| Shima Mahmoudi | 2 Articles |
Nosocomial, or hospital-acquired, infections are considered the most common complications affecting hospitalized patients. According to results obtained from studies conducted in the Children Medical Center Hospital, a teaching children's hospital and a tertiary care referral unit in Tehran, Iran, improvements in infection control practices in our hospital seem necessary. The aim of this study was to identify risk management and review potential hospital hazards that may pose a threat to the health as well as safety and welfare of patients in an Iranian referral hospital. Barriers to compliance and poor design of facilities, impractical guidelines and policies, lack of a framework for risk management, failure to apply behavioral-change theory, and insufficient obligation and enforcement by infection control personnel highlight the need of management systems in infection control in our hospital. In addition, surveillance and early reporting of infections, evaluation of risk-based interventions, and production of evidence-based guidelines in our country are recommended.
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Objectives
The clinical importance of <i>Staphylococcus aureus</i> (<i>S. aureus</i>) is attributed to notable virulence factors, surface proteins, toxins, and enzymes as well as the rapid development of drug resistance. The aim of this study was to compare the occurrence of virulence factors produced by <i>S. aureus</i> strains isolated from children in an Iranian referral children's hospital. Methods The presence of genes encoding for the enterotoxins A (<i>sea</i>), B (<i>seb</i>), C (<i>sec</i>), D (<i>sed</i>), TSST-1 (<i>tsst</i>), exfoliative toxin A (<i>eta</i>), and exfoliative toxin B (<i>etb</i>) were detected by Multiplex polymerase chain reaction (PCR) using specific primers. In addition, the standardized Kirby-Bauer disc-diffusion method was performed on Mueller-Hinton agar. Results In total, 133 <i>S. aureus</i> isolates were obtained from different patients. Of these <i>S. aureus</i> isolates, 64 (48%) were methicillin-resistant <i>S. aureus</i> (MRSA), and all of these tested positive for the <i>mecA</i> gene. Regarding the classical enterotoxin genes, <i>sea</i> gene (40.6%) was the most prevalent followed by <i>seb</i> (19.6%), <i>tsst</i> (12.8%), <i>eta</i> (11.3%), <i>etb</i> (9%), <i>sed</i> (4.5%), and <i>sec</i> (3%). Among methicillin-susceptible <i>S. aureus</i> (MSSA) isolates, <i>seb</i> and <i>tsst</i> were the more prevalent toxins in comparison with MRSA isolates (<i>p</i> < 0.05), while the frequency of <i>sea</i>, <i>sed</i>, <i>eta</i>, and <i>etb</i> genes were higher among MRSA isolates (<i>p</i> > 0.05). Conclusion In our study enterotoxin A was produced by 40.6% of the isolates (48% from MRSA and 33% from MSSA isolates) which was higher than in previous reports. According to our results, strict hygiene and preventative measures during food processing are highly recommended. Citations
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