Presència dels familiars al box de crítics dels serveis d’urgències / Presencia de los familiares en el box de críticos de los servicios de urgencias / Family presence in the resuscitation room of pediatric emergency departments

Fonament. La presència dels familiars és cada cop més habitual als serveis d’urgències pediàtriques (SUP), on participen activament en la presa de decisions, els tractamentsi les cures del pacient.Objectiu. 1) Conèixer la proporció de SUP catalans en quèla presència dels familiars és habitual als boxs de crítics ien quines condicions. 2) Descriure els problemes que se’nderiven.Mètode. Estudi descriptiu multicèntric. Se sol·licita als responsables dels SUP que complimentin una enquesta sobrela presència de familiars als boxs de crítics (protocol, ubicació, acompanyament dels familiars, problemes derivats).Resultats. S’envien divuit enquestes, i s’obtenen setze respostes (taxa de resposta 88,8%) d’hospitals de mitjana(12/16) i alta (4/16) complexitat. Tots els SUP disposen debox de crítics i en 15/16 s’ofereix als familiars ser-hi presents durant l’atenció de l’infant; en un SUP no s’ofereixaquesta opció perquè l’espai és reduït, malgrat que la troben necessària. Dos SUP disposen de protocol. Durantl’atenció al pacient greu, els familiars estan acompanyatsper algun sanitari (11/16), però intermitentment (7/16). Espermeten un o dos familiars, sempre que ho desitgin(13/16) o després de l’estabilització inicial (2/16). Dos responsables manifesten problemes derivats, com el nerviosisme i l’agressivitat familiar.Conclusions. La presència de familiars als boxs de crítics éshabitual als SUP enquestats, sense problemes destacables.No obstant això, s’han detectat alguns aspectes millorables(elaboració de protocols i acompanyament dels familiars). (AU)

Fundamento. La presencia de familiares es cada vez más habitualen los servicios de urgencias pediátricas (SUP), colaborando en latoma de decisiones, tratamientos y cuidados del paciente. Objetivo. 1) Conocer la proporción de SUP catalanes en los que lapresencia de familiares es habitual en el box de críticos y en quécondiciones. 2) Describir problemas derivados.Método. Estudio descriptivo multicéntrico. Se solicita a los responsables de los SUP cumplimentar una encuesta sobre la presenciade familiares en el box de críticos (protocolo, ubicación, acompañamiento de los familiares, problemas derivados).Resultados. Se envían 18 encuestas y se obtienen 16 respuestas(tasa de respuesta (88,8%) de hospitales de mediana (12/16) yalta (4/16) complejidad. Todos los SUP disponen de box de críticos y en 15/16 se ofrece la presencia de familiares durante laatención del paciente crítico, en uno de ellos no está permitida porespacio reducido, pero la consideran necesaria. Dos SUP disponende protocolo. Los familiares están acompañados por algún profesional sanitario (11/16), pero de manera intermitente (7/16). Sepermiten 1 o 2 familiares, siempre que lo deseen (13/16) o después de la estabilización inicial (2/16). Dos responsables notificanproblemas puntuales (nerviosismo y agresividad familiar).Conclusiones. La presencia de familiares en los boxes de críticoses habitual en los SUP participantes, sin problemas destacables.Se han detectado algunos aspectos de mejora (elaboración de protocolos y acompañamiento de los familiares). (AU)

Background. Family presence is common in pediatric emergencydepartments (PED), and relatives actively collaborate in decisionmaking, treatment, and patient care.Objective. 1) To identify the proportion of Catalan PED where family presence is allowed in the resuscitation room and to describethe characteristics of family presence. 2) To describe the problemsthat arise from the presence of family members.Method. A multicenter descriptive study was designed. Chiefphysicians of PED were asked to participate via email in a surveyasking about the PED characteristics and the family presence inthe resuscitation room (protocol, location, relatives’ companion,problems).Results. 18 surveys were sent, obtaining 16 responses (responserate 88.8%) from middle (12/16) and high (4/16) complexity hospitals. All the PED have a resuscitation room, and family presence is offered in 15 of them (in one hospital family presence is notallowed because of limited space). 2 PEDs have a written protocolabout family presence in the resuscitation room. Family membersare accompanied by a healthcare worker (11/16), but not continuously (7/16). One or two relatives are usually allowed to be present in the resuscitation room, for as long as they desire (13/16)or after initial stabilization (2/16). Two chief physicians reportedoccasional problems (family anxiety and aggressivity).Conclusions. Family presence in the resuscitation room is commonin Catalan PED, without significant related problems. However,some aspects should be improved, particularly related to writtenprotocols and accompaniment of family members. (AU)

Impairments of mecA gene detection in bovine Staphylococcus spp.

Staphylococcus aureus antimicrobial resistance, especially to beta-lactams, favors treatment failures and its persistence in herd environment. This work aimed to develop a more specific primer for mecA gene detection based on the comparison of the conserved regions from distinct host origins and also investigated the presence of homologue mecA(LGA251) in bovine strains. A total of 43 Staphylococcus spp. were included in this study, comprising 38 bovine S. aureus, two human and three equine coagulase-negative staphylococci (CNS). Phenotypical methicillin-resistance detection was performed through oxacillin agar-screening and cefoxitin disk-diffusion test. None isolate tested positive for mecA(LGA251) gene. For mecA gene PCR, new primers were designed based on the sequences of human S. aureus (HE681097) and bovine S. sciuri (AY820253) mecA. The new primers based on the S. aureus mecA sequence amplified fragments of human and equine CNS and the ones based on S. sciuri mecA sequence only yielded fragments for S. aureus bovine strains. Multiples alignments of mecA gene sequences from bovine, human and equine revealed punctual but significant differences in bovine strains that can lead to the mecA gene detection impairment. The observed divergences of mecA gene sequences are not a matter of animal or human origin, it is a specificity of bovine samples.

Impairments of mecA gene detection in bovine Staphylococcus spp.

Staphylococcus aureus antimicrobial resistance, especially to beta-lactams, favors treatment failures and its persistence in herd environment. This work aimed to develop a more specific primer for mecA gene detection based on the comparison of the conserved regions from distinct host origins and also investigated the presence of homologue mecA LGA251 in bovine strains. A total of 43 Staphylococcus spp. were included in this study, comprising 38 bovine S. aureus, two human and three equine coagulase-negative staphylococci (CNS). Phenotypical methicillin-resistance detection was performed through oxacillin agar-screening and cefoxitin disk-diffusion test. None isolate tested positive for mecA LGA251 gene. For mecA gene PCR, new primers were designed based on the sequences of human S. aureus (HE681097) and bovine S. sciuri (AY820253) mecA. The new primers based on the S. aureus mecA sequence amplified fragments of human and equine CNS and the ones based on S. sciuri mecA sequence only yielded fragments for S. aureus bovine strains. Multiples alignments of mecA gene sequences from bovine, human and equine revealed punctual but significant differences in bovine strains that can lead to the mecA gene detection impairment. The observed divergences of mecA gene sequences are not a matter of animal or human origin, it is a specificity of bovine samples.