scholarly journals Evaluation of Multiplex Real-time PCR and WHO Criteria for Diagnosing Childhood Bacterial Meningitis in a Tertiary Referral Hospital in Iran

2022 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gholamreza Pouladfar ◽  
Anahita Sanaei Dashti ◽  
Mohammad Rahim Kadivar ◽  
Maedeh Jafari ◽  
Bahman Pourabbas ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Real Time ◽  
Real Time Pcr ◽  
Predictive Value ◽  
Referral Hospital ◽  
World Health ◽  
Haemophilus Influenzae Type ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Who Criteria

Background: Childhood bacterial meningitis (BM) requires prompt and precise diagnosis to provide proper treatment and decline mortality and morbidity. Objectives: We aimed to evaluate the World Health Organization (WHO) criteria and polymerase chain reaction (PCR) for diagnosing BM in children admitted to a tertiary referral hospital in Shiraz, southern Iran. Materials: We included all 492 children aged one month to 17 years suspected of meningitis who had cerebrospinal fluid (CSF) leukocytosis admitted to Nemazi Hospital from August 2016 to September 2017. The CSF specimens were examined for routine analysis, Gram staining, and culture. A multiplex real-time PCR was used to identify Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis in the CSF samples. Seven viruses were also investigated using real-time PCR. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using the WHO criteria and the multiplex real-time PCR results. Results: Seventy-four CSF samples had leukocytosis. Nineteen (22.9%) patients had BM caused by S. pneumoniae (n = 14), Hib (n = 2), Salmonella enterica (n = 2), and N. meningitidis (n = 1). The PCR test detected all cases, except for two with Salmonella meningitis (sensitivity 89.4%, specificity 100%, PPV 100%, and NPV 96%). The WHO criteria detected all cases, except three who received antibiotics at least four days before performing lumbar puncture (sensitivity 84.2%, specificity 98.2%, PPV 94.1%, and NPV 94.7%). Enterovirus was the most common viral etiology (6.75%). Conclusions: The WHO criteria and the multiplex real-time PCR had high accuracy in our setting, and their use could decrease the antibiotic over-prescription in febrile children suspected of meningitis.

scholarly journals Prevalence of hearing loss in children following bacterial meningitis in a tertiary referral hospital

2014 ◽  
Vol 7 (1) ◽  
Author(s):  
Benson Wahome Karanja ◽  
Herbert Ouma Oburra ◽  
Peter Masinde ◽  
Dalton Wamalwa
Keyword(s):  
Hearing Loss ◽  
Bacterial Meningitis ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

Hand hygiene practices among healthcare workers in a newborn unit of a tertiary referral hospital in Kenya

2018 ◽  
Vol 20 (3) ◽  
pp. 132-138
Author(s):  
Serah K Ngugi ◽  
Florence V Murila ◽  
Rachel N Musoke
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Compliance Rate ◽  
Referral Hospital ◽  
World Health ◽  
Tertiary Referral ◽  
Improvement Strategy ◽  
Tertiary Referral Hospital ◽  
Effective Measure ◽  
Hospitalised Patients

Background: Health care-associated infection (HCAI) is a significant cause of morbidity and mortality among hospitalised patients, particularly neonates. Compliance with hand hygiene (HH) recommendations is the simplest and most effective measure in preventing this infection. Objectives: To determine the HH practices among healthcare workers (HCWs) in the newborn unit of a tertiary referral hospital in Kenya, their knowledge and perceptions regarding HCAI and importance of HH, and barriers to the recommended HH practices. Methods: A descriptive cross-sectional study was conducted to evaluate the HCWs’ compliance with the World Health Organization (WHO) ‘5 Moments for Hand Hygiene’ and a structured self-administered questionnaire adopted from the WHO knowledge and perception of HCW questionnaires was used to answer the secondary objectives. Results: The overall HH compliance rate was 15%. HCWs were twice more likely to take a HH action ‘after’ than ‘before’ a patient care procedure (odds ratio [OR] = 2.05; 95% confidence interval [CI] = 1.02–4.19; P = 0.03). Nurses and nursing students had statistically significant lower compliance (OR 0.41; 95% CI = 0.18-0.91; p=0.016) and (OR 0.21; 95% CI = 0.06-0.70; p = 0.004) respectively, compared to the doctors. More than half (52%) of the HCWs were unaware of the five moments/indication for HH. Lack of supplies, forgetfulness and use of gloves were the commonly cited barriers to HH compliance. Discussion: HH compliance rate among HCWs in the newborn unit of the tertiary referral hospital was very low. The observed and reported barriers to optimal HH compliance demonstrate a necessity for the adoption of the WHO recommended multimodal HH improvement strategy in this unit.

scholarly journals Prevalence of Glioblastoma-Not Otherwise Specified (NOS) Based on the Clinical and Histopathology Findings in Main Tertiary Referral Hospital in Bandung, Indonesia

2020 ◽  
Vol 13 (3) ◽  
pp. 132-141
Author(s):  
Hendrikus Masang Ban Bolly ◽  
Ahmad Faried ◽  
Danny Halim ◽  
Yulius Hermanto ◽  
Firman Priguna Tjahjono ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Molecular Techniques ◽  
Referral Hospital ◽  
World Health ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Not Otherwise Specified ◽  
Mutational Status ◽  
Macroscopic Findings ◽  
Health Organization

Introduction: Glioblastoma is the deadliest malignant brain tumors in adults. The main challenges in treating glioblastoma are its resistance to the chemo-radiotherapy, poor outcome and low survival rate. The World Health Organization (WHO) 2016 classification identifies two types of glioblastoma by its mutational status of isocitrate dehydrogenase (IDH); since our national insurance experiences budget-limitation, we could not freely apply it in our institutions. We aims to find the prevalence and outcome of glioblastoma-not otherwise specified (NOS) based on its clinical manifestations and histopathology findings. Methods: We performed retrograde-analysis based on clinical and histology findings on 48 glioblastoma-NOS patients from 2012-2017. We analyzed its characteristic, primary complains, lesions location, macroscopic findings, therapy and the final outcomes. Results: Glioblastoma-NOS is the most common type of gliomas occurs in adults ages 49.29±12.13 years (range 17-72 years). The tumor predominantly involves the frontal lobe (25%) with chronic progressive headache as the chief complaint (90%); 93.8% of the patients underwent tumor removal and received chemo-radiotherapy after surgery based on the histopathology findings. The median survival is 18 months and the prevalence of glioblastoma-NOS in our tertiary referral hospital is 4.72%. Conclusion: Hopefully, our study will improve the understanding of the regional differences in glioblastoma-NOS prevalence and pave the way for identifying the regional risk factors that would allow us to improve the protocols on glioblastoma detection, prevention and management. Further studies, incorporating molecular techniques into a patient’s tumor analysis for IDH1 mutant or wild type are required for the promise of personalized medicine.

DEVELOPMENT OF MULTIPLEX REAL-TIME PCR ASSAY FOR SIX PATHOGENS: RAPID TOOL FOR DIAGNOSIS OF BACTERIAL MENINGITIS

2019 ◽  
pp. 60-66
Author(s):  
Viet Quynh Tram Ngo ◽  
Thi Ti Na Nguyen ◽  
Hoang Bach Nguyen ◽  
Thi Tuyet Ngoc Tran ◽  
Thi Nam Lien Nguyen ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Real Time ◽  
Real Time Pcr ◽  
Diagnostic Methods ◽  
Type B ◽  
E Coli ◽  
Pcr Assays ◽  
Set Up ◽  
Etiological Agents ◽  
Suis Serotype

Introduction: Bacterial meningitis is an acute central nervous infection with high mortality or permanent neurological sequelae if remained undiagnosed. However, traditional diagnostic methods for bacterial meningitis pose challenge in prompt and precise identification of causative agents. Aims: The present study will therefore aim to set up in-house PCR assays for diagnosis of six pathogens causing the disease including H. influenzae type b, S. pneumoniae, N. meningitidis, S. suis serotype 2, E. coli and S. aureus. Methods: inhouse PCR assays for detecting six above-mentioned bacteria were optimized after specific pairs of primers and probes collected from the reliable literature resources and then were performed for cerebrospinal fluid (CSF) samples from patients with suspected meningitis in Hue Hospitals. Results: The set of four PCR assays was developed including a multiplex real-time PCR for S. suis serotype 2, H. influenzae type b and N. meningitides; three monoplex real-time PCRs for E. coli, S. aureus and S. pneumoniae. Application of the in-house PCRs for 116 CSF samples, the results indicated that 48 (39.7%) cases were positive with S. suis serotype 2; one case was positive with H. influenzae type b; 4 cases were positive with E. coli; pneumococcal meningitis were 19 (16.4%) cases, meningitis with S. aureus and N. meningitidis were not observed in any CSF samples in this study. Conclusion: our in-house real-time PCR assays are rapid, sensitive and specific tools for routine diagnosis to detect six mentioned above meningitis etiological agents. Key words: Bacterial meningitis, etiological agents, multiplex real-time PCR

Micafungin use in a UK tertiary referral hospital

2018 ◽  
Vol 15 ◽  
pp. 82-87 ◽  
Author(s):  
David A. Enoch ◽  
Michael E. Murphy ◽  
Christianne Micallef ◽  
Huina Yang ◽  
Nicholas M. Brown ◽  
...  
Keyword(s):  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

scholarly journals Mortality in children with COVID-19: Lessons learned from a tertiary referral hospital in Indonesia

2021 ◽  
Author(s):  
Rismala Dewi ◽  
Nastiti Kaswandani ◽  
Mulya Rahma Karyanti ◽  
Darmawan Budi Setyant ◽  
Antonius Hocky Pudjiadi ◽  
...  
Keyword(s):  
Lessons Learned ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

scholarly journals Carbapenemase screening in an Irish tertiary referral hospital: Best practice, or can we do better?

2020 ◽  
Vol 2 (4) ◽  
pp. 100100
Author(s):  
S. Fahy ◽  
J.A. O'Connor ◽  
D. O'Brien ◽  
L. Fitzpatrick ◽  
M. O'Connor ◽  
...  
Keyword(s):  
Best Practice ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital
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