Eleni Apostolopoulou

Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic

BackgroundHuman papillomavirus (HPV) infection is a causative factor for cervical cancer. Early detection of high risk HPV types might help to identify women at high risk of cervical cancer. The aim of the present study was to examine the HPV prevalence and distribution in cervical smears in a sample of Greek women attending a gynecological outpatient clinic and to explore the determinants of the infection.MethodsA total of 225 women were studied. All women underwent a regular gynecological control. 35 HPV types were studied; 6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 61, 62, 66, 68, 70, 71, 72, 73, 81, 82, 83, 84, 85 and 89. Also, basic demographic information, sociodemographic characteristics and sexual behavior were recorded.ResultsHPV was detected in 22.7% of the study population. The percentage of the newly diagnosed women with HPV infection was 17.3%. HPV-16 was the most common type detected (5.3%) followed by HPV-53 (4.9%). 66.2% of the study participants had a Pap test during the last year without any abnormalities. HPV infection was related positively with alcohol consumption (OR: 2.19, 95% CI: 1.04-4.63, P = 0.04) and number of sexual partners (OR: 2.16, 95% CI: 1.44-3.25, P < 0.001), and negatively with age (OR: 0.93, 95% CI: 0.87-0.99, P = 0.03), and monthly income (OR: 0.63, 95% CI: 0.44-0.89, P = 0.01).ConclusionThe prevalence of HPV in women attending an outpatient clinic is high. Number of sexual partners and alcohol consumption were the most significant risk factors for HPV infection, followed by young age and lower income.

Infection Probability Score, APACHE II and KARNOFSKY scoring systems as predictors of bloodstream infection onset in hematology-oncology patients.

BackgroundBloodstream Infections (BSIs) in neutropenic patients often cause considerable morbidity and mortality. Therefore, the surveillance and early identification of patients at high risk for developing BSIs might be useful for the development of preventive measures. The aim of the current study was to assess the predictive power of three scoring systems: Infection Probability Score (IPS), APACHE II and KARNOFSKY score for the onset of Bloodstream Infections in hematology-oncology patients.MethodsA total of 102 patients who were hospitalized for more than 48 hours in a hematology-oncology department in Athens, Greece between April 1st and October 31st 2007 were included in the study. Data were collected by using an anonymous standardized recording form. Source materials included medical records, temperature charts, information from nursing and medical staff, and results on microbiological testing. Patients were followed daily until hospital discharge or death.ResultsAmong the 102 patients, Bloodstream Infections occurred in 17 (16.6%) patients. The incidence density of Bloodstream Infections was 7.74 per 1,000 patient-days or 21.99 per 1,000 patient-days at risk. The patients who developed a Bloodstream Infection were mainly females (p = 0.004), with twofold time mean length of hospital stay (p < 0.001), with fourfold time mean length of neutropenia (p < 0.001), with neutropenia < 500 (p < 0.001), suffered mainly from acute myeloid leukemia (p < 0.001), had been exposed to antibiotics (p = 0.045) and chemotherapy (p = 0.023), had a surgery (p = 0.048) and a Hickman catheter (p = 0.025) as compared to the patients without Bloodstream Infection. The best cut-off value of IPS for the prediction of a Bloodstream Infection was 10 with a sensitivity of 75% and specificity of 70.9%ConclusionBetween the three different prognostic scoring systems, Infection Probability Score had the best sensitivity in predicting Bloodstream Infections.

Infection probability score : a predictor of clostridium difficile-associated disease onset in patients with haematological malignancy

PURPOSE to assess the predictive power of three systems: Infection Probability Score, APACHE II and KARNOFSKY score for the onset of Clostridium difficile-associated disease (CDAD) in hematology-oncology patients. METHODS AND SAMPLE A retrospective pilot surveillance survey was conducted in the hematology unit of a general hospital in Greece. Data were collected by using an anonymous standardised case-record form. The sample consisted of 102 hospitalized patients. RESULTS The majority of the patients (33.3%) suffered from acute myeloid leukemia. The cumulative incidence of CDAD was 10.8% and the incidence rate of C difficile associated diarrhea was 5 per 1000 patient-days (14.2 per 1000 patient-days at risk). Patients with CDAD had twofold higher time of mean length of hospital stay compared with patients without CDAD (38.82 ± 23.88 vs 19.45 ± 14.56 days). Additionally patients with CDAD had received a greater number of different antibiotics compared to those without CDAD (5.18 ± 1.99 vs 2.54 ± 2.13), suffered from diabetes, from non Hodgkins lymphoma, had a statistically significant higher duration of neutropenia ≥3 days and had received antifungal treatment. The best cutoff value of IPS for the prediction of CDAD was 13 with a sensitivity of 45.5% and a specificity of 82.4%. CONCLUSIONS IPS is an early diagnostic test for CDAD detection.

Associations on Dimensions of Burnout and Family Support for a Sample of Greek Nurses

To assess correlations for perceived family support with burnout in Greek nurses, the Julkunen Family Support Questionnaire and the Maslach Burnout Inventory were administered to nurses (22 men and 88 women; M age = 35.6 yr., SD = 5.7 yr.; M work experience = 12.2 yr., SD = 6.2 yr.). The correlation was positive but low for family support and sense of personal accomplishment by women; all the other correlations were low, accounting for very small variance.

Influenza vaccination among nurses in Greece

Seasonal influenza has become a serious public health problem worldwide, and vaccination is recognized as the most effective preventative measure. However, data suggest that influenza vaccination rates are generally low among health care workers. The present study showed that the vaccination rates for influenza among nurses are 21.2%.

Observational study of healthcare associated infections and mortality caused by carbapenem resistant Gram-negative bacteria in a Greek ICU

Maria Gamvrouli RN; BSN, MSc, Staf Nurse, General Hospital of Nikaias, Piraeus, Greece Ioanna Pavlopoulou MD, PhD, Associate Professor of Paediatrics-Infection, P & A Kyriakou Children’s Hospital; Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece Maria Kapritsou RN; BSN, MSc, PhD, Staf Nurse, Hellenic Anticancer Institute, Saint Savvas Hospital, Athens, Greece; Department of Nursing, National and Kapodistrian University of Athens, Greece *Margarita Giannakopoulou RN, BSc, PhD, Associate Professor, Department of Nursing, National and Kapodistrian University of Athens, Greece Maria Kalafati RN; BSN, MSc, PhD, Laboratory Teaching Staf, Clinical Instructor, Department of Nursing, National and Kapodistrian University of Athens, Greece Evangelos A Konstantinou RN; BSN, MSc, PhD, Associate Professor of Nursing Anesthesiology, Department of Nursing, National and Kapodistrian University of Athens, Greece Eleni Apostolopoulou RN; BSc, PhD, Professor, Department of Nursing, National and Kapodistrian University of Athens, Greece

Tetanus vaccination coverage among nurses in Greece

To the Editor: Hepatitis B virus is mainly transmitted parenterally and represents amajor risk factor forhealth careworkers because of their frequent exposure to patient biologic materials (blood and body fluid). Epidemiologic studies have shown that the incidence of infection following a needlestick contaminated with hepatitis B virus ranges from 6% to 30%. Therefore, workers performing tasks involving exposure to blood or blood-contaminated body fluids should be vaccinated. With this study, we wanted to estimate the coverage levels of hepatitis B vaccination among Greek nurses against hepatitis B. A self-reported questionnaire was used, based on the original questionnaire used in the survey of McEwen and Farren (after permission of the authors). In our study, 63.2% of the participant Greek nurses reported that they were fully vaccinated. The majority of immunized nurses (66%) was female (P5 .008), and 72.6% of fully vaccinated nurses worked in intensive care units; 84.3% of those who were fully vaccinated had their antibody titer measured to assess the efficacy of the vaccine. Of these, 10.5% reported their titer was negative. Reported reasons for declining vaccination included concerns about adverse effects, beliefs that are not in increased risk for infection and prior hepatitis B infection. The main reasons for receiving vaccination were self-protection and family protection. Compared with other studies, we found lower vaccination rates among nurses. The higher vaccination levels in these studies probably rely in development and application of continuing immunization programs for health care workers. In conclusion, our study showed that a substantial number of Greek nurses (40%) are not vaccinated for hepatitis B, despite being in great risk for infection because of frequent exposure to blood or other potentially infectious biologic materials. Although efforts have been made to tackle this issue during the last years, there is still a need for more efficient vaccination strategies. This would contribute further into reducing the number of unprotected health care workers and