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Falsaperla R, Vitaliti G, Sciacca M, Tardino L, Marino SD, Marino S, Moscheo C, Meli M, Vitaliti MC, Barbagallo M, Di Stefano VA, Saporito MAN, Ruggieri M. Neonatal neurologic emergencies requiring access to paediatric emergency units: a retrospective observational study. Sci Rep 2022; 12:10273. [PMID: 35715441 PMCID: PMC9205415 DOI: 10.1038/s41598-022-13703-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/26/2022] [Indexed: 11/22/2022] Open
Abstract
Herein, authors present a retrospective, multi-center study to determine the number of accesses to Pediatric Emergency Unit (PEU) of patients within 28 days of life, admitted to (1) the Acute and Emergency Pediatric Unit, San Marco University Hospital, Catania, Italy; (2) Garibaldi Hospital for Emergency Care, Catania, Italy; (3) Cannizzaro Hospital for Emergency Care, Catania, Italy. We included neonates admitted for neurologic problems, from January 2015 to December 2020, to the 1—Acute and Emergency Access of the San Marco University Hospital, Catania, Italy [observation center 1 (OC1)]; 2—Garibaldi Hospital for Emergency Care, Catania, Italy (Observation Center 2—OC2); 3—Cannizzaro Hospital for Emergency Care, Catania, Italy (Observation Center 3—OC3). For each patient, we evaluated the severity of urgency, by studying the admission triage-coloured codes, the clinical data at admission and the discharge diagnosis. Neonates who had access to PEU were 812 in the OC1, 3720 in the OC2, and 748 in the OC3 respectively; 69 (8.4%), 138 (3.7%), and 55 (7.4%) was the proportion of neonatal accesses for neurological conditions. We observed that in the study period, the three hospitals had an important decrease of pediatric accesses to their PEU, but the proportion of neonates who had access to the OC1 for neurologic diseases, with respect to the total neonatal accesses, remained stable. We found that the most frequent neurologic disease for which newborns had access to PEU was Cyanosis, (46.1% of all neonatal accesses). Apnea was the second most frequent cause, with a number of 76 accesses (29%). In the literature there are numerous studies on the assessment of diseases that most frequently concern the pediatric patient in an emergency room, but there are very few references on neonatal accesses for urgent neurologic diseases. Therefore, appropriate training is required to avoid unnecessary tests without overlooking potentially serious conditions.
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Affiliation(s)
- Raffaele Falsaperla
- Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy. .,Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy.
| | - Giovanna Vitaliti
- Pediatrics Operative Unit, Department of Medical Sciences, Section of Pediatrics, University of Ferrara, Ferrara, Italy.
| | - Monica Sciacca
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Lucia Tardino
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Simona Domenica Marino
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Silvia Marino
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Carla Moscheo
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Mariaclaudia Meli
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Maria Concetta Vitaliti
- Pediatrics and Pediatric Emergency Operative Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Massimo Barbagallo
- Department of Paediatrics, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione "Garibaldi", Catania, Italy
| | | | - Marco Andrea Nicola Saporito
- Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95124, Catania, Italy
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Li J, Xia S, Liu Y, Zhang S, Jin Z. Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicemia and Associated Factors of ICU Hospitalization Days. Infect Drug Resist 2022; 15:427-438. [PMID: 35177910 PMCID: PMC8846624 DOI: 10.2147/idr.s341536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the microorganisms involved in neonatal septicemia and its antibiotic susceptibility pattern and to further investigate the factors associated with the length of intensive care unit (ICU) stay in neonatal septicemia. Patients and Methods A total of 297 infants with septicemia at neonatal ICU (NICU), Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2020 were enrolled. Identification of bacterial species was done using the standard positive blood culture. Data included demographics, signs at time of septicemia, laboratory values, patient sources, complications, microbiologic characteristics, and the duration of ICU stay. Univariate and multivariate gamma regression analyses were applied to determine the variables associated with ICU stay. Results The result demonstrated that the main causative pathogens of neonatal septicemia in our hospital were Gram-positive bacteria, among which Staphylococcus epidermidis (100 isolates, 47.17%) was the main conditional pathogens; Escherichia coli (27 isolates, 49.09%) was most frequently isolated among Gram-negative pathogens. Gram-positive bacteria had higher susceptibility to vancomycin, tigecycline and linezolid. Escherichia coli was susceptive to piperacillin (27/27, 100.00%), cefotetan (27/27, 100.00%), meropenem and imipenem (27/27, 100.00%). Streptococcus agalactiae (95% CI: 0.140–0.539), for patients who were transferred from other hospital (95% CI: 0.016 to 0.354), septicemia during hospitalization (95% CI: 0.411 to 0.825), the use of antibacterial drug during pregnancy (95% CI: 0.362 to 2.136), feeding intolerance (95% CI: 0.127 to 0.437), bradycardia (95% CI: 0.196 to 0.838), septicemia newborns have complications (95% CI: 0.063 to 0.291), the onset age (95% CI: 0.006 to 0.023), TRIPS score (95% CI: 0.005 to 0.016), and CRP level (95% CI: 0.002 to 0.005) were related to prolonged ICU stay days. Conclusion This study summarized common pathogens and associated drug sensitivity, and factors influencing ICU stay length. Prevention and control policy in the NICU should be strengthened.
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Affiliation(s)
- Jinchun Li
- Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China
| | - Shiwen Xia
- Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China
- Correspondence: Shiwen Xia, Tel +86 027-65395034, Fax +86 027-87163133, Email ;
| | - Yong Liu
- Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China
| | - Shasha Zhang
- Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China
| | - Zhengjiang Jin
- Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China
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