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Moral responsibilities of care, prevention and control of infections Authors:* Zahra Ayazi1- sayed Jalil Hosseini Irani2- Homeira Mohamadi3-Nasrin Khosravi4 1.Iran. shahrekord- university of medical sciences -MSc medical Seines & BSc Nursing- Tel: 13313349561 – 19131345619- Email: [email protected]. 2. shahrekord university of medical sciences .MSc Nursing-Tel: 1331-3349561 – 19134133635Email: [email protected]. 3.shahrekord university of medical sciences ,BSc Nursing-Mobile:19131343630-Email: [email protected]. 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:[email protected] -2ایران-داوشگبٌ علًم پسشکی شُرکرد-معبيوت درمبن--بلًارشُیدآیت-ادارٌ پرستبری -کبرشىبس ارشدپرستبری-تلفهEmail:[email protected]: -3ایران-داوشگبٌ علًم پسشکی شُرکرد-معبيوت درمبن--بلًارشُیدآیت-ادارٌ پرستبری -کبرشىبس پرستبری-تلفه َمراٌEmail: [email protected] -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:[email protected] 2. Shahre-kord university of medical science.MSc Nursing-Tel: 6381-3342566 – 62134133685- Email: [email protected] 3.Shahre-kord university of medical science ,BSc Nursing-Mobile:62131848630-Email: [email protected] 4. Shahre-kord university of medical science -MSc medical Seines & BSc Nursing- Tel: 6381-3342566 – 62131845662- Email: [email protected] 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:[email protected] -1ایران-داوشگاٌ علًم پسشکی شهرکرد-معايوت درمان--بلًارشهیدآیت-ادارٌ پرستاری -کارشىاس پرستاری-تلفه همراٌ-62111838010: Email: [email protected] -3ایران-داوشگاٌ علًم پسشکی شهرکرد-معايوت درمان--بلًارشهیدآیت-ادارٌ پرستاری-کارشىاس ارشدپرستاری،آمًزش پسشکی- Email:[email protected] 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: [email protected] 2.shahrekord university of medical sciences – GP- specialty and subspecialty Polyclinic Imam Ali (AS) -Tel:1331-2241231-19132312116- Email: [email protected] 3.shahrekord university of medical sciences ,BSc Nursing-Mobile:19131343630-Email: [email protected] 4. shahrekord university of medical sciences.Godal cheshme- corresponding Author: MSc-Medical Education and BSc Nursing-1331-3349561 – 19131345619- Email: [email protected] 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:[email protected]: -2 ایران داوشگاٌ علًم پسشکی شهرکرد -پسشک عمًمی ،پلی کلیىیک تخصصی يفًق تخصصی امام علی(ع) -59132852116- Email:[email protected] -3ایران-داوشگاٌ علًم پسشکی شهرکرد-معايوت درمان--بلًارشهیذآیت-ادارٌ پرستاری -کارشىاس پرستاری-تلفه همراٌ-59131848637: Email: [email protected] -4ایران-داوشگاٌ علًم پسشکی شهرکرد-معايوت درمان--بلًارشهیذآیت-ادارٌ پرستاری-کارشىاس ارشذپرستاری،آمًزش پسشکی- Email:[email protected] 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: [email protected] 2. shahrekord university of medical sciences -MSc medical Seines & BSc Nursing- Tel: 1331-3345561 – 15131345615Email: [email protected] 3. shahrekord university [email protected] of medical sciences. MSc Nursing-Tel: 1331-3345561 – 15134133635- Email: 4.shahrekord university of medical sciences ,BSc Nursing-Mobile:15131343630-Email: [email protected] 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:[email protected]-2داوطگاٌ علًم پسضکی ضهرکرد-معايوت درمان--بلًارضهیذآیت-ادارٌ پرستاری-کارضىاس ارضذپرستاری،آمًزش پسضکی- Email:[email protected] -3داوطگاٌ علًم پسضکی ضهرکرد-معايوت درمان--بلًارضهیذآیت-ادارٌ پرستاری -کارضىاس ارضذپرستاری- تلفهEmail:[email protected]: -4داوطگاٌ علًم پسضکی ضهرکرد-معايوت درمان--بلًارضهیذآیت-ادارٌ پرستاری -کارضىاس پرستاری-تلفه همراٌEmail: [email protected] -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: [email protected] 2.shahrekorduniversity –Tel:73133367736- Email: [email protected] 3. shahrekord university of medical sciences. MSc Nursing-Tel: 7331-3343567 – 73134133635Email: [email protected] 4. shahrekord university of medical sciences.Godal cheshme- corresponding Author: MSc-Medical Education and BSc Nursing-7331-3343567 – 73131345673- Email: [email protected] 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: [email protected]: -2ایران-داوشگاٌ شُرکرد—داوشجًی مقطع کارشىاسی رشتٍ زیست شىاسی عمًمی-79138867736- Email:[email protected] -3ایران-داوشگاٌ علًم پسشکی شُرکرد-معايوت درمان--بلًارشُیدآیت-ادارٌ پرستاری -کارشىاس ارشدپرستاری- تلفهEmail:[email protected]: -4ایران-داوشگاٌ علًم پسشکی شُرکرد-معايوت درمان--بلًارشُیدآیت-ادارٌ پرستاری-کارشىاس ارشدپرستاری،آمًزش پسشکیEmail:[email protected] 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 Medical Sciences, Mashhad, Iran 1 Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran 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 Materials and Methods: 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 [email protected] 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: [email protected], 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:[email protected] 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 الکترونیک[email protected] : 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: [email protected] 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. Materials and Methods: 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 [email protected] 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 [email protected] 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:[email protected] 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 [email protected] 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 [email protected] 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 [email protected] 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 Introduction and Objectives: 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. Materials and Methods: 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 3. Expert Health Center of Disease- 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 1. Expert Health Center of Disease- Mashhad University of Medical 2. The Director of the Department of disaeses, Mashhad University of Medical 3. Expert Health Center of Disease- Mashhad University of Medical Introduction and Objectives 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 [email protected] .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: [email protected] 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 Medical Sciences, Mashhad, Iran 2. Patient Safety Research Center , Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran 3. Patient Safety Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran * Corresponding author: Ali Bazzi: , Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Email: [email protected] 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 Medical Sciences, Mashhad, Iran Presenter: Zohreh Dalirsani Address: Dental School, Vakil Abad BLVD, Mashhad, Iran Postal code: 91735 Email: [email protected] Tel: 09155002857 Introduction and Objectives: 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. Materials and Methods: 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 Introduction and Objectives 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: [email protected] 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: [email protected] 2. MSc, Behavioral Sciences Research Center, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
