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Actions of the Hospital Infantil de México Federico Gómez in response to the pandemicSince the beginning of 2020, Mexico has been preparing for the COVID-19 pandemic. One of the measures was the restructuring of hospitals. The Hospital Infantil de México Federico Gómez (HIMFG) was designated as a COVID-19 hospital for the pediatric

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BackgroundAn automated hand-hygiene monitoring system (AHHMS) was implemented in October 2019 at the Hospital Infantil de México Federico Gómez (HIMFG), a tertiary pediatric referral hospital, in four of the hospital wards with the highest rates of Healthcare Associated Infections (HAIs). The clinical and economic impact of this system had not yet been assessed prior to this study. This study aimed to evaluate if the AHHMS is a cost-effective alternative in reducing HAIs in the HIMFG.MethodologyA full cost-effectiveness economic assessment was carried out for the hospital. The alternatives assessed were AHHMS implementation vis-a-vis AHHMS non-implementation (historical tendency). The outcomes of interest were infection rate per 1,000 patient-days and cost savings as a result of prevented infections. Infection rate data per 1,000 patient-days (PD) were obtained from the hospital's Department of Epidemiology with respect to the AHHMS. As regards historical tendency, an infection-rate model was designed for the most recent 6-year period. Infection costs were obtained from a review of available literature on the subject, and the cost of the implemented AHHMS was provided by the hospital. The assessment period was 6 months. The incremental cost-effectiveness ratio was estimated. Costs are reported in US Dollars (2021). Univariate sensitivity and threshold analysis for different parameters was conducted.ResultsThe total estimated cost of the AHHMS alternative represented potential savings of $308,927–$546,795 US Dollars compared to non-implementation of the system (US$464,102 v. US$773,029–$1,010,898) for the period. AHHMS effectiveness was reflected in a diminished number of infections, 46–79 (−43.4–56.7%) compared to non-implementation (60 v. 106-139 infections).ConclusionThe AHHMS was found to be a cost-saving alternative for the HIMFG given its cost-effectiveness and lower cost vis-a-vis the alternate option. Accordingly, the recommendation was made of extending its use to other areas in the hospital.

Health personnel (HP) have been universally recognized as especially susceptible to COVID-19. In Mexico, our home country, HP has one of the highest death rates from the disease. From the beginning of the SARS-CoV-2 pandemic, an office for initial attention for HP and a call center were established at a COVID-19 national reference pediatric hospital, aimed at early detection of COVID-19 cases and stopping local transmission. The detection and call center implementation and operation, and tracing methodology are described here. A total of 1,042 HP were evaluated, with 221 positive cases identified (7.7% of all HP currently working and 26% of the HP tested). Community contagion was most prevalent (46%), followed by other HP (27%), household (14%), and hospitalized patients (13%). Clusters and contact network analysis are discussed. This is one of the first reports that address the details of the implementation process of contact tracing in a pediatric hospital from the perspective of a hybrid hospital with COVID-19 and non-COVID-19 areas.

Aims: 1) To assess the safety of intravenous varicella zoster virus hyperimmune globulin G (IV‐VZVIG) in neonates; 2) measure varicella zoster virus‐specific IgG antibody (VZVIG) changes in newborn IV‐VZVIG recipients. Methods: Eighteen neonatal intensive care unit (NICU) neonates with varicella exposure were given 1 ml/kg (43 International Units (IU)/kg) Varitect® IV‐VZVIG. Serum VZVIG titers were assayed in neonatal recipients 0, 1, 7, 14, 21, 28, and 35 d after IV‐VZVIG. Also, serum samples for VZV‐IgM antibody determinations were obtained at 4 wk post‐infusion. Results: No varicella developed in the 18 infants. Infusion of 1 ml/kg (43 IU/kg) IV‐VZVIG was generally safe. The IV‐VZVIG dose resulted in seroconversion of a non‐immune newborn. Five infants had low basal VZVIG titers, and two of them had a 0.6‐log10 increase at 24 h post‐infusion. Neonatal VZVIG titers (mean±SEM in log10) before IV‐VZVIG and after by 1, 7, 14, 21, 28, and 35 d were 2.22±0.15, 2.17±0.17, 2.02±0.12, 0.87±0.2, 1.09±0.19, 2.33±0.07, and 2.16±0.1, respectively. Conclusions: One ml/kg (43 IU/kg) IV‐VZVIG was generally safe. Our neonatal mean VZV‐immune status did not significantly increase after the 1 ml/kg (43 IU/kg) IV‐VZVIG dose, although no varicella developed and it caused a VZV‐specific seroconversion.

Background: On March 11, 2020, the World Health Organization declared the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, and on February 28, Mexico reported its first case. Internationally, cases in newborns are few and the outcomes, in general, are good. There is no certainty of possible vertical transmission, and the presence of the virus in human milk is improbable. The gold standard for diagnosis is the reverse transcription-polymerase chain reaction (RT-PCR) test. We performed a literature review and presented a case of perinatal COVID-19. Clinical case: We describe the case of a full-term male infant with a birth weight of 3450 g and history of rooming-in with another mother-baby pair, both positive for SARS-CoV-2. On the second day of life, the neonate developed pneumonia, with clinical, X-ray and ultrasound diagnostic confirmation. On the third day of life, RT-PCR was positive for SARS-CoV-2; the mother was also positive but remained asymptomatic. The patient required mechanical ventilation and was transferred to a tertiary level neonatal unit on day 5 of life, where congenital heart disease was ruled out. He evolved satisfactorily with a negative RT-PCR test for SARS-CoV-2 on day 8 and was extubated and discharged on day 21 of life. Telephone follow-up was performed without complications. Conclusions: The present case was classified as horizontal transmission with a short incubation period of

BackgroundAt the beginning of the current COVID-19 pandemic, it became critical to isolate all infected patients, regardless of their age. Isolating children has a negative effect on both, them and their parents/caregivers. Nevertheless isolation was mandatory because of the potential risk that visitation might have on COVID-19 dissemination mostly among health personnel.MethodsFrom the starting of the COVID-19 pandemic in our pediatric hospital visits were forbidden. This 2 months period (April–May) was called P1. In June parents were allowed to visit (P2), under a visiting protocol previously published. Hospital workers were monitored for the presence of COVID-19 symptoms and tested for the infection when clinically justified. The positivity proportion and the relative risk (RR) of COVID-19 among the health personnel between periods were calculated. The caregivers were also followed up by phone calls.ResultsSince April 2020 to November 2020, 2,884 health personnel were studied for 234 days, (318,146 workers days). Although the COVID-19/1,000 health personnel days rate decreased from one period to another (1.43 vs 1.23), no statistically significant differences were found. During P1, 16 patients with COVID-19 were treated. During the follow up none of the family members were infected/symptomatic in P1, while in P2, 6/129 (4.65%) were symptomatic or had a positive test. All of them initiated between 2 and 4 days after the patient's admission. As they also had some other infected family members it was not possible to ensure the source of infection. There were no statistically significant differences in the RR of COVID-19 in health personnel, (RR 1, 95% CI 0.69–1.06, p = 0.162).ConclusionsWhen safely implemented, allowing parents/caregivers to spend time with their hospitalized COVID-19 children does not increase the contagion risk for hospital workers or among themselves.