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
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.
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.
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