scholarly journals Factors associated with vancomycin-resistant enterococci colonization in a pediatric intensive care unit of Paraguay: A cross-sectional study on hospital charts

Medwave ◽  
2019 ◽  
Vol 19 (08) ◽  
pp. e7694-e7694
Author(s):  
Laura Duarte ◽  
Antonio Arbo ◽  
Mirna Gallardo ◽  
Irma Riquelme ◽  
Lorena Delgadillo ◽  
...  
Author(s):  
Jennifer L. van Helmond ◽  
Brittany Fitts ◽  
Jigar C. Chauhan

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.


2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Fauziyyah Ramadhani ◽  
Mohammad Ghozali ◽  
Leni Lismayanti

Dengue hemorrhagic fever (DHF) is still the leading cause of hospitalization and death among children in Indonesia because of plasma leakage leading to shock syndromes. This study aimed to associate the hematocrit difference (first and second) from serial hematocrit (Hct) examination just after admission with DHF severity. A analytical cross-sectional study was involving medical records of pediatric patients with DHF admitted at the pediatric ward and the Pediatric Intensive Care Unit (PICU) of Dr. Hasan Sadikin General Hospital, Bandung in January–December 2015. The subjects excluded if other conditions also cause plasma leakage. The difference in first and second Hct (∆Hct) from serial Hct examination just after admission and DHF grade of severity (DHF I–IV) confirmed by a positive result in serologic tests (anti-dengue IgM/IgG), or detection of dengue virus antigen (NS1Ag test) obtained. Spearman association analysis test used for analysis. A total of 16 subjects with DHF I, 21 subjects with DHF II, 31 subjects with DHF III and two subjects with DHF IV included in this study. There was no significant correlation between positive ∆Hct value (hemoconcentration) and DHF severity (r=0.247, p=0.394, CI=95%). In conclusion, the difference in first and second Hct from serial Hct examination just after admission has no significant association with the disease severity. DUA NILAI HEMATOKRIT SERIAL SESAAT SETELAH ADMISI SEBAGAI PREDIKTOR KEPARAHAN DEMAM BERDARAH DENGUEDemam berdarah dengue (DBD) merupakan penyebab utama hospitalisasi dan kematian anak di Indonesia disebabkan oleh kebocoran plasma yang berujung pada syok. Tujuan penelitian ini mengetahui hubungan perbedaan hematokrit pertama dan kedua pada pemeriksaan hematokrit serial sesaat setelah admisi dengan keparahan DBD. Penelitian merupakan analytical cross-sectional study menggunakan data sekunder berupa rekam medis pasien anak yang dirawat di ruang perawatan anak dan Pediatric Intensive Care Unit (PICU) RSUP Dr. Hasan Sadikin Bandung pada Januari–Desember 2015. Subjek penelitian dieksklusi apabila pada rekam medis terdapat diagnosis lain yang menyebabkan kebocoran plasma. Variabel penelitian ini adalah perbedaan hematokrit pertama dan kedua (∆Hct) pada pemeriksaan hematokrit serial serta diagnosis DBD (DBD I–IV) yang dikonfirmasi oleh hasil positif pada pemeriksaan serologis (IgM/IgG antidengue) atau deteksi antigen virus (NS1Ag). Terdapat 16 subjek DBD I, 21 subjek DBD II, 31 subjek DBD III, dan 2 subjek DBD IV. Dengan menggunakan Uji Analisis Spearman, tidak terdapat korelasi yang signifikan antara nilai positif ∆Hct (hemokonsentrasi) dan tingkat keparahan DBD (r=0,247; p=0,394; CI=95%). Simpulan, perbedaan hematokrit pertama dan kedua pada pemeriksaan hematokrit serial tidak berhubungan dengan keparahan DBD.


2020 ◽  
Author(s):  
Tigist Bacha ◽  
Netsanet Tsegaye ◽  
Wagari Tuli

Abstract Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.


2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104


Author(s):  
Erman Yıldız

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHOD: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.


2010 ◽  
Vol 31 (1) ◽  
pp. 95-98 ◽  
Author(s):  
Aaron M. Milstone ◽  
Lisa L. Maragakis ◽  
Karen C. Carroll ◽  
Trish M. Perl

Performing admission surveillance cultures is a resource-intensive strategy to identify asymptomatic patients with vancomycin-resistant Enterococcus (VRE) colonization. We measured VRE prevalence among children admitted to the pediatric intensive care unit. Targeted surveillance captured 94% of VRE-colonized children and may be an effective strategy to identify VRE carriers and facilitate pediatric infection prevention strategies.


2021 ◽  
Vol 7 (4) ◽  
pp. 318-319
Author(s):  
Laura Herranz ◽  
Juliana Gurgel da Silveira ◽  
Luis Filipe Lannes Trocado ◽  
Anna Luiza Alvaraes ◽  
Juliana Fittipaldi

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