Device-associated infections in a paediatric intensive care unit in Pakistan

Haque, Anwarul; Ahmed, Shakeel; Rafique, Zohra; Abbas, Qalab; Jurair, Humaira

doi:10.1016/j.jhin.2016.10.021

Cited by 13 publications

(10 citation statements)

References 10 publications

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“…Although multi-center studies reporting HAIs in other countries were not published, a single-center study in an ICU reported a high device associated HAI incidence rate of 27.3 per 1000 patient-days in Nepal (68). In Pakistan, a single pediatric ICU study reported a device associated HAI incidence rate of 6.3 per 1000 patient-days (69), whereas in Cambodia, the device associated HAI incidence rate in one pediatric ICU was reported as 4.6 per 1000 patientdays (70).…”

Section: Bacterial Disease Burden In Hospital-acquired Infectionsmentioning

confidence: 99%

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Alvarez-Uria²,

et al. 2020

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SUMMARY Antimicrobial resistance (AMR) is a serious global health threat and is predicted to cause significant health and economic impacts, particularly in low- and middle-income countries (LMICs). AMR surveillance is critical in LMICs due to high burden of bacterial infections; however, conducting AMR surveillance in resource-limited settings is constrained by poorly functioning health systems, scarce financial resources, and lack of skilled personnel. In 2015, the United Nations World Health Assembly endorsed the World Health Organization’s Global Action Plan to tackle AMR; thus, several countries are striving to improve their AMR surveillance capacity, including making significant investments and establishing and expanding surveillance networks. Initial data generated from AMR surveillance networks in LMICs suggest the high prevalence of resistance, but these data exhibit several shortcomings, such as a lack of representativeness, lack of standardized laboratory practices, and underutilization of microbiology services. Despite significant progress, AMR surveillance networks in LMICs face several challenges in expansion and sustainability due to limited financial resources and technical capacity. This review summarizes the existing health infrastructure affecting the establishment of AMR surveillance programs, the burden of bacterial infections demonstrating the need for AMR surveillance, and current progress and challenges in AMR surveillance efforts in eight South and Southeast Asian countries.

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Section: Bacterial Disease Burden In Hospital-acquired Infectionsmentioning

confidence: 99%

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Alvarez-Uria²,

et al. 2020

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“…More male than female children were admitted, which was a similar finding to other studies. [16] There were 34.1% HIV-exposed children, while 12.2% were HIV PCR-positive. We were unable to calculate how many children were denied beds owing to their positive HIV status, as this information was unavailable.…”

Section: Discussionmentioning

confidence: 95%

An audit of primary medical conditions in children admitted to the paediatric intensive care unit of Charlotte Maxeke Johannesburg Academic Hospital

2016

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“…Another important aspect is infection prevention and control (IPC). Though we do have standard practices and protocols for IPC and have shown an associated reduction in NI, ongoing training remains essential [24]. We have developed a one-day IPC workshop to train PICU nurses on standard IPC practices, which will help reduce potentially preventable mortality.…”

Section: Discussionmentioning

confidence: 99%

Potentially Preventable Mortality in the Pediatric Intensive Care Unit: Findings from a Retrospective Mortality Analysis

Abbas

Memon

Laghari

et al. 2020

Cureus

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The goal of this study was to estimate the proportion and causes of potentially preventable mortality among critically ill children admitted to the pediatric intensive care unit (PICU). Methods The medical records of all patients who died in the PICU (age range: one month to 16 years) between January 2014 and December 2015 were evaluated by two independent reviewers to determine whether there had been any delayed recognition of deteriorating conditions, delayed interventions, unintentional/unanticipated harm, medication errors, adverse reactions to transfusions, and hospitalacquired infections that could have resulted in unanticipated death. Preventability was labeled on a 6-point scale. Results During the study period, 92 of 690 patients did not survive [median age: 60 months, interquartile range (IQR): 114]. The median Pediatric Risk of Mortality (PRISM) III score was 17 (IQR: 6). Major diagnostic categories included sepsis (n = 29, 35%), central nervous system diseases (n = 16, 17%), oncological/hematological diseases (n = 6, 6%), cardiac diseases (n = 4, 4%), and miscellaneous conditions. None of the deaths had definitive or strong evidence of preventability. Four (4.3%) patients were in category 4 (i.e., possibly preventable, >50/50 chance), 15 (16.3%) in category 3 (possibly preventable, <50/50 chance), 28 (30.4%) had some evidence of preventability, and 45 (49.0%) were labeled as definitely not preventable. Late identification (diagnostic error) of the worsening condition in four (21.0%) patients, slow intervention in six (31.6.0%), and hospital-acquired infections in 10 (52.6%) were found to be related to potentially preventable mortality. Conclusions Preventable diagnostic errors and nosocomial infections (NIs) are major contributors to preventable mortality. Structured mortality analysis provides actionable information for future preventive strategies. Improvement in care processes, including clinical decision support systems, could help reduce preventable mortality rates.

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Device-associated infections in a paediatric intensive care unit in Pakistan

Cited by 13 publications

References 10 publications

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

An audit of primary medical conditions in children admitted to the paediatric intensive care unit of Charlotte Maxeke Johannesburg Academic Hospital

Potentially Preventable Mortality in the Pediatric Intensive Care Unit: Findings from a Retrospective Mortality Analysis

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