264 Impact Analysis of an Evidence Based Guideline on Urinary Tract Infection (UTI) in Children: Determinants of Implementation

Abstract

Abstracts count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinical indication. EV or HPeV DNA was detected by PCR in plasma and/or CSF. Urine cultures were performed when urine screening was positive. 10 children with urinary tract infection were excluded. Data of the remaining 148 children were analysed. Results EV/HPeV PCR was performed in 122/148 children: 45 (37%) were EV positive and 22 (18%) HPeV positive. The most prominent difference between children with EV and HPeV was age. HPeV was solely diagnosed in children under 126 days of age. Clinical characteristics at presentation did not differ. Children with HPeV had lower leukocyte counts and lower CRP values. No difference in clinical management was found between EV and HPeV positive children. Conclusion Sepsis-like illness due to EV and HPeV infection is common in young children, and appeared in 37% and 18% of cases respectively. HPeV occurs in younger children and causes less elevation of infectious parameters than EV infection. All other clinical characteristics are similar. Clinical management does not differ. Background and Aim To evaluate the association between respiratory tract Ureaplasma urealyticum (Uu) colonization and development of retinopathy of prematurity (ROP) requiring treatment. Methods The infants with birthweight ≤1250 g born in a third level neonatal intensive care unit between March 2009 and May 2010 were prospectively identified. Nasopharyngeal swabs for Uu colonization were taken in postnatal first 3 days. Culture positive patients were reevaluated on the 12 th day by nasopharyngeal swabs for Uu. The primary outcome was to define whether there was an association between respiratory tract Uu colonization and severe ROP requiring treatment. Independent samples t-test or Mann whitney U test was used to compare continuous variables and Chi square test or Fisher's exact test for categorical variables. Multivariate (backward) logistic regression analysis was performed to simultaneously measure the influence of the independent variables with ROP as the dependent variable. Results Twenty-five (12.1%) infants developed severe ROP requiring treatment among 206 infants who underwent ROP screening. Mean birthweight and gestational age of total cohort were 1013±159 g and 27.9±1.6 weeks, respectively. Multivariate analysis demonstrated that birthweight (OR: 0.64 (95% Cl 0.47-0.88); p=0.006), duration of mechanical ventilation (OR: 1.17 (95% Cl 1.06-1.28); p=0.001), premature rupture of membrane >18 h (OR: 3.83 (95% Cl 1.2-12.2); p=0.02) and Uu positivity in both cultures (OR: 5.02 (95% Cl 1.8-13.9); p=0.002) were independent risk factors for the development of severe ROP requiring treatment. Conclusions Respiratory tract colonization with Uu was independently associated with severe ROP requiring treatment. THE ASSOCIATION BETWEEN RESPIRATORY TRACT