scholarly journals Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil

2016 ◽  
Vol 37 (11) ◽  
pp. 1302-1309 ◽  
Author(s):  
Laura Folgori ◽  
Paola Bernaschi ◽  
Simone Piga ◽  
Michaela Carletti ◽  
Filippe Pirrone Cunha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Case Fatality ◽  
Neonatal Intensive Care Units ◽  
Healthcare Associated Infections ◽  
Day Case ◽  
Healthcare Associated

OBJECTIVESTo describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs.DESIGNMulticenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014.SETTINGThree tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds.PATIENTSInclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI.RESULTSA total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains.CONCLUSIONSInfection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs.Infect Control Hosp Epidemiol 2016;1–8

scholarly journals Perspectives and practices of healthcare providers and caregivers on healthcare-associated infections in the neonatal intensive care units of two hospitals in Ghana

2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i38-i50
Author(s):  
Gifty Sunkwa-Mills ◽  
Lal Rawal ◽  
Christabel Enweronu-Laryea ◽  
Matilda Aberese-Ako ◽  
Kodjo Senah ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Healthcare Providers ◽  
Neonatal Intensive Care Units ◽  
Healthcare Associated Infections ◽  
Middle Income ◽  
Middle Income Countries ◽  
Healthcare Associated ◽  
Low And Middle Income

Abstract Healthcare-associated infections (HAIs) remain a serious threat to patient safety worldwide, particularly in low- and middle-income countries. Reducing the burden of HAIs through the observation and enforcement of infection prevention and control (IPC) practices remains a priority. Despite growing emphasis on HAI prevention in low- and middle-income countries, limited evidence is available to improve IPC practices to reduce HAIs. This study examined the perspectives of healthcare providers (HPs) and mothers in the neonatal intensive care unit on HAIs and determined the major barriers and facilitators to promoting standard IPC practices. This study draws on data from an ethnographic study using 38 in-depth interviews, four focus group discussions and participant observation conducted among HPs and mothers in neonatal intensive care units of a secondary- and tertiary-level hospital in Ghana. The qualitative data were analysed using a grounded theory approach, and NVivo 12 to facilitate coding. HPs and mothers demonstrated a modest level of understanding about HAIs. Personal, interpersonal, community, organizational and policy-level factors interacted in complex ways to influence IPC practices. HPs sometimes considered HAI concerns to be secondary in the face of a heavy clinical workload, a lack of structured systems and the quest to protect professional authority. The positive attitudes of some HPs, and peer interactions promoted standard IPC practices. Mothers expressed interest in participation in IPC activities. It however requires systematic efforts by HPs to partner with mothers in IPC. Training and capacity building of HPs, provision of adequate resources and improving communication between HPs and mothers were recommended to improve standard IPC practices. We conclude that there is a need for institutionalizing IPC policies and strengthening strategies that acknowledge and value mothers’ roles as caregivers and partners in IPC. To ensure this, HPs should be better equipped to prioritize communication and collaboration with mothers to reduce the burden of HAIs.

scholarly journals Adverse events and other incidents in neonatal intensive care units

2015 ◽  
Vol 20 (3) ◽  
pp. 937-946 ◽  
Author(s):  
Luciana da Silva Lanzillotti ◽  
Marismary Horsth De Seta ◽  
Carla Lourenço Tavares de Andrade ◽  
Walter Vieira Mendes Junior
Keyword(s):  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Healthcare Associated Infections ◽  
Age Group ◽  
Intravascular Catheters ◽  
Healthcare Associated

The occurrence of avoidable adverse events (AEs) represents a problem of quality of care that is responsible for the increase in monetary and social costs, causing suffering to the patient, their family members and the professional involved. This situation is aggravated when it involves newborns (NBs) with very low birth weights and shorter gestational ages, admitted to neonatal intensive care units (NICU). The scope of this study is to understand more about these incidents and adverse events in NICUs. The article aims to identify the occurrence of incidents, with and without injury that have occurred in NICUs in the literature and correlate this with the gestational age group of the NBs most affected. This is a systematic review of the available literature on incidents, particularly AEs as witnessed in NICUs. This study reveals that the types of incidents that occur in NICUs, with or without injury to the patient, are related to errors or failures in medication use, healthcare-associated infections (HAIs), skin injuries, mechanical ventilation and intravascular catheters. The cause of incidents and adverse events in NICUs are associated with human factors and the outcomes that are most damaging are due to HAIs. Furthermore, the study points out ways to mitigate these occurrences.

scholarly journals The treatment and risk factors of retinopathy of prematurity in neonatal intensive care units

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Yunxia Leng ◽  
Wenzhi Huang ◽  
Guoliang Ren ◽  
Cheng Cai ◽  
Qingbiao Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units

scholarly journals Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units

2018 ◽  
Vol 102 (12) ◽  
pp. 1711-1716 ◽  
Author(s):  
Ahmet Yagmur Bas ◽  
Nihal Demirel ◽  
Esin Koc ◽  
Dilek Ulubas Isik ◽  
İbrahim Murat Hirfanoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Relative Weight ◽  
Neonatal Intensive Care Units ◽  
Screening Criteria ◽  
Prospective Multicentre Study

BackgroundTo evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition.MethodsA prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses.ResultsThe TR-ROP study included 6115 infants: 4964 (81%) with a GA≤32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW≤1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW≤1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment.ConclusionsScreening of infants with a GA≤34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs.Trial registration numberNCT02814929, Results.

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