-19 pandemic situation was very challenging for anyone as an institution, as an IPC team and as an individual too. There were no established guidelines on a national and international level and after every few days, we were receiving new guidelines and were confused that what should be the final strategy. However every day we learned something good for the future and to prevent our hospital team as they are assets of any healthcare facility especially in the situation of the outbreak of any infectious diseases. The best strategies are to teach them, establish the criteria for the tracing list of contacted healthcare workers, effective implementation of home isolation and strict monitoring system for their clinical status.
Limitations:
There were lots of challenges we had faced as mentioned below:
1. On initial stage staff and departmental HODs were not cooperative and they were reluctant
to inform that they had contact with suspected or confirm COVID-19 patients in their family, friend circle, and community.
2. Departments were reluctant to fill the tracing list and send it to IPC department as they had fears and doubts in their minds.
3. There had been many changes in national and international guidelines.
4. Management was reluctant to quarantine of contacted healthcare workers.
5. RT-PCR test could not be formed all contacted healthcare workers due to cost issues and for symptomatic staffs due to the unavailability of kit in market and cost as well that who should paid .
6. Vigilant follow-up of contacted healthcare workers for their clinical status till 14 days was quite challenging for the IPC team besides other IPC activities which needed to be carryout as smoothly as demand.
Virendra Rawat
Founder of Green Mentors, India
Title: Hygiene and infection control audit daily office cleaning tasks involves a checklist
Biography:
Virendra Rawat is the originator of Global Green Schooling Concept, recognized by United Nations as Global Solution, which is listed on UN Global Innovation Exchange. His Green Schooling concept is creating a community of Nature Champions Worldwide. He has addressed the Harvard University and United Nations on Sustainable Practices in Education. He is also recipient of UNGA Award - 2019 for his contribution towards promoting UN SDG No. 4. He also hosted first national Conference on Hygiene and Infection Control with association of City University of New York. He is the author of Diploma on Hygiene and Infection Control in India. He has trained more than 500 Certified Hygiene and Infection Control Auditors in India.
Abstract:
The COVID-19 pandemic continues to evolve, hygiene and infection control audit and germs free certification for all outdoor learning, working, trading, manufacturing, health caring, travelling, staying and eating spaces free form the fear of infections. Everyone is society is eagerly looking for the solutions to respond Covid-19 by making working spaces more safer than ever before. Hygiene & infection control audit and germs free spaces certification brings power to occupants to learn, work, travel, stay and eat safe and fearless environment by making all outdoor spaces clean conducive and virus protected. Keeping this in mind, green mentors offering hygiene and infection control audit of all outdoor spaces including learning, working, trading, manufacturing, health caring, travelling, staying and eating spaces to respond the challenges of Covid-19 by offering safe and fearless environment through germs free spaces certification. Germs free spaces assures every member to learn, work travel, stay and eat Safe with confidence and also assure their families to send their loved one to outdoor space without any fear. Hygiene & infection control audit is a set of hygiene Safety and infection prevention indicators for outdoor spaces. Each safety and prevention indicator is in turn measured against a set of objective of global standards for outdoor spaces infection control.
Huang Wei Ling
Medical Acupuncture and Pain Management Clinic, Brazil
Title: Is it necessary to isolate patients with Acute Herpes Zoster
Biography:
Huang Wei Ling, born in Taiwan, raised and graduated in medicine in Brazil, specialist in infectious and parasitic diseases, General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress (1998). Since 1997, she works with the approach and treatment of all chronic diseases in a holistic way, with treatment guided through teachings of Traditional Chinese Medicine and Hippocrates.
Abstract:
Introduction: Herpes Zoster (HZ) is the virus that causes shingles or chickenpox, characterized by painful skin rashes with blisters in a localized area. Western medicine standard treatment recommends the isolation of patients to prevent dissemination of the virus. According to traditional Chinese medicine (TCM), HZ is caused by energy imbalances leading to Heat and Dampness.
Purpose: To demonstrate that herpes zoster has energy imbalances as a root, related to the deficiency of the chakras energy leading to formation of Heat and Dampness.
Methods: Two case reports. The first: 70-year-old female, diabetic, with HZ on the back. Chakras measurement was performed, and all chakras appeared in level 1 (minimum level) of 8 (normal level). The second patient: 36-year-old male, having recurrent crisis of HZ on the left armpit. The measurement of the chakras showed extreme lack of energy on six of the seven chakras.
Results: Both patients were not isolated, because according to the author, the root of the problem would be an energy imbalance. Chinese dietary counselling, auricular acupuncture, apex ear bloodletting were used with great improvement, without the use of any antiviral medication.
Conclusion: The conclusion of this study is that herpes zoster has an internal imbalance as a root, originated from the deficiency of the chakras, leading to an immune deficiency, leading to Heat retention and retention of Phlegm. With this kind of reasoning, there is no need of isolating patients, because it will not be contagious as it is related to the energy deficiency of the patient.
Vrancianu Ovidi
University of Bucharest, Romania
Title: Tracking down multidrug-resistant Acinetobacter baumannii isolates from hospital to the aquatic environment via the wastewater network
Biography:
Mr. Ovidiu Vrancianu's academic credentials include a BSc in Biology at the Faculty of Biology, University of Bucharest, and an MSc in Applied Genetics and Biotechnology at the same university. In the present, he is a PhD student at the University of Bucharest, Faculty of Biology, The Research Institute of the University of Bucharest, Romania. His current research interest is to investigate the mechanisms of antibiotic resistance and innovative treatment strategies in Acinetobacter baumannii.
Abstract:
Hospital sewages and wastewater treatment plants (WWTPs) are hotspots for development and dissemination of antibiotic resistance. We have characterized multidrug-resistant Acinetobacter baumannii (MDR Ab) strains isolated in the same temporal sequence from hospital infections (HI) and from two WWTPs collecting wastewaters (Is and Gl) from Northern Romania.
Experimental Procedure:
The strains isolated on carbapenem and third generation cephalosporin supplemented culture media were identified and characterized for their resistance profiles using phenotypic (disc-diffusimetric) and genetic (PCR and ERIC- PCR) methods.
Acknowledgements: This paper was co-financed from the Human Capital Operational Program 2014-2020, project number POCU / 380/6/13/125245 no. 36482 / 23.05.2019 “Excellence in interdisciplinary PhD and post-PhD research, career alternatives through entrepreneurial initiative (EXCIA)”, coordinator The Bucharest University of Economic Studies
Results: A total of 1 HI/34 WWTP MDR Ab (Is) and 28 WWTP MDR Ab strains (Gl) were isolated and tested for resistance. 40% of the Is clinical and water isolates showed resistance to all antibiotics tested. The resistance rates of Is WWTP vs Gl WWTP Ab strains were 71.4%/17.8 % (SAM), 94.2%/100% (FOX), 100%/82.1% (ATM), 80%/71.4% for (MEM), 82.8%/85.7% (CIP), 82.8%/78.5% (AK), 77.1%/57.1% (TE) (Table 1). Carbapenemase-encoding genes were revealed in 1 HI and 27 WWTP Ab strains from Iasi and in 18 WWTP Ab strains from Galati. Aminoglycosides-modifying enzymes were detected in 19 WWTP and 1 HI from Iasi and in 9 Gl WWTP Ab strains. The 1HI/34 WWTP Ab strains from Iasi belonged to 3 (Fig. 1) and the 28 Gl WWTP MDR Ab to 6 clones (Fig. 2).
Conclusion:
The MDR Ab strains circulating in the hospital and released in the wastewater environments in Northern Romania belonged to multiple clones and revealed high resistance rates to beta- lactams, quinolones, aminoglycosides and tetracyclines, >50% harbouring carbapenemases, thus essentially contributing to the environmental reservoir of antimicrobial resistance.
Huang Wei Ling
Medical Acupuncture and Pain Management Clinic, Brazil
Title: What do we need to know to prevent and control nosocomial infections completely
Biography:
Huang Wei Ling, born in Taiwan, raised and graduated in medicine in Brazil, specialist in infectious and parasitic diseases, General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress (1998). Since 1997, she works with the approach and treatment of all chronic diseases in a holistic way, with treatment guided through teachings of Traditional Chinese Medicine and Hippocrates.
Abstract:
Nosocomial infections are a widespread problem around the world. The Center for Disease Control (CDC) estimates that nosocomial infections affect around 1.7 million patients per year, and cause 99.000 deaths. According to CDC, 32% of all healthcare acquired infections are urinary tract infections, 22% are surgical site infections, 15% are pneumonia and 14% are bloodstream infections. Nowadays, only 1/3 of nosocomial infections can be prevented with the Infection Control Programs. The other 2/3 cannot be prevented with the programs used nowadays. In USA, 31 billions of dollars are spent in the treatment of nosocomial infections per year.
Purpose: The purpose of this study is to demonstrate how this 2/3 of nosocomial infections could be controlled with the use ancient medicines reasoning, such as Traditional Chinese Medicine and Hippocrates theories. Another goal is to make evident the possible economy to healthcare when using these techniques and tools in the treatment of nosocomial infections.
Methods: The methodology used was a review of studies, such as those presented by Hippocrates (“Natural forces within us are the true healers of disease.”), as well as others from oriental medicines, which comprehend the disease as originated from three factors: external (exposure to cold, heat, humidity, wind and dryness), internal (emotional) and dietary.
Findings: When comprehending the patient in a broader view, considering the energy imbalances of Yin, Yang, Qi, Blood and Heat retention, it is possible to control and prevent better more nosocomial infections, reducing the costs for the healthcare’s. Conclusion: The 2/3 of not controlled nosocomial infections cannot be prevented because of the reasoning used in the treatment of infections in Western Medicine. When using ancient oriental medicines reasoning, a different thinking can be used. According to Einstein, “We cannot solve our problems with the same thinking we used when we created them.”
Recent Publications:
• Huang W.L. Can Hospital Osteomyelitis Be Treated Without the Use of Antibiotics? Int J Microbiol Infect Dis. 2018; 2(1): 1-6.
• Huang Wei Ling. “Why do Patients Still Catch Hospital Infections despite the Practice of Infection Prevention and Control Programs?” Acta Scientific Microbiology 1.4 (2018) 34-43.
• Huang Wei Ling. “Can Recurrent Furunculosis be Treated without the Use of Antibiotics?”. Acta Scientific Microbiology 1.9 (2018): 04-12.
• Huang, W.L. Can Leptospirosis Be Treated Without Any Kind of Medication? Journal of Clinical Review & Case Reports. V.3, I.4, 01-04
• Huang Wei Ling. “Could Postsurgical Nosocomial Cellulitis be Treated without the Use of Antibiotics?”. Acta Scientific Microbiology 1.9 (2018): 24-31.
• Huang, W.L. How Do You Treat Back Pain in Your Practice? Part 2. MEDICAL ACUPUNCTURE, Volume 30, Number 1, 2018. 50-53.
Vladimir Zajac
Cancer Research Institute, Slovakia
Title: A new approach to eliminating coronavirus and preventing the second wave of infection
Biography:
Vladimir Zajac has completed his PhD. in 1982 at the Cancer Research Institute of Slovak Academy of Sciences in Bratislava (Slovakia), where he worked as the Head of Department of Cancer Genetics from 1996 to 2010. He joined the Medical Faculty of the Comenius University as Associate Professor of Genetics in 2007. He has published 74 papers mostly in reputed journals and he was editor of the book, Bacteria, viruses and parasites in AIDS process“(In Tech, 2011).
Abstract:
Every virus is a parasite. They cannot exist by themselves. He is envious of your wearer. This is the basic condition of its existence. What living cell carries viruses? Based on work with bovine leukosis virus (BLV) in the stables, we monitored the course of infection in healthy animals and concluded that a bacterial cell can be the host of the virus. We tested this assumption and confirmed the results. This idea was then tested on the HIV model. Even with this virus, we have been able to prove that its host may be bacteria, which was confirmed at the level of DNA as well as proteins. Based on these results and indications, we conclude that all viruses are transmitted by bacteria or by yeasts. If all, the coronavirus. By destroying the bacteria carrying the viruses, the virus ceases to exist. If this idea is confirmed, many, if not all viral infections can be stopped. The virus-containing bacteria are stored in the respiratory and intestinal tracts and under optimal conditions, they multiply, penetrate the body through the cardiovascular system and attack the recipient's cells. This reversal, called the second wave of infection, can be prevented by applying appropriate antibiotics, which eliminate coronavirus-containing bacteria in the intestinal and respiratory tracts.
Victor D. Rosenthal
International Nosocomial Infection Control Consortium, USA
Title: Bloodstream infection rates and their association with differently designed needle-free connectors
Biography:
Victor Rosenthal is a Founder and Chairman of INCC and his hospital Epidemiology and Infection Control Medical Doctor graduated in Argentina, Specialist in Internal Medicine, in Infectious Diseases, Certified on Infection Control. Fellow of infectious diseases at University of Wisconsin. Fellow of the Program of Clinical Effectiveness of Harvard University. Non-profit international research center which focuses on Healthcare-Associated Infections (HAIs) leading trials and activities about HAI with more than 2,000 researchers in hundreds of cities in more than 50 countries.
Abstract:
During 6-year study period, from January 2012-December 2017, in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, members of International Nosocomial Infection Control Consortium (INICC), for an aggregate of 2,197,304 patient days, were collected through INICC Surveillance Online System (ISOS). US CDC-NHSN definitions for central line associated bloodstream infection (CLAB) were applied. In the medical-surgical ICUs of INICC, the pooled CLAB rate was 5.05 and in US ICUs was 0.8 per 1,000 central line-days. During 6-year study period, from September 1st, 2013 to 31st May, 2019, a prospective, surveillance study on peripheral line associated BSI (PLAB) conducted by INICC, in 727 ICUs, from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. Were followed 149,609 ICU patients for 731,135 bed-days and 743,508 peripheral line (PL) -days. Were identified 1,789 PLABs, amounting to a rate of 2.41/1000 PL-days. Mortality in patients with PL but without PLAB was 6.67%, and 18% in patients with PL and with PLAB. The length of stay in patients with PL but without PLAB was 4.83 days, and 9.85 days in patients with PL and PLAB. Between April 2012 and August 2014, a Randomized Clinical Trial (RCT) with 1,096 patients in 5 ICUs was conducted in India. We compared Needle-free connectors (NFCs) vs three-way stopcocks (3WSCs) to analyse impact on CLAB rates. The study included 547 patients and 3619 central line (CL)-days for the NFC group, and 549 patients and 4061 CL-days for the 3WSC group. CLAB rates were 2.21 per 1000 CL-days for NFC and 6.40 per 1000 CL-days for 3WSC (RR, 0.35; 95% CI, 0.16-0.76; P 0.006). Using a NFC for each extra dollar invested resulted in a savings of $124.
A meta-analysis was conducted comparing NFC vs 3WSC regarding BSI rates. Relevant randomized studies published from January 2000 to September 2018 were reviewed. We identified, and selected for the meta-analysis, 8 studies comparing BSI rates associated with NFCs with negative-displacement, neutral-displacement, or positive-displacement devices, with 3WSC. The results were: RR 0.53, 95% CI 0.28-1.00, and the Relative Difference was -0.018 with a 95% CI: 0.039-0.004. BSI risk was 47% higher using 3WSC compared with NFCs.
Conclusions: CLAB and PLAB rates are high worldwide, and NFCs are associated with lower rates of BSI, and lower healthcare costs.
Jason Kloshnitsky & Claudia Kleiner
NeuroLogica Company, USA
Title: Infection prevention with bodytom elite mobile CT
Biography:
NeuroLogica, the healthcare subsidiary of Samsung Electronics Co. Ltd., develops, manufactures, and markets innovative imaging technologies and is committed to delivering fast, easy, and accurate diagnostic solutions to healthcare providers. NeuroLogica, the global corporate headquarters and manufacturer of computed tomography, is also the US headquarters for sales, marketing, and distribution of all Samsung digital radiography and ultrasound systems. Our advanced medical technologies are used worldwide in leading healthcare institutions, helping providers enhance patient care, improve patient satisfaction, and increase workflow efficiency. Samsung is committed to being a leader in the field of healthcare imaging.
Abstract:
Neurological, established in 2004 and acquired by Samsung Medical in 2013 is located in Danvers, MA (metro Boston) where all mobile CT scanners are designed, manufactured, inspected, shipped and upgraded; Our vision is to provide advanced healthcare solutions through inspired innovators. We have 700+ scanners worldwide.
Our history of innovation started with the CereTom, the 1st multi-slice mobile head CT launched in 2005 when initially our focus was on brain imaging hence our name, Neurological. As we grew our mission expanded well beyond the brain and to bringing life-saving CT scanning where it had never gone before: in the back of an ambulance for stroke diagnosis on the scene and a Mobile CT Clinic for low dose lung cancer screening in underserved populations.
Our Body Tom CT scanner was the 1st multi-slice full-body mobile CT launched in 2012 and upgraded in 2017 as Body Tom Elite. Body Tom Elite was the perfect answer to a life-threatening situation where infection prevention was paramount such as the COVID-19 pandemic and the need for CT Distancing.
Neurological has made it possible and practical for a CT scanner to go where no scanner has ever gone before and makes it possible to set up a scanning area specifically for infectious disease patients.
Vilma G Duschak
National Institute of Parasitol, Argentina
Title: Roles of sulfotopes from glycoconjugates (glycoproteins and sulfatides) in trypanosoma cruzy, the causal agent of chagas disease
Biography:
Vilma G Duschak, Doctor in Biochemistry (1989) UBA. CONICET Researcher, Argentina since 1994. Post-grade in Medicine Chile University (1990); Cooperation: Instituto-Cs-Biomedicas- San Pablo-University-Brasil (2005) Universite-Jules Verne-Amiens- France (2007) Bernhard Notch Institute of Tropical Medicine, Hamburg, Germany (2010-2011). Editorial Advisory Board Member, Bentham Science Publishers, USA. Awards and distinctions: 6 Publications: more than 40 Assistance to more than 100 National and international congresses. Directed Thesis: 5 Roche Diagnostics International Meeting experts, New York, USA (2016). Evaluator of research projects from ANPCyT, CONICET and UBA (Argentina), OTKA (Hungary) and European Union international projects, Brussels (2018).
Abstract:
Trypanosoma cruzi, the causative agent of Changes disease (ChD), contains a major antigen, cruzipain (Cz). Its C-terminal domain (C-T), bears several post-translational modifications The presence of sulfated oligosaccharides was demonstrated in Cz, in a minor antigen with serine-carboxypeptidase activity, and sulfatides Sulfate-bearing glycoproteins in Trypanosomatids are targets of specific immune responses. T. cruzi chronically-infected-subjects mount specific humoral immune responses to sulfated-Cz. In absence of infection, mice immunized with C-T- but not with sulfate-depleted-C-T, showed surprising ultrastructural heart pathological effects. Moreover, the synthetic anionic sugar conjugate NAcGlc6SO3 mimics the N-glycan-linked sulfated epitope (sulfotope) humoral response. Furthermore, the participation of sulfotopes in the immunomodulation by host-parasite interaction via sialic-acid-Ig-like-specific-lectins (Siglec) binding to sulfosialylated glycoproteins as well as in the parasite infection process has been reported. Strickingly, recent evidences involved to sulfotopes and their specific antibodies in the immunopathogenesis and infection processes of the experimental ChD. Interestingly, sera from chronically T. cruzi-infected individuals with mild disease displayed higher levels of IgG2 antibodies specific for sulfated glycoproteins and sulfatides compared with those in more severe forms of the disease, evidencing that T. cruzi sulfotopes are antigenic independently of the sulfated-glycoconjugate type. Ongoing assays indicate that antibodies specific for sulfotopes might play a role as predictors of stability from the early stages of chronic ChD and might be considered biomarkers of human ChD progression.