scholarly journals Metagenomic Next-Generation Sequencing of Bloodstream Microbial Cell-Free Nucleic Acid in Children With Suspected Sepsis in Pediatric Intensive Care Unit

Author(s):  
Gangfeng Yan ◽  
Jing Liu ◽  
Weiming Chen ◽  
Yang Chen ◽  
Ye Cheng ◽  
...  

Bloodstream infection is a life-threatening complication in critically ill patients. Multi-drug resistant bacteria or fungi may increase the risk of invasive infections in hospitalized children and are difficult to treat in intensive care units. The purpose of this study was to use metagenomic next-generation sequencing (mNGS) to understand the bloodstream microbiomes of children with suspected sepsis in a pediatric intensive care unit (PICU). mNGS were performed on microbial cell-free nucleic acid from 34 children admitted to PICU, and potentially pathogenic microbes were identified. The associations of serological inflammation indicators, lymphocyte subpopulations, and other clinical phenotypes were also examined. mNGS of blood samples from children in PICU revealed potential eukaryotic microbial pathogens. The abundance of Pneumocystis jirovecii was positively correlated with a decrease in total white blood cell count and immunodeficiency. Hospital-acquired pneumonia patients showed a significant increase in blood bacterial species richness compared with community-acquired pneumonia children. The abundance of bloodstream bacteria was positively correlated with serum procalcitonin level. Microbial genome sequences from potential pathogens were detected in the bloodstream of children with suspected sepsis in PICU, suggesting the presence of bloodstream infections in these children.

2016 ◽  
Vol 07 (03) ◽  
pp. 682-692 ◽  
Author(s):  
Richard Holden ◽  
Kathryn Flynn ◽  
Yushi Yang ◽  
Laila Azam ◽  
Matthew Scanlon ◽  
...  

SummaryThe purpose of this study was to explore providers’ perspectives on the use of a novel technology, “Large Customizable Interactive Monitor” (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit.We employed a qualitative approach to collect and analyze data from pediatric intensive care physicians, pediatric nurse practitioners, and acute care specialists. Using semi-structured interviews, we collected data from January to April, 2015. The research team analyzed the transcripts using an iterative coding method to identify common themes.Study results highlight contextual data on providers’ use routines of the LCIM. Findings from thirty six interviews were classified into three groups: 1) providers’ familiarity with the LCIM; 2) providers’ use routines (i.e. when and how they use it); and 3) reasons why they use or do not use it.It is important to conduct baseline studies of the use of novel technologies. The importance of training and orientation affects the adoption and use patterns of this new technology. This study is notable for being the first to investigate a LCIM system, a next generation system implemented in the pediatric critical care setting. Our study revealed this next generation HIT might have great potential for family-centered rounds, team education during rounds, and family education/engagement in their child’s health in the patient room. This study also highlights the effect of training and orientation on the adoption patterns of new technology. Citation: Asan O, Holden RJ, Flynn KE, Yang Y, Azam L, Scanlon MC. Provider use of a novel EHR display in the pediatric intensive care unit: Large customizable interactive monitor (LCIM).


2015 ◽  
Vol 52 (Suppl 1) ◽  
pp. A9.1-A9
Author(s):  
Hussein Daoud ◽  
Stephanie M Luco ◽  
Rui Li ◽  
Christine Armour ◽  
Nancy Carson ◽  
...  

2016 ◽  
Vol 188 (11) ◽  
pp. E254-E260 ◽  
Author(s):  
Hussein Daoud ◽  
Stephanie M. Luco ◽  
Rui Li ◽  
Eric Bareke ◽  
Chandree Beaulieu ◽  
...  

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