Epidemiologic Investigation ofBurkholderia cepaciaAcquisition in Two Pediatric Intensive Care Units

2003 ◽  
Vol 24 (9) ◽  
pp. 707-710 ◽  
Author(s):  
Chawki Loukil ◽  
Carole Saizou ◽  
Catherine Doit ◽  
Philippe Bidet ◽  
Patricia Mariani-Kurkdjian ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Burkholderia Cepacia ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Respiratory Therapy ◽  
University Hospital ◽  
Heated Humidifier ◽  
Epidemiologic Investigation ◽  
Source Of Infection

AbstractObjectives:To investigate and describe an outbreak ofBurkholderia cepaciain a neonatal intensive care unit (NICU) and a pediatric intensive care unit (PICU), and to report the interventions leading to the cessation of the outbreak.Design:We conducted an epidemiologic investigation of an outbreak ofB. cepaciacolonization or infection in two clinical wards during a 35-month period (December 1998 to October 2001).Setting:A 500-bed, university hospital-affiliated, tertiary-care pediatric institution in Paris, France, with a 22-bed PICU and 31-bed NICU.Methods:Ribotyping was used to determine the genotypes ofB. cepaciaisolates. Procedures for the maintenance and disinfection of respiratory therapy devices were reviewed.Results:Thirty-two children were colonized (n = 14) or infected (n = 18) byB. cepaciain 2 wards (28 in the PICU and 4 in the NICU). In the PICU, a single ribotype was found among the isolates obtained from all of the patients except 1, and from the 6 isolates obtained from respiratory therapy devices (ie, heated humidifier water). In the NICU, the isolates obtained from the patients harbored a single ribotype unrelated to that of the epidemic strain isolated in the PICU; no environmental source of infection was found.Conclusion:Two different outbreaks appeared to be associated with 2 ribotypes, 1 of which was linked to patient-to-patient transmission via respiratory therapy devices. Complete elimination of the outbreak was achieved only when disposable, sterilizable, or easy-to-disinfect materials were used in the PICU. The source of infection in the NICU was not found.

scholarly journals Criteria for referral of pediatric SARS-CoV-2 infection: a real-life experience in the pandemic era

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Carlotta Montagnani ◽  
Elisabetta Venturini ◽  
Manuela L’Erario ◽  
Chiara Tersigni ◽  
Barbara Bortone ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Experience ◽  
Tertiary Care ◽  
Real Life ◽  
Pediatric Intensive Care ◽  
University Hospital ◽  
Children At Risk ◽  
Referral Criteria ◽  
Practical Guidance

AbstractA practical guidance on the management of children with COVID-19 to insure homogeneous criteria for referral to a higher-level facility, according to the disease severity, is pivotal in the pandemic era. A panel of experts in pediatric infectious diseases and intensive care at the tertiary-care Meyer Children’s University Hospital, Florence, Italy, issued a practical document shared with Tuscany hospitals. The rationale was to target the referral for those children at risk of requiring an intensive support, since the above mentioned hospital has the pediatric intensive care unit. Overall, 378 patients between 0 and 19 years of age were diagnosed with COVID-19 infection in the Tuscany region with 24 (6.3%) hospitalizations. Only three children were centralized to Meyer Children’s University Hospital according to reported criteria. Considering that appropriate referral criteria have been associated with reduced mortality in other conditions, our document might be useful to improve outcomes of children with COVID-19.

Simulating a Vertical Evacuation of a NICU and PICU to Examine the Relationship Between Training and Preparedness

2021 ◽  
pp. 1-3
Author(s):  
Ramon E. Gist ◽  
Pia Daniel ◽  
Nizar Tejani ◽  
Andrew Grock ◽  
Adam Aluisio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disaster Preparedness ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Full Scale ◽  
University Hospital ◽  
Evaluation Tool ◽  
Vertical Evacuation

Abstract Objective: The aim of this study was to implement pediatric vertical evacuation disaster training and evaluate its effectiveness by using a full-scale exercise to compare outcomes in trained and untrained participants. Methods: Various clinical and nonclinical staff in a tertiary care university hospital received pediatric vertical evacuation training sessions over a 6-wk period. The training consisted of disaster and evacuation didactics, hands-on training in use of evacuation equipment, and implementation of an evacuation toolkit. An unannounced full-scale simulated vertical evacuation of neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) patients was used to evaluate the effectiveness of the training. Drill participants completed a validated evaluation tool. Pearson chi-squared testing was used to analyze the data. Results: Eighty-four evaluations were received from drill participants. Forty-three (51%) of the drill participants received training and 41 (49%) did not. Staff who received pediatric evacuation training were more likely to feel prepared compared with staff who did not (odds ratio, 4.05; confidence interval: 1.05-15.62). Conclusions: There was a statistically significant increase in perceived preparedness among those who received training. Recently trained pediatric practitioners were able to achieve exercise objectives on par with the regularly trained emergency department staff. Pediatric disaster preparedness training may mitigate the risks associated with caring for children during disasters.

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

Use of Molecular Biology to Confirm a Bacteremia Outbreak Caused by Burkholderia Cepacia in a Pediatric Intensive Care Unit

2012 ◽  
Vol 40 (5) ◽  
pp. e113
Author(s):  
Hilda G. Hernandez Orozco ◽  
Genny Sanchez ◽  
Miguela Caniza ◽  
Don Guimera ◽  
Jhonson M. Kyle ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Molecular Biology ◽  
Pediatric Intensive Care Unit ◽  
Burkholderia Cepacia ◽  
Pediatric Intensive Care

scholarly journals Bacteriological profile of neonatal and pediatrics sepsis in intensive care unit at a tertiary care hospital in western India

2021 ◽  
Vol 8 (3) ◽  
pp. 460
Author(s):  
Ajit Kumar Shrivastava ◽  
Prema Ram Choudhary ◽  
Santosh Kumar Roy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Bacterial Pathogen ◽  
Pediatric Intensive Care ◽  
Western India ◽  
Care Hospital ◽  
Older Children ◽  
Bacteriological Profile

Background: Neonatal and pediatrics sepsis are one of the main causes of mortality in neonatal and pediatric intensive care units of developing countries. This study was conducted to determine bacteriological profile of neonatal and pediatrics sepsis in the intensive care unit. Methods: A prospective cross-sectional study was conducted in the neonatal and pediatric intensive care unit, for the period of two years. All 400 neonates and pediatrics patients admitted with suspected clinical sepsis were included. Sepsis screens and cultures were sent under aseptic conditions. Isolation of microorganisms and their identification was done according to standard microbiological techniques bacteriological profile was analyzed with descriptive statistics.Results: Incidence of septicemia is 35.34% in neonates, 9.83% in post neonates and 22.95% in older children. Most common associated factor in neonates were preterm 41.46% in neonates, fever of unknown origin 50% and 78.57% in post neonates and children respectively. Out of 232 suspected cases on neonates in 36.07% cases bacterial pathogen were isolated, 62 suspected cases on post neonates in 9.83% cases bacterial were isolated and 106 suspected cases of older children in 22.95% cases bacterial pathogen were isolated. Common bacterial species isolated were Klebsiella sp. 39.02% in neonates, S. aureus 50% and 35.71% in post neonates and older children respectively.Conclusions: There is entail prevention of infection control measures and rational antibiotic strategy to decrease the economic burden of hospital and community. 

Study of fungal infections in pediatric intensive care unit in Menoufiya University Hospital

2014 ◽  
Vol 27 (1) ◽  
pp. 55
Author(s):  
NagwanY. Saleh ◽  
FadyM. ElGendy ◽  
FahimaM. Hassan ◽  
AhmedA. Khatab ◽  
GhadaR. El-Hendawy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Fungal Infections ◽  
Pediatric Intensive Care ◽  
University Hospital

scholarly journals 1134. Antibiotic Indications and Appropriateness in the Pediatric Intensive Care Unit: A 10 Center Point Prevalence Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S403-S404
Author(s):  
Kathleen Chiotos ◽  
Jennifer Blumenthal ◽  
Juri Boguniewicz ◽  
Debra Palazzi ◽  
Emily Berkman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Empiric Therapy ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Point Prevalence Study

Abstract Background Antibiotics are prescribed in up to 80% of pediatric intensive care unit (PICU) patients, but multicenter studies systematically evaluating antibiotic indications and appropriateness in this high-utilizing population are lacking. Methods A multicenter point prevalence study was conducted at 10 geographically diverse tertiary care US children’s hospitals. All PICU patients < 21 years of age who were receiving systemic antibiotics at 8:00 AM on each study day were included. Study days occurred in February and March 2019. Data were abstracted by critical care and/or infectious diseases trained clinicians using standardized data collection forms and definitions of antibiotic appropriateness. Results 408 of 732 PICU patients (56%) received 618 antibiotics on the two study days. Empiric therapy for suspected bacterial infections without sepsis was the most common indication for antibiotics (22%), followed by treatment of community-acquired pneumonia and empiric therapy for septic shock (12% each, Figure 1). Overall, 194 antibiotic orders (32%) were classified as inappropriate and 158 patients (39%) received at least one inappropriate antibiotic. Vancomycin, cefepime, and ceftriaxone were the antibiotics most often inappropriately prescribed (Figure 2). Antibiotics prescribed inappropriately for the top 5 indications shown in Figure 1 accounted for 77% of all inappropriate antibiotic use. Prolonged ( >4 days) empiric therapy and prolonged ( >24 hours) post-operative prophylaxis were the most common reasons antibiotics prescribed for these indications were classified as inappropriate. Pneumonia and ventilator-associated infections were the most common infections for which antibiotics were prescribed inappropriately (46%). Reasons for inappropriate antibiotic use included lack of evidence supporting a bacterial infection (no radiographic infiltrate or significant increase in respiratory support) and use of unnecessarily broad antibiotics (Table 1). Conclusion Inappropriate antibiotic use is common in the PICU, particularly for pneumonia. Studies focused on defining optimal treatment strategies, as well as improved diagnostic approaches to curtail prolonged courses of empiric therapy, should be prioritized. Disclosures All authors: No reported disclosures.

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