14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 33.002 Session: Tuberculosis: Epidemiology, Prevention & Control Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation A validated clinical practice guideline for community health nurses working in tuberculosis Outpatient Clinics A. Ahmed, S. Soliman, L. A. Awad Faculty of Nursing Mansoura University, Dakahlia, Egypt Background: Tuberculosis is a major contributor to disease burden in developing countries; it is considered the second fatal disease all over the world and the third most important public health problem in Egypt. The direct causes of increasing the burden of tuberculosis are the inconsistent and fragmented health services. The nursing interventions of tuberculosis in community settings require system of recommendation that ensures the consistency of care. The present study aimed at provid a valid clinical guideline that assist nurses to intervene consistently to the newly diagnosed pulmonary tuberculosis patient. Methods: The needs analysis of community health nurses working in out patient chest clinics in addition to the expectation of newly diagnosed pulmonary tuberculosis patient regarding nursing interventions. The guideline development process established according to the criteria of experts of guideline development organizations. The Scottish Intercollegiate Guidelines Network (Sign) research appraisal tools were used for the critical appraisal phase of the obtained evidence. AGREE instrument was used for assessing the internal validity of the guideline. The guideline and apprised for internal validity by academic nursing and medical staff, nursing, and medical practitioners. Results: The scores of all appraisers in relation to scope and Purpose, stakeholder involvement, rigour of development ranged from (62.9- 77.7%, 53.5- 77.7%, and 66.6- 76.2%), respectively. While the scores for the clarity and presentation were 50- 76.4, applicability were 61.9- 68.5, and editorial independence were 88- 93. The four groups of revision strongly recommended the application of the guideline. Conclusion: In conclusion, the developed guideline based on the needs of the intended users of nurses and end points beneficiaries, i.e., patients. It was strongly recommended by the reviewers and stockholders to be used in the out-patients chest clinics. It is recommended that the guideline should disseminate to the authoritative level to be applied in the chest out patient clinics and evaluated for applicability and achieved outcomes.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 33.003 Session: Tuberculosis: Epidemiology, Prevention & Control Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Genetic diversity of Mycobacterium tuberculosis population in Bulgaria V. Valcheva Institute of microbiology, Sofia, Bulgaria Background: Molecular typing of Mycobacterium tuberculosis isolates is a useful tool for epidemiological studies at different levels. Tuberculosis remains an important public health issue for Bulgaria, a Balkan country located in the world region with contrasting epidemiological situation for tuberculosis. Here we presents the insight into the population structure and drug resistance of M. tuberculosis strains currently circulating in Bulgaria, as a necessary step towards an implementation and better understanding of molecular epidemiology of TB here. We further looked at our data at a global scale through comparison with the international SITVIT2 database. Methods: Study sample included 133 M. tuberculosis clinical isolates originating from different regions of Bulgaria and analyzed by various DNA fingerprinting methods We additionally investigated molecular basis of drug resistance of the studied strains. Results: Comparison with SITVIT2 database (Institut Pasteur de Guadeloupe) revealed a heterogeneous population structure of M. tuberculosis in Bulgaria. The Beijing genotype strains were not found in spite of close links with Russia in the recent and historical past. Novel 15/24- loci MIRU-VNTR format achieved the highest discrimination. We additionally investigated molecular basis of drug resistance of the studied strains. Three types of the rpoB mutations were found in 20 of 27 RIF-resistant isolates; rpoB S531L was the most frequent. Eleven (48%) of 23 INH-resistant isolates had katG S315T mutation. inhA -15C>T mutation was detected in one INHresistant isolate and three INH-susceptible isolates. A mutation in embB306 was found in 7 of 11 EMB-resistant isolates. Conclusion: This study gave a first molecular snapshot of M. tuberculosis strains circulating in Bulgaria. It demonstrated a heterogeneity of the Bulgarian M. tuberculosis population that appears to be dominated by several worldwide distributed and Balkan specific spoligotypes. Comparison with genotyping data did not reveal a statistical difference in the prevalence of drug resistance between clustered and non-clustered isolates. Emergence and spread of drugresistant and MDR-TB in Bulgaria is not associated with any particular spoligotype or MIRU- VNTR cluster.
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