The strategy, based on implementing five specific measures in a unit with a high rate of hospital-related infections, proved effective in reducing their incidence. This reduction could contribute to lowering the use of mechanical ventilation, blood products, and vasoactive drugs.
participating neonatal units within the network. 10 cases from each unit were included. These referred to term or preterm infants who required intravenous antibiotics for suspected or confirmed early onset sepsis with a minimum length of stay of 10 days. The data were analysed using SPSS 17.0. Results 15 units participated. 149 babies were recruited with a mean gestational age of 32+2 weeks. 91.3% of babies received intravenous benzyl penicillin and gentamicin as first line treatment. In 25% of cases there were prescribing issues regarding gentamicin. 20.1% received cefotaxime. 19.5% of babies underwent a lumbar puncture. 17.5% of babies received antifungal agents. In 15.4% of which as treatment. Conclusions The overall outcome was positive with prompt recognition of risk factors and initiation of treatment across all units. This unified policy promotes good quality of care. However, the percentage of prescribing issues regarding gentamicin was worryingly high. Hence, further studies and review of literature are required to evaluate the efficiency of our practice and to establish alternative choice of antibiotics.
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IMPACT OF THE NEW ALGORITHM FOR MANAGEMENT OF NEWBORNS WITH RESPECT TO RISK FOR EARLY-ONSET GBS DISEASEM García Díaz, T González Martínez, V García González, J GonzáLez García, B Fernández Martinez, C Pérez Mendez. Servicio de Pediatria, Hospital de Cabueñes, Gijon, Spain 10. 1136/archdischild-2014-307384.516 Background Guidelines for the prevention of perinatal group B streptococcal (GBS) disease were updated in 2010, including a revised algorithm for management of newborns with respect to risk for early-onset GBS disease (EOD-GBS). Aim To know the impact of this new algorithm on EOD-GBS evaluations, hospital admissions, and detection of EOD-GBS cases in a newborn unit. Methods Retrospective cohort study of infants of GBS-colonised mothers born at ≥36 weeks gestational age in two periods of time: from July to December 2010, and from July to December 2012. The following variables were analysed: gender, gestational age, chorioamnionitis, indication for and prescription of antibiotics to the mother, EOD-GBS evaluations, infant admission and outcome. Continuous data were compared by using t test; discrete data using chi square. Preventable fraction in the exposed (Pf e ) was used to quantify the impact or the new algorithm. Results One hundred and fifty-two neonates were included in 2010 and 130 in 2012. No significant differences between both groups were found regarding gender, gestational age, chorioamnionitis, obstetric care and antibiotic prophylaxis received by mothers. There were no cases of GBS infection in both periods. The new algorithm avoided 88% evaluations in EOD-GBS screening from 2010 to 2012 (Pf e = 0.88, 95% confidence interval [CI]: 0.39-0.96). The number of infants admitted for suspected EOD--GBS was reduced by 48.1% (Pf e : 0.481, 95% CI: -0.648-0.864). Conclusions Implementation of the 2010 algorithm resulted in a decrease of EOD-GBS evaluations and the number of newborn adm...
Objetivo. El objetivo principal es analizar las características clínicas, epidemiológicas y microbiológicas de los pacientes ingresados con gastroenteritis aguda (GEA) en el Complejo Hospitalario Universitario de Albacete. Como objetivo secundario se pretende analizar la prevalencia de población vacunada a partir de la introducción de la vacuna frente a rotavirus a finales de 2006 y si existe algún cambio en el patrón epidemiológico. Diseño. Se estudiaron los pacientes menores de 5 años ingresados en el Complejo Hospitalario Universitario de Albacete entre octubre de 2004 y abril de 2010. Mediciones principales. Se recogieron datos demográficos, epidemiológicos y clínicos en todos los pacientes ingresados por gastroenteritis. Resultados. Los ingresos por GEA suponen un 7,8-15,0% del total de ingresos anuales de niños menores de 5 años. La edad media de los ingresados fue de 14 meses. La etiología fue vírica en el 65% de los casos. Rotavirus es el germen más frecuentemente aislado, predominando los serotipos G9 y G1. Tras la introducción de la vacuna, se registra una disminución del 79% de los ingresos secundarios a rotavirus. Conclusiones. Tendencia decreciente en el número de ingresos por GEA en menores de 5 años, con predominio de la etiología vírica a expensas de la infección por rotavirus. Utilidad del score de gravedad como predictor de etiología. Reducción significativa del número de ingresos secundarios a rotavirus tras la introducción de la vacuna en 2006, siendo imposible determinar con nuestro estudio si la vacunación es el único factor determinante de este fenómeno. Importante porcentaje de pacientes sin diagnóstico microbiológico con las detecciones empleadas de rutina en nuestra área de salud. Palabras Clave. Gastroenteritis, Niño, Infecciones por Rotavirus.
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