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d
e
v
e
lo
pe
d
c
o
un
t
r
i
e
s
t
h
a
t
o
n
l
y
4.
8
to
15
.
5%
[
5
].
N
o
s
o
c
o
m
i
a
l
i
n
f
e
c
t
i
o
n
s
c
a
n
c
a
u
s
e
o
l
de
r
pa
t
i
e
n
t
s
t
r
e
a
t
e
d
a
t
t
h
e
Ho
s
p
i
t
a
l
.
Da
t
a
i
n
c
i
de
n
c
e
o
f
n
o
s
o
c
o
m
i
a
l
i
n
f
e
c
t
i
o
n
s
i
n
de
v
e
l
o
p
i
ng
c
o
un
t
r
i
e
s
i
s
n
o
t
s
o
c
l
e
a
r
.
T
h
e
n
u
m
be
r
s
j
u
s
t
c
a
m
e
f
r
o
m
s
e
ve
r
a
l
s
t
ud
i
e
s
i
n
s
e
v
e
r
a
l
h
o
s
p
it
a
l
s
[
7
]
.
No
s
o
c
o
m
i
a
l
i
n
f
e
c
t
i
o
n
i
s
a
he
a
l
t
h
c
a
r
e
pr
o
bl
e
m
t
h
a
t
o
f
t
e
n
o
c
c
ur
s
.
No
s
o
c
o
m
i
a
l
i
nf
e
c
t
i
o
n
s
c
a
us
e
in
c
r
e
a
s
e
d
m
o
r
bi
d
i
t
y
a
n
d
m
o
r
t
a
l
i
t
y
,
a
dd
i
t
i
o
n
a
l
da
y
s
o
f
t
r
e
a
t
m
e
n
t
,
a
n
d
i
nc
r
e
a
s
e
t
h
e
c
o
s
t
o
f
c
a
r
e
[
8
]
.
S
o
m
e
i
nc
i
de
n
c
e
o
f
n
o
s
o
c
o
m
i
a
l
i
n
f
e
c
t
i
o
n
m
a
y
not
c
a
us
e
t
h
e
pa
t
i
e
n
t
'
s
de
a
t
h
,
b
ut
l
e
a
d
s
to
l
o
n
ge
r
pa
t
i
e
n
t
t
r
e
a
t
e
d
i
n
h
o
s
p
i
t
a
l
[
9
]
,
[
10
]
.
On
e
e
f
f
o
r
t
to
pr
e
v
e
n
t
n
o
s
o
c
o
m
i
a
l
i
nf
e
c
t
i
o
ns
i
s
by
p
a
yi
ng
a
t
ten
t
i
o
n
t
o
s
a
ni
t
a
r
y
a
s
pe
c
t
s
.
M
a
n
a
g
e
m
e
n
t
o
f
h
o
s
p
i
t
a
l
s
a
ni
t
a
t
i
o
n
i
s
im
po
r
t
a
n
t
to
n
ot
e
,
b
e
c
a
us
e
t
h
e
h
o
s
p
i
t
a
l
i
s
a
h
e
a
l
t
h
-
c
a
r
e
f
a
c
il
i
t
i
e
s
f
o
r
t
h
e
ge
n
e
r
a
l
pu
bli
c
.
E
nvi
r
o
nm
e
nt
a
l
s
a
ni
t
a
t
i
o
n
h
o
s
p
i
t
a
l
s
i
n
c
o
n
t
r
o
l
li
ng
t
he
gr
o
w
t
h
o
f
mi
c
r
o
or
ga
ni
s
m
s
c
a
n
b
e
a
c
c
o
m
p
l
i
s
he
d
t
h
r
o
ugh
s
t
e
r
i
li
z
a
t
i
o
n
[
11
]
.
S
a
ni
t
a
r
y
i
ns
t
a
ll
a
t
i
o
ns
h
o
s
p
i
t
a
l
s
,
e
s
pe
c
i
a
l
ly
i
n
t
h
e
d
i
s
i
nf
e
c
t
i
o
n
a
c
t
i
vi
t
i
e
s
h
a
v
e
a
dut
y
a
n
d
r
e
s
po
n
s
i
b
il
i
t
y
to
s
upe
r
vi
s
e
a
n
d
d
i
s
i
n
f
e
c
t
i
o
n
m
e
a
s
ur
e
s
e
x
a
mi
na
t
i
o
n
r
oo
m
,
o
pe
r
a
t
i
n
g
r
o
o
m
,
tr
e
a
t
m
e
n
t
r
oo
m
a
n
d
a
n
i
s
o
l
a
t
i
o
n
r
oo
m
i
n
a
n
e
f
f
o
r
t
to
pr
e
v
e
n
t
n
o
s
o
c
o
m
i
a
l
i
n
f
e
c
t
i
o
ns
[
12
].
D
i
s
i
n
f
e
c
t
i
o
n
i
s
a
n
a
tt
e
m
pt
t
o
r
e
duc
e
t
h
e
n
u
m
be
r
o
f
d
i
s
e
a
s
e
-
c
a
u
s
i
ng
m
i
c
r
o
o
r
ga
ni
s
m
s
o
r
p
ot
e
n
t
i
a
l
pa
t
ho
ge
n
s
s
uc
h
a
s
b
a
c
t
e
r
i
a
,
vi
r
us
e
s
,
pa
r
a
s
i
t
e
s
a
n
d
f
u
n
g
i
[
13
]
,
[
14
]
.
A
c
c
o
r
di
n
g
t
o
K
r
i
s
e
t
y
o
wa
t
i
,
d
i
s
i
n
f
e
c
t
i
o
n
o
f
h
o
s
p
i
t
a
l
c
a
r
e
r
oo
m
f
l
o
o
r
to
d
o
wi
t
h
R
e
f
i
s
o
l
.
M
o
pp
i
n
g
t
h
e
f
l
o
o
r
us
i
n
g
R
e
f
i
s
o
l
s
h
o
wn
to
de
c
r
e
a
s
e
t
h
e
n
u
m
be
r
o
f
b
a
c
t
e
r
i
a
i
n
a
h
o
s
p
i
t
a
l
r
oo
m
f
l
o
o
r
[
12
]
.
U
l
i
n
Ho
s
p
i
t
a
l
B
a
nj
a
r
m
a
s
i
n
i
s
t
h
e
h
o
s
p
i
t
a
l
do
i
n
g
med
i
c
a
l
a
c
t
i
vi
t
y
.
Ac
c
o
r
di
n
g
to
t
h
e
a
nn
ua
l
r
e
po
r
t
o
f
t
h
e
10
d
i
s
e
a
s
e
s
i
n
Ho
s
p
i
t
a
l
U
li
n
B
a
nj
a
r
m
a
s
i
n
,
e
s
p
e
c
i
a
ll
y
i
n
t
h
e
M
a
w
a
r
r
oo
m
.
T
h
e
r
e
s
u
l
t
s
o
f
t
h
e
e
x
a
mi
na
t
i
o
n
c
o
n
duc
t
e
d
by
U
li
n
Ho
s
p
i
t
a
l
s
a
i
d
t
h
a
t
t
h
e
t
ot
a
l
n
u
m
be
r
o
f
ge
r
m
s
o
n
t
h
e
f
l
o
o
r
o
f
t
h
e
t
r
e
a
t
m
e
n
t
r
oom
i
n
U
li
n
Ho
s
pi
t
a
l
i
s
16
C
F
U
/
c
m
2
.
T
hi
s
a
l
r
e
a
d
y
e
xc
e
e
d
s
t
he
e
xi
s
t
i
n
g
s
t
a
n
da
r
ds
f
o
r
tot
a
l
b
a
c
t
e
r
i
a
i
n
t
h
e
r
o
o
m
whi
c
h
i
s
a
b
o
ut
5
-
10
C
F
U
/
c
m
2
.
T
hi
s
i
s
f
e
a
r
e
d
to
c
a
us
e
n
o
s
oc
o
m
i
a
l
i
nf
e
c
t
i
o
ns
.
C
o
n
t
a
m
i
na
t
i
o
n
s
o
f
ge
r
m
s
n
o
t
o
nl
y
c
o
m
e
f
r
o
m
t
h
e
pa
t
i
e
n
t
o
r
a
tt
e
n
da
n
t
.
P
o
l
l
ut
i
o
n
a
l
s
o
c
o
m
e
s
f
r
o
m
t
h
e
e
nvi
r
o
nm
e
n
t
s
uc
h
a
s
a
i
r
,
f
l
o
o
r
s
,
wa
l
l
s
,
wa
t
e
r
,
f
o
od
s
a
n
d
t
oo
l
s
us
e
d
[
14
]
.
Va
r
i
o
us
a
c
t
i
o
ns
m
a
y
b
e
t
a
ke
n
to
a
ddr
e
s
s
t
h
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pr
o
bl
e
m
o
f
po
l
l
ut
i
o
n
c
a
u
s
e
d
by
t
h
e
b
a
c
t
e
r
i
a
i
n
t
h
e
h
o
s
p
i
t
a
l
,
o
n
e
o
f
t
he
m
by
im
pr
o
vi
ng
s
a
ni
t
a
t
i
o
n
i
n
h
o
s
p
i
t
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l
s
.
I
m
p
l
e
m
e
n
t
a
t
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o
n
o
f
s
a
ni
t
a
t
i
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n
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by
a
pp
lyi
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o
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ke
e
p
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ng
.
B
a
s
e
d
o
n
t
h
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a
b
o
ve
r
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a
r
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r
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a
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o
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M
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s
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nj
a
r
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2.
RE
S
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AR
CH
M
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D
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No
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m
be
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Na
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[
22]
.
T
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ly
[
23
]
,
[
24]
.
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[
25
]
,
[
26
]
.
D
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f
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c
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is
an
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f
f
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/
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(
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po
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)
[
27]
.
M
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[
28]
.
A
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[
29
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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[
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[
30
]
.
A
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[
31
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,
[
32
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.
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[
33
]
,
[
34
]
.
Ho
s
pi
t
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l
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e
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t
unf
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1
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4
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E.
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9
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