Nosocomial infection rates in US children’s hospitals’ neonatal and pediatric intensive care units

Stover, Beth H.; Shulman, Stanford T.; Bratcher, Denise F.; Brady, Michael T.; Levine, Gail; Jarvis, William R.

doi:10.1067/mic.2001.115407

Cited by 181 publications

(116 citation statements)

References 8 publications

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“…[1][2][3][4] Central venous catheter (CVC)-associated BSI rates in PICUs range from 7.7 to 46.9 infections per 1,000 CVC-days. [4][5][6][7][8][9] These rates are comparable to BSI rates found in burn units and neonatal intensive care units. 6 Coagulasenegative staphylococci are the most common pathogens identified among patients with catheter-related BSI (38% of episodes), although gram-negative rods are isolated in 25% of PICU bacteremia cases.…”

supporting

confidence: 57%

Risk Factors for Nosocomial Primary Bloodstream Infection in Pediatric Intensive Care Unit Patients: A 2-Year Prospective Cohort Study

Elward

Fraser

2006

Infect. Control Hosp. Epidemiol.

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supporting

confidence: 57%

Risk Factors for Nosocomial Primary Bloodstream Infection in Pediatric Intensive Care Unit Patients: A 2-Year Prospective Cohort Study

Elward

Fraser

2006

Infect. Control Hosp. Epidemiol.

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“…Por outro lado, pode evitar o uso indiscriminado de tratamento com antibiotiócos e, assim, diminuir o risco de desenvolvimento de patógenos multirresistentes e proporcionar a diminuição dos custos hospitalares. 4,8,11,12 Dessa forma, o objetivo deste estudo foi verificar o valor do leucograma, da PCR, IL-6 e do TNF-α, isoladamente e em conjunto, na detecção da sepse neonatal tardia em diferentes períodos nas primeiras 48 horas da doença.…”

Section: Introductionunclassified

Accuracy of white blood cell count, C-reactive protein, interleukin-6 and tumor necrosis factor alpha for diagnosing late neonatal sepsis

Caldas¹,

Marba²,

Blotta³

et al. 2008

J Pediatr (Rio J)

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ARTIGO ORIGINALAccuracy of white blood cell count, C-reactive protein, interleukin-6 and tumor necrosis factor alpha for diagnosing late neonatal sepsis Acurácia diagnóstica do leucograma, Resultados: Estudaram-se 82 crianças, sendo 42 no grupo SC, 16 no SP e 24 NI. Nos três momentos, as medianas da PCR e da IL-6 mostraram-se significativamente mais elevadas nos grupos SC e SP, e as do TNF-α alteraram-se apenas no grupo SC. Os índices diagnósticos da PCR foram elevados nos três momentos e com acurácia superior a do leucograma e semelhante a da IL-6 e a do TNF-α em suas primeiras medidas. Entre as citocinas, não houve diferença estatística entre elas, nem em relação ao leucograma. A associação dos testes não aumentou a capacidade diagnóstica, exceto na combinação entre leucograma e PCR2 e na dosagem seriada de PCR. Conclusões:A PCR e o leucograma mostram-se úteis no diagnóstico de sepse neonatal tardia e comparáveis à IL-6 e ao TNF-α. A acurácia aumentou com a associação PCR-leucograma e a dosagem seriada da PCR.J Pediatr (Rio J). 2008;84(6):536-542: Recém-nascido, sepse, proteína C-reativa, interleucina-6, fator de necrose tumoral, citocina, mediadores da inflamação. AbstractObjective: To evaluate the diagnostic value for late neonatal sepsis of white blood cell count (WBC) and assays for C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α), in isolation and in conjunction.Methods: This was a diagnostic test validation study. Chemiluminescence was used to assay CRP, IL-6 and TNF-α at the time of clinical suspicion and again after 24 and 48 hours, whereas the WBC was performed only once, at the time of suspicion. Patients were classified into three groups based on clinical progress and culture results: confirmed sepsis (CS), probable sepsis (PS), and not infected (NI). Statistical analysis was performed using the Wilcoxon and chi-square tests and Friedman analysis of variance; cutoffs were defined by plotting receiver operator characteristic curves. Results:The total study sample comprised 82 children, 42 of whom were classed as CS, 16 as PS and 24 as NI. At all three test times, the medians for CRP and IL-6 were significantly more elevated in the CS and PS groups, while the medians for TNF-α were abnormal only in the CS group. The CRP test had elevated indices of diagnostic utility at all three test times, better accuracy than the WBC and similar accuracy to the first IL-6 and TNF-α assays. There was no statistical difference between the cytokines, nor between them and the WBC. Combining tests did not increase diagnostic power, with the exception of the combination of WBC with CRP2 and when the sequential CRP assays were combined. Conclusions:Both CRP and WBC were useful for the diagnosis of late neonatal sepsis and comparable with IL-6 and TNF-α. Accuracy increased when CRP and WBC were combined and when sequential CRP assay results were used.J Pediatr (Rio J). 2008;84(6):536-542: Neonate, sepsis, C-reactive protein, interleukin-6, tumor necrosis factor, cytokine, inflammatory...

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“…Where only an estimated 0.1% of term infants will have an infection in the neonatal period, 20% of VLBW infants will be infected during their hospital stay. 24,34,35 The incidence of sepsis increases with decreasing gestational age. Stratified by weight, 10% of 1000 to 1500 g infants, 35% of <1000 g infants and 50% of <750 g infants will have the diagnosis of sepsis during the neonatal period.…”

Section: Impact Of Gestational Age On Infection: Term Versus Preterm mentioning

confidence: 99%

The changing spectrum of neonatal infectious disease

Plano

2010

J Perinatol

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To understand the changing spectrum of neonatal infectious disease, one must first be familiar with the history, the variety of organisms and the progression of change of neonatal infections over the years. As progressively more immature neonates are surviving, the spectrum of infectious disease has changed in response to current medical practice responsible for this success and to selective pressures on the microorganisms. The surviving very low birth weight infants are at a significant risk for contracting infections from this expanding repertoire of pathogens. Microorganisms once thought seemingly benign and nonpathogenic are now commonly accepted as pathogens and are among the most likely organisms to cause infections in this extremely vulnerable patient population. When considering the possible identity of infecting organisms and attempting to tailor specific therapies to decrease unwanted consequences, one must consider the level of maturity and the age of neonate, as well as the intensity of care necessary for a successful outcome. This brief review focuses primarily on the changing spectrum of bacterial and fungal infections and will not substantially address viral infections.

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Nosocomial infection rates in US children’s hospitals’ neonatal and pediatric intensive care units

Cited by 181 publications

References 8 publications

Risk Factors for Nosocomial Primary Bloodstream Infection in Pediatric Intensive Care Unit Patients: A 2-Year Prospective Cohort Study

Risk Factors for Nosocomial Primary Bloodstream Infection in Pediatric Intensive Care Unit Patients: A 2-Year Prospective Cohort Study

Accuracy of white blood cell count, C-reactive protein, interleukin-6 and tumor necrosis factor alpha for diagnosing late neonatal sepsis

The changing spectrum of neonatal infectious disease

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