RESUMO
During the outbreak of Ebola virus disease that struck West Africa during 2014-2016, a small handful of expatriate patients were evacuated to specialized high-level containment care units, or biocontainment units, in the United States and Western Europe. Given the lower mortality rate (18% versus 40% for those treated in Africa) among these patients, it is likely that high-level containment care will be used in the future with increasing frequency. It is also likely that children infected with Ebola and other highly hazardous communicable diseases will someday require such care. The National Ebola Training and Education Center convened a pediatric workgroup to consider the unique and problematic issues posed by these potential child patients. We report here the results of those discussions.
Assuntos
Conferências de Consenso como Assunto , Contenção de Riscos Biológicos , Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/terapia , Controle de Infecções/métodos , Pediatria/métodos , África Ocidental , Criança , Europa (Continente) , Humanos , Pais/psicologia , Isolamento de Pacientes/métodos , Estados UnidosRESUMO
Mycobacterium cosmeticum is a rapidly growing mycobacterium that was recently identified. However, its role in human infection has not been well described. We present a case of an extremely premature neonate born with bacteraemia due to M. cosmeticum that resolved without sequelae. The infection likely occurred during a prolonged intrauterine transfusion procedure.
Assuntos
Bacteriemia/microbiologia , Transfusão de Sangue Intrauterina/efeitos adversos , Infecções por Mycobacterium/microbiologia , Mycobacterium , Complicações Infecciosas na Gravidez/microbiologia , Bacteriemia/etiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Infecções por Mycobacterium/transmissão , GravidezRESUMO
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known nosocomial pathogen of neonatal intensive care unit (NICU) patients and can cause both serious infections in preterm neonates and prolonged MRSA outbreaks in NICUs. OBJECTIVES: Our objectives were to determine the prevalence of and identify risk factors for MRSA colonization and infection in the NICU and the impact of an active surveillance program on MRSA in the NICU. METHODS: We collected weekly nasal MRSA surveillance cultures on 2,048 infants admitted to NICU over 3 years. Data on these infants were collected retrospectively. Characteristics of MRSA colonized and infected infants were analyzed and compared. RESULTS: MRSA colonization was detected in 6.74% of infants, and MRSA infection occurred in 22% of those colonized. Using clinical cultures alone, only 41 (27.5%) of 149 MRSA affected infants were identified. The majority (75%) developed MRSA infection within 17 days of colonization. For every 10-day increment in NICU stay, the odds ratio of being infected and colonized with MRSA increased by 1.32 and 1.29, respectively. Colonization was significantly associated with longer NICU stay, low birth weight, low gestational age, and multiple gestation status. CONCLUSION: Colonization is a risk factor for infection with MRSA in NICUs. Clinical cultures underestimate MRSA affected infants in NICUs, whereas active surveillance cultures could detect MRSA affected infants earlier and limit nosocomial spread.