Methods Web-based questionnaire (Survey monkey ® ), developed by the NEonatal Sepsis Trial NETwork (http://www.nest-net.org), was sent to neonatologists worldwide. Questions regarding management (n = 7) were introduced by scenarios levelled to low-, medium-and high risk for neonatal EOS. Demographic questions (n = 4) are based on competency, caseload, experience of fatal cases (deaths) and country of origin. Results 439 Neonatologist from 10 countries participated. Laboratory investigations are used in 31% to start, and in 72% to stop antibiotic treatment. The decision regarding stop of antibiotic therapy is mainly dependent on conventional laboratory investigations. Only a minority uses newer infection markers as procalcitonin (17%) or interleukins (9%). There is a high variance in when to start and when to stop antibiotic therapy with a national distribution. Variance is lower within one country compared to the variance in all participating countries. There is no dependency on other demographic variables. Conclusions There is a high variance in the management of neonatal EOS. Discontinuation has a high dependency on laboratory infection markers. Clinical research should focus on safety and predictive values of (new) infection markers to support the decision to stop antibiotic therapy early and prevent possibly unnecessary antibiotic treatment. Objetives The control of tuberculosis (TB) transmission and prevention of outbreaks requires appropriate studies for the contacts. We're going to present an outbreak of tuberculosis in a daycare centre. Methods A case of pulmonary TB were reported in a 3 years old boy from a daycare, admitted with pneumonia without response to conventional antibiotic therapy, tuberculin test (PPD):5 mm, positive quantiferon. Study of family contacts was negative. PO-0254 TUBERCULOSIS OUTBREAK IN A DAYCARE CENTREAfter that pulmonary TB was confirmed in a caregiver from the daycare, she was considered baciliferus and also the index case. Results Contact study was performed in 90 persons exposed. 85%(77/90) contacts from the daycare (67 children under 3 years and 10 adults).15 people had positive tuberculin, 8 contacts from the daycare (7 children and 1 caregiver). 5 patients of the group mentioned before were considered latent tuberculosis infection, receiving secondary chemoprophylaxis and 3 were diagnosed with tuberculosis disease, being treated with satisfactory outcome in all cases.The index case had over a month off work so that children with negative tuberculin was repeated at 5 weeks being negative in all cases. Conclusions TB in children can be confused with other typical lung infections, however, must be ruled out if it has a subacute respiratory symptoms and poor response to conventional treatment. It's really important the rapid detection of contacts incase of adults with TB disease, especially if those work with susceptible people like children. The PPD is still an easy and simple tool for unvaccinated contacts diagnostic.
Introduction Neonatal ICU enters as a fundamental tool to quality care to sick newborns, becoming of paramount importance in reducing neonatal mortality. Knowing the population served allows appropriate care plan and strategize improvements in care for mother and newborn. Objective To identify risk factors related to admissions to Neonatal ICU of the Hospital Teaching Alcides Carneiro-RJ/Brazil Methodology A descriptive, cross-sectional study to Neonatal ICU, January 1 to March 31, 2014 Results In the period 692 children was born in the maternity ward, 78 (11.7%) admitted to the neonatal intensive care unit. The total number of hospitalizations was 83 infants, five external drives. Maternal diagnoses that contributed: infection (70.3%), hypertensive disease (28.4%), infections mandatory prenatal screening (9.45%), gestational diabetes (5.4%), Premature detachment of placenta (2.7%). The caesarean rate was 65%, with the main indications: fetal distress (29.6%), preeclampsia (24%). Regarding gestational age 61.4% were premature, 16.8% of these extremely preterm infants. We observed 50% of newborns with low birth weight, very low birth weight 7.3% and 8.5% extremely low birth weight. The admission diagnoses were: respiratory disorders (68.6%), prematurity (50.6%), infection (21.6%), asphyxia (15.6%), hyperbilirubinemia (7.2%), metabolic disorders (7.2%), congenital infection (6%). Conclusion As the only service of reference for the public health system in our county, received a maternal and child care to higher morbidity. Identify possible causes related to the hospitalisation of newborns, are preventable infections that can be diagnosed and addressed during prenatal causes rethink the health system offered to pregnant women and propose our discussion forums.
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