To our knowledge, this is the first study to demonstrate a positive correlation between RSV test data and hospitalizations both statewide and for individual regions within Florida. It would be prudent for clinicians to obtain results of local RSV virology data to guide decisions on timing of prophylaxis to prevent RSV hospitalizations.
Objective: To review the literature on respiratory syncytial virus (RSV) as a cause of nosocomial infections (NI) on neonatal intensive care units (NICUs) and pediatric wards, and the effectiveness of various containment strategies.Study Design: We conducted a literature review to define characteristics of RSV NI, and to evaluate the relative effectiveness of various infection containment programs, including the use of palivizumab on the reported incidence of RSV NI on NICUs and pediatric wards.Result: Highly variable rates of RSV NI have not significantly changed since RSV was first identified. The evaluation of the effectiveness of containment strategies has relied on before/after study designs. Focus on rapid patient diagnosis, compliance of acceptable handwashing techniques and cohorting of patients and staff appears to form the backbone of most prevention and containment programs. When these or other measures have failed, the administration of palivizumab has been useful in halting the spread of RSV NI in children.
Local RSV surveillance provides meaningful data to guide decisions on the administration of palivizumab. Reliance on current AAP guidelines for RSV prophylaxis would result in under-protection of at-risk children in all regions within the state of Florida.
Resistance of most clinical pathogens to beta-lactam antimicrobial agents is currently primarily mediated by the microorganisms' ability to product beta-lactamases. There are a variety of beta-lactamases which are primarily differentiated by whether they are plasmid- or chromosome-mediated and by their substrate and inhibition profiles. The most common group of beta-lactamases produced by clinical isolates are the plasmid-mediated TEM enzymes (Richmond-Sykes type III a) which exist in many Enterobacteriaceae, Hemophilus influenzae, and Neisseria species. Development of new beta-lactam antimicrobial agents during the past decades has resulted in a number of drugs with increased, albeit not total, resistance to beta-lactamases. Another approach has been the development of beta-lactamase inhibitors that can be used with a beta-lactam drug to overcome the resistance created by the beta-lactamase.
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